Science.gov

Sample records for regional healthcare information

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

    PubMed

    Yao, Ye-hong; Zhang, Jian-guo

    2008-09-01

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

  2. The outcomes of regional healthcare information systems in health care: a review of the research literature.

    PubMed

    Mäenpää, Tiina; Suominen, Tarja; Asikainen, Paula; Maass, Marianne; Rostila, Ilmari

    2009-11-01

    The resulting regional healthcare information systems were expected to have effects and impacts on health care procedures, work practices and treatment outcomes. The aim is to find out how health information systems have been investigated, what has been investigated and what are the outcomes. A systematic review was carried out of the research on the regional health information systems or organizations. The literature search was conducted on four electronic Cinahl Medline, Medline/PubMed and Cochrane. The common type of study design was the survey research and case study, and the data collection was carried out via different methodologies. They found out different types of regional health information systems (RHIS). The systems were heterogeneous and were in different phases of these developments. The RHIS outcomes focused on the five main areas: flow of information, collaboration, process redesign, system usability and organization culture. The RHIS improved the clinical data access, timely information, and clinical data exchange and improvement in communication and coordination within a region between professionals but also there was inadequate access to patient relevant clinical data. There were differences in organization culture, vision and expectations of leadership and consistency of strategic plan. Nevertheless, there were widespread participation by both healthcare providers and patients.

  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. 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

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

    PubMed

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

    2010-11-13

    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.

  6. Buying a healthcare information system.

    PubMed

    Clegg, T A

    1998-01-01

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

  7. Infrastructuring Multicultural Healthcare Information Systems.

    PubMed

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

    2017-01-01

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

  8. [Consumer health-care information technology].

    PubMed

    Sunyaev, A

    2013-06-01

    Consumer health-care information technology is intended to improve patients' opportunities to gather information about their own health. Ideally, this will be achieved through an improved involvement of existing data bases and an improved communication of information to patients and to care providers, if desired by patients. Additionally, further interconnection of existing and new systems and pervasive system design may be used. All consumer health-care information technology services are optional and leave patients in control of their medical data at all times. This article reflects the current status of consumer health-care information technology research and suggests further research areas that should be addressed.

  9. 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.

  10. Guest editorial. Integrated healthcare information systems.

    PubMed

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

    2012-07-01

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

  11. 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.

  12. Middleware for healthcare information systems.

    PubMed

    Spahni, S; Scherrer, J R; Sauquet, D; Sottile, P A

    1998-01-01

    Middleware is now a commonly used expression and anyone building distributed applications is referring to "middleware services". Nevertheless this notion lacks of sound theoretical foundation. This paper tries to clarify the relationship between the components of distributed environments, especially in healthcare, and to establish some classification aiming at gaining a common understanding of the functionalities and interdependency of the existing modules of distributed environments.

  13. The value of information technology in healthcare.

    PubMed

    Skinner, Richard I

    2003-01-01

    Not only will healthcare investments in information technology (IT) continue, they are sure to increase. Just as other industries learned over time how to extract more value from IT investments, so too will the healthcare industry, and for the same reason: because they must. This article explores the types of business value IT has generated in other industries, what value it can generate in healthcare, and some of the barriers encountered in achieving that value. The article ends with management principles for IT investment.

  14. Defense Healthcare Information Assurance Program

    DTIC Science & Technology

    2001-06-01

    assurance. RADIUS Prototype I • lementation As depicted in Figure 5, the DHIAP Team used ISE results ( Emerging TechnologyI to identify specific situations...VA, facility size/purpose (from outpatient clinic to regional medical center), and facility type (fixed, mobile , deployed). TATRC called for

  15. An overview in healthcare information systems security.

    PubMed

    Bourka, A; Polemi, N; Koutsouris, D

    2001-01-01

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

  16. 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

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

    PubMed

    McGrath, I

    1997-01-01

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

  18. 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.

  19. 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

  20. Role of Healthcare Information Technology in handoffs.

    PubMed

    Koppel, Ross; Telles, Joel Leon

    2013-01-01

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

  1. Security threats categories in healthcare information systems.

    PubMed

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

    2010-09-01

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

  2. Is healthcare information technology based on evidence?

    PubMed

    Koppel, R

    2013-01-01

    Is healthcare information technology (HIT) based on evidence of efficacy? Are the trillions of dollars already devoted and in the pipeline for HIT implementations based on systematic evaluations? If evaluated, would those evaluations focus on patient safety, return on investment, clinical efficiency, improved clinician satisfaction, and/or workflow integration? Do we have reliable evidence of usable interfaces, of successful implementations, of data standards allowing interoperability, of continuous improvement, of responsiveness to clinician feedback? While measurement of HIT's efficacy is extraordinarily difficult-complicated by a myriad of other factors involved in providing healthcare and in organizational dynamics-it is not impossible. But is such evidence required before most implementations? Any implementation? Or are the goals of patient safety and efficiency so self-evident, profoundly desired, and laudable that HIT's beneficence is accepted without rigorous data? Note that lack of systematic evidence does not mean HIT is ineffective. HIT may provide untold benefits even if there is no hard proof of those benefits. We find that HIT is seldom objectively measured, and that evidence of its efficacy is at best spotty, and often influenced by self-promotion. Most measures, especially those associated with cost-benefit analyses, are aspirational or hubris transubstantiated into numbers.

  3. Successfully integrating information systems into healthcare.

    PubMed

    Wallhouse, R

    1992-01-01

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

  4. 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.

  5. 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

  6. 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.

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

    PubMed

    Romagnoli, Carlo; Minelli, Liliana

    2008-01-01

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

  8. 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

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

    PubMed

    2002-11-01

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

  10. 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.

  11. 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.

  12. Older Adults Seeking Healthcare Information on the Internet

    ERIC Educational Resources Information Center

    Hardt, Jeffrey H.; Hollis-Sawyer, Lisa

    2007-01-01

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

  13. 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…

  14. The secure authorization model for healthcare information system.

    PubMed

    Hsu, Wen-Shin; Pan, Jiann-I

    2013-10-01

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

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

    PubMed

    Gudea, Sorin

    2005-11-08

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

  16. 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.

  17. Towards specialised middleware for healthcare information systems.

    PubMed

    Spahni, S; Scherrer, J R; Sauquet, D; Sottile, P A

    1999-01-01

    Middleware is now a commonly used expression and anyone building distributed applications is referring to 'middleware services'. Nevertheless this notion lacks of sound theoretical foundation. This paper tries to clarify the relationship between the components of distributed environments, especially in healthcare and to establish some classification aiming at gaining a common understanding of the functionality and interdependency of the existing modules of distributed environments. A case study is presented and the potential benefits of using a middleware approach are discussed.

  18. 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.

  19. Security in health-care information systems--current trends.

    PubMed

    Smith, E; Eloff, J H

    1999-04-01

    Ever since health-care information systems have been implemented, their security is being considered an important issue, especially in the light of the fact that their data are deemed to comprise extremely sensitive information. The prospect of storing health information in electronic form raises concerns about patient privacy and data security. Any attempt to introduce computerised health-care information systems should, therefore, guarantee adequate protection of the confidentiality and integrity of patient information. At the same time, the patient information also needs to be readily available to all authorised health-care providers, in order to ensure the proper treatment of the patient. The principal aim of the present paper is, however, not to make a new contribution to the subject of security per se, but rather to give an overview of current trends in the security aspects of health-care information systems. The final section of the paper will be devoted to a number of proposals for further research possibilities in the domain of health-care information systems security.

  20. 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.

  1. 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.

  2. Design principles for achieving integrated healthcare information systems.

    PubMed

    Jensen, Tina Blegind

    2013-03-01

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

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

    PubMed

    Bhandari, Neeraj; Shi, Yunfeng; Jung, Kyoungrae

    2014-01-01

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

  4. 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

  5. Enhancing security and improving interoperability in healthcare information systems.

    PubMed

    Gritzalis, D A

    1998-01-01

    Security is a key issue in healthcare information systems, since most aspects of security become of considerable or even critical importance when handling healthcare information. In addition, the intense need for information exchange has revealed interoperability of systems and applications as another key issue. Standardization can play an important role towards both these issues. In this paper, relevant standardization activities are briefly presented, and existing and emerging healthcare information security standards are identified and critically analysed. The analysis is based on a framework which has been developed for this reason. Therefore, the identification of gaps and inconsistencies in current standardization, the description of the conflicts of standards with legislation, and the analysis of implications of these standards to user organizations, are the main results of this paper.

  6. Regional Health Information Systems

    PubMed Central

    Fuller, Sherrilynne

    1997-01-01

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

  7. Health information exchange and healthcare utilization.

    PubMed

    Vest, Joshua R

    2009-06-01

    Health information exchange (HIE) makes previously inaccessible data available to clinicians, resulting in more complete information. This study tested the hypotheses that HIE information access reduced emergency room visits and inpatient hospitalizations for ambulatory care sensitive conditions among medically indigent adults. HIE access was quantified by how frequently system users' accessed patients' data. Encounter counts were modeled using zero inflated binomial regression. HIE was not accessed for 43% of individuals. Patient factors associated with accessed data included: prior utilization, chronic conditions, and age. Higher levels of information access were significantly associated with increased counts of all encounter types. Results indicate system users were more likely to access HIE for patients for whom the information might be considered most beneficial. Ultimately, these results imply that HIE information access did not transform care in the ways many would expect. Expectations in utilization reductions, however logical, may have to be reevaluated or postponed.

  8. 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.

  9. Understanding healthcare innovation systems: the Stockholm region case.

    PubMed

    Larisch, Lisa-Marie; Amer-Wåhlin, Isis; Hidefjäll, Patrik

    2016-11-21

    Purpose There is an increasing interest in understanding how innovation processes can address current challenges in healthcare. The purpose of this paper is to analyze the wider socio-economic context and conditions for such innovation processes in the Stockholm region, using the functional dynamics approach to innovation systems (ISs). Design/methodology/approach The analysis is based on triangulation using data from 16 in-depth interviews, two workshops, and additional documents. Using the functional dynamics approach, critical structural and functional components of the healthcare IS were analyzed. Findings The analysis revealed several mechanisms blocking innovation processes such as fragmentation, lack of clear leadership, as well as insufficient involvement of patients and healthcare professionals. Furthermore, innovation is expected to occur linearly as a result of research. Restrictive rules for collaboration with industry, reimbursement, and procurement mechanisms limit entrepreneurial experimentation, commercialization, and spread of innovations. Research limitations/implications In this study, the authors analyzed how certain functions of the functional dynamics approach to ISs related to each other. The authors grouped knowledge creation, resource mobilization, and legitimacy as they jointly constitute conditions for needs articulation and entrepreneurial experimentation. The economic effects of entrepreneurial experimentation and needs articulation are mainly determined by the stage of market formation and existence of positive externalities. Social implications Stronger user involvement; a joint innovation strategy for healthcare, academia, and industry; and institutional reform are necessary to remove blocking mechanisms that today prevent innovation from occurring. Originality/value This study is the first to provide an analysis of the system of innovation in healthcare using a functional dynamics approach, which has evolved as a tool for public

  10. Object technology: raising the standards for healthcare information systems.

    PubMed

    Pollard, D L; Hammond, W E

    1998-01-01

    Netscape and the public Internet have accelerated the acceptance of many different open "Internet standards". Through wide acceptance of its browser, Netscape gave a boost to the Java programming language helping it become truly platform independent. Objects written in Java are ideal building blocks for application components. CORBA gives such objects the ability to communicate and operate over networks. Applications built with these distributed objects become the services in an Internet-wide healthcare framework. The convergence of object technologies has raised the standards for modern healthcare information systems. To illustrate the relationship among such technologies, this paper presents an architecture for a Universal Healthcare Information System (UHIS) in terms of its web, Java and CORBA components.

  11. 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.

  12. 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

  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.

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

    PubMed

    Joyce, Phil; Green, Rosamund; Winch, Graham

    2007-01-01

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

  15. 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.

  16. 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.

  17. An Informatics Blueprint for Healthcare Quality Information Systems

    PubMed Central

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

    2006-01-01

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

  18. 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

  19. 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.

  20. 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.

  1. A Connectivity Framework for Social Information Systems Design in Healthcare

    PubMed Central

    Kuziemsky, Craig E.; Andreev, Pavel; Benyoucef, Morad; O'Sullivan, Tracey; Jamaly, Syam

    2016-01-01

    Social information systems (SISs) will play a key role in healthcare systems’ transformation into collaborative patient-centered systems that support care delivery across the entire continuum of care. SISs enable the development of collaborative networks andfacilitate relationships to integrate people and processes across time and space. However, we believe that a “connectivity” issue, which refers to the scope and extent of system requirements for a SIS, is a significant challenge of SIS design. This paper’s contribution is the development of the Social Information System Connectivity Framework for supporting SIS design in healthcare. The framework has three parts. First, it defines the structure of a SIS as a set of social triads. Second, it identifies six dimensions that represent the behaviour of a SIS. Third, it proposes the Social Information System Connectivity Factor as our approximation of the extent of connectivity and degree of complexity in a SIS. PMID:28269869

  2. 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.

  3. Managing information resources: a study of ten healthcare organizations.

    PubMed

    Austin, C J; Hornberger, K D; Shmerling, J E

    2000-01-01

    This article presents the results of information technology management audits conducted by senior executives at ten healthcare organizations. The audits evaluated how well the following seven information technology management responsibilities were carried out: (1) strategic information systems planning; (2) employment of a user focus in system development; (3) recruiting of competent personnel; (4) information systems integration; (5) protection of information security and confidentiality; (6) employment of effective project management in system development; and (7) post-implementation evaluation of information systems. The audit results suggest that most of these responsibilities are being met to a considerable extent by a majority of the organizations studied. However, substantial variation across organizations was noted. Executives participating in the study were able to define areas in which the management of information resources in their organizations was in need of attention. The audit process encourages senior management to provide the leadership required to ensure that information technology is used to maximum advantage.

  4. 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…

  5. Advanced technology program: information infrastructure for healthcare focused program.

    PubMed

    Spivack, Richard N

    2002-01-01

    This paper describes an initiative begun by the Advanced Technology Program in 1994 referred to as the Information Infrastructure for Healthcare (IIH) focused program. The IIH focus program began with an initial exchange of ideas among members of the private and public sectors (industry's submission of "white papers"; workshops conducted by the ATP; meetings held between individuals from both groups) to identify those technologies necessary for the development of a national information infrastructure in healthcare. A discussion of the development of the focus program through a "white paper" process notes differences that existed between what the ATP had hoped to gain through this method and how the private sector responded. A statistical description of the participants as well as a brief discussion of the ATP review and selection process is included.

  6. High level security policies for Healthcare Information Systems.

    PubMed

    Katsikas, Sokratis; Kokolakis, Spyros

    2003-01-01

    Healthcare Establishments (HCE) have are today highly dependent upon Information and Communications Technologies (ICT). This increasing reliance upon ICT has stressed the need to foster security in Healthcare Information Systems (HIS). Security policies may have a significant contribution to this effort, but they could become the cause of portability and interoperability problems. Moreover, policies that fail to take into account all the aspects of HIS security, the legal and regulatory requirements, and the existence of several stakeholders may lead to ineffective or inefficient security measures. Policies of a special category, named Generic Security Policies (GSPs), should be developed to provide policy-level harmonisation and guidance to policy-makers within HCEs. Five such policies are comparatively reviewed herein.

  7. Healthcare information system architecture (HISA) and its middleware models.

    PubMed

    Scherrer, J R; Spahni, S

    1999-01-01

    The use of middleware to develop widely distributed healthcare information systems (HIS) has become inevitable. However, the fact that many different platforms, even sometimes heterogeneous to each other, are hooked into the same network makes the integration of various middleware components more difficult than some might believe. This paper discusses the HISA standard and proposes extensions to the model that, in turn, could be compliant with other various existing distributed platforms and their middleware components.

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

    PubMed

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

    2013-01-01

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

  9. 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.

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

    PubMed

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

    2005-01-01

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

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

    PubMed

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

    1999-01-01

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

  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. 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.

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

    Code of Federal Regulations, 2012 CFR

    2012-10-01

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

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

    Code of Federal Regulations, 2011 CFR

    2011-10-01

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

  16. 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.

  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.

  18. Impact of information technology on human resources in healthcare.

    PubMed

    Anvari, Mehran

    2007-01-01

    Incorporation of advances in information communications technology (ICT) into the workplace has had a major impact in human resource utilization in sectors of the economy where it has occurred in a substantial manner, such as manufacturing and financial services. While some benefits of ICT have been realized in healthcare, the full impact of its benefits will only be realized if it is incorporated in a systematic form, rather than in the current patchy and uneven manner seen around the province and across the country to date.

  19. 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.

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

    PubMed

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

    2011-01-01

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

  1. 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.

  2. 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.

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

    PubMed

    Chhanabhai, Prajesh N; Holt, Alec

    2010-09-15

    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.

  4. The Piemonte Regional Allergy Network: a model of healthcare organization.

    PubMed

    Galimberti, M; Cadario, G; Belliero, B; Maspoli, M; Di Pietrantonj, C; Demicheli, V

    2011-12-01

    The Allergology Hospital Network and Regional Register for Severe Allergic Reactions (Regional Observatory) is the Piemonte Health Authority new challenge. It satisfied the need to promote and monitor the best practice among a variegated pool of specialists and to define both state of the art and evolution of efficiency and efficacy of standard working process. Harmonization in clinical daily activities and report of severe allergic reactions notified to Regional Observatory, had been gained by mean of a customized Information Technology (IT) solution. The overall target is to ensure a correct diagnostic treatment to patients with severe allergic reactions preventing possible future reactions. Statistics data as a whole, provide basilar epidemiological information to allocate both economical and human resources and to fulfill the rising of health diseases. Piemonte Allergology Medical Network with the Regional Register are an Italian unique and innovative project. It would represent a benchmark for other medical branches.

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

    ERIC Educational Resources Information Center

    Khudair, Ahmad A.; Cooke, Louise

    2008-01-01

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

  6. 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.

  7. 45 CFR 61.12 - Requesting information from the Healthcare Integrity and Protection Data Bank.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

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

  8. 45 CFR 61.12 - Requesting information from the Healthcare Integrity and Protection Data Bank.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

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

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

    PubMed

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

    2009-01-01

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

  10. Evaluating Healthcare Information Technology Outside of Academia: Observations from the National Resource Center for Healthcare Information Technology at the Agency for Healthcare Research and Quality

    PubMed Central

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

    2009-01-01

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

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

    Code of Federal Regulations, 2010 CFR

    2010-10-01

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

  12. 45 CFR 61.14 - Confidentiality of Healthcare Integrity and Protection Data Bank information.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

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

  13. Value of information and pricing new healthcare interventions.

    PubMed

    Willan, Andrew R; Eckermann, Simon

    2012-06-01

    Previous application of value-of-information methods to optimal clinical trial design have predominantly taken a societal decision-making perspective, implicitly assuming that healthcare costs are covered through public expenditure and trial research is funded by government or donation-based philanthropic agencies. In this paper, we consider the interaction between interrelated perspectives of a societal decision maker (e.g. the National Institute for Health and Clinical Excellence [NICE] in the UK) charged with the responsibility for approving new health interventions for reimbursement and the company that holds the patent for a new intervention. We establish optimal decision making from societal and company perspectives, allowing for trade-offs between the value and cost of research and the price of the new intervention. Given the current level of evidence, there exists a maximum (threshold) price acceptable to the decision maker. Submission for approval with prices above this threshold will be refused. Given the current level of evidence and the decision maker's threshold price, there exists a minimum (threshold) price acceptable to the company. If the decision maker's threshold price exceeds the company's, then current evidence is sufficient since any price between the thresholds is acceptable to both. On the other hand, if the decision maker's threshold price is lower than the company's, then no price is acceptable to both and the company's optimal strategy is to commission additional research. The methods are illustrated using a recent example from the literature.

  14. Healthcare IT trends raise bar for information security.

    PubMed

    Glaser, John; Aske, Jennings

    2010-07-01

    A provider's initial priorities for protecting the security of healthcare IT should include the following: Security governance and management. Laptop and device encryption. Internal content filtering. E-mail encryption. Access management. Social media policies and guidelines.

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

    PubMed

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

    2013-01-01

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

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

    DTIC Science & Technology

    2010-08-31

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

  17. Meeting the information needs of clinicians for the practice of evidence-based healthcare.

    PubMed

    Pyne, T; Newman, K; Leigh, S; Cowling, A; Rounce, K

    1999-03-01

    This article reports on clinicians' use of library resources and the competencies they require to access information necessary for the practice of evidence-based healthcare. It is based on the results of a study commissioned by North Thames Region to identify the training needs of clinicians for the adoption and practice of evidence-based healthcare. Participants in this qualitative research study included librarians, clinicians (doctors, nurses and PAMs) and managers from four Acute and Community Trusts in and around London. The research indicates that the majority of clinicians recognize the need to keep up-to-date with changes in their specialty and many visit their libraries on a frequent basis, however, few appear to be searching for information with which to inform their immediate clinical decisions. Our sample acknowledged their low usage of journals such as Bandolier, the Health Effectiveness Bulletin and Journal of Evidence-Based Medicine. Similarly, low use of electronic databases, such as Cochrane and Cinahl, were reported. Examination of skill and self-efficacy levels in accessing and using information databases revealed wide variations across professions, specialities and Trusts. Qualitative research methods were employed to elicit the key competencies required to access clinically relevant research evidence, and a framework for integrating these competencies is presented.

  18. [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.

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

    PubMed

    Moore, An'Nita; Fisher, Kathleen

    2012-03-01

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

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

    PubMed

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

    2010-01-01

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

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

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-10

    ... AFFAIRS Proposed Information Collection (Women Veterans Healthcare Barriers Survey) AGENCY: Veterans...) 395-7316. Please refer to ``OMB Control No. 2900-NEW, Women Veterans Healthcare Barriers Survey'' in..., fax (202) 632-7583 or email crystal.rennie@va.gov . Please refer to ``OMB Control No. 2900-NEW,...

  4. 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…

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

    PubMed

    Ghane, Kamran

    2014-01-01

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

  6. 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.

  7. IMITS: Information and Clinical Technologies for the Advancement of Healthcare

    DTIC Science & Technology

    2008-12-01

    command dashboards 24  Central image routing engine  Image compression process  DICOM image transmission process  Functional image transfer...accommodate interfaces following accepted healthcare interfacing standards such: Digital Image and Communications in Medicine ( DICOM ), Health Level 7...Approved Technology – Software Development Libraries – Merge DICOM Libraries – Compression Libraries (TBD) Low Medium Low Medium AFMS Approved FY05 DWA

  8. 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.

  9. An Ethnographically Informed Participatory Design of Primary Healthcare Information Technology in a Developing Country Setting.

    PubMed

    Shidende, Nima Herman; Igira, Faraja Teddy; Mörtberg, Christina Margaret

    2017-01-01

    Ethnography, with its emphasis on understanding activities where they occur, and its use of qualitative data gathering techniques rich in description, has a long tradition in Participatory Design (PD). Yet there are limited methodological insights in its application in developing countries. This paper proposes an ethnographically informed PD approach, which can be applied when designing Primary Healthcare Information Technology (PHIT). We use findings from a larger multidisciplinary project, Health Information Systems Project (HISP) to elaborate how ethnography can be used to facilitate participation of health practitioners in developing countries settings as well as indicating the importance of ethnographic approach to participatory Health Information Technology (HIT) designers. Furthermore, the paper discusses the pros and cons of using an ethnographic approach in designing HIT.

  10. How secure is your information system? An investigation into actual healthcare worker password practices.

    PubMed

    Cazier, Joseph A; Medlin, B Dawn

    2006-09-27

    For most healthcare information systems, passwords are the first line of defense in keeping patient and administrative records private and secure. However, this defense is only as strong as the passwords employees chose to use. A weak or easily guessed password is like an open door to the medical records room, allowing unauthorized access to sensitive information. In this paper, we present the results of a study of actual healthcare workers' password practices. In general, the vast majority of these passwords have significant security problems on several dimensions. Implications for healthcare professionals are discussed.

  11. 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

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

    PubMed

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

    2009-08-01

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

  13. 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.

  14. 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

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

    PubMed

    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.

  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. 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…

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

    PubMed

    Manca, Terra

    2013-09-01

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

  20. 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…

  1. 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…

  2. [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.

  3. Normative models and healthcare planning: network-based simulations within a geographic information system environment.

    PubMed Central

    Walsh, S J; Page, P H; Gesler, W M

    1997-01-01

    OBJECTIVES: Network analysis to integrate patient, transportation and hospital characteristics for healthcare planning in order to assess the role of geographic information systems (GIS). A normative model of base-level responses of patient flows to hospitals, based on estimated travel times, was developed for this purpose. DATA SOURCES/STUDY SETTING: A GIS database developed to include patient discharge data, locations of hospitals, US TIGER/Line files of the transportation network, enhanced address-range data, and U.S. Census variables. The study area included a 16-county region centered on the city of Charlotte and Mecklenburg County, North Carolina, and contained 25 hospitals serving nearly 2 million people over a geographic area of nearly 9,000 square miles. STUDY DESIGN: Normative models as a tool for healthcare planning were derived through a spatial Network analysis and a distance optimization model that was implemented within a GIS. Scenarios were developed and tested that involved patient discharge data geocoded to the five-digit zip code, hospital locations geocoded to their individual addresses, and a transportation network of varying road types and corresponding estimated travel speeds to examine both patient discharge levels and a doubling of discharge levels associated with total discharges and DRG 391 (Normal Newborns). The Network analysis used location/allocation modeling to optimize for travel time and integrated measures of supply, demand, and impedance. DATA COLLECTION/EXTRACTION METHODS: Patient discharge data from the North Carolina Medical Database Commission, address-ranges from the North Carolina Institute for Transportation Research and Education, and U.S. Census TIGER/Line files were entered-into the ARC/INFO GIS software system for analysis. A relational database structure was used to organize the information and to link spatial features to their attributes. PRINCIPAL FINDINGS: Advances in healthcare planning can be achieved by

  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. 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.

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

    PubMed

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

    2015-02-01

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

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

    PubMed

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

    2016-12-01

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

  8. Increasing the safety of healthcare information systems through improved procurement: toward a framework for selection of safe healthcare systems.

    PubMed

    Kushniruk, Andre; Beuscart-Zéphir, Marie-Catherine; Grzes, Alexis; Borycki, Elizabeth; Watbled, Ludivine; Kannry, Joseph

    2010-01-01

    In this article, we describe a framework that we have developed for improving the effectiveness of critical decision-making in selecting information systems. In our framework, we consider system selection in terms of strength of evidence obtained from the testing of candidate systems in order to reduce risk and increase the likelihood of selection and implementation of an effective and safe system. Two case studies, one from a major North American hospital and one from a major European hospital, are presented to illustrate how methods such as usability testing can be applied to improve system selection as well as customization (through early identification of system-organization mismatches and error-prone system features). It is argued that technology-organization fit and consideration of the potential for technology-induced error should be important selection criteria in the procurement process. Here, implications are discussed for the development of improved procurement processes to lead to safer healthcare systems.

  9. A novel middleware solution to improve ubiquitous healthcare systems aided by affective information.

    PubMed

    Taleb, Tarik; Bottazzi, Dario; Nasser, Nidal

    2010-03-01

    The arousal of emotion might have consequences for physical health is a broadly acknowledged idea. Therapy for depression, prevention for heart pathologies, and rehabilitation treatments for drug addiction are just a few examples of application domains that may benefit from technologies capable of monitoring, detecting, representing, and disseminating information pertaining to patients' physical and psychological/emotional states. However, the design and development of healthcare applications of this kind is a rather challenging issue that requires to integrate sensor infrastructures, which are able to detect changes in patients' physiological and emotional states, and of sharing this information to interested caregivers, such as professional medical staff, relatives, and friends. This paper proposes the Pervasive Environment for AffeCtive Healthcare (PEACH) framework, a middleware level support for affective healthcare that incarnates these ideas and describes its effective functions in a drug addiction treatment application scenario.

  10. 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.

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

    PubMed

    Ferrara, F M

    1998-01-01

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

  12. Regional disparities in the distribution of healthcare workers: evidence from Iran, Chaharmahal and Bakhtiari province.

    PubMed

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

    2015-02-09

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

  13. 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.

  14. Assessing the effects of the HIPAA privacy rule on release of patient information by healthcare facilities.

    PubMed

    Houser, Shannon H; Houser, Howard W; Shewchuk, Richard M

    2007-03-23

    The HIPAA privacy rule (HIPAA) has had both positive and negative effects on the release of patient information by healthcare facilities. Although the intention of HIPAA was to protect patient privacy and to promote security and confidentiality of patient information, it has had unintended consequences for facilities. To identify some of these unintended effects, two expert panels of health information management directors from healthcare facilities participated in the nominal group technique meetings. They identified 70 barriers related to release of patient information associated with the implementation of HIPAA. The perceived biggest barriers were increases in the public's misunderstanding about release of patient information, lack of an umbrella policy or regulation defining infractions and enforcement that allows individual institutions to make their own interpretations, and challenges to health information management professionals in controlling safeguards related to release of information given the transition to electronic health records and the increased involvement of information technology. The findings from this study suggest there is a need for additional clarification of the regulations governing HIPAA, standardized instructions, and extensive training of healthcare workers.

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

    PubMed

    Hsieh, Chang-tseh; Lin, Binshan

    2011-01-01

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

  16. Information Poverty and Reproductive Healthcare: Assessing the Reasons for Inequity between Income Groups.

    PubMed

    Zimmerman, Margaret S

    2017-04-03

    It is commonly known that in the United States women who are low income do not access reproductive healthcare services and information with the same reliability and regularity of women who are higher income. A qualitative research approach was undertaken to assess the root cause of this disparity. In-depth semistructured interviews were conducted with 15 women divided among socioeconomic lines. The primary barriers to care for women who are low income are clinical staff attitudes, knowledge of care available and needed, and cost or lack of insurance. This study adds to the current understanding of the barriers to reproductive healthcare for women of different socioeconomic statuses.

  17. Informal rural healthcare providers in North and South India

    PubMed Central

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

    2014-01-01

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

  18. 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

  19. Information Expensiveness Perceived by Vietnamese Patients with Respect to Healthcare Provider’s Choice

    PubMed Central

    Quan-Hoang, Vuong

    2016-01-01

    Background: Patients have to acquire information to support their decision on choosing a suitable healthcare provider. But in developing countries like Vietnam, accessibility issues remain an obstacle, thus adversely affect both quality and costliness of healthcare information. Vietnamese use both sources from health professionals and friends/relatives, especially when quality of the Internet-based cheaper sources appear to be still questionable. The search of information from both professionals and friends/relatives incurs some cost, which can be viewed as low or high depending low or high accessibility to the sources. These views potentially affect their choices. Aim and Objectives: To investigate the effects that medical/health services information on perceived expensiveness of patients’ labor costs. Two related objectives are a) establishing empirical relations between accessibility to sources and expensiveness; and, b) probabilistic trends of probabilities for perceived expensiveness. Results: There is evidence for established relations among the variables “Convexp” and “Convrel” (all p’s < 0.01), indicating that both information sources (experts and friends/relatives) have influence on patients perception of information expensiveness. The use of experts source tends to increase the probability of perceived expensiveness. Conclusion: a) Probabilistic trends show Vietnamese patients have propensity to value healthcare information highly and do not see it as “expensive”; b) The majority of Vietnamese households still take non-professional advices at their own risks; c) There is more for the public healthcare information system to do to reduce costliness and risk of information. The Internet-based health service users communities cannot replace this system. PMID:28077894

  20. Challenges of information security incident learning: an industrial case study in a Chinese healthcare organization.

    PubMed

    He, Ying; Johnson, Chris

    2017-01-09

    Security incidents can have negative impacts on healthcare organizations, and the security of medical records has become a primary concern of the public. However, previous studies showed that organizations had not effectively learned lessons from security incidents. Incident learning as an essential activity in the "follow-up" phase of security incident response lifecycle has long been addressed but not given enough attention. This paper conducted a case study in a healthcare organization in China to explore their current obstacles in the practice of incident learning. We interviewed both IT professionals and healthcare professionals. The results showed that the organization did not have a structured way to gather and redistribute incident knowledge. Incident response was ineffective in cycling incident knowledge back to inform security management. Incident reporting to multiple stakeholders faced a great challenge. In response to this case study, we suggest the security assurance modeling framework to address those obstacles.

  1. Methods to evaluate health information systems in healthcare settings: a literature review.

    PubMed

    Rahimi, Bahlol; Vimarlund, Vivian

    2007-10-01

    Although information technology (IT)-based applications in healthcare have existed for more than three decades, methods to evaluate outputs and outcomes of the use of IT-based systems in medical informatics is still a challenge for decision makers, as well as to those who want to measure the effects of ICT in healthcare settings. The aim of this paper is to review published articles in the area evaluations of IT-based systems in order to gain knowledge about methodologies used and findings obtained from the evaluation of IT-based systems applied in healthcare settings. The literature review includes studies of IT-based systems between 2003 and 2005. The findings show that economic and organizational aspects dominate evaluation studies in this area. However, the results focus mostly on positive outputs such as user satisfaction, financial benefits and improved organizational work. This review shows that there is no standard framework for evaluation effects and outputs of implementation and use of IT in the healthcare setting and that until today no studies explore the impact of IT on the healthcare system' productivity and effectiveness.

  2. Cyber-Security Issues in Healthcare Information Technology.

    PubMed

    Langer, Steve G

    2017-02-01

    In 1999-2003, SIIM (then SCAR) sponsored the creation of several special topic Primers, one of which was concerned with computer security. About the same time, a multi-society collaboration authored an ACR Guideline with a similar plot; the latter has recently been updated. The motivation for these efforts was the launch of Health Information Portability and Accountability Act (HIPAA). That legislation directed care providers to enable the portability of patient medical records across authorized medical centers, while simultaneously protecting patient confidentiality among unauthorized agents. These policy requirements resulted in the creation of numerous technical solutions which the above documents described. While the mathematical concepts and algorithms in those papers are as valid today as they were then, recent increases in the complexity of computer criminal applications (and defensive countermeasures) and the pervasiveness of Internet connected devices have raised the bar. This work examines how a medical center can adapt to these evolving threats.

  3. Information needs in home based healthcare in South Africa.

    PubMed

    de la Harpe, Retha; Barnes, Jay; Korpela, Mikko

    2010-01-01

    Home based health care (HBHC) is advocated by the WHO "to ensure better accessibility to effective and efficient health care in community and home-settings to improve health and well-being, and contribute to morbidity and mortality reduction". In South Africa the government and many other role players see an increasingly important role for HBHC. Many researchers believe that the evolution of HBHC will follow the socio-technical network evolution. There can be no doubt that the focus is on using information and communication technologies (ICT) to implement HBHC solutions. The objective of this paper is to provide a rich picture of the current situation and needs for improvement in HBHC in South Africa today through descriptive research in one specific case. The longer-term purpose is to identify pain-points that require socio-technical solutions, including but not exclusively ICT-supported solutions.

  4. 45 CFR 61.15 - How to dispute the accuracy of Healthcare Integrity and Protection Data Bank information.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

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

  5. 45 CFR 61.15 - How to dispute the accuracy of Healthcare Integrity and Protection Data Bank information.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

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

  6. 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…

  7. [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.

  8. 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.

  9. 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

  10. Pros and cons of healthcare information technology implementation: the pros win.

    PubMed

    Maffei, Roxana

    2006-01-01

    Countless studies and investigations have been performed siding either for or against the implementation of technology in the healthcare setting. This article presents both sides of this debate, with an obvious conclusion that the pros of this debate win. The practice of information technology in the medical domain lags behind its knowledge and discovery by at least 7 years. The key to closing this gap is to show, through various studies, how information technology systems provide decision support to users at the point in time when decisions are needed. What the reader will obtain from this article is that the pros for information technology implementation in healthcare settings weigh much more and have a greater effect than the cons.

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

    PubMed Central

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

    2011-01-01

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

  14. Incremental adoption of information security in health-care organizations: implications for document management.

    PubMed

    Lorence, Daniel P; Churchill, Richard

    2005-06-01

    The incremental adoption of electronic media in U.S. health care has created increased risk of security and privacy violations in provider organizations. Protective regulatory efforts have been proposed to address ineffective security of patient information, with severe noncompliance penalties. Using data from a nationwide survey of health information managers, this study examines how industry-wide knowledge management trends may influence the degree of security program adoption in health-care organizations. Results suggest that significant nonadoption of mandated security measures continues to occur across the health-care industry. Paper-based systems still prevail, and computerized settings tend to have less security measures. Implications for document management and knowledge policy are discussed.

  15. The Copernican era of healthcare terminology: a re-centering of health information systems.

    PubMed

    Chute, C G

    1998-01-01

    Health terminology and classifications have been an unseen backwater in healthcare practice and information systems development. Today however, the recognized need for comparable patient data is driving a new discovery about its strategic importance. Consistent patient descriptions and concept-centered data representations are crucial for efficient discovery of optimal treatments, best outcomes, and efficient practice patterns. The fabled linkage of knowledge sources at the time and place of care requires the conceptual intermediary of common terminology. A brief history overviewing the evolution of health classifications will provide the foundation for considering present and evolving health terminology developments. Their roles in health information systems will be characterized. Discussion will focus on the likely influences of the HIPAA legislation nationally and the new ISO Healthcare Informatics Technical Committee internationally, on terminology adaptation and incorporation.

  16. Assessing graduate programs for healthcare information management/technology (HIM/T) executives.

    PubMed

    Moore, Rick A; Berner, Eta S

    2004-03-18

    This paper describes a methodology to assess health/medical informatics graduate-level education curricula. The authors used the Certified Professional in Healthcare Information Management Systems (CPHIMS) exam objectives published by the Healthcare Information and Management Systems Society (HIMSS) as the basis for their assessment. The authors compared the 69 CPHIMS exam objectives against four health/medical informatics program course objectives as stated in the selected program's online graduate catalog. Results showed that the two programs with management as a focus addressed the majority (67 and 59%) of the CPHIMS objectives within core and elective courses combined. Overall, the other two programs addressed closer to a third of the CPHIMS objectives (36 and 32%). This methodology could prove to be useful in assisting students interested in graduate-level training programs with a tool by which to measure the congruence of the curricula of different programs with the mission of the programs and with their own professional interests.

  17. 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.

  18. Securing Information in the Healthcare Industry: Network Security, Incident Management, and Insider Threat

    DTIC Science & Technology

    2016-06-07

    2010 Carnegie Mellon University Securing Information in the Healthcare Industry: Network Security, Incident Management , and Insider Threat http...1 hour per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and...Industry: Network Security, Incident Management , and Insider Threat 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d

  19. 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

    ... Collection (Health-Care Use Survey for Enduring Freedom and Operation Iraqi Freedom (OEF/OIF) Veterans...-New (10-0478).'' SUPPLEMENTARY INFORMATION: Title: Health-Care Use Survey for Enduring Freedom and... VA health care; (2) document unique barriers to VA care for women and men; and (3) provide...

  20. Healthcare System Information at Language Schools for Newly Arrived Immigrants: A Pertinent Setting in Times of Austerity

    ERIC Educational Resources Information Center

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

    2017-01-01

    Objective: In most European countries, immigrants do not systematically learn about the host countries' healthcare system when arriving. This study investigated how newly arrived immigrants perceived the information they received about the Danish healthcare system. Methods: Immigrants attending a language school in Copenhagen in 2012 received…

  1. Clinical utility of the informant AD8 as a dementia case finding instrument in primary healthcare.

    PubMed

    Chan, Qun Lin; Xu, Xin; Shaik, Muhammad Amin; Chong, Steven Shih Tsze; Hui, Richard Jor Yeong; Chen, Christopher Li-Hsian; Dong, YanHong

    2016-01-01

    The informant AD8 has excellent discriminant ability for dementia case finding in tertiary healthcare settings. However, its clinical utility for dementia case finding at the forefront of dementia management, primary healthcare, is unknown. Therefore, we recruited participants from two primary healthcare centers in Singapore and measured their performance on the Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), Clinical Dementia Rating (CDR), and a local formal neuropsychological battery, in addition to the AD8. Logistic regression was conducted to examine the associations between demographic factors and dementia. Area under the receiver operating characteristics (ROC) curve analysis was used to establish the optimal cut-off points for dementia case finding. Of the 309 participants recruited, 243 (78.7%) had CDR = 0, 22 (7.1%) CDR = 0.5, and 44 (14.2%) CDR ≥1. Age was strongly associated with dementia, and the optimal age for dementia case finding in primary healthcare settings was ≥75 years. In this age group, the AD8 has excellent dementia case finding capability and was superior to the MMSE and equivalent to the MoCA [AD8 AUC (95% CI): 0.95 (0.91-0.99), cut-off: ≥3, sensitivity: 0.90, specificity: 0.88, PPV: 0.79 and NPV: 0.94; MMSE AUC (95% CI): 0.87 (0.79-0.94), p = 0.04; MoCA AUC (95% CI): 0.88 (0.82-0.95), p = 0.06]. In conclusion, the AD8 is well suited for dementia case finding in primary healthcare settings.

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

    PubMed

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

    2010-01-01

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

  3. 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

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

    PubMed

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

    2011-01-01

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

  5. Cognitive evaluation: how to assess the usability of information technology in healthcare.

    PubMed

    Beuscart-Zéphir, M C; Brender, J; Beuscart, R; Ménager-Depriester, I

    1997-09-01

    As the adoption of information technology has increased, so too has the demands that these systems become more adapted to the physicians and nurses environments, to make access and management of information easier. The developers of information systems in Healthcare must use quality management techniques to ensure that their product will satisfy given requirements. This underlines the importance of the preliminary phase where Users Requirements are elicited. Some methodologies, such as KAVAS (E.M.S. Van Gennip, F. Grémy, Med. Inform. 18, 1993, 179) chose to use a continuous assessment protocol as a key strategy for quality management. At each stage of the conception and development of a prototype, the assessment checks that it conforms to the expectation of the users' requirements. The methodology of evaluation is then seen as a dynamic process which is able to improve the design and development of a dedicated system. The purpose of this paper is to demonstrate the necessity to include a cognitive evaluation phase in the process of evaluation by: (1) evaluating the integration (usability) of the I.T. in the activity of the users; and (2) understanding the motives underlying their management of information. This will help the necessary integration of information management in the workload of the healthcare professionals and the compatibility of the prototypes with the daily activity of the users.

  6. 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.

  7. 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

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

    PubMed

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

    2010-01-01

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

  9. Systematic review of factors influencing the adoption of information and communication technologies by healthcare professionals.

    PubMed

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

    2012-02-01

    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.

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

    PubMed

    Grams, R R

    1998-10-01

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

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

    ERIC Educational Resources Information Center

    Muglia, Victor O.

    2010-01-01

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

  12. 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

  13. 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.

  14. Understanding requirements of novel healthcare information systems for management of advanced prostate cancer.

    PubMed

    Wagholikar, Amol S; Fung, Maggie; Nelson, Colleen C

    2012-01-01

    Effective management of chronic diseases is a global health priority. A healthcare information system offers opportunities to address challenges of chronic disease management. However, the requirements of health information systems are often not well understood. The accuracy of requirements has a direct impact on the successful design and implementation of a health information system. Our research describes methods used to understand the requirements of health information systems for advanced prostate cancer management. The research conducted a survey to identify heterogeneous sources of clinical records. Our research showed that the General Practitioner was the common source of patient's clinical records (41%) followed by the Urologist (14%) and other clinicians (14%). Our research describes a method to identify diverse data sources and proposes a novel patient journey browser prototype that integrates disparate data sources.

  15. 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

  16. 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

  17. Primary healthcare in Portugal: 10 years of contractualization of health services in the region of Lisbon.

    PubMed

    Monteiro, Baltazar Ricardo; Pisco, Ana Maria Silva Azenha; Candoso, Fátima; Bastos, Sónia; Reis, Magda

    2017-03-01

    Contractualization consists in the development and implementation of a documented agreement whereby one party (payer) provides compensation to the other party (provider) in exchange for a set of health services to a targeted population. We describe, through a case study, the history and the process of implementation of primary health care contractualization (since 1992) in Portugal, emphasizing the consolidation and future challenges of the primary healthcare reform started in 2005. This article resorts to a case study to reflect on the results obtained in the Cluster of Health Centers of the Northern West, Regional Administration of Lisbon and Tagus Valley, between 2009 and 2015, following implementation of contractualization. It was found that the incentive-related payments will have to be weighted considering the results obtained, strongly influenced by epidemiological and socioeconomic change.

  18. Informing Women on Menopause and Hormone Therapy: Know the Menopause a Multidisciplinary Project Involving Local Healthcare System

    PubMed Central

    Donati, Serena; Satolli, Roberto; Colombo, Cinzia; Senatore, Sabrina; Cotichini, Rodolfo; Da Cas, Roberto; Spila Alegiani, Stefania; Mosconi, Paola

    2013-01-01

    Background Hormone therapy (HT) in the menopause is still a tricky question among healthcare providers, women and mass media. Informing women about hormone replacement therapy was a Consensus Conference (CC) organized in 2008: the project Know the Menopause has been launched to shift out the results to women and healthcare providers and to assess the impact of the cc’s statement. Methods And Findings: The project, aimed at women aged 45-60 years, was developed in four Italian Regions: Lombardy, Tuscany, Lazio, Sicily, each with one Local Health Unit (LHU) as “intervention” and one as “control”. Activities performed were: survey on the press; training courses for health professionals; educational materials for target populations; survey aimed at women, general practitioners (GPs), and gynaecologists; data analysis on HT drugs’ prescription. Local activities were: training courses; public meetings; dissemination on mass media. About 3,700 health professionals were contacted and 1,800 participated in the project. About 146,500 printed leaflets on menopause were distributed to facilitate the dialogue among women and health care professionals. Training courses and educational cascade-process activities: participation ranged 25- 72% of GPs, 17-71% of gynaecologists, 14-78% of pharmacists, 34-85% of midwives. Survey: 1,281 women interviewed. More than 90% believed menopause was a normal phase in life. More than half did not receive information about menopause and therapies. HT prescription analysis: prevalence fell from 6% to 4% in five years. No differences in time trends before-after the intervention. Major limitations are: organizational difficulties met by LHU, too short time for some local activities. Conclusions A huge amount of information was spread through health professionals and women. The issue of menopause was also used to discuss women’s wellbeing. This project offered an opportunity to launch a multidisciplinary, multimodal approach to

  19. 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.

  20. 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.

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

    PubMed

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

    1999-01-01

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

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

    PubMed Central

    Graves, Barbara Ann

    2008-01-01

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

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

    PubMed

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

    2016-01-01

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

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

    PubMed

    Dietzel

    1999-12-16

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

  5. 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.

  6. 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

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

    PubMed

    Bhavnani, Suresh K; Peck, Frederick A

    2010-04-01

    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.

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

    PubMed

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

    2014-09-01

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

  9. 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.

  10. The Electronic Healthcare Record for Clinical Research (EHR4CR) information model and terminology.

    PubMed

    Ouagne, David; Hussain, Sajjad; Sadou, Eric; Jaulent, Marie-Christine; Daniel, Christel

    2012-01-01

    A major barrier to repurposing routinely collected data for clinical research is the heterogeneity of healthcare information systems. Electronic Healthcare Record for Clinical Research (EHR4CR) is a European platform designed to improve the efficiency of conducting clinical trials. In this paper, we propose an initial architecture of the EHR4CR Semantic Interoperability Framework. We used a model-driven engineering approach to build a reference HL7-based multidimensional model bound to a set of reference clinical terminologies acting as a global as view model. We then conducted an evaluation of its expressiveness for patient eligibility. The EHR4CR information model consists in one fact table dedicated to clinical statement and 4 dimensions. The EHR4CR terminology integrates reference terminologies used in patient care (e.g LOINC, ICD-10, SNOMED CT, etc). We used the Object Constraint Language (OCL) to represent patterns of eligibility criteria as constraints on the EHR4CR model to be further transformed in SQL statements executed on different clinical data warehouses.

  11. 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

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

    PubMed Central

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

    2012-01-01

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

  14. 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,…

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

    PubMed

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

    2000-01-01

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

  16. 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.

  17. Region 7 Laboratory Information Management System

    EPA Pesticide Factsheets

    This is metadata documentation for the Region 7 Laboratory Information Management System (R7LIMS) which maintains records for the Regional Laboratory. Any Laboratory analytical work performed is stored in this system which replaces LIMS-Lite, and before that LAST. The EPA and its contractors may use this database. The Office of Policy & Management (PLMG) Division at EPA Region 7 is the primary managing entity; contractors can access this database but it is not accessible to the public.

  18. [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.

  19. 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...

  20. Information system interoperability in a regional health care system infrastructure: a pilot study using health care information standards.

    PubMed

    Spyrou, Stergiani S; Berler, Alexander A; Bamidis, Panagiotis D

    2003-01-01

    The 1st and 2nd Regional Health Care System Authority of Central Macedonia (1st and 2nd PeSY) are two of the seventeen Regional Healthcare System Authorities in Greece. Every single PeSY aims to improve the level of quality that health care organisations offer as well as to control the expenditure of health care services provided by the health care organisations, Hospitals and Primary Care Health units. There is currently an urgent need for Regional Health Authorities to deploy integrated healthcare information system, based on secure networks. The limited interoperability of current hospital information systems (HIS) poses a risk for the management of patient related information since there is a difficulty to transform processed data into useful information and knowledge. Thus, a pilot system was developed to achieve data integration record synchronisation using the Health Level 7 protocol between the existing HIS of two Hospitals of Thessaloniki and the central Offices of the PeSY. The pilot was funded by the Third Community Support Framework (jointly funded by EU and Greece) funds in order to prepare the forthcoming major healthcare IT projects in Greece. It is shown that such a system is pragmatic, achieves data integration and provides acceptable integration costs.

  1. 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.

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

    PubMed

    Tieman, Jennifer; Bradley, Sandra L

    2013-01-01

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

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

    PubMed

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

    2009-01-01

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

  4. 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

  5. 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.

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

    PubMed Central

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

    2014-01-01

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

  7. 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.

  8. Consumer support for health information exchange and personal health records: a regional health information organization survey.

    PubMed

    Patel, Vaishali N; Dhopeshwarkar, Rina V; Edwards, Alison; Barrón, Yolanda; Sparenborg, Jeffrey; Kaushal, Rainu

    2012-06-01

    In order to characterize consumer support for electronic health information exchange (HIE) and personal health records (PHRs) in a community where HIE is underway, we conducted a survey of English speaking adults who visited primary care practices participating in a regional community-wide clinical data exchange, during August, 2008. Amongst the 117 respondents, a majority supported physicians' use of HIE (83%) or expressed interest in potentially using PHRs (76%). Consumers' comfort sending personal information electronically over the Internet and their perceptions regarding the potential benefits of HIE were independently associated with their support for HIE. Consumers' prior experience using the Internet to manage their healthcare, perceptions regarding the potential benefits of PHRs and college education were independently associated with potential PHR use. Bolstering consumer support for HIE and PHRs will require addressing privacy and security concerns, demonstrating clinical benefits, and reaching out to those who are less educated and computer literate.

  9. 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

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

    PubMed

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

    2015-12-11

    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).

  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.

  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. 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.

  15. 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

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

    PubMed

    Alam, Rahul; Speed, Shaun; Beaver, Kinta

    2012-03-01

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

  17. The Triangle Model for evaluating the effect of health information technology on healthcare quality and safety.

    PubMed

    Ancker, Jessica S; Kern, Lisa M; Abramson, Erika; Kaushal, Rainu

    2012-01-01

    With the proliferation of relatively mature health information technology (IT) systems with large numbers of users, it becomes increasingly important to evaluate the effect of these systems on the quality and safety of healthcare. Previous research on the effectiveness of health IT has had mixed results, which may be in part attributable to the evaluation frameworks used. The authors propose a model for evaluation, the Triangle Model, developed for designing studies of quality and safety outcomes of health IT. This model identifies structure-level predictors, including characteristics of: (1) the technology itself; (2) the provider using the technology; (3) the organizational setting; and (4) the patient population. In addition, the model outlines process predictors, including (1) usage of the technology, (2) organizational support for and customization of the technology, and (3) organizational policies and procedures about quality and safety. The Triangle Model specifies the variables to be measured, but is flexible enough to accommodate both qualitative and quantitative approaches to capturing them. The authors illustrate this model, which integrates perspectives from both health services research and biomedical informatics, with examples from evaluations of electronic prescribing, but it is also applicable to a variety of types of health IT systems.

  18. Optimizing information technology to improve sexual health-care delivery: public and patient preferences.

    PubMed

    Ross, J D C; Copas, A; Stephenson, J; Fellows, L; Gilleran, G

    2007-07-01

    Information and communication technology (ICT) has the potential to improve the quality of care and efficiency in sexual health clinics, but its introduction requires input not only from health-care professionals and ICT specialists but also from service users and potential future users. In this study, views on ICT in relation to the delivery of sexual health services were assessed using a structured interview in two groups - a community sample of young people and a clinic sample of existing patients. In all, 542 community interviewees and 202 clinic patients participated. About 75% of respondents had access to the Internet and overall 60% reported that the self-collection of a sexual history on an electronic form was acceptable. Black Caribbean individuals had significantly less access to the Internet and a lower acceptance of electronic data collection. For booking an appointment, the majority of patients reported the telephone (community sample 93%, clinic sample 96%) or attending in person (community sample 77%, clinic sample 54%) to be acceptable, with a smaller proportion choosing email (community sample 10%, clinic sample 27%) or the Internet (community sample 7%, clinic sample 11%). Electronic booking was significantly less acceptable to Black Caribbean respondents. Although new technologies offer the opportunity to improve the quality of sexual health services, patient preferences and differences between groups in access to technology also need to be considered when services are reconfigured.

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

    PubMed

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

    2016-03-01

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

  20. [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.

  1. [Healthcare expenditure].

    PubMed

    Huguier, Michel

    2012-10-01

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

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

    PubMed

    Zvárová, Jana; Pribík, Vladimír

    2002-11-20

    A prognosis of how the information society in health care will look like in 2013 must start from the current state of affairs at the given locality regarding healthcare management by public authorities including legislative, ICT technological levels and accessibility of professional knowledge in individual fields of medicine. It is presumed that after 10 years the influence of this 'starting point' will still persist and knowledge of the current state of affairs will be needed to positively but also negatively differentiates the prognosis [Health Care in the Information Society: A Prognosis for the Year 2013, in this issue] for individual localities, e.g. Germany versus neighbouring the Czech Republic. The present article focuses on aims of Czech health care and the measures that are taken in Czech health care that are carried out and which have been already initiated. Their significance towards the future prognosis according to [Health Care in the Information Society: A Prognosis for the Year 2013, in this issue] is clear. The first measure is legalisation of conditions, which allow health care administration only be carried out with electronic forms and the protection of these sensitive personal data when they are placed in a centralised data depository where they are prepared for physicians who use them while providing health care in health institutions. In the Czech Republic an information system is developed called Internet Access to Health Patient Information (IHPI). The second measure is creating a unified central system of health information together with methodologies for data collection, data standards and protocols. In the Czech Republic there is the National Health Information System (NHIS) governed by the Institute for Health Information and Statistics (IHIS CR). The NHIS enables care providers to get information about the health state of citizens, about health institutions, about their activities and economics, it enables to regulate the provision of

  3. 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

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

    PubMed

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

    2012-07-01

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

  5. 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.

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

    PubMed Central

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

    2014-01-01

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

  7. 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.

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

    PubMed Central

    Sittig, Dean F.; Singh, Hardeep

    2011-01-01

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

  9. Healthcare Lean.

    PubMed

    Long, John C

    2003-01-01

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

  10. 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.

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

    PubMed Central

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

    2014-01-01

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

  12. 77 FR 2299 - Agency Information Collection Activities; Proposed Collection; Comment Request; Healthcare...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-01-17

    ... Collection; Comment Request; Healthcare Professional Survey of Prescription Drug Promotion AGENCY: Food and... Survey of Prescription Drug Promotion. This survey is designed to explore the opinions and perceptions of physicians, nurse practitioners, and physician assistants with regard to the promotion of prescription...

  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. PMID:27610246

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

    PubMed Central

    Yucesoy, Berran; Talzhanov, Yerkebulan; Barmada, M. Michael; 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

    2017-01-01

    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

  16. Patient dumping, outlier payments, and optimal healthcare payment policy under asymmetric information.

    PubMed

    Takahara, Tsuyoshi

    2016-12-01

    We analyze a rationale for official authorization of patient dumping in the prospective payment policy framework. We show that when the insurer designs the healthcare payment policy to let hospitals dump high-cost patients, there is a trade-off between the disutility of dumped patients (changes in hospitals' rent extraction due to low-severity patients) and the shift in the level of cost reduction efforts for high-severity patients. We also clarify the welfare-improving conditions by allowing hospitals to dump high-severity patients. Finally, we show that if the efficiency of the cost reduction efforts varies extensively and the healthcare payment cost is substantial, or if there are many private hospitals, the patient dumping policy can improve social welfare in a wider environment.

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

    PubMed

    Hao, Haijing; Padman, Rema; Telang, Rahul

    2011-01-01

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

  18. 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

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

    PubMed

    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.

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

    PubMed Central

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

    2016-01-01

    The integration of behavioral health services in primary care has been referred to in many ways, but ultimately refers to common structures and processes. Behavioral health is integrated into primary care because it increases the effectiveness and efficiency of providing care and reduces costs in the care of primary care patients. Reimbursement is one factor, if not the main factor, that determines the level of integration that can be achieved. The federal health reform agenda supports changes that will eventually permit behavioral health to be fully integrated and will allow the health of the population to be the primary target of intervention. In an effort to develop more integrated services at Baylor Scott and White Healthcare, models of integration are reviewed and the advantages and disadvantages of each model are discussed. Recommendations to increase integration include adopting a disease management model with care management, planned guideline-based stepped care, follow-up, and treatment monitoring. Population-based interventions can be completed at the pace of the development of alternative reimbursement methods. The program should be based upon patient-centered medical home standards, and research is needed throughout the program development process. PMID:27034543

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

    PubMed Central

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

    2010-01-01

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

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

    PubMed

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

    2010-04-01

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

  3. Regional Logistics Information Resources Integration Patterns and Countermeasures

    NASA Astrophysics Data System (ADS)

    Wu, Hui; Shangguan, Xu-ming

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

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

    PubMed

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

    2009-01-01

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

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

    ERIC Educational Resources Information Center

    Regional Development Dialogue, 1987

    1987-01-01

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

  6. 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

  7. 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.

  8. 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.

  9. 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.

  10. 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.

  11. [Collecting and sharing information about dietary supplements and functional foods among healthcare professionals using internet-based system].

    PubMed

    Asahina, Yasuko; Hori, Satoko; Sawada, Yasufumi

    2010-01-01

    Since we do not know much about the efficacy and safety of dietary supplements and functional foods (DS), it is important to collect DS-related events and to share the information among healthcare professionals. Therefore, we aimed to develop an internet-based system which would allow medical doctors and pharmacists to report DS-related events. We conducted a questionnaire survey among pharmacists about their experiences and views of DS-related adverse event reporting. Many pharmacists did not report events because they never had any patient who reported an event. This might have been, in part, owing to lack of awareness of an occurrence, so we collected events using our internet-based system, which periodically offers educational DS information. After educational commentaries and elucidation were appended, collected cases were distributed to the registered members via web pages to encourage them to be more concerned about the safety of DS. Additionally, we constructed a simple posting system for members to easily report similar events, because the questionnaire survey revealed that lack of time and uncertainty of causal relation between an event and DS were sometimes reasons not to report. We obtained several DS-related events both via the normal data collecting form and the simple posting system, and subsequently confirmed reports by e-mail contact. Our interactive system enabled us to obtain more detailed information about posted events. In conclusion, this information system for DS was proved to be useful to facilitate reporting of DS-related events by healthcare professionals and to accumulate events similar to already reported cases.

  12. 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

  13. 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.

  14. Arctic Region Policy: Information Sharing Model Options

    DTIC Science & Technology

    2010-09-01

    complying. ( Ostrom , 2010) D. CONCLUSION The 2009 Arctic Region Policy highlights the need to develop capabilities to protect U.S. air, land and sea...polar icebreaker modernization: Background, issues, and options for Congress (RL34391). Washington, DC: Congressional Research Service. Ostrom , E

  15. 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.

  16. Quality of neonatal healthcare in Kilimanjaro region, northeast Tanzania: learning from mothers' experiences

    PubMed Central

    2013-01-01

    Background With a decline of infant mortality rates, neonatal mortality rates are striking high in development countries particularly sub Saharan Africa. The toolkit for high quality neonatal services describes the principle of patient satisfaction, which we translate as mother’s involvement in neonatal care and so better outcomes. The aim of the study was to assess mothers’ experiences, perception and satisfaction of neonatal care in the hospitals of Kilimanjaro region of Tanzania. Methods A cross sectional study using qualitative and quantitative approaches in 112 semi structured interviews from 14 health facilities. Open ended questions for detection of illness, care given to the baby and time spent by the health worker for care and treatment were studied. Probing of the responses was used to extract and describe findings by a mix of in-depth interview skills. Closed ended questions for the quantitative variables were used to quantify findings for statistical use. Narratives from open ended questions were coded by colours in excel sheet and themes were manually counted. Results 80 mothers were interviewed from 13 peripheral facilities and 32 mothers were interviewed at a zonal referral hospital of Kilimanjaro region. 59 mothers (73.8%) in the peripheral hospitals of the region noted neonatal problems and they assisted for attaining diagnosis after a showing a concern for a request for further investigations. 11 mothers (13.8%) were able to identify the baby’s diagnosis directly without any assistance, followed by 7 mothers (8.7%) who were told by a relative, and 3 mothers (3.7%) who were told of the problem by the doctor that their babies needed medical attention. 24 times mothers in the peripheral hospitals reported bad language like “I don’t have time to listen to you every day and every time.” 77 mothers in the periphery (90.6%) were not satisfied with the amount of time spent by the doctors in seeing their babies. Conclusion Mothers of the

  17. 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

  18. 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…

  19. 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.

  20. Using Geographic Information Systems (GIS) to Examine Barriers to Healthcare Access for Hispanic and Latino Immigrants in the U.S. South.

    PubMed

    Edward, Jean; Biddle, Donald J

    2017-04-01

    Geographic barriers to accessing timely and appropriate primary health care services have been identified as significant social determinants of health that contribute to the growing health inequities among Hispanic and Latino immigrants in the United States. The purpose of this study was to examine the geographic factors that serve as barriers to healthcare access for Hispanic and Latino immigrants in the southern community of Louisville, Kentucky. Accessibility to healthcare services was examined using spatial analysis techniques, a Geographic Information System and geographic data from the U.S. Census Bureau and the Louisville and Jefferson County Information Consortium. Results from this study indicated that physical location, socioeconomic factors, distance, and transportation served as barriers to accessing healthcare services. Findings provide significant implications for future research and policy-based interventions focused on eliminating geographic barriers and promoting social and health equity for the underserved.

  1. 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.

  2. Place Matters in Non-Traditional Migration Areas: Exploring Barriers to Healthcare for Latino Immigrants by Region, Neighborhood, and Community Health Center.

    PubMed

    Topmiller, Michael; Zhen-Duan, Jenny; Jacquez, Farrah J; Vaughn, Lisa M

    2016-12-30

    This paper identifies differences in adult Latino immigrant barriers to healthcare in the Cincinnati area in Hamilton County, OH, on three levels: by region, by neighborhood, and by community health center. Secondary data analysis was performed on 439 surveys. Respondents were aggregated by the geographic regions and neighborhoods where they live and by two community health centers where they receive care. Outcome measures included pragmatic and skill barrier indices adapted from the Barriers to Care Questionnaire (BCQ); the pragmatics index consists logistical barriers, including transportation and cost; the skills index is made up of items related to navigating the healthcare system, including communicating with physicians and completing paperwork. The results indicate that immigrant Latinos living in western Cincinnati and northern Hamilton County face significantly higher pragmatic barriers to care, while Latino immigrants going to a community health center in western Cincinnati have significantly fewer pragmatic and skill barriers than immigrants utilizing a nearby community health center. Because healthcare options for undocumented immigrants do not improve with the Affordable Care Act, community health centers will continue to serve as their primary source of care. This is particularly true in non-traditional migration areas, where immigrants tend to be isolated and lack resources. Efforts to improve access to healthcare for immigrant Latinos require place-based approaches that allow for targeted resources to improve care in these locations. This study helps to fill that need by identifying variation in barriers to care on multiple levels and offering strategies to alleviate these barriers.

  3. 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.

  4. 78 FR 4983 - Proposed Information Collection; Women Veterans Healthcare Barriers Survey Activity: Comment Request

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-23

    ....Regulations.gov ; or to Cynthia Harvey-Pryor, Veterans Health Administration (10P7BFP), Department of Veterans Affairs, 810 Vermont Avenue NW, Washington, DC 20420 or email: cynthia.harvey-pryor@va.gov . Please refer...: Cynthia Harvey-Pryor at (202) 461-5870 or FAX (202) 273-9381. SUPPLEMENTARY INFORMATION: Under the PRA...

  5. 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.

  6. 77 FR 60997 - Agency for Healthcare Research and Quality Agency Information Collection Activities: Proposed...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-05

    ...) create a library of patient health education materials, (3) review EHR's patient education capabilities... and literature on consumers' understanding of health information. Seek TEP review of the summary of... reliability of the HIRS on English- language health education materials. Seek TEP review of results...

  7. 76 FR 61707 - Agency for Healthcare Research and Quality Agency Information Collection Activities: Proposed...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-05

    ...: AHRQ's OMB Desk Officer by fax at (202) 395-6974 (attention: AHRQ's desk officer) or by e-mail at OIRA...) 427-1477, or by e-mail at doris.lefkowitz@AHRQ.hhs.gov . SUPPLEMENTARY INFORMATION: Proposed Project... support the R21 and R24 complex patient grantees, AHRQ funded a Learning Network and Technical...

  8. 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.

  9. 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

  10. 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

  11. 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

  12. Lean healthcare.

    PubMed

    Weinstock, Donna

    2008-01-01

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

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

    PubMed Central

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

    2013-01-01

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

  14. Information storage for health-care providers: it's not as simple as it seems.

    PubMed

    Hanauer, David

    2004-01-01

    As medical practices migrate from paper to computers for record keeping, new issues surrounding the safe storage of such data are arising. These range from choosing an electronic storage format to ensuring that any electronic information stored today will be available and readable years into the future. Privacy and security issues also continue to be important, especially since the HIPAA regulations were instituted. With the rapid advances in technology, finding the right solution may be like trying to hit a moving target, yet some basic principles, outlined in this article, should make this difficult task easier.

  15. A region growing vessel segmentation algorithm based on spectrum information.

    PubMed

    Jiang, Huiyan; He, Baochun; Fang, Di; Ma, Zhiyuan; Yang, Benqiang; Zhang, Libo

    2013-01-01

    We propose a region growing vessel segmentation algorithm based on spectrum information. First, the algorithm does Fourier transform on the region of interest containing vascular structures to obtain its spectrum information, according to which its primary feature direction will be extracted. Then combined edge information with primary feature direction computes the vascular structure's center points as the seed points of region growing segmentation. At last, the improved region growing method with branch-based growth strategy is used to segment the vessels. To prove the effectiveness of our algorithm, we use the retinal and abdomen liver vascular CT images to do experiments. The results show that the proposed vessel segmentation algorithm can not only extract the high quality target vessel region, but also can effectively reduce the manual intervention.

  16. The National Cancer Institute’s Health Information National Trends Survey [HINTS]: a national cross-sectional analysis of talking to your doctor and other healthcare providers for health information

    PubMed Central

    2014-01-01

    Background The need to understand preferred sources of health information remains important to providing patient-centered care. The Internet remains a popular resource for health information, but more traditional sources may still be valid for patients during a recent health need. This study sought to understand the characteristics of patients that turn to their doctor or healthcare provider first for a recent health or medical information need. Methods Using the national cross-sectional survey, Health Information National Trend Study [HINTS], characteristics of those who sought a doctor or healthcare provider for a recent health information need were compared to other sources. Weighted survey responses from Cycle 1 and Cycle 2 of the HINTS survey were used for multivariable logistic regression. Results A total 5,307 patient responses were analyzed. Overall, those who seek a doctor or healthcare provider first for a health need are female, 46–64 years, White non-Hispanic, educated, in good health and users of the Internet. Yet, adjusted logistic regressions showed that those who sought a doctor or healthcare provider first during a recent health information need compared to other sources were most likely to be 65+ years, in poor health, less educated and have health insurance. Conclusions Patients who seek their doctor or healthcare provider first for health information rather than other sources of information represent a unique population. Doctors or healthcare providers remain an important resource for these patients during recent needs, despite the wide use of the Internet as a source of health information. PMID:24906558

  17. 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.

  18. Methodical Bases for the Regional Information Potential Estimation

    ERIC Educational Resources Information Center

    Ashmarina, Svetlana I.; Khasaev, Gabibulla R.; Mantulenko, Valentina V.; Kasarin, Stanislav V.; Dorozhkin, Evgenij M.

    2016-01-01

    The relevance of the investigated problem is caused by the need to assess the implementation of informatization level of the region and the insufficient development of the theoretical, content-technological, scientific and methodological aspects of the assessment of the region's information potential. The aim of the research work is to develop a…

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

    PubMed

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

    2009-11-01

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

  20. The regional drug information service: a factor in health care?

    PubMed

    Leach, F N

    1978-03-25

    Most regional health authorities throughout the United Kingdom have established drug information units to provide health service staff with a wide range of information about drugs and drug use. The units, which are staffed by drug information pharmacists, provide their service mainly by answering inquiries, although some disseminate information more positively through lectures and bulletins.An analysis of inquiries received by regional information units during 1976 showed that most were submitted by hospital doctors or pharmacists; comparatively few were received from general practitioners. Topics of inquiry included adverse effects of drugs, source of supply and identification, current treatment, dosage, route, precautions, and pharmaceutical problems such as stability or formulation of drug preparations. A more detailed analysis of the inquiries received by the North-western Regional Drug Information Service at Manchester over three years showed that the number of inquiries gradually increased and that more were received from general practitioners after a programme of lectures had been introduced to tell them about the service. The North-western service also received more requests from hospital pharmacists than other units, though many originated from clinicians.The regional drug information units consulted widely with clinical and other specialists in answering questions, but about a quarter of all inquiries were pharmaceutical, relating to stability and incompatibility. A multidisciplinary approach therefore seems necessary to provide a comprehensive and advisory drug information service.

  1. The regional drug information service: a factor in health care?

    PubMed Central

    Leach, F N

    1978-01-01

    Most regional health authorities throughout the United Kingdom have established drug information units to provide health service staff with a wide range of information about drugs and drug use. The units, which are staffed by drug information pharmacists, provide their service mainly by answering inquiries, although some disseminate information more positively through lectures and bulletins. An analysis of inquiries received by regional information units during 1976 showed that most were submitted by hospital doctors or pharmacists; comparatively few were received from general practitioners. Topics of inquiry included adverse effects of drugs, source of supply and identification, current treatment, dosage, route, precautions, and pharmaceutical problems such as stability or formulation of drug preparations. A more detailed analysis of the inquiries received by the North-western Regional Drug Information Service at Manchester over three years showed that the number of inquiries gradually increased and that more were received from general practitioners after a programme of lectures had been introduced to tell them about the service. The North-western service also received more requests from hospital pharmacists than other units, though many originated from clinicians. The regional drug information units consulted widely with clinical and other specialists in answering questions, but about a quarter of all inquiries were pharmaceutical, relating to stability and incompatibility. A multidisciplinary approach therefore seems necessary to provide a comprehensive and advisory drug information service. PMID:630339

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

    ERIC Educational Resources Information Center

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

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

  3. Implementation of a Regional Healthcare Information Organization in South Central Texas

    DTIC Science & Technology

    2007-12-06

    Antonio Hospital Council REPORT NUMBER 7500 US Highway 90 West AT&T Building, Suite 200 San Antonio, TX 78227-4023 9. SPONSORINGIMONITORING AGENCY NAME(S...AND ADDRESS(ES) 10. SPONSORMONITOR’S ACRONYM(S) US Army Medical Department Center and School BLDG 2841 MCCS-HFB (Army-Baylor Program in Health and...Business Administration) 3151 Scott Road Suite 1411 11. SPONSORIMONITOR’S REPORT Fort Sam Houston, TX 78234-6135 NUMBER(S) 34-06 12. DISTRIBUTION

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

    PubMed

    Shanmugasundaram, Jothiganesh; Soulalay, Vongdeuane; Chettiyappan, Visvanathan

    2012-06-01

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

  5. 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.

  6. 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.

  7. Mobile healthcare.

    PubMed

    Morgan, Stephen A; Agee, Nancy Howell

    2012-01-01

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

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

    PubMed

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

    2016-06-01

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

  9. The Oklahoma Health Information Technology Regional Extension Center.

    PubMed

    Bratzler, Dale W

    2010-09-01

    With the passage of the Health Information Technology for Economic and Clinical Health Act (HITECH) the government has created a network of Health Information Technology Regional Extension Centers to provide direct technical assistance to primary care providers in small practices to adopt and meaningfully use electronic health records (EHR). Regional Extension Centers will work directly with practitioner offices to identify effective strategies to select, implement, and meaningfully use certified EHR technology. The Oklahoma Foundation for Medical Quality (OFMQ) was awarded the cooperative agreement to serve as the Regional Extension Center for the state, and is actively recruiting practices to provide support on implementation of an EHR. There is some urgency for physician practices to consider work with the Regional Extension Center since the federal matching funding for the program will be substantially reduced beginning in 2012, and because the incentive funds for a practice that adopts and meaningfully uses an EHR are reduced beginning in 2013.

  10. 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.

  11. 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

  12. 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.

  13. Taking a Regional Healthcare Coalition Approach to Mitigating Surge Capacity Needs of Mass Casualty or Pandemic Events

    DTIC Science & Technology

    2012-06-01

    at Flagler College, who prepared me for the rigors of a postgraduate degree, and Dr. Joe Saviak, who pushed my writing skills beyond what I thought...establish a healthcare coalition. 105 Harry P. Hatry, Jake Cowan, Ken Weider and Linda Lampkin...TerrorismCapabilitiesSeptem.aspx. Hatry, Harry P., Jake Cowan, Ken Weider , and Linda Lampkin. “Developing community-wide outcome indicators for specific services.” 2003

  14. 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.

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

    PubMed Central

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

    2014-01-01

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

  16. Early Experience of the Contribution of an Information Specialist within a Primary Healthcare Team: A Partnership Venture between Library and Healthcare Services

    ERIC Educational Resources Information Center

    Wilson, Diane; Bateman, Hilarie; Bailey, Peter

    2004-01-01

    This article describes the early experience of an Information Officer appointed within a newly formed primary health care team in the new township of Cambourne, west of Cambridge. The post was jointly defined and funded through a partnership between Cambridgeshire Libraries, the Primary Care Trust and Monkfield Medical Practice. The article…

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

    PubMed

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

    2015-10-01

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

  18. 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.

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

    PubMed

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

    2014-07-01

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

  20. [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.

  1. [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.

  2. Building an interoperable regional health information network today with IHE integration profiles.

    PubMed

    Donnelly, John; Mussi, José; Parisot, Charles; Russler, Dan

    2006-01-01

    One of the key challenges of architecting electronic record sharing solutions that are scalable and can provide acceptable performance is how to create a longitudinal record for a patient when the desired data will be stored in several distributed point-of-service systems. This paper will review the design and standards selection process that has been made by Integrating the Healthcare Enterprise, a multi-national collaborative of care providers and developers that analyzed a variety of approaches. In particular, the requirements, issues, and alternative solutions for scalable, standards-based data locating services supporting regional and national health information exchange solutions will be discussed. Guidance will be offered to architects of regional health information organizations to take advantage of this experience and leverage the IHE Technical Framework, its testing processes, and tools to accelerate their projects and facilitate the interfacing of EHR systems serving different care settings from different vendors or developers. The implementation experience in 2005-2006 of the IHE Integration Profile specifications supporting an interoperable RHIO solution among various EHR systems from more than 30 vendors will be analyzed, with key lessons summarized.

  3. 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.

  4. Healthcare provider attitudes, practices, and recommendations for enhancing routine HIV testing and linkage to care in the Mississippi Delta region.

    PubMed

    Sison, Nathan; Yolken, Annajane; Poceta, Joanna; Mena, Leandro; Chan, Philip A; Barnes, Arti; Smith, Erin; Nunn, Amy

    2013-09-01

    The Mississippi Delta region is one of the communities most heavily impacted by HIV/AIDS in the United States. To understand local provider attitudes and practices regarding HIV testing and care, we conducted 25 in-depth qualitative interviews with local primary care providers and infectious disease specialists. Interviews explored attitudes and practices regarding HIV testing and linkage to care. Most providers did not routinely offer HIV testing, noting financial barriers, financial disincentives to offer routine screening, misperceptions about local informed consent laws, perceived stigma among patients, and belief that HIV testing was the responsibility of the health department. Barriers to enhancing treatment and care included stigma, long distances, lack of transportation, and paucity of local infectious disease specialists. Opportunities for enhancing HIV testing and care included provider education programs regarding billing, local HIV testing guidelines, and informed consent, as well as telemedicine services for underserved counties. Although most health care providers in our study did not currently offer routine HIV testing, all were willing to provide more testing and care services if they were able to bill for routine testing. Increasing financial reimbursement and access to care, including through the Affordable Care Act, may provide an opportunity to enhance HIV/AIDS services in the Mississippi Delta.

  5. 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

    2016-01-14

    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.

  6. 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

  7. 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.

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

    PubMed

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

    2011-01-01

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

  9. Assessing the evolution of primary healthcare organizations and their performance (2005-2010) in two regions of Québec province: Montréal and Montérégie

    PubMed Central

    2010-01-01

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

  10. 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

  11. Bronchial asthma healthcare costs in Mexico: analysis of trends from 1991-1996 with information from the Mexican Institute of Social Security.

    PubMed

    Rico-Méndez, F G; Barquera, S; Cabrera, D A; Escobedo, S; Ochoa, L G; Massey-Reynaud, L F

    2000-01-01

    Cost trends for bronchial asthma have not been previously estimated in Mexico. The increasing prevalence of bronchial asthma as well as its elevated costs make it necessary to expand the availability of information for health planners. This is a growing problem which has been given little attention in national health reports. We did a descriptive, retrospective analysis using national data from the Mexican Institute for Social Security. We estimated the number of medical consultations provided by the state family medicine and specialty areas. A total of 756,843 consultations due to bronchial asthma were provided between 1991 and 1996 in the service areas under study. The healthcare expenditure for bronchial asthma showed an ascending and sustained trend during the study period. When analyzing the trends by type of service, a significant increase in in-hospital care was observed, ranging from US $14.5 (1991) to $19.8 (1996) million and a maximum of $28.4 (1994) million. A similar increase was found in specialty consultation, from $3.96 (1991) to $8.5 (1996) million; in emergencies, from $1. 1 (1991) to $2.9 (1996) million; and family medicine, from $0.66 (1991) to $0.79 (1996) million. Bronchial asthma follows the same pattern as other noncommunicable chronic diseases, increasing in highly urbanized areas and nationwide. In order to improve healthcare and maximize results with scarce resources, a set of strategies is presented to reduce bronchial asthma recurrence, decrease healthcare costs, and improve quality of life.

  12. 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.

  13. Region merging techniques using information theory statistical measures.

    PubMed

    Calderero, Felipe; Marques, Ferran

    2010-06-01

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

  14. 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

  15. Healthcare and Social Assistance Sector (NAICS 62)

    EPA Pesticide Factsheets

    Environmental regulations and information for the Healthcare sector, including doctor's offices, hospitals, and medical laboratories. Includes information about dental amalgam wastewater, sterilizers, and medical waste.

  16. Proactive Population Health Management in the Context of a Regional Health Information Exchange Using Standards-Based Decision Support

    PubMed Central

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

    2007-01-01

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

  17. 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

  18. 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

  19. Characteristics of healthcare wastes

    SciTech Connect

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

    2008-07-01

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

  20. 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.

  1. 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

  2. [Personal identification using information from cranio-facial region].

    PubMed

    Minaguchi, Kiyoshi

    2007-11-01

    Much of Forensic Odontology is concerned with personal identification, through examination of cranio-facial region. This paper describes several studies in which we worked with materials derived from cranio-facial region. The following topics are addressed : (1) Human saliva contains proteins specific to salivary glands, proteins which are highly polymorphic compared with those found in other body fluids. In particular, six genes for proline-rich proteins coded many proteins found in human saliva, and we found several of them. At least five kinds of cystatin are secreted in saliva. We constructed recombinant polymorphic proteins, cystatin SAl and SA2. Using these proteins, we compared effects of amino acid mutation on protease inhibitor activity, and demonstrated a novel function for type-2 cystatin cytokine-inducing activity. (2) Among autosomal STR loci, we identified the D12S67 locus as highly polymorphic, with a heterozygosity of 95%, by investigating differences in nucleotide repeat units. Highly polymorphic autosomal STR loci offer an effective forensic tool under certain conditions, in addition to multiplex PCR, and therefore merit further study in forensic practice. (3) Although digitalization is prevalent in photography, analog images are preferable in certain circumstances as they offer better resolution. (4) Usually, information on mtDNA polymorphisms from HV1 and HV2 in the control region is used in forensic practice. However, information from the coding region considerably increases the discrimination power of mtDNA polymorphisms. It is important to increase the volume of coding region information available with regard to mtDNA polymorphisms for future forensic practice. (5) Y-STR polymorphisms are closely associated with binary haplogroups, and it is possible to estimate a binary haplogroup from an STR haplotype. (6) Mitochondrial DNA and Y-chromosomal polymorphisms can be used to determine geographic origin in individuals from East Asia, something

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

    ERIC Educational Resources Information Center

    Del Casino Jr, Vincent

    2004-01-01

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

  4. 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.

  5. Evidence-Based Knowledge Management: an approach to effectively promote good health-care decision-making in the Information Era.

    PubMed

    Corrao, Salvatore; Arcoraci, Vincenzo; Arnone, Sabrina; Calvo, Luigi; Scaglione, Rosario; Di Bernardo, Cristofaro; Lagalla, Roberto; Caputi, Achille Patrizio; Licata, Giuseppe

    2009-04-01

    The sharing of information and the growth of knowledge together represent a foundation for the promotion of quality improvement of health care systems. This paper concerns knowledge, not only from an epistemological point of view, but also from a pragmatic one. In our paper, knowledge is discussed as the hub to promote better decision making and continuous professional development. Effective thinking is particularly needed. The critical point is to think about how health care systems can develop both an effective knowledge management network and how health-care organizations can actually be based on it. In this way, knowledge and knowledge hierarchy are defined according to Russel Achkoff's vision. Generally, knowledge is crucial in decision-making, and Evidence-Based Medicine has its roots in knowledge. In particular, information management is the basis for a significant production of knowledge to promote good health-care decision-making. Thus, relationships between knowledge management and Evidence-Based Medicine are discussed, and a new paradigm is proposed: the Evidence-Based Knowledge Management. Finally, the role of Evidence-Based Knowledge Management within Clinical Governance is discussed together with some considerations about clinical governance implementation problems in Italy.

  6. Acceptability of Service Targets for ICT-Based Healthcare

    PubMed Central

    Jeon, Eun Min

    2016-01-01

    Objectives In order to adopt and activate telemedicine it is necessary to survey how medical staff, who are providers of medical service, and consumers, who are the service targets, perceive information and communication technology (ICT)-based healthcare service. Methods This study surveyed the awareness and acceptability of ICT-based healthcare by involving service targets, specifically workers and students living in the Seoul and Gyeonggi regions who are consumers of healthcare service. To determine the correlation among awareness of ICT-based healthcare, the need for self-management, and acceptability, this study conducted a correlation analysis and a simple regression analysis. Results According to the responses to the questions on the need for ICT-based healthcare service by item, blood pressure (n = 279, 94.3%) and glucose (n = 277, 93.6%) were revealed to be the physiological signal monitoring area. Among the six measurement factors affecting ICT-based healthcare service acceptability, age, health concerns, and effect expectation had the most significant effects. As effect expectation increased, acceptability became 4.38 times higher (p < 0.05). Conclusions This study identified a positive awareness of service targets on ICT-based healthcare service. The fact that acceptability is higher among people who have family disease history or greater health concerns may lead to service targets’ more active participation. This study also confirmed that a policy to motivate active participation of those in their 40s (who had high prevalence rates) was needed. PMID:27895966

  7. 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

  8. 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.

  9. 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.

  10. Delivering quality-evaluated healthcare information in the era of Web 2.0: design implications for Intute: Health and Life Sciences.

    PubMed

    Abbott, Robert

    2010-03-01

    The internet, though an invaluable and ubiquitous resource for health-related information, is perceived as being undermined by concerns about quality and reliability. Some recent developments, by permitting so-called user-generated content to be published on the internet, exacerbate these concerns. The impact of these developments, mostly characterized as Web 2.0, on the use of healthcare educational and information resources is explored in this article. There is a recognized need for an authoritative service that can address issues of quality. Intute: Health and Life Sciences is one such service, and its design in the context of meeting current Web 2.0 expectations and addressing concerns about quality is the focus of the article.

  11. 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.

  12. [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.

  13. 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

  14. 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...

  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, 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...

  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, 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...

  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, 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...

  19. 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

  20. Use of Climatic Information In Regional Water Resources Assessment

    NASA Astrophysics Data System (ADS)

    Claps, P.

    Relations between climatic parameters and hydrological variables at the basin scale are investigated, with the aim of evaluating in a parsimonious way physical parameters useful both for a climatic classification of an area and for supporting statistical models of water resources assessment. With reference to the first point, literature methods for distributed evaluation of parameters such as temperature, global and net solar radiation, precipitation, have been considered at the annual scale with the aim of considering the viewpoint of the robust evaluation of parameters based on few basic physical variables of simple determination. Elevation, latitude and average annual number of sunny days have demonstrated to be the essential parameters with respect to the evaluation of climatic indices related to the soil water deficit and to the radiative balance. The latter term was evaluated at the monthly scale and validated (in the `global' term) with measured data. in questo caso riferite al bilancio idrico a scala annuale. Budyko, Thornthwaite and Emberger climatic indices were evaluated on the 10,000 km2 territory of the Basilicata region (southern Italy) based on a 1.1. km grid. They were compared in terms of spatial variability and sensitivity to the variation of the basic variables in humid and semi-arid areas. The use of the climatic index data with respect to statistical parameters of the runoff series in some gauging stations of the region demonstrated the possibility to support regionalisation of the annual runoff using climatic information, with clear distinction of the variability of the coefficient of variation in terms of the humidity-aridity of the basin.

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

    PubMed

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

    2016-04-01

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

  2. 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

  3. 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

    ... forth in paragraph (b) of this section. (b) Procedures for disputing a report with the reporting entity... reporting entity to resolve the dispute. If the reporting entity revises the information originally... that the original information has been revised. If the reporting entity does not revise the...

  4. 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

  5. Regional Ocean Data Portal: Transforming Information to Knowledge

    NASA Astrophysics Data System (ADS)

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

    2009-12-01

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

  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.

  7. Electronic health records and information portability: a pilot study in a rural primary healthcare center in India.

    PubMed

    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.

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

    PubMed Central

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

    2014-01-01

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

  9. 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

  10. Healthcare and healthcare systems: inspiring progress and future prospects

    PubMed Central

    2016-01-01

    Background Healthcare systems globally have experienced intensive changes, reforms, developments, and improvement over the past 30 years. Multiple actors (governmental and non-governmental) and countries have played their part in the reformation of the global healthcare system. New opportunities are presenting themselves while multiple challenges still remain especially in developing countries. Better way to proceed would be to learn from historical patterns while we plan for the future in a technology-driven society with dynamic demographic, epidemiological and economic uncertainties. Methods A structured review of both peer-reviewed and gray literature on the topic was carried out. Results On the whole, people are healthier, doing better financially and live longer today than 30 years ago. The number of under-5 mortality worldwide has declined from 12.7 million in 1990 to 6.3 million in 2013. Infant and maternal mortality rates have also been reduced. However, both rates are still considered high in Africa and some Asian countries. The world’s population nearly doubled in these 30 years, from 4.8 billion in 1985 to 7.2 billion in 2015. The majority of the increasing population was coming from the least developed countries, i.e., 3.66 to 5.33 billion. The world will be short of 12.9 million health-care workers by 2035; today, that figure stands at 7.2 million. Health care expenditures among countries also show sharp differences. In high income countries, per person health expenditure is over USD 3,000 on average, while in poor countries, it is as low as USD 12, WHO estimate of minimum spending per person per year needed to provide basic, life-saving services is USD 44. The challenges faced by the global health system over the past 30 years have been increased in population and urbanization, behavioral changes, rise in chronic diseases, traumatic injuries, infectious diseases, specific regional conflicts and healthcare delivery security. Over the next 30 years

  11. 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.

  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. Healthcare in Myanmar.

    PubMed

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

    2016-05-01

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

  14. 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

  15. Intermediate Information Processing. Curriculum Improvement Project. Region II.

    ERIC Educational Resources Information Center

    Sartor, Beth

    This course curriculum is intended for community college instructors and administrators to use in implementing an intermediate 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…

  16. 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…

  17. 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.

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

    PubMed

    Al-Shammary, Dhiah; Khalil, Ibrahim

    2010-01-01

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

  19. Brain Region and Cell Type Transcripts for Informative Diagnostics

    DTIC Science & Technology

    2010-09-01

    cerebral cortex (CTX) region that is a sheet of neural tissue that is outermost to the cerebrum of the mammalian brain and takes a key role in...the cerebrum of the mammalian brain and plays a role in memory, attention, perceptual awareness, thought, language, and consciousness. The MDRN

  20. 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...

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

    PubMed

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

    2014-01-01

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

  2. 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.

  3. Mobile healthcare in the home environment.

    PubMed

    Price, Sheila; Summers, Ron

    2006-01-01

    Mobile healthcare provision in the home environment presents many challenges. Patients are becoming more informed about the management of chronic conditions and the use of technology to support the process is rising. Issues such as system interoperability, cost, security and training all have to be addressed to ensure effective use of mobile devices within the home healthcare arena. An aging population will impact upon traditional healthcare delivery methods.

  4. Willingness to Participate in Accountable Care Organization: Healthcare Managers’ Perspective

    PubMed Central

    Wan, Thomas T.H.; Demachkie, Maysoun Masri; Ortiz, Judith; Lin, Blossom Y. J.

    2014-01-01

    This study examines how healthcare managers responded to the accountable care organization (ACO). The effect of perceived benefits and barriers of the commitment to develop a strategic plan for ACOs and willingness to participate in ACOs is analyzed, using organizational social capital, health information technology uses, health systems integration and size of the health networks, geographic factors and knowledge about ACOs as predictors. Propensity score matching and analysis is used to adjust the state- and regional variations. When the number of perceived benefits is greater than the number of perceived barriers, healthcare managers are more likely to reveal a stronger commitment to develop a strategic plan for ACO adoption. Healthcare managers who perceived their organizations as lacking leadership support or commitment, financial incentives, and legal and regulatory support to ACO adoption were less willing to participate in ACOs in the future. Future research should gather more diverse views from a larger sample size of health professionals regarding ACOs participation. The perspective of healthcare managers should be seriously considered in the adoption of an innovative health care delivery system. The transparency on policy formulation should consider multiple views of healthcare managers. PMID:24463593

  5. 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…

  6. Home Healthcare Workers: How to Prevent Latex Allergies

    MedlinePlus

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

  7. 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…

  8. Healthcare seeking behaviour among Chinese elderly.

    PubMed

    Lu, Hui; Wang, Wei; Xu, Ling; Li, Zhenhong; Ding, Yan; Zhang, Jian; Yan, Fei

    2017-04-18

    Purpose The Chinese population is rapidly ageing before they are rich. The purpose of this paper is to describe healthcare seeking behaviour and the critical factors associated with healthcare seeking behaviour. Design/methodology/approach Using a purposive sampling method, the authors recruited 44 adults aged 60 years or older from three provinces, representing the developed (Shanghai), undeveloped (Ningxia) regions and the regions in between (Hubei). From July to September 2008, using a semi-structured guide, the authors interviewed participants in focus group discussions. Findings The healthcare needs for chronic and catastrophic diseases were high; however, the healthcare demands were low and healthcare utilizations were even lower owing to the limited accessibility to healthcare services, particularly, in underdeveloped rural areas. "Too expensive to see a doctor" was a prime complaint, explaining substantial discrepancies between healthcare needs, demands and use. Care seeking behaviour varied depending on insurance availability, perceived performance, particularly hospital services, and prescription medications. Participants consistently rated increasing healthcare accessibility as a high priority, including offering financial aid, and improving service convenience. Improving social security fairness was the first on the elderly's wish list. Originality/value Healthcare demand and use were lower than needs, and were influenced by multiple factors, primarily, service affordability and efficiency, perceived performance and hospital service quality.

  9. Defense Healthcare Information Assurance Program

    DTIC Science & Technology

    1999-11-01

    DRAWINGS, SPECIFICATIONS, OR OTHER DATA INCLUDED IN THIS DOCUMENT FOR ANY PURPOSE OTHER THAN GOVERNMENT PROCUREMENT DOES NOT IN ANY WAY OBLIGATE THE U.S...GOVERNMENT. THE FACT THAT THE GOVERNMENT FORMULATED OR SUPPLIED THE DRAWINGS, SPECIFICATIONS, OR OTHER DATA DOES NOT LICENSE THE HOLDER OR ANY OTHER...PERSON OR CORPORATION; OR CONVEY ANY RIGHTS OR PERMISSION TO MANUFACTURE, USE, OR SELL ANY PATENTED INVENTION THAT MAY RELATE TO THEM. LIMITED RIGHTS

  10. Strategies for navigating the healthcare credit market.

    PubMed

    Wareham, T L

    2001-04-01

    Not-for-profit healthcare organizations are experiencing a tightened credit market due to financial stresses on the healthcare industry such as declining payments, effects of the Balanced Budget Act of 1997, and the shift to outpatient care. In the future, healthcare organizations wanting to access the capital market will be expected to preserve cash as an "insurance policy," offer greater security and stricter covenants, and report financial information on a quarterly basis. To meet these requirements and navigate today's tighter credit market, healthcare financial managers will need to focus on the organization's most reliably profitable areas of business, link strategic and financial issues, and carefully monitor the balance sheet.

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

    PubMed Central

    2011-01-01

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

  12. 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.

  13. 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...

  14. Integrating Healthcare Ethical Issues into IS Education

    ERIC Educational Resources Information Center

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

    2011-01-01

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

  15. 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.

  16. 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.

  17. 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.

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

    PubMed

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

    2006-07-01

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

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

    NASA Astrophysics Data System (ADS)

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

    2010-05-01

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

  20. 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 ...

  1. Data warehousing as a healthcare business solution.

    PubMed

    Scheese, R

    1998-02-01

    Because of the trend toward consolidation in the healthcare field, many organizations have massive amounts of data stored in various information systems organizationwide, but access to the data by end users may be difficult. Healthcare organizations are being pressured to provide managers easy access to the data needed for critical decision making. One solution many organizations are turning to is implementing decision-support data warehouses. A data warehouse instantly delivers information directly to end users, freeing healthcare information systems staff for strategic operations. If designed appropriately, data warehouses can be a cost-effective tool for business analysis and decision support.

  2. 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

  3. Healthcare technology and technology assessment.

    PubMed

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

    2007-08-01

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

  4. 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

  5. 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

  6. 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.

  7. Personalized healthcare through intelligent gadgets.

    PubMed

    Jang, Hyeju; Kim, Sanghyun; Bae, Changseok

    2008-01-01

    An intelligent gadget is a wearable platform which is reconfigurable, scalable, and component-based and which can be equipped, carried as a personal accessory, or in a certain case, implanted internally into a body. Various kinds of personal information can be gathered with intelligent gadgets, and that information is used to provide specially personalized services to people in the ubiquitous computing environment. In this paper, we show a personalized healthcare service through intelligent gadgets. A service based on intelligent gadgets can be built intuitively and easily with a context representation language, called the intelligent gadget markup language (IGML) based on the event-condition-action (ECA) rule. The inherent nature of extensibility, not only environmental information but also physiological information can be specified as a context in IGML and can be dealt with an intelligent gadget with ease. It enables intelligent gadgets to be adopted to many different kinds of personalized healthcare services.

  8. 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…

  9. 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

  10. 76 FR 52317 - Proposed Information Collection; Comment Request; Northwest Region Vessel Identification...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-22

    ... 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 Vessel Identification Requirements AGENCY: National Oceanic and Atmospheric Administration...

  11. 76 FR 12339 - Proposed Information Collection; Comment Request; Southwest Region Vessel Identification...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-07

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

  12. 78 FR 19648 - Proposed Information Collection; Comment Request; Northeast Region Dealer Purchase Reports

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-02

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF COMMERCE National Oceanic and Atmospheric Administration Proposed Information Collection; Comment Request; Northeast Region Dealer Purchase Reports AGENCY: National Oceanic and Atmospheric Administration (NOAA),...

  13. 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...

  14. 78 FR 48149 - Proposed Information Collection; Comment Request; Statement of Financial Interests, Regional...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-07

    ... Proposed Information Collection; Comment Request; Statement of Financial Interests, Regional Fishery Management Councils AGENCY: National Oceanic and Atmospheric Administration (NOAA). ACTION: Notice. SUMMARY... collection). The Magnuson-Stevens Fishery Conservation and Management Act (Magnuson Stevens Act)...

  15. 78 FR 10600 - Proposed Information Collection; Comment Request; Southeast Region Logbook Family of Forms

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-14

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

  16. 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

  17. 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.

  18. [The primary healthcare centres].

    PubMed

    Brambilla, Antonio; Maciocco, Gavino

    2014-04-01

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

  19. 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

  20. Public Access to Electronic Federal Depository Information in Regional Depository Libraries.

    ERIC Educational Resources Information Center

    Ford, Stephanie

    This study describes regional depository institutions, the organization of their document collections, the staffing of their documents departments, and factors relevant to their providing access to electronic government information. Surveys were sent to 53 regional depository libraries in March 1995. Forty-one of the 53 libraries responded (77%…

  1. 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…

  2. 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

    ... Capacity Related to Regional, Sectoral, and Cross-Cutting Assessments for the 2013 U.S. National Climate... related to National Climate Assessment (NCA) regional, sectoral, and cross-cutting topics proposed for the... strategic plan, proposed report outline, and information about the National Climate Assessment...

  3. A study on an information security system of a regional collaborative medical platform.

    PubMed

    Zhao, Junping; Peng, Kun; Leng, Jinchang; Sun, Xiaowei; Zhang, Zhenjiang; Xue, Wanguo; Ren, Lianzhong

    2010-01-01

    The objective of this study was to share the experience of building an information security system for a regional collaborative medical platform (RCMP) and discuss the lessons learned from practical projects. Safety measures are analyzed from the perspective of system engineering. We present the essential requirements, critical architectures, and policies for system security of regional collaborative medical platforms.

  4. Globalization of healthcare.

    PubMed

    2012-05-01

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

  5. 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...

  6. Healthcare inequality issues among immigrant elders after neoliberal welfare reform: empirical findings from the United States.

    PubMed

    Yeo, Younsook

    2016-06-03

    Even with the increasing importance being placed on research into immigrant elders' healthcare use as countries change their policies to reflect their increasing immigrant and aging populations, little research has examined changes in healthcare use disparities between immigrant and native elders in relation to these policy changes. To fill this gap in the literature, this study examined healthcare disparities in relation to the welfare reform that the US implemented in 1996 and then compared significant indicators of immigrants' healthcare use during the pre- and post-reform periods. The difference-in-difference (DD) analyses and post hoc probing of the DD analyses were used in multivariate logistic regression of the National Health Information Survey data that were pooled for the pre- and post-reform periods. The results revealed that while inequalities in healthcare existed before the reform, they significantly increased after the reform. A further test showed that the changes in the inequalities were significant among relatively long-stay immigrants, but not significant among immigrants who entered the US before the reform and thus were exempted from the reform restrictions. During the pre-reform period, insurance, employment, sex, and race/ethnicity were related to healthcare use; however, the enabling factors (i.e., insurance, income, and education) and social structural factors (i.e., marital status, family structure, length of US residency, race/ethnicity, and geographical region) explained the post-reform immigrants' healthcare use, while controlling for healthcare needs factors. These findings suggest that welfare reform may be the driving force of inequalities in healthcare.

  7. The role of severity information in health policy debates: a survey of state and regional concerns.

    PubMed

    Iezzoni, L I; Shwartz, M; Restuccia, J

    1991-01-01

    Severity of illness measurement has recently dominated many regional health policy debates, and some states now require severity ratings for inpatients. We summarize results of a telephone survey of regional activities involving severity data. Parties use severity information either to evaluate hospital resource use or to assist in comparing quality of hospital care. For quality assessment, various constituencies frequently specify different goals for the severity information. Business representatives commonly believe that it can quantify hospital performance and help them target cost-effective providers; in contrast, providers view severity information only as a screen for substandard care, suggesting areas requiring detailed examination.

  8. 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.

  9. Mapping the Health Information Landscape in a Rural, Culturally Diverse Region: Implications for Interventions to Reduce Information Inequality.

    PubMed

    Ramírez, A Susana; Estrada, Erendira; Ruiz, Ariana

    2017-02-21

    The media is an important source of health information, especially critical in rural communities with geographically-dispersed populations that are harder to reach through other channels. Yet health information is unequally distributed; these information disparities are compounded in rural areas, which may contribute to health disparities. We identify and describe health-related news in a culturally-diverse rural California county characterized by high levels of poverty, unemployment, low educational attainment, and over half of Mexican-origin. We conducted a census of all available print news sources and then used content analysis to identify and characterize all health information printed in a 6-month study period. A total of 570 health-related articles were published. Five newspapers accounted for more than 80% of published health-related articles (n = 466); only one targeted the majority Latino population. The most common topic was access to health care/insurance/policy (33%), followed by diet/nutrition (13%), infectious disease (10%), and general prevention (9%). Just over one-quarter of health-related articles included useful information. Differences across newspaper types existed: independent newspapers reported more on health-related events compared with chain newspapers, and both ethnic-targeted newspapers and independently-published papers were more likely to include useful information compared with chain newspapers. While this region suffers from high rates of obesity and diabetes, there were relatively few articles on obesity and diabetes themselves, or linking behavioral risk factors with these conditions. One area we found absent from coverage pertained to the numerous environmental health threats prevalent in this heavily polluted, agricultural area (just 40 articles discussed environmental health threats). We also discovered that coverage of social determinants of health was lacking (just 24 of the 570 health articles), which was notable in a

  10. 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.

  11. 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

    2015-02-02

    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.

  12. Organizational change strategies within healthcare.

    PubMed

    Steinke, Claudia; Dastmalchian, Ali; Blyton, Paul; Hasselback, Paul

    2013-01-01

    This study explores ways in which healthcare organizations can improve their organizational fitness for change using Beer and Nohria's framework of Theory E (concentrating on the economic value of change) and Theory O (concentrating on the organization's long-term capabilities for change). Data were collected from senior leaders/medical directors from health regions in Alberta. The results show that even though there is a tendency for reliance on Theory E change strategies, the respondents demonstrated other preferred approaches to change.

  13. 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.

  14. Regional spatially adaptive total variation super-resolution with spatial information filtering and clustering.

    PubMed

    Yuan, Qiangqiang; Zhang, Liangpei; Shen, Huanfeng

    2013-06-01

    Total variation is used as a popular and effective image prior model in the regularization-based image processing fields. However, as the total variation model favors a piecewise constant solution, the processing result under high noise intensity in the flat regions of the image is often poor, and some pseudoedges are produced. In this paper, we develop a regional spatially adaptive total variation model. Initially, the spatial information is extracted based on each pixel, and then two filtering processes are added to suppress the effect of pseudoedges. In addition, the spatial information weight is constructed and classified with k-means clustering, and the regularization strength in each region is controlled by the clustering center value. The experimental results, on both simulated and real datasets, show that the proposed approach can effectively reduce the pseudoedges of the total variation regularization in the flat regions, and maintain the partial smoothness of the high-resolution image. More importantly, compared with the traditional pixel-based spatial information adaptive approach, the proposed region-based spatial information adaptive total variation model can better avoid the effect of noise on the spatial information extraction, and maintains robustness with changes in the noise intensity in the super-resolution process.

  15. Log Pearson type 3 quantile estimators with regional skew information and low outlier adjustments

    NASA Astrophysics Data System (ADS)

    Griffis, V. W.; Stedinger, J. R.; Cohn, T. A.

    2004-07-01

    The recently developed expected moments algorithm (EMA) [, 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.

  16. 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.

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

    PubMed Central

    Umemiya, Chisa

    2006-01-01

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

  18. [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

  19. [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.

  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. [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.

  2. Wearable device implications in the healthcare industry.

    PubMed

    Erdmier, Casey; Hatcher, Jason; Lee, Michael

    2016-01-01

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

  3. 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 researcher…

  4. 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.

  5. Usefulness of a Regional Health Care Information System in primary care: a case study.

    PubMed

    Maass, Marianne C; Asikainen, Paula; Mäenpää, Tiina; Wanne, Olli; Suominen, Tarja

    2008-08-01

    The goal of this paper is to describe some benefits and possible cost consequences of computer based access to specialised health care information. A before-after activity analysis regarding 20 diabetic patients' clinical appointments was performed in a Health Centre in Satakunta region in Finland. Cost data, an interview, time-and-motion studies, and flow charts based on modelling were applied. Access to up-to-date diagnostic information reduced redundant clinical re-appointments, repeated tests, and mail orders for missing data. Timely access to diagnostic information brought about several benefits regarding workflow, patient care, and disease management. These benefits resulted in theoretical net cost savings. The study results indicated that Regional Information Systems may be useful tools to support performance and improve efficiency. However, further studies are required in order to verify how the monetary savings would impact the performance of Health Care Units.

  6. Informed Consent in cross-cultural perspective: clinical research in the Tibetan Autonomous Region, PRC.

    PubMed

    Adams, Vincanne; Miller, Suellen; Craig, Sienna; Sonam; Nyima; Droyoung; Le, Phuoc V; Varner, Micheal

    2007-12-01

    Procedures of Informed Consent are considered a high priority for international biomedical research. However, informed consent protocols are not necessarily transferable across cultural, national or ethnic groups. Recent debates identify the need for balancing ethical universals with practical and local conditions and paying attention to questions of cultural competence when it comes to the Informed Consent process for clinical biomedical research. This article reports on the results of a two-year effort to establish a culturally appropriate Informed Consent process for biomedical research in the Tibet Autonomous Region in the People's Republic of China. A team of Tibetan and American researchers, physicians, health professionals and medical anthropologists conducted the research. The Informed Consent was specifically for undertaking a triple-blind, double placebo-controlled randomized clinical trial of a Tibetan medicine compared with Misoprostol for reducing postpartum blood loss. The findings suggest greater need for flexibility and cooperation in establishing Informed Consent protocols across cultures and nations.

  7. AVIRIS data calibration information: Wasatch Mountains and Park City region, Utah

    USGS Publications Warehouse

    Rockwell, Barnaby W.; Clark, Roger N.; Livo, K. Eric; McDougal, Robert R.; Kokaly, Raymond F.

    2002-01-01

    This report contains information regarding the reflectance calibration of spectroscopic imagery acquired over the Wasatch Mountains and Park City region, Utah, by the Airborne Visible/Infrared Imaging Spectrometer (AVIRIS) sensor on August 5, 1998. This information was used by the USGS Spectroscopy Laboratory to calibrate the Park City AVIRIS imagery to unitless reflectance prior to spectral analysis.  The Utah AVIRIS data were analyzed as a part of the USEPA-USGS Utah Abandoned Mine Lands Imaging Spectroscopy Project.

  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. Distinct Regions of Prefrontal Cortex Are Associated with the Controlled Retrieval and Selection of Social Information

    PubMed Central

    Satpute, Ajay B.; Badre, David; Ochsner, Kevin N.

    2014-01-01

    Research in social neuroscience has uncovered a social knowledge network that is particularly attuned to making social judgments. However, the processes that are being performed by both regions within this network and those outside of this network that are nevertheless engaged in the service of making a social judgment remain unclear. To help address this, we drew upon research in semantic memory, which suggests that making a semantic judgment engages 2 distinct control processes: A controlled retrieval process, which aids in bringing goal-relevant information to mind from long-term stores, and a selection process, which aids in selecting the information that is goal-relevant from the information retrieved. In a neuroimaging study, we investigated whether controlled retrieval and selection for social information engage distinct portions of both the social knowledge network and regions outside this network. Controlled retrieval for social information engaged an anterior ventrolateral portion of the prefrontal cortex, whereas selection engaged both the dorsomedial prefrontal cortex and temporoparietal junction within the social knowledge network. These results suggest that the social knowledge network may be more involved with the selection of social information than the controlled retrieval of it and incorporates lateral prefrontal regions in accessing memory for making social judgments. PMID:23300111

  10. 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…

  11. The healthcare volunteer.

    PubMed

    Tuckman, H P; Chang, C F

    1994-01-01

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

  12. 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.

  13. 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.

  14. 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...

  15. 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…

  16. 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…

  17. 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)

  18. 78 FR 40103 - Proposed Information Collection; Comment Request; Alaska Region Gear Identification Requirements

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-03

    ... Region Gear Identification Requirements AGENCY: National Oceanic and Atmospheric Administration (NOAA... markings. The marking of gear aids law enforcement and enables other fishermen to report on misplaced gear. II. Method of Collection No information is submitted; this is a gear-marking requirement. ] III....

  19. 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...

  20. 75 FR 55301 - Proposed Information Collection; Comment Request; Northeast Region Gear Identification Requirements

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-10

    ... Region Gear Identification Requirements AGENCY: National Oceanic and Atmospheric Administration (NOAA... fishing permit holders using specified fishing gear mark that gear with specified information for the... methods identified in the regulations). The regulations also specify how the gear is to be marked for...

  1. 78 FR 68817 - Proposed Information Collection; Comment Request; Northeast Region Gear Identification

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-15

    ... Region Gear Identification AGENCY: National Marine Fisheries Service (NMFS), National Oceanic and.... Abstract This notice is for the extension of Paperwork Reduction Act requirements regarding fishing gear... fishing gear mark the gear with specified information. The gear marking requirements provide vessel...

  2. 75 FR 31761 - Proposed Information Collection; Comment Request; Alaska Region Gear Identification Requirements

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-04

    ... Region Gear Identification Requirements AGENCY: National Oceanic and Atmospheric Administration (NOAA... also specify the size and color of markings. The marking of gear aids law enforcement and enables other fishermen to report on misplaced gear. II. Method of Collection No information is submitted; this is a...

  3. The Regional Information Exchange: A Review of Program Operations and Accomplishments.

    ERIC Educational Resources Information Center

    Hayward, Becky Jon

    This report reports activities of the Regional Information Exchange (RIE) program under the National Institute on Disability and Rehabilitation Research's Knowledge Dissemination and Utilization Program. An overview compares the RIE program with a National Diffusion Network unit--the Joint Dissemination Review Panel, which also focuses on…

  4. Information needs assessment for HIV/AIDS and STIs in the Eastern Mediterranean Region.

    PubMed

    Tawilah, J; Tawil, O; Bassiri, S; Ziady, H

    2002-11-01

    We assessed information needs about HIV/AIDS and sexually transmitted infections (STI) in the Eastern Mediterranean Region by surveying a sample of people considered knowledgeable about the subject. Respondents felt that information on certain areas of HIV/AIDS/STIs was much needed. Health care workers were perceived to see a high need for information and services generally. Religious and community leaders were perceived to see less need for some information and services (such as condom promotion, sex education for young people). All groups were perceived to see a need for education and services for people living with AIDS and drug users. Television and radio were considered the best channels for health education while training was seen as the most effective method for information exchange.

  5. 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.

  6. 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.

  7. PKI security in large-scale healthcare networks.

    PubMed

    Mantas, Georgios; Lymberopoulos, Dimitrios; Komninos, Nikos

    2012-06-01

    During the past few years a lot of PKI (Public Key Infrastructures) infrastructures have been proposed for healthcare networks in order to ensure secure communication services and exchange of data among healthcare professionals. However, there is a plethora of challenges in these healthcare PKI infrastructures. Especially, there are a lot of challenges for PKI infrastructures deployed over large-scale healthcare networks. In this paper, we propose a PKI infrastructure to ensure security in a large-scale Internet-based healthcare network connecting a wide spectrum of healthcare units geographically distributed within a wide region. Furthermore, the proposed PKI infrastructure facilitates the trust issues that arise in a large-scale healthcare network including multi-domain PKI infrastructures.

  8. [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

  9. A phylogenetically informed delineation of floristic regions within a biodiversity hotspot in Yunnan, China.

    PubMed

    Li, Rong; Kraft, Nathan J B; Yang, Jie; Wang, Yuhua

    2015-03-30

    Traditional attempts to delineate floristic regions typically focus on species distributions, often ignoring the rich context that phylogenetic relationships can provide. In this study, we explore how phylogenetic relatedness, taxonomic composition, and regional phylogenetic structure change across a global biodiversity hotspot region, Yunnan, located in southwestern China. We propose a system of floristic regions within Yunnan by combining data on the distributions and phylogenetic relationships of 1,983 genera of native seed plants. We identified eight distinct floristic regions in Yunnan, which were grouped into two larger northern and southern geographical units. Phylogenetic relatedness was well correlated with taxonomic composition between floras in Yunnan. Across the Yunnan region we examined, the central Yunnan region shows the lowest level of spatial turnover in phylogenetic relationships and taxonomic composition of the floristic assemblages. Using null model analyses, we found evidence of nonrandom phylogenetic structure across the region, in which four areas show higher phylogenetic turnover than expected given the underlying taxonomic composition between sites. Our results show that the integration of phylogenetic information can provide valuable insight in floristic assessments, and help us to better understand the structure of a global biodiversity hotspot.

  10. A phylogenetically informed delineation of floristic regions within a biodiversity hotspot in Yunnan, China

    PubMed Central

    Li, Rong; Kraft, Nathan J. B.; Yang, Jie; Wang, Yuhua

    2015-01-01

    Traditional attempts to delineate floristic regions typically focus on species distributions, often ignoring the rich context that phylogenetic relationships can provide. In this study, we explore how phylogenetic relatedness, taxonomic composition, and regional phylogenetic structure change across a global biodiversity hotspot region, Yunnan, located in southwestern China. We propose a system of floristic regions within Yunnan by combining data on the distributions and phylogenetic relationships of 1,983 genera of native seed plants. We identified eight distinct floristic regions in Yunnan, which were grouped into two larger northern and southern geographical units. Phylogenetic relatedness was well correlated with taxonomic composition between floras in Yunnan. Across the Yunnan region we examined, the central Yunnan region shows the lowest level of spatial turnover in phylogenetic relationships and taxonomic composition of the floristic assemblages. Using null model analyses, we found evidence of nonrandom phylogenetic structure across the region, in which four areas show higher phylogenetic turnover than expected given the underlying taxonomic composition between sites. Our results show that the integration of phylogenetic information can provide valuable insight in floristic assessments, and help us to better understand the structure of a global biodiversity hotspot. PMID:25820037

  11. Novel lattice Boltzmann method based on integrated edge and region information for medical image segmentation.

    PubMed

    Wen, Junling; Yan, Zhuangzhi; Jiang, Jiehui

    2014-01-01

    The lattice Boltzmann (LB) method is a mesoscopic method based on kinetic theory and statistical mechanics. The main advantage of the LB method is parallel computation, which increases the speed of calculation. In the past decade, LB methods have gradually been introduced for image processing, e.g., image segmentation. However, a major shortcoming of existing LB methods is that they can only be applied to the processing of medical images with intensity homogeneity. In practice, however, many medical images possess intensity inhomogeneity. In this study, we developed a novel LB method to integrate edge and region information for medical image segmentation. In contrast to other segmentation methods, we added edge information as a relaxing factor and used region information as a source term. The proposed method facilitates the segmentation of medical images with intensity inhomogeneity and it still allows parallel computation. Preliminary tests of the proposed method are presented in this paper.

  12. 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.

  13. 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

  14. Board Governance: Transformational Approaches Under Healthcare Reform.

    PubMed

    Zastocki, Deborah K

    2015-01-01

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

  15. 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.

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

    PubMed

    Eason, Tarsha; Cabezas, Heriberto

    2012-02-01

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

  17. A study of extraction of petal region on flower picture using HSV color information

    NASA Astrophysics Data System (ADS)

    Yanagihara, Yoshio; Nakayama, Ryo

    2014-01-01

    It is one of useful and interesting applications to discriminate the kind of the flower or recognize the name of the flower, as example of retrieving flower database. As its contour line of the petal region of flower is useful for such problems, it is important to extract the precise region of the petal of a flower picture. In this paper, the method which extracts petal regions on a flower picture using HSV color information is proposed, such to discriminate the kind of the flower. The experiments show that the proposed method can extract petal regions at the success rate of about 90%, which is thought to be satisfied. In detail, the success rates of one-colored flower, plural-colored flower, and white flower are about 98%, 85%, and 83%, respectively.

  18. Healthcare financing in Yemen.

    PubMed

    Holst, Jens; Gericke, Christian A

    2012-01-01

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

  19. Method for technology-delivered healthcare measures.

    PubMed

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

    2011-12-01

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

  20. Internet developments and their significance for healthcare.

    PubMed

    Briggs, J S; Early, G H

    1999-01-01

    This paper reviews some recent developments in the technology of the Internet, and shows how they may affect the way in which healthcare is provided. Starting with a brief technical history of the Internet, the paper discusses some of the technical developments that have taken place or been proposed in recent years, and speculates on the realities of their adoption within the next five years. The paper also discusses trends in public accessibility to the Internet and the development of Internet services. Finally, the impact of the technological developments on the way in which new healthcare services may be provided is discussed. Our conclusions are that the growth rate in Internet access and the improvements in performance resulting from the new technologies will make the Internet the focus of many new healthcare developments, in particular in the areas of telemedicine and in communication between patient and healthcare professionals. Increasingly, the Internet will be used to convey more 'real-time' information.

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

    PubMed Central

    2014-01-01

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

  2. 1992 healthcare business outlook.

    PubMed

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

    1992-01-06

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

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

    PubMed

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

    2001-01-01

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

  4. 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

  5. [Prediction of regional soil quality based on mutual information theory integrated with decision tree algorithm].

    PubMed

    Lin, Fen-Fang; Wang, Ke; Yang, Ning; Yan, Shi-Guang; Zheng, Xin-Yu

    2012-02-01

    In this paper, some main factors such as soil type, land use pattern, lithology type, topography, road, and industry type that affect soil quality were used to precisely obtain the spatial distribution characteristics of regional soil quality, mutual information theory was adopted to select the main environmental factors, and decision tree algorithm See 5.0 was applied to predict the grade of regional soil quality. The main factors affecting regional soil quality were soil type, land use, lithology type, distance to town, distance to water area, altitude, distance to road, and distance to industrial land. The prediction accuracy of the decision tree model with the variables selected by mutual information was obviously higher than that of the model with all variables, and, for the former model, whether of decision tree or of decision rule, its prediction accuracy was all higher than 80%. Based on the continuous and categorical data, the method of mutual information theory integrated with decision tree could not only reduce the number of input parameters for decision tree algorithm, but also predict and assess regional soil quality effectively.

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

    PubMed

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

    2016-05-01

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

  7. 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.

  8. An entropy-based approach for the identification of phylogenetically informative genomic regions of Papillomavirus.

    PubMed

    Batista, Marcus V A; Ferreira, Tiago A E; Freitas, Antonio C; Balbino, Valdir Q

    2011-12-01

    The papillomaviruses form a highly diverse group that infect mammals, birds and reptiles. We know little about their genetic diversity and therefore the evolutionary mechanisms that drive the diversity of these viruses. Genomic sequences of papillomaviruses are highly divergent and so it is important to develop methods that select the most phylogenetic informative sites. This study aimed at making use of a novel approach based on entropy to select suitable genomic regions from which to infer the phylogeny of papillomavirus. Comparative genomic analyzes were performed to assess the genetic variability of each gene of Papillomaviridae family members. Regions with low entropy were selected to reconstruct papillomavirus phylogenetic trees based on four different methods. This methodology allowed us to identify regions that are conserved among papillomaviruses that infect different hosts. This is important because, despite the huge variation among all papillomaviruses genomes, we were able to find regions that are clearly shared among them, presenting low complexity levels of information from which phylogenetic predictions can be made. This approach allowed us to obtain robust topologies from relatively small datasets. The results indicate that the entropy approach can successfully select regions of the genome that are good markers from which to infer phylogenetic relationships, using less computational time, making the estimation of large phylogenies more accessible.

  9. 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.

  10. 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.

  11. 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

  12. Norovirus in Healthcare Settings

    MedlinePlus

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

  13. 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.

  14. 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

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

    PubMed

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

    2013-01-15

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

  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. 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.

  18. 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.

  19. 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.

  20. 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.

  1. Healthcare Industry Study

    DTIC Science & Technology

    2003-01-01

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

  2. Identifying Patients at Risk of High Healthcare Utilization

    PubMed Central

    Sheets, Lincoln; Popejoy, Lori; APRN, GCNS-BC; Khalilia, Mohammed; Petroski, Greg; Parker, Jerry C.

    2016-01-01

    Objective. To develop a systematic and reproducible way to identify patients at increased risk for higher healthcare costs. Methods. Medical records were analyzed for 9,581 adults who were primary care patients in the University of Missouri Health System and who were enrolled in Medicare or Medicaid. Patients were categorized into one of four risk tiers as of October 1, 2013, and the four tiers were compared on demographic characteristics, number of healthcare episodes, and healthcare charges in the year before and the year after cohort formation. Results. The mean number of healthcare episodes and the sum of healthcare charges in the year following cohort formation were higher for patients in the higher-risk tiers. Conclusions. Retrospective information that is easily extracted from medical records can be used to create risk tiers that provide highly useful information about the prospective risk of healthcare utilization and costs. PMID:28269910

  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. [Healthcare and maternal morbidity and mortality: a hospital-based case-control study in two regions of Colombia (Bogotá and Antioquia), 2009-2011].

    PubMed

    Yepes, Francisco J; Gómez, Joaquin G; Zuleta, John Jairo; Londoño, Juan Luis; Acosta-Reyes, Jorge Luis; Sánchez-Gómez, Luz Helena; Ramírez, Marta L

    2016-11-01

    The study aimed to identify whether payment forms and insurance schemes are associated with severe obstetric complications and maternal mortality. A hospital-based case-control study was conducted in two regions of Colombia, 2009-2011. Data were obtained from each woman's clinical history. Unconditional logistic regression was used. The sample included 1,011 patients: 337 cases and 674 controls. No quality component was statistically significant in either region. In Bogotá, the risk of obstetric complications was significantly higher in the contributive insurance scheme than in subsidized coverage or uninsured; Antioquia showed similar associations, but not statistically significant. Differences in maternal morbidity according to payment scheme were not statistically significant in either Antioquia or Bogotá. Factors associated with maternal morbidity and mortality differed according to the study population, suggesting the need for local studies to identify determinants and make appropriate decisions.

  5. 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.

  6. 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.

  7. 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

  8. 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.

  9. 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.

  10. 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.

  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. The Coordinated Regional Downscaling Experiment (CORDEX): A Framework for Mitigation and Adaptation Information (Invited)

    NASA Astrophysics Data System (ADS)

    Gutowski, W. J.; Wcrp Task Force On Regional Climate Downscaling

    2010-12-01

    The Coordinated Regional Downscaling Experiment (CORDEX) is a program developed by the Task Force on Regional Climate Downscaling of World Climate Research Programme (WCRP). The Task Force’s mandate is to develop a framework to evaluate regional climate downscaling techniques; foster an international coordinated effort to develop improved downscaling techniques and to provide feedback to the global modeling community; and promote greater interactions between global climate modelers, downscalers and end-users. Within this mandate, the primary goal of CORDEX is to extend to a global framework the lessons learned from regional climate downscaling programs focused on one continent. The framework includes statistical downscaling as well as regional climate models (RCMs), with an aim of evaluating the strengths and weaknesses of downscaled climate information. CORDEX also provides coordination among existing and emerging downscaling programs around the world. This talk will emphasize the statistical downscaling component of CORDEX. CORDEX has defined a set of target regions covering most land areas of the planet. A primary region of emphasis is Africa, which has received less attention than most other continents in regional climate-change and climate-impacts research. Baseline downscaling efforts by statistical downscaling and RCMs have started, focusing on the period covered by the ERA-Interim Reanalysis: 1987-2007. Future work will include downscaling GCM output for extended periods in the twentieth and twenty-first centuries, where future projections will be based on Representative Concentration Pathway (RCP) greenhouse gas and aerosol scenarios, specifically RCP 4.5 and RCP 8.5. CORDEX has established a preliminary set of archival protocols and targeted variables for output that will be stored in a central, openly accessible repository. Although CORDEX intends to produce simulations and analyses for the IPCC Fifth Assessment Report, the WCRP Task Force views CORDEX

  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. 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.

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

    NASA Astrophysics Data System (ADS)

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

    2013-05-01

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

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

    PubMed

    Lewy, Hadas

    2015-02-01

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

  17. Pilot study of compliance with healthcare facility smoking laws in Georgia.

    PubMed

    Schick, S; Gvinianidze, K; Tsereteli, D; Novotny, T; Hammond, K

    2008-01-01

    In 2003 Georgian Parliament restricted smoking in all healthcare facilities to designated smoking areas. Observed compliance has been low. This quantitative study of airborne nicotine and particulate concentrations in nine healthcare facilities in Tbilisi and Region Kakheti in February, 2007 was a pilot to assess the degree of noncompliance with the law and to identify potential strategies for increasing compliance. Passive sampling of nicotine and active sampling of PM(2.5) in selected healthcare facilities. None of the facilities we monitored had designated smoking areas that met the legal requirements. Fifty of the 51 samplers registered concentrations of nicotine above the level of detection. Of these, 52% showed concentrations below 1 microg/m(3) nicotine, 27% showed concentrations between 1 and 5 microg/m(3) and 20% were above 5 microg/m(3). The highest nicotine levels were found in medical staff offices, and in undesignated "informal smoking areas". These data support qualitative observations that the law restricting smoking in Georgian healthcare facilities to designated areas is poorly enforced and does not protect patients and employees from secondhand smoke. These findings suggest that Georgian law should be changed to make all healthcare institutions smoke free environments and that there is a need for tobacco control programs targeted at medical professionals in Georgia.

  18. A Model for Good Governance of Healthcare Technology Management in the Public Sector: Learning from Evidence-Informed Policy Development and Implementation in Benin

    PubMed Central

    Houngbo, P. Th.; Zweekhorst, M.; De Cock Buning, Tj.; Medenou, D.; Bunders, J. F. G.

    2017-01-01

    Good governance (GG) is an important concept that has evolved as a set of normative principles for low- and middle-income countries (LMICs) to strengthen the functional capacity of their public bodies, and as a conditional prerequisite to receive donor funding. Although much is written on good governance, very little is known on how to implement it. This paper documents the process of developing a strategy to implement a GG model for Health Technology Management (HTM) in the public health sector, based on lessons learned from twenty years of experience in policy development and implementation in Benin. The model comprises six phases: (i) preparatory analysis, assessing the effects of previous policies and characterizing the HTM system; (ii) stakeholder identification and problem analysis, making explicit the perceptions of problems by a diverse range of actors, and assessing their ability to solve these problems; (iii) shared analysis and visioning, delineating the root causes of problems and hypothesizing solutions; (iv) development of policy instruments for pilot testing, based on quick-win solutions to understand the system’s responses to change; (v) policy development and validation, translating the consensus solutions identified by stakeholders into a policy; and (vi) policy implementation and evaluation, implementing the policy through a cycle of planning, action, observation and reflection. The policy development process can be characterized as bottom-up, with a central focus on the participation of diverse stakeholders groups. Interactive and analytical tools of action research were used to integrate knowledge amongst actor groups, identify consensus solutions and develop the policy in a way that satisfies criteria of GG. This model could be useful for other LMICs where resources are constrained and the majority of healthcare technologies are imported. PMID:28056098

  19. A Model for Good Governance of Healthcare Technology Management in the Public Sector: Learning from Evidence-Informed Policy Development and Implementation in Benin.

    PubMed

    Houngbo, P Th; Coleman, H L S; Zweekhorst, M; De Cock Buning, Tj; Medenou, D; Bunders, J F G

    2017-01-01

    Good governance (GG) is an important concept that has evolved as a set of normative principles for low- and middle-income countries (LMICs) to strengthen the functional capacity of their public bodies, and as a conditional prerequisite to receive donor funding. Although much is written on good governance, very little is known on how to implement it. This paper documents the process of developing a strategy to implement a GG model for Health Technology Management (HTM) in the public health sector, based on lessons learned from twenty years of experience in policy development and implementation in Benin. The model comprises six phases: (i) preparatory analysis, assessing the effects of previous policies and characterizing the HTM system; (ii) stakeholder identification and problem analysis, making explicit the perceptions of problems by a diverse range of actors, and assessing their ability to solve these problems; (iii) shared analysis and visioning, delineating the root causes of problems and hypothesizing solutions; (iv) development of policy instruments for pilot testing, based on quick-win solutions to understand the system's responses to change; (v) policy development and validation, translating the consensus solutions identified by stakeholders into a policy; and (vi) policy implementation and evaluation, implementing the policy through a cycle of planning, action, observation and reflection. The policy development process can be characterized as bottom-up, with a central focus on the participation of diverse stakeholders groups. Interactive and analytical tools of action research were used to integrate knowledge amongst actor groups, identify consensus solutions and develop the policy in a way that satisfies criteria of GG. This model could be useful for other LMICs where resources are constrained and the majority of healthcare technologies are imported.

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

    PubMed

    Smith, Riley

    2015-01-01

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