Modelling Distributed Cognition Systems in PVS

We report on our efforts to formalise DiCoT, an informal structured approach for analysing complex work systems, such as hospital and day care units, as distributed cognition systems. We focus on DiCoT's information flow model, which describes how information is transformed and propagated in the system. Our contribution is a set of generic models for the specification and verification system PVS. The developed models can be directly mapped to the informal descriptions adopted by human-computer interactions experts. The models can be verified against properties of interest in the PVS theorem prover. Also, the same models can be simulated, thus facilitating analysts to engage with stakeholders when checking the correctness of the model. We trial our ideas on a case study based on a real-world medical system

Success factors for hospital information system implementation in public university hospitals

Hospital Information System (HIS) could help the delivery of high quality health services and improve patient care and patient safety. The development and the adoption of the system need to commence if high quality patient care is to be provided. However, successful HIS implementation is not an easy task and it depends on multiple factors such as adequate computer skills, lack of training and education. Despite the presence of a literature on nurse’s satisfaction on HIS, there is still a controversy over the success of HIS implementation. The input from the Information and Organisation culture, Trust and the nurses themselves, have not been considered. The aim of this study therefore, is to identify the success factors that influence a successful HIS implementation and to propose a research model which could fulfil the objective. Based on DeLone and Mc Lean's information, a success model system with an addition of four additional factors namely the Information culture, Organisational cultures, Trust and User quality was developed in this study. Employing a quantitative research methodology, this study began by conducting a pilot study involving 160 nurses from a university hospital to validate the reliability of the questionnaire to be used. Then, 1200 questionnaires were distributed to seven public university hospitals in Iran and 1028 (86%) usable responses were used for analysis. The covariance-based on structural equation modelling using STATA was employed to evaluate the model. Findings revealed that fourteen out of sixteen proposed hypotheses are significant on successful HIS implementation. The Information quality, Service quality, Organisation culture and the Information culture were among the most influential constructs in the final model. As the study was empirically tested in the Iranian setting, it contributes to theoretical and practical aspect of research especially in the Iranian public university hospital context

An assessment of technology-based service encounters & network security on the e-health care systems of medical centers in Taiwan

<p>Abstract</p> <p>Background</p> <p>Enhancing service efficiency and quality has always been one of the most important factors to heighten competitiveness in the health care service industry. Thus, how to utilize information technology to reduce work load for staff and expeditiously improve work efficiency and healthcare service quality is presently the top priority for every healthcare institution. In this fast changing modern society, e-health care systems are currently the best possible way to achieve enhanced service efficiency and quality under the restraint of healthcare cost control. The electronic medical record system and the online appointment system are the core features in employing e-health care systems in the technology-based service encounters.</p> <p>Methods</p> <p>This study implemented the Service Encounters Evaluation Model, the European Customer Satisfaction Index, the Attribute Model and the Overall Affect Model for model inference. A total of 700 copies of questionnaires from two authoritative southern Taiwan medical centers providing the electronic medical record system and the online appointment system service were distributed, among which 590 valid copies were retrieved with a response rate of 84.3%. We then used SPSS 11.0 and the Linear Structural Relationship Model (LISREL 8.54) to analyze and evaluate the data.</p> <p>Results</p> <p>The findings are as follows: (1) Technology-based service encounters have a positive impact on service quality, but not patient satisfaction; (2) After experiencing technology-based service encounters, the cognition of the service quality has a positive effect on patient satisfaction; and (3) Network security contributes a positive moderating effect on service quality and patient satisfaction.</p> <p>Conclusion</p> <p>It revealed that the impact of electronic workflow (online appointment system service) on service quality was greater than electronic facilities (electronic medical record systems) in technology-based service encounters. Convenience and credibility are the most important factors of service quality in technology-based service encounters that patients demand. Due to the openness of networks, patients worry that transaction information could be intercepted; also, the credibility of the hospital involved is even a bigger concern, as patients have a strong sense of distrust. Therefore, in the operation of technology-based service encounters, along with providing network security, it is essential to build an atmosphere of psychological trust.</p

Model-Supported Business Alignment of IT — Conceptual Foundations

Business Information Technology (IT) alignment focuses on the efficient support of business processes by IT. Therefore,existing software artifacts are addressed by business process models. When the processes change, however, there is a need toadjust the supporting software systems. Thus, already during the design phase of business process models, IT artifacts shouldto be considered. The instrument of conceptual modeling gains wide acceptance, especially in the health care sector todescribe and manage clinical processes, such as Clinical Practice Guidelines (CPG) and Clinical Pathways (CP). There are noholistic approaches so far that provide the alignment between these two concepts and ensure the quality of treatment and theconsistent adaptation of a Hospital Information System (HIS), in particular the hospital’s Workflow Management System(WfMS). To link business process models and the WfMS, the Description Kit Approach (DKA) is used to prepare conceptualmodels to make them automatically analyzable. It is suggested that at an early stage of the modeling process the use ofguidelines has an substantial benefit for avoiding integration conflicts in conceptual models. Furthermore, due to the way theapproach bridges the semantic gap, changes of business requirements as well as technical implementation restrictionsinfluence each other. This results in an ongoing system development process that can be interpreted as a permanentmanagement of application systems. Our results contribute to model-based management theories that have so far neglectedthe distributed construction of conceptual models

Facilitating the analysis of a UK national blood service supply chain using distributed simulation

In an attempt to investigate blood unit ordering policies, researchers have created a discrete-event model of the UK National Blood Service (NBS) supply chain in the Southampton area of the UK. The model has been created using Simul8, a commercial-off-the-shelf discrete-event simulation package (CSP). However, as more hospitals were added to the model, it was discovered that the length of time needed to perform a single simulation severely increased. It has been claimed that distributed simulation, a technique that uses the resources of many computers to execute a simulation model, can reduce simulation runtime. Further, an emerging standardized approach exists that supports distributed simulation with CSPs. These CSP Interoperability (CSPI) standards are compatible with the IEEE 1516 standard The High Level Architecture, the defacto interoperability standard for distributed simulation. To investigate if distributed simulation can reduce the execution time of NBS supply chain simulation, this paper presents experiences of creating a distributed version of the CSP Simul8 according to the CSPI/HLA standards. It shows that the distributed version of the simulation does indeed run faster when the model reaches a certain size. Further, we argue that understanding the relationship of model features is key to performance. This is illustrated by experimentation with two different protocols implementations (using Time Advance Request (TAR) and Next Event Request (NER)). Our contribution is therefore the demonstration that distributed simulation is a useful technique in the timely execution of supply chains of this type and that careful analysis of model features can further increase performance

Comparing conventional and distributed approaches to simulation in complex supply-chain health systems

Decision making in modern supply chains can be extremely daunting due to their complex nature. Discrete-event simulation is a technique that can support decision making by providing what-if analysis and evaluation of quantitative data. However, modelling supply chain systems can result in massively large and complicated models that can take a very long time to run even with today's powerful desktop computers. Distributed simulation has been suggested as a possible solution to this problem, by enabling the use of multiple computers to run models. To investigate this claim, this paper presents experiences in implementing a simulation model with a 'conventional' approach and with a distributed approach. This study takes place in a healthcare setting, the supply chain of blood from donor to recipient. The study compares conventional and distributed model execution times of a supply chain model simulated in the simulation package Simul8. The results show that the execution time of the conventional approach increases almost linearly with the size of the system and also the simulation run period. However, the distributed approach to this problem follows a more linear distribution of the execution time in terms of system size and run time and appears to offer a practical alternative. On the basis of this, the paper concludes that distributed simulation can be successfully applied in certain situations

Commercial-off-the-shelf simulation package interoperability: Issues and futures

Commercial-Off-The-Shelf Simulation Packages (CSPs) are widely used in industry to simulate discrete-event models. Interoperability of CSPs requires the use of distributed simulation techniques. Literature presents us with many examples of achieving CSP interoperability using bespoke solutions. However, for the wider adoption of CSP-based distributed simulation it is essential that, first and foremost, a standard for CSP interoperability be created, and secondly, these standards are adhered to by the CSP vendors. This advanced tutorial is on an emerging standard relating to CSP interoperability. It gives an overview of this standard and presents case studies that implement some of the proposed standards. Furthermore, interoperability is discussed in relation to large and complex models developed using CSPs that require large amount of computing resources. It is hoped that this tutorial will inform the simulation community of the issues associated with CSP interoperability, the importance of these standards and its future

Extending the Carrel system to mediate in the organ and tissue allocation processes: a first approach

In this paper we extend the formalization of Carrel, a virtual organization for the procurement of tissues for transplantation purposes, in order to model also the procurement of human organs for transplants. We will focus in the organ allocation process to show how it can be formalized with the ISLANDER formalism. Also we present a first mechanism to federate the institution in several geographically-distributed platforms.Postprint (published version