Science.gov

Sample records for administration healthcare integrity

  1. Validity of Eight Integrated Healthcare Delivery Organizations’ Administrative Clinical Data to Capture Breast Cancer Chemotherapy Exposure

    PubMed Central

    Delate, Thomas; Bowles, Erin J. Aiello; Pardee, Roy; Wellman, Robert D.; Habel, Laurel A.; Yood, Marianne Ulcickas; Nekhlyudov, Larissa; Goddard, Katrina A.; Davis, Robert L.; McCarty, Catherine A.; Onitilo, Adedayo A.; Feigelson, Heather Spencer; Freml, Jared; Wagner, Edward

    2012-01-01

    Background Cancer Research Network (CRN) sites use administrative data to populate their Virtual Data Warehouse (VDW). However, information on VDW chemotherapy data validity is limited. The purpose of this study was to assess the validity of VDW chemotherapy data. Methods This was a retrospective, cohort study of women ≥18 years with incident, invasive breast cancer diagnosed between January 1999 and December 2007. Pharmacy and procedure chemotherapy data were extracted from each site’s VDW. Random samples of 50 patients stratified on trastuzumab, anthracyclines, and no chemotherapy exposure were selected from each site for detailed chart abstraction. Weighted sensitivities and specificities of VDW compared to abstracted data were calculated. Cumulative doses calculated from VDW data were compared to doses obtained from the medical chart review. Results The cohort included 13497 patients with 6456 (48%) chart-review eligible. Patients in the sample (N=400) had a mean age of 65 years. Trastuzumab, anthracycline, and other chemotherapy weighted sensitivities were 95%, 97%, and 100%, respectively; specificities were 99%, 99%, and 93%, respectively; positive predictive values were 96%, 99%, and 55%, respectively; and negative predictive values were 99%, 96%, and 100%. Trastuzumab and anthracyclines VDW mean doses were 873 mgs and 386 mgs, respectively, while abstracted mean doses were 1734 mgs and 369 mgs, respectively (R2=0.14, p<0.01 and R2=0.05, p=0.03, respectively). Conclusions Sensitivities and specificities for CRN chemotherapy VDW data were high and dosages were correlated with chart information. Impact The findings support the use of CRN data in evaluating chemotherapy exposures and related outcomes. PMID:22337532

  2. Healthcare succession planning: an integrative review.

    PubMed

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

    2009-12-01

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

  3. Integrating the healthcare supply chain.

    PubMed

    Brennan, C D

    1998-01-01

    Today's integrated delivery systems (IDSs) require efficient supply chain processes to speed products to users at the lowest possible cost. Most excess costs within the supply chain are a result of inefficient and redundant processes involved in the transport and delivery of supplies from suppliers to healthcare providers. By integrating and assuming control of these supply chain processes, improving supply chain management practices, and organizing and implementing a disciplined redesign plan, IDSs can achieve substantial savings and better focus their organizations on their core patient care mission.

  4. Integrating healthcare for older populations.

    PubMed

    Boult, C; Pacala, J T

    1999-01-01

    The complex array of needs posed by older adults has frequently produced fragmentation of care in traditional fee-for-service systems. Integration of care components in newer health systems will maximize patient benefits and organizational efficiency. This article outlines the major issues involved in integration of care for older populations. A health system must integrate its care of older adults in many ways: among providers, both in primary care and specialty services; with community-based sources of care; and across sites of care (clinic, hospital, emergency department, and nursing home). Integrating reimbursement structures for various services will serve to create a client-oriented system, as opposed to a finance-centered system, thereby enhancing coordination of care. The extent to which two experimental comprehensive systems, PACE (Program of All-inclusive Care of the Elderly) and SHMO II (Social Health Maintenance Organization), have achieved clinical and financial integration are discussed in detail. Healthcare organizations are encouraged to create integrated models of care and to study the effects of integration on patient outcomes.

  5. Interprofessional Competencies in Integrative Primary Healthcare

    PubMed Central

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

    2015-01-01

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

  6. Interprofessional Competencies in Integrative Primary Healthcare.

    PubMed

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

    2015-09-01

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

  7. 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.

  8. 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...

  9. 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...

  10. Integrative healthcare: arriving at a working definition.

    PubMed

    Boon, Heather; Verhoef, Marja; O'Hara, Dennis; Findlay, Barb; Majid, Nadine

    2004-01-01

    A variety of integrative healthcare programs and clinics have been initiated both in Canada and the United States. Many different terms (eg, integrative medicine, integrated medicine, multidisciplinary care, integrative health care) are used to describe these initiatives. The diversity of terminology and absence of a shared conceptual framework makes it difficult to assess when integration is actually happening. The objective of this paper was to explore current efforts to conceptualize integrative healthcare and to identify its components. A qualitative content analysis of articles identified in an extensive literature review resulted in the identification of four key components of integrative care: philosophy/values, structure, process and outcomes. These were used to guide the development of a definition of integrative healthcare that should be seen as an "ideal type" or goal toward which practitioners and health systems could strive.

  11. 45 CFR 61.12 - Requesting information from the Healthcare Integrity and Protection Data Bank.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Integrity and Protection Data Bank. 61.12 Section 61.12 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION HEALTHCARE INTEGRITY AND PROTECTION DATA BANK FOR FINAL ADVERSE INFORMATION... Integrity and Protection Data Bank § 61.12 Requesting information from the Healthcare Integrity...

  12. Interprofessional care teams: the role of the healthcare administrator.

    PubMed

    Begun, James W; White, Kenneth R; Mosser, Gordon

    2011-03-01

    As the delivery of healthcare services increasingly emphasizes interprofessional activity, one major occupation, healthcare administration, is conspicuously absent from the discussion. This situation reflects the structure of healthcare delivery organizations as professional bureaucracies, with clinical professionals practicing with relative autonomy and with administrators viewed as quasi- or semi-professionals. Not only is this a missed opportunity for administrators, but it seriously weakens the potential for change and improvement promised by interprofessional practice. In this article, we argue that healthcare administrators are important to the success of interprofessional care because they often are in a strong position to champion and implement the system-wide cultural and structural conditions for successful interprofessional care. We also note that changes are needed in the role expectations and education of healthcare administrators to increase the familiarity and comfort of administrators with clinical care and to help them more effectively influence the organizational conditions for collaborative interprofessional exchange. Changes in the expectations and education of clinical professionals also will help accomplish the goal of greater "complementarity" between administrators and clinical healthcare professionals. Such changes are consistent with larger societal forces that are increasing professionalism among administrators and creating more accountability from both administrators and clinical professionals for the quality, cost, and collaboration of services.

  13. Modeling veterans healthcare administration disclosure processes :

    SciTech Connect

    Beyeler, Walter E; DeMenno, Mercy B.; Finley, Patrick D.

    2013-09-01

    As with other large healthcare organizations, medical adverse events at the Department of Veterans Affairs (VA) facilities can expose patients to unforeseen negative risks. VHA leadership recognizes that properly handled disclosure of adverse events can minimize potential harm to patients and negative consequences for the effective functioning of the organization. The work documented here seeks to help improve the disclosure process by situating it within the broader theoretical framework of issues management, and to identify opportunities for process improvement through modeling disclosure and reactions to disclosure. The computational model will allow a variety of disclosure actions to be tested across a range of incident scenarios. Our conceptual model will be refined in collaboration with domain experts, especially by continuing to draw on insights from VA Study of the Communication of Adverse Large-Scale Events (SCALE) project researchers.

  14. IVR and administrative operations in healthcare and hospitals.

    PubMed

    Mouza, Anna-Maria

    2003-01-01

    IVR (Interactive Voice Response) systems are effectively used in healthcare and hospitals for drug and health library information, prescription refills, history records, medical transcripts, patient information services, automated pre-admissions, patient account records, appointment scheduling and reminder, lab results notification, food services, and many other applications. Among its benefits, IVR relieves administrative staff and physicians of routine customer interactions and helps healthcare organizations increase their efficiency, productivity, and profitability.

  15. 45 CFR 61.14 - Confidentiality of Healthcare Integrity and Protection Data Bank information.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Protection Data Bank information. 61.14 Section 61.14 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION HEALTHCARE INTEGRITY AND PROTECTION DATA BANK FOR FINAL ADVERSE INFORMATION ON... and Protection Data Bank § 61.14 Confidentiality of Healthcare Integrity and Protection Data...

  16. Safety and Traceability in Patient Healthcare through the Integration of RFID Technology for Intravenous Mixtures in the Prescription-Validation-Elaboration-Dispensation-Administration Circuit to Day Hospital Patients

    PubMed Central

    Martínez Pérez, María; Vázquez González, Guillermo; Dafonte, Carlos

    2016-01-01

    This work presents the integration of the RFID technology with the aim of ensuring the traceability of patients and minimization of adverse events during the process of prescription-validation-elaboration-dispensation-administration of medication by means of the implementation of various passive and active WIFI RFID systems in the Pharmacy and Day Hospital services of the Complejo Hospitalario Universitario A Coruña. Obtaining patient traceability and using the patient/drug binomial during this process allows us to minimize the occurrence of adverse events. The key points in this work are the unmistakably unique identification and accurate real time location of the controlled items (patients and medication). RFID technology has proved to be invaluable in assisting with the everyday clinical practice of a hospital, and has been successfully implemented in this environment and others. In services such as the day hospital, the implementation of said technology is further justified by the high costs of the service and the high risk to the patient. PMID:27483269

  17. Safety and Traceability in Patient Healthcare through the Integration of RFID Technology for Intravenous Mixtures in the Prescription-Validation-Elaboration-Dispensation-Administration Circuit to Day Hospital Patients.

    PubMed

    Martínez Pérez, María; Vázquez González, Guillermo; Dafonte, Carlos

    2016-07-28

    This work presents the integration of the RFID technology with the aim of ensuring the traceability of patients and minimization of adverse events during the process of prescription-validation-elaboration-dispensation-administration of medication by means of the implementation of various passive and active WIFI RFID systems in the Pharmacy and Day Hospital services of the Complejo Hospitalario Universitario A Coruña. Obtaining patient traceability and using the patient/drug binomial during this process allows us to minimize the occurrence of adverse events. The key points in this work are the unmistakably unique identification and accurate real time location of the controlled items (patients and medication). RFID technology has proved to be invaluable in assisting with the everyday clinical practice of a hospital, and has been successfully implemented in this environment and others. In services such as the day hospital, the implementation of said technology is further justified by the high costs of the service and the high risk to the patient.

  18. 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'.

  19. Integrating patients’ perspectives into integrated TB/HIV healthcare

    PubMed Central

    Daftary, Amrita; Padayatchi, Nesri

    2013-01-01

    Background Escalating rates of TB/HIV coinfection call for improved coordination of TB and HIV healthcare services in high-burden countries such as South Africa. Patient perspectives, however, are poorly understood in the context of current integration efforts. Method Under a qualitative research framework, we interviewed 40 HIV-positive adult TB patients and 8 key-informant healthcare workers across 3 clinics in KwaZulu-Natal province to explore non-clinical and non-operational aspects of TB/HIV healthcare. Findings Qualitative analysis highlighted critical social and ethical considerations for the concurrent delivery of TB and HIV care. Coinfected patients navigating between TB and HIV programs are exposed to missed opportunities for TB and HIV service integration, fragmented or vertical care for their dual infections, and contrasting experiences within TB and HIV clinics. These intersecting issues appear to affect patients’ health-related decisions, particularly HIV nondisclosure to non-HIV healthcare workers, and their preferences for integrated healthcare. Conclusion Our study highlights the imperative to address service fragmentation, HIV medical confidentiality and provider mistrust within the healthcare system, and the cultural differences associated with TB and HIV disease control. PMID:23407149

  20. 45 CFR 61.12 - Requesting information from the Healthcare Integrity and Protection Data Bank.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 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 INFORMATION ON HEALTH CARE PROVIDERS, SUPPLIERS AND PRACTITIONERS Disclosure of Information by the...

  1. 45 CFR 61.12 - Requesting information from the Healthcare Integrity and Protection Data Bank.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 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 INFORMATION ON HEALTH CARE PROVIDERS, SUPPLIERS AND PRACTITIONERS Disclosure of Information by the...

  2. Fully Integrated Biochip Platforms for Advanced Healthcare

    PubMed Central

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

    2012-01-01

    Recent advances in microelectronics and biosensors are enabling developments of innovative biochips for advanced healthcare by providing fully integrated platforms for continuous monitoring of a large set of human disease biomarkers. Continuous monitoring of several human metabolites can be addressed by using fully integrated and minimally invasive devices located in the sub-cutis, typically in the peritoneal region. This extends the techniques of continuous monitoring of glucose currently being pursued with diabetic patients. However, several issues have to be considered in order to succeed in developing fully integrated and minimally invasive implantable devices. These innovative devices require a high-degree of integration, minimal invasive surgery, long-term biocompatibility, security and privacy in data transmission, high reliability, high reproducibility, high specificity, low detection limit and high sensitivity. Recent advances in the field have already proposed possible solutions for several of these issues. The aim of the present paper is to present a broad spectrum of recent results and to propose future directions of development in order to obtain fully implantable systems for the continuous monitoring of the human metabolism in advanced healthcare applications. PMID:23112644

  3. 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.

  4. Integrated Environment for Ubiquitous Healthcare and Mobile IPv6 Networks

    NASA Astrophysics Data System (ADS)

    Cagalaban, Giovanni; Kim, Seoksoo

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

  5. Successfully integrating information systems into healthcare.

    PubMed

    Wallhouse, R

    1992-01-01

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

  6. Healthcare administration education in the 21st century: the case for entrepreneurship.

    PubMed

    Williams, David R; Duncan, W Jack; Ginter, Peter M

    2005-01-01

    This paper recommends the broadening of the course content in several of the current required courses within the core curriculum of healthcare management education to include entrepreneurship topics and the inclusion of a separate entrepreneurship course. The current state of entrepreneurship within healthcare is described through the discussion of a healthcare entrepreneurship continuum. Because of the evolution of the healthcare industry in the past ten years, healthcare administration programs must also evolve to make our curriculum more relevant and increase student placement options. The current healthcare administration education shortcomings are discussed and recommendations for curriculum change are presented. Finally, a readings and resources list is provided as a basis for further curriculum development.

  7. 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,…

  8. 78 FR 55282 - Federal Housing Administration (FHA) Healthcare Facility Documents: Notice of Information...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-10

    ... URBAN DEVELOPMENT Federal Housing Administration (FHA) Healthcare Facility Documents: Notice of... published in the Federal Register a notice that announced that FHA's healthcare facility documents completed... concluded a 10-month process through which HUD solicited public comment to update 115 healthcare...

  9. 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...

  10. 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...

  11. 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.

  12. Design principles for achieving integrated healthcare information systems.

    PubMed

    Jensen, Tina Blegind

    2013-03-01

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

  13. Conscientious Objection in Healthcare and Moral Integrity.

    PubMed

    Wicclair, Mark

    2017-01-01

    There are several reasons for accommodating health professionals' conscientious objections. However, several authors have argued that among the most important and compelling reasons is to enable health professionals to maintain their moral integrity. Accommodation is said to provide "moral space" in which health professionals can practice without compromising their moral integrity. There are, however, alternative conceptions of moral integrity and corresponding different criteria for moral-integrity-based claims. It is argued that one conception of moral integrity, the identity conception, is sound and suitable in the specific context of responding to health professionals' conscientious objections and their requests for accommodation. According to the identity conception, one maintains one's moral integrity if and only if one's actions are consistent with one's core moral convictions. The identity conception has been subject to a number of criticisms that might call into question its suitability as a standard for determining whether health professionals have genuine moral-integrity-based accommodation claims. The following five objections to the identity conception are critically examined: (1) it does not include a social component, (2) it is a conception of subjective rather than objective integrity, (3) it does not include a reasonableness condition, (4) it does not include any substantive moral constraints, and (5) it does not include any intellectual integrity requirement. In response to these objections, it is argued that none establishes the unsuitability of the identity conception in the specific context of responding to health professionals' conscientious objections and their requests for accommodation.

  14. 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

  15. Integrated Community-Healthcare Diabetes Interventions to Reduce Disparities

    PubMed Central

    Peek, Monica E.; Ferguson, Molly; Bergeron, Nyahne; Maltby, Debra; Chin, Marshall H.

    2014-01-01

    Racial and ethnic minorities suffer disproportionately from diabetes-related morbidity and mortality. With the creation of Accountable Care Organizations (ACOs) under the Affordable Care Act, healthcare organizations may have an increased motivation to implement interventions that collaborate with community resources and organizations. As a result, there will be an increasing need for evidence-based strategies that integrate healthcare and community components to reduce diabetes disparities. This paper summarizes the types of community/health system partnerships that have been implemented over the past several years to improve minority health and reduce disparities among racial/ethnic minorities and describes the components that are most commonly integrated. In addition, we provide our recommendations for creating stronger healthcare and community partnerships through enhanced community support. PMID:24464339

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

    PubMed Central

    Juhnke, Christin; Mühlbacher, Axel C.

    2013-01-01

    Introduction Patient-centred healthcare is becoming a more significant success factor in the design of integrated healthcare systems. The objective of this study is to structure a patient-relevant hierarchy of needs and expectations for the design of organised healthcare delivery systems. Methods A questionnaire with 84 items was conducted with N = 254 healthcare experts and N = 670 patients. Factor analyses were performed using SPSS©18. The number of factors retained was controlled by Kaiser's criterion, validation of screeplots and interpretability of the items. Cronbach's α was used to assess the internal consistency of the subscales. Results Exploratory factor analysis led to 24 factors in the expert sample and 20 in the patient sample. After analysing the screeplots, confirmatory factor analyses were computed for 7-factor solutions accounting for 42.963% of the total variance and Kaiser–Meyer–Olkin of 0.914 for the patients (experts: 38.427%, Kaiser–Meyer–Olkin = 0.797). Cronbach's α ranged between 0.899 and 0.756. Based on the analysis, coordinated care could be differentiated into seven dimensions: access, data and information, service and infrastructure, professional care, interpersonal care, individualised care, continuity and coordination. Conclusion and Discussion The study provides insight into patient and experts expectations towards the organisation of integrated healthcare delivery systems. If providers and payers can take into account patient needs and expectations while implementing innovative healthcare delivery systems, greater acceptance and satisfaction will be achieved. In the best case, this will lead to better adherence resulting in better clinical outcomes. PMID:24363639

  17. Guiding healthcare technology implementation: a new integrated technology implementation model.

    PubMed

    Schoville, Rhonda R; Titler, Marita G

    2015-03-01

    Healthcare technology is used to improve delivery of safe patient care by providing tools for early diagnosis, ongoing monitoring, and treatment of patients. This technology includes bedside physiologic monitors, pulse oximetry devices, electrocardiogram machines, bedside telemetry, infusion pumps, ventilators, and electronic health records. Healthcare costs are a challenge for society, and hospitals are pushed to lower costs by discharging patients sooner. Healthcare technology is being used to facilitate these early discharges. There is little understanding of how healthcare facilities purchase, implement, and adopt technology. There are two areas of theories and models currently used when investigating technology: technology adoption and implementation science. Technology adoption focuses mainly on how the end users adopt technology, whereas implementation science describes methods, interventions, and variables that promote the use of evidence-based practice. These two approaches are not well informed by each other. In addition, amplifying the knowledge gap is the limited conceptualization of healthcare technology implementation frameworks. To bridge this gap, an all-encompassing model is needed. To understand the key technology implementation factors utilized by leading healthcare facilities, the prevailing technology adoption and implementation science theories and models were reviewed. From this review, an integrated technology implementation model will be set forth.

  18. [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.

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

    PubMed Central

    Ross, Christina L.

    2009-01-01

    Today’s medicine is in the midst of an undeniable crisis. Calls to reform healthcare are in the forefront of economic and political discussions worldwide. Economic pressures reduce the amount of time physicians can spend with patients contributing to burnout among medical staff and endangering the patient iatrogenically. Politicians are getting involved as the public is calling for more affordable healthcare. A new paradigm must be embraced in order to address all aspects of this dilemma. It is clear that science and technology have resulted in vastly improved understanding, diagnosis, and treatment of disease, but the emphasis on science and technology to the exclusion of other elements of healing has also served to limit the development of a model that humanizes healthcare. The healing of a patient must include more than the biology and chemistry of their physical body; by necessity, it must include the mental, emotional and spiritual aspects. Because of these challenges, the development of an integral healthcare system that is rooted in appropriate regulation and supported by rigorous scientific evidence is the direction that many models of integrative healthcare are moving towards in the 21st century. PMID:21614160

  20. Integrating Identity Management With Federated Healthcare Data Models

    NASA Astrophysics Data System (ADS)

    Hu, Jun; Peyton, Liam

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

  1. A framework for administrative claim data to explore healthcare coordination and collaboration.

    PubMed

    Uddin, Shahadat; Kelaher, Margaret; Srinivasan, Uma

    2015-11-09

    Previous studies have documented the application of electronic health insurance claim data for health services research purposes. In addition to administrative and billing details of healthcare services, insurance data reveal important information regarding professional interactions and/or links that emerge among healthcare service providers through, for example, informal knowledge sharing. By using details of such professional interactions and social network analysis methods, the aim of the present study was to develop a research framework to explore health care coordination and collaboration. The proposed framework was used to analyse a patient-centric care coordination network and a physician collaboration network. The usefulness of this framework and its applications in exploring collaborative efforts of different healthcare professionals and service providers is discussed.What is known about the topic? Application of methods and measures of social network analytics in exploring different health care collaboration and coordination networks is a comparatively new research direction. It is apparent that no other study in the present healthcare literature proposes a generic framework for examining health care collaboration and coordination using an administrative claim dataset.What does this paper add? Using methods and measures of social network analytics, this paper proposes a generic framework for analysing various health care collaboration and coordination networks extracted from an administrative claim dataset.What are the implications for the practitioners? Healthcare managers or administrators can use the framework proposed in the present study to evaluate organisational functioning in terms of effective collaboration and coordination of care in their respective healthcare organisations.

  2. 45 CFR 61.1 - The Healthcare Integrity and Protection Data Bank.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 45 Public Welfare 1 2011-10-01 2011-10-01 false The Healthcare Integrity and Protection Data Bank... HEALTHCARE INTEGRITY AND PROTECTION DATA BANK FOR FINAL ADVERSE INFORMATION ON HEALTH CARE PROVIDERS, SUPPLIERS AND PRACTITIONERS General Provisions § 61.1 The Healthcare Integrity and Protection Data Bank....

  3. 45 CFR 61.1 - The Healthcare Integrity and Protection Data Bank.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 45 Public Welfare 1 2012-10-01 2012-10-01 false The Healthcare Integrity and Protection Data Bank... HEALTHCARE INTEGRITY AND PROTECTION DATA BANK FOR FINAL ADVERSE INFORMATION ON HEALTH CARE PROVIDERS, SUPPLIERS AND PRACTITIONERS General Provisions § 61.1 The Healthcare Integrity and Protection Data Bank....

  4. 45 CFR 61.1 - The Healthcare Integrity and Protection Data Bank.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 45 Public Welfare 1 2010-10-01 2010-10-01 false The Healthcare Integrity and Protection Data Bank... HEALTHCARE INTEGRITY AND PROTECTION DATA BANK FOR FINAL ADVERSE INFORMATION ON HEALTH CARE PROVIDERS, SUPPLIERS AND PRACTITIONERS General Provisions § 61.1 The Healthcare Integrity and Protection Data Bank....

  5. Rekindling the spark. Five strategies to help healthcare administrators remain motivated when facing change.

    PubMed

    Veninga, R L

    1992-11-01

    Many healthcare administrators find it difficult to stay renewed in their careers as pressure mounts on an already stressful work environment. Five strategies can rekindle the spark that once made a healthcare career so attractive. Sharply focused goals are the infrastructure of a harmonious work environment. When people progress toward achieving goals, dissatisfaction with their work environment decreases. Healthcare administrators must also find solutions to problems that chip away at happiness, such as chronic understaffing or a personality conflict with a colleague. If supervisors develop positive problem-solving attitudes, employees tend to emulate them. Administrators need to personalize their leadership style. If subordinates sense their administrator is involved in their occupational struggles, their loyalty will increase and their stress will decrease. A manager needs to be surrounded by creative, energized people because upbeat people have a way of renewing one's spirits. Meaningful friendships can provide support and a fresh perspective on problems. Finally, healthcare administrators must remain steadfastly hopeful even when budgets cast red ink and the future direction of healthcare is uncharted.

  6. Mentoring junior healthcare administrators: a description of mentoring practices in 127 U.S. hospitals.

    PubMed

    Finley, Frances R; Ivanitskaya, Lana V; Kennedy, Michael H

    2007-01-01

    A survey instrument about mentoring junior healthcare administrators was mailed to 485 senior-level executives-chief executive officers, hospital administrators, and presidents. Completed surveys were returned by 127 senior executives (26 percent response rate). On average, the respondents were 53 years old, had nine years of organizational tenure in their current position, and had 16.5 years of career tenure as a senior healthcare executive. The mean age of when the respondents first had a mentor was 28 years old. The average length of the respondents' relationship with their mentor was 3.56 years. Although healthcare executives believed mentoring benefits the healthcare industry as a whole, they reported that the benefits were even greater for the hospital where mentoring was done. Personal satisfaction was cited as the primary reason for serving as a mentor. In the 127 organizations represented by the respondents, informal mentoring programs were more prevalent than formal mentoring programs. Our findings suggest that healthcare executives in formal mentoring programs may be more likely to support mentoring than individuals who entered informal mentoring relationships. Those who reported being mentors or engaging in mentoring-supportive activities had a longer job tenure and career tenure than did individuals who had not served as mentors. The study suggests that mentoring--in particular, informal mentoring--is a popular activity in U.S. hospitals and is carried out by experienced healthcare executives whose primary motivation is personal satisfaction.

  7. 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.

  8. 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…

  9. Mechanical Model of Traditional Thai Massage for Integrated Healthcare.

    PubMed

    Rattanaphan, Salinee; Srichandr, Panya

    2015-01-01

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

  10. Augmented reality in healthcare education: an integrative review.

    PubMed

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

    2014-01-01

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

  11. Augmented reality in healthcare education: an integrative review

    PubMed Central

    Zhu, Egui; Hadadgar, Arash; Masiello, Italo

    2014-01-01

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

  12. 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.

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

    PubMed

    Wan, Thomas T H; Wang, Bill B L

    2003-05-01

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

  14. Computerization of Mental Health Integration complexity scores at Intermountain Healthcare.

    PubMed

    Oniki, Thomas A; Rodrigues, Drayton; Rahman, Noman; Patur, Saritha; Briot, Pascal; Taylor, David P; Wilcox, Adam B; Reiss-Brennan, Brenda; Cannon, Wayne H

    2014-01-01

    Intermountain Healthcare's Mental Health Integration (MHI) Care Process Model (CPM) contains formal scoring criteria for assessing a patient's mental health complexity as "mild," "medium," or "high" based on patient data. The complexity score attempts to assist Primary Care Physicians in assessing the mental health needs of their patients and what resources will need to be brought to bear. We describe an effort to computerize the scoring. Informatics and MHI personnel collaboratively and iteratively refined the criteria to make them adequately explicit and reflective of MHI objectives. When tested on retrospective data of 540 patients, the clinician agreed with the computer's conclusion in 52.8% of the cases (285/540). We considered the analysis sufficiently successful to begin piloting the computerized score in prospective clinical care. So far in the pilot, clinicians have agreed with the computer in 70.6% of the cases (24/34).

  15. The public/private debate in the funding, administration and delivery of healthcare in Canada.

    PubMed

    Marchildon, Gregory P

    2004-01-01

    To help clarify the confusing debate concerning the public-private divide in Canada and the respective positions of the Romanow and Kirby reports, a new approach is proposed. The funding, administration and delivery of the healthcare "system" is split into distinct analytical categories and then applied to three major coverage groupings: universal public (Canada Health Act) coverage for medically necessary/required services; mixed coverage for drug care, home and long-term care; and private health goods and services. While there were no fundamental differences between Romanow and Kirby concerning the funding of public healthcare in Canada, there were some important differences on issues of administration. In particular, the Romanow report recommended that home mental healthcare services become universally covered under the Canada Health Act as well as fundamental changes to the regulation and administration of prescription drug care. The reports also differed in terms of framing the private delivery question, with the Romanow report questioning whether the evidence justified private-for-profit delivery replacing current private not-for-profit or public arm's length delivery modes.

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

    PubMed Central

    2013-01-01

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

  17. An integrated narrative nursing model: towards a new healthcare paradigm.

    PubMed

    Artioli, Giovanna; Foà, Chiara; Taffurelli, Chiara

    2016-11-22

    In the traditional biomedical model of clinical practice, which assumes a medicine focused on disease, diseases are considered as biological or psycho-physiological universal entities. This explanation, although necessary, is not enough. Several authors have recently become interested in the use of narrative practices in the medical care setting, underlining the increasing importance of "a patient-centered approach", a "relationship -centered care" and "narrative medicine". Even in Nursing, the challenge was to combine two models that seemed incompatible: the Evidence-Based Nursing Model and the Narrative-Based Nursing Model. The first one is based on the disease and is capable of reaching measurable objectives. It is marked by rationality, objectivity, determinism, unilateralism and linearity, and its methods emphasize logic, control, measurement and deduction. The second model is based on a global approach, resulting in a psycho-social perspective which stresses the importance of individuality, interpersonal relationship, and the illness and sickness as significant parts of healthcare. Through a short examination of different narrative models in medicine, we underlined some principles which can be used in nursing practice and we suggested a new healthcare paradigm based on integrated narrative nursing. It represents a groundbreaking new normative approach, deriving from different epistemological (positivist paradigm and interpretive paradigm) and methodological approaches that integrate quantitative data already normally detected on the patient, with subjective information obtained from the person and his family, and by the social impact that the disease causes. The integrated narrative nursing makes use of quantitative (e.g. scales and scientific evidence) and qualitative tools (e.g. narratives, autobiographies, therapeutic emplotment and patient's agenda). This approach, based on holistic comprehension, hermeneutic dialogue and a high degree of narrative skill

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

    PubMed

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

    2015-02-01

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

  19. Investigating enterprise application integration benefits and barriers in healthcare organisations: an exploratory case study.

    PubMed

    Khoumbati, Khalil; Themistocleous, Marinos; Irani, Zahir

    2006-01-01

    Over the years, healthcare organisations have focused on the latest technological innovations to overcome their organisational problems. There was rarely a single approach for implementing Information Systems (IS), as healthcare organisations have developed their applications without a common enterprise architectural planning. Nowadays, dozens, if not hundreds of different types of open and proprietary systems exist in healthcare organisations. This growing complexity of healthcare IS has driven IS managers to seek applicable solutions for integrating their systems. As a result, different integration efforts have continuously been made to overcome integration problems. Recently technological developments have emerged in the area of integration technology such as enterprise application integration (EAI) and web services. This paper seeks to expand the knowledge on EAI, and focuses on understanding the EAI benefits and barriers in healthcare organisations.

  20. CLARA: an integrated clinical research administration system

    PubMed Central

    Bian, Jiang; Xie, Mengjun; Hogan, William; Hutchins, Laura; Topaloglu, Umit; Lane, Cheryl; Holland, Jennifer; Wells, Thomas

    2014-01-01

    Administration of human subject research is complex, involving not only the institutional review board but also many other regulatory and compliance entities within a research enterprise. Its efficiency has a direct and substantial impact on the conduct and management of clinical research. In this paper, we report on the Clinical Research Administration (CLARA) platform developed at the University of Arkansas for Medical Sciences. CLARA is a comprehensive web-based system that can streamline research administrative tasks such as submissions, reviews, and approval processes for both investigators and different review committees on a single integrated platform. CLARA not only helps investigators to meet regulatory requirements but also provides tools for managing other clinical research activities including budgeting, contracting, and participant schedule planning. PMID:24778201

  1. CLARA: an integrated clinical research administration system.

    PubMed

    Bian, Jiang; Xie, Mengjun; Hogan, William; Hutchins, Laura; Topaloglu, Umit; Lane, Cheryl; Holland, Jennifer; Wells, Thomas

    2014-10-01

    Administration of human subject research is complex, involving not only the institutional review board but also many other regulatory and compliance entities within a research enterprise. Its efficiency has a direct and substantial impact on the conduct and management of clinical research. In this paper, we report on the Clinical Research Administration (CLARA) platform developed at the University of Arkansas for Medical Sciences. CLARA is a comprehensive web-based system that can streamline research administrative tasks such as submissions, reviews, and approval processes for both investigators and different review committees on a single integrated platform. CLARA not only helps investigators to meet regulatory requirements but also provides tools for managing other clinical research activities including budgeting, contracting, and participant schedule planning.

  2. [The origins of the basic healthcare system in Brazil: the District System of Sanitation Administration].

    PubMed

    Campos, Carlos Eduardo Aguilera

    2007-01-01

    There exists an interaction between multiple issues involving policy making, the building of knowledge and the implementation of practices in the health sector, which results in the particular way health services are provided in different historical contexts. The emergence and consolidation of sanitation organization was the result of a political process based on an idea of meeting the needs perceived in a given historical context. The historical course taken by the basic healthcare system in Brazil is analyzed from the perspective of its organizational and welfare principles, its expansion in physical terms, and its function within the public health system between 1918 and 1942. The article seeks to describe in detail the antecedents and initiatives taken in the establishment of a district system of sanitation administration, first in Rio de Janeiro and later across Brazil, which was a precursor of the basic healthcare system in Brazil.

  3. Innovations in integrative healthcare education: Integrative Medicine DesignShop and National Education Dialogue.

    PubMed

    Sierpina, Victor; Kreitzer, Mary Jo

    2005-11-01

    Content on integrative healthcare and complementary and alternative medicine (CAM) is now being taught in hundreds of educational programs across the country. Nursing, medical, osteopathic, chiropractic, acupuncture, naturopathic, and other programs are finding creative and innovative ways to include these approaches in new models of education and practice. This column spotlights such innovations in integrative healthcare and CAM education and presents readers with specific educational interventions that they can adapt into new or ongoing educational efforts at their institution or program. We invite readers to submit brief descriptions of efforts in their institutions that reflect the creativity, diversity, and interdisciplinary nature of the field. Please submit to Dr. Sierpina at vssierpi@utmb.edu or Dr. Kreitzer at kreit003@umn.edu. Submissions should be brief, no more than 300 to 400 words. Please include any Web site or other resource that is relevant as well as contact information.

  4. Accuracy of administrative data for surveillance of healthcare-associated infections: a systematic review

    PubMed Central

    van Mourik, Maaike S M; van Duijn, Pleun Joppe; Moons, Karel G M; Bonten, Marc J M; Lee, Grace M

    2015-01-01

    Objective Measuring the incidence of healthcare-associated infections (HAI) is of increasing importance in current healthcare delivery systems. Administrative data algorithms, including (combinations of) diagnosis codes, are commonly used to determine the occurrence of HAI, either to support within-hospital surveillance programmes or as free-standing quality indicators. We conducted a systematic review evaluating the diagnostic accuracy of administrative data for the detection of HAI. Methods Systematic search of Medline, Embase, CINAHL and Cochrane for relevant studies (1995–2013). Methodological quality assessment was performed using QUADAS-2 criteria; diagnostic accuracy estimates were stratified by HAI type and key study characteristics. Results 57 studies were included, the majority aiming to detect surgical site or bloodstream infections. Study designs were very diverse regarding the specification of their administrative data algorithm (code selections, follow-up) and definitions of HAI presence. One-third of studies had important methodological limitations including differential or incomplete HAI ascertainment or lack of blinding of assessors. Observed sensitivity and positive predictive values of administrative data algorithms for HAI detection were very heterogeneous and generally modest at best, both for within-hospital algorithms and for formal quality indicators; accuracy was particularly poor for the identification of device-associated HAI such as central line associated bloodstream infections. The large heterogeneity in study designs across the included studies precluded formal calculation of summary diagnostic accuracy estimates in most instances. Conclusions Administrative data had limited and highly variable accuracy for the detection of HAI, and their judicious use for internal surveillance efforts and external quality assessment is recommended. If hospitals and policymakers choose to rely on administrative data for HAI surveillance, continued

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

    PubMed

    Phillips, Andrew B; Merrill, Jacqueline A

    2015-12-01

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

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

    PubMed

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

    2012-12-01

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

  7. The individual mandate as healthcare regulation: what the Obama Administration should have said in NFIB v. Sebelius.

    PubMed

    Moncrieff, Abigail R

    2013-01-01

    There was an argument that the Obama Administration's lawyers could have made--but didn't--in defending Obamacare's individual mandate against constitutional attack. That argument would have highlighted the role of comprehensive health insurance in steering individuals' healthcare savings and consumption decisions. Because consumer-directed healthcare, which reaches its apex when individuals self-insure, suffers from several known market failures and because comprehensive health insurance policies play an unusually aggressive regulatory role in attempting to correct those failures, the individual mandate could be seen as an attempt to eliminate inefficiencies in the healthcare market that arise from individual decisions to self-insure. This argument would done a better job than the Obama Administration's of aligning the individual mandate with existing Commerce Clause and Necessary and Proper Clause precedent, and it would have done a better job of addressing the conservative Justices' primary concerns with upholding the mandate. This Article lays out this forgone defense of the individual mandate.

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

    PubMed

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

    2016-07-01

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

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

    PubMed

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

    2015-10-01

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

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

    PubMed Central

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

    2015-01-01

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

  11. Integration of healthcare and financial information: Evaluation in a public hospital using a comprehensive approach.

    PubMed

    Escobar-Pérez, Bernabé; Escobar-Rodríguez, Tomás; Bartual-Sopena, Lourdes

    2016-12-01

    Public healthcare organisations are moving towards the use of new technologies to automate and improve their internal processes in order to increase the effectiveness and efficiency of their use of resources. The aim of this research is to tackle the systematic evaluation of an experience of integrating information in a healthcare organisation, paying attention to the implications that this entails. The results show that the integration of the information in the hospital results in higher levels of quality. This study contributes a vision of interrelated work, in which tasks are shared and aims are jointly established.

  12. Executive competencies in healthcare administration: preceptors of the Army-Baylor University Graduate Program.

    PubMed

    Finstuen, Kenn; Mangelsdorff, A David

    2006-01-01

    The purpose of this research was to identify the mentoring and executive competencies required among preceptors of the Army-Baylor University Graduate Program in Health and Business Administration, and to specify the requisite skills, knowledge, and abilities (SKAs) needed to achieve those competencies. In the first wave of inquiry, a list of 123 competencies and associated SKAs was elicited from a network of 80 current and past preceptor executives employing a Delphi methodology using e-mail. An expert panel, which consisted of seven past program directors, examined and sorted the list into four preceptor content domains, viz., Health Systems Management (HS Management), Leadership, Residency Administration, and Community Involvement. Frequency analyses showed that the HS Management domain constituted over half of the competencies, with particular emphasis on strategic thinking, planning, billing, finance, manpower, and contracting. In the second wave, the preceptor Delphi network reviewed the expertpanel list and made 7-pointSKA importance ratings on an 80-item structured questionnaire representative of the four domains. Findings indicated thataverage SKA ratings were reliable and agreed upon to a high degree among preceptors. Results, rank ordered by SKA item means within preceptor content domains and overall, suggested that the most important rated items centered on teamwork, negotiation, interpersonal skills, communication, leadership vision, and customer and healthcare business operations. Outcomes from the competency list are expected to be useful for preceptor mentoring, self-assessment, and for professional development. Additionally, specific SKAs can provide a means for developing job requirements and career performance criteria at a behavioral task level, and can contribute information for identifying continuing education and conference topical needs.

  13. Curating and Integrating Data from Multiple Sources to Support Healthcare Analytics.

    PubMed

    Ng, Kenney; Kakkanatt, Chris; Benigno, Michael; Thompson, Clay; Jackson, Margaret; Cahan, Amos; Zhu, Xinxin; Zhang, Ping; Huang, Paul

    2015-01-01

    As the volume and variety of healthcare related data continues to grow, the analysis and use of this data will increasingly depend on the ability to appropriately collect, curate and integrate disparate data from many different sources. We describe our approach to and highlight our experiences with the development of a robust data collection, curation and integration infrastructure that supports healthcare analytics. This system has been successfully applied to the processing of a variety of data types including clinical data from electronic health records and observational studies, genomic data, microbiomic data, self-reported data from surveys and self-tracked data from wearable devices from over 600 subjects. The curated data is currently being used to support healthcare analytic applications such as data visualization, patient stratification and predictive modeling.

  14. [China is poised to build a better healthcare delivery system using the integrative health paradigm].

    PubMed

    Hui, Ka Kit; Zhang, Wei-jun

    2011-01-01

    China and the United States share similar goals regarding their health care reform: expanding coverage, bending the curve of healthcare expenditure, and ensuring quality improvement and effectiveness of healthcare. Though many differences in the two health care systems exist, there are still many innovative strategies both countries can learn from each other. This paper first discusses two major problems in the America's health care system: an increasing aging population coupled with ineffective chronic disease management; and a failing primary care system. Next it discusses the role of integrative medicine in the United States health care reform. We also review some key strategies in China's health care reform, which we believe if these policies are implemented fully and effectively, China is poised to build a better healthcare delivery system using the integrative health paradigm.

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

    PubMed

    Yang, Xuebing; Miao, Yuan

    2011-06-01

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

  16. Primary Care Providers' Perceptions of and Experiences with an Integrated Healthcare Model

    ERIC Educational Resources Information Center

    Westheimer, Joshua M.; Steinley-Bumgarner, Michelle; Brownson, Chris

    2008-01-01

    Objective and Participants: The authors examined the experiences of primary care providers participating in an integrated healthcare service between mental health and primary care in a university health center. In this program, behavioral health providers work collaboratively with primary care providers in the treatment of students. Participants…

  17. 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

  18. Integrating precision cancer medicine into healthcare-policy, practice, and research challenges.

    PubMed

    Bertier, Gabrielle; Carrot-Zhang, Jian; Ragoussis, Vassilis; Joly, Yann

    2016-10-24

    Precision medicine (PM) can be defined as a predictive, preventive, personalized, and participatory healthcare service delivery model. Recent developments in molecular biology and information technology make PM a reality today through the use of massive amounts of genetic, 'omics', clinical, environmental, and lifestyle data. With cancer being one of the most prominent public health threats in developed countries, both the research community and governments have been investing significant time, money, and efforts in precision cancer medicine (PCM). Although PCM research is extremely promising, a number of hurdles still remain on the road to an optimal integration of standardized and evidence-based use of PCM in healthcare systems. Indeed, PCM raises a number of technical, organizational, ethical, legal, social, and economic challenges that have to be taken into account in the development of an appropriate health policy framework. Here, we highlight some of the more salient issues regarding the standards needed for integration of PCM into healthcare systems, and we identify fields where more research is needed before policy can be implemented. Key challenges include, but are not limited to, the creation of new standards for the collection, analysis, and sharing of samples and data from cancer patients, and the creation of new clinical trial designs with renewed endpoints. We believe that these issues need to be addressed as a matter of priority by public health policymakers in the coming years for a better integration of PCM into healthcare.

  19. Large scale healthcare data integration and analysis using the semantic web.

    PubMed

    Timm, John; Renly, Sondra; Farkash, Ariel

    2011-01-01

    Healthcare data interoperability can only be achieved when the semantics of the content is well defined and consistently implemented across heterogeneous data sources. Achieving these objectives of interoperability requires the collaboration of experts from several domains. This paper describes tooling that integrates Semantic Web technologies with common tools to facilitate cross-domain collaborative development for the purposes of data interoperability. Our approach is divided into stages of data harmonization and representation, model transformation, and instance generation. We applied our approach on Hypergenes, an EU funded project, where we use our method to the Essential Hypertension disease model using a CDA template. Our domain expert partners include clinical providers, clinical domain researchers, healthcare information technology experts, and a variety of clinical data consumers. We show that bringing Semantic Web technologies into the healthcare interoperability toolkit increases opportunities for beneficial collaboration thus improving patient care and clinical research outcomes.

  20. Integration of healthcare information: from enterprise PACS to patient centered multimedia health record.

    PubMed

    Soriano, Enrique; Plazzotta, Fernando; Campos, Fernando; Kaminker, Diego; Cancio, Alfredo; Aguilera Díaz, Jerónimo; Luna, Daniel; Seehaus, Alberto; Carcía Mónaco, Ricardo; de Quirós, Fernán González Bernaldo

    2010-01-01

    Every single piece of healthcare information should be fully integrated and transparent within the electronic health record. The Italian Hospital of Buenos Aires initiated the project Multimedia Health Record with the goal to achieve this integration while maintaining a holistic view of current structure of the systems of the Hospital, where the axis remains are the patient and longitudinal history, commencing with section Computed Tomography. Was implemented DICOM standard for communication and image storage and bought a PACS. It was necessary adapt our generic reporting system for live up to the commercial RIS. The Computerized Tomography (CT) Scanners of our hospital were easily integrated into the DICOM network and all the CT Scans generated by our radiology service were stored in the PACS, reported using the Structured Reporting System (we installed diagnostic terminals equipped with 3 monitors) and displayed in the EHR at any point of HIBA's healthcare network.

  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.

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

    PubMed

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

    2015-02-01

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

  3. Reclaiming Scientific Integrity in the Next Administration

    NASA Astrophysics Data System (ADS)

    Grifo, F.; Donaghy, T.; Halpern, M.; McCarthy, M.

    2008-12-01

    Political interference in science has penetrated deeply into the culture and practices of federal agencies. These systemic problems cannot be resolved quickly or simply. Leadership and an unwavering commitment to scientific integrity from our next president, continued oversight from the legislative branch, and the persistent and energetic engagement of many different stakeholders are critical. The United States government must adhere to high standards of scientific integrity in forming and implementing its policies. To meet its obligation to serve the public interest, the government must have reliable scientific work and advice at its disposal. This requires the government to provide the resources needed to carry out its scientific missions, and to create an environment that respects the scientific method. To that end, scientists should have the freedoms and protections they need to fulfill their public responsibilities. Depoliticizing federal government science requires a five-pronged approach: protecting government scientists, making government more transparent, reforming the regulatory process, ensuring robust scientific input to federal decision-making, and depoliticizing monitoring and enforcement of existing regulations, and statutes.

  4. Success factors for strategic change initiatives: a qualitative study of healthcare administrators' perspectives.

    PubMed

    Kash, Bita Arbab; Spaulding, Aaron; Johnson, Christopher E; Gamm, Larry

    2014-01-01

    Success factors related to the implementation of change initiatives are well documented and discussed in the management literature, but they are seldom studied in healthcare organizations engaged in multiple strategic change initiatives. The purpose of this study was to identify key success factors related to implementation of change initiatives based on rich qualitative data gathered from health leader interviews at two large health systems implementing multiple change initiatives. In-depth personal interviews with 61 healthcare leaders in the two large systems were conducted and inductive qualitative analysis was employed to identify success factors associated with 13 change initiatives. Results from this analysis were compared to success factors identified in the literature, and generalizations were drawn that add significantly to the management literature, especially to that in the healthcare sector. Ten specific success factors were identified for the implementation of change initiatives. The top three success factors were (1) culture and values, (2) business processes, and (3) people and engagement. Two of the identified success factors are unique to the healthcare sector and not found in the literature on change models: service quality and client satisfaction (ranked fourth of 10) and access to information (ranked ninth). Results demonstrate the importance of human resource functions, alignment of culture and values with change, and business processes that facilitate effective communication and access to information to achieve many change initiatives. The responses also suggest opportunities for leaders of healthcare organizations to more formally recognize the degree to which various change initiatives are dependent on one another.

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

    PubMed Central

    Juhnke, Christin; Bethge, Susanne

    2016-01-01

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

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

    PubMed

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

    2016-02-01

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

  7. Comparing Approaches to Integrating Refugee and Asylum-Seeking Healthcare Professionals in Canada and the UK

    PubMed Central

    Leblanc, Yvonne; Bourgeault,, Ivy L.; Neiterman,, Elena

    2013-01-01

    In this paper, we examine barriers to the integration of refugee doctors and nurses in Canada and the United Kingdom. Key obstacles impeding the integration of internationally trained health professionals are well documented, but less attention has been paid to the integration of refugee health professionals, particularly in Canada. Based on documentary analysis and semi-structured interviews with 46 Canadian and 34 UK stakeholders, our research shows that there are no simple solutions to mitigating the core obstacles that prohibit the professional integration of refugee doctors and nurses into host countries. The targeted approach adopted in parts of the UK does provide some promising practices for Canada, which has yet to develop policies and initiatives specific to health professional refugees. This study is intended to contribute to our understanding of how immigration and health human resources policies have shaped the economic integration of refugee healthcare professionals in the UK and Canada in distinct ways. PMID:24289945

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

    PubMed

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

    2017-03-10

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

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

    PubMed

    Strudwick, Gillian

    2015-05-01

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

  10. A low-power RFID integrated circuits for intelligent healthcare systems.

    PubMed

    Lee, Shuenn-Yuh; Wang, Liang-Hung; Fang, Qiang

    2010-11-01

    This paper presents low-power radio-frequency identification (RFID) technology for intelligent healthcare systems. With attention to power-efficient communication in the body sensor network, RF power transfer was estimated and the required low-power ICs, which are important in the development of a healthcare system with miniaturization and system integration, are discussed based on the RFID platform. To analyze the power transformation, this paper adopts a 915-MHz industrial, scientific, and medical RF with a radiation power of 70 mW to estimate the power loss under the 1-m communication distance between an RFID reader (bioinformation node) and a transponder (biosignal acquisition nodes). The low-power ICs of the transponder will be implemented in the TSMC 0.18-μm CMOS process. The simulation result reveals that the transponder's IC can fit in with the link budget of the UHF RFID system.

  11. Integrating criminal justice, community healthcare, and support services for adults with severe mental disorders.

    PubMed

    Weisman, R L; Lamberti, J S; Price, N

    2004-01-01

    Persons with severe mental disorders are overrepresented in our nation's jails and prisons. Factors including cooccurring substance use disorders, homelessness, and lack of access to community services have contributed to this problem, as have gaps between criminal justice, healthcare, and community support systems. In order to address these issues, Project Link was developed by the University of Rochester Department of Psychiatry in collaboration with five local community agencies. Project Link is designed to prevent involvement of individuals with severe mental illness from entering the criminal justice system. While many models of diversion programs exist, they are all dependent on access to appropriate community-based services. This paper will describe the steps that Project Link has taken towards integrating criminal justice, healthcare, and community support services for individuals with severe mental disorders involved in the criminal justice system.

  12. Development of a wearable system integrated with novel biomedical sensors for ubiquitous healthcare.

    PubMed

    Hung, Kevin; Lee, C C; Chan, W M; Choy, Sheung-On; Kwok, Paul

    2012-01-01

    The world's ageing population has led to an urgent need for long-term and patient-centered healthcare solutions. Hence, there is a growing need for wearable systems for physiologic monitoring. While various biosignals are monitored with traditional approaches, it is worthwhile to investigate alternative sensing techniques in order to improve accessibility and understanding of patients' conditions. This paper presents our laboratory's development of such a wearable system, which makes use of unconventional techniques for physiologic monitoring. With its integrated textile electrocardiogram (ECG) electrodes, intelligent finger-ring photoplethysmogram (PPG) sensor, miniaturized optical fiber-based temperature sensor, eye dynamics monitor, global positioning system (GPS) module, and wireless capability, it demonstrates a feasible solution for ubiquitous healthcare.

  13. Flexible and Stretchable Physical Sensor Integrated Platforms for Wearable Human-Activity Monitoringand Personal Healthcare.

    PubMed

    Trung, Tran Quang; Lee, Nae-Eung

    2016-06-01

    Flexible and stretchable physical sensors that can measure and quantify electrical signals generated by human activities are attracting a great deal of attention as they have unique characteristics, such as ultrathinness, low modulus, light weight, high flexibility, and stretchability. These flexible and stretchable physical sensors conformally attached on the surface of organs or skin can provide a new opportunity for human-activity monitoring and personal healthcare. Consequently, in recent years there has been considerable research effort devoted to the development of flexible and stretchable physical sensors to fulfill the requirements of future technology, and much progress has been achieved. Here, the most recent developments of flexible and stretchable physical sensors are described, including temperature, pressure, and strain sensors, and flexible and stretchable sensor-integrated platforms. The latest successful examples of flexible and stretchable physical sensors for the detection of temperature, pressure, and strain, as well as their novel structures, technological innovations, and challenges, are reviewed first. In the next section, recent progress regarding sensor-integrated wearable platforms is overviewed in detail. Some of the latest achievements regarding self-powered sensor-integrated wearable platform technologies are also reviewed. Further research direction and challenges are also proposed to develop a fully sensor-integrated wearable platform for monitoring human activity and personal healthcare in the near future.

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

    PubMed Central

    2012-01-01

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

  15. Supporting Public Administration with an Integrated BPR Environment

    NASA Astrophysics Data System (ADS)

    Ciaghi, Aaron; Villafiorita, Adolfo; Weldemariam, Komminist; Mattioli, Andrea; Phan, Quoc-Sang

    The definition or redesign of Public Administration (PA) procedures is particularly challenging. This is, for example, due to the requirement of cooperation of different organizational units and actors, different laws and procedures for the production of several artifacts, and maintaining traceability while integrating processes with new laws.

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

    NASA Astrophysics Data System (ADS)

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

    2012-04-01

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

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

    PubMed

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

    2015-12-01

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

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

    NASA Astrophysics Data System (ADS)

    Azmi, Noraini; Kamarudin, Latifah Munirah

    2017-03-01

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

  19. The integration of primary care and behavioral healthcare in northern California Kaiser-Permanente.

    PubMed

    Dea, R A

    2000-01-01

    Integration of behavioral healthcare and primary care has a number of presumed benefits, including better communication between providers and systems, leading to improved patient care. There are studies showing medical cost offsets, although they tend to be in circumscribed research settings. Northern California Kaiser-Permanente has designed a new primary care system providing mental health clinicians on a primary care team. Those clinicians evaluate patients, create treatment plans, provide brief interventions, coordinate care with specialty behavioral healthcare, and consult with primary care physicians. Those physicians also have an increased role in the detection and treatment of behavioral health problems via guidelines developed with behavioral health. Structural changes within the overall system, including regional call centers and computerized clinical information systems, support the integration. Quality programs also support the ongoing improvement of the integration process. There are investment expenses in this type of re-design, but also expected cost savings. An infrastructure is now in place to measure both clinical outcomes, and cost effects of the new model.

  20. Classification and retrieval of medical images in an integrated healthcare environment.

    PubMed

    José, Alexandre Bellezi; dos Reis, Maria do Carmo; Camapum, Juliana F; Carvalho, Hervaldo S; Vasconcelos, Daniel F; da Rocha, Adson F; de A Barbosa, Talles M G

    2006-01-01

    This work presents a new approach for classification and retrieval of echocardiographic images from textual information of the anatomical structures and diagnosis features. These textual attributes will be acquired from the electronic medical report generated in an integrated healthcare environment. The medical report is provided by a specialist in the area during the analysis of the medical image stored in a PACS environment. Such innovation guarantees a more accurate classifier and a better optimization of the medical work, since the medical report and the attributes for the medical image classifier will be created at the same time. The system is being developed in the University Hospital of the University of Brasilia.

  1. Protocol for validating cardiovascular and cerebrovascular ICD-9-CM codes in healthcare administrative databases: the Umbria Data Value Project

    PubMed Central

    Cozzolino, Francesco; Orso, Massimiliano; Mengoni, Anna; Cerasa, Maria Francesca; Eusebi, Paolo; Ambrosio, Giuseppe; Montedori, Alessandro

    2017-01-01

    Introduction Administrative healthcare databases can provide a comprehensive assessment of the burden of diseases in terms of major outcomes, such as mortality, hospital readmissions and use of healthcare resources, thus providing answers to a wide spectrum of research questions. However, a crucial issue is the reliability of information gathered. Aim of this protocol is to validate International Classification of Diseases, 9th Revision—Clinical Modification (ICD-9-CM) codes for major cardiovascular diseases, including acute myocardial infarction (AMI), heart failure (HF), atrial fibrillation (AF) and stroke. Methods and analysis Data from the centralised administrative database of the entire Umbria Region (910 000 residents, located in Central Italy) will be considered. Patients with a first hospital discharge for AMI, HF, AF or stroke, between 2012 and 2014, will be identified in the administrative database using the following groups of ICD-9-CM codes located in primary position: (1) 410.x for AMI; (2) 427.31 for AF; (3) 428 for HF; (4) 433.x1, 434 (excluding 434.x0), 436 for ischaemic stroke, 430 and 431 for haemorrhagic stroke (subarachnoid haemorrhage and intracerebral haemorrhage). A random sample of cases, and of non-cases, will be selected, and the corresponding medical charts retrieved and reviewed for validation by pairs of trained, independent reviewers. For each condition considered, case adjudication of disease will be based on symptoms, laboratory and diagnostic tests, as available in medical charts. Divergences will be resolved by consensus. Sensitivity and specificity with 95% CIs will be calculated. Ethics and dissemination Research protocol has been granted approval by the Regional Ethics Committee. Study results will be disseminated widely through peer-reviewed publications and presentations at national and international conferences. PMID:28360241

  2. 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

  3. 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.

  4. Research priorities for administrative challenges of integrated networks of care.

    PubMed

    Pilgrim, Randy; Hilton, Joshua A; Carrier, Emily; Pines, Jesse M; Hufstetler, Greg; Thorby, Suzette; Milling, T J; Cesta, Beth; Hsia, Renee Y

    2010-12-01

    In 2006, the Institute of Medicine (IOM) advanced the concept of "coordinated, regionalized, and accountable emergency care systems" to address significant problems with the delivery of emergency medical care in the United States. Achieving this vision requires the thoughtful implementation of well-aligned, system-level structures and processes that enhance access to emergency care and improve patient outcomes at a sustainable cost. Currently, the delivery of emergency medical care is supported by numerous administrative systems, including economic; reimbursement; legal and regulatory structures; licensure, credentialing, and accreditation processes; medicolegal systems; and quality reporting mechanisms. In addition, many regionalized systems may not optimize patient outcomes because of current administrative barriers that make it difficult for providers to deliver the best care. However, certain administrative barriers may also threaten the sustainability of integration efforts or prevent them altogether. This article identifies significant administrative challenges to integrating networks of emergency care in four specific areas: reimbursement, medical-legal, quality reporting mechanisms, and regulatory aspects. The authors propose a research agenda for indentifying optimal approaches that support consistent access to quality emergency care with improved outcomes for patients, at a sustainable cost. Researching administrative challenges will involve careful examination of the numerous natural experiments in the recent past and will be crucial to understand the impact as we embark on a new era of health reform.

  5. Integrative Literature Review: A Review of Literature Related to Geographical Information Systems, Healthcare Access, and Health Outcomes

    PubMed Central

    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

  6. Dual embedded agency: physicians implement integrative medicine in health-care organizations.

    PubMed

    Keshet, Yael

    2013-11-01

    The paradox of embedded agency addresses the question of how embedded agents are able to conceive of new ideas and practices and then implement them in institutionalized organizations if social structures exert so powerful an influence on behavior, and agents operate within a framework of institutional constraints. This article proposes that dual embedded agency may provide an explanation of the paradox. The article draws from an ethnographic study that examined the ways in which dual-trained physicians, namely medical doctors trained also in some modality of complementary and alternative medicine, integrate complementary and alternative medicine into the biomedical fortress of mainstream health-care organizations. Participant observations were conducted during the years 2006-2011. The observed physicians were found to be embedded in two diverse medical cultures and to have a hybrid professional identity that comprised two sets of health-care values. Seeking to introduce new ideas and practices associated with complementary and alternative medicine to medical institutions, they maneuvered among the constraints of institutional structures while using these very structures, in an isomorphic mode of action, as a platform for launching complementary and alternative medicine practices and values. They drew on the complementary and alternative medicine philosophical principle of interconnectedness and interdependency of seemingly polar opposites or contrary forces and acted to achieve change by means of nonadversarial strategies. By addressing the structure-agency dichotomy, this study contributes to the literature on change in institutionalized health-care organizations. It likewise contributes both theoretically and empirically to the study of integrative medicine and to the further development of this relatively new area of inquiry within the sociology of medicine.

  7. Qualitative and quantitative evaluation of a pilot integrative coping and resiliency program for healthcare professionals.

    PubMed

    Tarantino, Bonnie; Earley, Michael; Audia, Donna; D'Adamo, Christopher; Berman, Brian

    2013-01-01

    Stress, fatigue, and burnout are common maladies among healthcare employees. To address this problem, a holistic integrative self-care program for healthcare practitioners was designed, implemented, and evaluated. A total of 84 participants, recruited via presentations, flyers, and word of mouth, completed the 8-week program. The experiential course, entitled Healing Pathways, combined training in Reiki, guided imagery, yoga, toning, meditation, intuitive scanning, creative expression, and mentorship to foster more empowered and resilient individuals. We measured the effectiveness of the program via mixed methods consisting of qualitative interviews providing in-depth feedback and quantitative analysis demonstrating statistically significant benefit. Participants reported significantly lower levels of stress and significantly increased confidence in their ability to cope at treatment conclusion (8 weeks) and long-term follow-up (12 months). These findings suggest that an integrative wellness and resiliency program, coupled with individual mentorship, may improve coping, decrease stress, and improve functioning and well-being for nurses and other health care providers.

  8. Integrative Health Coaching and Motivational interviewing: Synergistic Approaches to Behavior Change in Healthcare.

    PubMed

    Simmons, Leigh Ann; Wolever, Ruth Q

    2013-07-01

    As rates of preventable chronic diseases and associated costs continue to rise, there has been increasing focus on strategies to support behavior change in healthcare. Health coaching and motivational interviewing are synergistic but distinct approaches that can be effectively employed to achieve this end. However, there is some confusion in the literature about the relationship between these two approaches. The purpose of this review is to describe a specific style of health coaching-integrative health coaching-and motivational interviewing, including their origins, the processes and strategies employed, and the ways in which they are similar and different. We also provide a case example of how integrative health coaching and motivational interviewing might be employed to demonstrate how these approaches are synergistic but distinct from each other in practice. This information may be useful for both researchers and clinicians interested in investigating or using behavior change interventions to improve health and cost outcomes in chronic disease.

  9. Integrative Health Coaching and Motivational interviewing: Synergistic Approaches to Behavior Change in Healthcare

    PubMed Central

    Wolever, Ruth Q.

    2013-01-01

    As rates of preventable chronic diseases and associated costs continue to rise, there has been increasing focus on strategies to support behavior change in healthcare. Health coaching and motivational interviewing are synergistic but distinct approaches that can be effectively employed to achieve this end. However, there is some confusion in the literature about the relationship between these two approaches. The purpose of this review is to describe a specific style of health coaching—integrative health coaching—and motivational interviewing, including their origins, the processes and strategies employed, and the ways in which they are similar and different. We also provide a case example of how integrative health coaching and motivational interviewing might be employed to demonstrate how these approaches are synergistic but distinct from each other in practice. This information may be useful for both researchers and clinicians interested in investigating or using behavior change interventions to improve health and cost outcomes in chronic disease. PMID:24416683

  10. Development of the Veterans Healthcare Administration (VHA) Ophthalmic Surgical Outcome Database (OSOD) project and the role of ophthalmic nurse reviewers.

    PubMed

    Lara-Smalling, Agueda; Cakiner-Egilmez, Tulay; Miller, Dawn; Redshirt, Ella; Williams, Dale

    2011-01-01

    Currently, ophthalmic surgical cases are not included in the Veterans Administration Surgical Quality Improvement Project data collection. Furthermore, there is no comprehensive protocol in the health system for prospectively measuring outcomes for eye surgery in terms of safety and quality. There are 400,000 operative cases in the system per year. Of those, 48,000 (12%) are ophthalmic surgical cases, with 85% (41,000) of those being cataract cases. The Ophthalmic Surgical Outcome Database Pilot Project was developed to incorporate ophthalmology into VASQIP, thus evaluating risk factors and improving cataract surgical outcomes. Nurse reviewers facilitate the monitoring and measuring of these outcomes. Since its inception in 1778, the Veterans Administration (VA) Health System has provided comprehensive healthcare to millions of deserving veterans throughout the U.S. and its territories. Historically, the quality of healthcare provided by the VA has been the main focus of discussion because it did not meet a standard of care comparable to that of the private sector. Information regarding quality of healthcare services and outcomes data had been unavailable until 1986, when Congress mandated the VA to compare its surgical outcomes to those of the private sector (PL-99-166). 1 Risk adjustment of VA surgical outcomes began in 1987 with the Continuous Improvement in Cardiac Surgery Program (CICSP) in which cardiac surgical outcomes were reported and evaluated. 2 Between 1991 and 1993, the National VA Surgical Risk Study (NVASRS) initiated a validated risk-adjustment model for predicting surgical outcomes and comparative assessment of the quality of surgical care in 44 VA medical centers. 3 The success of NVASRS encouraged the VA to establish an ongoing program for monitoring and improving the quality of surgical care, thus developing the National Surgical Quality Improvement Program (NSQIP) in 1994. 4 According to a prospective study conducted between 1991-1997 in 123

  11. Administrative measures for preventing Mycobacterium tuberculosis infection among healthcare workers in a teaching hospital in Rio de Janeiro, Brazil

    PubMed Central

    da Costa, P. Albuquerque; Trajman, A.; de Queiroz Mello, F. Carvalho; Goudinho, S.; Silva, M.A. Monteiro Vieira; Garret, D.; Ruffino-Netto, A.; Kritski, A. Lineu

    2009-01-01

    Summary Tuberculosis (TB) is an occupational disease of healthcare workers (HCWs). Administrative and engineering interventions simultaneously implemented in hospitals of developed countries have reduced the risk of nosocomial transmission of M. tuberculosis. We have studied the impact of administrative infection control measures on the risk for latent TB infection (LTBI) among HCWs in a resource-limited, high-burden country. An intervention study was undertaken in a university-affiliated, inner-city hospital in Rio de Janeiro, where routine serial tuberculin skin test (TST) is offered to all HCWs. From October 1998 to February 2001, the following administrative infection control measures were progressively implemented: isolation of TB suspects and confirmed TB inpatients, quick turnaround for acid-fast bacilli sputum tests and HCW education in use of protective respirators. Among 1336 initially tested HCWs, 599 were retested. The number of TST conversions per 1000 person-months during and after the implementation of these measures was reduced from 5.8/1000 to 3.7/1000 person-months (P = 0.006). The most significant reductions were observed in the intensive care unit (from 20.2 to 4.5, P < 0.001) and clinical wards (from 10.3 to 6.0, P < 0.001). Physicians and nurses had the highest reductions (from 7.6 to 0, P < 0.001; from 9.9 to 5.8, P = 0.001, respectively). We conclude that isolated administrative measures for infection control can significantly reduce LTBI among HCWs in high-burden countries and should be implemented even when resources are not available for engineering infection control measures. PMID:19278753

  12. AGU President's Message: Obama Administration's Commitment to Scientific Integrity

    NASA Astrophysics Data System (ADS)

    McPhaden, Michael J.

    2011-01-01

    In March 2009, President Barack Obama issued a memorandum on the subject of scientific integrity in which he stated emphatically, 'Science and the scientific process must inform and guide decisions of my Administration on a wide range of issues, including improvement of public health, protection of the environment, increased efficiency in the use of energy and other resources, mitigation of the threat of climate change, and protection of national security.” The president charged John Holdren, director of the Office of Science and Technology Policy (OSTP), with developing specific recommendations “for ensuring the highest level of integrity in all aspects of the executive branch's involvement with scientific and technological processes.” On Friday, 17 December, OSTP released federal department and agency guidelines for implementing the administration’s policies on scientific integrity.

  13. A case for integrating the Patient and Family Centered Care Methodology and Practice in Lean healthcare organizations.

    PubMed

    DiGioia, Anthony M; Greenhouse, Pamela K; Chermak, Tanya; Hayden, Margaret A

    2015-12-01

    Many healthcare organizations using Lean are becoming interested in the Patient and Family Centered Care Methodology and Practice (PFCC M/P). We suggest that integrating the two approaches can accelerate the pace of improvement and provide a powerful mechanism to keep the patient and family as the primary focus of improvement activities. We describe the two approaches and note the ways in which they are complementary. We then discuss the ways in which integrating the PFCC M/P adds value to patients, families, providers, and organizations and accelerates transformation. Finally, we suggest ways to implement PFCC M/P within Lean healthcare organizations.

  14. 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.

  15. The role of research in integrated healthcare systems: the HMO Research Network.

    PubMed

    Vogt, Thomas M; Elston-Lafata, Jennifer; Tolsma, Dennis; Greene, Sarah M

    2004-09-01

    Science is the basis of medicine. Good science leads to better decisions and more effective systems to support those decisions. Most individuals associate science primarily with academic institutions. However, top-quality research relevant to managing the health of populations and the care of specific clinical conditions is increasingly being carried out by investigators working in integrated healthcare systems. This introduction outlines the activities of the HMO Research Network, whose researchers have made and continue to make important contributions to the field of health research. Its objective is to inform readers of the activities and value of systems-based health research. We describe the importance and extent of the research conducted by HMO Research Network members, as well as the advantages of conducting research in such settings.

  16. Administrative measures for preventing Mycobacterium tuberculosis infection among healthcare workers in a teaching hospital in Rio de Janeiro, Brazil.

    PubMed

    da Costa, P Albuquerque; Trajman, A; Mello, F Carvalho de Queiroz; Goudinho, S; Silva, M A Monteiro Vieira; Garret, D; Ruffino-Netto, A; Kritski, A Lineu

    2009-05-01

    Tuberculosis (TB) is an occupational disease of healthcare workers (HCWs). Administrative and engineering interventions simultaneously implemented in hospitals of developed countries have reduced the risk of nosocomial transmission of M. tuberculosis. We studied the impact of administrative infection control measures on the risk for latent TB infection (LTBI) among HCWs in a resource-limited, high-burden country. An intervention study was undertaken in a university-affiliated, inner-city hospital in Rio de Janeiro, where routine serial tuberculin skin testing (TST) is offered to all HCWs. From October 1998 to February 2001, the following infection control measures were progressively implemented: isolation of TB suspects and confirmed TB inpatients, quick turnaround for acid-fast bacilli sputum tests and HCW education in use of protective respirators. Among 1336 initially tested HCWs, 599 were retested. The number of TST conversions per 1000 person-months during and after the implementation of these measures was reduced from 5.8/1000 to 3.7/1000 person-months (P=0.006). The most significant reductions were observed in the intensive care unit (from 20.2 to 4.5, P<0.001) and clinical wards (from 10.3 to 6.0, P<0.001). Physicians and nurses had the highest reductions (from 7.6 to 0, P<0.001; from 9.9 to 5.8, P=0.001, respectively). We conclude that administrative measures for infection control can significantly reduce LTBI among HCWs in high-burden countries and should be implemented even when resources are not available for engineering infection control measures.

  17. Faculty and Administrator Knowledge of the Family Educational Rights and Privacy Act at Select U.S. Complimentary and Alternative Healthcare Educational Institutions

    ERIC Educational Resources Information Center

    Werosh, Keith R.

    2013-01-01

    The purpose of this study was to determine what relationship exists between knowledge of the Family Educational Rights and Privacy Act (FERPA) to organizational position and training among faculty and administrators employed within complementary and alternative healthcare educational institutions. Within these knowledge levels, this study…

  18. A wireless sensor network compatible wearable u-healthcare monitoring system using integrated ECG, accelerometer and SpO2.

    PubMed

    Chung, Wan-Young; Lee, Young-Dong; Jung, Sang-Joong

    2008-01-01

    This paper presents the design and development of a wearable ubiquitous healthcare monitoring system using integrated electrocardiogram (ECG), accelerometer and oxygen saturation (SpO(2)) sensors. In this design, non-intrusive healthcare system was designed based on wireless sensor network (WSN) for wide area coverage with minimum battery power to support RF transmission. We have developed various devices such as wearable ubiquitous sensor network (USN) node, wearable chest sensor belt and wrist pulse oximeter for this system. Low power ECG, accelerometer and SpO(2) sensors board was integrated to the wearable USN node for user's health monitoring. The wearable ubiquitous healthcare monitoring system allows physiological data to be transmitted in wireless sensor network using IEEE 802.15.4 from on-body wearable sensor devices to a base-station which is connected to a server PC. Physiological data can be displayed and stored in the server PC continuously.

  19. Transforming trauma healthcare delivery in rural areas by use of an integrated call center

    PubMed Central

    Agrawal, Deepak

    2012-01-01

    Introduction: There is poor penetration of trauma healthcare delivery in rural areas. On the other hand, mobile penetration in India is now averaging 80% with most families having access to mobile phone. Aims and Objectives: The aim of this study was to assess the implementation and socioeconomic impact of a call center in providing healthcare delivery for patients with head and spinal injuries. Materials and Methods: This was a prospective observational study carried out over a 6-month period at a level I trauma Center in New Delhi, India. A nine-seater call center was outsourced to a private company and the hospital's electronic medical records were integrated with the call-center operations. The call center was given responsibility of maintaining appointments and scheduling clinics for the whole hospital as well as ensuring follow-up visits. Trained call-center staff handled simple patient queries and referred the rest via email to concerned doctors. A telephonic survey was done prior to the start of call-center operations and after 3 months to assess for user satisfaction. Results: The initial cost of outsourcing the call center was Rs 1.6 lakhs (US$ 4000), with a recurring cost of Rs 80,000 (US$ 2000) per month. A total of 484 patients were admitted in the department of Neurosurgery during the study period. Of these, 63% (n=305) were from rural areas. Patients’ overall experience for clinic visits improved markedly following implementation of call center. Patient satisfaction for follow-up visits increased from a mean of 32-96%. Ninety-five percent patients reported a significant decrease in waiting time in clinics 80.4% reporting improved doctor-patient interaction. A total of 52 visits could be postponed/cancelled for patients living in far flung areas resulting in major socioeconomic benefits to these families. Conclusions: As shown by our case study, call centers have the potential to revolutionize delivery of trauma healthcare to rural areas in an

  20. Integrating mental health into chronic care in South Africa: the development of a district mental healthcare plan

    PubMed Central

    Petersen, Inge; Fairall, Lara; Bhana, Arvin; Kathree, Tasneem; Selohilwe, One; Brooke-Sumner, Carrie; Faris, Gill; Breuer, Erica; Sibanyoni, Nomvula; Lund, Crick; Patel, Vikram

    2016-01-01

    Background In South Africa, the escalating prevalence of chronic illness and its high comorbidity with mental disorders bring to the fore the need for integrating mental health into chronic care at district level. Aims To develop a district mental healthcare plan (MHCP) in South Africa that integrates mental healthcare for depression, alcohol use disorders and schizophrenia into chronic care. Method Mixed methods using a situation analysis, qualitative key informant interviews, theory of change workshops and piloting of the plan in one health facility informed the development of the MHCP. Results Collaborative care packages for the three conditions were developed to enable integration at the organisational, facility and community levels, supported by a human resource mix and implementation tools. Potential barriers to the feasibility of implementation at scale were identified. Conclusions The plan leverages resources and systems availed by the emerging chronic care service delivery platform for the integration of mental health. This strengthens the potential for future scale up. PMID:26447176

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

    PubMed

    Faruque, Fazlay S; Li, Hui; Williams, Worth B; Waller, Lance A; Brackin, Bruce T; Zhang, Lei; Grimes, Kim A; Finley, Richard W

    2014-12-01

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

  2. An integrated decision making approach for assessing healthcare waste treatment technologies from a multiple stakeholder.

    PubMed

    Shi, Hua; Liu, Hu-Chen; Li, Ping; Xu, Xue-Guo

    2017-01-01

    With increased worldwide awareness of environmental issues, healthcare waste (HCW) management has received much attention from both researchers and practitioners over the past decade. The task of selecting the optimum treatment technology for HCWs is a challenging decision making problem involving conflicting evaluation criteria and multiple stakeholders. In this paper, we develop an integrated decision making framework based on cloud model and MABAC method for evaluating and selecting the best HCW treatment technology from a multiple stakeholder perspective. The introduced framework deals with uncertain linguistic assessments of alternatives by using interval 2-tuple linguistic variables, determines decision makers' relative weights based on the uncertainty and divergence degrees of every decision maker, and obtains the ranking of all HCW disposal alternatives with the aid of an extended MABAC method. Finally, an empirical example from Shanghai, China, is provided to illustrate the feasibility and effectiveness of the proposed approach. Results indicate that the methodology being proposed is more suitable and effective to handle the HCW treatment technology selection problem under vague and uncertain information environment.

  3. Integrating the 3Ds--social determinants, health disparities, and health-care workforce diversity.

    PubMed

    LaVeist, Thomas A; Pierre, Geraldine

    2014-01-01

    The established relationships among social determinants of health (SDH), health disparities, and race/ethnicity highlight the need for health-care professionals to adequately address SDH in their encounters with patients. The ethnic demographic transition slated to occur during the next several decades in the United States will have numerous effects on the health-care sector, particularly as it pertains to the need for a more diverse and culturally aware workforce. In recent years, a substantial body of literature has developed, exploring the extent to which diversity in the health-care workforce may be used as a tool to eliminate racial/ethnic disparities in health and health care in the U.S. We explore existing literature on this topic, propose a conceptual framework, and identify next steps in health-care policy for reducing and eliminating health disparities by addressing SDH and diversification of the health-care workforce.

  4. Semantic Bim and GIS Modelling for Energy-Efficient Buildings Integrated in a Healthcare District

    NASA Astrophysics Data System (ADS)

    Sebastian, R.; Böhms, H. M.; Bonsma, P.; van den Helm, P. W.

    2013-09-01

    The subject of energy-efficient buildings (EeB) is among the most urgent research priorities in the European Union (EU). In order to achieve the broadest impact, innovative approaches to EeB need to resolve challenges at the neighbourhood level, instead of only focusing on improvements of individual buildings. For this purpose, the design phase of new building projects as well as building retrofitting projects is the crucial moment for integrating multi-scale EeB solutions. In EeB design process, clients, architects, technical designers, contractors, and end-users altogether need new methods and tools for designing energy-efficiency buildings integrated in their neighbourhoods. Since the scope of designing covers multiple dimensions, the new design methodology relies on the inter-operability between Building Information Modelling (BIM) and Geospatial Information Systems (GIS). Design for EeB optimisation needs to put attention on the inter-connections between the architectural systems and the MEP/HVAC systems, as well as on the relation of Product Lifecycle Modelling (PLM), Building Management Systems (BMS), BIM and GIS. This paper is descriptive and it presents an actual EU FP7 large-scale collaborative research project titled STREAMER. The research on the inter-operability between BIM and GIS for holistic design of energy-efficient buildings in neighbourhood scale is supported by real case studies of mixed-use healthcare districts. The new design methodology encompasses all scales and all lifecycle phases of the built environment, as well as the whole lifecycle of the information models that comprises: Building Information Model (BIM), Building Assembly Model (BAM), Building Energy Model (BEM), and Building Operation Optimisation Model (BOOM).

  5. Elements of a violence prevention program for healthcare workers. U.S. Department of Labor, Occupational Safety and Health Administration.

    PubMed

    1997-01-01

    For many years, healthcare and social service workers have faced a significant risk of work-related violence. In this article, OSHA's new violence prevention guidelines are presented, providing the agency's recommendations for reducing workplace violence. Through these guidelines, OSHA assists healthcare and social service employers and providers in preventing such violence and in providing a safe and healthful workplace through effective violence prevention programs. By adopting these practical measures, OSHA states, the serious threat to worker safety can be significantly reduced.

  6. Satisfaction with web-based training in an integrated healthcare delivery network: do age, education, computer skills and attitudes matter?

    PubMed Central

    Atreja, Ashish; Mehta, Neil B; Jain, Anil K; Harris, CM; Ishwaran, Hemant; Avital, Michel; Fishleder, Andrew J

    2008-01-01

    Background Healthcare institutions spend enormous time and effort to train their workforce. Web-based training can potentially streamline this process. However the deployment of web-based training in a large-scale setting with a diverse healthcare workforce has not been evaluated. The aim of this study was to evaluate the satisfaction of healthcare professionals with web-based training and to determine the predictors of such satisfaction including age, education status and computer proficiency. Methods Observational, cross-sectional survey of healthcare professionals from six hospital systems in an integrated delivery network. We measured overall satisfaction to web-based training and response to survey items measuring Website Usability, Course Usefulness, Instructional Design Effectiveness, Computer Proficiency and Self-learning Attitude. Results A total of 17,891 healthcare professionals completed the web-based training on HIPAA Privacy Rule; and of these, 13,537 completed the survey (response rate 75.6%). Overall course satisfaction was good (median, 4; scale, 1 to 5) with more than 75% of the respondents satisfied with the training (rating 4 or 5) and 65% preferring web-based training over traditional instructor-led training (rating 4 or 5). Multivariable ordinal regression revealed 3 key predictors of satisfaction with web-based training: Instructional Design Effectiveness, Website Usability and Course Usefulness. Demographic predictors such as gender, age and education did not have an effect on satisfaction. Conclusion The study shows that web-based training when tailored to learners' background, is perceived as a satisfactory mode of learning by an interdisciplinary group of healthcare professionals, irrespective of age, education level or prior computer experience. Future studies should aim to measure the long-term outcomes of web-based training. PMID:18922178

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

    PubMed

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

    2014-01-01

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

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

    PubMed Central

    Zary, Nabil; Kononowicz, Andrzej A.

    2014-01-01

    Background. Massive Open Online Courses (MOOCs) are an emerging trend in online learning. However, their technology is not yet completely adjusted to the needs of healthcare education. Integration of Virtual Patients within MOOCs to increase interactivity and foster clinical reasoning skills training, has been discussed in the past, but not verified by a practical implementation. Objective. To investigate the technical feasibility of integrating MOOCs with Virtual Patients for the purpose of enabling further research into the potential pedagogical benefits of this approach. Methods. We selected OpenEdx and Open Labyrinth as representative constituents of a MOOC platform and Virtual Patient system integration. Based upon our prior experience we selected the most fundamental technical requirement to address. Grounded in the available literature we identified an e-learning standard to guide the integration. We attempted to demonstrate the feasibility of the integration by designing a “proof-of-concept” prototype. The resulting pilot implementation was subject of verification by two test cases. Results. A Single Sign-On mechanism connecting Open Labyrinth with OpenEdx and based on the IMS LTI standard was successfully implemented and verified. Conclusion. We investigated the technical perspective of integrating Virtual Patients with MOOCs. By addressing this crucial technical requirement we set a base for future research on the educational benefits of using virtual patients in MOOCs. This provides new opportunities for integrating specialized software in healthcare education at massive scale. PMID:25405078

  9. Integrating Low-Cost Rapid Usability Testing into Agile System Development of Healthcare IT: A Methodological Perspective.

    PubMed

    Kushniruk, Andre W; Borycki, Elizabeth M

    2015-01-01

    The development of more usable and effective healthcare information systems has become a critical issue. In the software industry methodologies such as agile and iterative development processes have emerged to lead to more effective and usable systems. These approaches highlight focusing on user needs and promoting iterative and flexible development practices. Evaluation and testing of iterative agile development cycles is considered an important part of the agile methodology and iterative processes for system design and re-design. However, the issue of how to effectively integrate usability testing methods into rapid and flexible agile design cycles has remained to be fully explored. In this paper we describe our application of an approach known as low-cost rapid usability testing as it has been applied within agile system development in healthcare. The advantages of the integrative approach are described, along with current methodological considerations.

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

    PubMed

    Akiyama, M

    2001-01-01

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

  11. A CORBA-based integration of distributed electronic healthcare records using the synapses approach.

    PubMed

    Grimson, J; Grimson, W; Berry, D; Stephens, G; Felton, E; Kalra, D; Toussaint, P; Weier, O W

    1998-09-01

    The ability to exchange in a meaningful, secure, and simple fashion relevant healthcare data about patients is seen as vital in the context of efficient and cost-effective shared or team-based care. The electronic healthcare record (EHCR) lies at the heart of this information exchange, and it follows that there is an urgent need to address the ability to share EHCR's or parts of records between carers and across distributed health information systems. This paper presents the Synapses approach to sharing based on a standardized shared record, the Federated Healthcare Record, which is implemented in an open and flexible manner using the Common Object Request Broker Architecture (CORBA). The architecture of the Federated Healthcare Record is based on the architecture proposed by the Technical Committee 251 of the European Committee for Standardization.

  12. 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.

  13. Complementary and Integrative Healthcare in a Long-term Care Facility: A Pilot Project

    PubMed Central

    Vihstadt, Corrie; Westrom, Kristine; Baldwin, Lori

    2015-01-01

    Introduction: The world's population is aging quickly, leading to increased challenges of how to care for individuals who can no longer independently care for themselves. With global social and economic pressures leading to declines in family support, increased reliance is being placed on community- and government-based facilities to provide long-term care (LTC) for many of society's older citizens. Complementary and integrative healthcare (CIH) is commonly used by older adults and may offer an opportunity to enhance LTC residents' wellbeing. Little work has been done, however, rigorously examining the safety and effectiveness of CIH for LTC residents. Objective: The goal of this work is to describe a pilot project to develop and evaluate one model of CIH in an LTC facility in the Midwestern United States. Methods: A prospective, mixed-methods pilot project was conducted in two main phases: (1) preparation and (2) implementation and evaluation. The preparation phase entailed assessment, CIH model design and development, and training. A CIH model including acupuncture, chiropractic, and massage therapy, guided by principles of collaborative integration, evidence informed practice, and sustainability, was applied in the implementation and evaluation phase. CIH services were provided for 16 months in the LTC facility. Quantitative data collection included pain, quality of life, and adverse events. Qualitative interviews of LTC residents, their family members, and LTC staff members queried perceptions of CIH services. Results: A total of 46 LTC residents received CIH care, most commonly for musculoskeletal pain (61%). Participants were predominantly female (85%) and over the age of 80 years (67%). The median number of CIH treatments was 13, with a range of 1 to 92. Residents who were able to provide self-report data demonstrated, on average, a 15% decline in pain and a 4% improvement in quality of life. No serious adverse events related to treatment were documented

  14. Testing a model of facilitated reflection on network feedback: a mixed method study on integration of rural mental healthcare services for older people

    PubMed Central

    Fuller, Jeffrey; Oster, Candice; Muir Cochrane, Eimear; Dawson, Suzanne; Lawn, Sharon; Henderson, Julie; O'Kane, Deb; Gerace, Adam; McPhail, Ruth; Sparkes, Deb; Fuller, Michelle; Reed, Richard L

    2015-01-01

    Objective To test a management model of facilitated reflection on network feedback as a means to engage services in problem solving the delivery of integrated primary mental healthcare to older people. Design Participatory mixed methods case study evaluating the impact of a network management model using organisational network feedback (through social network analysis, key informant interviews and policy review). Intervention A model of facilitated network reflection using network theory and methods. Setting A rural community in South Australia. Participants 32 staff from 24 services and 12 senior service managers from mental health, primary care and social care services. Results Health and social care organisations identified that they operated in clustered self-managed networks within sectors, with no overarching purposive older people's mental healthcare network. The model of facilitated reflection revealed service goal and role conflicts. These discussions helped local services to identify as a network, and begin the problem-solving communication and referral links. A Governance Group assisted this process. Barriers to integrated servicing through a network included service funding tied to performance of direct care tasks and the lack of a clear lead network administration organisation. Conclusions A model of facilitated reflection helped organisations to identify as a network, but revealed sensitivity about organisational roles and goals, which demonstrated that conflict should be expected. Networked servicing needed a neutral network administration organisation with cross-sectoral credibility, a mandate and the resources to monitor the network, to deal with conflict, negotiate commitment among the service managers, and provide opportunities for different sectors to meet and problem solve. This requires consistency and sustained intersectoral policies that include strategies and funding to facilitate and maintain health and social care networks in rural

  15. Optimization of health-care organization and perceived improvement of patient comfort by switching from intra-venous BU four-times-daily infusions to a once-daily administration scheme in adult hematopoietic stem cell recipients.

    PubMed

    Xhaard, A; Rzepecki, P; Valcarcel, D; Santarone, S; Fürst, S; Serrano, D; De Angelis, G; Krüger, W; Scheid, C

    2014-04-01

    Previous studies have shown an equivalent pharmacokinetic profile between four-times-daily (4QD) and once-daily (QD) administration of intra-venous (IV) BU, without increased toxicity. We assess the impact of a switch in IV BU from a 4QD to a QD schedule, in terms of health-care organization, staff working conditions, quality of care dispensed and perceived patient comfort. Clinicians, nurses and pharmacists from nine allogeneic transplantation units in five European countries were interviewed face to face. Overall perception of QD versus 4QD BU was very positive. Both administration schemes were evaluated to be equally efficaciousZ. QD BU was perceived to be safer and more convenient. Clinicians and nurses perceived that patient comfort was improved, due to fewer complications associated with repeated infusions, and avoiding night infusions associated with stress, anxiety and decreased quality of sleep. Switching from 4QD to QD BU had a significant impact on health-care organization, with a better integration in the overall management and usual timelines in the pharmacies and transplantation units. Time spent to prepare and administer BU was significantly reduced, leading to potential financial savings that merit further assessment and would be of particular interest in the current economic climate.

  16. 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.

  17. Evaluating Outcomes in Patients with Overactive Bladder within an Integrated Healthcare Delivery System Using a Treatment Patterns Analyzer

    PubMed Central

    Ng, Daniel B.; McCart, Melissa; Klein, Christopher; Campbell, Chelsey; Schoenhaus, Robert; Berner, Todd

    2016-01-01

    Background Overactive bladder (OAB) is a relatively common disease that has been linked to a variety of comorbidities, reductions in quality of life, and increased healthcare costs. Antimuscarinic agents are the standard of care among pharmacologic treatments for OAB, but these drugs are linked to high levels of anticholinergic burden, especially in the elderly. Objective To demonstrate how efficient data analysis can be used to identify gaps in care as a result of improvement strategies for OAB within an integrated healthcare delivery system setting. Methods We developed an OAB treatment patterns analyzer, a clinical outcomes software analysis program, to identify gaps in care, high anticholinergic burden, and potential quality improvement initiatives. Deidentified pharmacy and medical claims data from an integrated delivery network were imported into the OAB treatment patterns analyzer. Patients with a diagnosis of OAB who were continuously enrolled in the network between January 1, 2009, and December 31, 2013, were identified and were imported into the analyzer. The analyzer used National Drug Code; International Classification of Diseases, Ninth Edition, Clinical Modification; Current Procedural Terminology; and UB-92 codes to measure treatment patterns, comorbid conditions, anticholinergic burden, concomitant use with anticholinesterases, costs, and healthcare resource utilization. Results Of 157,710 members in the integrated delivery network population, 7309 patients met the study eligibility criteria. Of patients taking medications for OAB, 85% were nonadherent and 73% discontinued treatment within 1 year. Among 1147 patients in the integrated healthcare delivery system who were using medications for OAB, 39 (3.4%) patients were concomitantly taking anticholinesterase drugs and an antimuscarinic agent. The per-month plan-paid cost per member was $318.67. Of all the patients with OAB within the population, the rates of all-cause office visits, emergency

  18. Using standards to automate electronic health records (EHRs) and to create integrated healthcare enterprises.

    PubMed

    Sloane, Elliot B; Carey, Carole C

    2007-01-01

    President Bush's 2004 Executive Order mandated the creation within the Secretary of Health and Human Services' staff of a new Office of the National Coordinator for Healthcare Information Technology (ONCHIT) that was tasked with creating the United States National Healthcare Information Network (NHIN). The Health Insurance Portability and Accountability Act of 1996 (HIPAA) and the 2004 and a subsequent 2006 Executive Orders have finally set the stage to design, and require, the use of standardized, electronic data interchange-enabled information systems as quickly as possible.

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

    NASA Astrophysics Data System (ADS)

    Kuzmak, Peter M.; Dayhoff, Ruth E.

    1998-07-01

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

  20. [Italian Decree D.lgs 231/2001--"Regulations regarding administrative responsibilities of corporate bodies of Companies and Associations including those not legally recognized"--an organizational model for the healthcare area].

    PubMed

    Roberti, Giovanni; Fiore, Rosalia; Franco, Claudia; Pimpinella, Giovanni; Piscioneri, Patrizia

    2010-01-01

    Healthcare organizations must implement organizational and management models of regulation and control systems for effectively preventing possible administrative torts by personnel. We define an organizational management and control model for healthcare organizations, based on the legal dispositions of Decree n.231/2001. The model identifies critical points in the administrative and healthcare services delivery processes that are at high-risk of violations to the code. Its primary aim is to prevent torts by the personnel and safeguard the organization at the same time.

  1. Mental health care: how can Family Health teams integrate it into Primary Healthcare?

    PubMed

    Gryschek, Guilherme; Pinto, Adriana Avanzi Marques

    2015-10-01

    Mental health is one of the responsibilities of Brazil's Family Health system. This review of literature sought to understand what position Mental Health occupies in the practice of the Family Health Strategy. A search was made of the scientific literature in the database of the Virtual Health Library (Biblioteca Virtual de Saúde), for the keywords: 'Mental Health'; 'Family Health'; 'Primary Healthcare'. The criteria for inclusion were: Brazilian studies from 2009 through 2012 that contributed to understanding of the following question: "How to insert Mental health care into the routine of the Family Health Strategy?" A total of 11 articles were found, which identified difficulties and strategies of the professionals in Primary Healthcare in relation to mental health. Referral, and medicalization, were common practices. Matrix Support is the strategy of training and skill acquisition for teams that enables new approaches in mental health in the context of Primary healthcare. It is necessary for Management of the Health System to take an active role in the construction of healthcare networks in mental health.

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

    PubMed Central

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

    2015-01-01

    There is a strong link between teamwork and patient safety. Emerging evidence supports the efficacy of teamwork improvement interventions. However, the availability of reliable, valid, and practical measurement tools and strategies is commonly cited as a barrier to long-term sustainment and spread of these teamwork interventions. This article describes the potential value of sensor-based technology as a methodology to measure and evaluate teamwork in healthcare. The article summarizes the teamwork literature within healthcare, including team improvement interventions and measurement. Current applications of sensor-based measurement of teamwork are reviewed to assess the feasibility of employing this approach in healthcare. The article concludes with a discussion highlighting current application needs and gaps and relevant analytical techniques to overcome the challenges to implementation. Compelling studies exist documenting the feasibility of capturing a broad array of team input, process, and output variables with sensor-based methods. Implications of this research are summarized in a framework for development of multi-method team performance measurement systems. Sensor-based measurement within healthcare can unobtrusively capture information related to social networks, conversational patterns, physical activity, and an array of other meaningful information without having to directly observe or periodically survey clinicians. However, trust and privacy concerns present challenges that need to be overcome through engagement of end users in healthcare. Initial evidence exists to support the feasibility of sensor-based measurement to drive feedback and learning across individual, team, unit, and organizational levels. Future research is needed to refine methods, technologies, theory, and analytical strategies. PMID:25053579

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

    PubMed

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

    2015-01-01

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

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

    NASA Astrophysics Data System (ADS)

    Kuzmak, Peter M.; Dayhoff, Ruth E.

    1999-07-01

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

  5. Integrated Medical Information Technology System (IMITS): Information and Clinical Technologies for the Advancement of Healthcare

    DTIC Science & Technology

    2010-08-31

    Communications in Medicine ( DICOM ) standard interfaces allow communication between the DRDWA and various PACS vendors throughout the Air Force. This...Final Report: FY05 IMITS: Information and Clinical Technologies for the Advancement of Healthcare Page 15  DICOM standardization ensures...interoperability with all existing DICOM capable imaging repositories and future additions to the Air Force medical imaging initiative. The Air Force maintains a

  6. Healthcare professionals’ views of the use and administration of two salvage therapy drugs for acute ulcerative colitis: a nested qualitative study within the CONSTRUCT trial

    PubMed Central

    Clement, Clare; Rapport, Frances; Seagrove, Anne; Alrubaiy, Laith; Williams, John

    2017-01-01

    Objectives Insight into healthcare professionals’ views and experiences of the use of ciclosporin and infliximab as salvage therapies for acute ulcerative colitis (UC) and how this may affect participation in a comparison trial is lacking. The study aimed to capture views and opinions of healthcare professionals about the two drugs within the CONSTRUCT trial. Design An interview-based qualitative study using Framework Analysis embedded within an open-label, pragmatic randomised trial. Setting National Health Service Health Boards and Trusts, including large teaching and district hospitals in England, Scotland and Wales. Participants Principal Investigators (PIs) for trial sites (who were all consultant gastroenterologists) and nurses responsible for administering and monitoring the salvage therapy drugs across trial sites. 15 PIs and 8 nurses recruited from a range of sites stratified by site recruitment rates were interviewed. Results Interviews revealed that professionals made judgements regarding the salvage therapies largely based on experience of giving the two drugs and perceptions of effectiveness and adverse side effects. A clear preference for infliximab among nurses was revealed, largely based on experiences of administration and drug handling, with some doctors strongly favouring infliximab based on experience of prescribing the drug as well as patient views and the existing evidence base. Most doctors were more equivocal, and all were prepared to suspend preferences and wait for evidence of effectiveness and safety from the CONSTRUCT trial. PIs also questioned guidelines around drug use and restrictions placed on personal autonomy in delivering best patient care. Conclusions Findings highlight healthcare professionals’ preference for the salvage treatment, infliximab in treating steroid-resistant UC, largely based on resource intensive nursing requirements of intravenous administration of ciclosporin. Not all doctors expressed this preference, being

  7. Planning the future of JPL's management and administrative support systems around an integrated database

    NASA Technical Reports Server (NTRS)

    Ebersole, M. M.

    1983-01-01

    JPL's management and administrative support systems have been developed piece meal and without consistency in design approach over the past twenty years. These systems are now proving to be inadequate to support effective management of tasks and administration of the Laboratory. New approaches are needed. Modern database management technology has the potential for providing the foundation for more effective administrative tools for JPL managers and administrators. Plans for upgrading JPL's management and administrative systems over a six year period evolving around the development of an integrated management and administrative data base are discussed.

  8. The Relationship between Periodontal Interventions and Healthcare Costs and Utilization. Evidence from an Integrated Dental, Medical, and Pharmacy Commercial Claims Database.

    PubMed

    Nasseh, Kamyar; Vujicic, Marko; Glick, Michael

    2017-04-01

    Periodontal disease has been linked to poor glycemic control among individuals with type 2 diabetes. Using integrated dental, medical, and pharmacy commercial claims from Truven MarketScan® Research Databases, we implement inverse probability weighting and doubly robust methods to estimate a relationship between a periodontal intervention and healthcare costs and utilization. Among individuals newly diagnosed with type 2 diabetes, we find that a periodontal intervention is associated with lower total healthcare costs (-$1799), lower total medical costs excluding pharmacy costs (-$1577), and lower total type 2 diabetes-related healthcare costs (-$408). © 2016 The Authors. Health Economics Published by John Wiley & Sons Ltd.

  9. The Relationship between Periodontal Interventions and Healthcare Costs and Utilization. Evidence from an Integrated Dental, Medical, and Pharmacy Commercial Claims Database

    PubMed Central

    Vujicic, Marko; Glick, Michael

    2016-01-01

    Abstract Periodontal disease has been linked to poor glycemic control among individuals with type 2 diabetes. Using integrated dental, medical, and pharmacy commercial claims from Truven MarketScan® Research Databases, we implement inverse probability weighting and doubly robust methods to estimate a relationship between a periodontal intervention and healthcare costs and utilization. Among individuals newly diagnosed with type 2 diabetes, we find that a periodontal intervention is associated with lower total healthcare costs (−$1799), lower total medical costs excluding pharmacy costs (−$1577), and lower total type 2 diabetes‐related healthcare costs (−$408). © 2016 The Authors. Health Economics Published by John Wiley & Sons Ltd. PMID:26799518

  10. Capturing Psychologists' Work in Integrated Care: Measuring and Documenting Administrative Outcomes.

    PubMed

    Kearney, Lisa K; Smith, Clifford A; Pomerantz, Andrew S

    2015-12-01

    With the expansion of integrated primary care and the increased focus on fiscal sustainability, it is critical for clinical managers of these innovative systems to have practical methods for measuring administrative outcomes. Administrative outcomes will assist leadership in the development of efficient, streamlined clinics to provide services to the primary care population. Additionally, administrative measures can be utilized to provide information to assist in guiding resource utilization and management decisions. Several administrative outcomes are suggested for integrated primary care managers to consider for application, including: clinic utilization measures, integrated care administrative measures, wait time and access metrics, and productivity monitors. Effective utilization of these measures can help office managers and clinic leadership not only to maximize patient care, but also to enhance essential business operations, which increase the long-term sustainability of integrated primary care programs.

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

    PubMed

    Adlassnig, Klaus-Peter; Rappelsberger, Andrea

    2008-01-01

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

  12. Toronto Heart Attack Collaborative: an administrative model that facilitated a successful city-wide integration initiative.

    PubMed

    Young, Justin; McLellan, Barry; Escaf, Marnie; Dzavik, Vladimir; Michaud, Susan; Newton, Janet; Newman, Erone

    2014-01-01

    This article provides a description of the administrative model that enabled a city-wide integration effort between Greater Toronto Area hospitals and Toronto Emergency Medical Services in the care of patients within the city of Toronto with ST elevation myocardial infarction (STEMI). This administrative structure, known as the Toronto Heart Attack Collaborative (THAC), enabled universal 24/7 access to primary percutaneous coronary intervention within Toronto, improving patient efficacy and outcomes. The lessons and administrative enablers from this experience may be useful for regions that are embarking on multi-centre integration efforts. This article presents a five-year perspective on the THAC integration effort.

  13. Incidence of Appendicitis over Time: A Comparative Analysis of an Administrative Healthcare Database and a Pathology-Proven Appendicitis Registry

    PubMed Central

    Clement, Fiona; Zimmer, Scott; Dixon, Elijah; Ball, Chad G.; Heitman, Steven J.; Swain, Mark; Ghosh, Subrata

    2016-01-01

    Importance At the turn of the 21st century, studies evaluating the change in incidence of appendicitis over time have reported inconsistent findings. Objectives We compared the differences in the incidence of appendicitis derived from a pathology registry versus an administrative database in order to validate coding in administrative databases and establish temporal trends in the incidence of appendicitis. Design We conducted a population-based comparative cohort study to identify all individuals with appendicitis from 2000 to2008. Setting & Participants Two population-based data sources were used to identify cases of appendicitis: 1) a pathology registry (n = 8,822); and 2) a hospital discharge abstract database (n = 10,453). Intervention & Main Outcome The administrative database was compared to the pathology registry for the following a priori analyses: 1) to calculate the positive predictive value (PPV) of administrative codes; 2) to compare the annual incidence of appendicitis; and 3) to assess differences in temporal trends. Temporal trends were assessed using a generalized linear model that assumed a Poisson distribution and reported as an annual percent change (APC) with 95% confidence intervals (CI). Analyses were stratified by perforated and non-perforated appendicitis. Results The administrative database (PPV = 83.0%) overestimated the incidence of appendicitis (100.3 per 100,000) when compared to the pathology registry (84.2 per 100,000). Codes for perforated appendicitis were not reliable (PPV = 52.4%) leading to overestimation in the incidence of perforated appendicitis in the administrative database (34.8 per 100,000) as compared to the pathology registry (19.4 per 100,000). The incidence of appendicitis significantly increased over time in both the administrative database (APC = 2.1%; 95% CI: 1.3, 2.8) and pathology registry (APC = 4.1; 95% CI: 3.1, 5.0). Conclusion & Relevance The administrative database overestimated the incidence of appendicitis

  14. Validity of ICD-9-CM codes for breast, lung and colorectal cancers in three Italian administrative healthcare databases: a diagnostic accuracy study protocol

    PubMed Central

    Abraha, Iosief; Serraino, Diego; Giovannini, Gianni; Stracci, Fabrizio; Casucci, Paola; Alessandrini, Giuliana; Bidoli, Ettore; Chiari, Rita; Cirocchi, Roberto; De Giorgi, Marcello; Franchini, David; Vitale, Maria Francesca; Fusco, Mario; Montedori, Alessandro

    2016-01-01

    Introduction Administrative healthcare databases are useful tools to study healthcare outcomes and to monitor the health status of a population. Patients with cancer can be identified through disease-specific codes, prescriptions and physician claims, but prior validation is required to achieve an accurate case definition. The objective of this protocol is to assess the accuracy of International Classification of Diseases Ninth Revision—Clinical Modification (ICD-9-CM) codes for breast, lung and colorectal cancers in identifying patients diagnosed with the relative disease in three Italian administrative databases. Methods and analysis Data from the administrative databases of Umbria Region (910 000 residents), Local Health Unit 3 of Napoli (1 170 000 residents) and Friuli-Venezia Giulia Region (1 227 000 residents) will be considered. In each administrative database, patients with the first occurrence of diagnosis of breast, lung or colorectal cancer between 2012 and 2014 will be identified using the following groups of ICD-9-CM codes in primary position: (1) 233.0 and (2) 174.x for breast cancer; (3) 162.x for lung cancer; (4) 153.x for colon cancer and (5) 154.0–154.1 and 154.8 for rectal cancer. Only incident cases will be considered, that is, excluding cases that have the same diagnosis in the 5 years (2007–2011) before the period of interest. A random sample of cases and non-cases will be selected from each administrative database and the corresponding medical charts will be assessed for validation by pairs of trained, independent reviewers. Case ascertainment within the medical charts will be based on (1) the presence of a primary nodular lesion in the breast, lung or colon–rectum, documented with imaging or endoscopy and (2) a cytological or histological documentation of cancer from a primary or metastatic site. Sensitivity and specificity with 95% CIs will be calculated. Dissemination Study results will be disseminated widely through

  15. Profiling Patients’ Healthcare Needs to Support Integrated, Person-Centered Models for Long-Term Disease Management (Profile): Research Design

    PubMed Central

    Elissen, Arianne MJ; Schaper, Nicolaas C; Vrijhoef, Hubertus JM; Ruwaard, Dirk

    2016-01-01

    Background: This article presents the design of PROFILe, a study investigating which (bio)medical and non-(bio)medical patient characteristics should guide more tailored chronic care. Based on this insight, the project aims to develop and validate ‘patient profiles’ that can be used in practice to determine optimal treatment strategies for subgroups of chronically ill with similar healthcare needs and preferences. Methods/Design: PROFILe is a practice-based research comprising four phases. The project focuses on patients with type 2 diabetes. During the first study phase, patient profiles are drafted based on a systematic literature research, latent class growth modeling, and expert collaboration. In phase 2, the profiles are validated from a clinical, patient-related and statistical perspective. Phase 3 involves a discrete choice experiment to gain insight into the patient preferences that exist per profile. In phase 4, the results from all analyses are integrated and recommendations formulated on which patient characteristics should guide tailored chronic care. Discussion: PROFILe is an innovative study which uses a uniquely holistic approach to assess the healthcare needs and preferences of chronically ill. The patient profiles resulting from this project must be tested in practice to investigate the effects of tailored management on patient experience, population health and costs. PMID:27616957

  16. Does service integration improve the sexual and reproductive healthcare of women living with HIV?

    PubMed

    Wielding, S; Flynn, B

    2016-10-01

    The sexual and reproductive health (SRH) care needs of a cohort of HIV-positive women were studied pre- and post-integration of genitourinary medicine (GUM) and SRH services. Pre-integration, 24.9% of women at risk of pregnancy were using an effective method of contraception, with a non-significant improvement post-integration to 39.3%. Pre-integration, 47.6% of pregnancies were unplanned, whilst 50% were still unplanned post-integration. Cervical cytology uptake within the previous 12 months improved significantly. It appears that the integration of services alone does not improve all aspects of the SRH of women living with HIV and additional novel strategies should be explored.

  17. An assisted-living home architecture with integrated healthcare services for elderly people.

    PubMed

    Marsh, Andy; Biniaris, Christos; Vergados, Dimitrios; Eppler, Arnold; Kavvadias, Christoforos; Bigalke, Olaf; Robert, Eric; Jerabek, Boro; Alevizos, Alevizos; Caragiozidis, Michael

    2008-01-01

    Since the population of elderly people grows absolutely and in relation to the overall population in the world, the improvement of the quality of life of elderly people at home is of a great importance. This can be achieved through the development of generic technologies for managing their domestic ambient environment consisting of medical sensors, entertainment equipment, home automation systems and white goods, increasing their autonomy and safety. In this context, the provision intelligent interactive healthcare services will improve their daily life and allowing at the same time the continuous monitoring of their health and their effective treatment. This work is supported by the INHOME Project EU IST-045061-STP, http://www.ist-inhome.eu.

  18. The prescribing clinical health psychologist: a hybrid skill set in the new era of integrated healthcare.

    PubMed

    McGuinness, Kevin M

    2012-12-01

    The prescribing clinical health psychologist brings together in one individual a combination of skills to create a hybrid profession that can add value to any healthcare organization. This article addresses the high demand for mental health services and the inequitable distribution of mental health practitioners across the nation. The close link between physical and mental health and evidence that individuals in psychological distress often enter the mental health system via primary care medical clinics is offered as background to a discussion of the author's work as a commissioned officer of the U.S. Public Health Service assigned to the Chaparral Medical Center of La Clinica de Familia, Inc. near the U.S.-Mexico border. The prescribing clinical health psychologist in primary care medical settings is described as a valuable asset to the future of professional psychology.

  19. A Markov Model for Forecasting Inventory Levels for U.S Navy Medical Service Corps Healthcare Administrators

    DTIC Science & Technology

    2014-03-01

    Administration, Medical Allied Sciences, Optometry , and Pharmacy. Today, the MSC comprises 31 subspecialties, organized under three major categories...Exper Psych 30 4% Clinical Dietetics 26 3% Financial Mgt 78 8% Research Psych 17 3% Optometry 109 11% MPT&E 31 3% Entomology 39 6% Pharmacy, General 136

  20. Integrated Healthcare Delivery: A Qualitative Research Approach to Identifying and Harmonizing Perspectives of Integrated Neglected Tropical Disease Programs

    PubMed Central

    Jacobson, Julie; Mosher, Aryc W.; Walson, Judd L.

    2016-01-01

    Background While some evidence supports the beneficial effects of integrating neglected tropical disease (NTD) programs to optimize coverage and reduce costs, there is minimal information regarding when or how to effectively operationalize program integration. The lack of systematic analyses of integration experiences and of integration processes may act as an impediment to achieving more effective NTD programming. We aimed to learn about the experiences of NTD stakeholders and their perceptions of integration. Methodology We evaluated differences in the definitions, roles, perceived effectiveness, and implementation experiences of integrated NTD programs among a variety of NTD stakeholder groups, including multilateral organizations, funding partners, implementation partners, national Ministry of Health (MOH) teams, district MOH teams, volunteer rural health workers, and community members participating in NTD campaigns. Semi-structured key informant interviews were conducted. Coding of themes involved a mix of applying in-vivo open coding and a priori thematic coding from a start list. Findings In total, 41 interviews were conducted. Salient themes varied by stakeholder, however dominant themes on integration included: significant variations in definitions, differential effectiveness of specific integrated NTD activities, community member perceptions of NTD programs, the influence of funders, perceived facilitators, perceived barriers, and the effects of integration on health system strength. In general, stakeholder groups provided unique perspectives, rather than contrarian points of view, on the same topics. The stakeholders identified more advantages to integration than disadvantages, however there are a number of both unique facilitators and challenges to integration from the perspective of each stakeholder group. Conclusions Qualitative data suggest several structural, process, and technical opportunities that could be addressed to promote more effective and

  1. [Intratumoral administration of biological preparations--recommendation for integrative medicine].

    PubMed

    Ebina, T

    2001-10-01

    The antitumor effect of biological preparations was examined in a double grafted tumor system. PSK is a hot water extract of cultured mycelia from Coliolus versicolor. Its protein content is about 38% and the main glycoside portion of PSK is beta-D-glucan. Lentinan is purified from fruit bodies of Lentinus edodes and is a beta-1, 3-glucan. Cepharanthin is an extract from the root of Stephania cepharantha HAYATA, consisting of 4 kinds of biscoclaurine alkaloids. TAHEEBO tea is a hot water extract of Tabebuia avellanedae, the active ingredient of which is naphthoquinones. If protein-bound polysaccharides were to be used in Western medicine, these polysaccharides would be purified, but purified beta-glucan loses its beneficial effects. Similarly, when raw Cepharanthin is purified to isolate its active ingredient (an alkaloid cepharanthine), its anti-tumor effect is weakened. Clear IAP induction was observed in serum of mice treated with extracts of Coliolus versicolor and Stephania cepharantha. However, IAP induction was not observed in the serum of mice treated with purified beta-glucan or purified alkaloid. This suggests that macrophages may recognize extracts but not purified substances. In Western medicine, purified substances with known chemical structures are recognized as drugs, but overdoses of these drugs are toxic to the body, thus adverse reactions are always an issue. In Chinese medicine, mixtures containing several crude drugs are recognized as drugs, whose active ingredients are not identified. In integrative medicine, drugs are extracts that contain active ingredients with known structures and functions. We propose a Japanese version of integrative medicine which is neither Western nor Chinese.

  2. The Patchwork Text Assessment--An Integral Component of Constructive Alignment Curriculum Methodology to Support Healthcare Leadership Development

    ERIC Educational Resources Information Center

    Leigh, J. A.; Rutherford, J.; Wild, J.; Cappleman, J.; Hynes, C.

    2013-01-01

    Background: A responsive and innovative postgraduate programme curriculum that produces an effective and competent multi professional healthcare leader whom can lead within the United Kingdom (UK) and international healthcare context offers a promising approach to contributing towards the challenging global healthcare agenda. Aims: The aim of the…

  3. The Healthcare Administrator’s Desk Reference: A Managed Care and Health Care Contracting Dictionary for the Military Health System

    DTIC Science & Technology

    1998-07-01

    Electrocardiogram ECP Engineering Change Proposal ECT Electroconvulsive Therapy EDI Electronic Data Interchange EEO Equal Employment Opportunity EEOC Equal...Administration OT Occupational Therapy OTC Over the Counter OTR Outpatient Treatment Record OTS Off the Shelf OTSG Office of the Surgeon General OWA...Standards Review Organization PT Physical Therapy PTMPY Per Thousand Members Per Year Desk Reference 85 Pub.Cont.L.J. Public Contract Law Journal PV 1

  4. Integrating Heterogeneous Healthcare Datasets and Visual Analytics for Disease Bio-surveillance and Dynamics

    SciTech Connect

    Ramanathan, Arvind; Pullum, Laura L; Steed, Chad A; Quinn, Shannon; Chennubhotla, Chakra; Parker, Tara L

    2013-01-01

    n this paper, we present an overview of the big data chal- lenges in disease bio-surveillance and then discuss the use of visual analytics for integrating data and turning it into knowl- edge. We will explore two integration scenarios: (1) combining text and multimedia sources to improve situational awareness and (2) enhancing disease spread model data with real-time bio-surveillance data. Together, the proposed integration methodologies can improve awareness about when, where and how emerging diseases can affect wide geographic regions.

  5. Office automation: The administrative window into the integrated DBMS

    NASA Technical Reports Server (NTRS)

    Brock, G. H.

    1985-01-01

    In parallel to the evolution of Management Information Systems from simple data files to complex data bases, the stand-alone computer systems have been migrating toward fully integrated systems serving the work force. The next major productivity gain may very well be to make these highly sophisticated working level Data Base Management Systems (DMBS) serve all levels of management with reports of varying levels of detail. Most attempts by the DBMS development organization to provide useful information to management seem to bog down in the quagmire of competing working level requirements. Most large DBMS development organizations possess three to five year backlogs. Perhaps Office Automation is the vehicle that brings to pass the Management Information System that really serves management. A good office automation system manned by a team of facilitators seeking opportunities to serve end-users could go a long way toward defining a DBMS that serves management. This paper will briefly discuss the problems of the DBMS organization, alternative approaches to solving some of the major problems, a debate about problems that may have no solution, and finally how office automation fits into the development of the Manager's Management Information System.

  6. Integrated healthcare for chronically ill. Reflections on the gap between science and practice and how to bridge the gap.

    PubMed

    van der Vlegel-Brouwer, Wilma

    2013-04-01

    Integrated care offers an opportunity to address healthcare efficiency and effectiveness concerns and is especially relevant for elderly patients with different chronic illnesses. In current care standards for chronic care focus is often on one disease. The chronic care model (CCM) is used as the basis of integrated care programs. It identifies essential components that encourage high-quality chronic disease care, involving the community and health system and including self-management support, delivery system design, decision support, and clinical information systems. Improvements in those interrelated components can produce system reform in which informed, activated patients interact with prepared, proactive practice teams. There is however a lack of research evidence for the impact of the chronic care model as a full model. Integrated care programs have widely varying definitions and components and failure to recognize these variations leads to inappropriate conclusions about the effectiveness of these programs and to inappropriate application of research results. It seems important to carefully consider the type and amount of data that are collected within the disease management programs for several purposes, as well as the methods of data collection. Understanding and changing the behavior of complex dynamic chronic care system requires an appreciation of its key patterns, leverage points and constraints. A different theoretical framework, that embraces complexity, is required. Research should be design-based, context bound and address relationships among agents in order to provide solutions that address locally defined demands and circumstances.

  7. Exploring New Ways to Deliver Value to Healthcare Organizations: Algorithmic Testing, Data Integration, and Diagnostic E-consult Service.

    PubMed

    Risin, Semyon A; Chang, Brian N; Welsh, Kerry J; Kidd, Laura R; Moreno, Vanessa; Chen, Lei; Tholpady, Ashok; Wahed, Amer; Nguyen, Nghia; Kott, Marylee; Hunter, Robert L

    2015-01-01

    As the USA Health Care System undergoes transformation and transitions to value-based models it is critical for laboratory medicine/clinical pathology physicians to explore opportunities and find new ways to deliver value, become an integral part of the healthcare team. This is also essential for ensuring financial health and stability of the profession when the payment paradigm changes from fee-for-service to fee-for-performance. About 5 years ago we started searching for ways to achieve this goal. Among other approaches, the search included addressing the laboratory work-ups for specialists' referrals in the HarrisHealth System, a major safety net health care organization serving mostly indigent and underserved population of Harris County, TX. We present here our experience in improving the efficiency of laboratory testing for the referral process and in building a prototype of a diagnostic e-consult service using rheumatologic diseases as a starting point. The service incorporates algorithmic testing, integration of clinical, laboratory and imaging data, issuing structured comprehensive consultation reports, incorporating all the relevant information, and maintaining personal contacts and an e-line of communications with the primary providers and referral center personnel. Ongoing survey of providers affords testimony of service value in terms of facilitating their work and increasing productivity. Analysis of the cost effectiveness and of other value indicators is currently underway. We also discuss our pioneering experience in building pathology residents and fellows training in integrated diagnostic consulting service.

  8. How Do Healthcare Employees Rate the Ethics of Their Organization? An Analysis Based on VA IntegratedEthics@ Staff Survey Data.

    PubMed

    Cohen, Jennifer H; Foglia, Mary Beth; Kwong, Katherine; Pearlman, Robert; Fox, Ellen

    2015-01-01

    Healthcare organizations with an ethical culture experience higher levels of employee productivity, less staff turnover, better levels of patient safety, resource and cost savings, and higher levels of patient satisfaction. Employees' perceptions of the ethics of their organization are considered a good indicator of the ethics culture. How employees rate the ethics of their organization is not well understood. Previous research has identified a number of attributes that are salient to employees' perceptions in this area. However, little is known about how employees synthesize their perceptions of these attributes to rate the ethics of their organization. Without this knowledge, managers have little specific information to act on to improve practices that would in turn improve employees' perceptions of their organization's ethics. For this study, we used data from Department of Veterans Affairs' (VA) 2014 IntegratedEthics@ Staff Survey administered to Veterans Health Administration (VHA) staff. We used multivariate regression analyses to investigate how VHA employees weigh their perceptions of eight attributes of an ethical organization to inform an overall rating of the ethics of their organization. We found that employee perceptions of fairness, clarity of expectations, accountability, and leadership's prioritization of ethics had the strongest associations with the overall rating. In addition, employees disproportionately weighed their positive perceptions in determining their overall rating. Therefore, a strategy to improve employees' perceptions of these attributes could potentially have the greatest marginal return on investment with respect to improving employees' perceptions of the ethics of an organization.

  9. Desiderata for Healthcare Integrated Data Repositories Based on Architectural Comparison of Three Public Repositories

    PubMed Central

    Huser, Vojtech; Cimino, James J.

    2013-01-01

    Integrated data repositories (IDRs) are indispensable tools for numerous biomedical research studies. We compare three large IDRs (Informatics for Integrating Biology and the Bedside (i2b2), HMO Research Network’s Virtual Data Warehouse (VDW) and Observational Medical Outcomes Partnership (OMOP) repository) in order to identify common architectural features that enable efficient storage and organization of large amounts of clinical data. We define three high-level classes of underlying data storage models and we analyze each repository using this classification. We look at how a set of sample facts is represented in each repository and conclude with a list of desiderata for IDRs that deal with the information storage model, terminology model, data integration and value-sets management. PMID:24551366

  10. Strategic plan modelling by hospital senior administration to integrate diversity management.

    PubMed

    Newhouse, John J

    2010-11-01

    Limited research suggests that some hospital senior administrators and chief executive officers (CEOs) have employed a strategic planning function to achieve diversity management practices. As the hospital industry struggles with how to integrate diversity practices to improve patient satisfaction, increase the quality of care and enhance clinical outcomes for minority populations, understanding the planning process involved in this endeavour becomes significant for senior hospital administrators. What is not well understood is what this strategic planning process represents and how it is applied to integrate diversity management. Scant research exists about the type of strategic models that hospital CEOs employ when they wish to reposition their organizations through diversity management. This study examines the strategic planning models used by senior administrators to integrate diversity management for an institutional-wide agenda. A qualitative survey process was used for CEOs in the states of New York, Pennsylvania, New Jersey and Delaware. The key research questions dealt with what type of strategic plan approach senior administrators used for integrating diversity management and what rationale they used to pursue this. Significant differences were reported between three types of strategic plan modelling used by CEOs. Also, when comparing past and current practices over time, such differences existed. The need to integrate diversity management is underscored by this study. How senior hospital administrators apply strategic plan models and what impact these approaches have represent the major implications that this study offers.

  11. Redefining the Core Competencies of Future Healthcare Executives under Healthcare Reform

    ERIC Educational Resources Information Center

    Love, Dianne B.; Ayadi, M. Femi

    2015-01-01

    As the healthcare industry has evolved over the years, so too has the administration of healthcare organizations. The signing into law of the Patient Protection and Affordable Care Act (ACA) has brought additional changes to the healthcare industry that will require changes to the healthcare administration curriculum. The movement toward a…

  12. Protocol for determining primary healthcare practice characteristics, models of practice and patient accessibility using an exploratory census survey with linkage to administrative data in Nova Scotia, Canada

    PubMed Central

    Marshall, Emily Gard; Gibson, Richard J; Lawson, Beverley; Burge, Frederick

    2017-01-01

    Introduction There is little evidence on how primary care providers (PCPs) model their practices in Nova Scotia (NS), Canada, what services they offer or what accessibility is like for the average patient. This study will create a database of all family physicians and primary healthcare nurse practitioners in NS, including information about accessibility and the model of care in which they practice, and will link the survey data to administrative health databases. Methods and analysis 3 census surveys of all family physicians, primary care nurse practitioners (ie, PCPs) and their practices in NS will be conducted. The first will be a telephone survey conducted during typical daytime business hours. At each practice, the person answering the telephone will be asked questions about the practice's accessibility and model of care. The second will be a telephone survey conducted after typical daytime business hours to determine what out-of-office services PCP practices offer their patients. The final will be a tailored fax survey that will collect information that could not be obtained in the first 2 surveys plus new information on scope of practice, practice model and willingness to participate in research. Survey data will be linked with billing data from administrative health databases. Multivariate regression analysis will be employed to assess whether access and availability outcome variables are associated with PCP and model of practice characteristics. Negative binomial regression analysis will be employed to assess the association between independent variables from the survey data and health system use outcomes from administrative data. Ethics and dissemination This study has received ethical approval from the Nova Scotia Health Authority and the Health Data Nova Scotia Data Access Committee. Dissemination approached will include stakeholder engagement at local and national levels, conference presentations, peer-reviewed publications and a public website. PMID

  13. Collecting, Integrating, and Disseminating Patient-Reported Outcomes for Research in a Learning Healthcare System

    PubMed Central

    Harle, Christopher A.; Lipori, Gloria; Hurley, Robert W.

    2016-01-01

    Introduction: Advances in health policy, research, and information technology have converged to increase the electronic collection and use of patient-reported outcomes (PROs). Therefore, it is important to share lessons learned in implementing PROs in research information systems. Case Description: The purpose of this case study is to describe a novel information system for electronic PROs and lessons learned in implementing that system to support research in an academic health center. The system incorporates freely available and commercial software and involves clinical and research workflows that support the collection, transformation, and research use of PRO data. The software and processes that comprise the system serve three main functions, (i) collecting electronic PROs in clinical care, (ii) integrating PRO data with non-patient generated clinical data, and (iii) disseminating data to researchers through the institution’s research informatics infrastructure, including the i2b2 (Informatics for Integrating Biology and the Bedside) system. Strategies: Our successful design and implementation was driven by three overarching strategies. First, we selected and implemented multiple interfaced technologies to support PRO collection, management, and research use. Second, we aimed to use standardized approaches to measuring PROs, sending PROs between systems, and disseminating PROs. Finally, we focused on using technologies and processes that aligned with existing clinical research information management strategies within our organization. Conclusion: These experiences and lessons may help future implementers and researchers enhance the scale and sustainable use of systems for research use of PROs. PMID:27563683

  14. 77 FR 52061 - Notice of Proposed Exemption Involving Sharp HealthCare Located in San Diego, CA

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-28

    ... Benefits Security Administration Notice of Proposed Exemption Involving Sharp HealthCare Located in San... involve the Sharp HealthCare Health and Dental Plan (the Plan). The proposed exemption, if granted, would... does not reflect the views of the Department. 1. Background Sharp is an integrated health care...

  15. Educational Preferences and Outcomes From Suicide Prevention Training in the Veterans Health Administration: One-Year Follow-Up With Healthcare Employees in Upstate New York

    PubMed Central

    Matthieu, Monica M.; Chen, Yufei; Schohn, Mary; Lantinga, Larry J.; Knox, Kerry L.

    2016-01-01

    This study identifies training outcomes and educational preferences of employees who work within the Veterans Health Administration (VHA). Using a longitudinal pre-postsurvey design, 71 employees from one geographic region of VHA healthcare facilities participated in an evaluation of a brief standardized gatekeeper program and a needs assessment on training preferences for suicide and suicide prevention. Results indicate significant differences in knowledge and self-efficacy from pre to post (p < 0.001), although only self-efficacy remained significant at 1 year follow-up, (M = 3.01; SD = 0.87) as compared to pretraining (M = 2.50, SD = 1.05) (t = −5.64, p < 0.001). At post-training, 90% of the participants were willing to learn more about suicide, with 88% willing to spend more than 1 hour in future training activities on more advanced topics. This training program can increase the knowledge and abilities of VHA staff to engage, identify, and refer veterans at risk for suicide to appropriate care. PMID:19960817

  16. Quality Assurance in Educational Administration in the Teaching of Farm Mathematics for National Integration in Nigeria

    ERIC Educational Resources Information Center

    Enemali, I. A.; Adah, Obe Christopher

    2015-01-01

    Farm mathematics, an aspect of agricultural science education is being taught in our educational institutions in the country. This effort is to enhance agricultural productivity and quality of agricultural science education for national integration. For the realization of this, a quality assured educational administration is vital. The paper…

  17. Facilitating Administrators' Instructional Leadership through the Use of a Technology Integration Discussion Protocol

    ERIC Educational Resources Information Center

    McLeod, Scott

    2015-01-01

    Digital learning tools are increasingly prevalent in classrooms, yet too often technology integration efforts by educators replicate rather than transform traditional instructional practices. Opportunities to take advantage of the new affordances that technologies bring to the learning environment thus become forfeit. Administrators' use of a…

  18. Multiple Integrated Examinations: An Observational Study of Different Academic Curricula Based on a Business Administration Assessment

    ERIC Educational Resources Information Center

    Ardolino, Piermatteo; Noventa, Stefano; Formicuzzi, Maddalena; Cubico, Serena; Favretto, Giuseppe

    2016-01-01

    An observational study has been carried out to analyse differences in performance between students of different undergraduate curricula in the same written business administration examination, focusing particularly on possible effects of "integrated" or "multi-modular" examinations, a recently widespread format in Italian…

  19. Understanding interactions between Chinese medicines and pharmaceutical drugs in integrative healthcare.

    PubMed

    Chan, Kelvin

    2015-02-01

    In the 21st century, the public are more informed, mainly via the Internet, about health and medical products and have become more knowledgeable about matters relating to their health conditions and well-being in curing and preventing illnesses. They often self-medicate themselves with various health products and over-the-counter (OTC) medicines apart from prescribed pharmaceutical drugs (PD). Some of those non-prescribed products may have doubtful quality control and contain harmful additives or unchecked ingredients; thus their usefulness is in doubt. The increasing popularity world-wide of using Chinese medicines (CM) and related OTC functional products has raised concerns over their concomitant use with PD and the consequential adverse effects. In most cases the alleged causes of adverse effects are linked with herbal sources, although the authorised information on the interactions between CM-PD is not plentiful in the literature. There is an urgent need for such a data base. The future professionals in health and medical care should be knowledgeable or aware of what their patients have been taking or given. In actual practice the patients may receive both treatments intentionally or unintentionally, with or without the awareness of the practitioner. In these situations a reliable database for interactions between CM-PD will be extremely useful for consultation when treatment problems appear or during emergency situations. Their combining of medications may be involved with possible outcomes of adverse reactions or beneficial effects. Such a database will be welcomed by both practitioners of herbal medicines and orthodox medicine practitioners in the emerging trend of integrative medicine. The author has been involved in various research projects of basic and clinical aspects in mainly CM among other herbal and PD. Examples will be given largely on those related to these disciplines as illustrations in this overview.

  20. [Sex differences in the integrated stroke management in a rural healthcare area in Asturias].

    PubMed

    Lopez-Martinez, T; Bernardo-Cofino, J; Garcia-Prieto, E; Feito-Alvarez, M; de Dios-Del Valle, R; Calleja-Puerta, S

    2016-08-16

    Introduccion. Las diferencias de sexo y el caracter (rural o urbano) de las poblaciones determinan en gran medida el abordaje integral de patologias dependientes del tiempo, como el ictus, principal causa de hospitalizacion y mortalidad femenina en nuestro medio. Objetivo. Determinar si en un area sanitaria rural del Principado de Asturias se ponen de manifiesto las caracteristicas diferenciales entre mujeres y hombres con ictus. Pacientes y metodos. Estudio descriptivo retrospectivo realizado en el Hospital de Jarrio. Se revisaron variables a traves de las historias clinicas informatizadas de los pacientes que sufrieron ictus en 2013. Resultados. Se produjeron 126 altas totales, el 53,2% en las mujeres, que sufrieron la enfermedad con un retraso de cinco años (p < 0,008) en relacion con los varones, los cuales fueron mas fumadores y consumidores perjudiciales de alcohol (p < 0,000). La demora prehospitalaria no arrojo diferencias de sexo significativas. El trastorno del lenguaje fue el sintoma principal en el grupo femenino (p < 0,008), que registro una puntuacion superior en la National Institute of Health Stroke Scale (p < 0,046). Los estudios complementarios, como el Holter (p < 0,04) y la ecografia de troncos supraaorticos (p < 0,02), se realizaron menos en las mujeres, que recibieron un tratamiento principalmente conservador con mayor hidratacion parenteral (p < 0,017) y reposo. El grupo femenino sufrio mas complicaciones, discapacidad al alta (p < 0,001) y a los tres meses (p < 0,004), y registro porcentajes mas elevados de institucionalizacion posterior (p < 0,005). Conclusiones. Existen diferencias de sexo demograficas, en el perfil de riesgo cerebrovascular, la presentacion clinica, el manejo hospitalario y la comorbilidad del ictus en esta poblacion rural, que sugieren areas de mejora.

  1. Crime and healthcare.

    PubMed

    Shinkman, R; Weissenstein, E

    1997-05-19

    When charges were made last summer against 12 men affiliated with a New Jersey-based third-party administrator firm, headlines trumpeted the arrests as the first major case of organized crime infiltrating the healthcare industry. While law enforcement experts don't believe the mob has established a major role in healthcare, they acknowledge the $1 trillion-a-year industry is a lucrative target for illicit activity.

  2. 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.

  3. Complementary and Integrative Healthcare for Patients with Mechanical Low Back Pain in a U.S. Hospital Setting

    PubMed Central

    Rhee, Taeho Greg; Leininger, Brent D.; Ghildayal, Neha; Evans, Roni L.; Dusek, Jeffery A.; Johnson, Pamela Jo

    2015-01-01

    Objectives Complementary and integrative healthcare (CIH) is commonly used to treat low back pain (LBP). While the use of CIH within hospitals is increasing, little is known regarding the delivery of these services within inpatient settings. We examine the patterns of CIH services among inpatients with mechanical LBP in a hospital setting. Methods This is a retrospective, practice-based study conducted at Abbot Northwestern hospital in Minnesota. Using electronic health record data from July 2009 to December 2012, 8,095 inpatients with mechanical LBP were identified using ICD-9 codes. We classified patients by reason for hospitalization. We examined demographic and clinical characteristics by receipt of CIH services. Then, we estimated the prevalence of types of CIH delivered and clinical foci for CIH visits among inpatients with mechanical LBP. Results Most inpatients with mechanical LBP (>90%) were hospitalized for surgical procedures. Overall, 14.2% received inpatient CIH services. All demographic and clinical characteristics differed by receipt of CIH (P<0.001), except race/ethnicity. CIH recipients were in poorer health than those who did not. Most commonly delivered CIH services were massage (62.1%), relaxation techniques (42.0%) and acupuncture (25.7%). Pain (45.1%), relaxation (17.5%), and comfort (8.2%) were the top three reasons for CIH visits. Conclusion There are important differences between CIH recipients and non-CIH recipients among patients with mechanical LBP within a hospital setting. The reasons documented for CIH visits included addressing physical, emotional and/or mental conditions of patients. Future studies are needed to determine the effectiveness of CIH services health and wellbeing outcomes in this population. PMID:26860795

  4. Integrating hospital administrative data to improve health care efficiency and outcomes: "the socrates story".

    PubMed

    Lawrence, Justin; Delaney, Conor P

    2013-03-01

    Evaluation of health care outcomes has become increasingly important as we strive to improve quality and efficiency while controlling cost. Many groups feel that analysis of large datasets will be useful in optimizing resource utilization; however, the ideal blend of clinical and administrative data points has not been developed. Hospitals and health care systems have several tools to measure cost and resource utilization, but the data are often housed in disparate systems that are not integrated and do not permit multisystem analysis. Systems Outcomes and Clinical Resources AdministraTive Efficiency Software (SOCRATES) is a novel data merging, warehousing, analysis, and reporting technology, which brings together disparate hospital administrative systems generating automated or customizable risk-adjusted reports. Used in combination with standardized enhanced care pathways, SOCRATES offers a mechanism to improve the quality and efficiency of care, with the ability to measure real-time changes in outcomes.

  5. Integrating Hospital Administrative Data to Improve Health Care Efficiency and Outcomes: “The Socrates Story”

    PubMed Central

    Lawrence, Justin; Delaney, Conor P.

    2013-01-01

    Evaluation of health care outcomes has become increasingly important as we strive to improve quality and efficiency while controlling cost. Many groups feel that analysis of large datasets will be useful in optimizing resource utilization; however, the ideal blend of clinical and administrative data points has not been developed. Hospitals and health care systems have several tools to measure cost and resource utilization, but the data are often housed in disparate systems that are not integrated and do not permit multisystem analysis. Systems Outcomes and Clinical Resources AdministraTive Efficiency Software (SOCRATES) is a novel data merging, warehousing, analysis, and reporting technology, which brings together disparate hospital administrative systems generating automated or customizable risk-adjusted reports. Used in combination with standardized enhanced care pathways, SOCRATES offers a mechanism to improve the quality and efficiency of care, with the ability to measure real-time changes in outcomes. PMID:24436649

  6. 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.

  7. Escaping the healthcare leadership cul-de-sac.

    PubMed

    Edmonstone, John Duncan

    2017-02-06

    Purpose This paper aims to propose that healthcare is dominated by a managerialist ideology, powerfully shaped by business schools and embodied in the Masters in Business Administration. It suggests that there may be unconscious collusion between universities, healthcare employers and student leaders and managers. Design/methodology/approach Based on a review of relevant literature, the paper examines critiques of managerialism generally and explores the assumptions behind leadership development. It draws upon work which suggests that leading in healthcare organisations is fundamentally different and proposes that leadership development should be more practice-based. Findings The way forward for higher education institutions is to include work- or practice-based approaches alongside academic approaches. Practical implications The paper suggests that there is a challenge for higher education institutions to adopt and integrate practice-based development methods into their programme designs. Originality/value The paper provides a challenge to the future role of higher education institutions in developing leadership in healthcare.

  8. Integration of Value Stream Map and Healthcare Failure Mode and Effect Analysis into Six Sigma Methodology to Improve Process of Surgical Specimen Handling.

    PubMed

    Hung, Sheng-Hui; Wang, Pa-Chun; Lin, Hung-Chun; Chen, Hung-Ying; Su, Chao-Ton

    2015-01-01

    Specimen handling is a critical patient safety issue. Problematic handling process, such as misidentification (of patients, surgical site, and specimen counts), specimen loss, or improper specimen preparation can lead to serious patient harms and lawsuits. Value stream map (VSM) is a tool used to find out non-value-added works, enhance the quality, and reduce the cost of the studied process. On the other hand, healthcare failure mode and effect analysis (HFMEA) is now frequently employed to avoid possible medication errors in healthcare process. Both of them have a goal similar to Six Sigma methodology for process improvement. This study proposes a model that integrates VSM and HFMEA into the framework, which mainly consists of define, measure, analyze, improve, and control (DMAIC), of Six Sigma. A Six Sigma project for improving the process of surgical specimen handling in a hospital was conducted to demonstrate the effectiveness of the proposed model.

  9. Crossing the Boundaries of Our Current Healthcare System by Integrating Ultra-Weak Photon Emissions with Metabolomics

    PubMed Central

    Burgos, Rosilene C. Rossetto; van Wijk, Eduard P. A.; van Wijk, Roeland; He, Min; van der Greef, Jan

    2016-01-01

    The current healthcare system is hampered by a reductionist approach in which diagnostics and interventions focus on a specific target, resulting in medicines that center on generic, static phenomena while excluding inherent dynamic nature of biological processes, let alone psychosocial parameters. In this essay, we present some limitations of the current healthcare system and introduce the novel and potential approach of combining ultra-weak photon emission (UPE) with metabolomics technology in order to provide a dynamic readout of higher organizational systems. We argue that the combination of metabolomics and UPE can bring a new, broader, view of health state and can potentially help to shift healthcare toward more personalized approach that improves patient well-being. PMID:28018239

  10. Crossing the Boundaries of Our Current Healthcare System by Integrating Ultra-Weak Photon Emissions with Metabolomics.

    PubMed

    Burgos, Rosilene C Rossetto; van Wijk, Eduard P A; van Wijk, Roeland; He, Min; van der Greef, Jan

    2016-01-01

    The current healthcare system is hampered by a reductionist approach in which diagnostics and interventions focus on a specific target, resulting in medicines that center on generic, static phenomena while excluding inherent dynamic nature of biological processes, let alone psychosocial parameters. In this essay, we present some limitations of the current healthcare system and introduce the novel and potential approach of combining ultra-weak photon emission (UPE) with metabolomics technology in order to provide a dynamic readout of higher organizational systems. We argue that the combination of metabolomics and UPE can bring a new, broader, view of health state and can potentially help to shift healthcare toward more personalized approach that improves patient well-being.

  11. 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

  12. Disaster Management: AN Integral Part of Science & Technology System and Land Administration-Management System

    NASA Astrophysics Data System (ADS)

    Ghawana, T.; Zlatanova, S.

    2016-06-01

    Disaster management is a multidisciplinary field, which requires a general coordination approach as well as specialist approaches. Science and Technology system of a country allows to create policies and execution of technical inputs required which provide services for the specific types of disasters management. Land administration and management agencies, as the administrative and management bodies, focus more on the coordination of designated tasks to various agencies responsible for their dedicated roles. They get help from Scientific and technical inputs & policies which require to be implemented in a professional manner. The paper provides an example of such integration from India where these two systems complement each other with their dedicated services. Delhi, the Capital of India, has such a disaster management system which has lot of technical departments of government which are mandated to provide their services as Emergency Service Functionaries. Thus, it is shown that disaster management is a job which is an integral part of Science & Technology system of a country while being implemented primarily with the help of land administration and management agencies. It is required that new policies or mandates for the Science and technology organizations of government should give a primary space to disaster management

  13. Integrated Tourism E-Commerce Platform for Scenery Administration Bureau, Travel Agency and Tourist

    NASA Astrophysics Data System (ADS)

    Liang, Zhixue; Wang, Shui

    Collaboration among multiple travel agencies and with scenery administration bureaus is vital for small or medium sized travel companies to succeed in the fierce competition of the tourism industry; business processes such as regrouping individual travelers between different agencies prove to be difficult and unpleasant user experience; tourists want to be more informed and have more initiative. To address these issues, proposes an integrated tourism e-commerce platform for travel agencies and scenery administration bureaus as well as tourists to interact in a more smooth way; this platform is constructed upon J2EE framework, provides online collaboration & coordination for companies and information services (such as self-navigation using Google Map etc) for tourists. A running implementation of this platform has been put into real business for a small travel company.

  14. Informatics competencies for healthcare professionals: the Technology Informatics Guiding Education Reform (TIGER) Initiative model.

    PubMed

    Hebda, Toni L; Calderone, Terri L

    2012-01-01

    A growing awareness exists that informatics competencies are essential skills for healthcare professionals today, yet the development of these competencies lags behind the need. The Technology Informatics Guiding Education Reform (TIGER) Initiative represents a comprehensive, interdisciplinary effort that is well suited to the integration of informatics into education, practice, administration, and research environments. This article briefly discusses the background and significance of the TIGER Initiative and why it may be used as a model to instill informatics among the healthcare professionals globally.

  15. Integration of mass drug administration programmes in Nigeria: The challenge of schistosomiasis.

    PubMed Central

    Richards, Frank O.; Eigege, Abel; Miri, Emmanuel S.; Jinadu, M. Y.; Hopkins, Donald R.

    2006-01-01

    PROBLEM: Annual mass drug administration (MDA) with safe oral anthelminthic drugs (praziquantel, ivermectin and albendazole) is the strategy for control of onchocerciasis, lymphatic filariasis (LF) and schistosomiasis. District health officers seek to integrate treatment activities in areas of overlapping disease endemicity, but they are faced with having to merge different programmatic guidelines. APPROACH: We proceeded through the three stages of integrated MDA implementation: mapping the distribution of the three diseases at district level; tailoring district training and logistics based on the results of the mapping exercises; and implementing community-based annual health education and mass treatment where appropriate. During the process we identified the "know-do" gaps in the MDA guidelines for each disease that prevented successful integration of these programmes. LOCAL SETTING: An integrated programme launched in 1999 in Plateau and Nasarawa States in central Nigeria, where all three diseases were known to occur. RELEVANT CHANGES: Current guidelines allowed onchocerciasis and LF activities to be integrated, resulting in rapid mapping throughout the two states, and states-wide provision of over 9.3 million combined ivermectin-albendazole treatments for the two diseases between 2000 and 2004. In contrast, schistosomiasis activities could not be effectively integrated because of the more restrictive guidelines, resulting in less than half of the two states being mapped, and delivery of only 701,419 praziquantel treatments for schistosomiasis since 1999. LESSONS LEARNED: Integration of schistosomiasis into other MDA programmes would be helped by amended guidelines leading to simpler mapping, more liberal use of praziquantel and the ability to administer praziquantel simultaneously with ivermectin and albendazole. PMID:16917658

  16. Structuring an integrated care system: interpreted through the enacted diversity of the actors involved—the case of a French healthcare network

    PubMed Central

    Grenier, Corinne

    2011-01-01

    Research question We are looking at the process of structuring an integrated care system as an innovative process that swings back and forth between the diversity of the actors involved, local aspirations and national and regional regulations. We believe that innovation is enriched by the variety of the actors involved, but may also be blocked or disrupted by that diversity. Our research aims to add to other research, which, when questioning these integrated systems, analyses how the actors involved deal with diversity without really questioning it. Case study The empirical basis of the paper is provided by case study analysis. The studied integrated care system is a French healthcare network that brings together healthcare professionals and various organisations in order to improve the way in which interventions are coordinated and formalised, in order to promote better detection and diagnosis procedures and the implementation of a care protocol. We consider this case as instrumental in developing theoretical proposals for structuring an integrated care system in light of the diversity of the actors involved. Results and discussion We are proposing a model for structuring an integrated care system in light of the enacted diversity of the actors involved. This model is based on three factors: the diversity enacted by the leaders, three stances for considering the contribution made by diversity in the structuring process and the specific leading role played by those in charge of the structuring process. Through this process, they determined how the actors involved in the project were differentiated, and on what basis those actors were involved. By mobilising enacted diversity, the leaders are seeking to channel the emergence of a network in light of their own representation of that network. This model adds to published research on the structuring of integrated care systems. PMID:21637706

  17. [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.

  18. 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

  19. 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.

  20. Healthcare is primary.

    PubMed

    Kumar, Raman

    2015-01-01

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

  1. Integrating mental health into primary care within the Veterans Health Administration.

    PubMed

    Post, Edward P; Metzger, Maureen; Dumas, Patricia; Lehmann, Laurent

    2010-06-01

    The Veterans Health Administration (VHA) has been undertaking a major transformational program of integrating collaborative mental health resources into primary care settings. Key components of the program include colocated collaborative care provided by mental health professionals; care management; and blended programs that combine elements of these two components, whose functions are highly complementary to each other. The program has grown since 2007 from an initiative implementing pilot programs at participating facilities, to a routine expectation of primary care within all VHA medical centers and large community-based outpatient clinics. The national program office supports this VHA initiative in multiple ways, including technical assistance to sites, program and policy development, dissemination of informational tools to facilitate continuous quality improvement, education and training, and partnerships with other existing and emerging VHA programs such as postdeployment health clinics and the patient-centered medical home.

  2. Sustainability in Primary Care and Mental Health Integration Projects in Veterans Health Administration

    PubMed Central

    Ford, James H.; Krahn, Dean; Oliver, Karen Anderson; Kirchner, JoAnn

    2015-01-01

    Objective To explore staff perceptions about sustainability, commitment to change, participation in change process, and information received about the change project within the Veterans Administration Primary Care and Mental Health Integration (PC-MHI) initiative and to examine differences from the Veterans Health Administration Mental Health Systems Redesign (MHSR) initiative. Data Sources Surveys of change team members involved in the Veterans Affairs PC-MHI and MHSR initiatives. Study Design One-way analysis of variance examined the relationship between commitment, participation and information, and sustainability. Differences in PC-MHI sustainability were explored by location and job classification. Staff sustainability perceptions were compared with MHSR results. Principal Findings Sustainability differed by staff discipline. Difference between MHSR and PC-MHI existed by job function and perceptions about the change benefits. Participation in the change process and information received about the change process were positively correlated with sustainability. Staff commitment to change was positively associated with staff perceptions about the benefits of change and staff attitudes toward change. Conclusions Sustainability is an important part of organizational change efforts. Change complexity seems to influence perception about sustainability and impacts staff perceptions about the benefits of change. These perceptions seem to be driven by the information received and opportunities to participate in the change process. Further research is needed to understand how information and participation influence sustainability and affect employee commitment to change. PMID:23011071

  3. Integration of Administrative, Clinical, and Environmental Data to Support the Management of Type 2 Diabetes Mellitus

    PubMed Central

    Dagliati, Arianna; Marinoni, Andrea; Cerra, Carlo; Decata, Pasquale; Chiovato, Luca; Gamba, Paolo; Bellazzi, Riccardo

    2015-01-01

    A very interesting perspective of “big data” in diabetes management stands in the integration of environmental information with data gathered for clinical and administrative purposes, to increase the capability of understanding spatial and temporal patterns of diseases. Within the MOSAIC project, funded by the European Union with the goal to design new diabetes analytics, we have jointly analyzed a clinical-administrative dataset of nearly 1.000 type 2 diabetes patients with environmental information derived from air quality maps acquired from remote sensing (satellite) data. Within this context we have adopted a general analysis framework able to deal with a large variety of temporal, geo-localized data. Thanks to the exploitation of time series analysis and satellite images processing, we studied whether glycemic control showed seasonal variations and if they have a spatiotemporal correlation with air pollution maps. We observed a link between the seasonal trends of glycated hemoglobin and air pollution in some of the considered geographic areas. Such findings will need future investigations for further confirmation. This work shows that it is possible to successfully deal with big data by implementing new analytics and how their exploration may provide new scenarios to better understand clinical phenomena. PMID:26630915

  4. Trends and challenges toward integration of traditional medicine in formal health-care system: Historical perspectives and appraisal of education curricula in Sub-Sahara Africa

    PubMed Central

    Innocent, Ester

    2016-01-01

    The population residing Sub-Sahara Africa (SSA) continues to suffer from communicable health problems such as HIV/AIDS, malaria, tuberculosis, and various neglected tropical as well as non-communicable diseases. The disease burden is aggravated by shortage of medical personnel and medical supplies such as medical devices and minimal access to essential medicine. For long time, human beings through observation and practical experiences learned to use different plant species that led to the emergence of traditional medicine (TM) systems. The ancient Pharaonic Egyptian TM system is one of the oldest documented forms of TM practice in Africa and the pioneer of world’s medical science. However, the medical practices diffused very fast to other continents being accelerated by advancement of technologies while leaving Africa lagging behind in the integration of the practice in formal health-care system. Challenging issues that drag back integration is the development of education curricula for training TM experts as the way of disseminating the traditional medical knowledge and practices imbedded in African culture. The few African countries such as Ghana managed to integrate TM products in the National Essential Medicine List while South Africa, Sierra Leone, and Tanzania have TM products being sold over the counters due to the availability of education training programs facilitated by research. This paper analyses the contribution of TM practice and products in modern medicine and gives recommendations that Africa should take in the integration process to safeguard the SSA population from disease burdens. PMID:27366358

  5. 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.

  6. Healthcare usage and economic impact of non-treated obesity in Italy: findings from a retrospective administrative and clinical database analysis

    PubMed Central

    Colao, Annamaria; Lucchese, Marcello; D'Adamo, Monica; Savastano, Silvia; Facchiano, Enrico; Veronesi, Chiara; Blini, Valerio; Degli Esposti, Luca

    2017-01-01

    Objectives Investigate the prevalence of obesity in Italy and examine its resource consumption and economic impact on the Italian national healthcare system (NHS). Design Retrospective, observational and real-life study. Setting Data from three health units from Northern (Bergamo, Lombardy), Central (Grosseto, Tuscany) and Southern (Naples, Campania) Italy. Participants All patients aged ≥18 years with at least one recorded body mass index (BMI) measurement between 1 January 2009 and 31 December 2012 were included. Interventions Information retrieved from the databases included primary care data, medical prescriptions, specialist consultations and hospital discharge records from 2009–2013. Costs associated with these data were also calculated. Data are presented for two time periods (1 year after BMI measurement and study end). Primary and secondary outcome measures Primary—to estimate health resources consumption and the associated economic impact on the Italian NHS. Secondary—the prevalence and characteristics of subjects by BMI category. Results 20 159 adult subjects with at least one documented BMI measurement. Subjects with BMI ≥30 kg/m2 were defined as obese. The prevalence of obesity was 22.2% (N=4471) and increased with age. At the 1-year observation period, obese subjects who did not receive treatment for their obesity experienced longer durations of hospitalisation (median length: 5 days vs 3 days), used more prescription drugs (75.0% vs 57.7%), required more specialised outpatient healthcare (mean number: 5.3 vs 4.4) and were associated with greater costs, primarily owing to prescription drugs and hospital admissions (mean annual cost per year per patient: €460.6 vs €288.0 for drug prescriptions, €422.7 vs € 279.2 for hospitalisations and €283.2 vs €251.7 for outpatient care), compared with normal weight subjects. Similar findings were observed for the period up to data cut-off (mean follow-up of 2.7

  7. Role Clarification Processes for Better Integration of Nurse Practitioners into Primary Healthcare Teams: A Multiple-Case Study

    PubMed Central

    D'Amour, Danielle; Contandriopoulos, Damien; Chouinard, Véronique; Dubois, Carl-Ardy

    2014-01-01

    Role clarity is a crucial issue for effective interprofessional collaboration. Poorly defined roles can become a source of conflict in clinical teams and reduce the effectiveness of care and services delivered to the population. Our objective in this paper is to outline processes for clarifying professional roles when a new role is introduced into clinical teams, that of the primary healthcare nurse practitioner (PHCNP). To support our empirical analysis we used the Canadian National Interprofessional Competency Framework, which defines the essential components for role clarification among professionals. A qualitative multiple-case study was conducted on six cases in which the PHCNP role was introduced into primary care teams. Data collection included 34 semistructured interviews with key informants involved in the implementation of the PHCNP role. Our results revealed that the best performing primary care teams were those that used a variety of organizational and individual strategies to carry out role clarification processes. From this study, we conclude that role clarification is both an organizational process to be developed and a competency that each member of the primary care team must mobilize to ensure effective interprofessional collaboration. PMID:25692039

  8. The argument for integrating vector control with multiple drug administration campaigns to ensure elimination of lymphatic filariasis

    PubMed Central

    Burkot, TR; Durrheim, DN; Melrose, WD; Speare, R; Ichimori, K

    2006-01-01

    Background There is a danger that mass drug administration campaigns may fail to maintain adequate treatment coverage to achieve lymphatic filariasis elimination. Hence, additional measures to suppress transmission might be needed to ensure the success of the Global Program for the Elimination of Lymphatic Filariasis. Discussion Vector control successfully eliminated lymphatic filariasis when implemented alone or with mass drug administration. Challenges to lymphatic filariasis elimination include uncertainty of the exact level and duration of microfilarial suppression required for elimination, the mobility of infected individuals, consistent non-participation of some infected individuals with mass drug administration, the possible development of anti-filarial drug resistance and treatment strategies in areas co-endemic with loasis. Integration of vector control with mass drug administration can address some of these challenges. The potential benefits of vector control would include: (1) the ability to suppress filariasis transmission without the need to identify all individual 'foci of infection'; (2) minimizing the risk of reestablishment of transmission from imported microfilaria positive individuals; and (3) decreasing the risk of dengue or malaria transmission where, respectively, Aedes or Anopheles are lymphatic filariasis vectors. Summary With adequate sustained treatment coverage, mass drug administration should meet the criteria for elimination of lymphatic filariasis. However, it may be difficult to sustain sufficiently high mass drug administration coverage to achieve lymphatic filariasis elimination in some areas, particularly, where Aedes species are the vectors. Since vector control was effective in controlling and even eliminating lymphatic filariasis transmission, integration of vector control with mass drug administration will ensure the sustainability of transmission suppression and thereby better ensure the success of national filariasis

  9. E pluribus unum: using group model building with many interdependent organizations to create integrated health-care networks.

    PubMed

    Pieters, Angèle; Akkermans, Henk; Franx, Arie

    2011-01-01

    This chapter reports on an action research case study of integrated obstetric care in the Netherlands. Efficient and patient-friendly patient flows through integrated care networks are of major societal importance. How to design and develop such interorganizational patient flows is still a nascent research area, especially when dealing with a large number (n>3) of stakeholders. We have shown that a modification of an existing method to support interorganizational collaboration by system dynamics-based group model building (GMB) (the Renga method, Akkermans, 2001) may be effective in achieving such collaboration.

  10. 76 FR 4725 - Apria Healthcare Customer Service Department; Fourteen Locations in Missouri Cameron, Cape...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-26

    ... Employment and Training Administration Apria Healthcare Customer Service Department; Fourteen Locations in... Healthcare, Customer Service Department, Thirteen Locations in Missouri: Cameron, Cape Girardeau, Columbia... Healthcare, Customer Service Department. The Clinton, Missouri location provided data entry services in...

  11. From Theory to Practice: Utilizing Integrative Seminars as Bookends to the Master of Public Administration Program of Study

    ERIC Educational Resources Information Center

    Stout, Margaret; Holmes, Maja Husar

    2013-01-01

    Integrative seminar style courses are most often used as an application-oriented capstone in place of a thesis or comprehensive exam requirement in Master of Public Administration (MPA) degree programs. This article describes and discusses the benefits of a unique approach of one National Association of Schools of Public Affairs and Administration…

  12. The Minneapolis Public School Administrators' Workshop Conference on Integration: St. John's University, August 16-18, 1972. An Evaluation.

    ERIC Educational Resources Information Center

    Faunce, R. W.; And Others

    "Humanizing our schools--preparation for development of integrated environments for learning" was the theme of this workshop conference for more than 250 Minneapolis Public School administrators. The goals of the conference were open communications on the topic of desegregation, discussions relevant to this topic, active involvement of…

  13. The Department of Veterans Health Administration Office of Nursing Service, "transforming nursing in a national healthcare system: an example of transformation in action".

    PubMed

    Wertenberger, Sydney; Chapman, Kathleen M; Wright-Brown, Salena

    2011-01-01

    The Department of Veterans Health Administration Office of Nursing Service has embarked on a multiyear transformational process, an example of which is the development of an organization-wide nursing handbook. The development of this handbook offered the opportunity to improve collaboration, redefine expectations and behavior, as well as prepare for the future of Nursing within the Veterans Health Administration. The lessons learned from this process have revolved around the themes of leadership skills for managing high-level change often in a virtual environment; constant collaboration; that the practice of nursing will continue to evolve on the basis of new evidence, technology, customer expectations, and resources; and that the process to accomplish this goal is powerful.

  14. Advanced cancer therapy by integrative antitumor actions via systemic administration of miR-499.

    PubMed

    Ando, Hidenori; Asai, Tomohiro; Koide, Hiroyuki; Okamoto, Ayaka; Maeda, Noriyuki; Tomita, Koji; Dewa, Takehisa; Minamino, Tetsuo; Oku, Naoto

    2014-05-10

    Previously, we developed tetraethylenepentamine-based polycation liposomes (TEPA-PCL) as a vector for the delivery of small RNAs. In the present research, we attempted tumor-targeted delivery of miR-499 via systemic administration and evaluated the potency of this system as a therapeutic strategy to treat cancer. Lipoplexes were formed by mixing cholesterol-grafted miR-499 (miR-499-C) with TEPA-PCL. Firstly, human umbilical endothelial cells (HUVECs) and Colon 26 NL-17 mouse carcinoma cells were transfected with these lipoplexes in vitro. The results showed that miR-499 had antiangiogenic effects on the HUVECs and suppressed the secretion of vascular endothelial growth factor (VEGF) from the Colon 26 NL-17 cells. In addition, the growth of the latter cells was inhibited by transfection with miR-499-C/TEPA-PCL. For in vivo delivery of miR-499 to tumors via systemic injection, miR-499-C/TEPA-PCL were decorated with Ala-Pro-Arg-Pro-Gly (APRPG) peptide-conjugated polyethylene glycol (PEG) to prepare APRPG-PEG-modified lipoplexes carrying miR-499 (APRPG-miR-499). APRPG-miR-499 were injected into tumor-bearing mice via a tail vein, and these lipoplexes accumulated sufficiently in both angiogenic vessels and cancer cells. In addition, the expression of miR-499-target proteins and VEGF in the tumor cells was clearly suppressed by the treatment with APRPG-miR-499. Finally, the therapeutic effect of miR-499 on tumor growth was evaluated in mice. The tumor growth was significantly inhibited by the intravenous injection of APRPG-miR-499 at such a low dose as 0.5mg/kg. These results suggest that miR-499 delivered by the present system has excellent potency to treat cancer via integrative anticancer actions.

  15. Balancing Team Integrity with Administrative Control in the Development and Management of Special Education Programs.

    ERIC Educational Resources Information Center

    Del-Val, Patricia B.; Griffin, Carol Lee

    The paper reviews the experiences of special education administrators in Quincy (MA) Public Schools regarding compliance with P.L. 94-142, the Education for All Handicapped Children Act. Noted are the decentralized model of Pupil Personnel Service Teams, the administrator's role in guiding teachers to set priorities in academic and vocational…

  16. Interoperative fundus image and report sharing in compliance with integrating the healthcare enterprise conformance and web access to digital imaging and communication in medicine persistent object protocol

    PubMed Central

    Wu, Hui-Qun; Lv, Zheng-Min; Geng, Xing-Yun; Jiang, Kui; Tang, Le-Min; Zhou, Guo-Min; Dong, Jian-Cheng

    2013-01-01

    AIM To address issues in interoperability between different fundus image systems, we proposed a web eye-picture archiving and communication system (PACS) framework in conformance with digital imaging and communication in medicine (DICOM) and health level 7 (HL7) protocol to realize fundus images and reports sharing and communication through internet. METHODS Firstly, a telemedicine-based eye care work flow was established based on integrating the healthcare enterprise (IHE) Eye Care technical framework. Then, a browser/server architecture eye-PACS system was established in conformance with the web access to DICOM persistent object (WADO) protocol, which contains three tiers. RESULTS In any client system installed with web browser, clinicians could log in the eye-PACS to observe fundus images and reports. Multipurpose internet mail extensions (MIME) type of a structured report is saved as pdf/html with reference link to relevant fundus image using the WADO syntax could provide enough information for clinicians. Some functions provided by open-source Oviyam could be used to query, zoom, move, measure, view DICOM fundus images. CONCLUSION Such web eye-PACS in compliance to WADO protocol could be used to store and communicate fundus images and reports, therefore is of great significance for teleophthalmology. PMID:24392341

  17. Bio-WiTel: A Low Power Integrated Wireless Telemetry System for Healthcare Applications in 401-406 MHz Band of MedRadio Spectrum.

    PubMed

    Srivastava, Abhishek; Sankar, Nithin; Chatterjee, Baibhab; Das, Devarshi; Ahmad, Meraj; Kukkundoor, Rakesh; Saraf, Vivek; Jayachandran, Ananthpadmanabhan; Sharma, Dinesh; Baghini, Maryam

    2016-12-14

    This paper presents a low power integrated wireless telemetry system (Bio-WiTel) for healthcare applications in 401- 406 MHz frequency band of Medical Device RadioCommunication (MedRadio) spectrum. In this work, necessary design considerations for telemetry system for short range (upto 3 m) communication of bio-signals are presented. These considerations greatly help in taking important design decisions, which eventually lead to a simple, low power, robust and reliable wireless system implementation. Transmitter (TX) and receiver (RX) of Bio-WiTel system have been fabricated in 180 nm mixed mode CMOS technology. While radiating -18 dBm output power to a 50 antenna, the packaged TX IC consumes 250 μW power in 100% on state from 1 V supply whereas the RX IC consumes 990 μW power from 1.8 V supply with a sensitivity of -75 dBm. Measurement results show that TX fulfils the spectral mask requirement at a maximum data rate of 72 kbps. The measured bit error rate of RX is less than 10-4 for a data rate of 200 kbps. The proposed Bio-WiTel system is tested successfully in home and hospital environments for the communication of electrocardiogram (ECG) and photoplethysmogram (PPG) signals at a data rate of 57.6 kbps with a measured BER of < 10-4 for a maximum distance of 3 m.

  18. Design and implementation of an application and associated services to support interdisciplinary medication reconciliation efforts at an integrated healthcare delivery network.

    PubMed

    Poon, Eric G; Blumenfeld, Barry; Hamann, Claus; Turchin, Alexander; Graydon-Baker, Erin; McCarthy, Patricia C; Poikonen, John; Mar, Perry; Schnipper, Jeffrey L; Hallisey, Robert K; Smith, Sandra; McCormack, Christine; Paterno, Marilyn; Coley, Christopher M; Karson, Andrew; Chueh, Henry C; Van Putten, Cheryl; Millar, Sally G; Clapp, Margaret; Bhan, Ishir; Meyer, Gregg S; Gandhi, Tejal K; Broverman, Carol A

    2006-01-01

    Confusion about patients' medication regimens during the hospital admission and discharge process accounts for many preventable and serious medication errors. Many organizations have begun to redesign their clinical processes to address this patient safety concern. Partners HealthCare, an integrated delivery network in Boston, Massachusetts, has answered this interdisciplinary challenge by leveraging its multiple outpatient electronic medical records (EMR) and inpatient computerized provider order entry (CPOE) systems to facilitate the process of medication reconciliation. This manuscript describes the design of a novel application and the associated services that aggregate medication data from EMR and CPOE systems so that clinicians can efficiently generate an accurate pre-admission medication list. Information collected with the use of this application subsequently supports the writing of admission and discharge orders by physicians, performance of admission assessment by nurses, and reconciliation of inpatient orders by pharmacists. Results from early pilot testing suggest that this new medication reconciliation process is well accepted by clinicians and has significant potential to prevent medication errors during transitions of care.

  19. Design and Implementation of an Application and Associated Services to Support Interdisciplinary Medication Reconciliation Efforts at an Integrated Healthcare Delivery Network

    PubMed Central

    Poon, Eric G.; Blumenfeld, Barry; Hamann, Claus; Turchin, Alexander; Graydon-Baker, Erin; McCarthy, Patricia C.; Poikonen, John; Mar, Perry; Schnipper, Jeffrey L.; Hallisey, Robert K.; Smith, Sandra; McCormack, Christine; Paterno, Marilyn; Coley, Christopher M.; Karson, Andrew; Chueh, Henry C.; Van Putten, Cheryl; Millar, Sally G.; Clapp, Margaret; Bhan, Ishir; Meyer, Gregg S.; Gandhi, Tejal K.; Broverman, Carol A.

    2006-01-01

    Confusion about patients’ medication regimens during the hospital admission and discharge process accounts for many preventable and serious medication errors. Many organizations have begun to redesign their clinical processes to address this patient safety concern. Partners HealthCare, an integrated delivery network in Boston, Massachusetts, has answered this interdisciplinary challenge by leveraging its multiple outpatient electronic medical records (EMR) and inpatient computerized provider order entry (CPOE) systems to facilitate the process of medication reconciliation. This manuscript describes the design of a novel application and the associated services that aggregate medication data from EMR and CPOE systems so that clinicians can efficiently generate an accurate pre-admission medication list. Information collected with the use of this application subsequently supports the writing of admission and discharge orders by physicians, performance of admission assessment by nurses, and reconciliation of inpatient orders by pharmacists. Results from early pilot testing suggest that this new medication reconciliation process is well accepted by clinicians and has significant potential to prevent medication errors during transitions of care. PMID:17114640

  20. Relationships between Western Area Power Administration`s power marketing program and hydropower operations at Salt Lake City area integrated projects

    SciTech Connect

    Veselka, T.D.; Folga, S.; Poch, L.A.

    1995-03-01

    This technical memorandum provides background information on the Western Area Power Administration (Western) and the physical characteristics of the Salt Lake City Area Integrated Projects (SLCA/IP) hydropower plants, which include the Colorado River Storage Project, the Rio Grande Project, and the Collbran Project. In addition, the history, electrical capacity, storage capacity, and flow restrictions at each dam are presented. An overview of Western`s current programs and services, including a review of statutory authorities, agency discretion, and obligations, is also provided. The variability of SLCA/IP hourly generation under various alternative marketing strategies and purchasing programs is discussed. The effects of Western`s services, such as area load control, outage assistance, and transmission, on SLCA/IP power plant operations are analyzed.

  1. An authentication scheme to healthcare security under wireless sensor networks.

    PubMed

    Hsiao, Tsung-Chih; Liao, Yu-Ting; Huang, Jen-Yan; Chen, Tzer-Shyong; Horng, Gwo-Boa

    2012-12-01

    In recent years, Taiwan has been seeing an extension of the average life expectancy and a drop in overall fertility rate, initiating our country into an aged society. Due to this phenomenon, how to provide the elderly and patients with chronic diseases a suitable healthcare environment has become a critical issue presently. Therefore, we propose a new scheme that integrates healthcare services with wireless sensor technology in which sensor nodes are employed to measure patients' vital signs. Data collected from these sensor nodes are then transmitted to mobile devices of the medical staff and system administrator, promptly enabling them to understand the patients' condition in real time, which will significantly improve patients' healthcare quality. As per the personal data protection act, patients' vital signs can only be accessed by authorized medical staff. In order to protect patients', the system administrator will verify the medical staff's identity through the mobile device using a smart card and password mechanism. Accordingly, only the verified medical staff can obtain patients' vital signs data such as their blood pressure, pulsation, and body temperature, etc.. Besides, the scheme includes a time-bounded characteristic that allows the verified staff access to data without having to have to re-authenticate and re-login into the system within a set period of time. Consequently, the time-bounded property also increases the work efficiency of the system administrator and user.

  2. Designing the future of healthcare.

    PubMed

    Fidsa, Gianfranco Zaccai

    2009-01-01

    This paper describes the application of a holistic design process to a variety of problems plaguing current healthcare systems. A design process for addressing complex, multifaceted problems is contrasted with the piecemeal application of technological solutions to specific medical or administrative problems. The goal of this design process is the ideal customer experience, specifically the ideal experience for patients, healthcare providers, and caregivers within a healthcare system. Holistic design is shown to be less expensive and wasteful in the long run because it avoids solving one problem within a complex system at the cost of creating other problems within that system. The article applies this approach to the maintenance of good health throughout life; to the creation of an ideal experience when a person does need medical care; to the maintenance of personal independence as one ages; and to the enjoyment of a comfortable and dignified death. Virginia Mason Medical Center is discussed as an example of a healthcare institution attempting to create ideal patient and caregiver experiences, in this case by applying the principles of the Toyota Production System ("lean manufacturing") to healthcare. The article concludes that healthcare is inherently dedicated to an ideal, that science and technology have brought it closer to that ideal, and that design can bring it closer still.

  3. Burnout among healthcare professionals.

    PubMed

    Wood, Ben D; Killion, Jeffrey B

    2007-01-01

    *From many accounts healthcare professionals are at increased risk for professional burnout. Professional burnout is generally described as prolonged stress that impairs one's ability to perform his or her job in demanding situations. *Precursors to professional burnout include, but are not limited to, employee workload, chronic fatigue, compassion fatigue, balance between family and career, sickness absence, and loss of confidence. *Administrators must watch for early signs of professional burnout to improve retention and promote employee morale. To reduce professional burnout, administrators must implement strategies to reduce burnout while also promoting productivity. *When professional burnout occurs, management must consider each employee's generational differences. All generations have differing values, beliefs, and opinions that influence his or her work ethic in regard to employee productivity.

  4. Childhood wheezing syndromes and healthcare data.

    PubMed

    Kozyrskyj, Anita L; Mustard, Cameron A; Becker, Allan B

    2003-08-01

    There is convincing evidence that several distinct wheezing syndromes exist in childhood. The purpose of this research was to assess the potential of using healthcare utilization profiles to identify wheezing syndromes in children which are distinct from asthma. Using population-based healthcare administrative data, a cohort of children, aged 5-15 years, with bronchitis diagnoses from time of birth to 1995, but no physician diagnoses of asthma, was followed over the period January 1996-March 1998. In this follow-up period, 13% had subsequent healthcare utilization for asthma, 23% had continued healthcare utilization for bronchitis, and 64% had no further healthcare utilization. The likelihood of bronchitis vs. asthma outcomes was determined for a variety of asthma risk factors. In a cohort of 11,043 children with initial healthcare contact for bronchitis but not asthma, two potentially distinct entities of bronchitis emerged from our data: 1) transient bronchitis, similar to transient wheezing of early childhood, which was associated with winter-only healthcare utilization and absence of allergy, and 2) recurrent bronchitis which differed from asthma on the basis of winter-only healthcare utilization, prematurity at birth, absence of allergy, and low socioeconomic status. Healthcare administrative records can be used to describe the natural history of wheezing in children and to identify markers which may discriminate asthma from other syndromes.

  5. The Integration Process for Incorporating Nuclear Explosion Monitoring Research Results into the National Nuclear Security Administration Knowledge Base

    SciTech Connect

    GALLEGOS, DAVID P.; CARR, DORTHE B.; HERRINGTON, PRESTON B.; HARRIS, JAMES M.; EDWARDS, C.L.; TAYLOR, STEVEN R.; WOGMAN, NED A.; ANDERSON, DALE N.; CASEY, LESLIE A.

    2002-09-01

    The process of developing the National Nuclear Security Administration (NNSA) Knowledge Base (KB) must result in high-quality Information Products in order to support activities for monitoring nuclear explosions consistent with United States treaty and testing moratoria monitoring missions. The validation, verification, and management of the Information Products is critical to successful scientific integration, and hence, will enable high-quality deliveries to be made to the United States National Data Center (USNDC) at the Air Force Technical Applications Center (AFTAC). As an Information Product passes through the steps necessary to become part of a delivery to AFTAC, domain experts (including technical KB Working Groups that comprise NNSA and DOE laboratory staff and the customer) will provide coordination and validation, where validation is the determination of relevance and scientific quality. Verification is the check for completeness and correctness, and will be performed by both the Knowledge Base Integrator and the Scientific Integrator with support from the Contributor providing two levels of testing to assure content integrity and performance. The Information Products and their contained data sets will be systematically tracked through the integration portion of their life cycle. The integration process, based on lessons learned during its initial implementations, is presented in this report.

  6. Leading Teams of Higher Education Administrators: Integrating Goal Setting, Team Role, and Team Life Cycle Theories

    ERIC Educational Resources Information Center

    Posthuma, Richard; Al-Riyami, Said

    2012-01-01

    Leaders of higher education institutions can create top management teams of academic administrators to guide and improve their organizations. This study illustrates how the leadership of top management teams can be accomplished successfully through a combination of goal setting (Doran, 1981; Locke & Latham, 1990), understanding of team roles…

  7. Administrative Integration of Information Resources and Services in Universities in Canada and the United States.

    ERIC Educational Resources Information Center

    Howard, Helen A.

    Eight Canadian and U.S. universities that have combined several information services under one administrator were studied. These services include the library and one or more other information handling functions such as audiovisual services, technical aids to instruction, computing services, telecommunications, bookstore, artistic properties,…

  8. A Rural Hospice Program: Integrating Social Work Administration, Program Planning, and Direct Services.

    ERIC Educational Resources Information Center

    Wood, Julie E.

    1986-01-01

    Describes multifacted role of a social worker in establishing a rural hospice care program in Cottage Grove, Oregon, a community of 8,000 inhabitants. Discusses program development, planning, coordination, and administration; problem identification and needs assessment; volunteer training; and client assessment and direct services. (NEC)

  9. Professional Integrity in Higher Education: A Study of Administrative Staff Ethics in Student Affairs

    ERIC Educational Resources Information Center

    Reybold, L. Earle; Halx, Mark D.; Jimenez, Anne L.

    2008-01-01

    This study examined administrative staff perceptions of professional ethics in a student affairs division at one university. In-depth interviews were conducted with 12 staff members (six assistant/associate vice presidents and six directors) and analyzed using the constant comparative method. Participants described three dimensions of professional…

  10. Supporting Comprehensive, Integrated, Three-Tiered Models of Prevention in Schools: Administrators' Perspectives

    ERIC Educational Resources Information Center

    Lane, Kathleen Lynne; Carter, Erik W.; Jenkins, Abbie; Dwiggins, Lauren; Germer, Kathryn

    2015-01-01

    We report findings from a statewide survey of 365 site-level administrators developed to (a) learn about the extent to which schools across the state were implementing components of multi-tiered systems of support and (b) determine the areas in which these schools might need professional development or resources to support them. At least half of…

  11. Utilizing Multiple Frameworks To Integrate Knowledge and Experience in Educational Administration Preparation Programs.

    ERIC Educational Resources Information Center

    Reitzug, Ulrich C.

    An argument for teaching vision development and clarification in educational administration programs through the use of multiple conceptual frameworks is presented in this paper. A review of two conceptual frameworks--reflective practice and leadership forces--concludes that vision, a key ingredient of effective leadership, must be more thoroughly…

  12. Healthcare Practitioners' Personal and Professional Values

    ERIC Educational Resources Information Center

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

    2016-01-01

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

  13. 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.

  14. Direct to consumer advertising in healthcare: history, benefits, and concerns.

    PubMed

    Adeoye, Sanjo; Bozic, Kevin J

    2007-04-01

    Physicians, health plans, hospitals, pharmaceutical companies, and medical device manufacturers have all recognized the benefits of marketing their products and services directly to the end user. As a result, there has been tremendous growth of direct-to-consumer advertising (DTCA), illustrated by the increase in spending on DTCA related to prescription drugs from an estimated $55 million in 1991 to $3.2 billion in 2003. This increase in DTCA has sparked vigorous debate among the major stakeholders in healthcare over the benefits and drawbacks of advertising directly to the healthcare consumer. Issues with DTCA include its impact on the doctor-patient relationship, patient education, inappropriate resource utilization, healthcare costs, healthcare quality, and overall patient wellbeing. Orthopaedic surgery is no longer insulated from this expanding trend in DTCA, as orthopaedic surgeons and hospitals are responsible for a substantial portion of DTCA related to orthopaedic devices and procedures. The Food and Drug Administration has a limited regulatory role and limited power related to DTCA due to considerable inefficiencies in its review and disciplinary processes. Therefore, physicians, including orthopaedic surgeons, must take a leadership role on this issue to ensure the integrity of information provided to patients and to protect the sanctity of the doctor-patient relationship.

  15. Pharmacokinetic-pharmacodynamic integration of danofloxacin after intravenous, intramuscular and subcutaneous administration to rabbits.

    PubMed

    Fernández-Varón, E; Marin, P; Escudero, E; Vancraeynest, D; Cárceles, C M

    2007-02-01

    The pharmacokinetics of danofloxacin was studied following intravenous (i.v.), intramuscular (i.m.) and subcutaneous (s.c.) administration of 6 mg/kg to healthy rabbits. Danofloxacin concentration were determined by high-performance liquid chromatography assay with fluorescence detection. Minimal inhibitory concentrations (MICs) assay of danofloxacin against 30 strains of Staphylococcus aureus from several European countries was performed in order to compute pharmacodynamic surrogate markers. The danofloxacin plasma concentration versus time data after i.v. administration could best be described by a two-compartment open model. The disposition of i.m. and subcutaneously administered danofloxacin was best described by a one-compartment model. The terminal half-life for i.v., i.m. and s.c. routes was 4.88, 6.70 and 8.20 h, respectively. Clearance value after i.v. dosing was 0.76 L/kg.h. After i.m. administration, the absolute bioavailability was mean (+/-SD) 102.34 +/- 5.17% and the Cmax was 1.87 mg/L. After s.c. administration, the absolute bioavailability was mean (+/-SD) 96.44 +/- 5.95% and the Cmax was 1.79 mg/L. Danofloxacin shows a favourable pharmacokinetics profile in rabbits reflected by parameters such as a long half-life and a high bioavailability. However, in consideration of the low AUC/MIC indices obtained, its use by i.m. and s.c. route against the S. aureus strains assayed in this study cannot be recommended given the risk for selection of first mutant subpopulations.

  16. Academic Integrity and Student Development: Legal Issues and Policy Perspectives: The Higher Education Administration Series.

    ERIC Educational Resources Information Center

    Kibler, William L.; And Others

    This book addresses policy and legal issues for colleges and universities interested in developing comprehensive programs to respond to academic integrity issues. It is divided into four sections. The first section defines academic dishonesty, provides a contemporary context for the issue, describes the scope of the problem, and considers reasons…

  17. Achieving Medical Currency via Selected Staff Integration in Civilian and Veterans Administration Medical Facilities

    DTIC Science & Technology

    2012-10-01

    the AFMS at a higher volume location before finally shifting to a smaller facility. The integration of doctors, nurses , and technicians into this...cycle is desirable, but existing professional certification requirements, labor union concerns, and scope of practice differences involving the nursing ...Royal Medical Service (RMS) medical specialist officers (surgeons, anesthetists , and medical subspecialists) enjoy a practice that produces reliable

  18. Barriers to healthcare coordination in market-based and decentralized public health systems: a qualitative study in healthcare networks of Colombia and Brazil.

    PubMed

    Vargas, Ingrid; Mogollón-Pérez, Amparo Susana; De Paepe, Pierre; Ferreira da Silva, Maria Rejane; Unger, Jean-Pierre; Vázquez, María-Luisa

    2016-07-01

    Although integrated healthcare networks (IHNs) are promoted in Latin America in response to health system fragmentation, few analyses on the coordination of care across levels in these networks have been conducted in the region. The aim is to analyse the existence of healthcare coordination across levels of care and the factors influencing it from the health personnel' perspective in healthcare networks of two countries with different health systems: Colombia, with a social security system based on managed competition and Brazil, with a decentralized national health system. A qualitative, exploratory and descriptive-interpretative study was conducted, based on a case study of healthcare networks in four municipalities. Individual semi-structured interviews were conducted with a three stage theoretical sample of (a) health (112) and administrative (66) professionals of different care levels, and (b) managers of providers (42) and insurers (14). A thematic content analysis was conducted, segmented by cases, informant groups and themes. The results reveal poor clinical information transfer between healthcare levels in all networks analysed, with added deficiencies in Brazil in the coordination of access and clinical management. The obstacles to care coordination are related to the organization of both the health system and the healthcare networks. In the health system, there is the existence of economic incentives to compete (exacerbated in Brazil by partisan political interests), the fragmentation and instability of networks in Colombia and weak planning and evaluation in Brazil. In the healthcare networks, there are inadequate working conditions (temporary and/or part-time contracts) which hinder the use of coordination mechanisms, and inadequate professional training for implementing a healthcare model in which primary care should act as coordinator in patient care. Reforms are needed in these health systems and networks in order to modify incentives, strengthen

  19. Barriers to healthcare coordination in market-based and decentralized public health systems: a qualitative study in healthcare networks of Colombia and Brazil

    PubMed Central

    Vargas, Ingrid; Mogollón-Pérez, Amparo Susana; De Paepe, Pierre; Ferreira da Silva, Maria Rejane; Unger, Jean-Pierre; Vázquez, María-Luisa

    2016-01-01

    Although integrated healthcare networks (IHNs) are promoted in Latin America in response to health system fragmentation, few analyses on the coordination of care across levels in these networks have been conducted in the region. The aim is to analyse the existence of healthcare coordination across levels of care and the factors influencing it from the health personnel’ perspective in healthcare networks of two countries with different health systems: Colombia, with a social security system based on managed competition and Brazil, with a decentralized national health system. A qualitative, exploratory and descriptive–interpretative study was conducted, based on a case study of healthcare networks in four municipalities. Individual semi-structured interviews were conducted with a three stage theoretical sample of (a) health (112) and administrative (66) professionals of different care levels, and (b) managers of providers (42) and insurers (14). A thematic content analysis was conducted, segmented by cases, informant groups and themes. The results reveal poor clinical information transfer between healthcare levels in all networks analysed, with added deficiencies in Brazil in the coordination of access and clinical management. The obstacles to care coordination are related to the organization of both the health system and the healthcare networks. In the health system, there is the existence of economic incentives to compete (exacerbated in Brazil by partisan political interests), the fragmentation and instability of networks in Colombia and weak planning and evaluation in Brazil. In the healthcare networks, there are inadequate working conditions (temporary and/or part-time contracts) which hinder the use of coordination mechanisms, and inadequate professional training for implementing a healthcare model in which primary care should act as coordinator in patient care. Reforms are needed in these health systems and networks in order to modify incentives

  20. Pharmacokinetic-pharmacodynamic integration of orbifloxacin in rabbits after intravenous, subcutaneous and intramuscular administration.

    PubMed

    Marín, P; Fernández-Varón, E; Escudero, E; Vancraeynest, D; Cárceles, C M

    2008-02-01

    The single-dose disposition kinetics of orbifloxacin were determined in clinically normal rabbits (n=6) after intravenous (i.v.), subcutaneous (s.c.) and intramuscular (i.m.) administration of 5 mg/kg bodyweight. Orbifloxacin concentrations were determined by high performance liquid chromatography with fluorescence detection. Minimal inhibitory concentrations (MICs) assay of orbifloxacin against 30 strains of Staphylococcus aureus from several European countries was performed in order to compute pharmacodynamic surrogate markers. The concentration-time data were analysed by compartmental and noncompartmental kinetic methods. Steady-state volume of distribution (V(ss)) and total body clearance (Cl) of orbifloxacin after i.v. administration were estimated to be 1.71+/-0.38 L/kg and 0.91+/-0.20 L/h x kg, respectively. Following s.c. and i.m. administration orbifloxacin achieved maximum plasma concentrations of 2.95+/-0.82 and 3.24+/-1.33 mg/L at 0.67+/-0.20 and 0.65+/-0.12 h, respectively. The absolute bio-availabilities after s.c. and i.m. routes were 110.67+/-11.02% and 109.87+/-8.36%, respectively. Orbifloxacin showed a favourable pharmacokinetic profile in rabbits. However, on account of the low AUC/MIC and C(max)/MIC indices obtained, its use by i.m. and s.c. routes against the S. aureus strains assayed in this study cannot be recommended given the risk of selection of resistant populations.

  1. Health informatics and analytics - building a program to integrate business analytics across clinical and administrative disciplines.

    PubMed

    Tremblay, Monica Chiarini; Deckard, Gloria J; Klein, Richard

    2016-07-01

    Health care organizations must develop integrated health information systems to respond to the numerous government mandates driving the movement toward reimbursement models emphasizing value-based and accountable care. Success in this transition requires integrated data analytics, supported by the combination of health informatics, interoperability, business process design, and advanced decision support tools. This case study presents the development of a master's level cross- and multidisciplinary informatics program offered through a business school. The program provides students from diverse backgrounds with the knowledge, leadership, and practical application skills of health informatics, information systems, and data analytics that bridge the interests of clinical and nonclinical professionals. This case presents the actions taken and challenges encountered in navigating intra-university politics, specifying curriculum, recruiting the requisite interdisciplinary faculty, innovating the educational format, managing students with diverse educational and professional backgrounds, and balancing multiple accreditation agencies.

  2. Improved surgical mesh integration into the rat abdominal wall with arginine administration.

    PubMed

    Arbos, M A; Ferrando, J M; Quiles, M T; Vidal, J; López-Cano, M; Gil, J; Manero, J M; Peña, J; Huguet, P; Schwartz-Riera, S; Reventós, J; Armengol, M

    2006-02-01

    Prosthetic meshes are used as the standard of care in abdominal wall hernia repair. However, hernia recurrences and side effects remain unsolved problems. The demand by health care providers for increasingly efficient and cost-effective surgery encourages the development of newer strategies to improve devices and outcomes. Here, we evaluated whether l-arginine administration was able to ameliorate long-term polypropylene prostheses incorporation into the abdominal wall of Sprague-Dawley rats. Meshes were placed on-lay and continuous l-arginine was administered. In vivo biocompatibility was studied at 7, 25 and 30 days post-implantation. Effectively, l-arginine administration in combination with mesh triggered subtle changes in ECM composition that impinged on critical biochemical and structural features. Lastly, tensile strength augmented and stiffness decreased over the control condition. This could help to restructure the mechanical load transfer from the implant to the brittle surrounding tissues, i.e., impact load and fatigue load associated with mechanical tensions could be distributed between the mesh and the restored tissue in a more balanced manner, and ultimately help to reduce the incidence of loosening, recurrences, and local wound complications. Since the newly formed tissue is more mechanically stable, this approach could eventually be introduced to human hernia repair.

  3. THE DESIGN OF PERFORMANCE MONITORING SYSTEMS IN HEALTHCARE ORGANIZATIONS: A STAKEHOLDER PERSPECTIVE.

    PubMed

    Rouhana, Rima E; Van Caillie, Didier

    2016-01-01

    Monitoring hospitals performance is evolving over time in search of more efficiency by integrating additional levels of care, reducing costs and keeping staff up-to-date. To fulfill these three potentially divergent aspects and to monitor performance, healthcare administrators are using dissimilar management control tools. To explain why, we suggest to go beyond traditional contingent factors to assess the role of the different stakeholders that are at the heart of any healthcare organization. We rely first on seminal studies to appraise the role of the main healthcare players and their influence on some organizational attributes. We then consider the managerial awareness and the perception of a suitable management system to promote a strategy-focused organization. Our methodology is based on a qualitative approach of twenty-two case studies, led in two heterogeneous environments (Belgium and Lebanon), comparing the managerial choice of a management system within three different healthcare organizational structures. Our findings allow us to illustrate, for each healthcare player, his positioning within the healthcare systems. Thus, we define how his role, perception and responsiveness manipulate the organization's internal climate and shape the design of the performance monitoring systems. In particular, we highlight the managerial role and influence on the choice of an adequate management system.

  4. Pharmacokinetics and pharmacokinetic/pharmacodynamic integration of marbofloxacin after intravenous and intramuscular administration in beagle dogs.

    PubMed

    Yohannes, Sileshi; Awji, Elias Gebru; Lee, Seung-Jin; Park, Seung-Chun

    2015-03-01

    1.The aim of the present study was to determine the PKs of marbofloxacin in beagle dogs after intravenous (i.v.) and intramuscular (i.m.) administration, the ex vivo and in vitro PK/PD indices of marbofloxacin against clinical isolates of Staphylococcus pseudintermedius, and the ex vivo AUC/MIC ratios associated with different levels of antibacterial activity. 2.After i.v. of marbofloxacin (2 mg/kg), the mean ± SEM values of AUC, t1/2β, Vss, and CL were 8.47 ± 3.51 h µg/mL, 8.08 ± 6.25 h, 2.32 ± 1.00 L/kg and 0.23 ± 0.06 L/kg/h and corresponding values after intramuscular injection were 11.37 ± 3.07 h µg/mL, 7.51 ± 3.70, 1.80 ± 0.90 L/kg and 0.17 ± 0.04 L/kg/h. After i.m. administration, a Cmax of 1.76 ± 0.09 µg/mL was achieved at Tmax of 0.47 ± 0.08 h. The ex-vivo AUC/MIC ratios required to produce bacteriostasis, bactericidal action and elimination of S. pseudintermedius were 65.03, 97.02 and 136.84 h. 3.The in vivo AUC/MIC ratios obtained after i.v. and i.m. administration of 2 mg/kg marbofloxacin (67.76 ± 1.23 and 91.18 ± 2.61) were below the ex vivo AUC/MIC ratios required for bactericidal activity and bacterial elimination (97.02 ± 9.24 2 mg/kg and 136.21 ± 7.58), suggesting that the recommended daily dosage (2 mg/kg) may not suffice to kill and eradicate S. pseudintermedius strains encountered in clinical area.

  5. Oral versus intramuscular administration of vitamin B12 for the treatment of patients with vitamin B12 deficiency: a pragmatic, randomised, multicentre, non-inferiority clinical trial undertaken in the primary healthcare setting (Project OB12)

    PubMed Central

    2012-01-01

    Background The oral administration of vitamin B12 offers a potentially simpler and cheaper alternative to parenteral administration, but its effectiveness has not been definitively demonstrated. The following protocol was designed to compare the effectiveness of orally and intramuscularly administered vitamin B12 in the treatment of patients ≥65 years of age with vitamin B12 deficiency. Methods/design The proposed study involves a controlled, randomised, multicentre, parallel, non-inferiority clinical trial lasting one year, involving 23 primary healthcare centres in the Madrid region (Spain), and patients ≥65 years of age. The minimum number of patients required for the study was calculated as 320 (160 in each arm). Bearing in mind an estimated 8-10% prevalence of vitamin B12 deficiency among the population of this age group, an initial sample of 3556 patients will need to be recruited. Eligible patients will be randomly assigned to one of the two treatment arms. In the intramuscular treatment arm, vitamin B12 will be administered as follows: 1 mg on alternate days in weeks 1 and 2, 1 mg/week in weeks 3–8,and 1 mg/month in weeks 9–52. In the oral arm, the vitamin will be administered as: 1 mg/day in weeks 1–8 and 1 mg/week in weeks 9–52. The main outcome variable to be monitored in both treatment arms is the normalisation of the serum vitamin B12 concentration at weeks 8, 26 and 52; the secondary outcome variables include the serum concentration of vitamin B12 (in pg/ml), adherence to treatment, quality of life (EuroQoL-5D questionnaire), patient 3satisfaction and patient preferences. All statistical tests will be performed with intention to treat and per protocol. Logistic regression with random effects will be used to adjust for prognostic factors. Confounding factors or factors that might alter the effect recorded will be taken into account in analyses. Discussion The

  6. 78 FR 44582 - Notice of HUD-Held Multifamily & Healthcare Loan Sale, (MHLS 2013-2)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-24

    ... URBAN DEVELOPMENT Notice of HUD-Held Multifamily & Healthcare Loan Sale, (MHLS 2013-2) AGENCY: Office of... healthcare mortgage loans, without Federal Housing Administration (FHA) insurance, in a competitive auction... healthcare mortgage loans (Mortgage Loans) secured by four (4) healthcare properties located in Texas...

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

    NASA Astrophysics Data System (ADS)

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

    2003-05-01

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

  8. Pharmacokinetic-pharmacodynamic integration of moxifloxacin in rabbits after intravenous, intramuscular and oral administration.

    PubMed

    Fernández-Varón, E; Bovaira, M J; Espuny, A; Escudero, E; Vancraeynest, D; Cárceles, C M

    2005-08-01

    The pharmacokinetics of moxifloxacin was studied following intravenous (i.v.), intramuscular (i.m.) and oral dose of 5 mg/kg to healthy white New Zealand rabbits (n = 6). Moxifloxacin concentrations were determined by HPLC assay with fluorescence detection. The moxifloxacin plasma concentration vs. time data after i.v. administration could best be described by a two-compartment open model. The disposition of i.m. and orally administered moxifloxacin was best described by a one-compartment model. The plasma moxifloxacin clearance (Cl) for the i.v route was (mean +/- SD) 0.80 +/- 0.02 L/h.kg. The steady-state volume of distribution (Vss) was 1.95 +/- 0.18 L/kg. The terminal half-life (t(1/2lambdaz)) was (mean +/- SD) 1.84 +/- 0.12, 2.09 +/- 0.05 and 2.15 +/- 0.07 h after i.v., i.m. and oral, respectively. Minimal inhibitory concentration (MIC) assays of moxifloxacin against different strains of S. aureus were performed in order to compute pharmacodynamic surrogate markers. From these data, it is concluded that a 5 mg/kg dose moxifloxacin would be effective by i.m. and oral routes in rabbits against bacterial isolates with MIC < or = 0.06 microg/mL and possibly for MIC < or = 0.12 microg/mL, but in the latter case a higher dose would be required.

  9. Costs of Integrated Mass Drug Administration for Neglected Tropical Diseases in Haiti

    PubMed Central

    Goldman, Ann S.; Brady, Molly A.; Direny, Abdel; Desir, Luccene; Oscard, Roland; Vely, Jean-Francois; Linehan, Mary; Baker, Margaret

    2011-01-01

    We conducted a cost analysis of Haiti's Ministry of Public Health and Population neglected tropical disease program, Projet des Maladies Tropicales Negligées and collected data for 9 of 55 communes participating in the May 2008–April 2009 mass drug administration (MDA). The Projet des Maladies Tropicales Negligées Program partnered with IMA World Health and Hôpital Ste. Croix to implement MDA for treatment of lymphatic filariasis and soil-transmitted helminthiasis by using once a year treatment with albendazole and diethylcarbamazine in a population of approximately 8 million persons. Methods included analyzing partner financial records and conducting retrospective surveys of personnel. In the nine communes, 633,261 persons were treated at a cost of U.S. $0.64 per person, which included the cost of donated drugs, and at a cost of U.S. $0.42 per person treated, when excluding donated drug costs. The MDA for lymphatic filariasis in Haiti began in 2000, with the treatment of 105,750 persons at a cost per person of U.S. $2.23. The decrease in cost per person treated is the result of cumulative implementation experience and economies of scale. PMID:22049035

  10. Clinical experiences of collaborative imaging diagnosis in Shanghai district healthcare services

    NASA Astrophysics Data System (ADS)

    Zhang, Kai; Ling, Tonghui; Yang, Yuanyuan; Sun, Jianyong; Wang, Mingqing; Zhang, Jianguo

    2016-03-01

    To improve healthcare service quality with balancing healthcare resources between large and small hospitals, as well as reducing costs, each district health administration in Shanghai with more than 24 million citizens has built image-enabled electronic healthcare records (iEHR) system to share patient medical records and encourage patients to visit small hospitals for initial evaluations and preliminary diagnoses first, then go to large hospitals to have better specialists' services. We implemented solution for iEHR systems, based on the IHE XDS-I integration profile and installed the systems in more than 100 hospitals cross three districts in Shanghai and one city in Jiangsu Province in last few years. Here, we give operational results of these systems in these four districts and evaluated the performance of the systems in servicing the regional collaborative imaging diagnosis.

  11. Veterans Health Administration mentoring model for new nurse executives.

    PubMed

    Weiss, Lizabeth M; Williams, Carol A; Wetzel, Donald E; Drake, Audrey C; Cumberlander, Lula B; Gordon, Cynthia L

    2008-01-01

    A nurse executive mentoring program was implemented through the Veterans Health Administration Office of Nursing Service to standardize orientation and increase retention rates in this vital healthcare role. The Veterans Health Administration system has 154 nurse executives throughout the United States with 74% eligible for retirement. This mentoring program is intended to support the integration of new appointees into the nurse executive role. The program has produced a written resource to support effective functioning in the role. The program includes a leader skills self-assessment to evaluate the leadership style and assist with senior leadership team integration.

  12. Implementation of Content and Language Integrated Learning (CLIL) Programmes in Public Administration: Russian Students' and Matriculants' Opinion about Their First CLIL Experience

    ERIC Educational Resources Information Center

    Rubtcova, Mariia; Kaisarova, Valentina

    2016-01-01

    Content and Language Integrated Learning (CLIL) is a pedagogic approach that has developed in response to the demand for integrating education in both school/university subjects and language skills. Our paper is devoted to the implementation of CLIL programmes in Public Administration within a particular sociolinguistic context: that of Russian…

  13. Globalization of healthcare.

    PubMed

    2012-05-01

    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.

  14. 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

  15. Fraud Detection in Healthcare

    SciTech Connect

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

    2015-01-01

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

  16. 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…

  17. National Oceanic and Atmospheric Administration's Cetacean and Sound Mapping Effort: Continuing Forward with an Integrated Ocean Noise Strategy.

    PubMed

    Harrison, Jolie; Ferguson, Megan; Gedamke, Jason; Hatch, Leila; Southall, Brandon; Van Parijs, Sofie

    2016-01-01

    To help manage chronic and cumulative impacts of human activities on marine mammals, the National Oceanic and Atmospheric Administration (NOAA) convened two working groups, the Underwater Sound Field Mapping Working Group (SoundMap) and the Cetacean Density and Distribution Mapping Working Group (CetMap), with overarching effort of both groups referred to as CetSound, which (1) mapped the predicted contribution of human sound sources to ocean noise and (2) provided region/time/species-specific cetacean density and distribution maps. Mapping products were presented at a symposium where future priorities were identified, including institutionalization/integration of the CetSound effort within NOAA-wide goals and programs, creation of forums and mechanisms for external input and funding, and expanded outreach/education. NOAA is subsequently developing an ocean noise strategy to articulate noise conservation goals and further identify science and management actions needed to support them.

  18. National Aeronautics and Space Administration (NASA) Environmental Control and Life Support (ECLS) Integrated Roadmap Development

    NASA Technical Reports Server (NTRS)

    Metcalf, Jordan; Peterson, Laurie; Carrasquillo, Robyn; Bagdigian, Robert

    2011-01-01

    investments for longer duration missions The final product of this paper is an agreed-to ECLSS roadmap detailing ground and flight testing to support the three mission scenarios previously mentioned. This information will also be used to develop the integrated NASA budget submit in January 2012.

  19. Mental healthcare for rural seniors. An outreach program in Cedar Rapids, IA, uses an integrated approach to break down barriers to care.

    PubMed

    Smith, M; Buckwalter, K C

    1993-03-01

    Several barriers prevent elderly persons, especially those living in rural areas, from receiving mental health services. The Abbe Center for Community Mental Health is breaking down some of these barriers in the Cedar Rapids, IA, area. The center's Elderly Outreach Project identifies and provides mental health services to the area's rural elderly. A multidisciplinary team (psychiatrist, nurse, and social worker) assesses and treats home-bound clients. Four major barriers prevent seniors from using traditional mental healthcare services: A lack of trained professionals. Because many professionals have not received training in geriatrics, those working with elderly clients should be encouraged to attend educational conferences to fill gaps in their knowledge. Organizational barriers. Transportation and cost may prohibit elderly persons from seeking mental healthcare. Facilities must revise policies detrimental to clients' well-being. Ageism. Many elderly persons have internalized negative and incorrect beliefs about what aging is or should be. Education about "normal" aging is essential. Stigma. The stigma of mental illness is particularly troublesome. Services such as in-home counseling allow clients to get the help they need while keeping their mental illness confidential. To eliminate the barriers to mental healthcare, increased financial resources are necessary to develop, implement, and maintain innovative programs that can reach frail, isolated, hard-to-find persons in need of mental health, medical, and social services.

  20. 78 FR 59366 - Multifamily, Healthcare Facilities, and Hospital Mortgage Insurance Premiums for Fiscal Year (FY...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-26

    ... URBAN DEVELOPMENT Multifamily, Healthcare Facilities, and Hospital Mortgage Insurance Premiums for... insurance premiums (MIPs) for Federal Housing Administration (FHA) Multifamily, Healthcare Facilities, and Hospital mortgage insurance programs that have commitments to be issued or reissued in FY 2014. FY...

  1. 78 FR 64018 - Manufacturer of Controlled Substances; Notice of Application; GE Healthcare

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-25

    ... From the Federal Register Online via the Government Publishing Office ] DEPARTMENT OF JUSTICE Drug Enforcement Administration Manufacturer of Controlled Substances; Notice of Application; GE Healthcare... September 12, 2013, GE Healthcare, 3350 North Ridge Avenue, Arlington Heights, Illinois 60004- 1412,...

  2. 78 FR 12103 - Manufacturer of Controlled Substances; Notice of Application; GE Healthcare

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-21

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF JUSTICE Drug Enforcement Administration Manufacturer of Controlled Substances; Notice of Application; GE Healthcare... August 31, 2012, GE Healthcare, 3350 North Ridge Avenue, Arlington Heights, Illinois 60004- 1412,...

  3. 78 FR 28631 - Experian, Experian Healthcare (Medical Present Value (MPV)-Credit Services and Decision Analytics...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-15

    ... Employment and Training Administration Experian, Experian Healthcare (Medical Present Value (MPV)-- Credit... 4, 2013, applicable to workers of Experian, Experian Healthcare, (medical Present Value (MPV... Present Value (MPV)--Credit Services and Decision Analytics), Plymouth, Massachusetts...

  4. 78 FR 70580 - Apria Healthcare LLC, Billing Department, Overland Park, Kansas; Notice of Negative Determination...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-26

    ... Healthcare LLC, Billing Department, Overland Park, Kansas; Notice of Negative Determination Regarding... LLC, Billing Department, Overland Park, Kansas (TA-W-82,838) requested administrative reconsideration... Adjustment Assistance (TAA), applicable to workers and former workers of Apria Healthcare LLC,...

  5. Business resilience: Reframing healthcare risk management.

    PubMed

    Simeone, Cynthia L

    2015-09-01

    The responsibility of risk management in healthcare is fractured, with multiple stakeholders. Most hospitals and healthcare systems do not have a fully integrated risk management system that spans the entire organizational and operational structure for the delivery of key services. This article provides insight toward utilizing a comprehensive Business Resilience program and associated methodology to understand and manage organizational risk leading to organizational effectiveness and operational efficiencies, with the fringe benefit of realizing sustainable operational capability during adverse conditions.

  6. 77 FR 12007 - Foreign-Trade Zone 7, Temporary/Interim Manufacturing Authority, Baxter Healthcare of Puerto Rico...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-28

    ... Healthcare of Puerto Rico, (Pharmaceutical and Nutritional Intravenous Bags and Administration Sets); Notice..., to manufacture pharmaceutical and nutritional intravenous bags and administration sets under...

  7. Administration on Aging

    MedlinePlus

    ... Administration on Aging Administration on Disabilities Center for Integrated Programs Center for Performance and Evaluation National Institute ... Project Aging Statistics Profile of Older Americans AGing Integrated Database (AGID) Census Data & Population Estimates Projected Future ...

  8. Achieving excellence in veterans healthcare--a balanced scorecard approach.

    PubMed

    Biro, Lawrence A; Moreland, Michael E; Cowgill, David E

    2003-01-01

    This article provides healthcare administrators and managers with a framework and model for developing a balanced scorecard and demonstrates the remarkable success of this process, which brings focus to leadership decisions about the allocation of resources. This scorecard was developed as a top management tool designed to structure multiple priorities of a large, complex, integrated healthcare system and to establish benchmarks to measure success in achieving targets for performance in identified areas. Significant benefits and positive results were derived from the implementation of the balanced scorecard, based upon benchmarks considered to be critical success factors. The network's chief executive officer and top leadership team set and articulated the network's primary operating principles: quality and efficiency in the provision of comprehensive healthcare and support services. Under the weighted benchmarks of the balanced scorecard, the facilities in the network were mandated to adhere to one non-negotiable tenet: providing care that is second to none. The balanced scorecard approach to leadership continuously ensures that this is the primary goal and focal point for all activity within the network. To that end, systems are always in place to ensure that the network is fully successful on all performance measures relating to quality.

  9. Veterans Health Administration

    MedlinePlus

    ... code here VA » Veterans Health Administration Veterans Health Administration Marine Continues to Serve by Serving Veterans David ... Read more » VA Medical Centers The Veterans Health Administration is home to the United States’ largest integrated ...

  10. Method for technology-delivered healthcare measures.

    PubMed

    Kramer-Jackman, Kelli Lee; Popkess-Vawter, Sue

    2011-12-01

    Current healthcare literature lacks development and evaluation methods for research and practice measures administered by technology. Researchers with varying levels of informatics experience are developing technology-delivered measures because of the numerous advantages they offer. Hasty development of technology-delivered measures can present issues that negatively influence administration and psychometric properties. The Method for Technology-delivered Healthcare Measures is designed to systematically guide the development and evaluation of technology-delivered measures. The five-step Method for Technology-delivered Healthcare Measures includes establishment of content, e-Health literacy, technology delivery, expert usability, and participant usability. Background information and Method for Technology-delivered Healthcare Measures steps are detailed.

  11. 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.

  12. Integrating chronic care with primary care activities: enriching healthcare staff knowledge and skills and improving glycemic control of a cohort of people with diabetes through the First Line Diabetes Care Project in the Philippines

    PubMed Central

    Ku, Grace Marie V.; Kegels, Guy

    2014-01-01

    Background This study investigated the effects of integrating primary chronic care with current healthcare activities in two local government health units (LGHU) of the Philippines on knowledge and skills of the LGHU staff and clinical outcomes for people with diabetes. Design Integration was accomplished through health service reorganization, (re)distribution of chronic care tasks, and training of LGHU staff. Levels of the staff's pre- and post-training diabetes knowledge and of their self-assessment of diabetes care-related skills were measured. Primary diabetes care with emphasis on self-care development was provided to a cohort of people with diabetes. Glycosylated hemoglobin (HbA1c) and obesity measures were collected prior to and one year after full project implementation. Results The training workshop improved diabetes knowledge (p<0.001) and self-assessed skills (p<0.001) of the LGHU staff. Significant reductions in HbA1c (p<0.001), waist–hip ratio (p<0.001) and waist circumference (p=0.011) of the cohort were noted. Although the reduction in HbA1c was somewhat greater among those whose community-based care providers showed improvement in knowledge and self-assessed skills, the difference was not statistically significant. Conclusions Primary care for chronic conditions such as diabetes may be integrated with other healthcare activities in health services of low-to-middle-income countries such as the Philippines, utilizing pre-existing human resources for health, and may improve clinical endpoints. PMID:25361726

  13. Buying a healthcare information system.

    PubMed

    Clegg, T A

    1998-01-01

    Replacing an antiquated computer system with state of the art equipment and software is a lengthy, at times frustrating, and never an easy decision. At Wesley Woods Center on Aging, Atlanta, an integrated provider of healthcare for the elderly affiliated with Emory University, the process consumed more than two and a half years. This article takes the reader through the entire process, from the initial decision to replace an existing system, through the final purchase and installation. It looks candidly at the problems that were encountered, including turnover among key personnel, difficulties with involving all of the user groups, changes in the technology and coordination with the University. The lessons Wesley Woods learned in its experience can be of benefit to any healthcare facility contemplating an information system change.

  14. Strategic planning in healthcare organizations.

    PubMed

    Rodríguez Perera, Francisco de Paula; Peiró, Manel

    2012-08-01

    Strategic planning is a completely valid and useful tool for guiding all types of organizations, including healthcare organizations. The organizational level at which the strategic planning process is relevant depends on the unit's size, its complexity, and the differentiation of the service provided. A cardiology department, a hemodynamic unit, or an electrophysiology unit can be an appropriate level, as long as their plans align with other plans at higher levels. The leader of each unit is the person responsible for promoting the planning process, a core and essential part of his or her role. The process of strategic planning is programmable, systematic, rational, and holistic and integrates the short, medium, and long term, allowing the healthcare organization to focus on relevant and lasting transformations for the future.

  15. Evaluating the effectiveness of care integration strategies in different healthcare systems in Latin America: the EQUITY-LA II quasi-experimental study protocol

    PubMed Central

    Vázquez, María-Luisa; Vargas, Ingrid; Unger, Jean-Pierre; De Paepe, Pierre; Mogollón-Pérez, Amparo Susana; Samico, Isabella; Albuquerque, Paulette; Eguiguren, Pamela; Cisneros, Angelica Ivonne; Rovere, Mario; Bertolotto, Fernando

    2015-01-01

    Introduction Although fragmentation in the provision of healthcare is considered an important obstacle to effective care, there is scant evidence on best practices in care coordination in Latin America. The aim is to evaluate the effectiveness of a participatory shared care strategy in improving coordination across care levels and related care quality, in health services networks in six different healthcare systems of Latin America. Methods and analysis A controlled before and after quasi-experimental study taking a participatory action research approach. In each country, two comparable healthcare networks were selected—intervention and control. The study contains four phases: (1) A baseline study to establish network performance in care coordination and continuity across care levels, using (A) qualitative methods: semi-structured interviews and focus groups with a criterion sample of health managers, professionals and users; and (B) quantitative methods: two questionnaire surveys with samples of 174 primary and secondary care physicians and 392 users with chronic conditions per network. Sample size was calculated to detect a proportion difference of 15% and 10%, before and after intervention (α=0.05; β=0.2 in a two-sided test); (2) a bottom-up participatory design and implementation of shared care strategies involving micro-level care coordination interventions to improve the adequacy of patient referral and information transfer. Strategies are selected through a participatory process by the local steering committee (local policymakers, health care network professionals, managers, users and researchers), supported by appropriate training; (3) Evaluation of the effectiveness of interventions by measuring changes in levels of care coordination and continuity 18 months after implementation, applying the same design as in the baseline study; (4) Cross-country comparative analysis. Ethics and dissemination This study complies with international and national legal

  16. [Lay agency and healthcare: producing healthcare maps].

    PubMed

    Cecilio, Luiz Carlos de Oliveira; Carapinheiro, Graça; Andreazza, Rosemarie; Souza, Ana Lúcia Medeiros de; Andrade, Maria da Graça Garcia; Santiago, Silvia Maria; Meneses, Consuelo Sampaio; Reis, Denizi Oliveira; Araújo, Eliane Cardoso; Pinto, Nicanor Rodrigues da Silva; Spedo, Sandra Maria

    2014-07-01

    This study aimed to characterize which regulatory logics (other than government regulation) result in healthcare output, using a two-stage qualitative study in two municipalities in the ABCD Paulista region in São Paulo State, Brazil. The first stage included interviews with strategic actors (managers and policymakers) and key health professionals. The second phase collected life histories from 18 individuals with high health-services utilization rates. An analysis of the researchers' involvement in the field allowed a better understanding of the narratives. Four regulatory systems were characterized (governmental, professional, clientelistic, and lay), indicating that regulation is a field in constant dispute, a social production. Users' action produces healthcare maps that reveal the existence of other possible health system arrangements, calling on us to test shared management of healthcare between health teams and users as a promising path to the urgent need to reinvent health.

  17. Relevance of health level 7 clinical document architecture and integrating the healthcare enterprise cross-enterprise document sharing profile for managing chronic wounds in a telemedicine context

    PubMed Central

    Gibaud, Bernard; Le Bouquin Jeannès, Régine

    2016-01-01

    The number of patients with complications associated with chronic diseases increases with the ageing population. In particular, complex chronic wounds raise the re-admission rate in hospitals. In this context, the implementation of a telemedicine application in Basse-Normandie, France, contributes to reduce hospital stays and transport. This application requires a new collaboration among general practitioners, private duty nurses and the hospital staff. However, the main constraint mentioned by the users of this system is the lack of interoperability between the information system of this application and various partners’ information systems. To improve medical data exchanges, the authors propose a new implementation based on the introduction of interoperable clinical documents and a digital document repository for managing the sharing of the documents between the telemedicine application users. They then show that this technical solution is suitable for any telemedicine application and any document sharing system in a healthcare facility or network. PMID:27222729

  18. Relevance of health level 7 clinical document architecture and integrating the healthcare enterprise cross-enterprise document sharing profile for managing chronic wounds in a telemedicine context.

    PubMed

    Finet, Philippe; Gibaud, Bernard; Dameron, Olivier; Le Bouquin Jeannès, Régine

    2016-03-01

    The number of patients with complications associated with chronic diseases increases with the ageing population. In particular, complex chronic wounds raise the re-admission rate in hospitals. In this context, the implementation of a telemedicine application in Basse-Normandie, France, contributes to reduce hospital stays and transport. This application requires a new collaboration among general practitioners, private duty nurses and the hospital staff. However, the main constraint mentioned by the users of this system is the lack of interoperability between the information system of this application and various partners' information systems. To improve medical data exchanges, the authors propose a new implementation based on the introduction of interoperable clinical documents and a digital document repository for managing the sharing of the documents between the telemedicine application users. They then show that this technical solution is suitable for any telemedicine application and any document sharing system in a healthcare facility or network.

  19. Five constants of information technology adoption in healthcare.

    PubMed

    Bernstein, Mariel L; McCreless, Tamuchin; Côté, Murray J

    2007-01-01

    The healthcare industry has developed a dependence on information technology (IT) for maintaining and improving both clinical and business operations. Whether IT is used for office automation or for reducing medical errors, there are five constants that routinely influence the successful integration of IT in healthcare. These constants are the proper use and maintenance of the IT budget, the role of supportive leadership, the use of project management, the process of implementation, and the significance of end user involvement. These constants challenge healthcare organizations to efficiently and effectively use their financial and human resources when adopting new IT. These constants also shape how the healthcare industry approaches the adoption and utilization of new IT. A collective understanding of these constants and their interrelationships will enable healthcare organizations to better integrate new IT and achieve organizational goals of developing a solid technological infrastructure to truly enhance the delivery of quality healthcare.

  20. 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…

  1. The healthcare volunteer.

    PubMed

    Tuckman, H P; Chang, C F

    1994-01-01

    Every year, volunteers contribute billions of dollars worth of time to the healthcare industry. Despite their contributions, however, little is known about who these volunteers are, what they do, why they volunteer, as well as the costs and benefits they bring to institutions. This article examines these and other characteristics of the healthcare volunteer.

  2. Virtual healthcare delivery: defined, modeled, and predictive barriers to implementation identified.

    PubMed Central

    Harrop, V. M.

    2001-01-01

    Provider organizations lack: 1. a definition of "virtual" healthcare delivery relative to the products, services, and processes offered by dot.coms, web-compact disk healthcare content providers, telemedicine, and telecommunications companies, and 2. a model for integrating real and virtual healthcare delivery. This paper defines virtual healthcare delivery as asynchronous, outsourced, and anonymous, then proposes a 2x2 Real-Virtual Healthcare Delivery model focused on real and virtual patients and real and virtual provider organizations. Using this model, provider organizations can systematically deconstruct healthcare delivery in the real world and reconstruct appropriate pieces in the virtual world. Observed barriers to virtual healthcare delivery are: resistance to telecommunication integrated delivery networks and outsourcing; confusion over virtual infrastructure requirements for telemedicine and full-service web portals, and the impact of integrated delivery networks and outsourcing on extant cultural norms and revenue generating practices. To remain competitive provider organizations must integrate real and virtual healthcare delivery. PMID:11825189

  3. The role of criminal law within the healthcare sector.

    PubMed

    Alhafaji, Yasmin

    2012-12-01

    Health is for most of us the most precious thing one can have. However, in practice situations occur where the patient is harmed within the healthcare institution. Traditionally, there are several ways to protect individuals in society: with civil, criminal and administrative procedures. Over the years in the Netherlands complaints procedures were established in which the complaints about healthcare providers' performance can be handled. Recently, there are some developments within the criminal law that concern the healthcare sector. Examples are: the establishment of the Public Prosecution Service's Expertise Center on Medical Matters, appointments of medical prosecutors. In addition, in legal literature suggestions are made that criminal law is nowadays applied in order to provide redress to the patients (relatives) and as a 'safety tool' that is to ensure security and to counter the risks within the healthcare sector. The article discusses the role of criminal law within the healthcare sector, and in particular, whether criminal procedure is suitable for handling complaints about healthcare.

  4. A comprehensive ubiquitous healthcare solution on an Android™ mobile device.

    PubMed

    Hii, Pei-Cheng; Chung, Wan-Young

    2011-01-01

    Provision of ubiquitous healthcare solutions which provide healthcare services at anytime anywhere has become more favorable nowadays due to the emphasis on healthcare awareness and also the growth of mobile wireless technologies. Following this approach, an Android™ smart phone device is proposed as a mobile monitoring terminal to observe and analyze ECG (electrocardiography) waveforms from wearable ECG devices in real time under the coverage of a wireless sensor network (WSN). The exploitation of WSN in healthcare is able to substitute the complicated wired technology, moving healthcare away from a fixed location setting. As an extension to the monitoring scheme, medicine care is taken into consideration by utilizing the mobile phone as a barcode decoder, to verify and assist out-patients in the medication administration process, providing a better and more comprehensive healthcare service.

  5. On the classification of emotional biosignals evoked while viewing affective pictures: an integrated data-mining-based approach for healthcare applications.

    PubMed

    Frantzidis, Christos A; Bratsas, Charalampos; Klados, Manousos A; Konstantinidis, Evdokimos; Lithari, Chrysa D; Vivas, Ana B; Papadelis, Christos L; Kaldoudi, Eleni; Pappas, Costas; Bamidis, Panagiotis D

    2010-03-01

    Recent neuroscience findings demonstrate the fundamental role of emotion in the maintenance of physical and mental health. In the present study, a novel architecture is proposed for the robust discrimination of emotional physiological signals evoked upon viewing pictures selected from the International Affective Picture System (IAPS). Biosignals are multichannel recordings from both the central and the autonomic nervous systems. Following the bidirectional emotion theory model, IAPS pictures are rated along two dimensions, namely, their valence and arousal. Following this model, biosignals in this paper are initially differentiated according to their valence dimension by means of a data mining approach, which is the C4.5 decision tree algorithm. Then, the valence and the gender information serve as an input to a Mahalanobis distance classifier, which dissects the data into high and low arousing. Results are described in Extensible Markup Language (XML) format, thereby accounting for platform independency, easy interconnectivity, and information exchange. The average recognition (success) rate was 77.68% for the discrimination of four emotional states, differing both in their arousal and valence dimension. It is, therefore, envisaged that the proposed approach holds promise for the efficient discrimination of negative and positive emotions, and it is hereby discussed how future developments may be steered to serve for affective healthcare applications, such as the monitoring of the elderly or chronically ill people.

  6. 78 FR 18317 - U.S. Healthcare Trade Mission to Russia- Amendment

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-26

    ... International Trade Administration U.S. Healthcare Trade Mission to Russia-- Amendment AGENCY: International... publishing this supplement to the Notice of the U.S. Healthcare Trade Mission to Russia published at 77 FR...), interested U.S. healthcare firms and trade organizations which have not already submitted an application...

  7. 78 FR 54914 - Importer of Controlled Substances; Notice of Registration; GE Healthcare

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-06

    ... Enforcement Administration Importer of Controlled Substances; Notice of Registration; GE Healthcare By Notice dated June 7, 2013, and published in the Federal Register on June 18, 2013, 78 FR 36594, GE Healthcare...) and 952(a) and determined that the registration of GE Healthcare to import the basic class...

  8. 77 FR 70179 - Notice of HUD-Held Multifamily and Healthcare Loan Sale

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-23

    ... URBAN DEVELOPMENT Notice of HUD-Held Multifamily and Healthcare Loan Sale AGENCY: Office of the... healthcare mortgage loans, without Federal Housing Administration (FHA) insurance, in a competitive, sealed... by multifamily and healthcare properties located throughout the United States. The Mortgage Loans...

  9. 78 FR 19017 - Manufacturer of Controlled Substances; Notice of Registration; Siemens Healthcare Diagnostics, Inc.

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-28

    ... Enforcement Administration Manufacturer of Controlled Substances; Notice of Registration; Siemens Healthcare..., 77 FR 72409, Siemens Healthcare Diagnostics Inc., Attn: RA, 100 GBC Drive, Mail Stop 514, Newark.... 823(a) and determined that the registration of Siemens Healthcare Diagnostics Inc., to manufacture...

  10. 77 FR 31390 - Manufacturer of Controlled Substances; Notice of Registration; Siemens Healthcare Diagnostics, Inc.

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-25

    ... Enforcement Administration Manufacturer of Controlled Substances; Notice of Registration; Siemens Healthcare..., 77 FR 5847, Siemens Healthcare Diagnostics Inc., 100 GBC Drive, Mail Stop 514, Newark, Delaware 19702.... 823(a) and determined that the registration of Siemens Healthcare Diagnostics Inc., to manufacture...

  11. Healthcare-associated infections: challenges to public health in Brazil

    PubMed Central

    Padoveze, Maria Clara; Fortaleza, Carlos Magno Castelo Branco

    2014-01-01

    This study presents a critical evaluation of the scientific literature related to this subject, aiming to assess the policies and administrative issues regarding the prevention and magnitude of healthcare-associated infections and discuss the challenges for their prevention in Brazil. The topics discussed included historical and administrative issues, challenges imposed by the characteristics of the healthcare system and the territorial dimension, laboratorial support limitations, costs, institutional culture, professional qualification, and patient engagement. It is urgent to hold a nationwide discussion among government representatives, institutions, and healthcare workers and users to overcome these challenges. PMID:26039403

  12. Integrated Information Support System (IISS). Volume 5. Common Data Model Subsystem. Part 1. CDM Administrator’s Manual

    DTIC Science & Technology

    1990-09-30

    and IDEFIX integration methodology. ONTEK Responsible for defining and testing a representative integrated system base in Artificial Intelligence...Reference Manual UM620341100 Neutral Data Definition Language (NDDL) User’s Guide UM620341002 Information Modeling Manual - IDEFI- Extended ( IDEFIX

  13. 1992 healthcare business outlook.

    PubMed

    Wagner, L; Burda, D; Kenkel, P J; Nemes, J; Lutz, S; Weissenstein, E; Greene, J; Pallarito, K; Gardner, E; Wagner, M

    1992-01-06

    Whether it's with apprehension or expectation, most of us are wondering what the new year will hold. With that question in mind, Modern Healthcare staff writers and healthcare industry leaders offer their short- and long-range forecasts for all sectors and on a variety of all-encompassing issues. Some key questions: Will presidential politics pressure healthcare reform efforts? How will investor-owned companies fare under another year of regulatory scrutiny? What awaits hospitals and physicians under the new fee schedule and other Medicare rule changes?

  14. Electronics for better healthcare.

    PubMed

    Wolf, Bernhard; Herzog, Karolin

    2013-06-01

    Microelectronics and microsystem technology have changed our daily lives considerably in the past 50 years. Countless everyday objects contain microelectronic components. In healthcare up to the present, however, it has not been possible to make major alterations in introducing electronics and information technology that would lead to innovative improvements and greater transparency. This paper describes initial steps in diagnostics and oncological therapy including telematic healthcare systems which can, for example, assist patients with cardiovascular diseases and shows, through these areas, how electronics and microsystems technology can contribute to better healthcare.

  15. Strategies for healthcare facilities, construction, and real estate management.

    PubMed

    Lee, James G

    2012-05-01

    Adventist HealthCare offers the following lessons learned in improving the value of healthcare facilities, construction, and real estate management: Use an integrated approach. Ensure that the objectives of the approach align the hospital or health system's mission and values. Embrace innovation. Develop a plan that applies to the whole organization, rather than specific business units. Ensure commitment of senior leaders.

  16. Integrated microsystems for controlled drug delivery.

    PubMed

    Razzacki, S Zafar; Thwar, Prasanna K; Yang, Ming; Ugaz, Victor M; Burns, Mark A

    2004-02-10

    Efficient drug delivery and administration are needed to realize the full potential of molecular therapeutics. Integrated microsystems that incorporate extremely fast sensory and actuation capabilities can fulfill this need for efficient drug delivery tools. Photolithographic technologies borrowed from the semiconductor industry enable mass production of such microsystems. Rapid prototyping allows for the quick development of customized devices that would accommodate for diverse therapeutic requirements. This paper reviews the capabilities of existing microfabrication and their applications in controlled drug delivery microsystems. The next generation of drug delivery systems--fully integrated and self-regulating--would not only improve drug administration, but also revolutionize the health-care industry.

  17. Coproduction of healthcare service

    PubMed Central

    Batalden, Maren; Batalden, Paul; Margolis, Peter; Seid, Michael; Armstrong, Gail; Opipari-Arrigan, Lisa; Hartung, Hans

    2016-01-01

    Efforts to ensure effective participation of patients in healthcare are called by many names—patient centredness, patient engagement, patient experience. Improvement initiatives in this domain often resemble the efforts of manufacturers to engage consumers in designing and marketing products. Services, however, are fundamentally different than products; unlike goods, services are always ‘coproduced’. Failure to recognise this unique character of a service and its implications may limit our success in partnering with patients to improve health care. We trace a partial history of the coproduction concept, present a model of healthcare service coproduction and explore its application as a design principle in three healthcare service delivery innovations. We use the principle to examine the roles, relationships and aims of this interdependent work. We explore the principle's implications and challenges for health professional development, for service delivery system design and for understanding and measuring benefit in healthcare services. PMID:26376674

  18. Norovirus in Healthcare Settings

    MedlinePlus

    ... Evaluating Environmental Cleaning Appendices to the Conceptual Program Model for Environmental Evaluation Basic Infection Control and Prevention Plan for Outpatient Oncology Settings Appendices Outpatient Care Guide Tools for Protecting Healthcare Personnel PPE Training ...

  19. Coproduction of healthcare service.

    PubMed

    Batalden, Maren; Batalden, Paul; Margolis, Peter; Seid, Michael; Armstrong, Gail; Opipari-Arrigan, Lisa; Hartung, Hans

    2016-07-01

    Efforts to ensure effective participation of patients in healthcare are called by many names-patient centredness, patient engagement, patient experience. Improvement initiatives in this domain often resemble the efforts of manufacturers to engage consumers in designing and marketing products. Services, however, are fundamentally different than products; unlike goods, services are always 'coproduced'. Failure to recognise this unique character of a service and its implications may limit our success in partnering with patients to improve health care. We trace a partial history of the coproduction concept, present a model of healthcare service coproduction and explore its application as a design principle in three healthcare service delivery innovations. We use the principle to examine the roles, relationships and aims of this interdependent work. We explore the principle's implications and challenges for health professional development, for service delivery system design and for understanding and measuring benefit in healthcare services.

  20. Center for Healthcare Technologies

    SciTech Connect

    Carrano, A.V.

    1994-03-01

    In the U.S., we now spend about 13% of the gross domestic product (CDP) on healthcare. This figure represents nearly $3000 per year per man, woman, and child. Moreover, this expenditure is projected to grow to about 20% of the GDP by the year 2000. Medical research and development accounts for only about 3% of national healthcare spending, and technology development represents only a small fraction of that 3%. New technologies that are far more cost-effective than previous ones - such as minimally invasive surgical procedures, advanced automated diagnostics, and better information systems - could save the nation billions of dollars per year to say nothing of the potential reductions in pain and suffering. A center is described that will coordinate ongoing Laboratory research aimed at developing more cost-effective tools for use by the healthcare community. The new Center for Healthcare Technologies will have many long-term benefits for the region and the nation.

  1. Healthcare practitioners' personal and professional values.

    PubMed

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

    2016-05-01

    Personal and professional values of healthcare practitioners influence their clinical decisions. Understanding these values for individuals and across healthcare professions can help improve patient-centred decision-making by individual practitioners and interprofessional teams, respectively. We aimed to identify these values and integrate them into a single framework using Schwartz's values model. We searched Medline, Embase, PsycINFO, CINAHL and ERIC databases for articles on personal and professional values of healthcare practitioners and students. We extracted values from included papers and synthesized them into a single framework using Schwartz's values model. We summarised the framework within the context of healthcare practice. We identified 128 values from 50 included articles from doctors, nurses and allied health professionals. A new framework for the identified values established the following broad healthcare practitioner values, corresponding to Schwartz values (in parentheses): authority (power); capability (achievement); pleasure (hedonism); intellectual stimulation (stimulation); critical-thinking (self-direction); equality (universalism); altruism (benevolence); morality (tradition); professionalism (conformity); safety (security) and spirituality (spirituality). The most prominent values identified were altruism, equality and capability. This review identified a comprehensive set of personal and professional values of healthcare practitioners. We integrated these into a single framework derived from Schwartz's values model. This framework can be used to assess personal and professional values of healthcare practitioners across professional groups, and can help improve practitioners' awareness of their values so they can negotiate more patient-centred decisions. A common values framework across professional groups can support shared education strategies on values and help improve interprofessional teamwork and decision-making.

  2. Character, Leadership, and the Healthcare Professions

    ERIC Educational Resources Information Center

    Holmes, Elizabeth

    2010-01-01

    The presentation by Elizabeth Holmes, PhD, summarized the integration of character and leadership development in the education of healthcare professionals. Citing the mission, vision, values, graduate attributes, and various examples of current programs and initiatives from both the United States Naval Academy and the University of Botswana, the…

  3. Healthcare Industry Study

    DTIC Science & Technology

    2003-01-01

    expenditure through measures of access, cost and quality . While the quality of the U.S. healthcare system is unparalleled in the areas of acute...system’s outcomes as measured by cost, access and quality , and makes recommendations targeted at government’s role in promoting the health of our...the system combine to produce an output that we call healthcare. That output can be measured in terms of access, cost and quality --the same market

  4. A Qualitative Analysis of Resource Sharing Agreements Between Naval Hospital Great Lakes and North Chicago Veterans Affairs Medical Center: The Iron Triangle Theory of Healthcare Integration

    DTIC Science & Technology

    2005-05-19

    62 Financial Accountability. ...................................................................................... 62 Culture and...analysis of the internal and external environment provides an awareness of organizational expectations and cultural norms integral to consider when planning...they can involve a single product line or envelope the joining of governance boards, organizational structures, and cultures Qualitative Analysis of

  5. The metaphor of nurse as guest with ethical implications for nursing and healthcare.

    PubMed

    Milton, Constance L

    2005-10-01

    Current healthcare advertising and customer relations terminology acknowledge that healthcare providers, including nurses, are to act as hosts for persons who enter into healthcare agencies and institutions. Indeed, much has been written aligning nursing and other healthcare services with consumer-oriented roles of the hospitality service industry commonly associated with hotels and restaurants. From a human becoming perspective, this article discusses possible ethical, administrative, and practice implications of nurses acting as guests entering into the lives of those we serve.

  6. Outsourcing real estate lease administration.

    PubMed

    Kardel, S

    1996-09-01

    Real estate lease administration is becoming increasingly important to healthcare organizations; however, not all organizations possess the in-house expertise to carry out this specialized function. For such organizations, outsourcing lease administration may be a more efficient way to manage their real estate portfolios and possibly improve their bottom lines.

  7. Wearable technologies - future challenges for implementation in healthcare services.

    PubMed

    Lewy, Hadas

    2015-02-01

    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.

  8. Is it me or is it you? Behavioral and electrophysiological effects of oxytocin administration on self-other integration during joint task performance.

    PubMed

    Ruissen, Margit I; de Bruijn, Ellen R A

    2015-09-01

    The neuropeptide oxytocin has been associated with promoting various social behaviors in humans including cooperation and trust. Surprisingly little, however, is known about the possible role of oxytocin in processes required for social interactive behavior such as joint task performance. The current study investigated whether intranasal administration of oxytocin leads to increased self-other integration using a social Simon task. A placebo-controlled double-blind between-subjects design was used. Behavioral and EEG measures were obtained from 63 healthy male volunteers who either received 24 intranasal units (IU) oxytocin or a placebo while they performed the social Simon task in an individual and a joint/social context. The behavioral results demonstrated an enhanced Simon effect in the social context after oxytocin administration. At the electrophysiological level, the stimulus-locked N2 component, reflecting response conflict, was increased in the social compared to the individual context for Go trials, but only after oxytocin administration. The P3 component, reflecting response inhibition, was increased for social compared to individual contexts, irrespective of condition. Both the behavioral and N2 findings suggest that oxytocin enhances self-other integration. While more inhibition is needed in the social context, this process seems less sensitive to changes in self-other integration. To conclude, the current study is the first to show oxytocin-induced modulations of processes that play a central role in joint task performance and thus importantly adds to our understanding of the neurocognitive mechanisms underlying the diverse social effects of oxytocin.

  9. Management by missions in the healthcare sector.

    PubMed

    Fonseca Pires, J; Rey, C; Más-Machuca, M; Bastons, M

    2016-01-01

    This article discusses the importance of the mission statement in the healthcare sector. It's also argued that only formal declaration of the mission it's insufficient to the appropriate professional coordination of doctors, nurses and managers. It's proposed a systematic approach to facilitate the introduction of the mission within the systems of the organization, what is called "Management by missions." It promotes horizontal and vertical integration between doctors, nurses and managers. Criteria that ensure this integration are specified.

  10. History of healthcare technology assessment in Japan.

    PubMed

    Hisashige, Akinori

    2009-07-01

    There has been a rapid growth of healthcare technology assessment (HTA) activities among health service researchers and physicians in Japan in the younger generation since the mid-1980s. HTA has become visible since the Ministry of Health, Labor, and Welfare (MHLW) set up the several committees related to HTA in the late 1990s. The MHLW had to participate in regulatory and administrative reform, coping with the serious economic stagnation since 1991, following the economic recession in the 1980s. However, HTA has not been developed as expected. The most important failure is that the application of HTA to health policy has been neglected by the MHLW. Only application to clinical practice has been implemented by developing evidence-based clinical practice guidelines. The MHLW had the main aim of containing costs by reducing excess or useless healthcare services through guidelines, rather than to implement a radical reform. Without a central organization for HTA, several researchers have still continued to do HTA studies, but most researchers and physicians promoting HTA have been moved into diverse related areas. Ultimately, increasing efficiency may be the only way of reconciling rising demands for health care with public financing constraints. Therefore, the reconsideration and reorganization of HTA, which covers not only healthcare services but also the healthcare system as a whole, is becoming an urgent matter for healthcare reform.

  11. [The conception of healthcare in Confucianism].

    PubMed

    Bao, Xiao-Dong

    2003-01-01

    As the founder of Confucianism, Confucius lead a life of frustration and experienced all difficulties. Interestingly, he enjoyed a long life of over seventy years old. Naturally, his viewpoint on healthcare aroused the interests of late-comers He first emphasized the morality, claiming that those kind people can live long, advocated the doctrine of the mean, open-minded and optimism, exercise of the body and mind, dietary hygiene, avoidance of ghost, and taking care of medication. As the important integral part of Chinese traditional culture, Confucianism also yields profound influence on the development of healthcare in China.

  12. Stretchable inorganic nanomembrane electronics for healthcare devices

    NASA Astrophysics Data System (ADS)

    Kim, Dae-Hyeong; Son, Donghee; Kim, Jaemin

    2015-05-01

    Flexible or stretchable electronic devices for healthcare technologies have attracted much attention in terms of usefulness to assist doctors in their operating rooms and to monitor patients' physical conditions for a long period of time. Each device to monitor the patients' physiological signals real-time, such as strain, pressure, temperature, and humidity, etc. has been reported recently. However, their limitations are found in acquisition of various physiological signals simultaneously because all the functions are not assembled in one skin-like electronic system. Here, we describe a skin-like, multi-functional healthcare system, which includes single crystalline silicon nanomembrane based sensors, nanoparticle-integrated non-volatile memory modules, electro-resistive thermal actuators, and drug delivery. Smart prosthetics coupled with therapeutic electronic system would provide new approaches to personalized healthcare.

  13. Master Contracting with Comprehensive Service Providers: A Tool to Simplify Administration and Promote Outcome-Focused, Integrated Services

    ERIC Educational Resources Information Center

    Lepler, Susan; Uyeda, Kimberly; Halfon, Neal

    2006-01-01

    In response to the problems caused by categorical funding for services to children and families, the National Commission on Children recommended a series of changes in the organization, administration, and implementation of programs at all levels of government, to encourage a more collaborative and comprehensive service delivery system, including…

  14. The Design and Testing of an Integrated Computer System for the Administrative Processes of the University. Progress Report.

    ERIC Educational Resources Information Center

    Stanford Univ., CA.

    This is the third in a series of reports on the activity carried out under Project INFO auspices at Stanford, and covers the period March 1971 - April 1972. During this time, the project has been principally engaged in continued development of the OASIS (Online Administrative Information System) data base management system and its implementation…

  15. Web 2.0 Integration into the Graduate Classroom: An Appreciative Inquiry into Prospective School Administrator Strengths and Leadership Experiences

    ERIC Educational Resources Information Center

    Calabrese, Raymond L.

    2012-01-01

    Purpose: The purpose of this study is to advance the preparation of prospective school administrator students by extending the Web 2.0 application of blogging to discover students' strengths and successful leadership experiences. During the blogging process, students reflected on and responded to appreciative inquiry (AI) blog posts that…

  16. 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.

  17. Systems Architecture for a Nationwide Healthcare System.

    PubMed

    Abin, Jorge; Nemeth, Horacio; Friedmann, Ignacio

    2015-01-01

    From a national level to give Internet technology support, the Nationwide Integrated Healthcare System in Uruguay requires a model of Information Systems Architecture. This system has multiple healthcare providers (public and private), and a strong component of supplementary services. Thus, the data processing system should have an architecture that considers this fact, while integrating the central services provided by the Ministry of Public Health. The national electronic health record, as well as other related data processing systems, should be based on this architecture. The architecture model described here conceptualizes a federated framework of electronic health record systems, according to the IHE affinity model, HL7 standards, local standards on interoperability and security, as well as technical advice provided by AGESIC. It is the outcome of the research done by AGESIC and Systems Integration Laboratory (LINS) on the development and use of the e-Government Platform since 2008, as well as the research done by the team Salud.uy since 2013.

  18. Characteristics of healthcare wastes

    SciTech Connect

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

    2008-07-01

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

  19. 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.

  20. Behavioral Reference Model for Pervasive Healthcare Systems.

    PubMed

    Tahmasbi, Arezoo; Adabi, Sahar; Rezaee, Ali

    2016-12-01

    The emergence of mobile healthcare systems is an important outcome of application of pervasive computing concepts for medical care purposes. These systems provide the facilities and infrastructure required for automatic and ubiquitous sharing of medical information. Healthcare systems have a dynamic structure and configuration, therefore having an architecture is essential for future development of these systems. The need for increased response rate, problem limited storage, accelerated processing and etc. the tendency toward creating a new generation of healthcare system architecture highlight the need for further focus on cloud-based solutions for transfer data and data processing challenges. Integrity and reliability of healthcare systems are of critical importance, as even the slightest error may put the patients' lives in danger; therefore acquiring a behavioral model for these systems and developing the tools required to model their behaviors are of significant importance. The high-level designs may contain some flaws, therefor the system must be fully examined for different scenarios and conditions. This paper presents a software architecture for development of healthcare systems based on pervasive computing concepts, and then models the behavior of described system. A set of solutions are then proposed to improve the design's qualitative characteristics including, availability, interoperability and performance.

  1. Diversity management: an imperative for healthcare organizations.

    PubMed

    Gathers, Daryl

    2003-01-01

    Historically, white males have represented the ideal manager in appearance, values, and behaviors, resulting in overt or subtle discrimination in selection, evaluation, and promotion practices in corporate America. Because women and minorities could not meet this ideal, they were often passed over for advancement. The author discusses key areas of diversity management for healthcare administrators to consider: the elements of diversity, the reasons behind diversity management, and solutions for addressing many of the issues involved.

  2. 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.

  3. 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

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

    PubMed Central

    2009-01-01

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

  5. [Photography, language and healthcare].

    PubMed

    Georgantelis, Cynthia

    2010-01-01

    Photography as an art is a way of accessing our emotions, naming them, understanding them and taking them into account in the healthcare relationship. A training session on the Photolangage method enables us not only to increase our knowledge but also to share our emotional experience and encourages reflection.

  6. Hygienic drainage for healthcare.

    PubMed

    Jennings, Peter

    2012-08-01

    Peter Jennings, technical director for ACO Building Drainage, which specialises in the development of corrosion-resistant drainage systems and building products, looks at the key issues to consider when specifying and installing pipework and drainage for hygiene-critical environments such as hospitals and other healthcare facilities.

  7. Effective healthcare process redesign through an interdisciplinary team approach.

    PubMed

    Snyder, Rita; Huynh, Nathan; Cai, Bo; Vidal, José; Bennett, Kevin

    2013-01-01

    Healthcare process redesign is a complex and often high risk undertaking. Typically, there is a limited understanding of the baseline process and often inadequate tools by which to assess it. This can be confounded by narrow redesign team expertise that can result in unanticipated and/or unintended redesign consequences. Interdisciplinary research teams of healthcare, biostatistics, engineering and computer science experts provide broad support for a more effective and safer approach to healthcare process redesign. We describe an interdisciplinary research team focused on medication administration process (MAP)redesign and its achievements and challenges.

  8. The Association of Adolescent Depressive Symptoms with Healthcare Utilization and Payer-Incurred Expenditures

    PubMed Central

    Wright, Davene R.; Katon, Wayne J.; Ludman, Evette; McCauley, Elizabeth; Oliver, Malia; Lindenbaum, Jeffrey; Richardson, Laura P.

    2015-01-01

    Objective Screening adolescents for depression is recommended by the U.S. Preventive Services Task Force. We sought to evaluate the impact of positive depression screens in an adolescent population on healthcare utilization and costs from a payer perspective. Methods We conducted depression screening among 13-17 year olds adolescents enrolled in a large integrated care system using the 2- and 9-item Patient Health Questionnaires (PHQ). Healthcare utilization and cost data were obtained from administrative records. Chi-square, Wilcoxon rank-sum, and t-tests were used to test for statistical differences in outcomes between adolescents based on screening status. Results Of the 4,010 adolescents who completed depression screening, 3,707 (92.4%) screened negative (PHQ-2 < 2 or PHQ-9 < 10), 186 (3.9%) screened positive for mild depression (PHQ-9 = 10-14), and 95 (2.4%) screened positive for moderate-to-severe depression (PHQ-9 ≥ 15). In the 12-months after screening, screen-positive adolescents were more likely than screen-negative adolescents to receive any emergency department visit or inpatient hospitalization, and had significantly higher utilization of outpatient medical (mean (SD) = 8.3 (1.5) vs. 3.5 (5.1)) and mental health (3.8 (9.3) vs. 0.7 (3.5)) visits. Mean total healthcare system costs for screen-positive adolescents ($5,083 ($10,489)) were more than twice as high as those of screen-negative adolescents ($2,357 ($7,621)). Conclusion Adolescent depressive symptoms, even when mild, are associated with increased healthcare utilization and costs. Only a minority of the increased costs is attributable to mental health care. Implementing depression screening and evidence-based mental health services may help to better control healthcare costs among screen-positive adolescents. PMID:26456002

  9. Implementing the HL7v3 standard in Croatian primary healthcare domain.

    PubMed

    Koncar, Miroslav

    2004-01-01

    The mission of HL7 Inc. is to provide standards for the exchange, management and integration of data that supports clinical patient care and the management, delivery and evaluation of healthcare services. The scope of this work includes the specifications of flexible, cost-effective approaches, standards, guidelines, methodologies, and related services for interoperability between healthcare information systems. In the field of medical information technologies, HL7 provides the world's most advanced information standards. Versions 1 and 2 of the HL7 standard have on the one hand solved many issues, but on the other demonstrated the size and complexity of the health information sharing problem. As the solution, a complete new methodology has been adopted, which is being encompassed in version 3 recommendations. This approach standardizes the Reference Information Model (RIM), which is the source of all domain models and message structures. Message design is now defined in detail, enabling interoperability between loosely-coupled systems that are designed by different vendors and deployed in various environments. At the start of the Primary Healthcare Information System project, we have decided to go directly to HL7v3. Implementing the HL7v3 standard in healthcare applications represents a challenging task. By using standardized refinement and localization methods we were able to define information models for Croatian primary healthcare domain. The scope of our work includes clinical, financial and administrative data management, where in some cases we were compelled to introduce new HL7v3-compliant models. All of the HL7v3 transactions are digitally signed, using the W3C XML Digital Signature standard.

  10. Antitrust and affiliations among healthcare providers: the need for a level playing field.

    PubMed

    Heightchew, A

    1997-01-01

    Under pressure to remain competitive in the rapidly changing healthcare industry, policy leaders and healthcare administrators face the challenge of resolving antitrust matters arising from the creation of innovative healthcare provider affiliations. Although guidance from the Federal Trade Commission (FTC) is available, development of new affiliations is hindered due to contradictory rulings and ambiguous guidelines. Provider associations are further disadvantaged by a federal act granting insurance companies antitrust exemption, which enables insurance companies to affiliate more easily. Current antitrust regulations create unequal market powers, resulting in the development of inefficient systems. Softening antitrust laws in favor of provider-sponsored healthcare affiliations will provide for the flexibility necessary for effective healthcare reform.

  11. Does one-to-one demonstration with insulin pads by health-care providers improves the insulin administration techniques among diabetic patients of a Tertiary Care Teaching Hospital in South India?

    PubMed Central

    Kapoor, Urvasi; Ramasamy, Gomathi; Selvaraj, Kalaiselvi; Sahoo, Jaya Prakash; Kar, Sitanshu Sekhar

    2016-01-01

    Objectives: The study was aimed to capture the effect of using injection pads as a tool in educating the diabetic patients who were on insulin. The attitude and practice of the patients in storage of insulin vials and disposal of insulin syringes were also assessed. Materials and Methods: A facility based Quasi-experimental study was carried out among the diabetic patients on insulin, attending diabetic clinic in endocrinology OPD in a tertiary care hospital, Puducherry. One to one intervention was given to the study participants or their attendants (who were involved in injecting insulin), by a trained investigator regarding all the steps of insulin administration. The insulin administration practices before and immediately after the intervention was assessed using a checklist. Results: In total 91 patients were included for the study with mean (SD) age of 53.9 (10.6) years and of them 76% were females. The attitude and practices of the study participants, such as hand washing before handling insulin, checking the expiry date, storage of insulin, inspection of injection site, rolling and cleaning the vial, withdrawal of the syringe up to the required dose, pushing the plunger after inserting the syringe into the vial, checking and removal of air bubbles, cleaning the injection site and allow to dry and injection technique improved significantly after the intervention (P < 0.05). Conclusion: This study findings shows that using injection pads for educating patients helps them to practise better insulin administration. The findings from the study can be applied in routine care and has to be explored further in diabetic patient management. PMID:27867877

  12. Impediments Involved in the Integration of Federally Administrated Tribal Areas (FATA) in the National Mainstream of Pakistan

    DTIC Science & Technology

    2009-12-11

    requires a national effort of integration which cannot be left to only one component of government i.e. Army and other LEAs. v ACKNOWLEDGMENTS I ...subject has proved invaluable. I am also indebted to Dr. Baumann, the Director of Graduate Degree Program, for his cooperation and assistance. My...committee also deserves recognition as its each member has been invaluable in his advice and guidance. I am grateful to Ms. Sharon Scott and Ms. Crystal

  13. 78 FR 42041 - U.S. Healthcare Trade Mission to Russia, October 21-25, 2013; Correction

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-15

    ... International Trade Administration U.S. Healthcare Trade Mission to Russia, October 21-25, 2013; Correction... Commercial Service published a document in the Federal Register of May 30, 2013 regarding the U.S. Healthcare... subject heading of the notice to read: U.S. Healthcare Trade Mission to Russia has been Cancelled, Oct...

  14. Administrators: Nursing Home Administrator

    ERIC Educational Resources Information Center

    Kahl, Anne

    1976-01-01

    Responsibilities, skills needed, training needed, earnings, employment outlook, and sources of additional information are outlined for the administrator who holds the top management job in a nursing home. (JT)

  15. [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.

  16. Actualizing Personalized Healthcare for Women through Connected Data Systems: Breast Cancer Screening and Diagnosis

    PubMed Central

    Weerasinghe, Roshanthi

    2013-01-01

    Background: Healthcare organizations have invested in electronic patient data systems, yet use of health data to optimize personalized care has been limited. Primary Study Objective: To develop and pilot an integrated source of health system data related to breast healthcare. Methods/Design: This study is a quality improvement project. Patient-level data from multiple internal sources were identified, mapped to a common data model, linked, and validated to create a breast healthcare-specific data mart. Linkages were based on matching algorithms using patient identifiers to group data from the same patient. Data definitions, a data dictionary, and indicators for quality and benchmarking aligned with standardized measures. Clinical pathways were developed to outline the patient populations, data elements, decision points, and outcomes for specific conditions. Setting: Electronic data sources in a community-based health system in the United States. Participants: Women receiving breast cancer screening, prevention, and diagnosis services. Main Outcome Measures: Distribution of mammography examinations and pathologic results of breast biopsies. Results: From 2008 to 2011, 200768 screening and 50200 diagnostic mammograms were obtained; rates varied by age over time. Breast biopsies for 7332 women indicated 23.3% with invasive breast cancer, 6.7% with ductal carcinoma in situ, and 70.0% with nonmalignant diagnoses that would not have been further differentiated by administrative codes alone. Limitations: Evaluation of validity and efficiency and additional tracking of clinical outcomes are needed. Conclusions: The creation of a patient-centered data system by connecting and integrating disparate data sources within a large health system allows customized analyses of data and improves capacity for clinical decision making and personalized healthcare. PMID:24416691

  17. Integration of structural health monitoring solutions onto commercial aircraft via the Federal Aviation Administration structural health monitoring research program

    NASA Astrophysics Data System (ADS)

    Swindell, Paul; Doyle, Jon; Roach, Dennis

    2017-02-01

    The Federal Aviation Administration (FAA) started a research program in structural health monitoring (SHM) in 2011. The program's goal was to understand the technical gaps of implementing SHM on commercial aircraft and the potential effects on FAA regulations and guidance. The program evolved into a demonstration program consisting of a team from Sandia National Labs Airworthiness Assurance NDI Center (AANC), the Boeing Corporation, Delta Air Lines, Structural Monitoring Systems (SMS), Anodyne Electronics Manufacturing Corp (AEM) and the FAA. This paper will discuss the program from the selection of the inspection problem, the SHM system (Comparative Vacuum Monitoring-CVM) that was selected as the inspection solution and the testing completed to provide sufficient data to gain the first approved use of an SHM system for routine maintenance on commercial US aircraft.

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

    PubMed

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

    2015-09-01

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

  19. Developing healthcare facilities for a changing environment.

    PubMed

    Campobasso, Fred; Kucharz, Joe

    2012-05-01

    When approaching facility and real estate development, healthcare leaders should: Enhance clinical integration and ensure more patient-friendly facilities. Focus on a facility's business requirements and operating needs. Create a business plan that demonstrates how a project would help deliver better care at lower cost during a time of declining payment levels. Develop an approach that balances the needs of all stakeholders, including payers, staff, and patients.

  20. 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

  1. Healthcare in Myanmar.

    PubMed

    Latt, Nyi Nyi; Myat Cho, Su; Htun, Nang Mie Mie; Yu Mon Saw; Myint, Myat Noe Htin Aung; Aoki, Fumiko; Reyer, Joshua A; Yamamoto, Eiko; Yoshida, Yoshitoku; Hamajima, Nobuyuki

    2016-05-01

    Myanmar transitioned to a civilian government in March, 2011. Although the democratic process has accelerated since then, many problems in the field of healthcare still exist. Since there is a limited overview on the healthcare in Myanmar, this article briefly describes the current states surrounding health services in Myanmar. According to the Census 2014, the population in the Republic of the Union of Myanmar was 51,410,000. The crude birth rate in the previous one year was estimated to be 18.9 per 1,000, giving the annual population growth rate of 0.89% between 2003 and 2014. The Ministry of Health reorganized into six departments. National non-governmental organizations and community-based organizations support healthcare, as well as international non-governmental organizations. Since hospital statistics by the government cover only public facilities, the information on private facilities is limited. Although there were not enough medical doctors (61 per 100,000 population), the number of medical students was reduced from 2,400 to 1,200 in 2012 to ensure the quality of medical education. The information on causes of death in the general population could not be retrieved, but some data was available from hospital statistics. Although the improvement was marked, the figures did not reach the levels set by Millennium Development Goals 4 and 5. A trial prepaid health insurance system started in July 2015, to be followed by evaluation one year later. There are many international donors, including the Japan International Cooperation Agency, supporting health in Myanmar. With these efforts and support, a marked progress is expected in the field of healthcare.

  2. [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.

  3. Healthcare in Myanmar

    PubMed Central

    Latt, Nyi Nyi; Myat Cho, Su; Htun, Nang Mie Mie; Yu Mon Saw; Myint, Myat Noe Htin Aung; Aoki, Fumiko; Reyer, Joshua A.; Yamamoto, Eiko; Yoshida, Yoshitoku; Hamajima, Nobuyuki

    2016-01-01

    ABSTRACT Myanmar transitioned to a civilian government in March, 2011. Although the democratic process has accelerated since then, many problems in the field of healthcare still exist. Since there is a limited overview on the healthcare in Myanmar, this article briefly describes the current states surrounding health services in Myanmar. According to the Census 2014, the population in the Republic of the Union of Myanmar was 51,410,000. The crude birth rate in the previous one year was estimated to be 18.9 per 1,000, giving the annual population growth rate of 0.89% between 2003 and 2014. The Ministry of Health reorganized into six departments. National non-governmental organizations and community-based organizations support healthcare, as well as international non-governmental organizations. Since hospital statistics by the government cover only public facilities, the information on private facilities is limited. Although there were not enough medical doctors (61 per 100,000 population), the number of medical students was reduced from 2,400 to 1,200 in 2012 to ensure the quality of medical education. The information on causes of death in the general population could not be retrieved, but some data was available from hospital statistics. Although the improvement was marked, the figures did not reach the levels set by Millennium Development Goals 4 and 5. A trial prepaid health insurance system started in July 2015, to be followed by evaluation one year later. There are many international donors, including the Japan International Cooperation Agency, supporting health in Myanmar. With these efforts and support, a marked progress is expected in the field of healthcare. PMID:27303099

  4. Primary healthcare renewal in Canada: a glass half empty?

    PubMed

    van Soeren, Mary; Hurlock-Chorostecki, Christina; Pogue, Pamela; Sanders, Jane

    2008-01-01

    Primary healthcare renewal was an important government initiative arising in the early 21st century. This sector of the healthcare system in Canada had been under-resourced and ignored for decades. Recent changes include the development of salaried models for physician care, the use of other professionals in primary care, the integration of inter-professional teams, funding for information management systems and some incentives to provide directed primary care services. However, these changes are limited by a lack of overall policy direction to drive innovation, the absence of a shift in the locus of control of healthcare, a lack of education for healthcare providers to support inter-professional team-based practices and a failure to be more accountable to the Canadian public's needs. Without these innovations, the primary healthcare system will again be overwhelmed by future healthcare needs. Based on these limitations, we question whether this renewal represents lasting change in primary healthcare or a band-aid solution to the continued issue of primary healthcare delivery.

  5. 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.

  6. Comparing middleware concepts for advanced healthcare system architectures.

    PubMed

    Blobel, B; Holena, M

    1997-09-01

    Different approaches to middleware, supporting systems integration in healthcare, are described and evaluated, regarding concepts, architectural framework, and relevance for healthcare enterprises. This evaluation includes CORBA, DHE, and HL7. CORBA, promoted in the healthcare area through the efforts of CORBAmed, is a strictly object-oriented approach, whereas DHE is based on process-related concepts. The earlier HL7 approach, without any modelling and with proprietary communication management, is changing to a harmonised information interchange concept in healthcare, taking into account also other protocols and medical domains with orientation to an electronic patient record. The opening also includes the separation of message definition and message exchange format, enabling the migration of different EDI standards. HL7 will also support the integration of standardised platforms as 'networking mediator applications'. Finally, some recommendations for future developments are given.

  7. Data, information, knowledge: a healthcare enterprise case study.

    PubMed

    Gudea, Sorin

    2005-11-08

    An efficient, integrated health services delivery enterprise requires the ability to coordinate service delivery across the provider network and avoid duplication of services. It must be able to associate relevant clinical information with patients regardless of which facility delivered the services. There are significant challenges in collecting, organizing, and extracting value from data collected in the course of providing healthcare. This paper follows a large urban public healthcare enterprise in its attempts to address some of these challenges. Using a case-study methodology, the paper shows how information technology (IT) can help a healthcare organization derive improved information and generate knowledge from data stored in disjoint systems.

  8. [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.

  9. 47 CFR 54.637 - Off-site data centers and off-site administrative offices.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... Healthcare Connect Fund § 54.637 Off-site data centers and off-site administrative offices. (a) The... the Healthcare Connect Fund, subject to the conditions and restrictions set forth in paragraph (b)...

  10. 47 CFR 54.637 - Off-site data centers and off-site administrative offices.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... Healthcare Connect Fund § 54.637 Off-site data centers and off-site administrative offices. (a) The... the Healthcare Connect Fund, subject to the conditions and restrictions set forth in paragraph (b)...

  11. Flexible solution for interoperable cloud healthcare systems.

    PubMed

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

    2012-01-01

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

  12. Priority-setting in Finnish healthcare.

    PubMed

    Rissanen, P; Häkkinen, U

    1999-12-01

    The characteristics which affect priority setting in the Finnish healthcare system include strong municipal (local) administration, no clear separation between producers and purchasers, a duality in funding, and the potential for physicians in public hospitals to practice in the private sector. This system has its strengths, such as the possibility to effectively co-ordinate social and healthcare services, and a strong incentive to take care of local needs, because of municipal responsibility to finance these services largely through local taxes. However, the municipalities are typically too small to take advantage of these potentials, their knowledge is scarce especially of secondary care and their negotiating power with respect to hospitals is low. Local politicians also have a dual role: they represent the needs of the local population but simultaneously they are decision-makers in hospitals. Full-time physicians are allowed to act in a dual role as well; they can run a private practice, which is paid for on a fee-for-service basis, while the hospital pays (mostly) a fixed monthly salary. The share of financing which flows from the National Sickness Insurance system to healthcare users may have adverse effects on the local use of resources. The broad national consensus statement on patient-level priorities did not reach any general rules on priorities. Strong support was given to citizens' equal right to access all healthcare services. In healthcare practice, this general rule has some exemptions. First, the reimbursement schemes for prescribed drugs vary depending on the severity and chronic nature of the disease. Secondly, the tax-financed dental services for the young are clearly prioritised over those of older citizens. In the consensus statement, emphasis was put on improving the efficiency of producing health services in order to avoid having to impose patient-level priorities.

  13. Integration of pharmacokinetic and pharmacodynamic indices of valnemulin in broiler chickens after a single intravenous and intramuscular administration.

    PubMed

    Zhao, Dong-Hao; Zhou, Yu-Feng; Yu, Yang; Shi, Wei; Yang, Xue; Xiao, Xia; Deng, Hui; Qiao, Guilin Gary; Fang, Bing-Hu; Liu, Ya-Hong

    2014-07-01

    The antibacterial efficacy of valnemulin against Staphylococcus aureus was studied ex vivo in broiler chickens after intravenous and intramuscular administration at a dose of 10 mg/kg bodyweight (BW). The minimum inhibitory concentrations (MICs) of valnemulin against S. aureus strains ATCC 25923 in broth and serum were 0.12 and 1 µg/mL, respectively. The MIC50 and MIC90 of valnemulin against all susceptible S. aureus strains isolated from chickens in the test population were 0.06 and 0.12 μg/mL, respectively. Protein binding, which greatly influences the efficacy of valnemulin, was assayed by equilibrium dialysate in vitro. A high binding fraction of 86.2% was found, which seems in good agreement with the difference of bacterial susceptibility tests observed in broth and serum. The surrogate index of AUC0-24/MIC required for the lowest bacteriostatic effect, and 2 log10CFU reduction in bacterial count were 24.4 h and 38.0 h, respectively. The required daily dose of valnemulin for a bacteriostatic activity was calculated to be 15 mg/kg BW based on the MIC90 of 0.12 µg/mL. Considering the slow disposition process of valnemulin and an AUC0-24 h value of more than 10-fold obtained from diseased animals, a suggested dose of 3 mg/kg BW is sufficient to achieve a satisfactory therapeutic efficacy in infected broilers. Due to the time-dependent antibacterial characteristics of valnemulin, the recommended daily dose should be split into two or three sub-doses to achieve the highest effectiveness while diminishing the risk of development of bacterial resistance.

  14. Innovating Traditional Nursing Administration Challenges.

    PubMed

    Joseph, M Lindell; Fowler, Debra

    2016-03-01

    The evolving and complex practice environment calls for new mindsets among nurse leaders, academics, and nurse innovators to envision innovative ways to manage and optimize traditional tasks and processes in nursing administration. The purpose of this article is to present 3 case studies that used linear programming and simulation to innovate staffing enterprises, financial management of healthcare systems, and curricula development.

  15. 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.

  16. The secure authorization model for healthcare information system.

    PubMed

    Hsu, Wen-Shin; Pan, Jiann-I

    2013-10-01

    Exploring healthcare system for assisting medical services or transmitting patients' personal health information in web application has been widely investigated. Information and communication technologies have been applied to the medical services and healthcare area for a number of years to resolve problems in medical management. In the healthcare system, not all users are allowed to access all the information. Several authorization models for restricting users to access specific information at specific permissions have been proposed. However, as the number of users and the amount of information grows, the difficulties for administrating user authorization will increase. The critical problem limits the widespread usage of the healthcare system. This paper proposes an approach for role-based and extends it to deal with the information for authorizations in the healthcare system. We propose the role-based authorization model which supports authorizations for different kinds of objects, and a new authorization domain. Based on this model, we discuss the issues and requirements of security in the healthcare systems. The security issues for services shared between different healthcare industries will also be discussed.

  17. Proposal for the creation of a European healthcare identifier.

    PubMed

    Quantin, Catherine; Allaert, François-André; Gouyon, Béatrice; Cohen, Olivier

    2005-01-01

    In France, the European health card was created in June 2004 to increase the quality of healthcare granted to european citizen anywhere in europe and to facilitate the reimbursement of the healthcare costs. The patient identifier included in this card is essentially based on the healthcare insurance number of the patient and does not allow any linkage with his (her) previous health care data if he (she) is affiliated to another national healthcare insurance system when working for a long duration outside France. The purpose of this paper is to present the concept of a personal identifier based on familial components which has been validated by the French authority for personal data protection in the framework of a genetic study. Results issued from the Burgundy perinatal network demonstrate the interest and the faisability of adding a maternal component to the individual component of the new-born to allow Mother/new-born healthcare data linkage after anonymization. The advantage of adding a familial component to the healthcare insurance number is debated. This proposal will permit to link the data of a patient even when residing outside his country in Europe. It will also contribute to establish european public health statistics by matching healthcare data of the patients' records with other administrative data (mortality, social information ..) after anonymisation of these data in accordance with the European directive on data protection.

  18. The Transformation of Behavioral Healthcare in New Mexico

    PubMed Central

    Willging, Cathleen E.; Lamphere, Louise; Rylko-Bauer, Barbara

    2014-01-01

    Since 1997, public-sector behavioral healthcare in New Mexico has remained under continual transition. We have conducted qualitative research to examine recent efforts in NM to establish a recovery-oriented behavioral healthcare system, focusing on comprehensive community support services, clinical homes, and core service agencies. We examine how decisions made in the outer context (e.g., the system level) shaped the implementation of each initiative within the inner context of service provision (e.g., provider agencies). We also clarify how sociopolitical factors, as exemplified in changes instituted by one gubernatorial administration and undone by its successor, can undermine implementation efforts and create crises within fragile behavioral healthcare systems. Finally, we discuss findings in relation to efforts to promote wraparound service planning and to establish medical home models under national healthcare reform. PMID:24980437

  19. Administration of flutamide alters sperm ultrastructure, sperm plasma membrane integrity and its stability, and sperm mitochondrial oxidative capability in the boar: in vivo and in vitro approach.

    PubMed

    Lydka, M; Piasecka, M; Gaczarzewicz, D; Koziorowski, M; Bilinska, B

    2012-08-01

    Our previous work has shown that an anti-androgen flutamide administered pre- and post-natally induced adverse effects on the epididymal morphology and function of adult boars. The present investigation is aimed to understand the effect of flutamide and its metabolite on changes in sperm plasma membrane integrity and its stability, changes in mitochondrial oxidative capability and frequency of abnormal sperm. In vivo effects of flutamide (50 mg/kg b.w.) on sperm ultrastructure were examined by electron microscopic observations. In vitro effects of 5, 50 and 100 μg/ml hydroxyflutamide, administered for 2 and 24 h, on sperm plasma membrane integrity were measured by LIVE/DEAD Sperm Vitality kit, while those on sperm membrane stability and mitochondrial oxidoreductive activity were investigated using Merocyanine 540 and NADH tests, respectively. The incidence of abnormal spermatozoa increased significantly (p < 0.05) in flutamide-treated boars compared with controls. In an in vitro approach, low dose of hydroxyflutamide in 2-h incubations appeared less effective in altering the sperm plasma membrane integrity and its stability than two higher doses used (p < 0.05). No further decrease in the membrane integrity was found when the effect of anti-androgen lasted for 24 h. On the other hand, a decrease in sperm membrane destabilization and mitochondrial oxidoreductive activity was strengthened after 24 h of hydroxyflutamide administration (p < 0.05). Characterization of sperm parameters with regard to oxidative capability of mitochondria, plasma membrane changes and sperm ultrastructure provides novel data on the boar sperm sensitivity to anti-androgen action. Results indicate high sensitivity of boar spermatozoa to androgen withdrawal.

  20. 78 FR 66336 - U.S. Healthcare Education Mission to New Delhi, Hyderabad, and Ahmedabad, India, January 27...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-05

    .... ACTION: Notice. SUMMARY: The United States Department of Commerce, International Trade Administration is... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF COMMERCE International Trade Administration U.S. Healthcare Education Mission to New Delhi, Hyderabad, and...

  1. 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

  2. Crossing and creating boundaries in healthcare innovation.

    PubMed

    Ingerslev, Karen

    2016-06-20

    Purpose - This paper reports from a qualitative case study of a change initiative undertaken in a Danish public hospital setting during national healthcare reforms. The purpose of this paper is to challenge understandings of innovations as defined by being value-adding per se. Whether the effects of attempting to innovate are positive or negative is in this paper regarded as a matter of empirical investigation. Design/methodology/approach - Narrative accounts of activities during the change initiative are analysed in order to elucidate the effects of framing the change initiative as innovation on which boundaries are created and crossed. Findings - Framing change initiatives as innovation leads to intended as well as unanticipated boundary crossings where healthcare practitioners from different organizations recognize a shared problem and task. It also leads to unintended boundary reinforcements between "us and them" that may exclude the perspectives of patients or stakeholders when confronting complex problems in healthcare. This boundary reinforcement can lead to further fragmentation of healthcare despite the stated intention to create more integrated services. Practical implications - The paper suggests that researchers as well as practitioners should not presume that intentions to innovate will by themselves enhance creativity and innovation. When analysing the intended, unintended as well as unanticipated consequences of framing change initiatives as innovation, researchers and practitioner gain nuanced knowledge about the effects of intending to innovate in complex settings such as healthcare. Originality/value - This paper suggests the need for an analytical move from studying the effects of innovation to studying the effects of framing complex problems as a call for innovation.

  3. Kumbh Mela 2013: Healthcare for the millions

    PubMed Central

    Cariappa, M.P.; Singh, B.P.; Mahen, A.; Bansal, A.S.

    2015-01-01

    Mass gatherings pose challenges to healthcare systems anywhere in the world. The Kumbh Mela 2013 at Allahabad, India was the largest gathering of humanity in the history of mankind, and posed an exciting challenge to the provision of healthcare services. At the finale of the Mela, it was estimated that about 120 million pilgrims had visited the site. Equitable geospatial distribution of adhoc health care facilities were created on a standardised template with integrated planning of evacuation modalities. Innovative and low cost response measures for disaster mitigation were implemented. Emergency patient management kits were prepared and stocked across the health care facilities for crisis response. Dynamic resource allocation (in terms of manpower and supplies) based on patient volumes was done on a daily basis, in response to feedback. An adhoc mega township created on the banks of a perennial river (Ganga) in the Indian subcontinent for accommodating millions of Hindu pilgrims. Conventional mindset of merely providing limited and static healthcare through adhoc facilities was done away with. Innovative concepts such as riverine ambulances and disaster kits were introduced. Managing the medical aspects of a mass gathering mega event requires allocation of adequate funds, proactive and integrated medical planning and preparedness. PMID:26288497

  4. "Cloud" health-care workers.

    PubMed Central

    Sherertz, R. J.; Bassetti, S.; Bassetti-Wyss, B.

    2001-01-01

    Certain bacteria dispersed by health-care workers can cause hospital infections. Asymptomatic health-care workers colonized rectally, vaginally, or on the skin with group A streptococci have caused outbreaks of surgical site infection by airborne dispersal. Outbreaks have been associated with skin colonization or viral upper respiratory tract infection in a phenomenon of airborne dispersal of Staphylococcus aureus called the "cloud" phenomenon. This review summarizes the data supporting the existence of cloud health-care workers. PMID:11294715

  5. Elucidation of arctigenin pharmacokinetics after intravenous and oral administrations in rats: integration of in vitro and in vivo findings via semi-mechanistic pharmacokinetic modeling.

    PubMed

    Gao, Qiong; Zhang, Yufeng; Wo, Siukwan; Zuo, Zhong

    2014-11-01

    Although arctigenin (AR) has attracted substantial research interests due to its promising and diverse therapeutic effects, studies regarding its biotransformation were limited. The current study aims to provide information regarding the pharmacokinetic properties of AR via various in vitro and in vivo experiments as well as semi-mechanistic pharmacokinetic modeling. Our in vitro rat microsome incubation studies revealed that glucuronidation was the main intestinal and liver metabolic pathway of AR, which occurred with V max, K m, and Clint of 47.5 ± 3.4 nmol/min/mg, 204 ± 22 μM, and 233 ± 9 μl/min/mg with intestinal microsomes and 2.92 ± 0.07 nmol/min/mg, 22.7 ± 1.2 μM, and 129 ± 4 μl/min/mg with liver microsomes, respectively. In addition, demethylation and hydrolysis of AR occurred with liver microsomes but not with intestinal microsomes. In vitro incubation of AR and its metabolites in intestinal content demonstrated that glucuronides of AR excreted in bile could be further hydrolyzed back to the parent compound, suggesting its potential enterohepatic circulation. Furthermore, rapid formation followed by fast elimination of arctigenic acid (AA) and arctigenin-4'-O-glucuronide (AG) was observed after both intravenous (IV) and oral administrations of AR in rats. Linear pharmacokinetics was observed at three different doses for AR, AA, and AG after IV administration of AR (0.48-2.4 mg/kg, r (2) > 0.99). Finally, an integrated semi-mechanistic pharmacokinetic model using in vitro enzyme kinetic and in vivo pharmacokinetic parameters was successfully developed to describe plasma concentrations of AR, AA, and AG after both IV and oral administration of AR at all tested doses.

  6. Effects of repeated social defeat on adolescent mice on cocaine-induced CPP and self-administration in adulthood: integrity of the blood-brain barrier.

    PubMed

    Rodríguez-Arias, Marta; Montagud-Romero, Sandra; Rubio-Araiz, Ana; Aguilar, María A; Martín-García, Elena; Cabrera, Roberto; Maldonado, Rafael; Porcu, Francesca; Colado, María Isabel; Miñarro, José

    2017-01-01

    Social stress in adulthood enhances cocaine self-administration, an effect that has been related with an increase in extracellular signal-regulated kinase and p38α mitogen-activated protein kinase phosphorylation. A detrimental effect of cocaine on blood-brain barrier (BBB) integrity has also been reported. This study evaluates the effects of repeated social defeat (RSD) during adolescence on the reinforcing and motivational effects of cocaine in adult mice and the changes induced by RSD on BBB permeability. Cocaine self-administration, conditioned place preference and quantitative analysis of claudin-5, laminin, collagen-IV and IgG immunoreactivity took place 3 weeks after RSD. Mice socially defeated during adolescence developed conditioned place preference and exhibited reinstated preference with a non-effective dose of cocaine (1 mg/kg). RSD mice needed significantly more sessions than control animals for the preference induced by 25 mg/kg of cocaine to be extinguished. However, acquisition of cocaine self-administration (0.5 mg/kg per injection) was delayed in the RSD group. Mice exposed to RSD displayed significant changes in BBB structure in adulthood, with a marked reduction in expression of the tight junction protein claudin-5 and an increase in basal laminin degradation (reflected by a decrease in laminin and collagen-IV expression) in the nucleus accumbens and hippocampus. The detrimental effect induced by cocaine (25 mg/kg) on collagen-IV expression in the hippocampus was more pronounced in RSD mice. In summary, our findings suggest that stress and cocaine can increase the long-term vulnerability of the brain to subsequent environmental insults as a consequence of a sustained disruption of the BBB.

  7. Class 1 overview of cultural resources for the Western Area Power Administration Salt Lake City Area Integrated Projects electric power marketing environmental impact statement

    SciTech Connect

    Moeller, K.L.; Malinowski, L.M.; Hoffecker, J.F.; Walitschek, D.A.; Shogren, L.; Mathews, J.E.; Verhaaren, B.T.

    1993-11-01

    Argonne National Laboratory conducted an inventory of known archaeological and historic sites in areas that could be affected by the hydropower operation alternatives under analysis in the power marketing environmental impact statement for the Western Area Power Administration`s Salt Lake City Area Integrated Projects. The study areas included portions of the Green River (Flaming Gorge Dam to Cub Creek) in Utah and Colorado and the Gunnison River (Blue Mesa Reservoir to Crystal Dam) in Colorado. All previous archaeological surveys and previously recorded prehistoric and historic sites, structures, and features were inventoried and plotted on maps (only survey area maps are included in this report). The surveys were classified by their level of intensity, and the sites were classified according to their age, type, and contents. These data (presented here in tabular form) permit a general assessment of the character and distribution of archaeological remains in the study areas, as well as an indication of the sampling basis for such an assessment. To provide an adequate context for the descriptions of the archaeological and historic sites, this report also presents overviews of the environmental setting and the regional prehistory, history, and ethnography for each study area.

  8. Integration of Administrative, Clinical, and Environmental Data to Support the Management of Type 2 Diabetes Mellitus: From Satellites to Clinical Care.

    PubMed

    Dagliati, Arianna; Marinoni, Andrea; Cerra, Carlo; Decata, Pasquale; Chiovato, Luca; Gamba, Paolo; Bellazzi, Riccardo

    2015-12-01

    A very interesting perspective of "big data" in diabetes management stands in the integration of environmental information with data gathered for clinical and administrative purposes, to increase the capability of understanding spatial and temporal patterns of diseases. Within the MOSAIC project, funded by the European Union with the goal to design new diabetes analytics, we have jointly analyzed a clinical-administrative dataset of nearly 1.000 type 2 diabetes patients with environmental information derived from air quality maps acquired from remote sensing (satellite) data. Within this context we have adopted a general analysis framework able to deal with a large variety of temporal, geo-localized data. Thanks to the exploitation of time series analysis and satellite images processing, we studied whether glycemic control showed seasonal variations and if they have a spatiotemporal correlation with air pollution maps. We observed a link between the seasonal trends of glycated hemoglobin and air pollution in some of the considered geographic areas. Such findings will need future investigations for further confirmation. This work shows that it is possible to successfully deal with big data by implementing new analytics and how their exploration may provide new scenarios to better understand clinical phenomena.

  9. Enhanced semantic interpretability by healthcare standards profiling.

    PubMed

    Lopez, Diego M; Blobel, Bernd G M E

    2008-01-01

    Several current healthcare standards support semantic interoperability. These standards are far to be completely adopted in health information system development, however. The objective of this paper is to provide a method and necessary tooling for reusing healthcare standards by exploiting the extensibility mechanisms of UML, by that way supporting the development of semantically interoperable systems and components. The method identifies first the models and tasks in the software development process in which health care standards can be reused. Then, the selected standard is formalized as a UML profile. Finally that profile is applied to system models, annotating them with the standard semantics. The supporting tools are Eclipse-based UML modeling tools. The method is integrated into a comprehensive framework for health information systems development. The feasibility of the approach is exemplified by a scenario reusing HL7 RIM and DIMs specifications. The approach presented is also applicable for harmonizing different standard specifications.

  10. [The future of urological care: the current situation in healthcare political environment].

    PubMed

    Knieps, F; Ex, P

    2012-08-01

    The healthcare system is the largest economic market in Germany. The specific requirements demand an intelligent mixture of market, self-administration and federal regulation, which must be permanently adapted to continuously altering environmental conditions. Urological care exemplifies the adaptation of healthcare to altered economic, social and medical environmental conditions.

  11. Infusing an Inter-Professional and Inter-University Perspective into Healthcare Education

    ERIC Educational Resources Information Center

    Goldberg, Lynette R.; Koontz, Jennifer Scott; Downs, David; Uhlig, Paul; Kumar, Neil G.; Shah, Sapna; Clark, Paige E.; Coiner, Christina; Crumrine, Daiquirie

    2010-01-01

    A national (USA) student-led, case-based CLinician/Administrator Relationship Improvement OrganizatioN (CLARION) competition focuses students in medical and related healthcare programs on the provision of healthcare that is safe, timely, equitable, patient-centred, effective and efficient. Students work in four-person, inter-professional teams to…

  12. 77 FR 72409 - Manufacturer of Controlled Substances; Notice of Application: Siemens Healthcare Diagnostics, Inc.

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-05

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF JUSTICE Drug Enforcement Administration Manufacturer of Controlled Substances; Notice of Application: Siemens Healthcare... notice that on November 7, 2012, Siemens Healthcare Diagnostics, Inc., Attn: RA, 100 GBC Drive, Mail...

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

    PubMed

    Jenkins, E K; Christenson, E

    2001-05-01

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

  14. Opportunities for administrators to promote disease management.

    PubMed

    Kash, Bita A; Gamm, Larry D; Bolin, Jane Nelson; Peck, B Mitchell

    2005-01-01

    Studies of disease management (DM) have shown that patients who participate in such programs achieve better health status and make fewer emergency room visits. Private and government payers have recently increased their efforts to promote DM initiatives through financial incentives to healthcare providers. This article explores opportunities for administrators of health services organizations (HSO) to promote DM in the current political and economic environment. Our survey of professionals (DM leaders, physicians, and DM nurses) in six DM programs reveals these professionals' assessments of the key players and resources that they deem important to their respective DM programs. They view DM programs as heavily dependent on the support of physicians, nurses, and health plan leaders but relatively less so on the support of HSO administrators- a situation that may suggest opportunities for administrators to take on greater leadership in moving the HSO toward developing DM programs. Survey results also indicate a strong need for the integration of resources such as communication systems, electronic medical records, and DM reporting. Taken collectively, these needs suggest a number of strategies for the administrator to play a larger role in supporting the adoption and effective implementation of DM. In the article, we propose that DM programs can benefit substantially from an administrator who can demonstrate a thorough knowledge of DM-related government and private-payer initiatives and who has the ability to provide leadership to develop and implement viable DM programs. Valued contributions that the administrator should bring to the table include support of standardized DM processes, use of practice guidelines, and provision of pertinent information systems.

  15. Integration

    ERIC Educational Resources Information Center

    Kalyn, Brenda

    2006-01-01

    Integrated learning is an exciting adventure for both teachers and students. It is not uncommon to observe the integration of academic subjects such as math, science, and language arts. However, educators need to recognize that movement experiences in physical education also can be linked to academic curricula and, may even lead the…

  16. Workplace Bullying in Healthcare: Part 3.

    PubMed

    Lamberth, By Becky

    2015-01-01

    As many as 53.5 million American workers have experienced workplace bullying, which can cost organizations an estimated $200 billion annually in lost productivity, increased sick d ays, increased med ical claims, legal costs, and staff turnover. Bullying can occur in any profession, but for many reasons it is most prevalent in healthcare. Bullying behavior in healthcare has been reported and documented in literature for over 35 years. Although physicians are often considered to be the primary culprit of bullying, healthcare bullies can be one any one of the professionals who work in the organization including nurses, radiology technologists, pharmacists, ancillary staff personnel, administrators, or other non-physician staff members. The first installment of the series focused on defining bullying and its impact on the organization. Part 2 discussed three legal protections for the bully to include at-will laws, unions, and bylaws related to physician privileging. The final installment in this series will evaluate specific bully types and implementing processes to address inappropriate behavior.

  17. Healthcare security staffing for smaller facilities: where science meets art.

    PubMed

    Warren, Bryan

    2013-01-01

    Obtaining effective security resourcing and staffing for smaller healthcare facilities presents many difficulties, according to the author In this article, he provides guidance to security practitioners on taking existing data and translating it into a language that administration will understand and appreciate.

  18. User needs and requirements analysis for big data healthcare applications.

    PubMed

    Zillner, Sonja; Lasierra, Nelia; Faix, Werner; Neururer, Sabrina

    2014-01-01

    The realization of big data applications that allow improving the quality and efficiency of healthcare care delivery is challenging. In order to take advantage of the promising opportunities of big data technologies, a clear understanding of user needs and requirements of the various stakeholders of healthcare, such as patients, clinicians and physicians, healthcare provider, payors, pharmaceutical industry, medical product suppliers and government, is needed. Our study is based on internet, literature and market study research as well as on semi-structured interviews with major stakeholder groups of healthcare delivery settings. The analysis shows that big data technologies could be used to align the opposing user needs of improved quality with improved efficiency of care. However, this requires the integrated view of various heterogeneous data sources, legal frameworks for data sharing and incentives that foster collaboration.

  19. Healthcare in Disasters and the Role of RFID.

    PubMed

    Madanian, Samaneh; Parry, David; Norris, Tony

    2015-01-01

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

  20. Innovation Concepts in Healthcare

    ScienceCinema

    None

    2016-07-12

    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

  1. [The primary healthcare centres].

    PubMed

    Brambilla, Antonio; Maciocco, Gavino

    2014-04-01

    The central attributes of primary care are: first contact (accessibility), longitudinality (person- focused preventive and curative care overtime), patient-oriented comprehensiveness and coordination (including navigation towards secondary and tertiary care). Besides taking care of the needs of the individuals, primary health care teams are also looking at the community, especially when addressing social determinants of health. The rationale for the benefits for primary care for health has been found in: 1) greater access to needed services; 2) better quality of care; 3) a greater focus on prevention; 4) early management of health problems; 5) organizing and delivering high quality care for chronic non-communicable diseases. This paper describes the role of primary healthcare centres in strengthening community primary services and in reducing health inequalities. Furthemore, the experiences of Regional Health Services from Tuscany and Emilia-Romagna are discussed, with a brief overview of the literature.

  2. Technology and healthcare costs

    PubMed Central

    Kumar, R Krishna

    2011-01-01

    Medicine in the 21st century is increasingly dependent on technology. Unlike in many other areas, the cost of medical technology is not declining and its increasing use contributes to the spiraling healthcare costs. Many medical professionals equate progress in medicine to increasing use of sophisticated technology that is often expensive and beyond the reach of the average citizen. Pediatric heart care is very technology-intensive and therefore very expensive and beyond the reach of the vast majority of children in the developing world. There is an urgent need to address this situation through development and use of appropriate technology in accordance with the needs and priorities of the society. A number of simple and inexpensive quality measures that have the potential of improving outcomes substantially without the need for expensive equipment should be instituted before embracing high-end technology. Innovations to reduce costs that are commonly used in limited resource environments should be tested systematically. PMID:21677816

  3. Consumer reaction to healthcare advertising.

    PubMed

    Klein, R F

    1998-07-01

    How do consumers view healthcare advertising? This question, along with many others, was addressed in a national survey conducted by Market Strategies for The Alliance For Healthcare Strategy And Marketing, and presented during The Alliance's annual advertising and promotion conference last June.

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

    PubMed

    Joyce, Phil; Green, Rosamund; Winch, Graham

    2007-01-01

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

  5. The great divide: social media's role in bridging healthcare's generational shift.

    PubMed

    Sarringhaus, Meredith M

    2011-01-01

    Social media, a resource largely untapped in the healthcare field, presents opportunities and advantages and, if used properly, can innovate healthcare and create a competitive advantage for adopters. Many organizations have considered social media but dismissed its advantages as fleeting products of the new generation entering the workforce: the millennials. However, the millennial generation has assumed a greater presence in clinical and administrative positions as the baby boomer generation prepares for retirement. This article advocates the adoption of social media in healthcare organizations as a strategic advantage in connecting with their patient population and recruiting and retaining millennial staff amid the generational shift of the healthcare workforce.

  6. Transcultural perspectives in nursing administration.

    PubMed

    Andrews, M M

    1998-11-01

    Population demographics are reshaping the healthcare work force with respect to race, ethnicity, gender, national origin, sexual orientation, age, handicap, disability, and related factors as national sensitivity to various forms of diversity grows. Given the demographic trends, it is inevitable that nurse administrators will need skill in transcultural administration as they manage diversity and identify the cultural origins of conflict in the multicultural workplace. Culture influences the manner in which administrators, staff and patients perceive, identify, define and solve problems. In this article, the complex and interrelated factors that influence workplace diversity are examined.

  7. Healthcare for Persons with Intellectual and Developmental Disability in the Community

    PubMed Central

    Ervin, David A.; Hennen, Brian; Merrick, Joav; Morad, Mohammed

    2014-01-01

    Introduction: While there has been impressive progress in creating and improving community healthcare delivery systems that support people with intellectual and developmental disabilities (IDD), there is much more that can and should be done. Methods: This paper offers a review of healthcare delivery concepts on which new models are being developed, while also establishing an historical context. We review the need for creating fully integrated models of healthcare, and at the same time offer practical considerations that range from specific healthcare delivery system components to the need to expand our approach to training healthcare providers. The models and delivery systems, and the areas of needed focus in their development are reviewed to set a starting point for more and greater work going forward. Conclusion: Today, we celebrate longer life spans of people with IDD, increased attention to the benefits of healthcare that is responsive to their needs, and the development of important healthcare delivery systems that are customized to their needs. We also know that the growing body of research on health status offers incentive to continue developing healthcare structures for people with IDD by training healthcare providers about the needs of people with IDD, by establishing systems of care that integrate acute healthcare with long-term services and support, by developing IDD medicine as a specialty, and by building health promotion and wellness resources to provide people with IDD a set of preventative health supports. PMID:25077139

  8. 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.

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

    PubMed

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

    2013-01-01

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

  10. Understanding business intelligence in the context of healthcare.

    PubMed

    Mettler, Tobias; Vimarlund, Vivian

    2009-09-01

    In today's fast changing healthcare sector, decision makers are facing a growing demand for both clinical and administrative information in order to comply with legal and customer-specific requirements. The use of business intelligence (BI) is seen as a possible solution to this actual challenge. As the existing research about BI is primarily focused on the industrial sector, it is the aim of this contribution to translate and adapt the current findings for the healthcare context. For this purpose, different definitions of BI are examined and condensed in a framework. Furthermore, the sector-specific preconditions for the effective use and future role of BI are discussed.

  11. Planning for the baby boomers' healthcare needs: a case study.

    PubMed

    Albert, Terri C; Johnson, Edward; Gasperino, Daniel; Tokatli, Pinar

    2003-01-01

    Will the impact of baby boomers, as they age, be a bonanza or a bust for the healthcare system? A range of perspectives prevail, from increasing in-patient admissions capacity to accommodate the sheer numbers, to the creation of a variety of healthcare services and delivery channels that address their unique requirements. This case study presents a top 100, regional hospital's approach to this dilemma. The strategic marketing process using segmentation, targeting, and positioning (STP) was employed to guide the administration's planning and decision making.

  12. Strategic integration of in vivo cardiovascular models during lead optimization: predictive value of 4 models independent of species, route of administration, and influence of anesthesia.

    PubMed

    Fryer, Ryan M; Harrison, Paul C; Muthukumarana, Akalushi; Nodop Mazurek, Suzanne G; Ng, Khing Jow; Chen, Rong Rhonda; Harrington, Kyle E; Dinallo, Roger M; Chi, Liguo; Reinhart, Glenn A

    2012-04-01

    The strategic integration of in vivo cardiovascular models is important during lead optimization to enable a wide therapeutic index for cardiovascular safety. However, under what conditions (eg, species, route of administration, anesthesia) studies should be performed to drive go/no-go is open to interpretation. Two compounds, torcetrapib and a novel steroid hormone mimetic (SHM-1121X), both with off-target cardiovascular liabilities, were profiled in 4 in vivo cardiovascular models. Overlapping plasma concentrations of torcetrapib were achieved in all models tested; values ranged from therapeutic to supratherapeutic. In anesthetized rats, intravenous torcetrapib elicited dose-dependent increases in mean arterial pressure (MAP; 2-18 mm Hg above vehicle during the low- and high-dose infusion), and in anesthetized dogs, torcetrapib increased MAP from 4 to 22 mm Hg. In conscious rats, a single oral dose of torcetrapib increased MAP from 10 to 18 mm Hg in the low-dose and high-dose groups, respectively, whereas in conscious dogs, MAP increased from 3 to 12 mm Hg. SHM-1121X produced marked hypotension in the same models. Pharmacokinetic-pharmacodynamic analysis demonstrated strong correlation across the models tested for both compounds. Results suggest that equivalency across models allows for flexibility to address key issues and enable go/no-go during lead optimization without concern for discordant results. The predictive value of each model was validated with torcetrapib and, when put into practice, led to a decisive no-go for SHM-1121X.

  13. [IHE ITI-ATNA profile-based solution for the security of regional healthcare information sharing].

    PubMed

    Yao, Ye-hong; Zhang, Jian-guo

    2008-09-01

    In designing and implementing regional healthcare information sharing systems, the security problem is a very important issue. According to the Audit Trail and Node Authentication (ATNA) Profile of Integrating the Healthcare Enterprise (IHE) and the practical experiences in several hospitals in Shanghai, a Proxy/Server based security solution for the integration of regional healthcare information sharing systems is proposed, which can solve the cross-platform security problems of integration, providing some security measures such as Central User Authentication, Audit Trail and Node Authentication.

  14. National Healthcare Reform: Implications for the Military Healthcare System

    DTIC Science & Technology

    2010-05-16

    healthcare for certain non-active duty reservists and extended chiropractic care to active duty members placing yet additional pressures on defense health...coalition of lobbyists and elected representatives to implement reforms. The recent passage of the Patient Protection and Affordable Care Act (PPACA... Care Act (PPACA), Capitation, Health Savings Accounts (HAS), AHLTA, VistA, TRICARE, Military Healthcare System (MHS). 16. SECURITY CLASSIFICATION

  15. [Healthcare patient loyalty].

    PubMed

    Ameri, Cinzia; Fiorini, Fulvio

    2016-01-01

    If the "old economy" preached standardization of products/services in order to reduce costs, the "new economy" is based on the recognition of the needs and the management of information. It is aimed at providing better and more usable services. One scenario is a national health service with regional management but based on competition between hospitals/companies.This led to a different handling of the user/patient, which has become the center of the health system: marketing seeks to retain the patient, trying to push a client-patient to not change their healthcare service provider. In costs terms, it is more economical to retain a customer rather than acquire a new one: a satisfied customer is also the best sounding board for each company. Customer equity is the management of relations with patients which can result in a greater customer value: it is possible to recognize an equity of the value, of the brand and of the report. Loyalty uses various marketing activities (basic, responsive, responsible, proactive and collaborative): each hospital/company chooses different actions depending on how many resources it plans to invest in loyalty.

  16. Healthcare financing in Yemen.

    PubMed

    Holst, Jens; Gericke, Christian A

    2012-01-01

    Yemen is a low-middle-income country where more than half of the population live in rural areas and lack access to the most basic health care. At US$40 per capita, Yemen's annual total health expenditure (THE) is among the lowest worldwide. This study analyses the preconditions and options for implementing basic social health protection in Yemen. It reveals a four-tiered healthcare system characterised by high geographic and financial access barriers mainly for the poor. Out-of-pocket payments constitute 55% of THE, and cost-sharing exemption schemes are not well organised. Resource-allocation practices are inequitable because about 30% of THE gets spent on treatment abroad for a small number of patients, mainly from better-off families. Against the background of a lack of social health protection, a series of small-scale and often informal solidarity schemes have developed, and a number of public and private companies have set up health benefit schemes for their employees. Employment-based schemes usually provide reasonable health care at an average annual cost of YR44 000 (US$200) per employee. In contrast, civil servants contribute to a mandatory health-insurance scheme without receiving any additional health benefits in return. A number of options for initiating a pathway towards a universal health-insurance system are discussed.

  17. Health sector reforms for 21(st) century healthcare.

    PubMed

    Shankar, Darshan

    2015-01-01

    The form of the public health system in India is a three tiered pyramid-like structure consisting primary, secondary, and tertiary healthcare services. The content of India's health system is mono-cultural and based on western bio-medicine. Authors discuss need for health sector reforms in the wake of the fact that despite huge investment, the public health system is not delivering. Today, 70% of the population pays out of pocket for even primary healthcare. Innovation is the need of the hour. The Indian government has recognized eight systems of healthcare viz., Allopathy, Ayurveda, Siddha, Swa-rigpa, Unani, Naturopathy, Homeopathy, and Yoga. Allopathy receives 97% of the national health budget, and 3% is divided amongst the remaining seven systems. At present, skewed funding and poor integration denies the public of advantage of synergy and innovations arising out of the richness of India's Medical Heritage. Health seeking behavior studies reveal that 40-70% of the population exercise pluralistic choices and seek health services for different needs, from different systems. For emergency and surgery, Allopathy is the first choice but for chronic and common ailments and for prevention and wellness help from the other seven systems is sought. Integrative healthcare appears to be the future framework for healthcare in the 21(st) century. A long-term strategy involving radical changes in medical education, research, clinical practice, public health and the legal and regulatory framework is needed, to innovate India's public health system and make it both integrative and participatory. India can be a world leader in the new emerging field of "integrative healthcare" because we have over the last century or so assimilated and achieved a reasonable degree of competence in bio-medical and life sciences and we possess an incredibly rich and varied medical heritage of our own.

  18. Transformative leadership: an ethical stewardship model for healthcare.

    PubMed

    Caldwell, Cam; Voelker, Carolyn; Dixon, Rolf D; LeJeune, Adena

    2008-01-01

    The need for effective leadership is a compelling priority for those who would choose to govern in public, private, and nonprofit organizations, and applies as much to the healthcare profession as it does to other sectors of the economy (Moody, Horton-Deutsch, & Pesut, 2007). Transformative Leadership, an approach to leadership and governance that incorporates the best characteristics of six other highly respected leadership models, is an integrative theory of ethical stewardship that can help healthcare professionals to more effectively achieve organizational efficiencies, build stakeholder commitment and trust, and create valuable synergies to transform and enrich today's healthcare systems (cf. Caldwell, LeJeune, & Dixon, 2007). The purpose of this article is to introduce the concept of Transformative Leadership and to explain how this model applies within a healthcare context. We define Transformative Leadership and identify its relationship to Transformational, Charismatic, Level 5, Principle-Centered, Servant, and Covenantal Leadership--providing examples of each of these elements of Transformative Leadership within a healthcare leadership context. We conclude by identifying contributions of this article to the healthcare leadership literature.

  19. Business process modeling in healthcare.

    PubMed

    Ruiz, Francisco; Garcia, Felix; Calahorra, Luis; Llorente, César; Gonçalves, Luis; Daniel, Christel; Blobel, Bernd

    2012-01-01

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

  20. 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

  1. Healthcare information technology and economics.

    PubMed

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

    2013-01-01

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

  2. Control of corruption in healthcare.

    PubMed

    Ahmed, Armin; Azim, Afzal

    2015-01-01

    A recently published article on corruption in Indian healthcare in the BMJ has triggered a hot debate and numerous responses (1, 2, 3, 4). We do agree that corruption in Indian healthcare is a colossal issue and needs to be tackled urgently (5). However, we want to highlight that corruption in healthcare is not a local phenomenon confined to the Indian subcontinent, though India does serve as a good case study and intervention area due to the magnitude of the problem and the country's large population (6). Good governance, strict rules, transparency and zero tolerance are some of the strategies prescribed everywhere to tackle corruption. However, those entrusted with implementing good governance and strict rules in India need to go through a process of introspection to carry out their duties in a responsible fashion. At present, it looks like a no-win situation. In this article, we recommend education in medical ethics as the major intervention for dealing with corruption in healthcare.

  3. The emergence and potential impact of medicine 2.0 in the healthcare industry.

    PubMed

    Stump, Terra; Zilch, Sarah; Coustasse, Alberto

    2012-01-01

    Medicine 2.0 has emerged within healthcare information technology to enable more defined relationships among providers and patients. Physicians, hospitals, and patients are using Medicine 2.0 through social networking to maintain their foothold in the evolution of medical technologies. The authors' purpose was to determine potential improvements that Medicine 2.0 has on communication and collaboration of healthcare information. Research has shown that Medicine 2.0 has integrated into the healthcare industry and is enabling an increase in communication in healthcare matters. The provider-patient relationship is improving through the use of Medicine 2.0 and has positively impacted society so far.

  4. Hearing the Cries of the Poor: Healthcare as Human Response

    ERIC Educational Resources Information Center

    Robinson, Adam M., Jr.

    2010-01-01

    The keynote address of Vice Admiral Adam Robinson, Surgeon General of the United States Navy, summarizes the integration of healthcare humanitarian assistance as central to the Navy's mission of defending and promoting world peace. Citing various examples of current programs and initiatives, the address explores the critical place of human hope as…

  5. Primary healthcare providers’ views on improving sexual and reproductive healthcare for adolescents in Bolivia, Ecuador, and Nicaragua

    PubMed Central

    Jaruseviciene, Lina; Orozco, Miguel; Ibarra, Marcia; Ossio, Freddy Cordova; Vega, Bernardo; Auquilla, Nancy; Medina, Joel; Gorter, Anna C.; Decat, Peter; De Meyer, Sara; Temmerman, Marleen; Edmonds, Alexander B.; Valius, Leonas; Lazarus, Jeffrey V.

    2013-01-01

    Objectives To elicit the views of primary healthcare providers from Bolivia, Ecuador, and Nicaragua on how adolescent sexual and reproductive health (ASRH) care in their communities can be improved. Methods Overall, 126 healthcare providers (46 from Bolivia, 39 from Ecuador, and 41 from Nicaragua) took part in this qualitative study. During a series of moderated discussions, they provided written opinions about the accessibility and appropriateness of ASRH services and suggestions for its improvement. The data were analyzed by employing a content analysis methodology. Results Study participants emphasized managerial issues such as the prioritization of adolescents as a patient group and increased healthcare providers’ awareness about adolescent-friendly approaches. They noted that such an approach needs to be extended beyond primary healthcare centers. Schools, parents, and the community in general should be encouraged to integrate issues related to ASRH in the everyday life of adolescents and become ‘gate-openers’ to ASRH services. To ensure the success of such measures, action at the policy level would be required. For example, decision-makers could call for developing clinical guidelines for this population group and coordinate multisectoral efforts. Conclusions To improve ASRH services within primary healthcare institutions in three Latin American countries, primary healthcare providers call for focusing on improving the youth-friendliness of health settings. To facilitate this, they suggested engaging with key stakeholders, such as parents, schools, and decision-makers at the policy level. PMID:23680267

  6. Pediatric home healthcare: a paradox.

    PubMed

    Krepper, R; Young, A; Cummings, E

    1994-01-01

    Although parents may welcome having their ill child cared for at home, they are not prepared to compromise privacy and family rituals, nor share control of their child. The purpose of this article is to provide a snapshot of problems that parents have encountered with pediatric home healthcare. Home care parents offer suggestions for other parents and home healthcare nurses and agencies, encouraging them to be proactive in preventing potential problems.

  7. Trust and Privacy in Healthcare

    NASA Astrophysics Data System (ADS)

    Singleton, Peter; Kalra, Dipak

    This paper considers issues of trust and privacy in healthcare around increased data-sharing through Electronic Health Records (EHRs). It uses a model structured around different aspects of trust in the healthcare organisation’s reasons for greater data-sharing and their ability to execute EHR projects, particularly any associated confidentiality controls. It reflects the individual’s personal circumstances and attitude to use of health records.

  8. Patient-centered healthcare design.

    PubMed

    Stichler, Jaynelle F

    2011-12-01

    Patient-centered care focuses on the patient's and family's experience in the hospital, and the design of the healthcare environment should support the patient-centered care concept. The purpose of this facility design department is to expand nurse leaders' knowledge and competencies in health facility design and enable them to take leadership roles in design efforts. This article focuses on healthcare design guiding principles and features to support organizational cultural initiatives such as patient- and family-centered care and Planetree.

  9. Strategies to Improve Healthcare Websites

    PubMed Central

    Johnson, Constance; Peterson, Susan K.; Turley, James P.; Ensor, Joe; Amos, Christopher; Spitz, Margaret; Levin, Bernard; Berry, Donald

    2006-01-01

    Healthcare websites that are influential in healthcare decision-making must be evaluated for accuracy, readability and understandability by the average population. Most existing frameworks for designing and evaluating interactive websites focus on the utility and usability of the site. Although these are significant to the design of the basic site, they are not sufficient. We have developed an iterative framework that considers additional attributes. PMID:17238588

  10. Campaign 2008: healthcare reform revisited.

    PubMed

    Wilensky, Gail R

    2008-10-01

    *An important lesson to be learned from the failed efforts at healthcare reform of the early 1990s is that successful reform cannot be an all-or-nothing proposition. *The McCain and Obama healthcare plans have some elements in common, but they also have important differences. *Whoever wins the election will face the challenge of persuading Congress to go along with his proposal.

  11. Understanding the cognitive impact of the contraceptive estrogen Ethinyl Estradiol: tonic and cyclic administration impairs memory, and performance correlates with basal forebrain cholinergic system integrity.

    PubMed

    Mennenga, Sarah E; Gerson, Julia E; Koebele, Stephanie V; Kingston, Melissa L; Tsang, Candy W S; Engler-Chiurazzi, Elizabeth B; Baxter, Leslie C; Bimonte-Nelson, Heather A

    2015-04-01

    Ethinyl Estradiol (EE), a synthetic, orally bio-available estrogen, is the most commonly prescribed form of estrogen in oral contraceptives, and is found in at least 30 different contraceptive formulations currently prescribed to women as well as hormone therapies prescribed to menopausal women. Thus, EE is prescribed clinically to women at ages ranging from puberty to reproductive senescence. Here, in two separate studies, the cognitive effects of cyclic or tonic EE administration following ovariectomy (Ovx) were evaluated in young female rats. Study I assessed the cognitive effects of low and high doses of EE, delivered tonically via a subcutaneous osmotic pump. Study II evaluated the cognitive effects of low, medium, and high doses of EE administered via a daily subcutaneous injection, modeling the daily rise and fall of serum EE levels with oral regimens. Study II also investigated the impact of low, medium and high doses of EE on the basal forebrain cholinergic system. The low and medium doses utilized here correspond to the range of doses currently used in clinical formulations, and the high dose corresponds to doses prescribed to a generation of women between 1960 and 1970, when oral contraceptives first became available. We evaluate cognition using a battery of maze tasks tapping several domains of spatial learning and memory as well as basal forebrain cholinergic integrity using immunohistochemistry and unbiased stereology to estimate the number of choline acetyltransferase (ChAT)-producing cells in the medial septum and vertical/diagonal bands. At the highest dose, EE treatment impaired multiple domains of spatial memory relative to vehicle treatment, regardless of administration method. When given cyclically at the low and medium doses, EE did not impact working memory, but transiently impaired reference memory during the learning phase of testing. Of the doses and regimens tested here, only EE at the highest dose impaired several domains of memory

  12. Reinventing Veterans Health Administration: focus on primary care.

    PubMed

    Armstrong, Brent; Levesque, Odette; Perlin, Jonathan B; Rick, Cathy; Schectman, Gordon

    2005-01-01

    Can we improve access in primary care without compromising the quality of care? The purpose of this article is to demonstrate how timely access to primary care can be achieved without compromising the quality of the care being delivered. The Veterans Health Administration (VHA) is an integrated healthcare system that has implemented change to improve primary care access to the veterans it serves, while not only maintaining but also actually improving the quality of care. Many healthcare executives are struggling with achieving desirable access to care and continuity of care. To confront this problem, many large and small practices have initiated an approach known as advanced clinic access, open access, or same-day scheduling, introduced by the Institute for Healthcare Improvement (IHI). This approach has increasingly been used to reduce waits and delays in primary care without adding resources. To measure quality of care, specific performance measures were developed to quantify the effectiveness of primary care in VHA. Although it was initially viewed with concern and suspicion and was seen as a symptom of unnecessary micromanagement, healthcare team members were encouraged to use performance feedback as an opportunity for systems improvement as well as self-assessment and performance improvement for the team. All quality data are posted quarterly on VHA's internal web site, providing visible accountability at all levels of the organization. Clinical workflow redesign leads to reduced wait times without compromising quality of care. These large system improvements are applicable to large and small organizations looking to tackle change through the use of a collaborative model.

  13. LEAN thinking in Finnish healthcare.

    PubMed

    Jorma, Tapani; Tiirinki, Hanna; Bloigu, Risto; Turkki, Leena

    2016-01-01

    Purpose - The purpose of this study is to evaluate how LEAN thinking is used as a management and development tool in the Finnish public healthcare system and what kind of outcomes have been achieved or expected by using it. The main focus is in managing and developing patient and treatment processes. Design/methodology/approach - A mixed-method approach incorporating the Webropol survey was used. Findings - LEAN is quite a new concept in Finnish public healthcare. It is mainly used as a development tool to seek financial savings and to improve the efficiency of patient processes, but has not yet been deeply implemented. However, the experiences from LEAN initiatives have been positive, and the methodology is already quite well-known. It can be concluded that, because of positive experiences from LEAN, the environment in Finnish healthcare is ready for the deeper implementation of LEAN. Originality/value - This paper evaluates the usage of LEAN thinking for the first time in the public healthcare system of Finland as a development tool and a management system. It highlights the implementation and achieved results of LEAN thinking when used in the healthcare environment. It also highlights the expectations for LEAN thinking in Finnish public healthcare.

  14. Serial murder by healthcare professionals.

    PubMed

    Yorker, Beatrice Crofts; Kizer, Kenneth W; Lampe, Paula; Forrest, A R W; Lannan, Jacquetta M; Russell, Donna A

    2006-11-01

    The prosecution of Charles Cullen, a nurse who killed at least 40 patients over a 16-year period, highlights the need to better understand the phenomenon of serial murder by healthcare professionals. The authors conducted a LexisNexis search which yielded 90 criminal prosecutions of healthcare providers that met inclusion criteria for serial murder of patients. In addition we reviewed epidemiologic studies, toxicology evidence, and court transcripts, to provide data on healthcare professionals who have been prosecuted between 1970 and 2006. Fifty-four of the 90 have been convicted; 45 for serial murder, four for attempted murder, and five pled guilty to lesser charges. Twenty-four more have been indicted and are either awaiting trial or the outcome has not been published. The other 12 prosecutions had a variety of legal outcomes. Injection was the main method used by healthcare killers followed by suffocation, poisoning, and tampering with equipment. Prosecutions were reported from 20 countries with 40% taking place in the United States. Nursing personnel comprised 86% of the healthcare providers prosecuted; physicians 12%, and 2% were allied health professionals. The number of patient deaths that resulted in a murder conviction is 317 and the number of suspicious patient deaths attributed to the 54 convicted caregivers is 2113. These numbers are disturbing and demand that systemic changes in tracking adverse patient incidents associated with presence of a specific healthcare provider be implemented. Hiring practices must shift away from preventing wrongful discharge or denial of employment lawsuits to protecting patients from employees who kill.

  15. Current issues in German healthcare.

    PubMed

    Graf von der Schulenburg, J M; Uber, A

    1997-11-01

    Germany has developed a model of social health insurance for financing healthcare. The basic characteristics of this model are compulsory membership, income-dependent contributions paid by employers and employees, a comprehensive package of healthcare entitlements, stringent government regulation and implementation by not-for-profit health insurers--the sickness funds--which operate under public law. Since the mid-1970s, when health care cost containment gradually evolved as a new issue in German healthcare policy-making, a long series of reform programmes have been initiated. Two recent development can be noted: the introduction of market competition in health insurance and the introduction of fixed budgets. Market competition in health insurance is now an explicit policy tool in Germany. This article analyses the German healthcare system, the history of healthcare reforms and the current healthcare acts. Special emphasis is given to the German drug market and its regulation. The paper describes the present cost-containment policy for pharmaceutical products, especially the global budget concept which was introduced for medicines and patients' copayments.

  16. Laboratory medicine in the new healthcare environment.

    PubMed

    Ferraro, Simona; Braga, Federica; Panteghini, Mauro

    2016-04-01

    The 21st century challenge is to redesign healthcare systems to be safe, efficient, effective, timely, equitable and patient-centred. Although laboratory medicine is integral to many of these objectives involving prevention, diagnosis, treatment, and managing disease of patients, it suffers from poor visibility as a medical discipline and as a profession and fewer rewards for educational efforts when compared to other medical disciplines. Laboratory scientists are often perceived as managing machinery and equipment, but conversely they need to take a position of shared clinical leadership, showing the role of laboratory tests to guarantee optimal care for patients. This is however challenging because of some reluctance by laboratory professionals to involve themselves in test structuring and requesting and in the inspection of work as it arrives because it is assumed that all requests are clinically necessary; there is a poor communication and integration between clinical wards and laboratory; and, importantly, there is the need for an excellent cultural and scientific background of laboratory professionals for implementing outcome research and to act as knowledge managers and skilled clinical consultants. By combining the unique talent of performing quality laboratory assays with knowledge of the pathophysiologic rationale behind the tests, laboratory professionals have the expertise to advise their clinical colleagues in regard to the appropriate test selection and interpretation of laboratory results, thereby creating opportunities to define the added value and the pivotal role of laboratory medicine on healthcare delivery.

  17. The contribution of qualitative research in designing a complex intervention for secondary prevention of coronary heart disease in two different healthcare systems

    PubMed Central

    Corrrigan, Mairead; Cupples, Margaret E; Smith, Susan M; Byrne, Molly; Leathem, Claire S; Clerkin, Pauline; Murphy, Andrew W

    2006-01-01

    Background Developing complex interventions for testing in randomised controlled trials is of increasing importance in healthcare planning. There is a need for careful design of interventions for secondary prevention of coronary heart disease (CHD). It has been suggested that integrating qualitative research in the development of a complex intervention may contribute to optimising its design but there is limited evidence of this in practice. This study aims to examine the contribution of qualitative research in developing a complex intervention to improve the provision and uptake of secondary prevention of CHD within primary care in two different healthcare systems. Methods In four general practices, one rural and one urban, in Northern Ireland and the Republic of Ireland, patients with CHD were purposively selected. Four focus groups with patients (N = 23) and four with staff (N = 29) informed the development of the intervention by exploring how it could be tailored and integrated with current secondary prevention activities for CHD in the two healthcare settings. Following an exploratory trial the acceptability and feasibility of the intervention were discussed in four focus groups (17 patients) and 10 interviews (staff). The data were analysed using thematic analysis. Results Integrating qualitative research into the development of the intervention provided depth of information about the varying impact, between the two healthcare systems, of different funding and administrative arrangements, on their provision of secondary prevention and identified similar barriers of time constraints, training needs and poor patient motivation. The findings also highlighted the importance to patients of stress management, the need for which had been underestimated by the researchers. The qualitative evaluation provided depth of detail not found in evaluation questionnaires. It highlighted how the intervention needed to be more practical by minimising administration, integrating

  18. Administrative Synergy

    ERIC Educational Resources Information Center

    Hewitt, Kimberly Kappler; Weckstein, Daniel K.

    2012-01-01

    One of the biggest obstacles to overcome in creating and sustaining an administrative professional learning community (PLC) is time. Administrators are constantly deluged by the tyranny of the urgent. It is a Herculean task to carve out time for PLCs, but it is imperative to do so. In this article, the authors describe how an administrative PLC…

  19. Some perspectives on affordable healthcare systems in China.

    PubMed

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

    2007-01-01

    citizens is proposed based on the development of miniaturized, integrated, networked, digitalized, and smart (MINDS) medical devices. Different from the traditional healthcare systems, the new one should bridge individuals and hospitals through a four-layer (PHCH) system structure: wearable intelligent sensors and devices for p-Healthcare system (PHS), home healthcare system (HHS), community healthcare system (CHS), and hospital health information system (H2IS). This four-layer structure should ensure people be monitored by the new system as closely as it can, resulting in the novel transformation of the function of healthcare systems from symptoms treatment to early risk detection and prevention. The new system is of particular importance to the cost reduction of healthcare services. It can reduce the chance of individual providers taking advantage of the provider-patient information asymmetry to prescribe unnecessary or inappropriate (but profitable) care. It also allows people to self-monitor their health conditions at their convenience in an attempt to lighten the workload of doctors and nurses. Moreover, more people can benefit from the new system with much lower medical insurance fees due to the reduced risk of developing severe diseases through regular, long-term and effective monitoring of citizens' health conditions nation-wide.

  20. [Do healthcare insurers have too much power?

    PubMed

    Schut, F T; Varkevisser, M

    2016-01-01

    In the Dutch healthcare system, healthcare insurers act as purchasers of care on behalf of their insured clients. To this end, the insurers form contractual agreements with healthcare providers. In the interest of balanced negotiations regarding price and quality, it is important that neither of the two parties has a disproportionate position of power. This paper discusses whether healthy power relationships exist between healthcare insurers and healthcare providers.

  1. The Puerto Rico Healthcare Crisis.

    PubMed

    Roman, Jesse

    2015-12-01

    The Commonwealth of Puerto Rico is an organized nonincorporated territory of the United States with a population of more than 3.5 million U.S. citizens. The island has been the focus of much recent attention due to the recent default on its debt (estimated at more than $70 billion), high poverty rates, and increasing unemployment. Less attention, however, has been given to the island's healthcare system, which many believe is on the verge of collapsing. Healthcare makes up 20% of the Puerto Rican economy, and this crisis affects reimbursement rates for physicians while promoting the disintegration of the island's healthcare infrastructure. A major contributor relates to a disparity in federal funding provided to support the island's healthcare system when compared with that provided to the states in the mainland and Hawaii. Puerto Rico receives less federal funding for healthcare than the other 50 states and the District of Columbia even though it pays its share of social security and Medicare taxes. To make matters worse, the U.S. Center for Medicaid and Medicare Services is planning soon to implement another 11% cut in Medical Advantage reimbursements. This disparity in support for healthcare is considered responsible for ∼$25 billion of Puerto Rico's total debt. The impact of these events on the health of Puerto Ricans in the island cannot be entirely predicted, but the loss of healthcare providers and diminished access to care are a certainty, and quality care will suffer, leading to serious implications for those with chronic medical disorders including respiratory disease.

  2. [Quality of community-based healthcare services].

    PubMed

    Wilf-Miron, Rachel; Shemer, Joshua

    2004-03-01

    The recent concern regarding the quality of healthcare services is partly due to the empowerment of health consumers, cost containment measures that may compromise quality, increased complexity of the medical practice and the accelerated growth of data on the magnitude and extent of quality problems. The framework of the delivery of health services, including quality parameters, differs fundamentally in the community as opposed to the hospital setting. In the community, the episode of care lacks geographic and temporal boundaries, and is divided among different facilities and caregivers. Hence, the healthcare systems lack control over the management of care. In the solo practice, the physician lacks the opportunity to discuss and share medical decisions with his/her peers and physician's reimbursement does not encourage him/her to invest time and effort in the provision of quality care. Furthermore, in the community setting, the patient is expected to take responsibility for compliance to the therapeutic regimen, a condition that may frequently interfere with regular life routines. Therefore, quality promotion should embody the "quality triangle" encompassing patients, caregivers, the healthcare system and appropriate interfaces. Ideally, the voice of the health consumer should be an integral consideration in the design of health policy, care should be patient-centered and physician reimbursement should reflect the quality of care provided. In addition, the design of the healthcare system information technology in supporting decision-making and training "quality leaders" to facilitate quality improvement programs. Consequently, it is pivotal to nurture agreement among policy-makers, patients and caregivers as to the essence of the dilemma: "What is quality in community care?" Meanwhile, we may suggest a primordial definition to community-based health care quality management: An ongoing multidisciplinary effort to identify and respond to the needs of patients, by

  3. A systematic review of nurse physical healthcare for consumers utilizing mental health services.

    PubMed

    Happell, B; Platania-Phung, C; Scott, D

    2014-02-01

    People with serious mental illness have higher rates of physical illness and are more likely to experience premature death than the general population. Nurse-led strategies to improve physical healthcare in mental healthcare services could potentially reduce these inequalities. However the extent of nurse involvement in physical healthcare (such as physical risk screening, health education and care co-ordination) in mental health settings is not known. A systematic review was conducted on nurse-led physical healthcare reported for consumers with serious mental illness (SMI) in mental health services, and their benefits. Electronic literature bases (CINAHL, Proquest, PsychINFO and Web of Science) were systematically searched, in conjunction with a manual search of literature reviews on physical healthcare in mental health services. Articles were included if they: (a) were published in the last 10 years; (b) were English language; (c) involved physical healthcare of adult consumers receiving mental healthcare services; and (d) reported nurse involvement in physical healthcare. Forty articles were included in the review. The distribution of types of care were: health education (47%), screening and/or monitoring (33.3%), care co-ordination and management (33.3%), lifestyle programme delivery (30.5%), follow-up actions to screening results (25%) and registers and data administration (5.5%). Overall, the evaluation of nurse-based physical healthcare is in early stages. Thus far, they appear to have positive implications for consumers with SMI.

  4. Comprehensibility of universal healthcare symbols for wayfinding in healthcare facilities.

    PubMed

    Lee, Seunghae; Dazkir, Sibel Seda; Paik, Hae Sun; Coskun, Aykut

    2014-07-01

    Healthcare facilities are often complex and overwhelming for visitors, and wayfinding in healthcare facilities can be challenging. As there is an increasing number of global citizens who travel to seek medical care in another country, it is critical to make wayfinding easy for visitors who are not familiar with the language in a foreign country. Among many wayfinding aids, symbols are helpful for those visitors who have limited ability to understand written language. This study tested universal healthcare symbols in the United States, South Korea, and Turkey to compare the comprehension of symbols cross-country and identify predictors of the correct comprehension. To explore statistically significant relationships between symbol comprehension and countries, Pearson's Chi-square tests, logistic regression, and ANOVA were conducted. The test results showed that ten symbols among 14 tested have significant relationship with countries. Results of this study demonstrate that symbol comprehension can be varied significantly in different countries.

  5. Healthcare benefits linked with Below Poverty Line registration in India: Observations from Maharashtra Anaemia Study (MAS)

    PubMed Central

    Ahankari, Anand; Fogarty, Andrew; Tata, Laila; Myles, Puja

    2017-01-01

    A 2015 Lancet paper by Patel et al. on healthcare access in India comprehensively discussed national health programmes where some benefits are linked with the country’s Below Poverty Line (BPL) registration scheme. BPL registration aims to support poor families by providing free/subsidised healthcare. Technical issues in obtaining BPL registration by poor families have been previously reported in the Indian literature; however there are no data on family assets of BPL registrants. Here, we provide evidence of family-level assets among BPL registration holders (and non-BPL households) using original research data from the Maharashtra Anaemia Study (MAS). Social and health data from 287 pregnant women and 891 adolescent girls (representing 1178 family households) across 34 villages in Maharashtra state, India, were analysed. Several assets were shown to be similarly distributed between BPL and non-BPL households; a large proportion of families who would probably be eligible were not registered, whereas BPL-registered families often had significant assets that should not make them eligible. This is likely to be the first published evidence where asset distribution such as agricultural land, housing structures and livestock are compared between BPL and non-BPL households in a rural population. These findings may help planning BPL administration to allocate health benefits equitably, which is an integral part of national health programmes. PMID:28232866

  6. Healthcare benefits linked with Below Poverty Line registration in India: Observations from Maharashtra Anaemia Study (MAS).

    PubMed

    Ahankari, Anand; Fogarty, Andrew; Tata, Laila; Myles, Puja

    2017-01-01

    A 2015 Lancet paper by Patel et al. on healthcare access in India comprehensively discussed national health programmes where some benefits are linked with the country's Below Poverty Line (BPL) registration scheme. BPL registration aims to support poor families by providing free/subsidised healthcare. Technical issues in obtaining BPL registration by poor families have been previously reported in the Indian literature; however there are no data on family assets of BPL registrants. Here, we provide evidence of family-level assets among BPL registration holders (and non-BPL households) using original research data from the Maharashtra Anaemia Study (MAS). Social and health data from 287 pregnant women and 891 adolescent girls (representing 1178 family households) across 34 villages in Maharashtra state, India, were analysed. Several assets were shown to be similarly distributed between BPL and non-BPL households; a large proportion of families who would probably be eligible were not registered, whereas BPL-registered families often had significant assets that should not make them eligible. This is likely to be the first published evidence where asset distribution such as agricultural land, housing structures and livestock are compared between BPL and non-BPL households in a rural population. These findings may help planning BPL administration to allocate health benefits equitably, which is an integral part of national health programmes.

  7. Healthcare waste management in Asia

    SciTech Connect

    Prem Ananth, A.; Prashanthini, V.; Visvanathan, C.

    2010-01-15

    The risks associated with healthcare waste and its management has gained attention across the world in various events, local and international forums and summits. However, the need for proper healthcare waste management has been gaining recognition slowly due to the substantial disease burdens associated with poor practices, including exposure to infectious agents and toxic substances. Despite the magnitude of the problem, practices, capacities and policies in many countries in dealing with healthcare waste disposal, especially developing nations, is inadequate and requires intensification. This paper looks upon aspects to drive improvements to the existing healthcare waste management situation. The paper places recommendation based on a 12 country study reflecting the current status. The paper does not advocate for any complex technology but calls for changes in mindset of all concerned stakeholders and identifies five important aspects for serious consideration. Understanding the role of governments and healthcare facilities, the paper also outlines three key areas for prioritized action for both parties - budget support, developing policies and legislation and technology and knowledge management.

  8. The Microbiome and Sustainable Healthcare

    PubMed Central

    Dietert, Rodney R.; Dietert, Janice M.

    2015-01-01

    Increasing prevalences, morbidity, premature mortality and medical needs associated with non-communicable diseases and conditions (NCDs) have reached epidemic proportions and placed a major drain on healthcare systems and global economies. Added to this are the challenges presented by overuse of antibiotics and increased antibiotic resistance. Solutions are needed that can address the challenges of NCDs and increasing antibiotic resistance, maximize preventative measures, and balance healthcare needs with available services and economic realities. Microbiome management including microbiota seeding, feeding, and rebiosis appears likely to be a core component of a path toward sustainable healthcare. Recent findings indicate that: (1) humans are mostly microbial (in terms of numbers of cells and genes); (2) immune dysfunction and misregulated inflammation are pivotal in the majority of NCDs; (3) microbiome status affects early immune education and risk of NCDs, and (4) microbiome status affects the risk of certain infections. Management of the microbiome to reduce later-life health risk and/or to treat emerging NCDs, to spare antibiotic use and to reduce the risk of recurrent infections may provide a more effective healthcare strategy across the life course particularly when a personalized medicine approach is considered. This review will examine the potential for microbiome management to contribute to sustainable healthcare. PMID:27417751

  9. Theory development in nursing and healthcare informatics: a model explaining and predicting information and communication technology acceptance by healthcare consumers.

    PubMed

    An, Ji-Young; Hayman, Laura L; Panniers, Teresa; Carty, Barbara

    2007-01-01

    About 110 million American adults are looking for health information and services on the Internet. Identification of the factors influencing healthcare consumers' technology acceptance is requisite to understanding their acceptance and usage behavior of online health information and related services. The purpose of this article is to describe the development of the Information and Communication Technology Acceptance Model (ICTAM). From the literature reviewed, ICTAM was developed with emphasis on integrating multidisciplinary perspectives from divergent frameworks and empirical findings into a unified model with regard to healthcare consumers' acceptance and usage behavior of information and services on the Internet.

  10. A Study of the Perceptions of Doctor of Nursing (DNP) Program Administrators regarding the Integration of Acupuncture and Acupressure in DNP Curricula

    ERIC Educational Resources Information Center

    Voight, Rebecca W.

    2012-01-01

    The purpose of this quantitative descriptive study was to explore the perceptions of DNP administrators regarding the extent acupuncture and acupressure are addressed in DNP curricula. Five research questions were addressed: 1. What are the perspectives of DNP program administrators regarding acupuncture and acupressure? 2. What are the…

  11. Universal Health Coverage and Primary Healthcare: Lessons From Japan

    PubMed Central

    Bloom, Gerald

    2017-01-01

    A recent editorial by Naoki Ikegami has proposed three key lessons from Japan’s experience of achieving virtually universal coverage with primary healthcare services: the need to integrate the existing providers of primary healthcare services into the organised health system; the need to limit government commitments to finance hospital services and the need to empower providers of primary healthcare to influence decisions that influence their livelihoods. Although the context of low- and middle-income countries (LMICs) differs in many ways from Japan in the late 19th and early 20th centuries, the lesson that short-term initiatives to achieve universal coverage need to be complemented by an understanding of the factors influencing long-term change management remains highly relevant.

  12. Redefining Health: Implication for Value-Based Healthcare Reform

    PubMed Central

    2017-01-01

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

  13. 76 FR 71593 - Notice of HUD-Held Multifamily and Healthcare Loan Sale (MHLS 2012-1)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-18

    ... URBAN DEVELOPMENT Notice of HUD-Held Multifamily and Healthcare Loan Sale (MHLS 2012-1) AGENCY: Office... and healthcare mortgage loans, without Federal Housing Administration (FHA) insurance, in a...-1 certain unsubsidized mortgage loans (Mortgage Loans) secured by multifamily and...

  14. Healthcare worker competencies for disaster training

    PubMed Central

    Hsu, Edbert B; Thomas, Tamara L; Bass, Eric B; Whyne, Dianne; Kelen, Gabor D; Green, Gary B

    2006-01-01

    Background Although training and education have long been accepted as integral to disaster preparedness, many currently taught practices are neither evidence-based nor standardized. The need for effective evidence-based disaster training of healthcare staff at all levels, including the development of standards and guidelines for training in the multi-disciplinary health response to major events, has been designated by the disaster response community as a high priority. We describe the application of systematic evidence-based consensus building methods to derive educational competencies and objectives in criteria-based preparedness and response relevant to all hospital healthcare workers. Methods The conceptual development of cross-cutting competencies incorporated current evidence through a systematic consensus building process with the following steps: (1) review of peer-reviewed literature on relevant content areas and educational theory; (2) structured review of existing competencies, national level courses and published training objectives; (3) synthesis of new cross-cutting competencies; (4) expert panel review; (5) refinement of new competencies and; (6) development of testable terminal objectives for each competency using similar processes covering requisite knowledge, attitudes, and skills. Results Seven cross-cutting competencies were developed: (1) Recognize a potential critical event and implement initial actions; (2) Apply the principles of critical event management; (3) Demonstrate critical event safety principles; (4) Understand the institutional emergency operations plan; (5) Demonstrate effective critical event communications; (6) Understand the incident command system and your role in it; (7) Demonstrate the knowledge and skills needed to fulfill your role during a critical event. For each of the cross-cutting competencies, comprehensive terminal objectives are described. Conclusion Cross-cutting competencies and objectives developed through a

  15. Standard Treatment Guidelines in Primary Healthcare Practice

    PubMed Central

    Gopalakrishnan, S.; Udayshankar, P.M.; Rama, R.

    2014-01-01

    In India, healthcare delivery is implemented at primary, secondary and tertiary levels. Of these, primary health care is the essential health care and is the first point of care for the public across the country. The primary health care system caters to nearly 70% of the population by treating about 90% of the common and locally prevailing problems. One of the integral elements of primary health care is provision of essential medicines, which should be available at all times in adequate amounts in appropriate dosage forms and at an affordable cost. It has an important bearing on the medical, economical and social outcomes of the healthcare delivery system. This situation mandates the need for rational use of medicines by standardizing the treatment of commonly occurring illness at the primary health care level. Standard Treatment Guidelines (STGs) have been in vogue in India only since recent times and is gaining popularity among practitioners. STGs have many advantages for the patients, healthcare providers, drug manufacturers and marketing agencies, and above all, the policy makers and the legislative system of the country. The drawback in STGs lies in the difficulties in implementation on a large scale. With due efforts to prioritize the health needs, comprehensive coverage of national health programs involving all the stakeholders including professional organizations, undergraduate medical curriculum planners and medical practitioners, STGs can be implemented effectively and thereby we can ensure a quality health care at the primary care level at an affordable cost as part of the now redefined Universal Health Coverage. This article is intended as a guide to understand the concept of STGs, prepared with the aim of capacity building for medical professionals in rationally treating patients in their day-to-day clinical practice. PMID:25657957

  16. Big Data Analytics in Healthcare.

    PubMed

    Belle, Ashwin; Thiagarajan, Raghuram; Soroushmehr, S M Reza; Navidi, Fatemeh; Beard, Daniel A; Najarian, Kayvan

    2015-01-01

    The rapidly expanding field of big data analytics has started to play a pivotal role in the evolution of healthcare practices and research. It has provided tools to accumulate, manage, analyze, and assimilate large volumes of disparate, structured, and unstructured data produced by current healthcare systems. Big data analytics has been recently applied towards aiding the process of care delivery and disease exploration. However, the adoption rate and research development in this space is still hindered by some fundamental problems inherent within the big data paradigm. In this paper, we discuss some of these major challenges with a focus on three upcoming and promising areas of medical research: image, signal, and genomics based analytics. Recent research which targets utilization of large volumes of medical data while combining multimodal data from disparate sources is discussed. Potential areas of research within this field which have the ability to provide meaningful impact on healthcare delivery are also examined.

  17. Big Data Analytics in Healthcare

    PubMed Central

    Belle, Ashwin; Thiagarajan, Raghuram; Soroushmehr, S. M. Reza; Navidi, Fatemeh; Beard, Daniel A.; Najarian, Kayvan

    2015-01-01

    The rapidly expanding field of big data analytics has started to play a pivotal role in the evolution of healthcare practices and research. It has provided tools to accumulate, manage, analyze, and assimilate large volumes of disparate, structured, and unstructured data produced by current healthcare systems. Big data analytics has been recently applied towards aiding the process of care delivery and disease exploration. However, the adoption rate and research development in this space is still hindered by some fundamental problems inherent within the big data paradigm. In this paper, we discuss some of these major challenges with a focus on three upcoming and promising areas of medical research: image, signal, and genomics based analytics. Recent research which targets utilization of large volumes of medical data while combining multimodal data from disparate sources is discussed. Potential areas of research within this field which have the ability to provide meaningful impact on healthcare delivery are also examined. PMID:26229957

  18. Perpetual transitions in Romanian healthcare.

    PubMed

    Spiru, Luiza; Traşcu, Răzvan Ioan; Turcu, Ileana; Mărzan, Mircea

    2011-12-01

    Although Romania has a long-lasting tradition in organized medical healthcare, in the last two decades the Romanian healthcare system has been undergoing a perpetual transition with negative effects on all parties involved. The lack of long-term strategic vision, the implementation of initiatives without any impact studies, hence the constant short-term approach from the policy makers, combined with the "inherited" low allocation from GDP to the healthcare system have contributed significantly to its current evolution. Currently, most measures taken are of the "fire-fighting" type, rather than looking to the broader, long time perspective. There should be no wonder then, that predictive and preventive services do not get the proper attention and support. Patient and physicians should step in and take action in regulating a system that was originally designed for them. But until this happens, the organizations with leadership skills and vision need to take action-and this has already started.

  19. Does mass drug administration for the integrated treatment of neglected tropical diseases really work? Assessing evidence for the control of schistosomiasis and soil-transmitted helminths in Uganda

    PubMed Central

    2011-01-01

    Background Less is known about mass drug administration [MDA] for neglected tropical diseases [NTDs] than is suggested by those so vigorously promoting expansion of the approach. This paper fills an important gap: it draws upon local level research to examine the roll out of treatment for two NTDs, schistosomiasis and soil-transmitted helminths, in Uganda. Methods Ethnographic research was undertaken over a period of four years between 2005-2009 in north-west and south-east Uganda. In addition to participant observation, survey data recording self-reported take-up of drugs for schistosomiasis, soil-transmitted helminths and, where relevant, lymphatic filariasis and onchocerciasis was collected from a random sample of at least 10% of households at study locations. Data recording the take-up of drugs in Ministry of Health registers for NTDs were analysed in the light of these ethnographic and social survey data. Results The comparative analysis of the take-up of drugs among adults revealed that although most long term residents have been offered treatment at least once since 2004, the actual take up of drugs for schistosomiasis and soil-transmitted helminths varies considerably from one district to another and often also within districts. The specific reasons why MDA succeeds in some locations and falters in others relates to local dynamics. Issues such as population movement across borders, changing food supply, relations between drug distributors and targeted groups, rumours and conspiracy theories about the 'real' purpose of treatment, subjective experiences of side effects from treatment, alternative understandings of affliction, responses to social control measures and historical experiences of public health control measures, can all make a huge difference. The paper highlights the need to adapt MDA to local circumstances. It also points to specific generalisable issues, notably with respect to health education, drug distribution and more effective use of

  20. Harnessing the privatisation of China's fragmented health-care delivery.

    PubMed

    Yip, Winnie; Hsiao, William

    2014-08-30

    Although China's 2009 health-care reform has made impressive progress in expansion of insurance coverage, much work remains to improve its wasteful health-care delivery. Particularly, the Chinese health-care system faces substantial challenges in its transformation from a profit-driven public hospital-centred system to an integrated primary care-based delivery system that is cost effective and of better quality to respond to the changing population needs. An additional challenge is the government's latest strategy to promote private investment for hospitals. In this Review, we discuss how China's health-care system would perform if hospital privatisation combined with hospital-centred fragmented delivery were to prevail--population health outcomes would suffer; health-care expenditures would escalate, with patients bearing increasing costs; and a two-tiered system would emerge in which access and quality of care are decided by ability to pay. We then propose an alternative pathway that includes the reform of public hospitals to pursue the public interest and be more accountable, with public hospitals as the benchmarks against which private hospitals would have to compete, with performance-based purchasing, and with population-based capitation payment to catalyse coordinated care. Any decision to further expand the for-profit private hospital market should not be made without objective assessment of its effect on China's health-policy goals.

  1. Willingness to Participate in Accountable Care Organization: Healthcare Managers’ Perspective

    PubMed Central

    Wan, Thomas T.H.; Demachkie, Maysoun Masri; Ortiz, Judith; Lin, Blossom Y. J.

    2014-01-01

    This study examines how healthcare managers responded to the accountable care organization (ACO). The effect of perceived benefits and barriers of the commitment to develop a strategic plan for ACOs and willingness to participate in ACOs is analyzed, using organizational social capital, health information technology uses, health systems integration and size of the health networks, geographic factors and knowledge about ACOs as predictors. Propensity score matching and analysis is used to adjust the state- and regional variations. When the number of perceived benefits is greater than the number of perceived barriers, healthcare managers are more likely to reveal a stronger commitment to develop a strategic plan for ACO adoption. Healthcare managers who perceived their organizations as lacking leadership support or commitment, financial incentives, and legal and regulatory support to ACO adoption were less willing to participate in ACOs in the future. Future research should gather more diverse views from a larger sample size of health professionals regarding ACOs participation. The perspective of healthcare managers should be seriously considered in the adoption of an innovative health care delivery system. The transparency on policy formulation should consider multiple views of healthcare managers. PMID:24463593

  2. Security in health-care information systems--current trends.

    PubMed

    Smith, E; Eloff, J H

    1999-04-01

    Ever since health-care information systems have been implemented, their security is being considered an important issue, especially in the light of the fact that their data are deemed to comprise extremely sensitive information. The prospect of storing health information in electronic form raises concerns about patient privacy and data security. Any attempt to introduce computerised health-care information systems should, therefore, guarantee adequate protection of the confidentiality and integrity of patient information. At the same time, the patient information also needs to be readily available to all authorised health-care providers, in order to ensure the proper treatment of the patient. The principal aim of the present paper is, however, not to make a new contribution to the subject of security per se, but rather to give an overview of current trends in the security aspects of health-care information systems. The final section of the paper will be devoted to a number of proposals for further research possibilities in the domain of health-care information systems security.

  3. Safe design of healthcare facilities

    PubMed Central

    Reiling, J

    2006-01-01

    The physical environment has a significant impact on health and safety; however, hospitals have not been designed with the explicit goal of enhancing patient safety through facility design. In April 2002, St Joseph's Community Hospital of West Bend, a member of SynergyHealth, brought together leaders in healthcare and systems engineering to develop a set of safety‐driven facility design recommendations and principles that would guide the design of a new hospital facility focused on patient safety. By introducing safety‐driven innovations into the facility design process, environmental designers and healthcare leaders will be able to make significant contributions to patient safety. PMID:17142606

  4. Folding 'health' back into healthcare.

    PubMed

    Green, David

    2015-03-01

    David Green, AlA, principal at the London offices of Perkins + Will, and Basak Alkan, AICP, LEED AP/healthcare district planner, at the architect, interior, and urban design company's Atlanta, US base, examine growing moves in the US to re-evaluate planning policies to ensure that local environments are built that promote healthy activities, with the creation of so-called 'Health Districts'. Equally, they explain, healthcare 'systems' are starting to see the value in using their campuses to promote this process. In the UK, they argue, 'the timing is perfect for the re-evaluation of the relationship between the medical campus and the city'.

  5. Deployment of Analytics into the Healthcare Safety Net: Lessons Learned

    PubMed Central

    Hartzband, David; Jacobs, Feygele

    2016-01-01

    Background As payment reforms shift healthcare reimbursement toward value-based payment programs, providers need the capability to work with data of greater complexity, scope and scale. This will in many instances necessitate a change in understanding of the value of data, and the types of data needed for analysis to support operations and clinical practice. It will also require the deployment of different infrastructure and analytic tools. Community health centers, which serve more than 25 million people and together form the nation’s largest single source of primary care for medically underserved communities and populations, are expanding and will need to optimize their capacity to leverage data as new payer and organizational models emerge. Methods To better understand existing capacity and help organizations plan for the strategic and expanded uses of data, a project was initiated that deployed contemporary, Hadoop-based, analytic technology into several multi-site community health centers (CHCs) and a primary care association (PCA) with an affiliated data warehouse supporting health centers across the state. An initial data quality exercise was carried out after deployment, in which a number of analytic queries were executed using both the existing electronic health record (EHR) applications and in parallel, the analytic stack. Each organization carried out the EHR analysis using the definitions typically applied for routine reporting. The analysis deploying the analytic stack was carried out using those common definitions established for the Uniform Data System (UDS) by the Health Resources and Service Administration.1 In addition, interviews with health center leadership and staff were completed to understand the context for the findings. Results The analysis uncovered many challenges and inconsistencies with respect to the definition of core terms (patient, encounter, etc.), data formatting, and missing, incorrect and unavailable data. At a population

  6. Healthcare Engineering Defined: A White Paper.

    PubMed

    Chyu, Ming-Chien; Austin, Tony; Calisir, Fethi; Chanjaplammootil, Samuel; Davis, Mark J; Favela, Jesus; Gan, Heng; Gefen, Amit; Haddas, Ram; Hahn-Goldberg, Shoshana; Hornero, Roberto; Huang, Yu-Li; Jensen, Øystein; Jiang, Zhongwei; Katsanis, J S; Lee, Jeong-A; Lewis, Gladius; Lovell, Nigel H; Luebbers, Heinz-Theo; Morales, George G; Matis, Timothy; Matthews, Judith T; Mazur, Lukasz; Ng, Eddie Yin-Kwee; Oommen, K J; Ormand, Kevin; Rohde, Tarald; Sánchez-Morillo, Daniel; Sanz-Calcedo, Justo García; Sawan, Mohamad; Shen, Chwan-Li; Shieh, Jiann-Shing; Su, Chao-Ton; Sun, Lilly; Sun, Mingui; Sun, Yi; Tewolde, Senay N; Williams, Eric A; Yan, Chongjun; Zhang, Jiajie; Zhang, Yuan-Ting

    2015-01-01

    Engineering has been playing an important role in serving and advancing healthcare. The term "Healthcare Engineering" has been used by professional societies, universities, scientific authors, and the healthcare industry for decades. However, the definition of "Healthcare Engineering" remains ambiguous. The purpose of this position paper is to present a definition of Healthcare Engineering as an academic discipline, an area of research, a field of specialty, and a profession. Healthcare Engineering is defined in terms of what it is, who performs it, where it is performed, and how it is performed, including its purpose, scope, topics, synergy, education/training, contributions, and prospects.

  7. Administrative Ecology

    ERIC Educational Resources Information Center

    McGarity, Augustus C., III; Maulding, Wanda

    2007-01-01

    This article discusses how all four facets of administrative ecology help dispel the claims about the "impossibility" of the superintendency. These are personal ecology, professional ecology, organizational ecology, and community ecology. Using today's superintendency as an administrative platform, current literature describes a preponderance of…

  8. Is healthcare information technology based on evidence?

    PubMed

    Koppel, R

    2013-01-01

    Is healthcare information technology (HIT) based on evidence of efficacy? Are the trillions of dollars already devoted and in the pipeline for HIT implementations based on systematic evaluations? If evaluated, would those evaluations focus on patient safety, return on investment, clinical efficiency, improved clinician satisfaction, and/or workflow integration? Do we have reliable evidence of usable interfaces, of successful implementations, of data standards allowing interoperability, of continuous improvement, of responsiveness to clinician feedback? While measurement of HIT's efficacy is extraordinarily difficult-complicated by a myriad of other factors involved in providing healthcare and in organizational dynamics-it is not impossible. But is such evidence required before most implementations? Any implementation? Or are the goals of patient safety and efficiency so self-evident, profoundly desired, and laudable that HIT's beneficence is accepted without rigorous data? Note that lack of systematic evidence does not mean HIT is ineffective. HIT may provide untold benefits even if there is no hard proof of those benefits. We find that HIT is seldom objectively measured, and that evidence of its efficacy is at best spotty, and often influenced by self-promotion. Most measures, especially those associated with cost-benefit analyses, are aspirational or hubris transubstantiated into numbers.

  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. Healthcare reform in the Middle East and the USA.

    PubMed

    Younis, Mustafa Z

    2017-01-01

    Mustafa Z Younis speaks to Laura Dormer, Commissioning Editor: Dr Mustafa Z Younis is an internationally recognized scholar and was a member of the Executive Committee of the International Society for Research of Healthcare Financial Management. Dr Younis has authored and published over 200 articles, abstracts and presentations in refereed journals and meetings, and has presented at national and international conferences. Dr Younis has administrative experience as Senior Adviser for the President at Zirve University, Turkey and as Chair of the Department of Health Policy and Management at Florida International University (FL, USA) where he led the accreditation efforts for the Healthcare Management Program. Dr Younis has a history of playing visible roles on the editorial boards of journals as Chief Editor, Guest Editor and Editorial board member of leading journals such as Journal of International Medical Research, Journal of Health Care Finance, Inquiry, Journal of Health and Human Services Administration, Journal of Public Budgeting, Accounting and Financial Management. Dr Younis is a frequent speaker for both academic and professional audiences. His talks often feature his latest research and work in progress as well as cross-industry trends and strategy implications. He has provided workshops and presentation for wide organizations. His research and findings applied to for-profit, non-profit settings, and government. Dr Younis has consulted with several organizations on healthcare finance, and economics. Dr Younis is often invited to speak about the challenges in the healthcare industry and other related topics to health economics, finance, and research. He has presented topics such as, healthcare reform, ownership structure, profitability, unit cost, payment system and efficiency in management, at a variety of forums and conferences in Europe, Asia and Middle East.

  11. Continued implementation and testing of a Neighborhood Office Center (NOC) and integration of the NOC with an administrative correspondence management information system

    NASA Technical Reports Server (NTRS)

    1978-01-01

    The concept of decentralized (remote) neighborhood offices, linked together through a self-sustaining communications network for exchanging voice messages, video images, and digital data was quantitatively evaluated. Hardware and procedures for the integrated multifunctional system were developed. The configuration of the neighborhood office center (NOC) is explained, its production statistics given, and an experiment for NOC network integration via satellite is described. The hardware selected for the integration NOC/management information system is discussed, and the NASA teleconferencing network is evaluated.

  12. Enabling Team Learning in Healthcare

    ERIC Educational Resources Information Center

    Boak, George

    2016-01-01

    This paper is based on a study of learning processes within 35 healthcare therapy teams that took action to improve their services. The published research on team learning is introduced, and the paper suggests it is an activity that has similarities with action research and with those forms of action learning where teams address collective…

  13. Middleware for healthcare information systems.

    PubMed

    Spahni, S; Scherrer, J R; Sauquet, D; Sottile, P A

    1998-01-01

    Middleware is now a commonly used expression and anyone building distributed applications is referring to "middleware services". Nevertheless this notion lacks of sound theoretical foundation. This paper tries to clarify the relationship between the components of distributed environments, especially in healthcare, and to establish some classification aiming at gaining a common understanding of the functionalities and interdependency of the existing modules of distributed environments.

  14. Recommended Vaccines for Healthcare Workers

    MedlinePlus

    ... and your family members. Make sure you are up-to-date with recommended vaccines. Healthcare workers include physicians, nurses, ... series, or if you don't have an up-to-date blood test that shows you are immune to ...

  15. Your Heart Failure Healthcare Team

    MedlinePlus

    ... Artery Disease Venous Thromboembolism Aortic Aneurysm More Your Heart Failure Healthcare Team Updated:Sep 28,2016 Patients with ... to the Terms and Conditions and Privacy Policy Heart Failure • Home • About Heart Failure • Causes and Risks for ...

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

    PubMed

    Cazier, Joseph A; Medlin, B Dawn

    2006-09-27

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

  17. 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

  18. Teaching healthcare marketing via community research: the LifeFlight project.

    PubMed

    Cellucci, Leigh W

    2005-01-01

    Undergraduate students in Healthcare Administration programs may benefit from cooperative learning strategies such as participation in community research. Collaborating with local healthcare facilities on class projects also encourages more active engagement between the academic and practice communities. This purpose of this paper is to briefly describe one collaborative venture undertakenby undergraduates in a Marketing for Healthcare Organizations class and a LifeFlight program at a local hospital. The students carried out a survey of members in the program, conducted a SWOT analysis, and made relevant recommendations. Student evaluations of this experience were positive, as was the hospital's assessment.

  19. Context-aware access control for pervasive access to process-based healthcare systems.

    PubMed

    Koufi, Vassiliki; Vassilacopoulos, George

    2008-01-01

    Healthcare is an increasingly collaborative enterprise involving a broad range of healthcare services provided by many individuals and organizations. Grid technology has been widely recognized as a means for integrating disparate computing resources in the healthcare field. Moreover, Grid portal applications can be developed on a wireless and mobile infrastructure to execute healthcare processes which, in turn, can provide remote access to Grid database services. Such an environment provides ubiquitous and pervasive access to integrated healthcare services at the point of care, thus improving healthcare quality. In such environments, the ability to provide an effective access control mechanism that meets the requirement of the least privilege principle is essential. Adherence to the least privilege principle requires continuous adjustments of user permissions in order to adapt to the current situation. This paper presents a context-aware access control mechanism for HDGPortal, a Grid portal application which provides access to workflow-based healthcare processes using wireless Personal Digital Assistants. The proposed mechanism builds upon and enhances security mechanisms provided by the Grid Security Infrastructure. It provides tight, just-in-time permissions so that authorized users get access to specific objects according to the current context. These permissions are subject to continuous adjustments triggered by the changing context. Thus, the risk of compromising information integrity during task executions is reduced.

  20. Healthcare Cost and Utilization Project (HCUP)

    Cancer.gov

    The Healthcare Cost and Utilization Project is a family of health care databases and related software tools and products developed through a Federal-State-Industry partnership and sponsored by the Agency for Healthcare Research and Quality.

  1. Home Healthcare Medical Devices: A Checklist

    MedlinePlus

    ... not using it. Contact your doctor and home healthcare team often to review your health condition. * Check ... assurance of their safety and effectiveness. A home healthcare medical device is any product or equipment used ...

  2. Discussing Diabetes with Your Healthcare Provider

    MedlinePlus

    ... of this page please turn Javascript on. Feature: Diabetes Discussing Diabetes with Your Healthcare Provider Past Issues / Fall 2009 Table of Contents Diabetes Medicines—Always Discuss Them with Your Healthcare Provider ...

  3. A Way Forward for Healthcare in Madagascar?

    PubMed

    Marks, Florian; Rabehanta, Nathalie; Baker, Stephen; Panzner, Ursula; Park, Se Eun; Fobil, Julius N; Meyer, Christian G; Rakotozandrindrainy, Raphaël

    2016-03-15

    A healthcare utilization survey was conducted as a component of the Typhoid Fever Surveillance in Africa Program (TSAP). The findings of this survey in Madagascar contrasted with those in other sites of the program; namely, only 30% of the population sought healthcare at the government-provided healthcare facilities for fever. These findings promoted us to determine the drivers and barriers in accessing and utilizing healthcare in Madagascar. Here we review the results of the TSAP healthcare utilization initiative and place them in the context of the current organization of the Madagascan healthcare system. Our work highlights the demands of the population for access to appropriate healthcare and the need for novel solutions that can quickly provide an affordable and sustainable basic healthcare infrastructure until a government-funded scheme is in place.

  4. [Fostering LGBT-friendly healthcare services].

    PubMed

    Wei, Han-Ting; Chen, Mu-Hong; Ku, Wen-Wei

    2015-02-01

    LGBT (lesbian, gay, bisexual, transgender) patients suffer from stigma and discrimination when seeking healthcare. A large LGBT healthcare survey revealed that 56% of gay patients and 70% of transgender patients suffered some type of discrimination while seeking healthcare in 2014. The fostering of LGBT-friendly healthcare services is not just an advanced step of gender mainstreaming but also a fulfillment of health equality and equity. Additionally, LGBT-friendly healthcare services are expected to provide new opportunities for healthcare workers. Therefore, proactive government policies, education, research, and clinical practice should all encourage the development of these healthcare services. We look forward to a well-developed LGBT-friendly healthcare system in Taiwan.

  5. Microcomputer Applications in Self-Help Healthcare

    PubMed Central

    Wallace, Douglas H.

    1984-01-01

    The trend towards self-help healthcare is a social current which appears to run counter to the increasing technological complexity and sophistication of modern medical care. Yet it is the development of consumer-oriented high-tech medical devices which is facilitating this trend and which will permit the development of an electronics-based self-care system within the next ten years. Data on the present status of computer-assisted self-care was obtained from several sources, including a survey of homecomputer owners. Several useful software applications programs are currently in the marketplace; however, a data-integrating advice and referral program remains to be written. This development is seen as the last major technological impediment to the introduction of a complete microcomputer-based self-care system.

  6. Healthcare and disease management in Ayurveda.

    PubMed

    Mishra, L; Singh, B B; Dagenais, S

    2001-03-01

    Because the disharmony of mental doshas (satogun, rajogun, and tamogun) and body doshas (vata, pitta, and kapha) are the major cause of illness, the goal of illness management in Ayurveda is to bring back harmony among the doshas. The management includes clinical examination, diagnosis, and dietary and lifestyle interventions and treatment. The clinical examination consists of Astha Sthana Pariksha (8-point diagnosis: pulse-diagnosis, urine, stool, tongue, voice and body sound, eye, skin, and total body appearance examinations) and examination of the digestive system and the patient's physical strength. The treatment consists of cleansing (Panchkarma), palliation (improve digestion, remove toxic waste, fasting, observe thirst, exercise, sunbathing, and meditation), mental nurturing, and spiritual healing depending on the disturbed doshas and the patient's constitution. The preferred use of bhasms and herbal formulas over the respective metallic salts or the single herbs is discussed. This review suggests a great potential for integration of Ayurvedic therapies into the healthcare system in the United States.

  7. Personalized biomedical devices & systems for healthcare applications

    NASA Astrophysics Data System (ADS)

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

    2011-03-01

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

  8. Public Health Risks from Mismanagement of Healthcare Wastes in Shinyanga Municipality Health Facilities, Tanzania

    PubMed Central

    Kuchibanda, Kizito; Mayo, Aloyce W.

    2015-01-01

    The increase of healthcare facilities in Shinyanga municipality has resulted in an increase of healthcare wastes, which poses serious threats to the environment, health workers, and the general public. This research was conducted to investigate management practices of healthcare wastes in Shinyanga municipality with a view of assessing health risks to health workers and the general public. The study, which was carried out in three hospitals, involved the use of questionnaires, in-depth interview, and observation checklist. The results revealed that healthcare wastes are not quantified or segregated in all the three hospitals. Healthcare wastes at the Shinyanga Regional Referral Hospital are disposed of by on-site incineration and burning and some wastes are disposed off-site. At Kolandoto DDH only on-site burning and land disposal are practiced, while at Kambarage UHC healthcare solid wastes are incinerated, disposed of on land disposal, and burned. Waste management workers do not have formal training in waste management techniques and the hospital administrations pay very little attention to appropriate management of healthcare wastes. In light of this, it is evident that management of healthcare solid wastes is not practiced in accordance with the national and WHO's recommended standards. PMID:26779565

  9. Healthcare technologies, quality improvement programs and hospital organizational culture in Canadian hospitals

    PubMed Central

    2013-01-01

    Background Healthcare technology and quality improvement programs have been identified as a means to influence healthcare costs and healthcare quality in Canada. This study seeks to identify whether the ability to implement healthcare technology by a hospital was related to usage of quality improvement programs within the hospital and whether the culture within a hospital plays a role in the adoption of quality improvement programs. Methods A cross-sectional study of Canadian hospitals was conducted in 2010. The sample consisted of hospital administrators that were selected by provincial review boards. The questionnaire consisted of 3 sections: 20 healthcare technology items, 16 quality improvement program items and 63 culture items. Results Rasch model analysis revealed that a hierarchy existed among the healthcare technologies based upon the difficulty of implementation. The results also showed a significant relationship existed between the ability to implement healthcare technologies and the number of quality improvement programs adopted. In addition, culture within a hospital served a mediating role in quality improvement programs adoption. Conclusions Healthcare technologies each have different levels of difficulty. As a consequence, hospitals need to understand their current level of capability before selecting a particular technology in order to assess the level of resources needed. Further the usage of quality improvement programs is related to the ability to implement technology and the culture within a hospital. PMID:24119419

  10. Who pays for providing spiritual care in healthcare settings? The ethical dilemma of taxpayers funding holistic healthcare and the first amendment requirement for separation of church and state.

    PubMed

    Warnock, Carla Jean Pease

    2009-12-01

    All US governmental, public, and private healthcare facilities and their staff fall under some form of regulatory requirement to provide opportunities for spiritual health assessment and care as a component of holistic healthcare. As often the case with regulations, these facilities face the predicament of funding un-reimbursable care. However, chaplains and nurses who provide most patient spiritual care are paid using funds the facility obtains from patients, private, and public sources. Furthermore, Veteran healthcare services, under the United States Department of Veterans Affairs (VA), are provided with taxpayer funds from local, state, and federal governments. With the recent legal action by the Freedom From Religion Foundation, Inc. (FFRF) against the Veterans Administration, the ethical dilemma surfaces between taxpayers funding holistic healthcare and the first amendment requirement for separation of church and state.

  11. Redefining global health-care delivery.

    PubMed

    Kim, Jim Yong; Farmer, Paul; Porter, Michael E

    2013-09-21

    Initiatives to address the unmet needs of those facing both poverty and serious illness have expanded significantly over the past decade. But many of them are designed in an ad-hoc manner to address one health problem among many; they are too rarely assessed; best practices spread slowly. When assessments of delivery do occur, they are often narrow studies of the cost-effectiveness of a single intervention rather than the complex set of them required to deliver value to patients and their families. We propose a framework for global health-care delivery and evaluation by considering efforts to introduce HIV/AIDS care to resource-poor settings. The framework introduces the notion of care delivery value chains that apply a systems-level analysis to the complex processes and interventions that must occur, across a health-care system and over time, to deliver high-value care for patients with HIV/AIDS and cooccurring conditions, from tuberculosis to malnutrition. To deliver value, vertical or stand-alone projects must be integrated into shared delivery infrastructure so that personnel and facilities are used wisely and economies of scale reaped. Two other integrative processes are necessary for delivering and assessing value in global health: one is the alignment of delivery with local context by incorporating knowledge of both barriers to good outcomes (from poor nutrition to a lack of water and sanitation) and broader social and economic determinants of health and wellbeing (jobs, housing, physical infrastructure). The second is the use of effective investments in care delivery to promote equitable economic development, especially for those struggling against poverty and high burdens of disease. We close by reporting our own shared experience of seeking to move towards a science of delivery by harnessing research and training to understand and improve care delivery.

  12. Healthcare and Listening: A Relationship for Caring

    ERIC Educational Resources Information Center

    Davis, Janis; Foley, Amy; Crigger, Nancy; Brannigan, Michael C.

    2008-01-01

    The optimal relationship between healthcare provider and patient is one of trust. This therapeutic relationship is dependent on the ability of the healthcare provider to communicate effectively with the patient. Research indicates that when healthcare providers listen to patients, there is more compliance with medical regimens, patient…

  13. The future of the healthcare supply chain.

    PubMed

    Parker, Jeff; DeLay, Dan

    2008-04-01

    To achieve savings in the healthcare supply chain, healthcare organizations need to cooperate instead of compete. By forming a consolidated service center (CSC), healthcare organizations can centralize their contracting, procurement, distribution, and logistical operations. The CSC would enable organizations to improve efficiency and reduce costs.

  14. Simple rationality? The law of healthcare resource allocation in England

    PubMed Central

    Foster, Charles

    2007-01-01

    This paper examines the law relating to healthcare resource allocation in England. The National Health Service (NHS) Act 1977 does not impose an absolute duty to provide specified healthcare services. The courts will only interfere with a resource allocation decision made by an NHS body if that decision is frankly irrational (or where the decision infringes the principle of proportionality when a right under the European Convention on Human Rights (ECHR) is engaged). Such irrationality is very difficult to establish. The ECHR has made no significant contribution to domestic English law in the arena of healthcare provision. The decision of the European Court in the Yvonne Watts case establishes that, in relation to the question of entitlement to seek treatment abroad at the expense of the NHS, a clinical judgment about the urgency of treatment trumps an administrative decision about waiting list targets. That decision goes against the grain of domestic law about healthcare allocation, but is not likely to have wide ramifications in domestic law. PMID:17601868

  15. 75 FR 63844 - Healthcare Infection Control Practices Advisory Committee (HICPAC)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-18

    ... HUMAN SERVICES Centers for Disease Control and Prevention Healthcare Infection Control Practices... healthcare infection control and strategies for surveillance, prevention, and control of healthcare... (NICU); draft guideline for Infection Control in Healthcare Personnel; and discussion of ]...

  16. Teaching medical students about fair distribution of healthcare resources

    PubMed Central

    Leget, C; Hoedemaekers, R

    2007-01-01

    Healthcare package decisions are complex. Different judgements about effectiveness, cost‐effectiveness and disease burden influence the decision‐making process. Moreover, different concepts of justice generate different ideas about fair distribution of healthcare resources. This paper presents a decision model that is used in medical school in order to familiarise medical students with the different concepts of justice and the ethical dimension of making concrete choices. The model is based on the four‐stage decision model developed in the Netherlands by the Dunning Committee and the discussion that followed its presentation in 1991. Having to deal with 10 medical services, students working with the model learn to discern and integrate four different ideas of distributive justice that are integrated in a flow chart: libertarian, communitarian, egalitarian and utilitarian. PMID:18055907

  17. Improving healthcare middleware standards with semantic methods and technologies.

    PubMed

    Román, Isabel; Calvillo, Jorge; Roa, Laura M; Madinabeitia, Germán

    2008-01-01

    A critical issue in healthcare informatics is to facilitate the integration and interoperability of applications. This goal can be achieved through an open architecture based on a middleware independent from specific applications; useful for working with existing systems, as well as for the integration of new systems. Several standard organizations are making efforts toward this target. This work is based on the EN 12967-1,2,3, developed by CEN, that follows the ODP (Open Distributed Processing) methodology, providing a specification of distributed systems based on the definition of five viewpoints. However, only the three upper viewpoints are used to produce EN 12967, the two lower viewpoints should be considered in the implementation context. We are using Semantic Grid for lower views and Semantic Web and Web Services for the definition of the upper views. We analyze benefits of using these methods and technologies and expose methodology for the development of this semantic healthcare middleware observing European Standards.

  18. Patient Tobacco Use, Quit Attempts, and Perceptions of Healthcare Provider Practices in a Safety-Net Healthcare System

    PubMed Central

    Moody-Thomas, Sarah; Celestin, Michael D.; Tseng, Tung-Sung; Horswell, Ronald

    2013-01-01

    Background Although smoking rates in the United States (US) are high, healthcare systems and clinicians can increase cessation rates through application of the US Public Health Service tobacco treatment guideline (2000, 2008). In primary care settings, however, guideline implementation remains low. This report presents the results from an assessment of patient tobacco use, quit attempts, and perceptions of provider treatment before (2004) and after (2010) guideline implementation. Methods By use of a systems approach, the Louisiana Tobacco Control Initiative integrated evidence-based treatment of tobacco use into patient care practices in Louisiana's public hospital system. This prospective study, designed to collect data at 2 time points for the purpose of evaluating the effect of the 5A protocol (ask, advise, assess, assist, and arrange), included 571 and 889 adult patients selected from primary care clinics in 2004 and 2010, respectively. Chi-square analyses determined differences between survey administrations, along with direct standardization of weighted rates to control for confounding factors. Results Patient reports indicated that provider adherence to the 5A clinical protocol increased from 2004 to 2010. Significant (P<0.001) improvements were observed for the assess (39% vs 72%), assist (24% vs 76%), and arrange (8% vs 31%) treatment variables. Patient-reported quit attempts increased, along with awareness of cessation services (from 19% to 70%, P<0.001), while use of cessation medications decreased (from 23% to 5%, P<0.002). Conclusion Following implementation of the guideline, significant improvements were noted in patient reports of provider treatment and awareness of cessation services. PMID:24052766

  19. Using the balanced scorecard to characterize benefits of integration in the safety net.

    PubMed

    Wells, Rebecca; Weiner, Bryan

    2005-05-01

    The purpose of this study was to develop a comprehensive framework depicting the potential benefits of integration among health-care providers that serve vulnerable populations. Research teams interviewed participants in 12 integrated functions across seven community health-centre-led networks. Functions included clinical processes; managed care contracting; and administrative services such as human resources, finance, and information systems. Using a Balanced Scorecard framework, benefits were identified across financial, customer, internal business, and learning and growth perspectives. Financial benefits were more frequently cited relative to managed care and administrative functions than relative to clinical functions. Clinical functions were frequently characterized by perceived improvements in patient care quality, while managed-care functions appeared to yield most benefits in access. Administrative functions were most often associated with improvements in internal business operations. There were substantial findings in learning and growth across all three types of integration, in keeping with the early stages of the integrated functions in the study. Findings imply that integration among health-care providers yields a wide range of benefits, but not necessarily quickly or financial in nature.

  20. How the Administration's "Stronger Together" School Integration Proposal Built on the Lessons Learned from the Flawed TASAP Program. Issue Brief No. 7

    ERIC Educational Resources Information Center

    McDermott, Kathryn A.; Frankenberg, Erica; DeBray, Elizabeth

    2016-01-01

    In 2009, Congress allocated $2.5 million for a competitive federal grant program, "Technical Assistance for Student Assignment Plans" (TASAP), that aimed to increase diversity in public schools, but which had only limited success. The Obama Administration's "Stronger Together" 2017 budget proposal (and the accompanying Stronger…

  1. Biological hazards and healthcare-associated infections in Italian healthcare facilities: some considerations on inspections and accountability.

    PubMed

    Messineo, A; Marsella, L T

    2015-01-01

    Healthcare-associated infections are a major clinical and public health problem that involve, in a variety of ways, healthcare professionals, hospital administrators and, above all, patients. In Italy, the incidence of infectious complications generally varies from 5-10% (hospitalized patients) to 1% (home care patients); 5-10% of such infections manifest epidemically, and infections caused by antibiotic-resistant microorganisms are becoming more and more common, with a mortality rate of 20-30%. Moreover, any "preventable deaths or serious injuries" attributable to a (concrete) causality resulting from a breach of rules, laws and regulations, as well as imprudence, incompetence or negligence by the operators will determine a possibility of a penal prosecution for manslaughter or grievous bodily harm, and also generate expenses for civil procedures and insurance compensation. The adoption of company policies covering appropriate risk assessment, epidemiological monitoring, implementation of guidelines, procedures and protocols, activity of the Hospital Infections Committee and proper communication between managers and facilities, training of healthcare personnel and medical surveillance of employees can help reduce the adverse phenomena of healthcare-associated infections.

  2. Healthcare information system architecture (HISA) and its middleware models.

    PubMed

    Scherrer, J R; Spahni, S

    1999-01-01

    The use of middleware to develop widely distributed healthcare information systems (HIS) has become inevitable. However, the fact that many different platforms, even sometimes heterogeneous to each other, are hooked into the same network makes the integration of various middleware components more difficult than some might believe. This paper discusses the HISA standard and proposes extensions to the model that, in turn, could be compliant with other various existing distributed platforms and their middleware components.

  3. Soft-leadership competencies for today's healthcare finance executives.

    PubMed

    Madden, Mark

    2015-05-01

    With the healthcare industry changing rapidly, organizations seek finance leaders who have skills that go beyond traditional expertise in revenue and expenses. These additional competencies fall under the heading of soft-leadership skills and include the ability to be strategy-oriented, agile, passionate, inspirational, influential, communicative, dependable, driven, integrative, and engaged. Networking, participation in a mentoring program, and continuing education provide avenues for finance leaders to develop these sorts of skills.

  4. Mental illness-related stigma in healthcare

    PubMed Central

    Mantler, Ed; Szeto, Andrew

    2017-01-01

    Mental illness-related stigma, including that which exists in the healthcare system and among healthcare providers, creates serious barriers to access and quality care. It is also a major concern for healthcare practitioners themselves, both as a workplace culture issue and as a barrier for help seeking. This article provides an overview of the main barriers to access and quality care created by stigmatization in healthcare, a consideration of contributing factors, and a summary of Canadian-based research into promising practices and approaches to combatting stigma in healthcare environments.

  5. Concepts in service marketing for healthcare professionals.

    PubMed

    Corbin, C L; Kelley, S W; Schwartz, R W

    2001-01-01

    Patients are becoming increasingly involved in making healthcare choices as their burden of healthcare costs continues to escalate. At the same time, healthcare has entered a tightened market economy. For these reasons, the marketing of healthcare services has become essential for the financial survival of physicians and healthcare organizations. Physicians can successfully use the fundamental service marketing principles proven by other service industries to win patient satisfaction and loyalty and remain competitive in today's market economy. Understanding concepts such as service quality zone of tolerance, levels of consumer satisfaction, the branding of services, patient participation, and service recovery can be useful in achieving these goals.

  6. Personalized healthcare through intelligent gadgets.

    PubMed

    Jang, Hyeju; Kim, Sanghyun; Bae, Changseok

    2008-01-01

    An intelligent gadget is a wearable platform which is reconfigurable, scalable, and component-based and which can be equipped, carried as a personal accessory, or in a certain case, implanted internally into a body. Various kinds of personal information can be gathered with intelligent gadgets, and that information is used to provide specially personalized services to people in the ubiquitous computing environment. In this paper, we show a personalized healthcare service through intelligent gadgets. A service based on intelligent gadgets can be built intuitively and easily with a context representation language, called the intelligent gadget markup language (IGML) based on the event-condition-action (ECA) rule. The inherent nature of extensibility, not only environmental information but also physiological information can be specified as a context in IGML and can be dealt with an intelligent gadget with ease. It enables intelligent gadgets to be adopted to many different kinds of personalized healthcare services.

  7. [Youth Healthcare guideline 'Skin disorders'].

    PubMed

    Deurloo, Jacqueline A; van Gameren-Oosterom, Helma B M; Kamphuis, Mascha

    2012-01-01

    There is a high incidence of skin disorders; these are also frequently encountered within Youth Healthcare (YHC). Some skin disorders are caused by an underlying disease, syndrome or child abuse. Therefore, detection of these causes in an early stage is important. Skin disorders can have a huge psychosocial impact on both child and parents. This is one of the reasons why prevention, detection, diagnosis, treatment, referral, and uniform advice and guidance are of great importance. The YHC Guideline examines counselling and advice, criteria for referral to primary or secondary healthcare, and skincare in general. It also describes the disorders that should be actively detected. The Guideline also looks at specific aspects of dark skins and ethnic diversity, and the impact of skin disorders on general wellbeing. The accompanying web-based tool includes argumentation and opinions from experts on more than 75 skin disorders, including illustrations and decision trees, to aid the drawing up of a treatment plan.

  8. Targeted Learning in Healthcare Research.

    PubMed

    Gruber, Susan

    2015-12-01

    The increasing availability of Big Data in healthcare encourages investigators to seek answers to big questions. However, nonparametric approaches to analyzing these data can suffer from the curse of dimensionality, and traditional parametric modeling does not necessarily scale. Targeted learning (TL) combines semiparametric methodology with advanced machine learning techniques to provide a sound foundation for extracting information from data. Predictive models, variable importance measures, and treatment benefits and risks can all be addressed within this framework. TL has been applied in a broad range of healthcare settings, including genomics, precision medicine, health policy, and drug safety. This article provides an introduction to the two main components of TL, targeted minimum loss-based estimation and super learning, and gives examples of applications in predictive modeling, variable importance ranking, and comparative effectiveness research.

  9. Legal briefing: Healthcare ethics committees.

    PubMed

    Pope, Thaddeus Mason

    2011-01-01

    This issue's "Legal Briefing" column covers recent legal developments involving institutional healthcare ethics committees. This topic has been the subject of recent articles in JCE. Healthcare ethics committees have also recently been the subject of significant public policy attention. Disturbingly, Bobby Schindler and others have described ethics committees as "death panels." But most of the recent attention has been positive. Over the past several months, legislatures and courts have expanded the use of ethics committees and clarified their roles concerning both end-of-life treatment and other issues. These developments are usefully grouped into the following eight categories: 1. Existence and availability. 2. Membership and composition. 3. Operating procedures. 4. Advisory roles. 5. Decision-making and gate-keeping roles. 6. Confidentiality. 7. Immunity. 8. Litigation and court cases.

  10. Multicultural healthcare: a transatlantic project.

    PubMed

    Koskinen, Liisa; Jokinen, Pirkko

    2007-01-01

    Healthcare is increasingly multicultural, posing a challenge for nurse educators in both Europe and the United States. Nursing education faculties are responding to the challenge of internationalization, for instance, by participating in international student exchange projects to foster students' intercultural competence. The authors describe an educational model constructed during a transatlantic project between European and American universities. The benefits of the project from the Finnish partner's perspective are also reported.

  11. Organizational change strategies within healthcare.

    PubMed

    Steinke, Claudia; Dastmalchian, Ali; Blyton, Paul; Hasselback, Paul

    2013-01-01

    This study explores ways in which healthcare organizations can improve their organizational fitness for change using Beer and Nohria's framework of Theory E (concentrating on the economic value of change) and Theory O (concentrating on the organization's long-term capabilities for change). Data were collected from senior leaders/medical directors from health regions in Alberta. The results show that even though there is a tendency for reliance on Theory E change strategies, the respondents demonstrated other preferred approaches to change.

  12. 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.

  13. Healthcare Energy Metering Guidance (Brochure)

    SciTech Connect

    Not Available

    2011-07-01

    This brochure is intended to help facility and energy managers plan and prioritize investments in energy metering. It offers healthcare-specific examples of metering applications, benefits, and steps that other health systems can reproduce. It reflects collaborative input from the U.S. Department of Energy national laboratories and the health system members of the DOE Hospital Energy Alliance's Benchmarking and Measurement Project Team.

  14. Bed bugs in healthcare settings.

    PubMed

    Munoz-Price, L Silvia; Safdar, Nasia; Beier, John C; Doggett, Stephen L

    2012-11-01

    Infestations caused by bed bugs have resurfaced during the past decade across all continents. Even though bed bugs primarily cause skin manifestations in humans, a major stigma is placed upon people or institutions found to carry them. It is important for healthcare facilities to be prepared for this pest by implementing policies, carefully selecting materials used for hospital furniture, and educating providers on early identification and control.

  15. The changing face of healthcare.

    PubMed

    Hoppes, Michelle

    2012-01-01

    There seems to be a theme in many publications, books, and media channels lately, and that theme is change. There are changes in global markets, economic factors, and healthcare reform, to name a few, and change.gov is a government Web site. Much discussion has taken place in the past year or so about embracing change, leading change, and overcoming change through resilience. As I look forward into 2012, I am indeed thinking about change.

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

    PubMed Central

    Jee, Kyoungyoung

    2013-01-01

    Objectives The main purpose of this study was to explore whether the use of big data can effectively reduce healthcare concerns, such as the selection of appropriate treatment paths, improvement of healthcare systems, and so on. Methods By providing an overview of the current state of big data applications in the healthcare environment, this study has explored the current challenges that governments and healthcare stakeholders are facing as well as the opportunities presented by big data. Results Insightful consideration of the current state of big data applications could help follower countries or healthcare stakeholders in their plans for deploying big data to resolve healthcare issues. The advantage for such follower countries and healthcare stakeholders is that they can possibly leapfrog the leaders' big data applications by conducting a careful analysis of the leaders' successes and failures and exploiting the expected future opportunities in mobile services. Conclusions First, all big data projects undertaken by leading countries' governments and healthcare industries have similar general common goals. Second, for medical data that cuts across departmental boundaries, a top-down approach is needed to effectively manage and integrate big data. Third, real-time analysis of in-motion big data should be carried out, while protecting privacy and security. PMID:23882412

  17. Use of healthcare services by injured people in Khartoum State, Sudan

    PubMed Central

    El Tayeb, Sally; Abdalla, Safa; Van den Bergh, Graziella; Heuch, Ivar

    2015-01-01

    Background Trauma care is an important factor in preventing death and reducing disability. Injured persons in low- and middle-income countries are expected to use the formal healthcare system in increasing numbers. The objective of this paper is to examine use of healthcare services after injury in Khartoum State, Sudan. Methods A community-based survey using a stratified two-stage cluster sampling technique in Khartoum State was performed. Information on healthcare utilisation was taken from injured people. A logistic regression analysis was used to explore factors affecting the probability of using formal healthcare services. Results During the 12 months preceding the survey a total of 441 cases of non-fatal injuries occurred, with 260 patients accessing formal healthcare. About a quarter of the injured persons were admitted to hospital. Injured people with primary education were less likely to use formal healthcare compared to those with no education. Formal health services were most used by males and in cases of road traffic injuries. The lowest socio-economic strata were least likely to use formal healthcare. Conclusions Public health measures and social security should be strengthened by identifying other real barriers that prevent low socio-economic groups from making use of formal healthcare facilities. Integration and collaboration with traditional orthopaedic practitioners are important aspects that need further attention. PMID:25205849

  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.

  19. Workplace Bullying among Healthcare Workers

    PubMed Central

    Ariza-Montes, Antonio; Muniz, Noel M.; Montero-Simó, María José; Araque-Padilla, Rafael Angel

    2013-01-01

    This paper aims to assess consistent predictors through the use of a sample that includes different actors from the healthcare work force to identify certain key elements in a set of job-related organizational contexts. The utilized data were obtained from the 5th European Working Conditions Survey, conducted in 2010 by the European Foundation for the Improvement of Living and Working Conditions. In light of these objectives, we collected a subsample of 284 health professionals, some of them from the International Standard Classification of Occupations—subgroup 22—(ISCO-08). The results indicated that the chance of a healthcare worker referring to him/herself as bullied increases among those who work on a shift schedule, perform monotonous and rotating tasks, suffer from work stress, enjoy little satisfaction from their working conditions, and do not perceive opportunities for promotions in their organizations. The present work summarizes an array of outcomes and proposes within the usual course of events that workplace bullying could be reduced if job demands were limited and job resources were increased. The implications of these findings could assist human resource managers in facilitating, to some extent, good social relationships among healthcare workers. PMID:23887621

  20. Workplace bullying among healthcare workers.

    PubMed

    Ariza-Montes, Antonio; Muniz, Noel M; Montero-Simó, María José; Araque-Padilla, Rafael Angel

    2013-07-24

    This paper aims to assess consistent predictors through the use of a sample that includes different actors from the healthcare work force to identify certain key elements in a set of job-related organizational contexts. The utilized data were obtained from the 5th European Working Conditions Survey, conducted in 2010 by the European Foundation for the Improvement of Living and Working Conditions. In light of these objectives, we collected a subsample of 284 health professionals, some of them from the International Standard Classification of Occupations--subgroup 22--(ISCO-08). The results indicated that the chance of a healthcare worker referring to him/herself as bullied increases among those who work on a shift schedule, perform monotonous and rotating tasks, suffer from work stress, enjoy little satisfaction from their working conditions, and do not perceive opportunities for promotions in their organizations. The present work summarizes an array of outcomes and proposes within the usual course of events that workplace bullying could be reduced if job demands were limited and job resources were increased. The implications of these findings could assist human resource managers in facilitating, to some extent, good social relationships among healthcare workers.