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Sample records for regional healthcare information

  1. Integrated healthcare information systems.

    PubMed

    Miller, J

    1995-01-01

    When it comes to electronic data processing in healthcare, we offer a guarded, but hopeful, prognosis. To be sure, the age of electronic information processing has hit healthcare. Employers, insurance companies, hospitals, physicians and a host of ancillary service providers are all being ushered into a world of high speed, high tech electronic information. Some are even predicting that the health information business will grow from $20 billion to over $100 billion in a decade. Yet, out industry lags behind other industries in its overall movement to the paperless world. Selecting and installing the most advanced integrated information system isn't a simple task, as we've seen. As in life, compromises can produce less than optimal results. Nevertheless, integrated healthcare systems simply won't achieve their goals without systems designed to support the operation of a continuum of services. That's the reality! It is difficult to read about the wonderful advances in other sectors, while realizing that many trees still fall each year in the name of the health care industry. Yes, there are some outstanding examples of organizations pushing the envelop in a variety of areas. Yet from a very practical standpoint, many (like our physician's office) are still struggling or are on the sidelines wondering what to do. Given the competitive marketplace, organizations without effective systems may not have long to wonder and wait.

  2. Evolution of a regional health-care information system--the design phase.

    PubMed

    Balkányi, L; Magyar, G; Lakner, G; Orosz, E

    1997-01-01

    In 1996 a program of the Soros Foundation was launched to study a regional health care inodel Main stake holders of health care financing and providing in three counties in South-Western Hungary found the idea appealing and the Soros Model Region Program was started. This paper outlines the activity of the second sub-project of the model region program: the development of a regional health care information system. The build-up of a data and knowledge base serving the differing needs of mentioned goals is based on international standards. Availability and user involvement is based on different media for presenting the information as printed publications, CD-ROM data bases and World Wide Web availability. A congruency and coherency principle is maintained by a unified data model used for different purposes and a planned unified communication protocol among all participants in the model region program. Studies regarding health care status, economics and financing on regional level show that a better fitting health care services profile and a more flexible resource management might be achieved based on the mentioned regionality principle.

  3. Securing Information Technology in Healthcare

    PubMed Central

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

    2014-01-01

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

  4. Creating a Regional Healthcare Network: People First.

    PubMed

    Michel-Verkerke, Margreet B

    2016-01-01

    Care organizations in the Dutch region Apeldoorn want to collaborate more in order to improve the care provision to elderly and psychiatric patients living independently. In order to support the collaboration they intend to create a regional digital healthcare network. The research was focused on the relevance of a regional healthcare network for care providers. Eleven semi-structured interviews based on the USE IT-model, were conducted with care providers and staff members. Results show that care providers need to tune their activities for this target group and create an agreement on integrated care. The relevance of a digital communication and collaboration platform is high. The regional healthcare network should support the collaboration between care providers by: 1. Offering a communication platform to replace the time consuming communication by telephone; 2. Making patient information available for patient and care provider at patients' homes; 3. Giving insight in who is giving what care to whom; and 4. Giving access to knowledge about the target group: elderly and psychiatric patients living independently. PMID:27577356

  5. Improving Medication Adherence in a Regional Healthcare Information Exchange using a Scalable, Claims-Driven, and Service-Oriented Approach

    PubMed Central

    Del Fiol, Guilherme; Kawamoto, Kensaku; LaPointe, Nancy M Allen; Eisenstein, Eric L; Anstrom, Kevin J; Wood, Laura L; Lobach, David F

    2010-01-01

    Evidence-based pharmacotherapy is a central aspect of optimal patient care for many chronic conditions. However, medication non-adherence frequently inhibits the attainment of optimal pharmacotherapy regimens. In this study, we designed, developed, and implemented a multifaceted clinical decision support (CDS) intervention that supports evidence-based pharmacotherapy and enhanced medication adherence through the use of a scalable, claims-driven, and service-oriented approach. The intervention includes a medication management report and a low adherence alert based on thirteen evidence-based pharmacotherapy rules for seven chronic conditions. Reports and alerts are delivered to primary care clinics and care managers that participate in a healthcare information exchange in North Carolina. The resulting system architecture may enable this CDS intervention to be widely disseminated to healthcare networks through an open-source model. PMID:21346956

  6. Healthcare information technology and economics

    PubMed Central

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

    2013-01-01

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

  7. 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.

  8. Information analytics for healthcare service discovery.

    PubMed

    Sun, Lily; Yamin, Mohammad; Mushi, Cleopa; Liu, Kecheng; Alsaigh, Mohammed; Chen, Fabian

    2014-01-01

    The concept of being 'patient-centric' is a challenge to many existing healthcare service provision practices. This paper focuses on the issue of referrals, where multiple stakeholders, such as General Practitioners (GPs) and patients, are encouraged to make a consensual decision based on patients' needs. In this paper, we present an ontology-enabled healthcare service provision, which facilitates both patients and GPs in jointly deciding upon the referral decision. In the healthcare service provision model, we define three types of profiles which represent different stakeholders' requirements. This model also comprises a set of healthcare service discovery processes: articulating a service need, matching the need with the healthcare service offerings, and deciding on a best-fit service for acceptance. As a result, the healthcare service provision can carry out coherent analysis using personalised information and iterative processes that deal with requirements which change over time.

  9. Information analytics for healthcare service discovery.

    PubMed

    Sun, Lily; Yamin, Mohammad; Mushi, Cleopa; Liu, Kecheng; Alsaigh, Mohammed; Chen, Fabian

    2014-01-01

    The concept of being 'patient-centric' is a challenge to many existing healthcare service provision practices. This paper focuses on the issue of referrals, where multiple stakeholders, such as General Practitioners (GPs) and patients, are encouraged to make a consensual decision based on patients' needs. In this paper, we present an ontology-enabled healthcare service provision, which facilitates both patients and GPs in jointly deciding upon the referral decision. In the healthcare service provision model, we define three types of profiles which represent different stakeholders' requirements. This model also comprises a set of healthcare service discovery processes: articulating a service need, matching the need with the healthcare service offerings, and deciding on a best-fit service for acceptance. As a result, the healthcare service provision can carry out coherent analysis using personalised information and iterative processes that deal with requirements which change over time. PMID:25516128

  10. Managing healthcare information: analyzing trust.

    PubMed

    Söderström, Eva; Eriksson, Nomie; Åhlfeldt, Rose-Mharie

    2016-08-01

    Purpose - The purpose of this paper is to analyze two case studies with a trust matrix tool, to identify trust issues related to electronic health records. Design/methodology/approach - A qualitative research approach is applied using two case studies. The data analysis of these studies generated a problem list, which was mapped to a trust matrix. Findings - Results demonstrate flaws in current practices and point to achieving balance between organizational, person and technology trust perspectives. The analysis revealed three challenge areas, to: achieve higher trust in patient-focussed healthcare; improve communication between patients and healthcare professionals; and establish clear terminology. By taking trust into account, a more holistic perspective on healthcare can be achieved, where trust can be obtained and optimized. Research limitations/implications - A trust matrix is tested and shown to identify trust problems on different levels and relating to trusting beliefs. Future research should elaborate and more fully address issues within three identified challenge areas. Practical implications - The trust matrix's usefulness as a tool for organizations to analyze trust problems and issues is demonstrated. Originality/value - Healthcare trust issues are captured to a greater extent and from previously unchartered perspectives. PMID:27477934

  11. 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

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

    PubMed Central

    Barengo, Noël C.; Tamayo, Diana Carolina

    2015-01-01

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

  13. Clinical information systems for integrated healthcare networks.

    PubMed Central

    Teich, J. M.

    1998-01-01

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

  14. Implementing healthcare information security: standards can help.

    PubMed

    Orel, Andrej; Bernik, Igor

    2013-01-01

    Using widely spread common approaches to systems security in health dedicated controlled environments, a level of awareness, confidence and acceptance of relevant standardisation is evaluated. Patients' information is sensitive, so putting appropriate organisational techniques as well as modern technology in place to secure health information is of paramount importance. Mobile devices are becoming the top priorities in advanced information security planning with healthcare environments being no exception. There are less and less application areas in healthcare without having a need for a mobile functionality which represents an even greater information security challenge. This is also true in emergency treatments, rehabilitation and homecare just to mention a few areas outside hospital controlled environments. Unfortunately quite often traditional unsecured communications principles are still in routine use for communicating sensitive health related information. The security awareness level with users, patients and care professionals is not high enough so potential threats and risks may not be addressed and the respective information security management is therefore weak. Standards like ISO/IEC 27000 ISMS family, the ISO/IEC 27799 information security guidelines in health are often not well known, but together with legislation principles such as HIPAA, they can help.

  15. 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.

  16. Factors affecting the adoption of healthcare information technology.

    PubMed

    Phichitchaisopa, Nisakorn; Naenna, Thanakorn

    2013-01-01

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

  17. Factors affecting the adoption of healthcare information technology

    PubMed Central

    Phichitchaisopa, Nisakorn; Naenna, Thanakorn

    2013-01-01

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

  18. 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

  19. Devolving healthcare delivery to regional health authorities: is health technology assessment prepared to follow?

    PubMed

    Gibis, Bernhard R; Juzwishin, Don

    2003-01-01

    Since the establishment of health technology assessment units in the latter 1980s, Canada has witnessed an unprecedented transformation of the governance, management and service delivery of its healthcare system. In Alberta, this transformation culminated in the establishment of regional health authorities that provide integrated healthcare to Albertans. With the shift of responsibility for healthcare delivery from the provincial to the regional level, the Alberta Heritage Foundation for Medical Research HTA unit recognized that for health technology assessment to continue to be relevant, it must follow this change. Four steps were taken to refocus the unit's scope: a thorough analysis of the healthcare environment; face-to-face interviews with the chief executive officers of the regions; the development of a framework for HTA in the regions; and the organization of a conference on evidence-based decision making. These steps were helpful in bringing HTA to the attention of regional decision makers. A formal, analytical assessment of the regional healthcare environment, provision of general information (through the framework and conference) and individual information (through face-to-face interviews) enabled a proactive engagement with regions. However, to meet the demands and needs of a population that expects comprehensive coverage that delivers "state of the art" diagnostics and treatments, the efficacy and effectiveness of interventions can sometimes be of subordinate importance.

  20. General Information about MRSA in Healthcare Settings

    MedlinePlus

    ... infections can cause sepsis and death. MRSA is methicillin-resistant Staphylococcus aureus , a type of staph bacteria that is resistant to many antibiotics. In a healthcare setting, such as a hospital ...

  1. 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.

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

    ERIC Educational Resources Information Center

    Pirhonen, Antti; Silvennoinen, Minna; Sillence, Elizabeth

    2014-01-01

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

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

    PubMed

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

    2006-01-01

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

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

    NASA Astrophysics Data System (ADS)

    Raitoharju, Reetta; Aarnio, Eeva

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

  5. [Mental disorders as introduced in the Regional Healthcare Strategic Plan].

    PubMed

    Ezoe, Satoshi

    2014-01-01

    The Ministry of Health, Labour and Welfare (MHLW) of Japan released their "Mental Health and Welfare Reform Vision" in September 2004, and addressed a basic mental health and welfare policy, "A Shift from Hospital to Community." At the halfway point of the Reform Vision in September 2009, a government panel on future mental health and welfare was held, and they put forward the recommendation that mental disorder should be a new priority disease in the Regional Healthcare Strategic Plan to provide a variety of mental healthcare services and establish a collaborating system among healthcare institutions. Subsequently, a proposal was made and discussed whereby mental disorders should be added to the current "4 priority diseases and 5 priority health services" to create "5 priority diseases and 5 priority health services" at a sectional meeting of the medical care subcommittee of the Social Security Council in December 2010. With this background, the government issued the Regional Healthcare Strategic Plan related to the government notices, including mental disorders as the fifth priority disease, on March 30, 2012. The new plan has been implemented since April 1, 2013.

  6. 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.

  7. 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.

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

    PubMed

    Boniface, Mike; Wilken, Paul

    2005-01-01

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

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

    PubMed Central

    Masaud-Wahaishi, Abdulmutalib; Ghenniwa, Hamada

    2009-01-01

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

  10. 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.

  11. 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

  12. Forming design teams to develop healthcare information systems.

    PubMed

    Saleem, Naveed; Jones, Donald R; Van Tran, Hien; Moses, Beulah

    2006-01-01

    Healthcare information systems are assuming an increasingly critical role in providing quality patient care in an effective and efficient manner. However, the success of these systems in achieving these goals remains a lingering concern. Consequently, investigating and devising strategies to enhance the likelihood of success of a healthcare information system continues to draw research interest. One strategy recommended by both researchers and practitioners alike is the participation of the target users in the design and development of the information system. However, practical considerations mandate representative, rather than universal, participation of users. Unfortunately, the information systems literature offers few guidelines for selecting user representatives to serve on a design team. This lack of guidelines easily results in system designers talking with the wrong users or managers assigning the wrong users to the design team. On the basis of the theoretical paradigms underlying the user participation and design team concepts, the authors examined and derived user characteristics that are considered the most critical criteria for selecting user members of a design team. They then report on a field survey they conducted to validate the derived criteria in healthcare information systems context. The authors conclude that the system-related functional expertise should be the primary criterion employed to select healthcare personnel to participate in system design and development. Other criteria, such as users' communication skills, computing backgrounds, and personality traits, should be given secondary considerations. Ignoring these guidelines can render user participation superfluous, resulting in system failures. PMID:16573013

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

    PubMed

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

    2015-01-01

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

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

    PubMed

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

    2015-01-01

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

  15. 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…

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

    NASA Astrophysics Data System (ADS)

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

    2009-02-01

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

  17. Healthcare information on YouTube: A systematic review.

    PubMed

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

    2015-09-01

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

  18. Healthcare Information Systems - Requirements and Vision

    NASA Astrophysics Data System (ADS)

    Williams, John G.

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

  19. Regional maintenance approach for PACS within the healthcare enterprise

    NASA Astrophysics Data System (ADS)

    Staley, Steven D.; Romlein, John R.; Chacko, Anna K.; Radvany, Martin

    2000-05-01

    With the proliferation of Picture Archiving and Communications Systems (PACS) throughout the U.S. Healthcare System, there is an immense need for alternative approaches to maintenance support of PACS systems. One method of cost reduction is through the implementation of regional maintenance programs. While many PACS vendors are willing to negotiate various forms of shared service arrangements, multi-facility and regional negotiations are rarely implemented. This paper will present such an approach by describing a four step process: (1) Identify maintenance tasks across the entire region/enterprise; (2) Identify maintenance resources within the region/enterprise that can be assigned against those tasks; (3) Identify vendor unique resources that must be added to regional/enterprise resources to complete the required coverage of maintenance tasks; and (4) Negotiate with all member sites of the region/enterprise and the vendor for the assignment of resources against all maintenance tasks. Additionally, these steps will be balanced through identification of the principal tradeoffs tied to maintenance resourcing, namely: quality, speed and cost. If this approach is implemented, it presents a mechanism for achieving maintenance service cost reductions, while supporting clinical operations, through the benefits of economies of scale and collective bargaining.

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

    PubMed

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

    1993-04-01

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

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

    PubMed

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

    1993-04-01

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

  2. Healthcare Information Systems to Assess Influenza Outbreaks

    PubMed Central

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

    2011-01-01

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

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

    PubMed Central

    2012-01-01

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

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

    SciTech Connect

    Kostagiolas, P.; Lappa, E.

    2015-02-09

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

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

    NASA Astrophysics Data System (ADS)

    Kostagiolas, P.; Lappa, E.

    2015-02-01

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

  6. Specific factors influencing information system/information and communication technology sourcing strategies in healthcare facilities.

    PubMed

    Potančok, Martin; Voříšek, Jiří

    2016-09-01

    Healthcare facilities use a number of information system/information and communication technologies. Each healthcare facility faces a need to choose sourcing strategies most suitable to ensure provision of information system/information and communication technology services, processes and resources. Currently, it is possible to observe an expansion of sourcing possibilities in healthcare informatics, which creates new requirements for sourcing strategies. Thus, the aim of this article is to identify factors influencing information system/information and communication technology sourcing strategies in healthcare facilities. The identification was based on qualitative research, namely, a case study. This study provides a set of internal and external factors with their impact levels. The findings also show that not enough attention is paid to these factors during decision-making.

  7. Specific factors influencing information system/information and communication technology sourcing strategies in healthcare facilities.

    PubMed

    Potančok, Martin; Voříšek, Jiří

    2016-09-01

    Healthcare facilities use a number of information system/information and communication technologies. Each healthcare facility faces a need to choose sourcing strategies most suitable to ensure provision of information system/information and communication technology services, processes and resources. Currently, it is possible to observe an expansion of sourcing possibilities in healthcare informatics, which creates new requirements for sourcing strategies. Thus, the aim of this article is to identify factors influencing information system/information and communication technology sourcing strategies in healthcare facilities. The identification was based on qualitative research, namely, a case study. This study provides a set of internal and external factors with their impact levels. The findings also show that not enough attention is paid to these factors during decision-making. PMID:25759064

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

    NASA Astrophysics Data System (ADS)

    Tanaka, Hiroshi

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

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

    PubMed

    Berler, Alexander; Pavlopoulos, Sotiris; Koutsouris, Dimitris

    2005-06-01

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

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

    PubMed

    Berler, Alexander; Pavlopoulos, Sotiris; Koutsouris, Dimitris

    2005-06-01

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

  11. Asan Medical Information System for Healthcare Quality Improvement

    PubMed Central

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

    2010-01-01

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

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

    PubMed

    Hsu, Chien-Lung; Lee, Ming-Ren; Su, Chien-Hui

    2013-10-01

    Privacy protection is an important issue and challenge in healthcare information systems (HISs). Recently, some privacy-enhanced HISs are proposed. Users' privacy perception, intention, and attitude might affect the adoption of such systems. This paper aims to propose a privacy-enhanced HIS framework and investigate the role of privacy protection in HISs adoption. In the proposed framework, privacy protection, access control, and secure transmission modules are designed to enhance the privacy protection of a HIS. An experimental privacy-enhanced HIS is also implemented. Furthermore, we proposed a research model extending the unified theory of acceptance and use of technology by considering perceived security and information security literacy and then investigate user adoption of a privacy-enhanced HIS. The experimental results and analyses showed that user adoption of a privacy-enhanced HIS is directly affected by social influence, performance expectancy, facilitating conditions, and perceived security. Perceived security has a mediating effect between information security literacy and user adoption. This study proposes several implications for research and practice to improve designing, development, and promotion of a good healthcare information system with privacy protection.

  13. 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.

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

    PubMed

    Koncar, Miroslav; Gvozdanović, Darko

    2006-01-01

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

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

    PubMed

    Blobel, B; Holena, M

    1997-01-01

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

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

    PubMed

    Blobel, B; Holena, M

    1997-01-01

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

  17. Healthcare information system approaches based on middleware concepts.

    PubMed

    Holena, M; Blobel, B

    1997-01-01

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

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

    PubMed

    Doukas, Charalampos; Pliakas, Thomas; Maglogiannis, Ilias

    2010-01-01

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

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

    PubMed Central

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

    1999-01-01

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

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

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 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 and Protection Data Bank. (a) Who may request information and what information may be available. Information...

  1. 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.

  2. Institutionalization of evidence-informed practices in healthcare settings

    PubMed Central

    2012-01-01

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

  3. TIDE: an intelligent home-based healthcare information & diagnostic environment.

    PubMed

    Abidi, S S

    1999-01-01

    The 21st century promises to usher in an era of Internet based healthcare services--Tele-Healthcare. Such services augur well with the on-going paradigm shift in healthcare delivery patterns, i.e. patient centred services as opposed to provider centred services and wellness maintenance as opposed to illness management. This paper presents a Tele-Healthcare info-structure TIDE--an 'intelligent' wellness-oriented healthcare delivery environment. TIDE incorporates two WWW-based healthcare systems: (1) AIMS (Automated Health Monitoring System) for wellness maintenance and (2) IDEAS (Illness Diagnostic & Advisory System) for illness management. Our proposal comes from an attempt to rethink the sources of possible leverage in improving healthcare; vis-à-vis the provision of a continuum of personalised home-based healthcare services that emphasise the role of the individual in self health maintenance.

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

    ERIC Educational Resources Information Center

    Khudair, Ahmad A.; Cooke, Louise

    2008-01-01

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

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

    PubMed Central

    Chhanabhai, Prajesh N; Holt, Alec

    2010-01-01

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

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

    PubMed Central

    Smith, Sean W; Koppel, Ross

    2014-01-01

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

  7. Increasing consumerism in healthcare through intelligent information technology.

    PubMed

    Cohen, Seth B; Grote, Kurt D; Pietraszek, Wayne E; Laflamme, Francois

    2010-12-01

    In healthcare, consumerism is not a product or program. Instead, it is an orientation to new care delivery models that encourage and enable greater patient responsibility through the intelligent use of information technology. Despite the promise of consumerism, current approaches have not fully realized the potential benefits of improved outcomes and lower cost. We recommend 4 guiding principles to ensure that next-generation innovation yields the returns that providers, patients, and other stakeholders expect: (1) keep the consumer at the center of innovation, (2) keep it simple, (3) link products and services to a broader "ecosystem" of care, and (4) encourage health in addition to treating illness. Now may be a particularly compelling time to invest in a consumerist approach. PMID:21314219

  8. Increasing consumerism in healthcare through intelligent information technology.

    PubMed

    Cohen, Seth B; Grote, Kurt D; Pietraszek, Wayne E; Laflamme, Francois

    2010-12-01

    In healthcare, consumerism is not a product or program. Instead, it is an orientation to new care delivery models that encourage and enable greater patient responsibility through the intelligent use of information technology. Despite the promise of consumerism, current approaches have not fully realized the potential benefits of improved outcomes and lower cost. We recommend 4 guiding principles to ensure that next-generation innovation yields the returns that providers, patients, and other stakeholders expect: (1) keep the consumer at the center of innovation, (2) keep it simple, (3) link products and services to a broader "ecosystem" of care, and (4) encourage health in addition to treating illness. Now may be a particularly compelling time to invest in a consumerist approach.

  9. 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 HEALTH CARE PROVIDERS, SUPPLIERS AND PRACTITIONERS Disclosure of Information by the Healthcare...

  10. The use of XML in healthcare information management.

    PubMed

    Seals, M

    2000-01-01

    Extensible Markup Language (XML) is an emerging Internet standard that is gaining momentum in many industries, including healthcare. This article examines the origins of XML, its components, and some potential uses for XML in the healthcare industry. It then discusses a specific initiative to use XML as the basis for an industry-standard scheduling protocol.

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

    Code of Federal Regulations, 2012 CFR

    2012-10-01

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

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 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...

  13. 45 CFR 61.14 - Confidentiality of Healthcare Integrity and Protection Data Bank information.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 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...

  14. 45 CFR 61.14 - Confidentiality of Healthcare Integrity and Protection Data Bank information.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 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...

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

    PubMed

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

    2016-04-01

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

  16. [Construction of a healthcare-related information technology education praxis for graduate school].

    PubMed

    Cardoso, Jefferson Paixão; Rosa, Valéria Argolo; Lopes, Claudia Ribeiro Santos; Vilela, Alba Benemérita Alves; de Santana, Aurisan Souza; da Silva, Sandro Tonini

    2008-01-01

    This paper presents an overview of an information technology education practice for healthcare practitioners in graduate school. Based on hands-on experience of the Information Technology Applied to Healthcare classes at the Jequié Campus of the Southeast Bahia State University (UESB) for the Nursing and Physiotherapy courses, an experience is reported that stresses the importance of teaching information technology by establishing links between Information and Communications Technologies and the praxis of the healthcare practitioners, enhancing the educational process and allowing students to 'visualize' how such technologies could be used for producing and qualifying impacts on their professional activities.

  17. The role of communication servers in the architecture of healthcare information systems.

    PubMed

    Heitmann, K U

    1997-01-01

    Communication between departmental subsystems within a hospital information system (HIS) is more and more supported by dedicated communication servers (CS). One of the main advantages is a centralized and standardized flow of information. Beside this "classic" approach a communication server may be embedded on at least two other hierarchical levels in the architecture of healthcare information systems: in an organizational unit within a hospital (subsystem) but also in large scale healthcare information systems covering aspects of communication between the involved external healthcare providers. PMID:10175357

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

    PubMed

    Sakamoto, N

    2001-01-01

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

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

    PubMed

    Sakamoto, N

    2001-01-01

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

  20. WISH: a Wireless Mobile Multimedia Information System in Healthcare using RFID.

    PubMed

    Yu, Weider D; Ray, Pradeep; Motoc, Tiberiu

    2008-05-01

    It is important to improve the efficiency of healthcare-related operations and the associated costs. Healthcare organizations are constantly under increased pressure to streamline operations and provide enhanced services to their patients. Wireless mobile computing technology has the potential to provide the desired benefits and would be a critical part of today's healthcare information system. In this paper, a system is presented to better facilitate the functions of physicians and medical staff in healthcare by using modern wireless mobile technology, Radio Frequency Identification (RFID) tools, and multimedia streaming. The paper includes a case study of the development of such a system in the context of healthcare in the United States. The results of the study show how wireless mobile multimedia systems can be developed for the improvement of the quality and efficiency in healthcare for other nations as well. Our testing data show a time reduction of more than 50% in the daily activities of hospital staff.

  1. Exploring Healthcare Consumer Acceptance of Personal Health Information Management Technology through Personal Health Record Systems

    ERIC Educational Resources Information Center

    Wu, Huijuan

    2013-01-01

    Healthcare technologies are evolving from a practitioner-centric model to a patient-centric model due to the increasing need for technology that directly serves healthcare consumers, including healthy people and patients. Personal health information management (PHIM) technology is one of the technologies designed to enhance an individual's ability…

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

    ERIC Educational Resources Information Center

    Aponte, Jorge I.

    2011-01-01

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

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

    PubMed Central

    Boachie, Micheal Kofi

    2016-01-01

    Background: In early 2012, National Health Insurance Scheme (NHIS) members in Ashanti Region were allowed to choose their own primary healthcare providers. This paper investigates the factors that enrolees in the Ashanti Region considered in choosing preferred primary healthcare providers (PPPs) and direction of association of such factors with the choice of PPP. Methods: Using a cross-sectional study design, the study sampled 600 NHIS enrolees in Kumasi Metro area and Kwabre East district. The sampling methods were a combination of simple random and systematic sampling techniques at different stages. Descriptive statistics were used to analyse demographic information and the criteria for selecting PPP. Multinomial logistic regression technique was used to ascertain the direction of association of the factors and the choice of PPP using mission PPPs as the base outcome. Results: Out of the 600 questionnaires administered, 496 were retained for further analysis. The results show that availability of essential drugs (53.63%) and doctors (39.92%), distance or proximity (49.60%), provider reputation (39.52%), waiting time (39.92), additional charges (37.10%), and recommendations (48.79%) were the main criteria adopted by enrolees in selecting PPPs. In the regression, income (-0.0027), availability of doctors (-1.82), additional charges (-2.14) and reputation (-2.09) were statistically significant at 1% in influencing the choice of government PPPs. On the part of private PPPs, availability of drugs (2.59), waiting time (1.45), residence (-2.62), gender (-2.89), and reputation (-2.69) were statistically significant at 1% level. Presence of additional charges (-1.29) was statistically significant at 5% level. Conclusion: Enrolees select their PPPs based on such factors as availability of doctors and essential drugs, reputation, waiting time, income, and their residence. Based on these findings, there is the need for healthcare providers to improve on their quality levels

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

    PubMed

    Nardon, Fabiane Bizinella; de A Moura, Lincoln

    2007-01-01

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

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

    PubMed

    Nardon, Fabiane Bizinella; de A Moura, Lincoln

    2007-01-01

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

  6. Mumps Virus: Modification of the Identify-Isolate-Inform Tool for Frontline Healthcare Providers.

    PubMed

    Koenig, Kristi L; Shastry, Siri; Mzahim, Bandr; Almadhyan, Abdulmajeed; Burns, Michael J

    2016-09-01

    Mumps is a highly contagious viral infection that became rare in most industrialized countries following the introduction of measles-mumps-rubella (MMR) vaccine in 1967. The disease, however, has been re-emerging with several outbreaks over the past decade. Many clinicians have never seen a case of mumps. To assist frontline healthcare providers with detecting potential cases and initiating critical actions, investigators modified the "Identify-Isolate-Inform" tool for mumps infection. The tool is applicable to regions with rare incidences or local outbreaks, especially seen in college students, as well as globally in areas where vaccination is less common. Mumps begins with a prodrome of low-grade fever, myalgias and malaise/anorexia, followed by development of nonsuppurative parotitis, which is the pathognomonic finding associated with acute mumps infection. Orchitis and meningitis are the two most common serious complications, with hearing loss and infertility occurring rarely. Providers should consider mumps in patients with exposure to a known case or international travel to endemic regions who present with consistent signs and symptoms. If mumps is suspected, healthcare providers must immediately implement standard and droplet precautions and notify the local health department and hospital infection control personnel. PMID:27625709

  7. A clinical information system strategic planning model for integrated healthcare delivery networks.

    PubMed

    Snyder-Halpern, R; Chervany, N L

    2000-12-01

    As healthcare organizations are transformed into consolidated healthcare delivery networks, their success is increasingly dependent on the integration and effectiveness of their clinical information systems (CIS). Greater financial investments are being made in CIS products and services to support processes related to clinical care oversight, direct care delivery, and ancillary clinical services. To make good investment decisions, these enterprises must engage in a comprehensive strategic planning process that tightly links their healthcare delivery network clinical strategy, CIS strategic vision, and specific CIS investments. The authors illustrate the linkages among these three strategic planning stages through the application of a clinical information system strategic planning model to a case example.

  8. 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

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

    PubMed

    Rheinecker, P

    1992-01-01

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

  10. Strategies for Leveraging Interoperable Health Information Exchange Systems Among Healthcare Communities.

    PubMed

    Alexander, Gregory L; Sensmeier, Joyce; McDonald, Joe; Goossen, William; Alexander, Mary M

    2016-01-01

    The panel will share international Health Information Exchange (HIE) projects to improve quality and lower costs in healthcare communities (i.e. hospitals, clinician practices, and aged care facilities). HIE allows healthcare professionals and patients to appropriately access and securely share a patient's vital medical information electronically within and across organizations. Intended audience: Researchers, consumers, practitioners, vendors, care providers, and policy makers with interests in technology design, development, implementation, and management, particularly focused on HIE. PMID:27332323

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

    PubMed

    Aggarwal, Vinod

    2002-10-01

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

  12. Drug information pharmacists at health-care facilities, universities, and pharmaceutical companies.

    PubMed

    Gong, S D; Millares, M; VanRiper, K B

    1992-05-01

    A national survey was conducted to provide a profile of drug information pharmacists. Questionnaires were mailed to 436 drug information pharmacists whose names were obtained from directors of drug information centers (DICs) at health-care facilities, universities, and pharmaceutical companies. The net response rate was 64% (278 usable replies). Most respondents were 30 to 39 years of age and had practiced in drug information for four years or less. There were equal numbers of male and female respondents. More than half had a doctor of pharmacy (Pharm.D.) degree, and about half had completed a postgraduate residency or fellowship. Respondents with a Pharm.D. degree or postgraduate training reported a more favorable professional outcome, including position, income, and job satisfaction. Respondents reported a high level of professional involvement, including faculty appointment, publishing, and professional membership. Common reasons cited for choosing a career in drug information were an opportunity to continually learn, job satisfaction, and regular work hours. More than 70% of respondents were either very satisfied or extremely satisfied with their current job position. The most frequently reported income range was $40,000-44,999; distribution of income differed significantly among geographic regions. Drug information pharmacists report a high level of job satisfaction and involvement in professional activities; they often have completed advanced pharmacy education or postgraduate training.

  13. Consequences of a decentralized healthcare governance model: measuring regional authority support for patient choice in Sweden.

    PubMed

    Fredriksson, Mio; Winblad, Ulrika

    2008-07-01

    What are the implications of a decentralized model of healthcare governance? This case study on patient choice in Sweden is an attempt to shed light on this issue. Due to decentralization and constitutional rights of self-determination, the regional authorities in Sweden, called County Councils (CCs), have far-reaching rights to manage the healthcare sector. The fact that patient choice is considered to be a soft law or a soft governance regulation, opens it up to regional variation. To examine the CCs level of support of patient choice, an index is presented. The Patient Choice Index (PCI) shows that there is extensive variation among the CCs. To explain the causes of these variations, a number of hypotheses are tested. The analyses imply that ideology and economy, and more specifically the CCs' governing majorities and running net profits, are major explanations for the level of support. A number of conclusions can be drawn from the results of this study. In short, the CCs appear to act according to a local point of view, which means that there is no functioning national patient choice standard, and thus patients do not have equal access to healthcare and patients' rights are unevenly distributed. Furthermore, the CCs' financial conditions and governing majorities seem to undermine equivalent reform realization in a national context. In summary, the results of this study emphasize the conflict between regional self-governance and national equality, which is particularly visible in the decentralized Swedish healthcare model.

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed

    Priori, Maria Rosaria; Barbato, Angelo

    2007-01-01

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

  16. Language interpreting as social justice work: perspectives of formal and informal healthcare interpreters.

    PubMed

    Hilfinger Messias, DeAnne K; McDowell, Liz; Estrada, Robin Dawson

    2009-01-01

    The assurance that limited-English-proficient individuals have access to quality healthcare depends on the availability of competent healthcare interpreters. To further understand the complex work of interpreting, we conducted in-depth interviews with 27 formal and informal healthcare interpreters. Participants identified the technical conduit role as the professional standard. Yet they experienced considerable role dissonance and blurring. From their position "in the middle," they witnessed discrimination and bias. Having a social justice perspective encouraged expanding their role to include advocacy and cultural brokering. Implications for nursing include a shared commitment to language access and social justice.

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

    PubMed Central

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

    1998-01-01

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

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

    NASA Astrophysics Data System (ADS)

    Wawrzyniak, Zbigniew M.; Lisiecka-Biełanowicz, Mira

    2013-10-01

    Modern healthcare systems are designed to fulfill needs of the patient, his system environment and other determinants of the treatment with proper support of technical aids. A whole system of care is compatible to the technical solutions and organizational framework based on legal rules. The purpose of this study is to present how can we use Information and Communication Technology (ICT) systemic tools in a new model of patient-oriented care, improving the effectiveness of healthcare for patients with chronic diseases. The study material is the long-term process of healthcare for patients with chronic illness. Basing on the knowledge of the whole circumstances of patient's ecosystem and his needs allow us to build a new ICT model of long term care. The method used is construction, modeling and constant improvement the efficient ICT layer for the patient-centered healthcare model. We present a new constructive approach to systemic process how to use ICT for information management in healthcare system for chronic disease patient. The use of ICT tools in the model for chronic disease can improve all aspects of data management and communication, and the effectiveness of long-term complex healthcare. In conclusion: ICT based model of healthcare can be constructed basing on the interactions of ecosystem's functional parts through information feedback and the provision of services and models as well as the knowledge of the patient itself. Systematic approach to the model of long term healthcare assisted functionally by ICT tools and data management methods will increase the effectiveness of patient care and organizational efficiency.

  19. The Influence of Organizational Subculture on Information Technology Project Success in the Healthcare Sector: A Qualitative, Multi-Case Study

    ERIC Educational Resources Information Center

    Mallet, Richard Kofi

    2014-01-01

    Healthcare providers face high demands for technology based healthcare services due to global population increases and adapting information technology (IT) to achieve quality patient care. IT has become center stage in the operations and management of healthcare organizations. IT requirements emerge from the visions, values, and beliefs of…

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

    PubMed

    Nuti, Sabina; Seghieri, Chiara

    2014-01-01

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

  1. The development of a risk identification screening framework for healthcare information systems.

    PubMed

    Keay, Elizabeth; Kushniruk, Andre

    2009-01-01

    Health information systems are costly, especially when they are not used or when they impede workflow. Risk assessment is used to identify and remedy problem areas so that systems are safe. While there are discussions of design project risk management, for example, see McConnell [1], there is little information about screening the fit of a system with respect to its users, the task and the healthcare organization. Such analyses could be important in improving the fit of information systems in healthcare, thereby decreasing risk of system and project failure. A risk-screening framework for health informatics is presented. PMID:19380968

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

    ERIC Educational Resources Information Center

    Fahlman, Dorothy

    2013-01-01

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

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

    ERIC Educational Resources Information Center

    Hare, Karen

    2008-01-01

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

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

    PubMed Central

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

    2014-01-01

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

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

    PubMed

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

    2012-11-01

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

  6. The enhancement of security in healthcare information systems.

    PubMed

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

    2012-06-01

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

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

    PubMed

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

    2016-05-01

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

  8. Successful strategies for high participation in three regional healthcare surveys: an observational study

    PubMed Central

    2011-01-01

    Background Regional healthcare facility surveys to quantitatively assess nosocomial infection rates are important for confirming standardized data collection and assessing health outcomes in the era of mandatory reporting. This is particularly important for the assessment of infection control policies and healthcare associated infection rates among hospitals. However, the success of such surveys depends upon high participation and representativeness of respondents. Methods This descriptive paper provides methodologies that may have contributed to high participation in a series of administrative, infection control, and microbiology laboratory surveys of all 31 hospitals in a large southern California county. We also report 85% (N = 72) countywide participation in an administrative survey among nursing homes in this same area. Results Using in-person recruitment, 48% of hospitals and nursing homes were recruited within one quarter, with 75% recruited within three quarters. Conclusions Potentially useful strategies for successful recruitment included in-person recruitment, partnership with the local public health department, assurance of anonymity when presenting survey results, and provision of staff labor for the completion of detailed survey tables on the rates of healthcare associated pathogens. Data collection assistance was provided for three-fourths of surveys. High compliance quantitative regional surveys require substantial recruitment time and study staff support for high participation. PMID:22208721

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

    PubMed

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

    2016-05-01

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

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

    PubMed

    Kisilowska, Malgorzata

    2006-01-01

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

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

    PubMed

    Kisilowska, Malgorzata

    2006-01-01

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

  12. Improving the delivery of care and reducing healthcare costs with the digitization of information.

    PubMed

    Noffsinger, R; Chin, S

    2000-01-01

    In the coming years, the digitization of information and the Internet will be extremely powerful in reducing healthcare costs while assisting providers in the delivery of care. One example of healthcare inefficiency that can be managed through information digitization is the process of prescription writing. Due to the handwritten and verbal communication surrounding prescription writing, as well as the multiple tiers of authorizations, the prescription drug process causes extensive financial waste as well as medical errors, lost time, and even fatal accidents. Electronic prescription management systems are being designed to address these inefficiencies. By utilizing new electronic prescription systems, physicians not only prescribe more accurately, but also improve formulary compliance thereby reducing pharmacy utilization. These systems expand patient care by presenting proactive alternatives at the point of prescription while reducing costs and providing additional benefits for consumers and healthcare providers. PMID:11066646

  13. 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.

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

    PubMed

    Blazona, Bojan; Koncar, Miroslav

    2006-01-01

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

  15. Is there room for containing healthcare costs? An analysis of regional spending differentials in Italy.

    PubMed

    Francese, Maura; Romanelli, Marzia

    2014-03-01

    This work aims at identifying the determinants of health spending differentials among Italian regions and at highlighting potential margins for savings. The analysis exploits a data set for the 21 Italian regions and autonomous provinces starting in the early 1990s and ending in 2006. After controlling for standard healthcare demand indicators, remaining spending differentials are found to be significant, and they appear to be associated with differences in the degree of appropriateness of treatments, health sector supply structure and social capital indicators. In general, higher regional expenditure does not appear to be associated with better reported or perceived quality in health services. In the regions that display poorer performances, inefficiencies appear not to be uniformly distributed among expenditure items. Overall, results suggest that savings could be achieved without reducing the amount of services provided to citizens. This seems particularly important given the expected rise in spending associated with the forecasted demographic developments.

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

    PubMed

    Yang, Tzu-Hsiang; Sun, Yeali S; Lai, Feipei

    2011-06-01

    Many existing healthcare information systems are composed of a number of heterogeneous systems and face the important issue of system scalability. This paper first describes the comprehensive healthcare information systems used in National Taiwan University Hospital (NTUH) and then presents a service-oriented architecture (SOA)-based healthcare information system (HIS) based on the service standard HL7. The proposed architecture focuses on system scalability, in terms of both hardware and software. Moreover, we describe how scalability is implemented in rightsizing, service groups, databases, and hardware scalability. Although SOA-based systems sometimes display poor performance, through a performance evaluation of our HIS based on SOA, the average response time for outpatient, inpatient, and emergency HL7Central systems are 0.035, 0.04, and 0.036 s, respectively. The outpatient, inpatient, and emergency WebUI average response times are 0.79, 1.25, and 0.82 s. The scalability of the rightsizing project and our evaluation results show that the SOA HIS we propose provides evidence that SOA can provide system scalability and sustainability in a highly demanding healthcare information system.

  17. 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.

  18. Educating patients about warfarin therapy using information technology: A survey on healthcare professionals’ perspectives

    PubMed Central

    Nasser, Sayeed; Mullan, Judy; Bajorek, Beata

    Objective To explore healthcare professionals' views about the benefits and challenges of using information technology (IT) resources for educating patients about their warfarin therapy. Methods A cross-sectional survey of both community and hospital-based healthcare professionals (e.g., doctors, pharmacists and nurses) involved using a purpose-designed questionnaire. The questionnaires were distributed using a multi-modal approach to maximise response rates. Results Of the total 300 questionnaires distributed, 109 completed surveys were received (43.3% response rate). Over half (53.2%) of the healthcare participants were aged between 40-59 years, the majority (59.5%) of whom were female. Fifty nine (54.1%) participants reported having had no access to warfarin-specific IT-based patient education resources, and a further 19 (38.0%) of the participants who had IT-access reported that they never used such resources. According to the healthcare participants, the main challenges associated with educating their patients about warfarin therapy included: patient-related factors, such as older age, language barriers, cognitive impairments and/or ethnic backgrounds or healthcare professional factors, such as time constraints. The healthcare professionals reported that there were several aspects about warfarin therapy which they found difficult to educate their patients about which is why they identified computers and interactive touch screen kiosks as preferred IT devices to deliver warfarin education resources in general practices, hospital-based clinics and community pharmacies. At the same time, the healthcare professionals also identified a number of facilitators (e.g., to reinforce warfarin education, to offer reliable and easily comprehensible information) and barriers (e.g., time and costs of using IT resources, difficulty in operating the resources) that could impact on the effective implementation of these devices in educating patients about their warfarin therapy

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

    PubMed

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

    2015-01-01

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

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

    ERIC Educational Resources Information Center

    Hao, Haijing

    2013-01-01

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

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

    PubMed Central

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

    2008-01-01

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

  2. Laboratory computing--process and information management supporting high-quality, cost-effective healthcare.

    PubMed

    Buffone, G J; Moreau, D R

    1995-09-01

    One currently observes many healthcare institutions rushing to reengineer and install information systems with the expectation of achieving enhanced efficiency, competitiveness, and, it is hoped, higher patient satisfaction resulting from timely, high-quality care. Unfortunately, information system concepts, design, and implementation have not yet addressed the complexity of representing and managing clinical processes. As a result, much of the synergy one might expect to derive from understanding and designing clinical processes to gain efficiency and quality while maintaining humanness is not readily achievable by implementing traditional information systems. In this presentation, with laboratory services as an example, we describe a conceptually different information systems model, which we believe would aid care-givers in their efforts to deliver compassionate, quality care while addressing the highly competitive nature of market-driven healthcare. PMID:7656450

  3. Patients' reasons for refraining from discussing internet health information with their healthcare providers.

    PubMed

    Imes, Rebecca S; Bylund, Carma L; Sabee, Christina M; Routsong, Tracy R; Sanford, Amy Aldridge

    2008-11-01

    This exploratory study examined factors that constrain patients from discussing Internet health information with their healthcare providers. Participants (N = 714) were asked to list reasons why they have not talked with their providers about Internet health information they had found. Factors (N = 767) included patient attributions about the information, systems or circumstances, fear of treading on the provider's turf, face-saving concerns, and patient perceptions of provider attributions about the information. Comparisons between those who had and those who had not talked to their healthcare providers about their Internet research revealed significant differences in types of constraining factors indicated. Issues concerning an increasingly Internet-savvy public and provider-patient relationships are considered in the discussion within the framework of the goals, planning, action theory. Continued efforts in provider and patient education can help to overcome barriers that restrict communication concerning Internet health research.

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

    PubMed

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

    2014-07-01

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

  5. The quality case for information technology in healthcare

    PubMed Central

    Bates, David W

    2002-01-01

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

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

    PubMed

    Turner, Kathleen E; Fuller, Sherrilynne

    2011-01-01

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

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

    PubMed

    Young, S T; Chang, J S

    1997-01-01

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

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

    PubMed Central

    2014-01-01

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

  9. Semantics-based information modeling for the health-care administration sector: the citation platform.

    PubMed

    Anagnostakis, Aristidis G; Tzima, Maria; Sakellaris, George C; Fotiadis, Dimitrios I; Likas, Aristidis C

    2005-06-01

    An information brokerage environment for effective information structuring, indexing, and retrieval in the health-care administration sector is presented. The system is based on ontology modeling, natural language processing, extensible markup language, semantics analysis, and behavioral description. Semantics-based information acquisition is achieved through the uniform modeling, representation, and handling of domain-specific knowledge, both content-based and procedural. The system has been validated using information located on several repositories in the web and its performance is reported in terms of precision and recall.

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

    PubMed

    Mamlin, Burke W; Tierney, William M

    2016-01-01

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

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

    NASA Astrophysics Data System (ADS)

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

    2007-03-01

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

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

    PubMed

    Mamlin, Burke W; Tierney, William M

    2016-01-01

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

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

    PubMed Central

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

    2007-01-01

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

  14. Ontology and terminology servers in agent-based health-care information systems.

    PubMed

    Falasconi, S; Lanzola, G; Stefanelli, M

    1997-01-01

    A new research paradigm is emerging based on the multi-agent system architectural framework, allowing human and software agents to interoperate and thus cooperate within common application areas. Within a multi-agent system, the different "views of the world" of knowledgeable agents are to be bridged through their commitment to common ontologies and terminologies. We developed a general methodology for the design or integration of new components into a Health-care Information System conceived as a network of software and human agents. In our view, ontological and terminological services are entrusted to dedicated agents, namely ontology and terminology servers, allowing the configuration of suitable application ontologies for distributed applications. The role is described that such servers, operatively coordinated in order to preserve semantic coherence, should play within a distributed Health-care Information System. PMID:9121372

  15. 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

    ... Integrity and Protection Data Bank information. 61.15 Section 61.15 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION HEALTHCARE INTEGRITY AND PROTECTION DATA BANK FOR FINAL ADVERSE... Integrity and Protection Data Bank § 61.15 How to dispute the accuracy of Healthcare Integrity...

  16. 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

    ... Integrity and Protection Data Bank information. 61.15 Section 61.15 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION HEALTHCARE INTEGRITY AND PROTECTION DATA BANK FOR FINAL ADVERSE... Integrity and Protection Data Bank § 61.15 How to dispute the accuracy of Healthcare Integrity...

  17. 75 FR 1120 - Agency Information Collection (Health-Care Use Survey for Enduring Freedom and Operation Iraqi...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-01-08

    ... AFFAIRS Agency Information Collection (Health-Care Use Survey for Enduring Freedom and Operation Iraqi...: Health-Care Use Survey for Enduring Freedom and Operation Iraqi Freedom (OEF/OIF) Veterans. OMB Control... study are to: (1) Examine the stigma-related barriers to VA health care; (2) document unique barriers...

  18. Advancing the evolution of healthcare: information technology in a person-focused population health model.

    PubMed

    Velianoff, George D

    2014-01-01

    The current changes introduced into the healthcare delivery system through the Affordable Care Act require more than the isolated, quality/cost process solutions utilized to date. Robust information systems with capabilities to push information and provide valid analytics and decision support utilizing point-of-care data input are required to achieve a complex, person-centered, lifetime-focused model. This article presents a review of the current state of population health, a model identifying components within population health, and an example of information technology integration.

  19. IS: the neural nexus. Why you should consider information systems as the central nervous system of an integrated healthcare network.

    PubMed

    Garets, D E; Miles, P V

    1994-02-01

    Until now, utilization of information systems in America's healthcare industry has been anything but scientific. And individual healthcare providers have managed to deliver the world's best healthcare services despite lousy information systems, lack of clinical outcomes data, lack of adequate service costing data and lack of customer satisfaction data. The key to the scientific improvement of the health status of a community health network is the acquisition and application of knowledge, which we believe to be wholly dependent upon scientifically designed clinical information systems. We've got some work to do. PMID:10132404

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

    PubMed

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

    2016-01-01

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

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

    PubMed

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

    2016-01-01

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

  2. Speech-language pathologists' informal learning in healthcare settings: behaviours and motivations.

    PubMed

    Walden, Patrick R; Bryan, Valerie C

    2011-08-01

    The current research sought to identify the types of informal learning behaviours speech-language pathologists (SLPs) working in healthcare settings engage in as well as SLPs' motivations for engaging in informal learning. Twenty-four American Speech-Language-Hearing Association (ASHA)-certified SLPs participated in this qualitative study. Data collection consisted of computer-mediated interviews, online journaling, and a virtual focus group. These textual data were coded and collapsed into themes. All participant SLPs reported that they learned through collaboration (inter- and intra-disciplinary), worked with patients to learn through trial-and-error, and consulted non-peer-reviewed material on the internet as well as peer-reviewed research in order to learn informally in the workplace. Eighteen of the 24 participants reported being motivated to learn at work to meet a patient's need to meet therapy goals. Five of the 24 participants reported meeting their own personal learning needs was a motivating factor and 10 of the 24 participants reported learning informally to meet the needs of the healthcare organization/SLP profession. Results were compared to past research on SLPs' information retrieval behaviours. It was concluded that SLPs acknowledge their personal work-related gaps in knowledge and skills and actively seek to develop their knowledge and skill base through informal means.

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

    PubMed Central

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

    2014-01-01

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

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

    PubMed

    Rosenälv, Jessica; Lundell, Karl-Henrik

    2012-01-01

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

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

    PubMed

    Rosenälv, Jessica; Lundell, Karl-Henrik

    2012-01-01

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

  6. 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.

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

    ERIC Educational Resources Information Center

    Muglia, Victor O.

    2010-01-01

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

  8. Regionalization of human resources. SCHCS healthcare facilities collaborate to head off labor shortages.

    PubMed

    Fordyce, M L

    1992-09-01

    Shortages of healthcare personnel become more pronounced each year. Effective human resource strategies are therefore important to facilities' success. The Sisters of Charity Health Care Systems (SCHCS), Cincinnati, is meeting the labor shortage head-on through collaborative regionalization among its facilities. Regionalization develops an integrated continuum of care on local and regional bases, helps SCHCS members avoid duplication of services, and ensures communities' future access to care by spreading financial risk among partners. SCHCS human resource personnel encourage employees to stay within the organization if they must relocate or are looking for career advancement. Members use a systemswide brochure to recruit nurses and allied health professionals. To attract employees from outside SCHCS, human resource personnel join forces at trade association conferences, job fairs, and school career days. SCHCS human resource personnel recruit and select values-oriented employees. Values-based human resource guidelines provide a framework for SCHCS members to assess how effectively the core values and mission are demonstrated in policies, programs, procedures, behaviors, and culture.

  9. Design and implementation of a smart card based healthcare information system.

    PubMed

    Kardas, Geylani; Tunali, E Turhan

    2006-01-01

    Smart cards are used in information technologies as portable integrated devices with data storage and data processing capabilities. As in other fields, smart card use in health systems became popular due to their increased capacity and performance. Their efficient use with easy and fast data access facilities leads to implementation particularly widespread in security systems. In this paper, a smart card based healthcare information system is developed. The system uses smart card for personal identification and transfer of health data and provides data communication via a distributed protocol which is particularly developed for this study. Two smart card software modules are implemented that run on patient and healthcare professional smart cards, respectively. In addition to personal information, general health information about the patient is also loaded to patient smart card. Health care providers use their own smart cards to be authenticated on the system and to access data on patient cards. Encryption keys and digital signature keys stored on smart cards of the system are used for secure and authenticated data communication between clients and database servers over distributed object protocol. System is developed on Java platform by using object oriented architecture and design patterns.

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

    PubMed

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

    2011-06-01

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

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

    PubMed

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

    2011-06-01

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

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

    PubMed Central

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

    2013-01-01

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

  13. User friendly web site a winner. San Diego's Sharp HealthCare provides wealth of information.

    PubMed

    Rees, Tom

    2003-01-01

    The Sharp HealthCare, San Diego, web site, a winner of the 2002 Medicine on the Net Web Excellence Award, provides a wealth of information without wasting space or confusing the visitor. The web site, www.sharp.com, can be viewed in both English and Spanish, a valuable consideration for those living in the California-Mexico border area served by Sharp. The integrated health network operates seven hospitals and three medical group practices. It has 2,541 physicians on medical staffs and more than 11,000 employees. PMID:12807120

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

    PubMed Central

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

    2014-01-01

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

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

    PubMed

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

    2007-01-01

    In order to improve the quality of patient care, while at the same time keeping up with the pace of increased needs of the population for healthcare services that directly impacts on the cost of care delivery processes, the Republic of Croatia, under the leadership of the Ministry of Health and Social Welfare, has formed a strategy and campaign for national public healthcare system reform. The strategy is very comprehensive and addresses all niches of care delivery processes; it is founded on the enterprise information systems that will aim to support end-to-end business processes in the healthcare domain. Two major requirements are in focus: (1) to provide efficient healthcare-related data management in support of decision-making processes; (2) to support a continuous process of healthcare resource spending optimisation. The first project is the Integrated Healthcare Information System (IHCIS) on the primary care level; this encompasses the integration of all primary point-of-care facilities and subjects with the Croatian Institute for Health Insurance and Croatian National Institute of Public Health. In years to come, IHCIS will serve as the main integration platform for connecting all other stakeholders and levels of health care (that is, hospitals, pharmacies, laboratories) into a single enterprise healthcare network. This article gives an overview of Croatian public healthcare system strategy aims and goals, and focuses on properties and characteristics of the primary care project implementation that started in 2003; it achieved a major milestone in early 2007 - the official grand opening of the project with 350 GPs already fully connected to the integrated healthcare information infrastructure based on the IHCIS solution.

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

    NASA Astrophysics Data System (ADS)

    Esmaeilzadeh, Pouyan; Sambasivan, Murali; Kumar, Naresh

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

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

    PubMed

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

    2007-01-01

    In order to improve the quality of patient care, while at the same time keeping up with the pace of increased needs of the population for healthcare services that directly impacts on the cost of care delivery processes, the Republic of Croatia, under the leadership of the Ministry of Health and Social Welfare, has formed a strategy and campaign for national public healthcare system reform. The strategy is very comprehensive and addresses all niches of care delivery processes; it is founded on the enterprise information systems that will aim to support end-to-end business processes in the healthcare domain. Two major requirements are in focus: (1) to provide efficient healthcare-related data management in support of decision-making processes; (2) to support a continuous process of healthcare resource spending optimisation. The first project is the Integrated Healthcare Information System (IHCIS) on the primary care level; this encompasses the integration of all primary point-of-care facilities and subjects with the Croatian Institute for Health Insurance and Croatian National Institute of Public Health. In years to come, IHCIS will serve as the main integration platform for connecting all other stakeholders and levels of health care (that is, hospitals, pharmacies, laboratories) into a single enterprise healthcare network. This article gives an overview of Croatian public healthcare system strategy aims and goals, and focuses on properties and characteristics of the primary care project implementation that started in 2003; it achieved a major milestone in early 2007 - the official grand opening of the project with 350 GPs already fully connected to the integrated healthcare information infrastructure based on the IHCIS solution. PMID:18005567

  18. Potential impact of advanced clinical information technology on healthcare in 2015.

    PubMed

    Sittig, Dean F

    2004-01-01

    Clinical information technologies now sporadically available will soon be in routine clinical use, bringing many changes to healthcare. For example, 1) The next generation Internet; 2) Real-time clinical decision support systems; 3) Off-line, population-based systems; 4) Large, integrated, individual patient-level phenotypic and genotypic databases with intelligent data mining capabilities; 5) Wireless, invasive and non-invasive physiologic monitoring devices; 6) Natural Language Processing (NLP) systems; and 7) Mathematical models of complex biological systems have the potential to impact significantly the future healthcare delivery system. While new information management and communication techniques and technologies will reduce many of the inefficiencies and inaccuracies of our present systems, there will be an equal, and potentially far more dangerous, set of unintended consequences. Informatics investigators and health system administrators must focus on the study of what is working and what is not, as well as, on development and testing of the new clinical information management and communication technologies, if we are to be ready for the future. PMID:15361041

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

    PubMed

    Graves, Barbara Ann

    2008-07-29

    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.

  20. 45 CFR 61.15 - How to dispute the accuracy of Healthcare Integrity and Protection Data Bank information.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Integrity and Protection Data Bank information. 61.15 Section 61.15 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION HEALTHCARE INTEGRITY AND PROTECTION DATA BANK FOR FINAL ADVERSE... Protection Data Bank information. (a) Who may dispute the HIPDB information. The HIPDB will routinely mail...

  1. Mumps Virus: Modification of the Identify-Isolate-Inform Tool for Frontline Healthcare Providers

    PubMed Central

    Koenig, Kristi L.; Shastry, Siri; Mzahim, Bandr; Almadhyan, Abdulmajeed; Burns, Michael J.

    2016-01-01

    Mumps is a highly contagious viral infection that became rare in most industrialized countries following the introduction of measles-mumps-rubella (MMR) vaccine in 1967. The disease, however, has been re-emerging with several outbreaks over the past decade. Many clinicians have never seen a case of mumps. To assist frontline healthcare providers with detecting potential cases and initiating critical actions, investigators modified the “Identify-Isolate-Inform” tool for mumps infection. The tool is applicable to regions with rare incidences or local outbreaks, especially seen in college students, as well as globally in areas where vaccination is less common. Mumps begins with a prodrome of low-grade fever, myalgias and malaise/anorexia, followed by development of nonsuppurative parotitis, which is the pathognomonic finding associated with acute mumps infection. Orchitis and meningitis are the two most common serious complications, with hearing loss and infertility occurring rarely. Providers should consider mumps in patients with exposure to a known case or international travel to endemic regions who present with consistent signs and symptoms. If mumps is suspected, healthcare providers must immediately implement standard and droplet precautions and notify the local health department and hospital infection control personnel. PMID:27625709

  2. Mumps Virus: Modification of the Identify-Isolate-Inform Tool for Frontline Healthcare Providers

    PubMed Central

    Koenig, Kristi L.; Shastry, Siri; Mzahim, Bandr; Almadhyan, Abdulmajeed; Burns, Michael J.

    2016-01-01

    Mumps is a highly contagious viral infection that became rare in most industrialized countries following the introduction of measles-mumps-rubella (MMR) vaccine in 1967. The disease, however, has been re-emerging with several outbreaks over the past decade. Many clinicians have never seen a case of mumps. To assist frontline healthcare providers with detecting potential cases and initiating critical actions, investigators modified the “Identify-Isolate-Inform” tool for mumps infection. The tool is applicable to regions with rare incidences or local outbreaks, especially seen in college students, as well as globally in areas where vaccination is less common. Mumps begins with a prodrome of low-grade fever, myalgias and malaise/anorexia, followed by development of nonsuppurative parotitis, which is the pathognomonic finding associated with acute mumps infection. Orchitis and meningitis are the two most common serious complications, with hearing loss and infertility occurring rarely. Providers should consider mumps in patients with exposure to a known case or international travel to endemic regions who present with consistent signs and symptoms. If mumps is suspected, healthcare providers must immediately implement standard and droplet precautions and notify the local health department and hospital infection control personnel.

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

    PubMed

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

    2014-09-01

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

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

    PubMed Central

    Bhavnani, Suresh K.; Peck, Frederick A.

    2015-01-01

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

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

    PubMed

    Jiang, Shunrong; Zhu, Xiaoyan; Wang, Liangmin

    2015-01-01

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

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

    PubMed Central

    Jiang, Shunrong; Zhu, Xiaoyan; Wang, Liangmin

    2015-01-01

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

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

    PubMed

    Jiang, Shunrong; Zhu, Xiaoyan; Wang, Liangmin

    2015-09-03

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

  8. Descriptive analysis of the inequalities of health information resources between Alberta's rural and urban health regions.

    PubMed

    Stieda, Vivian; Colvin, Barb

    2009-01-01

    In an effort to understand the extent of the inequalities in health information resources across Alberta, SEARCH Custom, HKN (Health Knowledge Network) and IRREN (Inter-Regional Research and Evaluation Network) conducted a survey in December 2007 to determine what library resources currently existed in Alberta's seven rural health regions and the two urban health regions. Although anecdotal evidence indicated that these gaps existed, the analysis was undertaken to provide empirical evidence of the exact nature of these gaps. The results, coupled with the published literature on the impact, effectiveness and value of information on clinical practice and administrative decisions in healthcare management, will be used to build momentum among relevant stakeholders to support a vision of equitably funded health information for all healthcare practitioners across the province of Alberta.

  9. A multimedia approach to raising awareness of information and communications technology amongst healthcare professionals.

    PubMed

    Grimson, J; Grimson, W; Flahive, M; Foley, C; O'Moore, R; Nolan, J; Chadwick, G

    2000-09-01

    This study is concerned with the application of advanced multimedia technology to the development of a programme aimed at raising awareness of information and communications technology (ICT) amongst health professionals in Ireland. The programme is delivered in the form of a symposium supplemented by a multimedia CD and associated web site. It examines how ICT can be used effectively in healthcare across all sectors - primary, secondary and tertiary - with a strong emphasis on supporting shared care. The aim is to empower users to make informed technological choices and to actively participate in the exploitation of ICT in the health sector. The programme was successfully completed and delivered to over 2300 health professionals across Ireland and follow-up activities include the active encouragement of leaders and champions within the sector. This will be supported by interactive web-based education and training material focused on specialised topics of particular interest within the broader context of continuing medical education (CME).

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

    PubMed

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

    2012-01-01

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

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

    PubMed Central

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

    2012-01-01

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

  12. 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.

  13. A Health Surveillance Software Framework to deliver information on preventive healthcare strategies.

    PubMed

    Macedo, Alessandra Alaniz; Pollettini, Juliana Tarossi; Baranauskas, José Augusto; Chaves, Julia Carmona Almeida

    2016-08-01

    A software framework can reduce costs related to the development of an application because it allows developers to reuse both design and code. Recently, companies and research groups have announced that they have been employing health software frameworks. This paper presents the design, proof-of-concept implementations and experimentation of the Health Surveillance Software Framework (HSSF). The HSSF is a framework that tackles the demand for the recommendation of surveillance information aiming at supporting preventive healthcare strategies. Examples of such strategies are the automatic recommendation of surveillance levels to patients in need of healthcare and the automatic recommendation of scientific literature that elucidates epigenetic problems related to patients. HSSF was created from two systems we developed in our previous work on health surveillance systems: the Automatic-SL and CISS systems. The Automatic-SL system aims to assist healthcare professionals in making decisions and in identifying children with developmental problems. The CISS service associates genetic and epigenetic risk factors related to chronic diseases with patient's clinical records. Towards evaluating the HSSF framework, two new systems, CISS+ and CISS-SW, were created by means of abstractions and instantiations of the framework (design and code). We show that HSSF supported the development of the two new systems given that they both recommend scientific papers using medical records as queries even though they exploit different computational technologies. In an experiment using simulated patients' medical records, we show that CISS, CISS+, and CISS-SW systems recommended more closely related and somewhat related documents than Google, Google Scholar and PubMed. Considering recall and precision measures, CISS+ surpasses CISS-SW in terms of precision.

  14. Health Information Exchange between Jails and Their Communities: A Bridge That Is Needed under Healthcare Reform

    PubMed Central

    Butler, Ben

    2014-01-01

    Jails have often been compared to islands because they are thought to be cut off from the community both physically and perceptually. Few people understand that besides being places of confinement, jails function as health care providers. The separation of jails from community results in disjointed health care services and treatment for individuals cycling in and out of jail. Healthcare providers in the community have little knowledge of the care their patients have received in jail; the same can be said of jail health providers about care provided in the community. With the passage of the Affordable Care Act (ACA) and the Health Information Technology for Economic and Clinical Health Act (HITECH), the federal government took the lead respectively in expanding health insurance coverage and in spurring the adoption of electronic health records (EHRs) and the development of health information exchanges (HIEs). Taken together, these initiatives place a strong emphasis on promoting continuity of care. With the expansion of Medicaid under the ACA, many of the individuals leaving jail will have access to health insurance for the first time. Community-based providers to the newly insured will want to know about the care that was provided in the jail. The developing technological infrastructure would seem to offer the best way to access this information. However linking the community and jail information systems is not just a technological issue, but requires the cooperation of all stakeholders. This paper presents two case studies: one in which a single champion made the decision to link the jail health care system to the local HIE and the other where all stakeholders were included in the process. In the first case study, the jail healthcare system reverted to its “island” status when the HIE was abandoned without protest from community stakeholders. In the second case study, the multiple stakeholder approach, while not necessarily a complete guarantee of long

  15. 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...

  16. Recognizing nurse stakeholder dissonance as a critical determinant of patient safety in new healthcare information technologies.

    PubMed

    Samaras, Elizabeth A; Real, Sara D; Curtis, Amber M; Meunier, Tessa S

    2012-01-01

    Proper identification of all stakeholders and the comprehensive assessment of their evolving and often conflicting Needs, Wants, and Desires (NWDs) is a fundamental principle of human factors science and human-centered systems engineering; it is not yet a consistent element in development and deployment of new health information technologies (HIT). As the single largest group of healthcare professionals, nurses are critical stakeholders for these new technologies. Careful analysis can reveal nurse stakeholder dissonance (NSD) when integrating new technologies into the healthcare environment. Stakeholder dissonance is a term that describes the conflict between the NWDs of different stakeholders which, if left unresolved, can result in dissatisfaction, workarounds, errors, and threats to patient safety. Three case studies drawn from the authors' experience in a variety of acute-care settings where new HITs have been recently deployed are examined to illustrate the concept of NSD. Conflicting NWDs, other stakeholders, and possible root causes of the NSD are analyzed and mapped to threats to patient safety. Lessons learned, practical guidance for anticipating, identifying, and mitigating NSD, future research and implications for HFE and nursing practice are discussed.

  17. Health economics in drug development: efficient research to inform healthcare funding decisions.

    PubMed

    Hall, Peter S; McCabe, Christopher; Brown, Julia M; Cameron, David A

    2010-10-01

    In order to decide whether a new treatment should be used in patients, a robust estimate of efficacy and toxicity is no longer sufficient. As a result of increasing healthcare costs across the globe healthcare payers and providers now seek estimates of cost-effectiveness as well. Most trials currently being designed still only consider the need for prospective efficacy and toxicity data during the development life-cycle of a new intervention. Hence the cost-effectiveness estimates are inevitably less precise than the clinical data on which they are based. Methods based on decision theory are being developed by health economists that can contribute to the design of clinical trials in such a way that they can more effectively lead to better informed drug funding decisions on the basis of cost-effectiveness in addition to clinical outcomes. There is an opportunity to apply these techniques prospectively in the design of future clinical trials. This article describes the problems encountered by those responsible for drug reimbursement decisions as a consequence of the current drug development pathway. The potential for decision theoretic methods to help overcome these problems is introduced and potential obstacles in implementation are highlighted.

  18. Conceptual Design of a Regional Information System.

    ERIC Educational Resources Information Center

    Denver Regional Council of Governments, CO.

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

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

    PubMed

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

    2008-01-01

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

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

    PubMed

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

    2008-01-01

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

  1. Healthcare information systems: data mining methods in the creation of a clinical recommender system

    NASA Astrophysics Data System (ADS)

    Duan, L.; Street, W. N.; Xu, E.

    2011-05-01

    Recommender systems have been extensively studied to present items, such as movies, music and books that are likely of interest to the user. Researchers have indicated that integrated medical information systems are becoming an essential part of the modern healthcare systems. Such systems have evolved to an integrated enterprise-wide system. In particular, such systems are considered as a type of enterprise information systems or ERP system addressing healthcare industry sector needs. As part of efforts, nursing care plan recommender systems can provide clinical decision support, nursing education, clinical quality control, and serve as a complement to existing practice guidelines. We propose to use correlations among nursing diagnoses, outcomes and interventions to create a recommender system for constructing nursing care plans. In the current study, we used nursing diagnosis data to develop the methodology. Our system utilises a prefix-tree structure common in itemset mining to construct a ranked list of suggested care plan items based on previously-entered items. Unlike common commercial systems, our system makes sequential recommendations based on user interaction, modifying a ranked list of suggested items at each step in care plan construction. We rank items based on traditional association-rule measures such as support and confidence, as well as a novel measure that anticipates which selections might improve the quality of future rankings. Since the multi-step nature of our recommendations presents problems for traditional evaluation measures, we also present a new evaluation method based on average ranking position and use it to test the effectiveness of different recommendation strategies.

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

    SciTech Connect

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

    2009-09-08

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

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

    PubMed Central

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

    2014-01-01

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

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

    PubMed Central

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

    2015-01-01

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

  5. [Sociological analysis of healthcare delivery in Russia regions with inclement natural conditions (in case of the Republic of Altai)].

    PubMed

    Kozhevnikov, A A

    2014-01-01

    The paper describes the results of a sociological study of delivery of healthcare in the Republic of Altai to search for ways to improve its quality and to provide access to the local population. Analysis was made with regard to an interdisciplinary, comprehensive approach to considering the range of problems associated with not only the health of local residents and identifying risk factors leading to diseases, but also by determining the possibilities that could promote the minimization of causes that have a considerable impact on the occurrence of diseases and also hamper healthcare delivery in the human settlements of Gornyi Altai, which are difficult of access. The investigation has used sociological and statistical methods. It has been ascertained that the available healthcare forces and means should be today employed at the regional level, by applying the principles of necessary sufficiency in conjunction with the local population's social motivation to be involved in the activity associated with the rendering of medical services. In addition, it is necessary to systemically use mobile medical units as a significant factor for the optimization of medical care to the population living in Russia's regions which are difficult of access.

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

    PubMed Central

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

    2016-01-01

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

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

    PubMed Central

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

    2016-01-01

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

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

    ERIC Educational Resources Information Center

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

    2009-01-01

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

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

    PubMed

    Babulak, Eduard

    2006-01-01

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

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

    PubMed

    Iakovidis, Dimitris; Smailis, Christos

    2012-01-01

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

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

    PubMed

    Babulak, Eduard

    2006-01-01

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

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

    PubMed

    Iakovidis, Dimitris; Smailis, Christos

    2012-01-01

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

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

    ERIC Educational Resources Information Center

    Davalos, Eugenia

    2013-01-01

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

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

    PubMed

    Korukonda, Appa Rao; Korukonda, Saritha

    2006-01-01

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

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

    PubMed

    Namoğlu, Nihan; Ulgen, Yekta

    2013-01-01

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

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

    PubMed

    Namoğlu, Nihan; Ulgen, Yekta

    2013-01-01

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

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

    PubMed

    Alam, Rahul; Speed, Shaun; Beaver, Kinta

    2012-03-01

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

  18. Leveraging health information technology to achieve the “triple aim” of healthcare reform

    PubMed Central

    Sood, Harpreet S; Bates, David W

    2015-01-01

    Objective To investigate experiences with leveraging health information technology (HIT) to improve patient care and population health, and reduce healthcare expenditures. Materials and methods In-depth qualitative interviews with federal government employees, health policy, HIT and medico-legal experts, health providers, physicians, purchasers, payers, patient advocates, and vendors from across the United States. Results The authors undertook 47 interviews. There was a widely shared belief that Health Information Technology for Economic and Clinical Health (HITECH) had catalyzed the creation of a digital infrastructure, which was being used in innovative ways to improve quality of care and curtail costs. There were however major concerns about the poor usability of electronic health records (EHRs), their limited ability to support multi-disciplinary care, and major difficulties with health information exchange, which undermined efforts to deliver integrated patient-centered care. Proposed strategies for enhancing the benefits of HIT included federal stimulation of competition by mandating vendors to open-up their application program interfaces, incenting development of low-cost consumer informatics tools, and promoting Congressional review of the The Health Insurance Portability and Accountability Act (HIPPA) to optimize the balance between data privacy and reuse. Many underscored the need to “kick the legs from underneath the fee-for-service model” and replace it with a data-driven reimbursement system that rewards high quality care. Conclusions The HITECH Act has stimulated unprecedented, multi-stakeholder interest in HIT. Early experiences indicate that the resulting digital infrastructure is being used to improve quality of care and curtail costs. Reform efforts are however severely limited by problems with usability, limited interoperability and the persistence of the fee-for-service paradigm—addressing these issues therefore needs to be the federal

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

    PubMed Central

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

    2014-01-01

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

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

    PubMed Central

    Carnicero, J.; Rojas, D.

    2010-01-01

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

  1. Association of MHC region SNPs with irritant susceptibility in healthcare workers.

    PubMed

    Yucesoy, Berran; Talzhanov, Yerkebulan; Michael Barmada, M; Johnson, Victor J; Kashon, Michael L; Baron, Elma; Wilson, Nevin W; Frye, Bonnie; Wang, Wei; Fluharty, Kara; Gharib, Rola; Meade, Jean; Germolec, Dori; Luster, Michael I; Nedorost, Susan

    2016-09-01

    Irritant contact dermatitis is the most common work-related skin disease, especially affecting workers in "wet-work" occupations. This study was conducted to investigate the association between single nucleotide polymorphisms (SNPs) within the major histocompatibility complex (MHC) and skin irritant response in a group of healthcare workers. 585 volunteer healthcare workers were genotyped for MHC SNPs and patch tested with three different irritants: sodium lauryl sulfate (SLS), sodium hydroxide (NaOH) and benzalkonium chloride (BKC). Genotyping was performed using Illumina Goldengate MHC panels. A number of SNPs within the MHC Class I (OR2B3, TRIM31, TRIM10, TRIM40 and IER3), Class II (HLA-DPA1, HLA-DPB1) and Class III (C2) genes were associated (p < 0.001) with skin response to tested irritants in different genetic models. Linkage disequilibrium patterns and functional annotations identified two SNPs in the TRIM40 (rs1573298) and HLA-DPB1 (rs9277554) genes, with a potential impact on gene regulation. In addition, SNPs in PSMB9 (rs10046277 and ITPR3 (rs499384) were associated with hand dermatitis. The results are of interest as they demonstrate that genetic variations in inflammation-related genes within the MHC can influence chemical-induced skin irritation and may explain the connection between inflamed skin and propensity to subsequent allergic contact sensitization. PMID:27258892

  2. 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.

  3. 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.

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

    PubMed

    Solly, Martin

    2007-01-01

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

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

    PubMed Central

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

    2014-01-01

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

  6. Conducting discrete choice experiments to inform healthcare decision making: a user's guide.

    PubMed

    Lancsar, Emily; Louviere, Jordan

    2008-01-01

    Discrete choice experiments (DCEs) are regularly used in health economics to elicit preferences for healthcare products and programmes. There is growing recognition that DCEs can provide more than information on preferences and, in particular, they have the potential to contribute more directly to outcome measurement for use in economic evaluation. Almost uniquely, DCEs could potentially contribute to outcome measurement for use in both cost-benefit and cost-utility analysis. Within this expanding remit, our intention is to provide a resource for current practitioners as well as those considering undertaking a DCE, using DCE results in a policy/commercial context, or reviewing a DCE. We present the fundamental principles and theory underlying DCEs. To aid in undertaking and assessing the quality of DCEs, we discuss the process of carrying out a choice study and have developed a checklist covering conceptualizing the choice process, selecting attributes and levels, experimental design, questionnaire design, pilot testing, sampling and sample size, data collection, coding of data, econometric analysis, validity, interpretation and welfare and policy analysis. In this fast-moving area, a number of issues remain on the research frontier. We therefore outline potentially fruitful areas for future research associated both with DCEs in general, and with health applications specifically, paying attention to how the results of DCEs can be used in economic evaluation. We also discuss emerging research trends. We conclude that if appropriately designed, implemented, analysed and interpreted, DCEs offer several advantages in the health sector, the most important of which is that they provide rich data sources for economic evaluation and decision making, allowing investigation of many types of questions, some of which otherwise would be intractable analytically. Thus, they offer viable alternatives and complements to existing methods of valuation and preference elicitation.

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

    PubMed

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

    2016-01-01

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

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

    PubMed

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

    2016-01-01

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

  9. Improved Glycemic Control Without Hypoglycemia in Elderly Diabetic Patients Using the Ubiquitous Healthcare Service, a New Medical Information System

    PubMed Central

    Lim, Soo; Kang, Seon Mee; Shin, Hayley; Lee, Hak Jong; Won Yoon, Ji; Yu, Sung Hoon; Kim, So-Youn; Yoo, Soo Young; Jung, Hye Seung; Park, Kyong Soo; Ryu, Jun Oh; Jang, Hak C.

    2011-01-01

    OBJECTIVE To improve quality and efficiency of care for elderly patients with type 2 diabetes, we introduced elderly-friendly strategies to the clinical decision support system (CDSS)-based ubiquitous healthcare (u-healthcare) service, which is an individualized health management system using advanced medical information technology. RESEARCH DESIGN AND METHODS We conducted a 6-month randomized, controlled clinical trial involving 144 patients aged >60 years. Participants were randomly assigned to receive routine care (control, n = 48), to the self-monitored blood glucose (SMBG, n = 47) group, or to the u-healthcare group (n = 49). The primary end point was the proportion of patients achieving A1C <7% without hypoglycemia at 6 months. U-healthcare system refers to an individualized medical service in which medical instructions are given through the patient’s mobile phone. Patients receive a glucometer with a public switched telephone network-connected cradle that automatically transfers test results to a hospital-based server. Once the data are transferred to the server, an automated system, the CDSS rule engine, generates and sends patient-specific messages by mobile phone. RESULTS After 6 months of follow-up, the mean A1C level was significantly decreased from 7.8 ± 1.3% to 7.4 ± 1.0% (P < 0.001) in the u-healthcare group and from 7.9 ± 1.0% to 7.7 ± 1.0% (P = 0.020) in the SMBG group, compared with 7.9 ± 0.8% to 7.8 ± 1.0% (P = 0.274) in the control group. The proportion of patients with A1C <7% without hypoglycemia was 30.6% in the u-healthcare group, 23.4% in the SMBG group (23.4%), and 14.0% in the control group (P < 0.05). CONCLUSIONS The CDSS-based u-healthcare service achieved better glycemic control with less hypoglycemia than SMBG and routine care and may provide effective and safe diabetes management in the elderly diabetic patients. PMID:21270188

  10. Healthcare fundamentals.

    PubMed

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

    2014-07-01

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

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

    PubMed

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

    2015-01-01

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

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed

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

    2015-01-01

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

  14. Addressing Work-Related Issues in Medical Rehabilitation: Revision of an Online Information Tool for Healthcare Professionals

    PubMed Central

    Wolf, Hans-Dieter; Gerlich, Christian; Vogel, Heiner; Neuderth, Silke

    2016-01-01

    Background. Medical rehabilitation increasingly considers occupational issues as determinants of health and work ability. Information on work-related rehabilitation concepts should therefore be made available to healthcare professionals. Objective. To revise a website providing healthcare professionals in medical rehabilitation facilities with information on work-related concepts in terms of updating existing information and including new topics, based on recommendations from implementation research. Method. The modification process included a questionnaire survey of medical rehabilitation centers (n = 28); two workshops with experts from rehabilitation centers, health payers, and research institutions (n = 14); the selection of new topics and revision of existing text modules based on expert consensus; and an update of good practice descriptions of work-related measures. Results. Health payers' requirements, workplace descriptions, and practical implementation aids were added as new topics. The database of good practice examples was extended to 63 descriptions. Information on introductory concepts was rewritten and supplemented by current data. Diagnostic tools were updated by including additional assessments. Conclusions. Recommendations from implementation research such as assessing user needs and including expert knowledge may serve as a useful starting point for the dissemination of information on work-related medical rehabilitation into practice. Web-based information tools such as the website presented here can be quickly adapted to current evidence and changes in medicolegal regulations.

  15. Addressing Work-Related Issues in Medical Rehabilitation: Revision of an Online Information Tool for Healthcare Professionals

    PubMed Central

    Wolf, Hans-Dieter; Gerlich, Christian; Vogel, Heiner; Neuderth, Silke

    2016-01-01

    Background. Medical rehabilitation increasingly considers occupational issues as determinants of health and work ability. Information on work-related rehabilitation concepts should therefore be made available to healthcare professionals. Objective. To revise a website providing healthcare professionals in medical rehabilitation facilities with information on work-related concepts in terms of updating existing information and including new topics, based on recommendations from implementation research. Method. The modification process included a questionnaire survey of medical rehabilitation centers (n = 28); two workshops with experts from rehabilitation centers, health payers, and research institutions (n = 14); the selection of new topics and revision of existing text modules based on expert consensus; and an update of good practice descriptions of work-related measures. Results. Health payers' requirements, workplace descriptions, and practical implementation aids were added as new topics. The database of good practice examples was extended to 63 descriptions. Information on introductory concepts was rewritten and supplemented by current data. Diagnostic tools were updated by including additional assessments. Conclusions. Recommendations from implementation research such as assessing user needs and including expert knowledge may serve as a useful starting point for the dissemination of information on work-related medical rehabilitation into practice. Web-based information tools such as the website presented here can be quickly adapted to current evidence and changes in medicolegal regulations. PMID:27610246

  16. Addressing Work-Related Issues in Medical Rehabilitation: Revision of an Online Information Tool for Healthcare Professionals.

    PubMed

    Lukasczik, Matthias; Wolf, Hans-Dieter; Gerlich, Christian; Küffner, Roland; Vogel, Heiner; Neuderth, Silke

    2016-01-01

    Background. Medical rehabilitation increasingly considers occupational issues as determinants of health and work ability. Information on work-related rehabilitation concepts should therefore be made available to healthcare professionals. Objective. To revise a website providing healthcare professionals in medical rehabilitation facilities with information on work-related concepts in terms of updating existing information and including new topics, based on recommendations from implementation research. Method. The modification process included a questionnaire survey of medical rehabilitation centers (n = 28); two workshops with experts from rehabilitation centers, health payers, and research institutions (n = 14); the selection of new topics and revision of existing text modules based on expert consensus; and an update of good practice descriptions of work-related measures. Results. Health payers' requirements, workplace descriptions, and practical implementation aids were added as new topics. The database of good practice examples was extended to 63 descriptions. Information on introductory concepts was rewritten and supplemented by current data. Diagnostic tools were updated by including additional assessments. Conclusions. Recommendations from implementation research such as assessing user needs and including expert knowledge may serve as a useful starting point for the dissemination of information on work-related medical rehabilitation into practice. Web-based information tools such as the website presented here can be quickly adapted to current evidence and changes in medicolegal regulations. PMID:27610246

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

    PubMed

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

    2004-03-31

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

  18. 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

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

    PubMed Central

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

    2013-01-01

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

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

    PubMed Central

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

    2012-01-01

    Background The healthcare system of mainland China is undergoing drastic reform and the optimal models for healthcare financing for provision of primary care will need to be identified. This study compared the performance indicators of the community health centres (CHCs) under different healthcare financing systems in the six cities of the Pearl River Delta region. Methods Approximately 300 hypertensive patients were randomly recruited from the computerized chronic disease management records provided by one CHC in each of the six cities in 2011 using a multi-stage cluster random sampling method. The major outcome measures included the treatment rate of hypertension, defined as prescription of ≥ one antihypertensive agent; and the control rate of hypertension, defined as systolic blood pressure levels <140 mmHg and diastolic blood pressure levels <90 mmHg in patients without diabetes mellitus, or <130/80 mmHg among patients with concomitant diabetes. Binary logistic regression analyses were conducted with these two measures as outcome variables, respectively, controlling for patients’ socio-demographic variables. The financing system (Hospital- vs. Government- vs. private-funded) was the independent variable tested for association with the outcomes. Results From 1,830 patients with an average age of 65.9 years (SD 12.8), the overall treatment and control rates were 75.4% and 20.2%, respectively. When compared with hospital-funded CHCs, patients seen in the Government-funded (adjusted odds ratio [AOR] 0.462, 95% C.I. 0.325–0.656) and private-funded CHCs (AOR 0.031, 95% C.I. 0.019–0.052) were significantly less likely to be prescribed antihypertensive medication. However, the Government-funded CHC was more likely to have optimal BP control (AOR 1.628, 95% C.I. 1.157–2.291) whilst the privately-funded CHC was less likely to achieve BP control (AOR 0.146, 95% C.I. 0.069–0.310), irrespective of whether antihypertensive drugs were prescribed. Conclusions

  1. Participatory approaches involving community and healthcare providers in family planning/contraceptive information and service provision: a scoping review.

    PubMed

    Steyn, Petrus S; Cordero, Joanna Paula; Gichangi, Peter; Smit, Jennifer A; Nkole, Theresa; Kiarie, James; Temmerman, Marleen

    2016-01-01

    As efforts to address unmet need for family planning and contraception (FP/C) accelerate, voluntary use, informed choice and quality must remain at the fore. Active involvement of affected populations has been recognized as one of the key principles in ensuring human rights in the provision of FP/C and in improving quality of care. However, community participation continues to be inadequately addressed in large-scale FP/C programmes. Community and healthcare providers' unequal relationship can be a barrier to successful participation. This scoping review identifies participatory approaches involving both community and healthcare providers for FP/C services and analyzes relevant evidence. The detailed analysis of 25 articles provided information on 28 specific programmes and identified three types of approaches for community and healthcare provider participation in FP/C programmes. The three approaches were: (i) establishment of new groups either health committees to link the health service providers and users or implementation teams to conduct specific activities to improve or extend available health services, (ii) identification of and collaboration with existing community structures to optimise use of health services and (iii) operationalization of tools to facilitate community and healthcare provider collaboration for quality improvement. Integration of community and healthcare provider participation in FP/C provision were conducted through FP/C-only programmes, FP/C-focused programmes and/or as part of a health service package. The rationales behind the interventions varied and may be multiple. Examples include researcher-, NGO- or health service-initiated programmes with clear objectives of improving FP/C service provision or increasing demand for services; facilitating the involvement of community members or service users and, in some cases, may combine socio-economic development and increasing self-reliance or control over sexual and reproductive health

  2. Participatory approaches involving community and healthcare providers in family planning/contraceptive information and service provision: a scoping review.

    PubMed

    Steyn, Petrus S; Cordero, Joanna Paula; Gichangi, Peter; Smit, Jennifer A; Nkole, Theresa; Kiarie, James; Temmerman, Marleen

    2016-07-22

    As efforts to address unmet need for family planning and contraception (FP/C) accelerate, voluntary use, informed choice and quality must remain at the fore. Active involvement of affected populations has been recognized as one of the key principles in ensuring human rights in the provision of FP/C and in improving quality of care. However, community participation continues to be inadequately addressed in large-scale FP/C programmes. Community and healthcare providers' unequal relationship can be a barrier to successful participation. This scoping review identifies participatory approaches involving both community and healthcare providers for FP/C services and analyzes relevant evidence. The detailed analysis of 25 articles provided information on 28 specific programmes and identified three types of approaches for community and healthcare provider participation in FP/C programmes. The three approaches were: (i) establishment of new groups either health committees to link the health service providers and users or implementation teams to conduct specific activities to improve or extend available health services, (ii) identification of and collaboration with existing community structures to optimise use of health services and (iii) operationalization of tools to facilitate community and healthcare provider collaboration for quality improvement. Integration of community and healthcare provider participation in FP/C provision were conducted through FP/C-only programmes, FP/C-focused programmes and/or as part of a health service package. The rationales behind the interventions varied and may be multiple. Examples include researcher-, NGO- or health service-initiated programmes with clear objectives of improving FP/C service provision or increasing demand for services; facilitating the involvement of community members or service users and, in some cases, may combine socio-economic development and increasing self-reliance or control over sexual and reproductive health

  3. [Methodology of strategy development for the improvement of efficiency of sanatorium-resort services in the regional healthcare system].

    PubMed

    Artamonova, G V; Zaĭtsev, N M

    2009-01-01

    Methodological aspects of the development of the strategy for the improvement of efficiency of sanatorium-resort services in the regional healthcare system based on the experience of "Prokopievsky" sanatorium, Kemerovo region. Different stages in the history of the sanatorium are described with special reference to its role in continuous medico-social rehabilitation of the patients and in the maintenance of continuity of medical care provided by municipal outpatient, inpatient, and sanatorium settings. Transition to new forms of organization and work of sanatorium-resort facilities required in-depth analysis of their day-by-day activities as well as problems and obstacles hindering their further development. After having overcome the crisis of 2001-2006, sanatorium "Prokopievsky" strengthened its position at the market of sanatorium-resort services not only by continuing basic activity but also by developing new lines of medical aid and attracting new categories of patients. In 2007, the share of proceeds from medical and commercial services reached 93.3% and 1.2% respectively compared with 0.12% and 1.32% in 2002. PMID:19882893

  4. [Methodology of strategy development for the improvement of efficiency of sanatorium-resort services in the regional healthcare system].

    PubMed

    Artamonova, G V; Zaĭtsev, N M

    2009-01-01

    Methodological aspects of the development of the strategy for the improvement of efficiency of sanatorium-resort services in the regional healthcare system based on the experience of "Prokopievsky" sanatorium, Kemerovo region. Different stages in the history of the sanatorium are described with special reference to its role in continuous medico-social rehabilitation of the patients and in the maintenance of continuity of medical care provided by municipal outpatient, inpatient, and sanatorium settings. Transition to new forms of organization and work of sanatorium-resort facilities required in-depth analysis of their day-by-day activities as well as problems and obstacles hindering their further development. After having overcome the crisis of 2001-2006, sanatorium "Prokopievsky" strengthened its position at the market of sanatorium-resort services not only by continuing basic activity but also by developing new lines of medical aid and attracting new categories of patients. In 2007, the share of proceeds from medical and commercial services reached 93.3% and 1.2% respectively compared with 0.12% and 1.32% in 2002.

  5. Healthcare Supported by Data Mule Networks in Remote Communities of the Amazon Region

    PubMed Central

    Coutinho, Mauro Margalho; Efrat, Alon; Richa, Andrea

    2014-01-01

    This paper investigates the feasibility of using boats as data mule nodes, carrying medical ultrasound videos from remote and isolated communities in the Amazon region in Brazil, to the main city of that area. The videos will be used by physicians to perform remote analysis and follow-up routine of prenatal examinations of pregnant women. Two open source simulators (the ONE and NS-2) were used to evaluate the results obtained utilizing a CoDPON (continuous displacement plan oriented network). The simulations took into account the connection times between the network nodes (boats) and the number of nodes on each boat route. PMID:27433519

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

    PubMed

    Torri, Maria Costanza; Hollenberg, Daniel

    2013-01-01

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

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

    PubMed

    Torri, Maria Costanza; Hollenberg, Daniel

    2013-01-01

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

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

    PubMed

    2006-01-01

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

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

    PubMed

    2006-01-01

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

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

    PubMed

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

    2016-02-01

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

  11. SURVEYING ADOLESCENTS ENROLLED IN A REGIONAL HEALTHCARE DELIVERY ORGANIZATION: MAIL & PHONE FOLLOW-UP--WHAT WORKS AT WHAT COST?

    PubMed Central

    Richards, Julie; Wiese, Cheryl; Katon, Wayne; Rockhill, Carol; McCarty, Carolyn; Grossman, David; McCauley, Elizabeth; Richardson, Laura P.

    2011-01-01

    PURPOSE To describe the differential completion rates and cost of sequential methods for a survey of adolescent regional healthcare delivery organization enrollees. METHODS 4000 randomly selected enrollees were invited to complete a mailed health survey. Techniques used to boost response included: 1) a follow-up mailing 2) varying the appearance of the survey 3) reminder calls 4) phone calls to obtain parent and child consent and administer the survey. We evaluated the outcome and costs of these methods. RESULTS 783 (20%) enrollees completed the 1st mailed survey, and 521 completed the 2nd, increasing the overall response rate to 33%. Completion was significantly higher for respondents who received only the plain survey than those receiving only the color (p<.001). Reminder calls boosted response by 8%. Switching to phone survey administration boosted response by 20% to 61%. The cost per completed survey was $29 for the first mailing, $26 after both mailings, $42 for mailings and reminder calls, and $48 for adding phone surveys. CONCLUSIONS The response to mailings and reminder calls was low and the cost high, with decreasing yield at each step, though some low cost techniques helpful. Results suggest phone surveys may be most effective among similar samples of adolescents. PMID:20616296

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

    PubMed

    Ko, Henry

    2016-05-01

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

  13. 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.

  14. Advances in Navy pharmacy information technology: accessing Micromedex via the Composite Healthcare Computer System and local area networks.

    PubMed

    Koerner, S D; Becker, F

    1999-07-01

    The pharmacy profession has long used technology to more effectively bring health care to the patient. Navy pharmacy has embraced technology advances in its daily operations, from computers to dispensing robots. Evolving from the traditional role of compounding and dispensing specialists, pharmacists are establishing themselves as vital team members in direct patient care: on the ward, in ambulatory clinics, in specialty clinics, and in other specialty patient care programs (e.g., smoking cessation). An important part of the evolution is the timely access to the most up-to-date information available. Micromedex, Inc. (Denver, Colorado), has developed a number of computer CD-ROM-based full-text pharmacy, toxicology, emergency medicine, and patient education products. Micromedex is a recognized leader with regard to total pharmaceutical information availability. This article discusses the implementation of Micromedex products within the established Composite Healthcare Computer System and the subsequent use by and effect on the international Navy pharmacy community.

  15. Engineering a learning healthcare system: using health information technology to develop an objective nurse staffing tool.

    PubMed

    Harper, Ellen M

    2012-01-01

    Nurses represent the largest proportion of direct healthcare providers. Overstaffed or understaffed units will have implications for the quality, cost, patient, and nurse satisfaction. It is vital that nurses are armed with appropriate instruments and data to help them plan and implement efficient and effective nursing teams. A compelling case is made for the association between nursing care and clinical, quality, and financial outcomes. Even though there is a great body of work on the correlation, there is little agreement on the best approach to determine the correct balance between the patient-to-nurse ratios. The sheer number of variables depicted in the literature suggests why precise evidenced based formulas are difficult to achieve. This paper will describe a practice based knowledge generation mixed methods study using detailed observation and electronic health record abstraction to generate a structural equation for use in predicting staffing needs.

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

    PubMed Central

    2010-01-01

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

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

    NASA Technical Reports Server (NTRS)

    Tilton, James C.; Pasolli, Edoardo

    2014-01-01

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

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

    PubMed

    Itoh, Kenji; Andersen, Henning Boje; Madsen, Marlene Dyrløv; Østergaard, Doris; Ikeno, Masaaki

    2006-07-01

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

  19. Why there can be no sustainable national healthcare IT program without a translational health information science.

    PubMed

    Lorence, Daniel

    2007-12-01

    Health information technology research has historically suffered from the persistence of paper-based systems as a barrier to research and refinement of information models. While the field of (non-medical) information science offers a potentially rich source of data, there exist relatively few theoretical links between medical and non-medical information models. This paper argues that the establishment of an integrated translational research pathway is not only useful, but is a critical and necessary step in the realization of a national health information infrastructure in the USA.

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

    PubMed

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

    2016-03-01

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

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

    PubMed

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

    2016-03-01

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

  2. 77 FR 18821 - Agency for Healthcare Research and Quality; Agency Information Collection Activities: Proposed...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-28

    ... collection project: ``Adapting Best Practices for Medicaid Readmissions.'' In accordance with the Paperwork....lefkowitz@AHRQ.hhs.gov . SUPPLEMENTARY INFORMATION: Proposed Project Adapting Best Practices for...

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

    PubMed

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

    2012-06-01

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

  4. A Framework for Information Retrieval and Knowledge Discovery from Online Healthcare Forums

    ERIC Educational Resources Information Center

    Sampathkumar, Hariprasad

    2016-01-01

    Information used to assist biomedical and clinical research has largely comprised of data available in published sources like scientific papers and journals, or in clinical sources like patient health records, lab reports and discharge summaries. Information from such sources, though extensive and organized, is often not readily available due to…

  5. Using technology to access regional environmental information.

    PubMed

    Minns, C K

    1992-03-01

    Distinctions between holistic and presciptive technologies, and holistic and reductionist science are a backdrop to examination of two widespread environmental problems: eutrophication in the Bay of Quinte, Lake Ontario, and acidification of lakes in eastern Canada. Evidence is presented on a shift from prescriptive toward holistic approaches. Holistic solutions to technological limitations are discussed with emphasis on the interactive procedures people use to solve problems, rather than on the physical tools which are often employed in a prescriptive manner. Local gathering and integration of environmental information is presented as the key to macro-environmental assessments. Recommendations stress (i) the need for ecologists in every ecosystem, (ii) training with emphasis on problem-solving techniques, (iii) wide-spread use of microcomputers, a potent holistic technology, to transfer information and concepts, and (iv) local selection of indicators with the advice that they be simple and biotic.

  6. Development through Information Networks in the Asia-Pacific Region.

    ERIC Educational Resources Information Center

    Amarasuriya, Nimala R.

    1987-01-01

    Discusses the need for access to scientific and technical information to attain national development goals in the Asia Pacific region, and outlines the objectives and program areas of a regional information network established by Unesco. Problems with the current system and future needs are identified. (CLB)

  7. Learning teams and networks: using information technology as a means of managing work process development in healthcare organizations.

    PubMed

    Korhonen, Vesa; Paavilainen, Eija

    2002-01-01

    This article focuses on the introduction of team learning and shared knowledge creation using computer-based learning environments and teams as networks in the development of healthcare organizations. Using computer technology, care units can be considered learning teams and the hospital a network of those learning teams. Team learning requires that the healthcare workers' intellectual capital and personal competence be viewed as an important resource in developing the quality of action of the entire healthcare organization.

  8. The perceived impact of interprofessional information sharing on young people about their sexual healthcare.

    PubMed

    Hyde, Abbey; Fullerton, Deirdre; Lohan, Maria; McKeown, Caroline; Dunne, Laura; Macdonald, Geraldine; Howlin, Frances; Healy, Maria

    2016-07-01

    This article presents the results from an analysis of data from service providers and young adults who were formerly in state care about how information about the sexual health of young people in state care is managed. In particular, the analysis focuses on the perceived impact of information sharing between professionals on young people. Twenty-two service providers from a range of professions including social work, nursing and psychology, and 19 young people aged 18-22 years who were formerly in state care participated in the study. A qualitative approach was employed in which participants were interviewed in depth and data were analysed using modified analytical induction (Bogdan & Biklen, 2007). Findings suggest that within the care system in which service provider participants worked it was standard practice that sensitive information about a young person's sexual health would be shared across team members, even where there appeared to be no child protection issues. However, the accounts of the young people indicated that they experienced the sharing of information in this way as an invasion of their privacy. An unintended outcome of a high level of information sharing within teams is that the privacy of the young person in care is compromised in a way that is not likely to arise in the case of young people who are not in care. This may deter young people from availing themselves of the sexual health services.

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

    PubMed

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

    2013-09-01

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

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

    PubMed Central

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

    2001-01-01

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

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

    NASA Astrophysics Data System (ADS)

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

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

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

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-23

    ... response to the notice to conduct an independent comprehensive study of the barriers to the provision of... collection of information on respondents, including through the use of automated collection techniques or the.... VA is responding by improving access and services for women. The study will help us better...

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

    PubMed

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

    2010-01-01

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

  14. 78 FR 21502 - Proposed Information Collection (Women Veterans Healthcare Barriers Survey)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-10

    ... any correspondence. FOR FURTHER INFORMATION CONTACT: Crystal Rennie, Enterprise Records Service..., fax (202) 632-7583 or email crystal.rennie@va.gov . Please refer to ``OMB Control No. 2900-NEW, Women... data collection. Abstract: Women Veterans comprise one of the fastest growing subpopulations...

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

    PubMed Central

    2012-01-01

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

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

    PubMed Central

    2014-01-01

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

  17. Wearable sensors in healthcare and sensor-enhanced health information systems: all our tomorrows?

    PubMed

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

    2012-06-01

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

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

    PubMed Central

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

    2012-01-01

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

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

    PubMed Central

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

    2013-01-01

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

  20. 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.

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

    PubMed

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

    2001-01-01

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

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

    PubMed

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

    2011-02-01

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

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

    NASA Astrophysics Data System (ADS)

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

    2009-12-01

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

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

    PubMed

    Somolinos, Roberto; Muñoz, Adolfo; Hernando, M Elena; Pascual, Mario; Cáceres, Jesús; Sánchez-de-Madariaga, Ricardo; Fragua, Juan A; Serrano, Pablo; Salvador, Carlos H

    2015-11-01

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

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

    PubMed Central

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

    2008-01-01

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

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

    PubMed

    Somolinos, Roberto; Muñoz, Adolfo; Hernando, M Elena; Pascual, Mario; Cáceres, Jesús; Sánchez-de-Madariaga, Ricardo; Fragua, Juan A; Serrano, Pablo; Salvador, Carlos H

    2015-11-01

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

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

    PubMed

    2004-12-01

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

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

    PubMed

    Shanmugasundaram, Jothiganesh; Soulalay, Vongdeuane; Chettiyappan, Visvanathan

    2012-06-01

    In Lao People's Democratic Republic (Lao PDR), a growth of healthcare centres, and the environmental hazards and public health risks typically accompanying them, increased the need for healthcare waste (HCW) management planning. An effective planning of an HCW management system including components such as the treatment plant siting and an optimized routeing system for collection and transportation of waste is deemed important. National government offices at developing countries often lack the proper tools and methodologies because of the high costs usually associated with them. However, this study attempts to demonstrate the use of an inexpensive GIS modelling tool for healthcare waste management in the country. Two areas were designed for this study on HCW management, including: (a) locating centralized treatment plants and designing optimum travel routes for waste collection from nearby healthcare facilities; and (b) utilizing existing hospital incinerators and designing optimum routes for collecting waste from nearby healthcare facilities. Spatial analysis paved the way to understand the spatial distribution of healthcare wastes and to identify hotspots of higher waste generating locations. Optimal route models were designed for collecting and transporting HCW to treatment plants, which also highlights constraints in collecting and transporting waste for treatment and disposal. The proposed model can be used as a decision support tool for the efficient management of hospital wastes by government healthcare waste management authorities and hospitals.

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

    PubMed

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

    2014-01-01

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

  10. Serving homeless veterans in the VA Desert Pacific Healthcare Network: a needs assessment to inform quality improvement endeavors.

    PubMed

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

    2013-08-01

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

  11. A Telephone Based Regional Adult Education Information Service.

    ERIC Educational Resources Information Center

    Eyler, David R.

    This report describes a cooperative project designed to inform area residents of available adult education opportunities and to establish a central information contact point. The regional Adult Education Coordinating Committee compiled a list of adult education courses and services offered by member institutions, devised newspaper and radio…

  12. The University, the Information Superhighway and Regional Economic Development.

    ERIC Educational Resources Information Center

    Barden, Laing

    1995-01-01

    The new information economy and the information superhighway provide opportunities for universities to play a central role in the economic development of their regions. Smart Isles, a partnership of 20 international companies, universities, and research organizations, is an example of a development initiative. (SK)

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

    PubMed

    Pedroso, Marcelo Caldeira; Malik, Ana Maria

    2012-10-01

    This article presents a model of the healthcare value chain which consists of a schematic representation of the Brazilian healthcare system. The proposed model is adapted for the Brazilian reality and has the scope and flexibility for use in academic activities and analysis of the healthcare sector in Brazil. It places emphasis on three components: the main activities of the value chain, grouped in vertical and horizontal links; the mission of each link and the main value chain flows. The proposed model consists of six vertical and three horizontal links, amounting to nine. These are: knowledge development; supply of products and technologies; healthcare services; financial intermediation; healthcare financing; healthcare consumption; regulation; distribution of healthcare products; and complementary and support services. Four flows can be used to analyze the value chain: knowledge and innovation; products and services; financial; and information. PMID:23099762

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

    NASA Astrophysics Data System (ADS)

    Ebinuma, Yukio

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

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

    USGS Publications Warehouse

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

    1982-01-01

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

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

    PubMed Central

    2013-01-01

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

  17. Healthcare compunetics.

    PubMed

    Marsh, Andy; Laxminarayan, Swamy; Bos, Lodewijk

    2004-01-01

    Changes in life expectancy, healthy life expectancy and health seeking behaviour are having an impact on the demand for care. Such changes could occur across the whole population, or for specific groups. Changes for specific groups will be particularly affected by policy initiatives, while both these and wider changes will be affected by people's levels of engagement with their health and the health service itself. Levels of education, income and media coverage of health issues are also important. These factors could also encourage an increase in people caring for themselves and their families or community. People are now expecting a patient-centred service with safe high quality treatment, comfortable accommodation services, fast access and an integrated joined-up system. The uptake of integrated Information and Communication technologies (ICT) will be crucial. Healthcare Compunetics, the combination of computing and networking customised for medical and care, will provide the common policy and framework for combined multi-disciplinary research, development, implementation and usage. PMID:15747899

  18. Toward a just policy on healthcare rationing. Ethical principles must inform the debate concerning the distribution of services.

    PubMed

    Hofmann, P B

    1994-04-01

    Perceptions of inequity and excess have given rise to a debate over whether policymakers should consider some form of rationing as a means of achieving a more just healthcare system. Three factors will be critical in determining whether the policies ultimately developed will be just and equitable. First, participants must grasp relevant facts involving the current distribution of healthcare services in the United States. Second, the debate must be based on a clear understanding of who has ultimate responsibility for making decisions regarding healthcare rationing. Finally, those committed to implementing a just approach to the issue must ensure that ethical principles relevant to policy-making are clear to everyone and affect the debate's outcome. The controversy over whether to ration healthcare services obscures the fact that healthcare is, in reality if not in policy, rationed now. A key advantage of promoting formal public policy decisions about the provision and limitation of healthcare services is that it shifts responsibility for these decisions from providers to society. Applying four classic bioethical principles to the question of rationing can also help ensure implementation of an appropriate public policy on healthcare rationing. For the debate on rationing to be meaningful, it must be conducted in a way that respects and promotes participants' autonomy. Policymakers should also observe the principle of nonmaleficence, which dictates that their policies not harm those they affect. A proper rationing policy should also fulfill the criterion of beneficence (i.e., actively promote the good of others). Last, such a policy should conform to the principle of justice by being fair and impartial. PMID:10132880

  19. Healthcare international.

    PubMed

    Hensley, S; Jaklevic, M C; Rauber, C; Weissenstein, E; Moore, J D; Shinkman, R; Pallarito, K; Katzman, C N; Hallam, K; Morrissey, J

    1998-11-01

    How people are treated when they need medical care depends on where in the world they are. In deciding which tools of the medical trade are used to treat disease and when they're used, location is paramount. A country's social policy, healthcare payment systems and cultural factors bear heavily on the utilization of medical technology. The cover story kicks off the magazine's third international healthcare section. PMID:10186352

  20. Regional regression of flood characteristics employing historical information

    USGS Publications Warehouse

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

    1987-01-01

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

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

    PubMed

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

    2015-10-01

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

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

    PubMed Central

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

    2016-01-01

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

  3. [Scientific medical forum as important source of scientific-information provision for innovation processes in the healthcare sector of Ukraine].

    PubMed

    Horban', A Ie; Zakrut'ko, L I; Uvarenko, S V; Prysiazhniuk, L V

    2013-12-01

    The article made a retrospective analysis of the scientific medical forums (congresses, symposia and scientific conferences) in the healthcare sector of Ukraine in 2008-2012, planned by higher medical schools and post-graduate medical education schools, scientific institutions of Ministry of Healthcare of Ukraine, National Academy of Medical Science of Ukraine, medical associations and scientific and medical societies. Quantitative and qualitative assessment was carried out of the effectiveness of their implementation, provided suggestions for improving the planning and conducting of medical research forums.

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

    PubMed

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

    2016-01-01

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

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

    PubMed Central

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

    2016-01-01

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

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

    PubMed

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

    2016-01-01

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

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

    ERIC Educational Resources Information Center

    Hodgin, Johnette; Muha, Susan

    2008-01-01

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

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

    PubMed Central

    Chauvin, Pierre; Bazin, Fabienne; Parizot, Isabelle

    2005-01-01

    Background The social inequalities in health have endured or even worsened comparatively throughout different social groups since the 1990s. Our objective was to identify the individual characteristics (socio-economic status, living conditions, individuals’ social integration, health beliefs, expectations and representation, and psychological characteristics) statistically associated with the fact of stating (or not) that healthcare had been forgone because of cost. Methods In this cross-sectional, multi-centre study we randomly selected a study sample from five underprivileged areas in the Paris region. A multiple logistic regression model was used to calculate the odds ratios (OR) and 95% CI. The validity of the model was assessed by goodness-of-fit tests (Pearson and deviance) and by the study of 100 bootstrap samples. Results After making adjustments for numerous individual socio-economic and health characteristics, we observed a higher occurrence of reported forgone healthcare among people who have had financial worries during adulthood (ORyes/no = 5.47 [1.44–20.75]), a life-course experience of physical, sexual or psychological abuse (ORyes/no = 2.86 [1.40–5.84]); who have experienced childhood difficulties (OR1/never difficulties = 5.28 [1.81–15.39], OR2–4/never = 7.62 [2.69–21.57], OR>4/never = 8.57 [2.39–30.80]); who have expressed a low degree of sickness orientation ORlows/high = 2.62 [1.33–5.14]), a high worry/concern about health (ORhigh/low = 2.71 [1.33–5.50]) and a low self-esteem (ORmedium/high = 8.28 [1.44–47.64], ORlow/high = 16.44 [2.81–96.24]). Conclusion Aside from purely financial hurdles, other factors play a role in the non-use of healthcare services. Health policies mainly promoting equal financial access to healthcare have little chance of abating health inequalities. PMID:15975951

  9. Data mining applications in healthcare.

    PubMed

    Koh, Hian Chye; Tan, Gerald

    2005-01-01

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

  10. Objective identification of informative wavelength regions in galaxy spectra

    SciTech Connect

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

    2014-05-01

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

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

    ERIC Educational Resources Information Center

    Del Casino Jr, Vincent

    2004-01-01

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

  12. Information Content of Aerosol Retrievals in the Sunglint Region

    NASA Technical Reports Server (NTRS)

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

    2013-01-01

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

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

    PubMed Central

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

    2014-01-01

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

  14. 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

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

    PubMed

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

    2014-02-01

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

  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. PMID:25737091

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

    PubMed Central

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

    2016-01-01

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

  18. [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. PMID:27374397

  19. Addressing healthcare.

    PubMed

    Daly, Rich

    2013-02-11

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

  20. Identifying organizational capacities and incentives for clinical data-sharing: the case of a regional perinatal information system.

    PubMed

    Korst, Lisa M; Signer, Jordana M K; Aydin, Carolyn E; Fink, Arlene

    2008-01-01

    The development of regional data-sharing among healthcare organizations is viewed as an important step in the development of health information technology (HIT), but little is known about this complex task. This is a case study of a regional perinatal data system that involved four hospitals, together responsible for over 10,000 births annually. Using standard qualitative methods, we chronicled project milestones, and identified 31 "critical incidents" that delayed or prevented their achievement. We then used these critical incidents to articulate six organizational capacity domains associated with the achievement of project milestones, and a seventh domain consisting of organizational incentives. Finally, we analyzed the relationship of milestone achievement to the presence of these capacities and incentives. This data center case suggests four requirements for sharing data across organizations: 1) a readiness assessment; 2) a perceived mandate; 3) a formal governance structure; and 4) a third party IT component.

  1. National and regional health information infrastructures: making use of information technology to promote access to evidence.

    PubMed

    Dykes, Patricia; Bakken, Suzanne

    2004-01-01

    The vision for national and regional health information infrastructures (HII) includes provision of a framework that is supportive of access and integration of health information with the goal of improving the health and safety of individuals, public health systems, and nations. Internationally, prominent examples of national and regional HIIs exist that provide a means for achievement of this goal. However, to fully realize benefits, an explicit mechanism is needed for linking national and regional HIIs with existing knowledge, automated processes and evaluation of the ability of HIIs to meet the information needs of primary recipients. Using the United States' Na-tion Health Information Infrastructure (NHII) as an example, the authors describe expansion of the conceptual framework to explicitly acknowledge the role of access to evidence at the overlap between the three dimensions of the NHII to create an "evidence-based" link between interrelated components. The role of national measures in setting e-communication goals and evaluating the evolving infrastructure in meeting informational needs of users is discussed. Additionally, automated knowledge management tools such as practice guidelines are presented as a means by which access to critical information is delivered to users, in a format that is appropriate for their health literacy level and that provides adequate support for informed decision making.

  2. 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

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

    PubMed

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

    2012-01-01

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

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

    PubMed

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

    2015-06-01

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

  5. Etiological explanation, treatability and preventability of childhood autism: a survey of Nigerian healthcare workers' opinion

    PubMed Central

    Bakare, Muideen Owolabi; Agomoh, Ahamefule O; Ebigbo, Peter O; Eaton, Julian; Okonkwo, Kevin O; Onwukwe, Jojo U; Onyeama, Gabriel M

    2009-01-01

    Background Because of their peculiar sociocultural background, healthcare workers in sub-Saharan African subcultures may have various conceptions on different aspects of autism spectrum disorders (ASD), such as etiology, treatment and issues of prognosis. These various conceptions, if different from current knowledge in literature about ASD, may negatively influence help-seeking behavior of parents of children with ASD who seek advice and information from the healthcare workers. This study assessed the opinions of healthcare workers in Nigeria on aspects of etiology, treatability and preventability of childhood autism, and relates their opinions to the sociodemographic variables. Methods Healthcare workers working in four tertiary healthcare facilities located in the south-east and south-south regions of Nigeria were interviewed with a sociodemographic questionnaire, personal opinion on etiology, treatability and preventability of childhood autism (POETPCA) questionnaire and knowledge about childhood autism among health workers (KCAHW) questionnaire to assess their knowledge and opinions on various aspects of childhood autism. Results A total of 134 healthcare workers participated in the study. In all, 78 (58.2%), 19 (14.2%) and 36 (26.9%) of the healthcare workers were of the opinion that the etiology of childhood autism can be explained by natural, preternatural and supernatural causes, respectively. One (0.7%) of the healthcare workers was unsure of the explanation of the etiology. Knowledge about childhood autism as measured by scores on the KCAHW questionnaire was the only factor significantly associated with the opinions of the healthcare workers on etiology of childhood autism. In all, 73 (54.5%) and 43 (32.1%), of the healthcare workers subscribed to the opinion that childhood autism is treatable and preventable respectively. Previous involvement with managing children with ASD significantly influenced the opinion of the healthcare workers in subscribing to

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

    PubMed

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

    2016-03-01

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

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

    NASA Astrophysics Data System (ADS)

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

    2006-03-01

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

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

    PubMed Central

    Godtfredsen, Nina Skavlan; Frølich, Anne

    2016-01-01

    Introduction: Despite many initiatives to improve coordination of patient pathways and intersectoral cooperation, Danish health care is still fragmented, lacking intra- and interorganisational integration. This study explores barriers to and facilitators of interorganisational integration as perceived by healthcare professionals caring for patients with chronic obstructive pulmonary disease within the Danish healthcare system. Methods: Seven focus groups were conducted in January through July 2014 with 21 informants from general practice, local healthcare centres and a pulmonary department at a university hospital in the Capital Region of Denmark. Results and discussion: Our results can be grouped into five influencing areas for interorganisational integration: communication/information transfer, committed leadership, patient engagement, the role and competencies of the general practitioner and organisational culture. Proposed solutions to barriers in each area hold the potential to improve care integration as experienced by individuals responsible for supporting and facilitating it. Barriers and facilitators to integrating care relate to clinical, professional, functional and normative integration. Especially, clinical, functional and normative integration seems fundamental to developing integrated care in practice from the perspective of healthcare professionals. PMID:27616948

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

    NASA Technical Reports Server (NTRS)

    Alexander, R. H. (Principal Investigator)

    1973-01-01

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

  10. User perspectives on the usability of a regional health information exchange

    PubMed Central

    Ho, Yun-Xian; Cala, Cather Marie; Blakemore, Dana; Chen, Qingxia; Frisse, Mark E; Johnson, Kevin B

    2011-01-01

    Objective We assessed the usability of a health information exchange (HIE) in a densely populated metropolitan region. This grant-funded HIE had been deployed rapidly to address the imminent needs of the patient population and the need to draw wider participation from regional entities. Design We conducted a cross-sectional survey of individuals given access to the HIE at participating organizations and examined some of the usability and usage factors related to the technology acceptance model. Measurements We probed user perceptions using the Questionnaire for User Interaction Satisfaction, an author-generated Trust scale, and user characteristic questions (eg, age, weekly system usage time). Results Overall, users viewed the system favorably (ratings for all usability items were greater than neutral (one-sample Wilcoxon test, p<0.0014, Bonferroni-corrected for 35 tests). System usage was regressed on usability, trust, and demographic and user characteristic factors. Three usability factors were positively predictive of system usage: overall reactions (p<0 0.01), learning (p<0.05), and system functionality (p<0.01). Although trust is an important component in collaborative relationships, we did not find that user trust of other participating healthcare entities was significantly predictive of usage. An analysis of respondents' comments revealed ways to improve the HIE. Conclusion We used a rapid deployment model to develop an HIE and found that perceptions of system usability were positive. We also found that system usage was predicted well by some aspects of usability. Results from this study suggest that a rapid development approach may serve as a viable model for developing usable HIEs serving communities with limited resources. PMID:21622933

  11. 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

  12. Web-based Service Portal in Healthcare

    NASA Astrophysics Data System (ADS)

    Silhavy, Petr; Silhavy, Radek; Prokopova, Zdenka

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

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

    PubMed

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

    2016-03-01

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

  14. RESHEN, a best practice approach for secure healthcare networks in Europe.

    PubMed

    Georgoulas, Aggelos; Bourka, Athena; Kaliontzoglou, Alexandros; Polemi, Nineta; Koutsouris, Dimitris

    2003-01-01

    Electronic communication of healthcare related information (in the framework of Regional Healthcare Information Networks), introduces a number of security risks with regard to confidentiality, integrity and availability, which can become quite crucial taking into account its sensitive nature. Public Key Infrastructure (PKI) is acknowledged as an appropriate means for dealing with such risks, as long as all the involved critical factors are first practically assessed. This paper presents a best-practice approach for secure regional healthcare networks in Europe, examining all the identified crucial parameters (technical, organisational, legal/regulatory, medical and business). Our approach is conducted at two levels (the regional and the European), including the integration of PKI-aware security mechanisms (strong authentication, encryption, digital signature, time-stamping) in three regional pilot sites in Greece, Finland and Germany and demonstrating their interconnection in a pan-European architecture. Following the above approach, some major conclusions are excluded, pointing out existing open issues and possible steps forward.

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

    Code of Federal Regulations, 2011 CFR

    2011-04-01

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

  16. 24 CFR Appendix A to Part 15 - Location Information for HUD FOIA Reading Rooms and Contact Information for Regional Counsel

    Code of Federal Regulations, 2013 CFR

    2013-04-01

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

  17. 24 CFR Appendix A to Part 15 - Location Information for HUD FOIA Reading Rooms and Contact Information for Regional Counsel

    Code of Federal Regulations, 2014 CFR

    2014-04-01

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

  18. 24 CFR Appendix A to Part 15 - Location Information for HUD FOIA Reading Rooms and Contact Information for Regional Counsel

    Code of Federal Regulations, 2012 CFR

    2012-04-01

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

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

    Code of Federal Regulations, 2010 CFR

    2010-04-01

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

  20. Privacy policy analysis for health information networks and regional health information organizations.

    PubMed

    Noblin, Alice M

    2007-01-01

    Regional Health Information Organizations (RHIOs) are forming in response to President George W. Bush's 2004 mandate that medical information be made available electronically to facilitate continuity of care. Privacy concerns are a deterrent to widespread acceptance of RHIOs. The Health Information Portability and Accountability Act of 1996 provides some guidelines for privacy protection. However, most states have stricter guidelines, causing difficulty when RHIOs form across these jurisdictions. This article compares several RHIOs including their privacy policies where available. In addition, studies were reviewed considering privacy concerns of people in the United States and elsewhere. Surveys reveal that Americans are concerned about the privacy of their personal health information and ultimately feel it is the role of the government to provide protection. The purpose of this article is to look at the privacy issues and recommend a policy that may help to resolve some of the concerns of both providers and patients. Policy research and action are needed to move the National Health Information Network toward reality. Efforts to provide consistency in privacy laws are a necessary early step to facilitate the construction and maintenance of RHIOs and the National Health Information Network.

  1. 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

  2. The new informatics of national healthcare reform.

    PubMed

    Manderscheid, R W; Henderson, M J

    1994-01-01

    The President's Health Security Act has succeeded in attracting America's attention. Several of its initiatives have been well-publicized and hotly debated in Congress. The act also includes a number of implications for healthcare informatics, and devotes an entire chapter to this subject, although this area has not received as much publicity. Every behavioral healthcare provider's information system would be significantly affected by enactment of the Health Security Act. Selected forms and data elements for the management and delivery of behavioral healthcare services would need to be standardized. Organizations of behavioral healthcare providers, managed care companies and purchasers would increasingly share selected patient and subscriber information in aggregated form, for a variety of purposes. As a result, tougher laws to protect patient data privacy will likely be forthcoming. The following article gives an overview of the informatics needs of the soon-to-be reformed American healthcare system, into which behavioral healthcare will be integrated. As part of the larger system, behavioral healthcare services and information systems will need to comply with the same guidelines and requirements, outlined below, as other healthcare providers. Preparation to meet the information demands of the evolving healthcare system will require adaptation of existing computerized information systems, utilization of new technology, consultation with the system's major shareholders and attention to continuous quality improvement processes.

  3. 77 FR 24952 - Agency Information Collection Activities; Proposed Collection; Comment Request; Regional Haze...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-04-26

    ... ICR (August 26, 2009; 74 FR 43118). The last collection request anticipated the program progressing... AGENCY Agency Information Collection Activities; Proposed Collection; Comment Request; Regional Haze... organizations and facilities potentially regulated under the regional haze rule. Title: Regional...

  4. 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. PMID:22925789

  5. 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.

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

    PubMed

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

    2008-01-01

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

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

    NASA Astrophysics Data System (ADS)

    Buizer, James; Goddard, Lisa; Guido, Zackry

    2015-04-01

    An integrated multi-disciplinary team of researchers from the University of Arizona and the International Research Institute for Climate and Society at Columbia University have joined forces with communities and institutions in the Caribbean, South Asia and West Africa to develop relevant, usable climate information and connect it to real decisions and development challenges. The overall objective of the "Integrating Climate Information and Decision Processes for Regional Climate Resilience" program is to build community resilience to negative impacts of climate variability and change. We produce and provide science-based climate tools and information to vulnerable peoples and the public, private, and civil society organizations that serve them. We face significant institutional challenges because of the geographical and cultural distance between the locale of climate tool-makers and the locale of climate tool-users and because of the complicated, often-inefficient networks that link them. To use an accepted metaphor, there is great institutional difficulty in coordinating the supply of and the demand for useful climate products that can be put to the task of building local resilience and reducing climate vulnerability. Our program is designed to reduce the information constraint and to initiate a linkage that is more demand driven, and which provides a set of priorities for further climate tool generation. A demand-driven approach to the co-production of appropriate and relevant climate tools seeks to meet the direct needs of vulnerable peoples as these needs have been canvassed empirically and as the benefits of application have been adequately evaluated. We first investigate how climate variability and climate change affect the livelihoods of vulnerable peoples. In so doing we assess the complex institutional web within which these peoples live -- the public agencies that serve them, their forms of access to necessary information, the structural constraints

  8. Regional Ocean Products Portal: Transforming Information to Knowledge

    NASA Astrophysics Data System (ADS)

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

    2010-12-01

    Scientific visualization of complex fusions of heterogeneous 2, 3, and 4-D data sets is a challenge in most fields of geosciences and oceanography is no exception. Despite increased computing power, dedicated graphic processing units, and more capable software, 30 years of change in the ways that geophysical sciences are conducted continues to challenge our ability to present the data in visually meaningful ways. Oceanography, for example, changed from a science in which a sole researcher studied a single phenomena, e.g. ocean currents to one in which a multidisciplinary collaborative teams study complex coupled systems. In three decades we’ve moved from a time where a map of mean circulation and a coastline rendered on a pen-plotter would suffice, to one in which we require detailed dynamic views of relationships and change. We now need to visualize multiple parameters of relatively sparse observed data combined with computer generated output on dense numerical model grids. We want parameters within ocean and atmosphere volumes rendered over detailed earth terrains with illumination and infrastructure. We want to “see” the dynamic relations between the oceans, atmosphere, land, biogeochemistry, biota, and ecosystem all at once and in context. As the computational power increased, the density of the model grid points increased accordingly. The latest challenge has been due to the internet, the notion of sensor webs, and the near real-time availability of high-bandwidth interoperable standards-based data streams. Not only do we want to see it all, we want to see it now, and we want to see it the way we want and that may change from moment to moment. Increasingly this involves 4D visualizations combined with a strong element of traditional Geographic Information System type presentation. The Gulf of Mexico Coastal Ocean Observing System Regional Association (GCOOS-RA) is one of 11 regional observing systems that comprise the non-federal part of the U

  9. 76 FR 37139 - Notice of Submission of Proposed Information Collection to OMB Sustainable Communities Regional...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-24

    ... public comments on the subject proposal. This data collection is designed to provide HUD information... collection is designed to provide HUD information regarding the Sustainable Communities Regional Planning... URBAN DEVELOPMENT Notice of Submission of Proposed Information Collection to OMB Sustainable...

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

    PubMed Central

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

    2014-01-01

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

  11. Regional Ocean Data Portal: Transforming Information to Knowledge

    NASA Astrophysics Data System (ADS)

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

    2009-12-01

    The mission of the Gulf of Mexico Coastal Ocean Observing System’s (GCOOS) regional data portal is to aggregate data and model output from distributed providers and to offer these, and derived products, through a single access point in standardized ways to a diverse set of users. The portal evolved under the NOAA-led U.S. Integrated Ocean Observing System (IOOS) program where automated largely-unattended machine-to-machine interoperability has always been a guiding tenet for system design. Initially, the portal focused on aggregating relatively homogeneous oceanographic and marine meteorological data from the principal Gulf of Mexico data providers. Obtaining community agreements from the data providers on data formats, vocabularies, and levels of service was relatively easy because the technical barriers to participation were low and we were able to provide financial support to them to make small additions or changes to their local data systems. Over time, the portal requirements became more complex as new parameters, new providers and heterogeneous data streams were added and the spatial domain increased to include beaches and adjacent wetlands. This began to strain our resources and take us outside our science domains of expertise. During the same period, the Gulf of Mexico Alliance (GOMA), a new environmental quality initiative involving the five Gulf states and Mexico with similar goals and directives as those of our sponsor, gained momentum and demanded both our attention and participation. GOMA is working, mostly among themselves, to discover or establish community standards for various types of data sets - e.g. water quality and nutrients. In addition to aggregation, the portal is also tasked with producing products from the collected information streams. Arriving at a prioritized list of desired products has been a major part of the business conducted by the GCOOS Regional Association (RA). Numerous stakeholder (e.g. emergency responders, oil and gas

  12. Benefits and Risks of Electronic Medical Record (EMR): An Interpretive Analysis of Healthcare Consumers' Perceptions of an Evolving Health Information Systems Technology

    ERIC Educational Resources Information Center

    Thompson, Chester D.

    2013-01-01

    The purpose of this study is to explore healthcare consumers' perceptions of their Electronic Medical Records (EMRs). Although there have been numerous studies regarding EMRs, there have been minimal, if any, research that explores healthcare consumers' awareness of this technology and the social implications that result. As consumers' health…

  13. Information=power. Modern Healthcare's third annual 100 Most Powerful ranking attests to the prominence of IT, quality and patient-safety initiatives.

    PubMed

    Romano, Michael

    2004-08-23

    The growing importance of IT is reflected in Modem Healthcare's third annual ranking of the 100 Most Powerful People in Healthcare. The person topping the 2004 list is a newcomer who recently vaulted to prominence. Who is he, and what other industry movers and shakers made the ranking.

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

    PubMed

    Haghparast-Bidgoli, Hassan; Kiadaliri, Aliasghar Ahmad; Skordis-Worrall, Jolene

    2014-01-01

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

  15. Implementing an integrated computerized patient record system: Towards an evidence-based information system implementation practice in healthcare.

    PubMed

    Rahimi, Bahlol; Moberg, Anna; Timpka, Toomas; Vimarlund, Vivian

    2008-11-06

    A large number of health information system (HIS) implementations fail due to insufficient organizational harmonization. The aim of this study is to examine whether these problems remain when implementing technically integrated and more advanced generations of HISs. In a case study, data from observations, interviews, and organizational documents were analyzed using qualitative methods. We found that critical issues in the case study implementation process were the techniques employed to teach the staff to use the integrated system, involvement of the users in the implementation process, and the efficiency of the human computer interface. Comparisons with a literature review showed both recurrence of previously reported implementation problems and new issues specific to the integrated system context. The results indicate that the development of evidence-based implementation processes should be considered.

  16. Big Data and Analytics in Healthcare.

    PubMed

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

    2015-01-01

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

  17. 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,…

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

    ERIC Educational Resources Information Center

    Rivera, Gloria

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

  19. The Imminent Healthcare and Emergency Care Crisis in Japan

    PubMed Central

    Suzuki, Tetsuji; Nishida, Masamichi; Suzuki, Yuriko; Kobayashi, Kunio

    2008-01-01

    Objectives Japan has a universal healthcare system, and this paper describes the reality of the healthcare services provided, as well as current issues with the system. Methods Academic, government, and press reports on Japanese healthcare systems and healthcare guidelines were reviewed. Results The universal healthcare system of Japan is considered internationally to be both low-cost and effective because the Japanese population enjoys good health status with a long life expectancy, while healthcare spending in Japan is below the average given by the Organization for Economic Corporation and Development (OECD). However, in many regions of Japan the existing healthcare resources are seriously inadequate, especially with regard to the number of physicians and other health professionals. Because healthcare is traditionally viewed as “sacred” work in Japan, healthcare professionals are expected to make large personal sacrifices. Also, public attitudes toward medical malpractice have changed in recent decades, and medical professionals are facing legal issues without experienced support of the government or legal professionals. Administrative response to the lack of resources and collaboration among communities are beginning, and more efficient control and management of the healthcare system is under consideration. Conclusion The Japanese healthcare system needs to adopt an efficient medical control organization to ease the strain on existing healthcare professionals and to increase the number of physicians and other healthcare resources. Rather than continuing to depend on healthcare professionals being able and willing to make personal sacrifices, the government, the public and medical societies must cooperate and support changes in the healthcare system. PMID:19561714

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

    PubMed Central

    2013-01-01

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

  1. Use of soil survey information to assess regional salinization risk using geographical information systems

    SciTech Connect

    Bui, E.N.; Smettem, K.R.J.; Moran, C.J.; Williams, J.

    1996-05-01

    Previous experience in southern and western Australia has shown that tree clearing alters the water balance in a landscape, leading to increased deep drainage and consequent rises in phreatic water tables. Assessment of the risk of regional salinization involves integration of hydrology, hydrogeology, soil and land management issues. An example of the use of soil survey data, integrated with water resources and digital elevation data in a GIS, to estimate the risk of salinization after tree clearing is illustrated for the upper Burdekin river basin in the wet/dry tropics of North Queensland. Soil map unit descriptions include information on soil-landform relations, parent material, soil thickness, depth to bedrock and dominant and subdominant soil types. Such information can be used to qualitatively estimate permeability and drainage classes (high, medium, or low) and to determine likely recharge and discharge areas was used to cross-check this qualitative classification. The distributions of saline soils and shallow water tables are used to assess the salinity hazard of the region. Where % total soluble salts (TSS) are >0.25% and water table <6 m deep, a salinity hazard is present. This hazard can translate into a salinity problem if the hydrologic balance is altered so that the salt is remobilized and redeposited in the landscape. An estimate of the likelihood and amount of increased recharge to groundwater after tree clearing was obtained using water balance models with soil physical parameters measured at key sites. Where physical data were not available, surrogate physical properties were estimated from the soil survey data. Results suggest that tree clearing may increase deep drainage by up to 10 times and that in watersheds where shallow unconfined aquifiers are present and where %TSS > 0.25%, recharge areas should not be cleared. 30 refs., 4 figs., 3 tabs.

  2. 76 FR 52637 - Proposed Information Collection; Comment Request; Southeast Region Vessel Identification...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-23

    ... Region Vessel Identification Requirements AGENCY: National Oceanic and Atmospheric Administration (NOAA... collection of information. NMFS Southeast Region requires that all permitted fishing vessels must mark their vessel with the official identification number or some form of identification. A vessel's official...

  3. 75 FR 20810 - Proposed Information Collection; Comment Request; Statement of Financial Interests, Regional...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-21

    ... National Oceanic and Atmospheric Administration Proposed Information Collection; Comment Request; Statement of Financial Interests, Regional Fishery Management Councils AGENCY: National Oceanic and Atmospheric... this opportunity to comment on proposed and/or continuing information collections, as required by...

  4. 78 FR 48149 - Proposed Information Collection; Comment Request; Statement of Financial Interests, Regional...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-07

    ... National Oceanic and Atmospheric Administration Proposed Information Collection; Comment Request; Statement of Financial Interests, Regional Fishery Management Councils AGENCY: National Oceanic and Atmospheric... this opportunity to comment on proposed and/or continuing information collections, as required by...

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

    PubMed Central

    Nunes, Miguel Baptista

    2016-01-01

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

  6. Overview of healthcare system in the Czech Republic

    PubMed Central

    2012-01-01

    The healthcare system in the Czech Republic underwent and still is undergoing dramatic changes since the Velvet revolution in 1989. History of the Czech healthcare system, main healthcare laws, and the current status of healthcare documented in the main healthcare indicators is described based on the several main sources as well as delivery of health services and the role of the main actors in healthcare system. The material is based mainly on Czech Health Statistics 2009, and HiT Summary, Health Care Systems in Translation, 2005, public information of Ministry of Health CR. PMID:22738178

  7. Downscaled Regional Climate Information for the Southeastern US

    EPA Science Inventory

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

  8. 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

  9. 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

  10. 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

  11. 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.

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

    ERIC Educational Resources Information Center

    London, Jonathan; Erbstein, Nancy

    2011-01-01

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

  13. A hospital information system based on Common Object Request Broker Architecture (CORBA) for exchanging distributed medical objects--an approach to future environment of sharing healthcare information.

    PubMed

    Ohe, K

    1998-01-01

    Tightly related subsystems in a HIS have to exchange medical data flexibly by the data object rather than by the battery of the data. We developed a CPR subsystem based on Common Object Request Broker Architecture (CORBA) that retrieves and stores clinical information in the object-oriented database via Internet Intra-ORB Protocol (IIOP). The system is hybridized with the legacy HIS applications on the client terminals. We believe that our solution and the experiences will contribute to the future CORBA-based environment in which computerized patient information is shared among hospitals, clinics, and tightly related systems.

  14. [Patients' increasing role in healthcare].

    PubMed

    Colombo, Cinzia

    2016-03-01

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

  15. 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…

  16. Effects of illness representation, perceived quality of information provided by the health-care professional, and perceived social support on depressive symptoms of the caregivers of children with leukemia.

    PubMed

    Bozo, Ozlem; Anahar, Selin; Ateş, Gizem; Etel, Evren

    2010-03-01

    The present study examined the effects of illness representation, perceived quality of information provided by the health-care professional, and perceived social support on the depressive symptoms of the caregivers of children with leukemia. The sample was composed of 71 caregivers of children with leukemia living in Turkey. The obtained data were analyzed by path analysis. The results show that caregivers of children with leukemia experience higher levels of depressive symptoms when they have negative illness representation and lower levels of depressive symptoms when they perceive higher levels of social support. Moreover, they perceive higher social support when they perceive high quality of information provided by health-care professionals. It can be suggested that intervention programs which aim to increase caregivers' social support and change their illness representation in a positive way would be helpful for the caregivers showing depressive symptoms. PMID:19898925

  17. Communication and care in an acute cancer center: the effects of patients' willingness to communicate about health, health-care environment perceptions, and health status on information seeking, participation in care practices, and satisfaction.

    PubMed

    Wright, Kevin B; Frey, Lawrence R

    2008-07-01

    This study investigated the role of willingness to communicate about health (WTCH) among older patients in a state-of-the-art cancer center. Specifically, relationships were examined between patients' WTCH and their information seeking, perceptions of coping activities the center offered, and satisfaction with the center. The study also explored how those relationships may be mediated by patients' perceptions of the health-care environment and their health status. The results indicated that WTCH may play an important role in predicting information-seeking behaviors, perceived helpfulness of center-sponsored activities, and overall satisfaction with care received at the center. Evidence also was found that perceptions of the health-care environment mediated cancer patients' WTCH. The implications of these findings for communication theory and application, as well as limitations and future directions for research, are discussed.

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

    PubMed Central

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

    1998-01-01

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

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

    ERIC Educational Resources Information Center

    Durrant, Fay

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

  20. Diseases and Organisms in Healthcare Settings

    MedlinePlus

    ... long-term care facilities and hospitals. For more information visit: Infection Control in Health Care Facilities Prevention Strategies for Seasonal Influenza in Healthcare Settings CDC’s Influenza ...

  1. 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

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

    Technology Transfer Automated Retrieval System (TEKTRAN)

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

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

    NASA Technical Reports Server (NTRS)

    Alexander, R. H. (Principal Investigator)

    1973-01-01

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

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

    EPA Science Inventory

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

  5. Precise regional baseline estimation using a priori orbital information

    NASA Technical Reports Server (NTRS)

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

    1990-01-01

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

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

    PubMed Central

    2009-01-01

    Background Chronic obstructive pulmonary disease (COPD) is a health problem that is becoming increasingly attended-to in Primary Care (PC). However, there is a scarcity of health-care programs and studies exploring the implementation of Clinical Practice Guidelines (CPG). The principal objective of the present study is to evaluate the effectiveness of a combined strategy directed towards health-care professionals and patients to improve the grade of clinical control and the quality-of-life (QoL) of the patients via a feedback on their state-of-health. A training plan for the health-care professionals is based on CPG and health education. Method/Design Multi-centred, before-after, quasi experimental, prospective study involving an intervention group and a control group of individuals followed-up for 12 months. The patients receive attention from urban and semi-urban Primary Care Centres (PCC) within the administrative area of the Costa de Ponent (near Barcelona). All the pacients corresponding to the PCC of one sub-area were assigned to the intervention group and patients from the rest of sub-areas to the group control. The intervention includes providing data to the health-care professionals (clinician/nurse) derived from a clinical history and an interview. A course of training focused on aspects of CPG, motivational interview and health education (tobacco, inhalers, diet, physical exercise, physiotherapy). The sample random includes a total of 801 patients (≥ 40 years of age), recorded as having COPD, receiving attention in the PCC or at home, who have had at least one clinical visit, and who provided written informed consent to participation in the study. Data collected include socio-demographic characteristics, drug treatment, exacerbations and hospital admissions, evaluation of inhaler use, tobacco consumption and life-style and health-care resources consumed. The main endpoints are dyspnoea, according to the modified scale of the Medical Research Council

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

    PubMed

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

    2014-12-01

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

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

    PubMed

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

    2014-12-01

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

  9. Healthcare Identifiers legislation: a whiff of fourberie.

    PubMed

    Mendelson, Danuta

    2010-05-01

    The Healthcare Identifiers Bill 2010 (Cth), which will establish "the national e-health Healthcare Identifiers Service to provide that patients, healthcare providers and provider organisations can be consistently identified", is in the process of being enacted by the Australian Federal Parliament. The legislation will enable the government to assign to each "healthcare recipient" a 26-digit electronic "Healthcare Identifier", which will be accessible, with or without the recipient's consent, to a broad range of health care service providers as well as other entities. The individual Healthcare Identifier file will initially contain such identifying information as, where applicable, the Medicare number and/or the Veterans' Affairs number; name; address; gender; date of birth; and "the date of birth accuracy indicator" presumably birth certificate. However, since each "service" provided by a health care provider to a health care recipient will be automatically recorded on each individual's Healthcare Identifier file, in time these electronic files should contain a full record of such services or contacts. Moreover, the Healthcare Identifiers are considered a "key" to, or a "foundation stone" for, the implementation of the shared electronic health records scheme, because they will enable linkage with and retrieval of each patient's clinical records throughout the health care service system. However, there has been virtually no discussion about the legal, ethical and social implications of this legislation. PMID:20552931

  10. 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.

  11. Healthcare financing in Malaysia.

    PubMed

    Kananatu, K

    2002-01-01

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

  12. Regional Health Information Networks—The Mode of the Future is Present Reality

    PubMed Central

    Mathis, Bill W.

    1983-01-01

    As the roles of physicians and hospitals in providing patient care become increasingly integrated, a move has begun to consolidate the traditionally disparate elements of clinical information into single, unified patient records—which until recently were relatively non-existent. Innovative applications of information technology make the creation of integrated patient records possible. Network communication is predicted to become the standard method for health care providers to share clinical information from many locations. Networking is giving rise to regional health care information systems. One regional network — Health Data Network, based in Louisville, Ky.—is described in detail.

  13. Norovirus in Healthcare Settings

    MedlinePlus

    ... Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Healthcare Settings Occupational Safety and Health Administration (OSHA) Fact Sheet on Noroviruses [PDF - 61 ...

  14. [Healthcare-Associated Infection Control with Awareness of Patient Safety].

    PubMed

    Murakami, Nobuo

    2016-03-01

    In order to provide safe and secure medical care for patients, health care-associated infections (HAI) must not occur. HAI should be considered as incidents, and countermeasures should be viewed as a patient safety management itself. Healthcare-associated infection control (HAIC) is practiced by the infection control team (ICT), which is based on multidisciplinary cooperation. Team members have to recognize that it is the most important to make use of the expertise of each discipline. In addition, all members must try to respond quickly, to help the clinic staff. Visualized rapid information provision and sharing, environmental improvement, outbreak factor analysis, hand hygiene compliance rate improvement, proper antibiotic use (Antimicrobial Stewardship Program: ASP), and regional cooperation & leadership comprise the role of the ICT in the flagship hospital. Regarding this role, we present our hospital's efforts and the outcomes. In conclusion, for medical practice quality improvement, healthcare-associated infection control should be conducted thoroughly along with an awareness of patient safety.

  15. Using GIS to profile health-care costs of VA Quality-Enhancement Research Initiative diseases.

    PubMed

    Yu, Wei; Cowper, Diane; Berger, Magdalena; Kuebeler, Mark; Kubal, Joe; Manheim, Larry

    2004-06-01

    The Health Services Research and Development (HSR&D) Service at the Department of Veterans Affairs (VA) Health Care System launched a Quality Enhancement Research Initiative (QUERI) in 1998. This study estimated health-care costs of nine diseases under the QUERI project and analyzed geographic differences in health-care costs and utilization across 22 VA Integrated Service Networks (VISNs), using a geographic information system (GIS). Patients with these diseases were identified from diagnoses recorded between October 1999 and September 2000. Annual health-care costs for each disease were estimated in four categories: inpatient medical or surgical, other inpatient, outpatient, and outpatient pharmacy. Geographic differences of costs and health-care utilization across the 22 VISNs for chronic heart failure, diabetes, and spinal-cord injury were mapped using a GIS package. Average costs and patterns of health-care utilization varied substantially across the 22 VISNs. The observed differences in health-care utilization across geographic regions raised questions for further investigation. PMID:15446617

  16. [The Spanish Society of Parenteral and Enteral Nutrition (SENPE) and its relation with healthcare authorities].

    PubMed

    García de Lorenzo, A; Alvarez, J; Celaya, S; García Cofrades, M; García Luna, P P; García Peris, P; León-Sanz, M; Jiménez, C P; Olveira, G; Smeets, M

    2011-01-01

    It has been well documented in medical literature that hyponutrition is a common issue at all healthcare levels, from primary to specialized health care, as well as geriatric healthcare facilities. This problem is not limited to countries with scarce economic resources or limited social development; it is also a universal issue in Europe. Hyponutrition increases the rates of morbidity, mortality, hospital admissions, and hospital stay. These higher figures also represent a higher use of healthcare resources. In spite of this, hyponutrition may often go undetected and the patient may not receive the necessary treatment. This problem requires the cooperation of multiple agents such as the Governments, the healthcare professionals, and the citizens themselves. The VIII Discussion Forum concludes on the need to establish a clear-cut plant for action (similar to the European Alliance for Health Nutrition) and the creation of a platform (coalition) encompassing the voices of healthcare professionals associations, institutions, professional colleges, patients associations, the pharmaceutical companies, and insurance companies. The goals of this platform will be to inform about the extent of this issue, to identity and promote leaders that will convey the aims of this initiative to regional and national healthcare authorities, to present solutions and to collaborate in their implementation, and finally to assess/control the actions taken.

  17. The Denver Public Library's Regional Energy/Environment Information Center: An Uncommon Cooperative Venture.

    ERIC Educational Resources Information Center

    Cayton, Colleen

    1981-01-01

    Describes a 10-state energy/environment information and referral service for the Rocky Mountain energy impacted region. The report presents details of funding, resources, and techniques for the provision of this service. (RAA)

  18. 76 FR 16236 - Prohibition Against Certain Flights Within the Tripoli (HLLL) Flight Information Region (FIR)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-23

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

  19. 75 FR 20812 - Proposed Information Collection; Comment Request; Northwest Region Pacific Whiting Shoreside...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-21

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

  20. Customer privacy on UK healthcare websites.

    PubMed

    Mundy, Darren P

    2006-09-01

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

  1. Customer privacy on UK healthcare websites.

    PubMed

    Mundy, Darren P

    2006-09-01

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

  2. Regional information network systems on Scientific research - two examples of Ishikawa and Toyama

    NASA Astrophysics Data System (ADS)

    Okuma, Kenji

    Science and Technology Agency has been promoting regional information network systems on scientific research. The common purpose of the systems is to enhance good communications among various researchers in regions as well as between researchers in Tsukuba and researchers in regions, and accordingly to contribute to the evolution of the regional R&D. These network systems with the help of the pursonal computor communication system have been carried out as prototypes since 1988, in not only Tsukuba area, but four other regions. Two of them are in Ishikawa prefecture and Toyama prefecture. The situations and details of the two are explained.

  3. How can healthcare standards be standardised?

    PubMed

    Shaw, Charles D

    2015-10-01

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

  4. How can healthcare standards be standardised?

    PubMed

    Shaw, Charles D

    2015-10-01

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

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

    PubMed Central

    2011-01-01

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

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

    PubMed

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

    2007-01-01

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

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

    ERIC Educational Resources Information Center

    Egghe, L.; Pissierssens, P.

    1997-01-01

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

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

    PubMed Central

    2014-01-01

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

  9. 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…

  10. Designing sustainable healthcare facilities.

    PubMed

    Nedin, Phil

    2007-09-01

    A sustainable approach to the design of healthcare premises is essential if the business effectiveness of facilities is to be maximised through their whole life. This report, by Phil Nedin, president of IHEEM and Arup global healthcare business leader, is based on a paper he presented at this year's annual general meeting of the Institute.

  11. The integration of genome-based information for common diseases into health policy and healthcare as a major challenge for Public Health Genomics: the example of the methylenetetrahydrofolate reductase gene in non-cancer diseases.

    PubMed

    Boccia, Stefania; Brand, Angela; Brand, Helmut; Ricciardi, Gualtiero

    2009-07-10

    Whereas medicine is currently undergoing remarkable developments from its morphological and phenotype orientation to a molecular and genotype orientation, promoting the importance of prognosis and prediction, the discussion about the role of genome-based information for epidemiological research and public health still is at the beginning. Public Health Genomics (PHG) contributes to this discussion by focussing on the use of genome-based information for epidemiological research, surveillance systems, health policy development, individual health information management and effective health services. The article focuses on the role of the methylenetetrahydrofolate reductase (MTHFR) gene polymorphisms in non-cancer diseases to demonstrate the urgent need for a responsible and systematic translation of genome-based information into health policy and healthcare.

  12. Promising Practices in Information Technology Accessibility in K-12 Education in the Southeast Region

    ERIC Educational Resources Information Center

    Southeast Disability and Business Technical Assistance Center (Southeast DBTAC), 2005

    2005-01-01

    As part of its mission to promote the use of accessible education-based information technology in the Southeast Region, the Southeast Disability and Business Technical Assistance Center (DBTAC) is working with colleges, universities, community colleges and K-12 schools to improve access to information technology for students with disabilities in…

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

    EPA Science Inventory

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

  14. Healthcare students' e-literacy skills.

    PubMed

    Brown, Cary A; Dickson, Rumona

    2010-01-01

    To be critical healthcare consumers, patients must learn self-management skills and become active participants in knowledge management and exchange. eHealth literacy is considered critical to the development of these self-management skills. The World Health Organization identifies five core competencies required of all healthcare providers working with persons with chronic conditions, and this paper focuses on the fourth--the ability to employ information and communication technology. To supplement our literature-based argument, we also present findings from a class of first-year masters-level occupational therapy students asked to complete an existing standardized e-health literacy survey, eHEALS, as a learning activity. The eHEALS revealed that students reported confidence in their ability to critically appraise internet information but were not confident enough in those skills to use the information to make decisions without consulting a healthcare provider. It appeared that the students were not yet fully immersed in their role of healthcare professional and seemed to move between the roles of healthcare provider and healthcare recipient as they reflected on the class' answers to the eHEALS assessment. Evaluation of eHealth literacy is complex and needs to consider the multiple roles assumed by those whose knowledge is being assessed.

  15. Dissociable parietal regions facilitate successful retrieval of recently learned and personally familiar information.

    PubMed

    Elman, Jeremy A; Cohn-Sheehy, Brendan I; Shimamura, Arthur P

    2013-03-01

    In fMRI analyses, the posterior parietal cortex (PPC) is particularly active during the successful retrieval of episodic memory. To delineate the neural correlates of episodic retrieval more succinctly, we compared retrieval of recently learned spatial locations (photographs of buildings) with retrieval of previously familiar locations (photographs of familiar campus buildings). Episodic retrieval of recently learned locations activated a circumscribed region within the ventral PPC (anterior angular gyrus and adjacent regions in the supramarginal gyrus) as well as medial PPC regions (posterior cingulated gyrus and posterior precuneus). Retrieval of familiar locations activated more posterior regions in the ventral PPC (posterior angular gyrus, LOC) and more anterior regions in the medial PPC (anterior precuneus and retrosplenial cortex). These dissociable effects define more precisely PPC regions involved in the retrieval of recent, contextually bound information as opposed to regions involved in other processes, such as visual imagery, scene reconstruction, and self-referential processing.

  16. 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.

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

    PubMed

    Stan, Sabina

    2015-01-01

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

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

    PubMed

    Stan, Sabina

    2015-01-01

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

  19. 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.

  20. 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. PMID:27441404

  1. [Asylum seekers and the healthcare situation].

    PubMed

    Klein, P

    2016-05-01

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

  2. Board Governance: Transformational Approaches Under Healthcare Reform.

    PubMed

    Zastocki, Deborah K

    2015-01-01

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

  3. Board Governance: Transformational Approaches Under Healthcare Reform.

    PubMed

    Zastocki, Deborah K

    2015-01-01

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

  4. A secure semantic interoperability infrastructure for inter-enterprise sharing of electronic healthcare records.

    PubMed

    Boniface, Mike; Watkins, E Rowland; Saleh, Ahmed; Dogac, Asuman; Eichelberg, Marco

    2006-01-01

    Healthcare professionals need access to accurate and complete healthcare records for effective assessment, diagnosis and treatment of patients. The non-interoperability of healthcare information systems means that interenterprise access to a patient's history over many distributed encounters is difficult to achieve. The ARTEMIS project has developed a secure semantic web service infrastructure for the interoperability of healthcare information systems. Healthcare professionals share services and medical information using a web service annotation and mediation environment based on functional and clinical semantics derived from healthcare standards. Healthcare professionals discover medical information about individuals using a patient identification protocol based on pseudonymous information. The management of care pathways and access to medical information is based on a well-defined business process allowing healthcare providers to negotiate collaboration and data access agreements within the context of strict legislative frameworks.

  5. Log Pearson type 3 quantile estimators with regional skew information and low outlier adjustments

    USGS Publications Warehouse

    Griffis, V.W.; Stedinger, J.R.; Cohn, T.A.

    2004-01-01

    [1] The recently developed expected moments algorithm (EMA) [Cohn et al., 1997] does as well as maximum likelihood estimations at estimating log-Pearson type 3 (LP3) flood quantiles using systematic and historical flood information. Needed extensions include use of a regional skewness estimator and its precision to be consistent with Bulletin 17B. Another issue addressed by Bulletin 17B is the treatment of low outliers. A Monte Carlo study compares the performance of Bulletin 17B using the entire sample with and without regional skew with estimators that use regional skew and censor low outliers, including an extended EMA estimator, the conditional probability adjustment (CPA) from Bulletin 17B, and an estimator that uses probability plot regression (PPR) to compute substitute values for low outliers. Estimators that neglect regional skew information do much worse than estimators that use an informative regional skewness estimator. For LP3 data the low outlier rejection procedure generally results in no loss of overall accuracy, and the differences between the MSEs of the estimators that used an informative regional skew are generally modest in the skewness range of real interest. Samples contaminated to model actual flood data demonstrate that estimators which give special treatment to low outliers significantly outperform estimators that make no such adjustment.

  6. The road to recovery: Egypt's healthcare reform.

    PubMed

    Haley, Donald Robert; Bég, Sama A

    2012-01-01

    As many industrial and third-world countries recover from the severe economic crisis of a global recession, they continue to struggle with its negative effect on their healthcare systems. Healthcare reform has become a leading policy agenda item for most countries. This is especially true for countries in the developing world who are struggling to allocate very limited resources to meet the growing health needs of their residents and the expectations of global health. In the late 1990s, the Egyptian government, in conjunction with the United States Agency for International Development, initiated a Health Sector Reform Program (HSRP) to completely reform the way healthcare was financed, organized and delivered with the intent to extend healthcare coverage to all of its citizens. Although some successes have resulted from the HSRP, Egypt's new government leaders will need to be informed on policies that may more effectively improve the health of the Egyptian population. PMID:21638310

  7. Apps for hearing healthcare.

    PubMed

    Paglialonga, Alessia; Tognola, Gabriella; Pinciroli, Francesco

    2015-01-01

    The hearing healthcare scenario is rapidly evolving due to the pervasive use of m-Health solutions, in particular mobile apps. This brings along significant advantages and opportunities (e.g., accessibility, affordability, personalized healthcare, patient empowerment) as well as significant potential risks and threats (e.g., safety, misuse, quality issues, privacy). Our research aims at the identification and assessment of apps in the hearing healthcare domain. In this article we present an overview of the current availability, variety, and penetration of hearing-related apps.

  8. Justice, health, and healthcare.

    PubMed

    Daniels, N

    2001-01-01

    Healthcare (including public health) is special because it protects normal functioning, which in turn protects the range of opportunities open to individuals. I extend this account in two ways. First, since the distribution of goods other than healthcare affect population health and its distribution, I claim that Rawls's principles of justice describe a fair distribution of the social determinants of health, giving a partial account of when health inequalities are unjust. Second, I supplement a principled account of justice for health and healthcare with an account of fair process for setting limits of rationing care. This account is provided by three conditions that comprise "accountability for reasonableness."

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

    PubMed

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

    2014-01-01

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

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

    PubMed

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

    2014-01-01

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

  11. Safety and Accountability in Healthcare From Past to Present

    SciTech Connect

    Hendee, William R.

    2008-05-01

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

  12. An analysis of 1997 healthcare initial public offerings.

    PubMed

    Palkon, D S

    1999-01-01

    The corporatization of healthcare is here to stay, and it is influencing much in the industry. Thus, it is important for healthcare executives and professionals to identify and evaluate companies in this sector of the economy. One method is to conduct annual surveys of new healthcare IPOs, obtain data on those companies, and assess growth and decline by following these corporations longitudinally. This study represents the example of establishing a baseline of IPOs in 1997. Since the information is public and relatively easy to access, healthcare professionals can use the wealth of information in a variety of ways.

  13. Factors Related to the Selection of Information Sources: A Study of Ramkhamhaeng University Regional Campuses Graduate Students

    ERIC Educational Resources Information Center

    Angchun, Peemasak

    2011-01-01

    This study assessed students' satisfaction with Ramkhamhaeng University regional library services (RURLs) and the perceived quality of information retrieved from other information sources. In particular, this study investigated factors relating to regional students' selection of information sources to meet their information needs. The…

  14. 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.

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

    PubMed

    Karampelas, Vasilios; Pallikarakis, Nicholas; Mantas, John

    2013-01-01

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

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

    PubMed

    Karampelas, Vasilios; Pallikarakis, Nicholas; Mantas, John

    2013-01-01

    The healthcare researchers', academics' and practitioners' interest concerning the development of Healthcare Information Systems has been on a steady rise for the last decades. Fueling this steady rise has been the healthcare professional need of quality information, in every healthcare provision incident, whenever and wherever this incident may take place. In order to address this need a truly mobile health care system is required, one that will be able to provide a healthcare provider with accurate patient-related information regardless of the time and place that healthcare is provided. In order to fulfill this role the present study proposes the architecture for a Healthcare Smartcard system, which provides authenticated healthcare professionals with remote mobile access to a Patient's Healthcare Record, through their Smartphone. Furthermore the research proceeds to develop a working prototype system. PMID:23823404

  17. 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. PMID:26376674

  18. 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

  19. Healthcare standards based sensory data exchange for Home Healthcare Monitoring System.

    PubMed

    Khan, Wajahat Ali; Hussain, Maqbool; Afzal, Muhammad; Amin, Muhammad Bilal; Lee, Sungyoung

    2012-01-01

    Interoperability is the among the key functionalities of an intelligent systems. Home Healthcare Monitoring Systems (HHMS) investigates patients activities at home, but lacks critical information exchange with Health Management Information System (HMIS). This information is vital for physicians to take necessary steps for timely and effective healthcare provisioning for patients. Physicians can only monitor and prescribe patients in time, if the data is shared with their HMIS. HMIS can be compliant to different healthcare standards. Therefore, mediation system is required to enable interoperability between HHMS and HMIS such that physicians and patients information can easily be exchanged. We propose Interoperability Mediation System (IMS) that provides interoperability services for exchange of information among HHMS and HMIS. We consider that HMIS are compliant to two heterogeneous EHR standards (HL7 CDA and openEHR). Alzheimer's patient case study is described as a proof of concept. Sensory information gathered at HHMS, is communicated with HMIS compliant to EHR based healthcare standards. Sensors information in XML form is converted by interoperability service to HL7 CDA and openEHR instances and communicated to HMIS afterwards. This allows the physicians registered with HHMS to monitor the patient using their HMIS and provide timely healthcare information.

  20. New information on regional subsidence and soil fracturing in Mexico City Valley

    NASA Astrophysics Data System (ADS)

    Auvinet, G.; Méndez-Sánchez, E.; Juárez-Camarena, M.

    2015-11-01

    In this paper, updated information about regional subsidence in Mexico City downtown area is presented. Data obtained by R. Gayol in 1891, are compared with information obtained recently from surveys using the reference points of Sistema de Aguas de la Ciudad de México (2008) and on the elevation of a cloud of points on the ground surface determined using Light Detection and Ranging (LiDAR) technology. In addition, this paper provides an overview of recent data obtained from systematic studies focused on understanding soil fracturing associated with regional land subsidence and mapping of areas susceptible to cracking in Mexico City Valley.

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

    PubMed

    Wickramasinghe, Nilmini; Schaffer, Jonathan L

    2006-01-01

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

  3. Uncovering middle managers' role in healthcare innovation implementation

    PubMed Central

    2012-01-01

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

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

    PubMed

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

    2012-01-01

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

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

    PubMed

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

    2012-01-01

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

  6. [The organization of system of information support of regional health care].

    PubMed

    Konovalov, A A

    2014-01-01

    The comparative analysis was implemented concerning versions of architecture of segment of unified public information system of health care within the framework of the regional program of modernization of Nizhniy Novgorod health care system. The author proposed means of increasing effectiveness of public investments on the basis of analysis of aggregate value of ownership of information system. The evaluation is given concerning running up to target program indicators and dynamics of basic indicators of informatization of institutions of oblast health care system.

  7. Distinct regions of prefrontal cortex are associated with the controlled retrieval and selection of social information.

    PubMed

    Satpute, Ajay B; Badre, David; Ochsner, Kevin N

    2014-05-01

    Research in social neuroscience has uncovered a social knowledge network that is particularly attuned to making social judgments. However, the processes that are being performed by both regions within this network and those outside of this network that are nevertheless engaged in the service of making a social judgment remain unclear. To help address this, we drew upon research in semantic memory, which suggests that making a semantic judgment engages 2 distinct control processes: A controlled retrieval process, which aids in bringing goal-relevant information to mind from long-term stores, and a selection process, which aids in selecting the information that is goal-relevant from the information retrieved. In a neuroimaging study, we investigated whether controlled retrieval and selection for social information engage distinct portions of both the social knowledge network and regions outside this network. Controlled retrieval for social information engaged an anterior ventrolateral portion of the prefrontal cortex, whereas selection engaged both the dorsomedial prefrontal cortex and temporoparietal junction within the social knowledge network. These results suggest that the social knowledge network may be more involved with the selection of social information than the controlled retrieval of it and incorporates lateral prefrontal regions in accessing memory for making social judgments.

  8. Getting back to healthcare: the new automation strategy.

    PubMed

    Lytle, J S; Lytle, B V

    1992-10-01

    The health information professional's role as partner, consultant, and problem solver for clinicians is critical as the healthcare industry, the last major industry to automate itself, progresses toward true information management.

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

    NASA Astrophysics Data System (ADS)

    Summers, Van

    2004-04-01

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

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

    NASA Astrophysics Data System (ADS)

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

    2011-03-01

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

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

    PubMed

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

    2016-04-01

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

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

    PubMed

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

    2016-04-01

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

  13. Applications of Business Analytics in Healthcare

    PubMed Central

    Ward, Michael J.; Marsolo, Keith A.

    2014-01-01

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

  14. Advanced networks and computing in healthcare

    PubMed Central

    Ackerman, Michael

    2011-01-01

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

  15. Applications of Business Analytics in Healthcare.

    PubMed

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

    2014-09-01

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

  16. Information gap analysis of flood model uncertainties and regional frequency analysis

    NASA Astrophysics Data System (ADS)

    Hine, Daniel; Hall, Jim W.

    2010-01-01

    Flood risk analysis is subject to often severe uncertainties, which can potentially undermine flood management decisions. This paper explores the use of information gap theory to analyze the sensitivity of flood management decisions to uncertainties in flood inundation models and flood frequency analysis. Information gap is a quantified nonprobabilistic theory of robustness. To analyze uncertainties in flood modeling, an energy-bounded information gap model is established and applied first to a simplified uniform channel and then to a more realistic 2-D flood model. Information gap theory is then applied to the estimation of flood discharges using regional frequency analysis. The use of an information gap model is motivated by the notion that hydrologically similar sites are clustered in the space of their L moments. The information gap model is constructed around a parametric statistical flood frequency analysis, resulting in a hybrid model of uncertainty in which natural variability is handled statistically while epistemic uncertainties are represented in the information gap model. The analysis is demonstrated for sites in the Trent catchment, United Kingdom. The analysis is extended to address ungauged catchments, which, because of the attendant uncertainties in flood frequency analysis, are particularly appropriate for information gap analysis. Finally, the information gap model of flood frequency is combined with the treatment of hydraulic model uncertainties in an example of how both sources of uncertainty can be accounted for using information gap theory in a flood risk management decision.

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

    PubMed Central

    2015-01-01

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

  18. 76 FR 55364 - Request for Information: Technical Inputs and Assessment Capacity Related to Regional, Sectoral...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-07

    ... Federal Register on Wednesday, July 13, 2011 (76 FR 41217). This RFI sought comments and expressions of... original Federal Register Notice of a Request for Information at 76 FR 41217 (July 13, 2011), or the United... Capacity Related to Regional, Sectoral, and Cross-Cutting Assessments for the 2013 U.S. National...

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

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-07

    ... Region Vessel Identification Requirements AGENCY: National Oceanic and Atmospheric Administration (NOAA... renewal of a current information collection. Regulations at 50 CFR 660.704 require that all vessels with... United States (U.S.) West Coast Highly Migratory Species Fisheries display the vessel's official...

  20. 76 FR 9550 - Proposed Information Collection; Comment Request; Northeast Region Vessel Identification Collection

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-18

    ... Region Vessel Identification Collection AGENCY: National Oceanic and Atmospheric Administration (NOAA... current information collection. Regulations at 50 CFR 648.8 and Sec. 697.8 require that owners of vessels... display the vessel's name and official number. The name and number must be of a specific size at...

  1. 78 FR 19648 - Proposed Information Collection; Comment Request; Northeast Region Dealer Purchase Reports

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-02

    ... Region Dealer Purchase Reports AGENCY: National Oceanic and Atmospheric Administration (NOAA), Commerce... official designee a detailed report of all fish purchased or received for a commercial purpose, other than... Collection Dealers submit purchase information through an electronic process by either the Web-based...

  2. 75 FR 9158 - Proposed Information Collection; Comment Request; Identification of Northeast Regional Ocean...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-01

    ...; Identification of Northeast Regional Ocean Council Information Network Using Social Network Analysis AGENCY.... NROC's members come from varied expertise and work on these issues in many capacities. A social network analysis will serve to identify the network of people working on NROC's key issues, both within and...

  3. Strategies To Help Students Cope with the High Information Flow in World Regional Geography Courses.

    ERIC Educational Resources Information Center

    Heath, Douglas E.

    A traditional world regional geography course inescapably entails a flow of information that many community college students find overwhelming. This paper delineates five strategies developed over 30 years of teaching to help students cope with this fundamental problem: (1) using study guides or a manual to help students understand assigned…

  4. Making a Traditional Study-Abroad Program Geographic: A Theoretically Informed Regional Approach

    ERIC Educational Resources Information Center

    Jokisch, Brad

    2009-01-01

    Geographers have been active in numerous focused study-abroad programs, but few have created or led language-based programs overseas. This article describes the development of a Spanish language program in Ecuador and how it was made geographic primarily through a theoretically informed regional geography course. The approach employs theoretical…

  5. Online Learning and Information Technology in the Asia-Pacific Region: Perspectives, Issues, and Divides.

    ERIC Educational Resources Information Center

    Hung, David; Chen, Der-Thanq

    2003-01-01

    This special issue presents articles contributed by academics from the Asia-Pacific region on perspectives and progress made in online learning and information technology (IT). The articles discuss online learning and IT efforts in South Korea, Hong Kong, China, Taiwan, Japan, Singapore, Australia, Guam, and New Zealand. (AEF)

  6. 76 FR 54737 - Proposed Information Collection; Comment Request; Southeast Region Gear Identification Requirements

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-02

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

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

    ERIC Educational Resources Information Center

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

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

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

    PubMed Central

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

    2014-01-01

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

  9. [Determination of wine original regions using information fusion of NIR and MIR spectroscopy].

    PubMed

    Xiang, Ling-Li; Li, Meng-Hua; Li, Jing-Mingz; Li, Jun-Hui; Zhang, Lu-Da; Zhao, Long-Lian

    2014-10-01

    Geographical origins of wine grapes are significant factors affecting wine quality and wine prices. Tasters' evaluation is a good method but has some limitations. It is important to discriminate different wine original regions quickly and accurately. The present paper proposed a method to determine wine original regions based on Bayesian information fusion that fused near-infrared (NIR) transmission spectra information and mid-infrared (MIR) ATR spectra information of wines. This method improved the determination results by expanding the sources of analysis information. NIR spectra and MIR spectra of 153 wine samples from four different regions of grape growing were collected by near-infrared and mid-infrared Fourier transform spe trometer separately. These four different regions are Huailai, Yantai, Gansu and Changli, which areall typical geographical originals for Chinese wines. NIR and MIR discriminant models for wine regions were established using partial least squares discriminant analysis (PLS-DA) based on NIR spectra and MIR spectra separately. In PLS-DA, the regions of wine samples are presented in group of binary code. There are four wine regions in this paper, thereby using four nodes standing for categorical variables. The output nodes values for each sample in NIR and MIR models were normalized first. These values stand for the probabilities of each sample belonging to each category. They seemed as the input to the Bayesian discriminant formula as a priori probability value. The probabilities were substituteed into the Bayesian formula to get posterior probabilities, by which we can judge the new class characteristics of these samples. Considering the stability of PLS-DA models, all the wine samples were divided into calibration sets and validation sets randomly for ten times. The results of NIR and MIR discriminant models of four wine regions were as follows: the average accuracy rates of calibration sets were 78.21% (NIR) and 82.57% (MIR), and the

  10. Infrared image non-rigid registration based on regional information entropy demons algorithm

    NASA Astrophysics Data System (ADS)

    Lu, Chaoliang; Ma, Lihua; Yu, Ming; Cui, Shumin; Wu, Qingrong

    2015-02-01

    Infrared imaging fault detection which is treated as an ideal, non-contact, non-destructive testing method is applied to the circuit board fault detection. Since Infrared images obtained by handheld infrared camera with wide-angle lens have both rigid and non-rigid deformations. To solve this problem, a new demons algorithm based on regional information entropy was proposed. The new method overcame the shortcomings of traditional demons algorithm that was sensitive to the intensity. First, the information entropy image was gotten by computing regional information entropy of the image. Then, the deformation between the two images was calculated that was the same as demons algorithm. Experimental results demonstrated that the proposed algorithm has better robustness in intensity inconsistent images registration compared with the traditional demons algorithm. Achieving accurate registration between intensity inconsistent infrared images provided strong support for the temperature contrast.

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

    NASA Astrophysics Data System (ADS)

    Tanaka, Koichi; Kitagawa, Yoichi; Hoshino, Kimiaki

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

  12. Healthcare is primary.

    PubMed

    Kumar, Raman

    2015-01-01

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

  13. 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.

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

    PubMed

    Waldman, Deane

    2013-01-01

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

  15. Developing Drought Outlook Forums in Support of a Regional Drought Early Warning Information System

    NASA Astrophysics Data System (ADS)

    Mcnutt, C. A.; Pulwarty, R. S.; Darby, L. S.; Verdin, J. P.; Webb, R. S.

    2011-12-01

    The National Integrated Drought Information System (NIDIS) Act of 2006 (P.L. 109-430) charged NIDIS with developing the leadership and partnerships necessary to implement an integrated national drought monitoring and forecasting system that creates a drought "early warning system". The drought early warning information system should be capable of providing accurate, timely and integrated information on drought conditions at the relevant spatial scale to facilitate proactive decisions aimed at minimizing the economic, social and ecosystem losses associated with drought. As part of this effort, NIDIS has held Regional Drought Outlook Forums in several regions of the U.S. The purpose of the Forums is to inform practices that reduce vulnerability to drought through an interactive and collaborative process that includes the users of the information. The Forums have focused on providing detailed assessments of present conditions and impacts, comparisons with past drought events, and seasonal predictions including discussion of the state and expected evolution of the El Niño Southern Oscillation phenomena. Regional Climate Outlook Forums (RCOFs) that include close interaction between information providers and users are not a new concept, however. RCOFs started in Africa in the 1990s in response to the 1997-98 El Niño and have since expanded to South America, Asia, the Pacific islands, and the Caribbean. As a result of feedback from the RCOFs a large body of research has gone into improving seasonal forecasts and the capacity of the users to apply the information in a way that improves their decision-making. Over time, it has become clear that more is involved than just improving the interaction between the climate forecasters and decision-makers. NIDIS is using the RCOF approach as one component in a larger effort to develop Regional Drought Early Warning Information Systems (RDEWS) around the U.S. Using what has been learned over the past decade in the RCOF process

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

    PubMed

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

    2015-11-01

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

  17. [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.

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

    PubMed Central

    Saokaew, Surasak; Sugimoto, Takashi; Kamae, Isao; Pratoomsoot, Chayanin; Chaiyakunapruk, Nathorn

    2015-01-01

    Background Health technology assessment (HTA) has been continuously used for value-based healthcare decisions over the last decade. Healthcare databases represent an important source of information for HTA, which has seen a surge in use in Western countries. Although HTA agencies have been established in Asia-Pacific region, application and understanding of healthcare databases for HTA is rather limited. Thus, we reviewed existing databases to assess their potential for HTA in Thailand where HTA has been used officially and Japan where HTA is going to be officially introduced. Method Existing healthcare databases in Thailand and Japan were compiled and reviewed. Databases’ characteristics e.g. name of database, host, scope/objective, time/sample size, design, data collection method, population/sample, and variables were described. Databases were assessed for its potential HTA use in terms of safety/efficacy/effectiveness, social/ethical, organization/professional, economic, and epidemiological domains. Request route for each database was also provided. Results Forty databases– 20 from Thailand and 20 from Japan—were included. These comprised of national censuses, surveys, registries, administrative data, and claimed databases. All databases were potentially used for epidemiological studies. In addition, data on mortality, morbidity, disability, adverse events, quality of life, service/technology utilization, length of stay, and economics were also found in some databases. However, access to patient-level data was limited since information about the databases was not available on public sources. Conclusion Our findings have shown that existing databases provided valuable information for HTA research with limitation on accessibility. Mutual dialogue on healthcare database development and usage for HTA among Asia-Pacific region is needed. PMID:26560127

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

    PubMed

    Aggarwal, A K; Travers, S

    2001-01-01

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

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

    PubMed

    Aggarwal, A K; Travers, S

    2001-01-01

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

  1. Architectural approach for quality and safety aware healthcare social networks.

    PubMed

    López, Diego M; Blobel, Bernd; González, Carolina

    2012-01-01

    Quality of information and privacy and safety issues are frequently identified as main limitations to make most benefit from social media in healthcare. The objective of the paper is to contribute to the analysis of healthcare social networks (SN), and online healthcare social network services (SNS) by proposing a formal architectural analysis of healthcare SN and SNS, considering the complexity of both systems, but stressing on quality, safety and usability aspects. Quality policies are necessary to control the quality of content published by experts and consumers. Privacy and safety policies protect against inappropriate use of information and users responsibility for sharing information. After the policies are established and documented, a proof of concept online SNS supporting primary healthcare promotion is presented in the paper.

  2. Developing a Security Metrics Scorecard for Healthcare Organizations.

    PubMed

    Elrefaey, Heba; Borycki, Elizabeth; Kushniruk, Andrea

    2015-01-01

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

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

    NASA Astrophysics Data System (ADS)

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

    2007-05-01

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

  4. Telemental health: responding to mandates for reform in primary healthcare.

    PubMed

    Myers, Kathleen M; Lieberman, Daniel

    2013-06-01

    Telemental health (TMH) has established a niche as a feasible, acceptable, and effective service model to improve the mental healthcare and outcomes for individuals who cannot access traditional mental health services. The Accountability Care Act has mandated reforms in the structure, functioning, and financing of primary care that provide an opportunity for TMH to move into the mainstream healthcare system. By partnering with the Integrated Behavioral Healthcare Model, TMH offers a spectrum of tools to unite primary care physicians and mental health specialist in a mind-body view of patients' healthcare needs and to activate patients in their own care. TMH tools include video-teleconferencing to telecommute mental health specialists to the primary care setting to collaborate with a team in caring for patients' mental healthcare needs and to provide direct services to patients who are not progressing optimally with this collaborative model. Asynchronous tools include online therapies that offer an efficient first step to treatment for selected disorders such as depression and anxiety. Patients activate themselves in their care through portals that provide access to their healthcare information and Web sites that offer on-demand information and communication with a healthcare team. These synchronous and asynchronous TMH tools may move the site of mental healthcare from the clinic to the home. The evolving role of social media in facilitating communication among patients or with their healthcare team deserves further consideration as a tool to activate patients and provide more personalized care. PMID:23611641

  5. Telemental health: responding to mandates for reform in primary healthcare.

    PubMed

    Myers, Kathleen M; Lieberman, Daniel

    2013-06-01

    Telemental health (TMH) has established a niche as a feasible, acceptable, and effective service model to improve the mental healthcare and outcomes for individuals who cannot access traditional mental health services. The Accountability Care Act has mandated reforms in the structure, functioning, and financing of primary care that provide an opportunity for TMH to move into the mainstream healthcare system. By partnering with the Integrated Behavioral Healthcare Model, TMH offers a spectrum of tools to unite primary care physicians and mental health specialist in a mind-body view of patients' healthcare needs and to activate patients in their own care. TMH tools include video-teleconferencing to telecommute mental health specialists to the primary care setting to collaborate with a team in caring for patients' mental healthcare needs and to provide direct services to patients who are not progressing optimally with this collaborative model. Asynchronous tools include online therapies that offer an efficient first step to treatment for selected disorders such as depression and anxiety. Patients activate themselves in their care through portals that provide access to their healthcare information and Web sites that offer on-demand information and communication with a healthcare team. These synchronous and asynchronous TMH tools may move the site of mental healthcare from the clinic to the home. The evolving role of social media in facilitating communication among patients or with their healthcare team deserves further consideration as a tool to activate patients and provide more personalized care.

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

    ERIC Educational Resources Information Center

    Maryland State Department of Education, 2004

    2004-01-01

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

  7. Delineating sea surface water quality regions from remotely sensed data using textural information

    NASA Astrophysics Data System (ADS)

    Kyriakidis, Phaedon C.; Vasios, George K.; Kitsiou, Dimitra

    2015-06-01

    The delineation of ocean regions with similar water quality characteristics is an all important component of the study of marine environment with direct implications for management actions. Marine eutrophication constitutes an important facet of ocean water quality, and pertains to the natural process representing excessive algal growth due to nutrient supply of marine systems. Remote sensing technology provides the de-facto means for marine eutrophication assessment over large regions of the ocean, with increasingly high spatial and temporal resolutions. In this work, monthly measurements of sea water quality variables - chlorophyll, nitrates, phosphates, dissolved oxygen - obtained from the Sea-viewing Wide Field-of-view Sensor (SeaWiFS) with spatial resolution 0.125 degrees for the East Mediterranean region over the period January 1999 to December 2010, are used to define regions or zones of similar eutrophication levels. A novel variant of the K-medoids clustering algorithm is proposed, whereby the spatial association of the different variables (multivariate textural information) is explicitly accounted for in terms of the multivariate variogram; i.e., a measure of joint dissimilarity between different variables as a function of geographical distance. Similar water quality regions are obtained for various months and years, focusing on the spring season and on the qualitative comparison of the traditional and proposed classification methods. The results indicate that the proposed clustering method yields more physically meaningful clusters due to the incorporation of the multivariate textural information.

  8. Computer skills for the next generation of healthcare executives.

    PubMed

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

    2005-01-01

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

  9. Computer skills for the next generation of healthcare executives.

    PubMed

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

    2005-01-01

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

  10. Exemplary healthcare facilities.

    PubMed

    1992-01-01

    Symposium attendees had the opportunity to choose from 13 different tours designed to meet their diverse needs. Each tour consisted of one or more facilities grouped together to show innovative solutions to the problems in healthcare design today. Tours were of exemplary healthcare facilities throughout the Boston area, some of which were presented as case studies in the program. Facility types included medical centers with special services, ambulatory care centers, long term care facilities, pediatric hospitals, a school and center for the blind, a hospice, research and educational facilities, a community health center, an AIDS respite project, and a Ronald McDonald house. PMID:10183786

  11. A Regional Response to Climate Information Needs during the 1993 Flood.

    NASA Astrophysics Data System (ADS)

    Kunkel, Kenneth E.; Changnon, Stanley A.; Hollinger, Steven E.; Reinke, Beth C.; Wendland, Wayne M.; Angel, James R.

    1995-12-01

    Effective responses by government agencies, businesses, and private industry to climate disasters such as the disastrous Mississippi River flood of 1993 hinge on the regional availability of diverse up-to-date weather, climate, and water information. In addition to the obvious need for accurate forecasts and warnings of severe weather and floods, other types of meteorologically based information can contribute to effective responses. Some examples of information requested during and after the 1993 flood include 1) hydroclimatic assessments of the magnitude of the event, 2) agricultural assessments of the impacts of heavy rains and flooding on corn and soybean production, and 3) probabilistic outlooks of the recurrence of flooding based on soil moisture conditions. Quick responses to these climate information needs necessitate 1) a real-time climate monitoring system, 2) physical models to assess effects and impacts, and 3) scientific expertise to address complex issues.

  12. Sharing self-related information is associated with intrinsic functional connectivity of cortical midline brain regions

    PubMed Central

    Meshi, Dar; Mamerow, Loreen; Kirilina, Evgeniya; Morawetz, Carmen; Margulies, Daniel S.; Heekeren, Hauke R.

    2016-01-01

    Human beings are social animals and they vary in the degree to which they share information about themselves with others. Although brain networks involved in self-related cognition have been identified, especially via the use of resting-state experiments, the neural circuitry underlying individual differences in the sharing of self-related information is currently unknown. Therefore, we investigated the intrinsic functional organization of the brain with respect to participants’ degree of self-related information sharing using resting state functional magnetic resonance imaging and self-reported social media use. We conducted seed-based correlation analyses in cortical midline regions previously shown in meta-analyses to be involved in self-referential cognition: the medial prefrontal cortex (MPFC), central precuneus (CP), and caudal anterior cingulate cortex (CACC). We examined whether and how functional connectivity between these regions and the rest of the brain was associated with participants’ degree of self-related information sharing. Analyses revealed associations between the MPFC and right dorsolateral prefrontal cortex (DLPFC), as well as the CP with the right DLPFC, the left lateral orbitofrontal cortex and left anterior temporal pole. These findings extend our present knowledge of functional brain connectivity, specifically demonstrating how the brain’s intrinsic functional organization relates to individual differences in the sharing of self-related information. PMID:26948055

  13. Inverse approaches with lithologic information for a regional groundwater system in southwest Kansas

    USGS Publications Warehouse

    Tsou, M.-S.; Perkins, S.P.; Zhan, X.; Whittemore, D.O.; Zheng, Lingyun

    2006-01-01

    Two practical approaches incorporating lithologic information for groundwater modeling calibration are presented to estimate distributed, cell-based hydraulic conductivity. The first approach is to estimate optimal hydraulic conductivities for geological materials by incorporating thickness distribution of materials into inverse modeling. In the second approach, residuals for the groundwater model solution are minimized according to a globalized Newton method with the aid of a Geographic Information System (GIS) to calculate a cell-wise distribution of hydraulic conductivity. Both approaches honor geologic data and were effective in characterizing the heterogeneity of a regional groundwater modeling system in southwest Kansas. ?? 2005 Elsevier Ltd All rights reserved.

  14. How useful is landslide hazard information? Lessons learned in the San Francisco Bay region

    USGS Publications Warehouse

    Howell, David G.; Brabb, Earl E.; Ramsey, David W.; Ernst, W.G.; Coleman, Robert G.

    2000-01-01

    Landslides, worldwide and in the United States, are arguably the most costly natural hazard. Substantial landslide information is available, but much of it remains underutilized, as a disconnect exists among geologists, decision makers, and the public. The lack of a national landslide insurance policy exacerbates this situation and promotes litigation as the principal recourse for recouping landslide-damage losses. The U.S. Geological Survey's landslide investigation in the San Francisco Bay region of California provides a context for making suggestions on how Earth science information could be used more effectively.

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

    PubMed

    Solomon, Michael R

    2007-02-01

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

  16. How useful is landslide hazard information? Lessons learned in the San Francisco Bay region

    USGS Publications Warehouse

    Howell, D.G.; Brabb, E.E.; Ramsey, D.W.

    1999-01-01

    Landslides, worldwide and in the United States, are arguably the most costly natural hazard. Substantial landslide information is available, but much of it remains underutilized, as a disconnect exists among geologists, decision makers, and the public. The lack of a national landslide insurance policy exacerbates this situation and promotes litigation as the principal recourse for recouping landslide-damage losses. The U.S. Geological Survey's landslide investigation in the San Francisco Bay region of California provides a context for making suggestions on how Earth science information could be used more effectively.

  17. 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

  18. Application of research and information to human resources policies: regional goals for the Americas.

    PubMed

    Mandelli, Marcos; Rigoli, Felix

    2015-12-01

    Objective Report experiences involving the use of research and information systems to support national human resources policies through benchmarking between different countries, with comparisons over time and between similar countries or regions. Method In 2007, the Pan American Health Organization (PAHO) promoted a set of goals for all the countries in the Americas to improve the situation of health human resources, using a uniform methodology and research process carried out by Observatories of Human Resources. Results The analysis focused on the progress made in relation to the main challenges in the Southern Cone countries, with a special emphasis on Brazil, noting improvements in the distribution of professionals in the regions. Conclusion These experiences showed how research and the use of information systems can stimulate the expansion of good practices in the training, retention and development of the health workforce in the Americas. PMID:26959168

  19. Application of research and information to human resources policies: regional goals for the Americas.

    PubMed

    Mandelli, Marcos; Rigoli, Felix

    2015-12-01

    Objective Report experiences involving the use of research and information systems to support national human resources policies through benchmarking between different countries, with comparisons over time and between similar countries or regions. Method In 2007, the Pan American Health Organization (PAHO) promoted a set of goals for all the countries in the Americas to improve the situation of health human resources, using a uniform methodology and research process carried out by Observatories of Human Resources. Results The analysis focused on the progress made in relation to the main challenges in the Southern Cone countries, with a special emphasis on Brazil, noting improvements in the distribution of professionals in the regions. Conclusion These experiences showed how research and the use of information systems can stimulate the expansion of good practices in the training, retention and development of the health workforce in the Americas.

  20. Engineering healthcare as a service system.

    PubMed

    Tien, James M; Goldschmidt-Clermont, Pascal J

    2010-01-01

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

  1. Informing Decisions with a Climate Synthesis Product: Implications for Regional Climate Services

    NASA Astrophysics Data System (ADS)

    Guido, Z.; Hill, D.; Crimmins, M.; Ferguson, D. B.

    2012-12-01

    The demand for regional climate information is increasing and spurring efforts to provide a broad slate of climate services that inform policy and resource management and elevate general knowledge. Routine syntheses of existing climate-related information may be an effective strategy for connecting climate information to decision making, but few studies have formally assessed their contribution to informing decisions. During the 2010-2011 winter, drought conditions expanded and intensified in Arizona and New Mexico, creating an opportunity to develop and evaluate a pithy, monthly regional climate communication product—La Niña Drought Tracker—that synthesized and interpreted drought and climate information. Six issues were published and subsequently evaluated through an online survey. On average, 417 people consulted the publication each month. Many of the survey respondents indicated that they made at least one drought-related decision, and the product at least moderately influenced the majority of those decisions, some of which helped mitigate economic losses and reduce climate vulnerability. The product also improved understanding of climate and drought for more than 90 percent of the respondents and helped the majority of them better prepare for drought. These, and other results demonstrate that routine interpretation and synthesis of existing climate information can help enhance access to and understanding and use of climate information in decision-making. Moreover, developing regional, contextual knowledge within climate service programs can facilitate the implementation of activities like the Tracker that enhance the use of climate information without engaging in time-consuming collaborative processes that can prevent the timely production of the services. We present results from the case study of the Tracker and place it within the context of the challenges and opportunities associated with providing climate services, particularly those services that

  2. Untangling healthcare competition.

    PubMed

    Harris, I C; McDaniel, R R

    1993-11-01

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

  3. Healthcare is primary

    PubMed Central

    Kumar, Raman

    2015-01-01

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

  4. Cell nuclei segmentation in fluorescence microscopy images using inter- and intra-region discriminative information.

    PubMed

    Song, Yang; Cai, Weidong; Feng, David Dagan; Chen, Mei

    2013-01-01

    Automated segmentation of cell nuclei in microscopic images is critical to high throughput analysis of the ever increasing amount of data. Although cell nuclei are generally visually distinguishable for human, automated segmentation faces challenges when there is significant intensity inhomogeneity among cell nuclei or in the background. In this paper, we propose an effective method for automated cell nucleus segmentation using a three-step approach. It first obtains an initial segmentation by extracting salient regions in the image, then reduces false positives using inter-region feature discrimination, and finally refines the boundary of the cell nuclei using intra-region contrast information. This method has been evaluated on two publicly available datasets of fluorescence microscopic images with 4009 cells, and has achieved superior performance compared to popular state of the art methods using established metrics.

  5. Determining business models for financial sustainability in regional health information organizations (RHIOs): a review.

    PubMed

    Maffei, Roxana; Burciago, Daniel; Dunn, Kim

    2009-10-01

    Regional health information organizations (RHIOs) have the potential to alleviate today's health care problems by granting providers access to a supported body of clinical information for all patients in a given region. While the promise of and enthusiasm for RHIOs is immense, the issue of their financial sustainability remains unclear. It has been said that the business model supporting a regional or national health information network is as essential, if not more essential, than the technology that makes it feasible. Currently, there is a clear lack of concrete business models implemented in RHIOs' projects. This article reports the results of a literature review of the current status of the adaptation and implementation of business models by RHIOs for successful financial sustainability. Based on the review, this article also attempts to evaluate the existing financial situation of RHIOs to determine and recommend the best models of economic sustainability. Significant findings include RHIOs' present financial environment, planning, and self-sustainability methods. Future studies will be needed as RHIOs continue to grow and move toward the implementation phase of their development.

  6. Determining business models for financial sustainability in regional health information organizations (RHIOs): a review.

    PubMed

    Maffei, Roxana; Burciago, Daniel; Dunn, Kim

    2009-10-01

    Regional health information organizations (RHIOs) have the potential to alleviate today's health care problems by granting providers access to a supported body of clinical information for all patients in a given region. While the promise of and enthusiasm for RHIOs is immense, the issue of their financial sustainability remains unclear. It has been said that the business model supporting a regional or national health information network is as essential, if not more essential, than the technology that makes it feasible. Currently, there is a clear lack of concrete business models implemented in RHIOs' projects. This article reports the results of a literature review of the current status of the adaptation and implementation of business models by RHIOs for successful financial sustainability. Based on the review, this article also attempts to evaluate the existing financial situation of RHIOs to determine and recommend the best models of economic sustainability. Significant findings include RHIOs' present financial environment, planning, and self-sustainability methods. Future studies will be needed as RHIOs continue to grow and move toward the implementation phase of their development. PMID:19848569

  7. Land-use planning of Volyn region (Ukraine) using Geographic Information Systems (GIS) technologies

    NASA Astrophysics Data System (ADS)

    Strielko, Irina; Pereira, Paulo

    2014-05-01

    Land-use development planning is carried out in order to create a favourable environment for human life, sustainable socioeconomic and spatial development. Landscape planning is an important part of land-use development that aims to meet the fundamental principles of sustainable development. Geographic Information Systems (GIS) is a fundamental tool to make a better landscape planning at different territorial levels, providing data and maps to support decision making. The objective of this work is to create spatio-temporal, territorial and ecological model of development of Volyn region (Ukraine). It is based on existing spatial raster and vector data and includes the analysis of territory dynamics as the aspects responsible for it. A spatial analyst tool was used to zone the areas according to their environmental components and economic activity. This analysis is fundamental to define the basic parameters of sustainability of Volyn region. To carry out this analysis, we determined the demographic capacity of districts and the analysis of spatial parameters of land use. On the basis of the existing natural resources, we observed that there is a need of landscape protection and integration of more are natural areas in the Pan-European Ecological Network. Using GIS technologies to landscape planning in Volyn region, allowed us to identify, natural areas of interest, contribute to a better resource management and conflict resolution. Geographic Information Systems will help to formulate and implement landscape policies, reform the existing administrative system of Volyn region and contribute to a better sustainable development.

  8. Improvement, trust, and the healthcare workforce

    PubMed Central

    Berwick, D

    2003-01-01

    Although major defects in the performance of healthcare systems are well documented, progress toward remedy remains slow. Accelerating improvement will require large shifts in attitudes toward and strategies for developing the healthcare workforce. At present, prevailing strategies rely largely on outmoded theories of control and standardisation of work. More modern, and much more effective, theories of production seek to harness the imagination and participation of the workforce in reinventing the system. This requires a workforce capable of setting bold aims, measuring progress, finding alternative designs for the work itself, and testing changes rapidly and informatively. It also requires a high degree of trust in many forms, a bias toward teamwork, and a predilection toward shouldering the burden of improvement, rather than blaming external factors. A new healthcare workforce strategy, founded on these principles, will yield much faster improvement than at present. PMID:14645740

  9. Managing healthcare services in the global marketplace.

    PubMed

    Fried, Bruce J; Harris, Dean M

    2007-01-01

    The world is getting "flatter"; people, information, technology, and ideas are increasingly crossing national borders. U.S. healthcare is not immune from the forces of globalization. Competition from medical tourism and the rapid growth in the number of undocumented aliens requiring care represent just two challenges healthcare organizations face. An international workforce requires leaders to confront the legal, financial, and ethical implications of using foreign-trained personnel. Cross-border institutional arrangements are emerging, drawing players motivated by social responsibility, globalization of competitors, growth opportunities, or an awareness of vulnerability to the forces of globalization. Forward-thinking healthcare leaders will begin to identify global strategies that address global pressures, explore the opportunities, and take practical steps to prepare for a flatter world. PMID:18220174

  10. [Big data in medicine and healthcare].

    PubMed

    Rüping, Stefan

    2015-08-01

    Healthcare is one of the business fields with the highest Big Data potential. According to the prevailing definition, Big Data refers to the fact that data today is often too large and heterogeneous and changes too quickly to be stored, processed, and transformed into value by previous technologies. The technological trends drive Big Data: business processes are more and more executed electronically, consumers produce more and more data themselves - e.g. in social networks - and finally ever increasing digitalization. Currently, several new trends towards new data sources and innovative data analysis appear in medicine and healthcare. From the research perspective, omics-research is one clear Big Data topic. In practice, the electronic health records, free open data and the "quantified self" offer new perspectives for data analytics. Regarding analytics, significant advances have been made in the information extraction from text data, which unlocks a lot of data from clinical documentation for analytics purposes. At the same time, medicine and healthcare is lagging behind in the adoption of Big Data approaches. This can be traced to particular problems regarding data complexity and organizational, legal, and ethical challenges. The growing uptake of Big Data in general and first best-practice examples in medicine and healthcare in particular, indicate that innovative solutions will be coming. This paper gives an overview of the potentials of Big Data in medicine and healthcare.

  11. Emerging Frontiers in Healthcare Research and Delivery.

    PubMed Central

    Stevens, Alan B.; Sanghi, Sandhya

    2010-01-01

    The Health Maintenance Organization Research Network (HMORN), a consortium of 16 healthcare delivery systems with integrated research centers, held their 16th annual conference in Austin, Texas from March 21–24, 2010. The conference was hosted by Scott & White Healthcare. Its theme “Emerging Frontiers in Healthcare Research and Delivery” reflected the objective of the conference which was to build synergy among scientists and clinicians to influence the health of the nation; to demonstrate the network’s commitment to reach beyond traditional collaborators; discuss tools and technologies; and to expand opportunities for public-private partnerships in cutting-edge healthcare research and delivery. More than 320 researchers and healthcare professionals, representing each of the member HMOs, participated in this conference. Representatives from the AHRQ, CDC, NCI and NIH met with researchers to advance the quality and breadth of public domain research in HMOs. The objective of this article is to provide information about the HMORN and its 16th annual conference. PMID:21177536

  12. Lean six sigma in healthcare.

    PubMed

    de Koning, Henk; Verver, John P S; van den Heuvel, Jaap; Bisgaard, Soren; Does, Ronald J M M

    2006-01-01

    Healthcare, as with any other service operation, requires systematic innovation efforts to remain competitive, cost efficient, and up-to-date. This article outlines a methodology and presents examples to illustrate how principles of Lean Thinking and Six Sigma can be combined to provide an effective framework for producing systematic innovation efforts in healthcare. Controlling healthcare cost increases, improving quality, and providing better healthcare are some of the benefits of this approach.

  13. [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.

  14. [Digital health as a motor for change towards new healthcare models and the relationship between patients and healthcare professionals. Disruption of healthcare processes].

    PubMed

    Garcia-Cuyàs, Francesc; de San Pedro, Marc; Martínez Roldan, Jordi

    2015-11-01

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

  15. [The use of information processes indices for prediction of sympathectomy efficiency in complex regional pain syndrome].

    PubMed

    Kuropatkin, A I

    2010-01-01

    Key significance of information processes for ensuring optimal sanogenesis was shown by wavelet-analysis of skin microvascular blood flow oscillations at 64 patients with complex regional pain syndrome after sympathectomy Early reorganization of information in trophotropic direction at the level of microvascular tissue systems, its predomination and conservation all along the microvascular networks facilitate optimal realization of adaptive reactions and, as a result, are conductive to maximum treatment efficiency. In these cases complete elimination of disease and achievement of excellent treatment results were possible. Maximum treatment efficiency could not be reached without the above-mentioned information changing. On the contrary predomination and conservation of ergotropic information at the early periods after surgery were unfavourable to prediction of clinical results of sympathectomy Tissue desympathisation is not required to formation of information trophotropic purposefulness in microvascular networks; it is enough to achieve certain threshold of sympathetic activity decrease. The results of this work may be useful for investigation of physiological mechanisms of information treatment technologies (homeopathy etc.).

  16. Analysis of surface-water data network in Kansas for effectiveness in providing regional streamflow information

    USGS Publications Warehouse

    Medina, K.D.; Tasker, Gary D.

    1985-01-01

    The surface water data network in Kansas was analyzed using generalized least squares regression for its effectiveness in providing regional streamflow information. The correlation and time-sampling error of the streamflow characteristic are considered in the generalized least squares method. Unregulated medium-flow, low-flow and high-flow characteristics were selected to be representative of the regional information that can be obtained from streamflow gaging station records for use in evaluating the effectiveness of continuing the present network stations, discontinuing some stations; and/or adding new stations. The analysis used streamflow records for all currently operated stations that were not affected by regulation and discontinued stations for which unregulated flow characteristics , as well as physical and climatic characteristics, were available. The state was divided into three network areas, western, northeastern, and southeastern Kansas, and analysis was made for three streamflow characteristics in each area, using three planning horizons. The analysis showed that the maximum reduction of sampling mean square error for each cost level could be obtained by adding new stations and discontinuing some of the present network stations. Large reductions in sampling mean square error for low-flow information could be accomplished in all three network areas, with western Kansas having the most dramatic reduction. The addition of new stations would be most beneficial for man- flow information in western Kansas, and to lesser degrees in the other two areas. The reduction of sampling mean square error for high-flow information would benefit most from the addition of new stations in western Kansas, and the effect diminishes to lesser degrees in the other two areas. Southeastern Kansas showed the smallest error reduction in high-flow information. A comparison among all three network areas indicated that funding resources could be most effectively used by

  17. Health-care district management information system plan: Review of operations analysis activities during calendar year 1975 and plan for continued research and analysis activities

    NASA Technical Reports Server (NTRS)

    Nielson, G. J.; Stevenson, W. G.

    1976-01-01

    Operations research activities developed to identify the information required to manage both the efficiency and effectiveness of the Veterans Administration (VA) health services as these services relate to individual patient care are reported. The clinical concerns and management functions that determine this information requirement are discussed conceptually. Investigations of existing VA data for useful management information are recorded, and a diagnostic index is provided. The age-specific characteristics of diseases and lengths of stay are explored, and recommendations for future analysis activities are articulated. The effect of the introduction of new technology to health care is also discussed.

  18. Information and communication on risks related to medications and proper use of medications for healthcare professionals and the general public: precautionary principle, risk management, communication during and in the absence of crisis situations.

    PubMed

    Molimard, Mathieu; Bernaud, Corine; Lechat, Philippe; Bejan-Angoulvant, Theodora; Benattia, Cherif; Benkritly, Amel; Braunstein, David; Cabut, Sandrine; David, Nadine; Fourrier-Réglat, Annie; Gallet, Benoit; Gersberg, Marta; Goni, Sylvia; Jolliet, Pascale; Lamarque-Garnier, Véronique; Le Jeunne, Claire; Leurs, Irina; Liard, François; Malbezin, Muriel; Micallef, Joelle; Nguon, Marina

    2014-01-01

    Recent drug crises have highlighted the complexity, benefits and risks of medication communication. The difficulty of this communication is due to the diversity of the sources of information and the target audience, the credibility of spokespersons, the difficulty to communicate on scientific uncertainties and the precautionary principle, which is influenced by variable perceptions and tolerances of the risk. Globally, there is a lack of training in risk management with a tendency of modern society to refuse even the slightest risk. Communication on medications is subject to regulatory or legal requirements, often uses tools and messages that are not adapted to the target audience and is often based on a poor knowledge of communication techniques. In order to improve this situation, the available information must be coordinated by reinforcing the unique medication information website and by coordinating communication between authorities by means of a single spokesperson. A particular effort must be made in the field of training in the proper use and risk of medications for both the general population and patients but also for healthcare professionals, by setting up a unified academic on-line teaching platform for continuing medical education on medications and their proper use.

  19. Information and communication on risks related to medications and proper use of medications for healthcare professionals and the general public: precautionary principle, risk management, communication during and in the absence of crisis situations.

    PubMed

    Molimard, Mathieu; Bernaud, Corine; Lechat, Philippe; Bejan-Angoulvant, Theodora; Benattia, Cherif; Benkritly, Amel; Braunstein, David; Cabut, Sandrine; David, Nadine; Fourrier-Réglat, Annie; Gallet, Benoit; Gersberg, Marta; Goni, Sylvia; Jolliet, Pascale; Lamarque-Garnier, Véronique; Le Jeunne, Claire; Leurs, Irina; Liard, François; Malbezin, Muriel; Micallef, Joelle; Nguon, Marina

    2014-01-01

    Recent drug crises have highlighted the complexity, benefits and risks of medication communication. The difficulty of this communication is due to the diversity of the sources of information and the target audience, the credibility of spokespersons, the difficulty to communicate on scientific uncertainties and the precautionary principle, which is influenced by variable perceptions and tolerances of the risk. Globally, there is a lack of training in risk management with a tendency of modern society to refuse even the slightest risk. Communication on medications is subject to regulatory or legal requirements, often uses tools and messages that are not adapted to the target audience and is often based on a poor knowledge of communication techniques. In order to improve this situation, the available information must be coordinated by reinforcing the unique medication information website and by coordinating communication between authorities by means of a single spokesperson. A particular effort must be made in the field of training in the proper use and risk of medications for both the general population and patients but also for healthcare professionals, by setting up a unified academic on-line teaching platform for continuing medical education on medications and their proper use. PMID:25099666

  20. 76 FR 18765 - National Advisory Council for Healthcare Research and Quality: Request for Nominations for Public...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-05

    ... of health care economics, information systems, law, ethics, business, or public policy; and, (7) in... HUMAN SERVICES Agency for Healthcare Research and Quality National Advisory Council for Healthcare Research and Quality: Request for Nominations for Public Members AGENCY: Agency for Healthcare Research...