Catalan Health Institute: 2014 Annual Report

Sistema sanitari públic; Activitat assistencial; MemòriaPublic health system; Healthcare activity; ReportSistema sanitario público; Actividad asistencial; MemoriaLa Memòria de l’Institut Català de la Salut vol ser un reflex de la realitat de l’empresa sanitària més gran del país. En aquest document trobareu un recull de la feina realitzada pels professionals de la institució, que s’orienta a millorar la salut de la ciutadania

Strategic analysis of I.R.C.C.S. Messina & Cost theory application

En este Trabajo Fin de Grado, la función que he realizado ha sido la de involucrarme dentro del ambiente que hay alrededor del “Istituto di Ricovero e Cura a Carttere Scientifico” (IRCCS) Bonino-Pulejo de Messina. Entendiendo como funciona este, y lo que supone para la sociedad siciliana e italiana. Tras ello y teniendo los suficientes datos he realizado un análisis estratégico tanto de la zona como del hospital, utilizando técnicas aprendidas a lo largo de la carrera. A parte de esto, realicé una comparación de las técnicas novedosas que se utilizan en el IRCCS con las técnicas tradicionales, intentado hacer una combinación óptima para la mejora del paciente. Finalmente habiendo realizado los análisis anteriores y a través de la teoría de coste pude llegar a la matriz de estrategias de actuación a través del análisis interno y externo, además de proponer diferentes indicadores que en un futuro se pueden utilizar para medir la mejora del hospital, teniendo un punto de referencia, donde está ahora, y un objetivo, donde se quiere llegar a estar.Departamento de Organización de Empresas y Comercialización e Investigación de MercadosGrado en Ingeniería en Organización Industria

Telemedicine

Telemedicine is a rapidly evolving field as new technologies are implemented for example for the development of wireless sensors, quality data transmission. Using the Internet applications such as counseling, clinical consultation support and home care monitoring and management are more and more realized, which improves access to high level medical care in underserved areas. The 23 chapters of this book present manifold examples of telemedicine treating both theoretical and practical foundations and application scenarios

Outpatients' opinion and experience regarding telepharmacy during the COVID-19 pandemic: the Enopex Project

[Abstract] Background: Telepharmacy, as a remote pharmaceutical care procedure, is being used worldwide during the COVID-19 pandemic, with the aim of preserving the health of patients and professionals. Its future development should incorporate the assessment of patient perception, but no research study has investigated it. Objective: The objective was to poll the opinions and experiences of outpatients with telepharmacy through a purpose-developed questionnaire and to assess it's quality through an internal validity and reliability analysis. Methods: Cross-sectional observational study of adult patients who used telepharmacy services during the COVID-19 lockdown period in Spain. The subjects answered a 24-item questionnaire, after giving their informed consent. Place of delivery, informed pharmacotherapeutic follow-up, opinion about telepharmacy, future development, ethics/satisfaction, and coordination constituted the six questionnaire categories. After assessing the adequate sample size with the Kaiser-Meyer-Olkin test, the Bartlett sphericity test analyzed the validity of the questionnaire. The intraclass correlation coefficient and Cronbach's α coefficient calculations verified the reliability and internal consistency. Results: A total of 9442 interviews were administered to patients from 81 hospitals, of which 8079 were valid (52.8% female). A 54.1% were aged between 41-65 years; 42.7% had been in treatment for more than 5 years; 42.8% lived between 6-31 miles from the hospital. As many as 96.7% of patients were "satisfied" or "very satisfied" with telepharmacy, 97.5% considering it complementary to their usual follow-up; 55.9% expressed a preference for being followed up face to face when visiting the hospital. 75.6% said they had rather receive their medication at home. The sample size obtained was deemed appropriate [the Kaiser-Meyer-Olkin test (0.789) and Bartlett's sphericity test (p<0.005)]. The reliability analysis resulted in a Cronbach α = 0.7. Conclusion: Patients have shown high satisfaction with telepharmacy and the ENOPEX questionnaire is a tool with sufficient validity and reliability to be used in the evaluation of the care that patients receive through telepharmacy

Integrated primary health care in Greece, a missing issue in the current health policy agenda: a systematic review

Background: Over the past years, Greece has undergone several endeavors aimed at modernizing and improving national health care services with a focus on PHC. However, the extent to which integrated primary health care has been achieved is still questioned. <br><br> Purpose: This paper explores the extent to which integrated primary health care (PHC) is an issue in the current agenda of policy makers in Greece, reporting constraints and opportunities and highlighting the need for a policy perspective in developing integrated PHC in this Southern European country. <br><br> Methods: A systematic review in PubMed/Medline and SCOPUS, along with a hand search in selected Greek biomedical journals was undertaken to identify key papers, reports, editorials or opinion letters relevant to integrated health care. <br><br> Results: Our systematic review identified 198 papers and 161 out of them were derived from electronic search. Fifty-three papers in total served the scope of this review and are shortly reported. A key finding is that the long-standing dominance of medical perspectives in Greek health policy has been paving the way towards vertical integration, pushing aside any discussions about horizontal or comprehensive integration of care. <br><br> Conclusion: Establishment of integrated PHC in Greece is still at its infancy, requiring major restructuring of the current national health system, as well as organizational culture changes. Moving towards a new policy-based model would bring this missing issue on the discussion table, facilitating further development

Information Systems and Healthcare XXXIV: Clinical Knowledge Management Systems—Literature Review and Research Issues for Information Systems

Knowledge Management (KM) has emerged as a possible solution to many of the challenges facing U.S. and international healthcare systems. These challenges include concerns regarding the safety and quality of patient care, critical inefficiency, disparate technologies and information standards, rapidly rising costs and clinical information overload. In this paper, we focus on clinical knowledge management systems (CKMS) research. The objectives of the paper are to evaluate the current state of knowledge management systems diffusion in the clinical setting, assess the present status and focus of CKMS research efforts, and identify research gaps and opportunities for future work across the medical informatics and information systems disciplines. The study analyzes the literature along two dimensions: (1) the knowledge management processes of creation, capture, transfer, and application, and (2) the clinical processes of diagnosis, treatment, monitoring and prognosis. The study reveals that the vast majority of CKMS research has been conducted by the medical and health informatics communities. Information systems (IS) researchers have played a limited role in past CKMS research. Overall, the results indicate that there is considerable potential for IS researchers to contribute their expertise to the improvement of clinical process through technology-based KM approaches

Compliance and Adherence to Enteral Nutrition Treatment in Adults: A Systematic Review

OBJECTIVE: To review the scientific literature that has verified and/or assessed compliance and adherence to enteral nutrition (EN) in adult patients. METHOD: This study involved a critical analysis of articles retrieved from MEDLINE (PubMed), The Cochrane Library, Embase, Scopus and Web of Science using the terms "Treatment Adherence and Compliance" and "Enteral Nutrition", applying the filters "Comparative Study" or "Clinical Trial", "Humans" and "Adults". Date of the search: 25 October 2018. RESULTS: A total of 512 references were retrieved, of which 23 documents were selected after applying the inclusion and exclusion criteria. The techniques measuring adherence to EN were determined by dietary intake, self-reporting, counts of leftover containers or presence of complications; however, in no case were validated questionnaires used. The time and periodicity of the assessment presented very heterogeneous results, with measurement predominantly being done at the beginning and at the end of the study. The best adherence rates were obtained in hospitalized patients (approximately 80%). CONCLUSIONS: Frequent and regular monitoring of the adherence of patients under prolonged treatment with EN is necessary, and the use of measurement techniques that allow obtaining information on the causes of non-adherence facilitates early interventions to optimize treatment outcomes. Patient and/or caregiver education in the management of EN and the intervention of the community pharmacy in monitoring patients can be key to improving the adherence to EN.The authors received no financial support for the research, authorship, and/or publication of this article. The protocol of this systematic review has not been registered.S

A framework for privacy aware design in future mobile applications

Mobile communications and applications play an important role in connecting people ubiquitously across different domain spaces due to their portable nature and easy accessibility. Mobile applications have drastically changed the way businesses are run by bringing them closer to their customers. Businesses today are connected to cloud based-tools, which makes it easier to start and run a business. Furthermore, mobile applications have changed the way we communicate with each other in our daily lives. They have increasingly been deployed by companies to help with, among other things, the management of business efficiency, ease in accessing information, simplifying communication and the provision of user-friendly applications. The number of mobile devices is increasing exponentially, it is estimated that 1.5 billion devices are available to the public worldwide. In addition, there is a multitude of operating systems running on these devices, all running on different architectures and configurations. The diversity of the different versions of applications that need to be constantly updated as they become outdated makes mobile applications highly susceptible to security and privacy flaws. Until recently, privacy has not been the main centre of interest within the design of mobile applications. Although, a number of privacy preserving solutions have been developed to improve privacy, existing research solutions adopt static design models which are not suitable for mobile applications. There is a significant gap between having common practices for designing and implementing privacy-preserving methods due to the cross-disciplinary nature of mobile applications. Most importantly, personal data are constantly collected and shared with unknown recipients. This is a challenging problem as users are not aware of how their data is used and shared without their consent. Furthermore, existing privacy policies are not stringently implemented during application development. Application designers do not comply with regulations envisaged by data protection regulation bodies. To investigate the problem domain, this thesis takes a bottom-up approach and contributes by analyzing current mobile applications to determine the integration of privacy mechanisms and privacy policies at the application level. We should however note that, the focus of this work contributes to the knowledge related to designing of holistic privacy preserving mobile applications and not the implementation aspect. Furthermore, this thesis introduces a novel privacy trade-off analysis framework that enables the design of privacy-aware applications. A privacy trade-off analysis generates a design solution that best suits an application's privacy goals and requirements. To demonstrate the privacy-aware framework, TRANK, two prototypes in the eHealth domain and the V2X Telematics domain, that integrate privacy-preserving technologies in modern mobile applications have been implemented and tested. Our implementation takes into consideration the trade-off between privacy, functionality and performance to provide a better privacy-aware application. The resulting system enables users to choose which data are to be collected about them. In this way, users can easily opt in and out of the application without having to give up all their personally identifiable information whenever they choose to, thus, enhance their overall privacy preservation. To the best of our knowledge our framework and the results in this thesis out perform the existing state of-the-art privacy preserving solutions. The privacy-enhancing technologies employed and the privacy-by-design mechanisms introduced at the initial stages of development thus, aid the improvement of privacy in mobile applications

Blockchain and Internet of Things in smart cities and drug supply management: Open issues, opportunities, and future directions

Blockchain-based drug supply management (DSM) requires powerful security and privacy procedures for high-level authentication, interoperability, and medical record sharing. Researchers have shown a surprising interest in Internet of Things (IoT)-based smart cities in recent years. By providing a variety of intelligent applications, such as intelligent transportation, industry 4.0, and smart financing, smart cities (SC) can improve the quality of life for their residents. Blockchain technology (BCT) can allow SC to offer a higher standard of security by keeping track of transactions in an immutable, secure, decentralized, and transparent distributed ledger. The goal of this study is to systematically explore the current state of research surrounding cutting-edge technologies, particularly the deployment of BCT and the IoT in DSM and SC. In this study, the defined keywords “blockchain”, “IoT”, drug supply management”, “healthcare”, and “smart cities” as well as their variations were used to conduct a systematic search of all relevant research articles that were collected from several databases such as Science Direct, JStor, Taylor & Francis, Sage, Emerald insight, IEEE, INFORMS, MDPI, ACM, Web of Science, and Google Scholar. The final collection of papers on the use of BCT and IoT in DSM and SC is organized into three categories. The first category contains articles about the development and design of DSM and SC applications that incorporate BCT and IoT, such as new architecture, system designs, frameworks, models, and algorithms. Studies that investigated the use of BCT and IoT in the DSM and SC make up the second category of research. The third category is comprised of review articles regarding the incorporation of BCT and IoT into DSM and SC-based applications. Furthermore, this paper identifies various motives for using BCT and IoT in DSM and SC, as well as open problems and makes recommendations. The current study contributes to the existing body of knowledge by offering a complete review of potential alternatives and finding areas where further research is needed. As a consequence of this, researchers are presented with intriguing potential to further create decentralized DSM and SC apps as a result of a comprehensive discussion of the relevance of BCT and its implementation.© 2023 The Author(s). Published by Elsevier B.V. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).fi=vertaisarvioitu|en=peerReviewed