Background: Health information systems (HIS) play a major role in decision-making. The aim is to identify the components of computerized HIS and their relationship to administrative decisions at the main referral hosp...Background: Health information systems (HIS) play a major role in decision-making. The aim is to identify the components of computerized HIS and their relationship to administrative decisions at the main referral hospitals for Sana’a city. Method: This applied research is a descriptive, cross-sectional study in which the HIS of 7 hospitals affiliated with Sana’a city hospitals during “2017-2020”, was evaluated based on Self-administered questionnaires. Data were collected by using Self-administered questionnaires and analyzed in SPSS 16 by using descriptive statistics. Results: A total of 626 users (95.7%) had responded. 73%, 75%, 69%, 70%, 71% of users mentioned that resources were available, for physical, software, human, organizational, and decision computerized HIS, respectively. The study showed a strong relationship between computerized information systems with their physical, software, human and organizational components, and medical and administrative decisions. While the study showed the absence of a relationship between demographic factors and computerized information systems with their hardware, software, human and organizational components, medical and administrative decisions, except for gender with organizational components, age, qualification with hardware and software components, and years of experience with all study variables. Conclusion: The application of HIS at hospitals in decision-making has several challenges, including the lack of updating of hardware and software components Furthermore, the absence of specific, focusing on developing their technical staffs, and mobilizing financial resources to achieve implementation properly. Therefore, establishing the technical management with clear roles and tasks with multi-disciplinary, and increasing the support of the administrative leadership in the process of implementing HIS are recommended.展开更多
Telemedicine is defined as a system that allows healthcare workers to deliver their services and consultations to the patients remotely without the need of their physical presence within academic institutions, hospita...Telemedicine is defined as a system that allows healthcare workers to deliver their services and consultations to the patients remotely without the need of their physical presence within academic institutions, hospitals, and medical clinics aiming to reduce the personal contact and limiting it to the need only. The field of telemedicine is growing every day and facilitating more flexible services for patients around the world especially during COVID-19 pandemic. Methods: This systematic review was conducted according to the Cochrane Handbook for Systematic Reviews. Database search was made on several databases including PubMed/Medline, Scopus, Web of Science, Publons, EMBASE, and Google Scholar using the relevant keywords. Inclusion criteria for articles in our study included the following original research (primary research articles), addressing the efficacy of teleaudiology for hearing aids programming and satisfaction of patients. Results: Seven studies were included in this systematic review article. Included studies were assessed using Cochrane handbook guidelines. Conclusions: The results of this work based on the currently available literature denote that remote programming for the hearing aids using modern technology is effective and provide comparable results with the standard face-to-face clinic programming, even for patients with no previous experience in hearing aids fitting in either of in-person physical presence programming or remotely over the internet using teleconferencing which is known as teleaudiology. Most of the results were positive and support the continuity to develop better facilities to improve the teleaudiology to be an essential part of hearing aids programming with its different types. Minimal results provided negative impact from the participating patients, this resulted because of the non-upgraded infrastructure and facilities of the audiology clinic or the personal computer of the patient in his home/ workplace or both sides don’t have enough specifications to smoothly perform this modern approach.展开更多
Models of services, processes and technology are useful tools for conceptualizing complex systems such as healthcare. The application of a component architecture helps illustrate the processes and technologies that ar...Models of services, processes and technology are useful tools for conceptualizing complex systems such as healthcare. The application of a component architecture helps illustrate the processes and technologies that are important to the operation of a health service and conceptualize the relationships between each component. Telehealth services are relatively recent and have characteristics that do not fit neatly into established models of health services. This paper analyzes the components used to build a telehealth in the home service in South Australia and the design choices that were taken. The service used commodity-based devices and systems to deliver simple to use, low-cost in the home care. Building on this analysis, the components required in an architectural component model of a telehealth service are identified enabling a provisional architecture for telehealth services to be derived from an existing internationally recognized architectural model for eHealth systems. Situated within the broad family of eHealth architectures, a Telehealth Architectural Model of telehealth processes, software, devices, common systems and ICT infrastructure is proposed that represents the components required to support telehealth and allows for customization of services according to clinical models of care.展开更多
Purpose: This research aims to evaluate the potential threats to patient privacy and confidentiality posed by mHealth applications on mobile devices. Methodology: A comprehensive literature review was conducted, selec...Purpose: This research aims to evaluate the potential threats to patient privacy and confidentiality posed by mHealth applications on mobile devices. Methodology: A comprehensive literature review was conducted, selecting eighty-eight articles published over the past fifteen years. The study assessed data gathering and storage practices, regulatory adherence, legal structures, consent procedures, user education, and strategies to mitigate risks. Results: The findings reveal significant advancements in technologies designed to safeguard privacy and facilitate the widespread use of mHealth apps. However, persistent ethical issues related to privacy remain largely unchanged despite these technological strides.展开更多
Current Nurse scheduling process has many challenges like work plan creation and working hour allocation for employees at specific planning horizon. Hospitals in most of the developing countries use manual methods to ...Current Nurse scheduling process has many challenges like work plan creation and working hour allocation for employees at specific planning horizon. Hospitals in most of the developing countries use manual methods to create nurse scheduling systems. With current existing manual nurse scheduling systems, most of the hospitals especially in developing countries don’t have efficient work plan allocation. Moreover, patients need nursing care throughout the day. Hence, current manual nurse scheduling approach with simple statistical functions is not efficient especially for highly populated countries. Our proposed automated nurse scheduling approach has carried out in two stages. Firstly, we propose an efficient data warehouse system based on online analytical method for hospital information system. Subsequently, Enhanced Greedy Optimization algorithm is implemented to optimize the nurse roster and compared with other optimization algorithms (Simulated Annealing and Genetic Algorithm). Experimental results (MYSQL, JAVA, OLAP) with proposed optimization algorithm outperforms compared with existing optimization solutions.展开更多
Securing large amounts of electronic medical records stored in different forms and in many locations, while making availability to authorized users is considered as a great challenge. Maintaining protection and privac...Securing large amounts of electronic medical records stored in different forms and in many locations, while making availability to authorized users is considered as a great challenge. Maintaining protection and privacy of personal information is a strong motivation in the development of security policies. It is critical for health care organizations to access, analyze, and ensure security policies to meet the challenge and to develop the necessary policies to ensure the security of medical information. The problem, then, is how we can maintain the availability of the electronic medical records and at the same time maintain the privacy of patients’ information. This paper will propose a novel architecture model for the Electronic Medical Record (EMR), in which useful statistical medical records will be available to the interested parties while maintaining the privacy of patients’ information.展开更多
Telestroke is an integral platform for physicians to provide accurate diagnosis and treatment to patients with a possible stroke in remote locations. We evaluated the performance of two iPad applications, Clear Sea an...Telestroke is an integral platform for physicians to provide accurate diagnosis and treatment to patients with a possible stroke in remote locations. We evaluated the performance of two iPad applications, Clear Sea and Cisco Jabber for potential usability in telestroke. We conducted a single blind study wherein 15 volunteers underwent 4 separate assessments using abbreviated versions of the National Institutes of Health on-site and off-site, each using Cisco Jabber and Clear Sea. Both volunteer and investigator surveys were collected. Perceptions and usability of each application were measured by grading each variable on a score of 1 - 5 on the Likert scale. The Cisco Jabber mean (±SD) total score was 4.15 ± 0.78 versus 3.88 ± 0.82 for Clear Sea (P = 0.18) indicating 91% probability that Jabber was superior to Clear Sea. A sample of 60 volunteers would have 80% power. The maximum difference was noted in image quality, where Cisco Jabber scored 3.93 ± 0.82 and Clear Sea scored 3.60 ± 0.78 (P = 0.13). Since the directionality of the experiment was not predetermined, a two-tailed pared t-test was used to arrive at a conclusion. With the statistical results shown above we concluded that there was a modest preference for Cisco Jabber over Clear Sea, but a larger trial with stroke patients was still warranted.展开更多
An electronic (web-based) questionnaire was devised to find out the extent of teleconsultation and e-mail use for patient-provided communications in dentistry. This project was carried out in 2011 inthe health care di...An electronic (web-based) questionnaire was devised to find out the extent of teleconsultation and e-mail use for patient-provided communications in dentistry. This project was carried out in 2011 inthe health care district of South-Ostrobothnia, in South-Western Finland.The questionnaire was sent by e-mail to all 120 regional dentists, to which 76 replies were obtained (response rate 63%). The responses indicated a surprisingly positive attitude towards teleconsultation. A clear majority of 91% indicated that it could bring additional benefits to the current consultation methods.This study revealed that a slight majority of dentists in the region use e-mail for patient communication and 53% used e-mail for consultation. Approximately 10% use videoconferencing for consultation.The study also revealed that the majority of those who do not yet use electronic consultation are willing to try them out in the future. Security issues are a concern for many dentists. Practically all respondents wish for written instructions on the use of electronic consultation.展开更多
With the explosive development of wireless communication and low power embedded techniques, Body Area Network (BAN) has opened up new frontiers in the race to provide real-time health monitoring. IEEE 802 has establis...With the explosive development of wireless communication and low power embedded techniques, Body Area Network (BAN) has opened up new frontiers in the race to provide real-time health monitoring. IEEE 802 has established a Task Group called IEEE 802.15.6 inNovember 2007 and aims to establish a communication standard optimized for low power, high reliability applied to medical and non-medical application for BANs. This paper overviews the path loss model and the communication scheme for implant-to-body surface channel presented by IEEE 802.15.6 standard. Comparing with the standard scheme where BCH (Bose-Chaudhuri-Hochquenghem) code is employing, we propose a new coding solution using convolutional code operating with Bit Interleaver based on the properties of implant-to-body surface channel. To analyze the performance of the two Error Correct Coding (ECC) schemes, we performed simulations in terms of Bit Error Rate (BER) and power consumption on MATLAB and FPGA platform, respectively. The simulation results proved that with appropriate constraint length, convolutional code has a better performance not only in BER, but also in minimization of resources and power consumption.展开更多
The purpose of this article is to briefly review some of the innovations that mobile mental health apps present to consumers and mental health practitioners. Particular attention was given to understanding some of the...The purpose of this article is to briefly review some of the innovations that mobile mental health apps present to consumers and mental health practitioners. Particular attention was given to understanding some of the important risks and the potential ethical dilemmas which may arise for counselors and psychologists who embrace them in their practice. Key considerations of issues pertinent to regulations, privacy concerns, and research are being discussed.展开更多
Background: This review delves into the effects of artificial intelligence (AI) on healthcare, which is a crucial aspect considering the increasing costs of healthcare worldwide. While there is potential for AI to enh...Background: This review delves into the effects of artificial intelligence (AI) on healthcare, which is a crucial aspect considering the increasing costs of healthcare worldwide. While there is potential for AI to enhance healthcare delivery and efficiency, there are still uncertainties surrounding its effectiveness, value, and broader adoption. This comprehensive literature review aims to explore and synthesize existing knowledge on the economic impact of AI in healthcare. The primary objective of this review is to understand the potential cost savings and efficiency improvements associated with the deployment of AI in healthcare settings. By highlighting the economic implications of AI, this review seeks to offer insights into the value proposition of investing in AI technologies for stakeholders such as healthcare providers, payers, and policymakers. Methods: To conduct this review, we conducted a search of literature from 2020 to 2023 across three databases: PubMed, Scopus and Google Scholar. We specifically focused on studies that discuss the impacts of AI in healthcare and include cost evaluations, using combinations of keywords related to AI, economics, healthcare, and cost evaluation. The inclusion criteria were studies that conducted some form of economic evaluation related to AI in healthcare settings, while exclusion criteria were studies without a cost evaluation component. Data extraction and quality assessment using the CASP checklist were undertaken on the final set of included studies. Results: After screening studies, we identified 10 out of a total of 28 studies and reports that met our criteria of outlining any form of economic impact and evaluation of AI in healthcare settings. Based on our findings, implementing AI in healthcare could potentially lead to cost savings. Several studies suggest savings ranging from $200 billion to $360 billion in the United States alone. The use of AI in healthcare sectors such as ophthalmology, radiology and disease screening has shown positive economic impacts. Conclusion: While AI has potential for cost savings and efficiency improvements, in healthcare settings, it’s crucial to conduct detailed context specific cost evaluations to optimize the adoption and implementation strategies of AI.展开更多
The HIS is recognised as an essential tool for optimising the management of a health establishment in particular and the health system in general. But it is still very little implemented in hospitals in the South. Ope...The HIS is recognised as an essential tool for optimising the management of a health establishment in particular and the health system in general. But it is still very little implemented in hospitals in the South. Open source HIS software, available on the Internet, can be a solution for starting a (HIS) project in these hospitals. A search on the Internet for open source HIS software allowed us to choose MedBoard, the second most popular open source software out of 381, to start an HIS project called PERFORMANCE at the Kara University Hospital in northern Togo. A questionnaire allowed us to assess the level of knowledge of health actors on hospital information systems. The results of this evaluation allowed us to strengthen our proposal. The analysis of the current computer park of the CHU Kara does not allow whatever the functionalities of MedBoard to implement PERFORMANCE at the CHU Kara. Logistics are needed to make PERFORMANCE work. The real difficulty to start and perpetuate HIS project is linked to the human factor.展开更多
Physical activity is critical to improve the condition of patients with chronic leg and foot ulcers, especially those who are obese and experienced multiple co-morbid conditions. Unfortunately, these individuals are u...Physical activity is critical to improve the condition of patients with chronic leg and foot ulcers, especially those who are obese and experienced multiple co-morbid conditions. Unfortunately, these individuals are unable to engage in guideline based physical activity (PA) programs. A prototype of BluetoothTM enabled acceleration tracking (BEAT) mHealth system was developed and manufactured for remote monitoring and stimulation of adherence to PA in deconditioned patients. The system consists of a miniature accelerometer-based sensor, smartphone application, and a network service. Validation testing showed high reliability and reproducibility of the BEAT sensors. Pilot study with human subjects demonstrated high accuracy of the BEAT system in recognition of different exercises and calculating overall outcomes of PA. Taken together, these results indicate that BEAT system could become a valuable tool for realtime monitoring of PA in deconditioned patients.展开更多
This paper proposes a scheme to obtain location and vital health information using ZigBee system. ZigBee systems are wireless communication systems defined by IEEE 802.154. In the proposed scheme, location information...This paper proposes a scheme to obtain location and vital health information using ZigBee system. ZigBee systems are wireless communication systems defined by IEEE 802.154. In the proposed scheme, location information is obtained using the Link Quality Indication (LQI) function of a ZigBee system, which represents the received signal strength. And, the vital health information are collected from the electrocardiogram monitor, the pulse and blood pressure device, attached to the patient’s body. This information is then transmitted to an outside network by ZigBee systems. In this way, vital health information can be transmitted as ZigBee sensor data while patients with the ZigBee terminal are moving. In the experiments using actual ZigBee devices, the proposed scheme could obtain accurate location and vital health information from the sensor data. Moreover, to achieve high reliability in the actual service, the collected amount of sensor data was confirmed by the theoretic calculation, when a ZigBee terminal passed through ZigBee routers. These results indicate that the proposed scheme can be used to detect the accurate location of the ZigBee terminal. And over 99% of the sensor data on vital health information was obtained when the ZigBee terminal passed through approximately four ZigBee routers.展开更多
With the advent of the pandemic, the Brazilian Ministry of Health structured in record time the Telehealth Service of the Unified Health System called TeleSUS, an ecosystem based on the intensive use of information te...With the advent of the pandemic, the Brazilian Ministry of Health structured in record time the Telehealth Service of the Unified Health System called TeleSUS, an ecosystem based on the intensive use of information technology involving automated mechanisms and a personalized health care center at distance. In addition to constant evaluations carried out in the service as a public health strategy, at clinical and epidemiological levels, the team involved in the project was also concerned with evaluating the system developed to enable the operation of remote care, from the conception of the organization of health actions to the technological development of the digital health tool. The objective of this study was to carry out an evaluation of a telehealth system, measuring the degree of satisfaction of users of health professionals regarding its usability and identifying factors that positively and/or negatively influence the evaluation.展开更多
M-health, which is known as the practice of medical and public health supported by mobile devices such as mobile phones and PDAs for delivering medical and healthcare services, is currently being heavily developed to ...M-health, which is known as the practice of medical and public health supported by mobile devices such as mobile phones and PDAs for delivering medical and healthcare services, is currently being heavily developed to keep pace with the continuously rising demand for personalized healthcare. To this end, the MobiHealthcare system, which provides a personalized healthcare based on body sensor network, is developed. The system includes various body sensors to collect physiological signals specifically for different requirements, a cell phone to facilitate the joint processing of spatially and temporally collected medical data from different parts of the body for resource optimization and systematic health monitoring, a server cluster with great data storage capacity, powerful analysis capabilities to provide data storage, data mining and visualization. Compared with existing M-Health system, the MobiHealthcare system is characteristics of low coupling and powerful parallel computing capabilities. Various healthcare applications have been implemented in the proposed system to demonstrate its effectiveness in providing a powerful platform.展开更多
Background: Total quality management (TQM) plays a major role in quality health services improvement. The aims of the study are to identify the concepts of total quality management in health institutions to know the n...Background: Total quality management (TQM) plays a major role in quality health services improvement. The aims of the study are to identify the concepts of total quality management in health institutions to know the nature of the relationship between the application of TQM and improving the quality of health services in Sana’a Governorate. Method: This applied research is a descriptive cross-sectional study in which the TQM of 13 affiliated Sana’a Governorate hospitals during “2017-2020”, were evaluated based on self-administered questionnaires. Data were collected by questionnaires including demographical variables, TQM dimensions variables. Data were analyzed by using SPSS version 16. Results: A total of 281 users 98.6% had responded. The employee’s responses for sixth study dimensions were the top manager’s commitment (TMC) 80.46%, customers focusing CF 81.55%, continuous improvement (CI) 82.32%, training (T) 71.51%, and strategic planning of the quality (SPQ) 74.76%, health services quality improvement (HSQI) 74.25%. There is a strong relationship between TQM and HSQI. There is no relationship between demographic factors gender, profession, years of experience, except age with TMC, T, HSQI, qualification with the TMC, CI, T, HSQI and job with all study variables. Conclusion: The application of TQM at hospitals in quality of health services improvement has several challenges, lacking staff experience and lacking leadership support, weakness of the training, customers focusing, continuous improvement, and strategic planning of the quality. Therefore, benefiting from the experiences of leading hospitals in implementing total quality management programs by sending some cadres to these hospitals for training and gaining experience or by hosting experienced cadres to conduct training courses is recommended.展开更多
In order to reduce the effort in the integration and actualization of heterogeneous healthcare legacy systems that should share a common database, we propose the creation of an interoperability bus using the HL7 stand...In order to reduce the effort in the integration and actualization of heterogeneous healthcare legacy systems that should share a common database, we propose the creation of an interoperability bus using the HL7 standard—the HL7Middleware. This interoperability bus is an intermediate layer responsible for the communication between a database, health information systems and medical equipment, called HL7Server. Connected systems use the HL7 messaging semantics to store and retrieve data from the database. We validate our approach with respect to two different criteria: performance and integration costs. Benchmark tests were executed with and without the use of HL7Middleware and with different network bandwidths. These results demonstrated that the performance of the interoperability bus is higher when compared to traditional database access for larger volumes of data and when the bandwidth of the user is considerably lower than the bandwidth of the connection between HL7Server and database. The overall development and deployment cost was considered low and the reusability degree of wrapper code was considered high, thus suggesting a progressive reduction of the integration costs of additional services and subsystems of an organization.展开更多
Objective: Describe the design and implementation of an electronic medical record—E-INTMED—customized for Internal Medicine in Dakar, Senegal. Methodology: This study was carried out in a public teaching hospital in...Objective: Describe the design and implementation of an electronic medical record—E-INTMED—customized for Internal Medicine in Dakar, Senegal. Methodology: This study was carried out in a public teaching hospital in Dakar Senegal. It entailed collaboration between physicians specialized in various fields in Internal Medicine and Computer Scientists to carry out the compilation of data and their electronic transcription to produce a prototype which met users’ needs. Results: E-INTMED software is structured around several hierarchical tables allowing users to register and store all relevant patients’ information. E-INTMED structures patient’s data to provide a clear overview of their medical history and users’ activity performance. E-INTMED makes medical users’ life so much easier. Users can generate and send letters and prescriptions quickly and efficiently using the customized templates which they can modify or create new ones. In addition to these capabilities, all of the features expected in an Internal Medicine EHR are handled by E-INTMED, such as lab orders and results, mechanisms for continuity of care, embedding and access to images and documents, and so much more. E-INTMED provides medical students with a number of educational, practical and administrative advantages. Conclusion: Computerization of medical records has become a necessity today. Crossing the line to Electronic medical records could help to improve medical practice and medical training.展开更多
Hospital facilities use a collection of heterogeneous devices, produced by many different vendors, to monitor the state of patient vital signs. The limited interoperability of current devices makes it difficult to syn...Hospital facilities use a collection of heterogeneous devices, produced by many different vendors, to monitor the state of patient vital signs. The limited interoperability of current devices makes it difficult to synthesize multivariate monitoring data into a unified array of real-time information regarding the patients state. Without an infrastructure for the integrated evaluation, display, and storage of vital sign data, one cannot adequately ensure that the assignment of caregivers to patients reflects the relative urgency of patient needs. This is an especially serious issue in critical care units (CCUs). We present a formal mathematical model of an operational critical care unit, together with metrics for evaluating the systematic impact of caregiver scheduling decisions on patient care. The model is rich enough to capture the essential features of device and patient diversity, and so enables us to test the hypothesis that integration of vital sign data could realistically yield a significant positive impact on the efficacy of critical care delivery outcome. To test the hypothesis, we employ the model within a computer simulation. The simulation enables us to compare the current scheduling processes in widespread use within CCUs, against a new scheduling algorithm that makes use of an integrated array of patient information collected by an (anticipated) vital sign data integration infrastructure. The simulation study provides clear evidence that such an infrastructure reduces risk to patients and lowers operational costs, and in so doing reveals the inherent costs of medical device non-interoperability.展开更多
文摘Background: Health information systems (HIS) play a major role in decision-making. The aim is to identify the components of computerized HIS and their relationship to administrative decisions at the main referral hospitals for Sana’a city. Method: This applied research is a descriptive, cross-sectional study in which the HIS of 7 hospitals affiliated with Sana’a city hospitals during “2017-2020”, was evaluated based on Self-administered questionnaires. Data were collected by using Self-administered questionnaires and analyzed in SPSS 16 by using descriptive statistics. Results: A total of 626 users (95.7%) had responded. 73%, 75%, 69%, 70%, 71% of users mentioned that resources were available, for physical, software, human, organizational, and decision computerized HIS, respectively. The study showed a strong relationship between computerized information systems with their physical, software, human and organizational components, and medical and administrative decisions. While the study showed the absence of a relationship between demographic factors and computerized information systems with their hardware, software, human and organizational components, medical and administrative decisions, except for gender with organizational components, age, qualification with hardware and software components, and years of experience with all study variables. Conclusion: The application of HIS at hospitals in decision-making has several challenges, including the lack of updating of hardware and software components Furthermore, the absence of specific, focusing on developing their technical staffs, and mobilizing financial resources to achieve implementation properly. Therefore, establishing the technical management with clear roles and tasks with multi-disciplinary, and increasing the support of the administrative leadership in the process of implementing HIS are recommended.
文摘Telemedicine is defined as a system that allows healthcare workers to deliver their services and consultations to the patients remotely without the need of their physical presence within academic institutions, hospitals, and medical clinics aiming to reduce the personal contact and limiting it to the need only. The field of telemedicine is growing every day and facilitating more flexible services for patients around the world especially during COVID-19 pandemic. Methods: This systematic review was conducted according to the Cochrane Handbook for Systematic Reviews. Database search was made on several databases including PubMed/Medline, Scopus, Web of Science, Publons, EMBASE, and Google Scholar using the relevant keywords. Inclusion criteria for articles in our study included the following original research (primary research articles), addressing the efficacy of teleaudiology for hearing aids programming and satisfaction of patients. Results: Seven studies were included in this systematic review article. Included studies were assessed using Cochrane handbook guidelines. Conclusions: The results of this work based on the currently available literature denote that remote programming for the hearing aids using modern technology is effective and provide comparable results with the standard face-to-face clinic programming, even for patients with no previous experience in hearing aids fitting in either of in-person physical presence programming or remotely over the internet using teleconferencing which is known as teleaudiology. Most of the results were positive and support the continuity to develop better facilities to improve the teleaudiology to be an essential part of hearing aids programming with its different types. Minimal results provided negative impact from the participating patients, this resulted because of the non-upgraded infrastructure and facilities of the audiology clinic or the personal computer of the patient in his home/ workplace or both sides don’t have enough specifications to smoothly perform this modern approach.
文摘Models of services, processes and technology are useful tools for conceptualizing complex systems such as healthcare. The application of a component architecture helps illustrate the processes and technologies that are important to the operation of a health service and conceptualize the relationships between each component. Telehealth services are relatively recent and have characteristics that do not fit neatly into established models of health services. This paper analyzes the components used to build a telehealth in the home service in South Australia and the design choices that were taken. The service used commodity-based devices and systems to deliver simple to use, low-cost in the home care. Building on this analysis, the components required in an architectural component model of a telehealth service are identified enabling a provisional architecture for telehealth services to be derived from an existing internationally recognized architectural model for eHealth systems. Situated within the broad family of eHealth architectures, a Telehealth Architectural Model of telehealth processes, software, devices, common systems and ICT infrastructure is proposed that represents the components required to support telehealth and allows for customization of services according to clinical models of care.
文摘Purpose: This research aims to evaluate the potential threats to patient privacy and confidentiality posed by mHealth applications on mobile devices. Methodology: A comprehensive literature review was conducted, selecting eighty-eight articles published over the past fifteen years. The study assessed data gathering and storage practices, regulatory adherence, legal structures, consent procedures, user education, and strategies to mitigate risks. Results: The findings reveal significant advancements in technologies designed to safeguard privacy and facilitate the widespread use of mHealth apps. However, persistent ethical issues related to privacy remain largely unchanged despite these technological strides.
文摘Current Nurse scheduling process has many challenges like work plan creation and working hour allocation for employees at specific planning horizon. Hospitals in most of the developing countries use manual methods to create nurse scheduling systems. With current existing manual nurse scheduling systems, most of the hospitals especially in developing countries don’t have efficient work plan allocation. Moreover, patients need nursing care throughout the day. Hence, current manual nurse scheduling approach with simple statistical functions is not efficient especially for highly populated countries. Our proposed automated nurse scheduling approach has carried out in two stages. Firstly, we propose an efficient data warehouse system based on online analytical method for hospital information system. Subsequently, Enhanced Greedy Optimization algorithm is implemented to optimize the nurse roster and compared with other optimization algorithms (Simulated Annealing and Genetic Algorithm). Experimental results (MYSQL, JAVA, OLAP) with proposed optimization algorithm outperforms compared with existing optimization solutions.
文摘Securing large amounts of electronic medical records stored in different forms and in many locations, while making availability to authorized users is considered as a great challenge. Maintaining protection and privacy of personal information is a strong motivation in the development of security policies. It is critical for health care organizations to access, analyze, and ensure security policies to meet the challenge and to develop the necessary policies to ensure the security of medical information. The problem, then, is how we can maintain the availability of the electronic medical records and at the same time maintain the privacy of patients’ information. This paper will propose a novel architecture model for the Electronic Medical Record (EMR), in which useful statistical medical records will be available to the interested parties while maintaining the privacy of patients’ information.
文摘Telestroke is an integral platform for physicians to provide accurate diagnosis and treatment to patients with a possible stroke in remote locations. We evaluated the performance of two iPad applications, Clear Sea and Cisco Jabber for potential usability in telestroke. We conducted a single blind study wherein 15 volunteers underwent 4 separate assessments using abbreviated versions of the National Institutes of Health on-site and off-site, each using Cisco Jabber and Clear Sea. Both volunteer and investigator surveys were collected. Perceptions and usability of each application were measured by grading each variable on a score of 1 - 5 on the Likert scale. The Cisco Jabber mean (±SD) total score was 4.15 ± 0.78 versus 3.88 ± 0.82 for Clear Sea (P = 0.18) indicating 91% probability that Jabber was superior to Clear Sea. A sample of 60 volunteers would have 80% power. The maximum difference was noted in image quality, where Cisco Jabber scored 3.93 ± 0.82 and Clear Sea scored 3.60 ± 0.78 (P = 0.13). Since the directionality of the experiment was not predetermined, a two-tailed pared t-test was used to arrive at a conclusion. With the statistical results shown above we concluded that there was a modest preference for Cisco Jabber over Clear Sea, but a larger trial with stroke patients was still warranted.
基金funded by Seinajoki Central Hospital research foundation.
文摘An electronic (web-based) questionnaire was devised to find out the extent of teleconsultation and e-mail use for patient-provided communications in dentistry. This project was carried out in 2011 inthe health care district of South-Ostrobothnia, in South-Western Finland.The questionnaire was sent by e-mail to all 120 regional dentists, to which 76 replies were obtained (response rate 63%). The responses indicated a surprisingly positive attitude towards teleconsultation. A clear majority of 91% indicated that it could bring additional benefits to the current consultation methods.This study revealed that a slight majority of dentists in the region use e-mail for patient communication and 53% used e-mail for consultation. Approximately 10% use videoconferencing for consultation.The study also revealed that the majority of those who do not yet use electronic consultation are willing to try them out in the future. Security issues are a concern for many dentists. Practically all respondents wish for written instructions on the use of electronic consultation.
文摘With the explosive development of wireless communication and low power embedded techniques, Body Area Network (BAN) has opened up new frontiers in the race to provide real-time health monitoring. IEEE 802 has established a Task Group called IEEE 802.15.6 inNovember 2007 and aims to establish a communication standard optimized for low power, high reliability applied to medical and non-medical application for BANs. This paper overviews the path loss model and the communication scheme for implant-to-body surface channel presented by IEEE 802.15.6 standard. Comparing with the standard scheme where BCH (Bose-Chaudhuri-Hochquenghem) code is employing, we propose a new coding solution using convolutional code operating with Bit Interleaver based on the properties of implant-to-body surface channel. To analyze the performance of the two Error Correct Coding (ECC) schemes, we performed simulations in terms of Bit Error Rate (BER) and power consumption on MATLAB and FPGA platform, respectively. The simulation results proved that with appropriate constraint length, convolutional code has a better performance not only in BER, but also in minimization of resources and power consumption.
文摘The purpose of this article is to briefly review some of the innovations that mobile mental health apps present to consumers and mental health practitioners. Particular attention was given to understanding some of the important risks and the potential ethical dilemmas which may arise for counselors and psychologists who embrace them in their practice. Key considerations of issues pertinent to regulations, privacy concerns, and research are being discussed.
文摘Background: This review delves into the effects of artificial intelligence (AI) on healthcare, which is a crucial aspect considering the increasing costs of healthcare worldwide. While there is potential for AI to enhance healthcare delivery and efficiency, there are still uncertainties surrounding its effectiveness, value, and broader adoption. This comprehensive literature review aims to explore and synthesize existing knowledge on the economic impact of AI in healthcare. The primary objective of this review is to understand the potential cost savings and efficiency improvements associated with the deployment of AI in healthcare settings. By highlighting the economic implications of AI, this review seeks to offer insights into the value proposition of investing in AI technologies for stakeholders such as healthcare providers, payers, and policymakers. Methods: To conduct this review, we conducted a search of literature from 2020 to 2023 across three databases: PubMed, Scopus and Google Scholar. We specifically focused on studies that discuss the impacts of AI in healthcare and include cost evaluations, using combinations of keywords related to AI, economics, healthcare, and cost evaluation. The inclusion criteria were studies that conducted some form of economic evaluation related to AI in healthcare settings, while exclusion criteria were studies without a cost evaluation component. Data extraction and quality assessment using the CASP checklist were undertaken on the final set of included studies. Results: After screening studies, we identified 10 out of a total of 28 studies and reports that met our criteria of outlining any form of economic impact and evaluation of AI in healthcare settings. Based on our findings, implementing AI in healthcare could potentially lead to cost savings. Several studies suggest savings ranging from $200 billion to $360 billion in the United States alone. The use of AI in healthcare sectors such as ophthalmology, radiology and disease screening has shown positive economic impacts. Conclusion: While AI has potential for cost savings and efficiency improvements, in healthcare settings, it’s crucial to conduct detailed context specific cost evaluations to optimize the adoption and implementation strategies of AI.
文摘The HIS is recognised as an essential tool for optimising the management of a health establishment in particular and the health system in general. But it is still very little implemented in hospitals in the South. Open source HIS software, available on the Internet, can be a solution for starting a (HIS) project in these hospitals. A search on the Internet for open source HIS software allowed us to choose MedBoard, the second most popular open source software out of 381, to start an HIS project called PERFORMANCE at the Kara University Hospital in northern Togo. A questionnaire allowed us to assess the level of knowledge of health actors on hospital information systems. The results of this evaluation allowed us to strengthen our proposal. The analysis of the current computer park of the CHU Kara does not allow whatever the functionalities of MedBoard to implement PERFORMANCE at the CHU Kara. Logistics are needed to make PERFORMANCE work. The real difficulty to start and perpetuate HIS project is linked to the human factor.
文摘Physical activity is critical to improve the condition of patients with chronic leg and foot ulcers, especially those who are obese and experienced multiple co-morbid conditions. Unfortunately, these individuals are unable to engage in guideline based physical activity (PA) programs. A prototype of BluetoothTM enabled acceleration tracking (BEAT) mHealth system was developed and manufactured for remote monitoring and stimulation of adherence to PA in deconditioned patients. The system consists of a miniature accelerometer-based sensor, smartphone application, and a network service. Validation testing showed high reliability and reproducibility of the BEAT sensors. Pilot study with human subjects demonstrated high accuracy of the BEAT system in recognition of different exercises and calculating overall outcomes of PA. Taken together, these results indicate that BEAT system could become a valuable tool for realtime monitoring of PA in deconditioned patients.
文摘This paper proposes a scheme to obtain location and vital health information using ZigBee system. ZigBee systems are wireless communication systems defined by IEEE 802.154. In the proposed scheme, location information is obtained using the Link Quality Indication (LQI) function of a ZigBee system, which represents the received signal strength. And, the vital health information are collected from the electrocardiogram monitor, the pulse and blood pressure device, attached to the patient’s body. This information is then transmitted to an outside network by ZigBee systems. In this way, vital health information can be transmitted as ZigBee sensor data while patients with the ZigBee terminal are moving. In the experiments using actual ZigBee devices, the proposed scheme could obtain accurate location and vital health information from the sensor data. Moreover, to achieve high reliability in the actual service, the collected amount of sensor data was confirmed by the theoretic calculation, when a ZigBee terminal passed through ZigBee routers. These results indicate that the proposed scheme can be used to detect the accurate location of the ZigBee terminal. And over 99% of the sensor data on vital health information was obtained when the ZigBee terminal passed through approximately four ZigBee routers.
文摘With the advent of the pandemic, the Brazilian Ministry of Health structured in record time the Telehealth Service of the Unified Health System called TeleSUS, an ecosystem based on the intensive use of information technology involving automated mechanisms and a personalized health care center at distance. In addition to constant evaluations carried out in the service as a public health strategy, at clinical and epidemiological levels, the team involved in the project was also concerned with evaluating the system developed to enable the operation of remote care, from the conception of the organization of health actions to the technological development of the digital health tool. The objective of this study was to carry out an evaluation of a telehealth system, measuring the degree of satisfaction of users of health professionals regarding its usability and identifying factors that positively and/or negatively influence the evaluation.
文摘M-health, which is known as the practice of medical and public health supported by mobile devices such as mobile phones and PDAs for delivering medical and healthcare services, is currently being heavily developed to keep pace with the continuously rising demand for personalized healthcare. To this end, the MobiHealthcare system, which provides a personalized healthcare based on body sensor network, is developed. The system includes various body sensors to collect physiological signals specifically for different requirements, a cell phone to facilitate the joint processing of spatially and temporally collected medical data from different parts of the body for resource optimization and systematic health monitoring, a server cluster with great data storage capacity, powerful analysis capabilities to provide data storage, data mining and visualization. Compared with existing M-Health system, the MobiHealthcare system is characteristics of low coupling and powerful parallel computing capabilities. Various healthcare applications have been implemented in the proposed system to demonstrate its effectiveness in providing a powerful platform.
文摘Background: Total quality management (TQM) plays a major role in quality health services improvement. The aims of the study are to identify the concepts of total quality management in health institutions to know the nature of the relationship between the application of TQM and improving the quality of health services in Sana’a Governorate. Method: This applied research is a descriptive cross-sectional study in which the TQM of 13 affiliated Sana’a Governorate hospitals during “2017-2020”, were evaluated based on self-administered questionnaires. Data were collected by questionnaires including demographical variables, TQM dimensions variables. Data were analyzed by using SPSS version 16. Results: A total of 281 users 98.6% had responded. The employee’s responses for sixth study dimensions were the top manager’s commitment (TMC) 80.46%, customers focusing CF 81.55%, continuous improvement (CI) 82.32%, training (T) 71.51%, and strategic planning of the quality (SPQ) 74.76%, health services quality improvement (HSQI) 74.25%. There is a strong relationship between TQM and HSQI. There is no relationship between demographic factors gender, profession, years of experience, except age with TMC, T, HSQI, qualification with the TMC, CI, T, HSQI and job with all study variables. Conclusion: The application of TQM at hospitals in quality of health services improvement has several challenges, lacking staff experience and lacking leadership support, weakness of the training, customers focusing, continuous improvement, and strategic planning of the quality. Therefore, benefiting from the experiences of leading hospitals in implementing total quality management programs by sending some cadres to these hospitals for training and gaining experience or by hosting experienced cadres to conduct training courses is recommended.
文摘In order to reduce the effort in the integration and actualization of heterogeneous healthcare legacy systems that should share a common database, we propose the creation of an interoperability bus using the HL7 standard—the HL7Middleware. This interoperability bus is an intermediate layer responsible for the communication between a database, health information systems and medical equipment, called HL7Server. Connected systems use the HL7 messaging semantics to store and retrieve data from the database. We validate our approach with respect to two different criteria: performance and integration costs. Benchmark tests were executed with and without the use of HL7Middleware and with different network bandwidths. These results demonstrated that the performance of the interoperability bus is higher when compared to traditional database access for larger volumes of data and when the bandwidth of the user is considerably lower than the bandwidth of the connection between HL7Server and database. The overall development and deployment cost was considered low and the reusability degree of wrapper code was considered high, thus suggesting a progressive reduction of the integration costs of additional services and subsystems of an organization.
文摘Objective: Describe the design and implementation of an electronic medical record—E-INTMED—customized for Internal Medicine in Dakar, Senegal. Methodology: This study was carried out in a public teaching hospital in Dakar Senegal. It entailed collaboration between physicians specialized in various fields in Internal Medicine and Computer Scientists to carry out the compilation of data and their electronic transcription to produce a prototype which met users’ needs. Results: E-INTMED software is structured around several hierarchical tables allowing users to register and store all relevant patients’ information. E-INTMED structures patient’s data to provide a clear overview of their medical history and users’ activity performance. E-INTMED makes medical users’ life so much easier. Users can generate and send letters and prescriptions quickly and efficiently using the customized templates which they can modify or create new ones. In addition to these capabilities, all of the features expected in an Internal Medicine EHR are handled by E-INTMED, such as lab orders and results, mechanisms for continuity of care, embedding and access to images and documents, and so much more. E-INTMED provides medical students with a number of educational, practical and administrative advantages. Conclusion: Computerization of medical records has become a necessity today. Crossing the line to Electronic medical records could help to improve medical practice and medical training.
文摘Hospital facilities use a collection of heterogeneous devices, produced by many different vendors, to monitor the state of patient vital signs. The limited interoperability of current devices makes it difficult to synthesize multivariate monitoring data into a unified array of real-time information regarding the patients state. Without an infrastructure for the integrated evaluation, display, and storage of vital sign data, one cannot adequately ensure that the assignment of caregivers to patients reflects the relative urgency of patient needs. This is an especially serious issue in critical care units (CCUs). We present a formal mathematical model of an operational critical care unit, together with metrics for evaluating the systematic impact of caregiver scheduling decisions on patient care. The model is rich enough to capture the essential features of device and patient diversity, and so enables us to test the hypothesis that integration of vital sign data could realistically yield a significant positive impact on the efficacy of critical care delivery outcome. To test the hypothesis, we employ the model within a computer simulation. The simulation enables us to compare the current scheduling processes in widespread use within CCUs, against a new scheduling algorithm that makes use of an integrated array of patient information collected by an (anticipated) vital sign data integration infrastructure. The simulation study provides clear evidence that such an infrastructure reduces risk to patients and lowers operational costs, and in so doing reveals the inherent costs of medical device non-interoperability.