Reporting an Experience on Design and Implementation of e-Health Systems on Azure Cloud

Electronic Health (e-Health) technology has brought the world with significant transformation from traditional paper-based medical practice to Information and Communication Technologies (ICT)-based systems for automatic management (storage, processing, and archiving) of information. Traditionally e-Health systems have been designed to operate within stovepipes on dedicated networks, physical computers, and locally managed software platforms that make it susceptible to many serious limitations including: 1) lack of on-demand scalability during critical situations; 2) high administrative overheads and costs; and 3) in-efficient resource utilization and energy consumption due to lack of automation. In this paper, we present an approach to migrate the ICT systems in the e-Health sector from traditional in-house Client/Server (C/S) architecture to the virtualised cloud computing environment. To this end, we developed two cloud-based e-Health applications (Medical Practice Management System and Telemedicine Practice System) for demonstrating how cloud services can be leveraged for developing and deploying such applications. The Windows Azure cloud computing platform is selected as an example public cloud platform for our study. We conducted several performance evaluation experiments to understand the Quality Service (QoS) tradeoffs of our applications under variable workload on Azure.Comment: Submitted to third IEEE International Conference on Cloud and Green Computing (CGC 2013

Development of Telephone-based e-Learning Portal

The proliferation of mobile phones in Nigeria, particularly among the student community, has continued to inspire the development and delivery of e-Learning applications. Most of the existing web-based e-Learning applications do not support nomadic voice-based learning (i.e. learning on the move through voice), and consequently do not provide a speedy access to information or enquiries on demand. Internet access is required to get every bit of information from most school portal system, which is not directly available to everyone. Lack of provision for voice in the existing web applications excludes support for people with limited capabilities such as the visually impaired and physical disabilities. In this paper, we present a design and development of a prototype telephone-based e-Learning portal that will be used for course registration and examination. This study is part of an ongoing e-Learning project involving the following modules: enrollment, course registration and examination, enquiries/information, messaging/collaboration, e-Learning and library. The prototype application was developed using VoiceXML for the voice user interface(VUI), PHP for database queries, Apache as the middle-ware and MySQL database as back-end. A unified modelling language (UML) was used to model and design the application. The proposed e-Learning system will compliment the web-based system in other to meet the needs of students with a range of disabilities such as visual impairment, repetitive strain injury, etc, that make reading and writing difficult. It also makes multiple platforms available to all users as well as boosting access to education for the physically challenged, particularly the sight impaired in the developing countries of the world. In institutions where students are not allowed to use mobile phones or where cost is an issue, then the alternative is the use of PC-phone

The effectiveness of mHealth interventions for maternal, newborn and child health in low- and middle-income countries:Protocol for a systematic review and meta-analysis

Rates of maternal, newborn and child (MNCH) mortality and morbidity are vastly greater in low– than in high–income countries and represent a major source of global health inequity. A host of systemic, economic, geopolitical and sociocultural factors have been implicated. Mobile information and communication technologies hold potential to ameliorate several of these challenges by supporting coordinated and evidence–based care, facilitating community based health services and enabling citizens to access health information and support. mHealth has attracted considerable attention as a means of supporting maternal, newborn and child health in developing countries and research to assess the impacts of mHealth interventions is increasing. While a number of expert reviews have attempted to summarise this literature, there remains a need for a fully systematic review employing gold standard methods of evidence capture, critical appraisal and meta–analysis, in order to comprehensively map, quality assess and synthesise this body of knowledge

Provisioning Quality of Service of Wireless Telemedicine for E-Health Services: A Review

In general, on-line medical consultation reduces time required for medical consultation and induces improvement in the quality and efficiency of healthcare services. The scope of study includes several key features of present day e-health applications such as X-ray, ECG, video, diagnosis images and other common applications. Moreover, the provision of Quality of Service (QoS) in terms of specific medical care services in e-health, the priority set for e-health services and the support of QoS in wireless networks and techniques or methods aimed at IEEE 802.11 to secure the provision of QoS has been assessed as well. In e-health, medical services in remote places which include rustic healthcare centres, ships, ambulances and home healthcare services can be supported through the applications of e-health services such as medical databases, electronic health data and the transferring of text, video, sound and images. Given this, a proposal has been made for a multiple service wireless networking with multiple sets of priorities. In relation to the terms of an acceptable QoS level by the customers of e-health services, prioritization is an important criterion in a multi-traffic network. The requirement for QoS in medical networking of wireless broadband has paved the way for bandwidth prerequisites and the live transmission or real-time medical applications. The proposed wireless network is capable of handling medical applications for both normal and life-threatening conditions as characterized by the level of emergencies. In addition, the allocation of bandwidth and the system that controls admittance designed based on IEEE 802.16 especially for e-health services or wireless telemedicine will be discussed in this study. It has been concluded that under busy traffic conditions, the proposed architecture can used as a feasible and reliable infrastructure network for telemedicine

Information Technology and Russia's Social Modernization

Information technologies play a very important role in modernizing Russia's economy and society as whole. Its competitive advantage lies in the availability of highly educated labour resources. Russia accounts for approximately 9% of researchers in the world as opposed to a share of about 0.3% in the world innovation market. Our approach is based on identifying ways to set up IT innovation centres and create an organizational and economic mechanisms making possible the transfer of new technologies to production processes and the creation of tools for innovative management. In the markets of high technology Russia will concentratie on software tools for IT security, applied modelling information systems, various types of software, and cryptographic systems, some types of specialized computing systems. In the Education Project two main mechanisms of systemic change are envisaged: to identify and support leading higher educational institutions; to introduce on a grand scale new knowledge-management methods and put mechanisms into practice. Among the main intentions of the Education Project the following should be mentioned: the modernization of its material-technical base, the internetization of education, the expansion of innovation centres on the pattern of universities and scientific and research institutes, the creation of Russian "Siliceous Valley"- Skolkovo complementary clusters of small, innovative companies. In the framework of the Health Care 2020 Programme. Activities are underway to introduce a Federal Register of the most widespread diseases, to operate waiting lists of those who need high technology medical help, and to centralize access to the common database of normative and reference information. Drafts of their electronic presentation formats are developed on the basis of international ISO standards. An Internet market for various types of medical and information services is being set up; telemedicine technologies are being taken into account. The social orientation of IT development will improve educational and health care systems, accelerate progress in extending the number of qualified professionals in IT (according to experts, the demand for these in 2012 will increase by up to 550,000 persons, and even then the country's demand will only be satisfied to the degree of 15%). A model enabling Russia to enter the group of countries with a high development of intellectual potential demands more intensive introduction of IT in modernization of Russian society. --codes Information technology,human factor,modern economy,social factors,telecommunication,education,personal training,medicine,national healthcare,telemedicine,social networks,internatization

Telesurgery information management systems in university hospitals of Tehran

    This is a descriptive study with research population coming from "telesurgery information management systems" in 23 teaching hospitals  of  Shahid  Beheshti and Tehran universities of medical sciences in 2011.The study used stratified and simple random sampling methods for subject selection, followed by observation and interview for data collection.  According to the results, video camera with 100%  application, was the most frequently used equipment in the hospitals for telesurgery data gathering.  Visual data analysis for developing three dimensional models was common just in 10% of hospitals.  Fiber Optic and satellite, with 40% application rate, were the most frequently used telecommunication equipments in the hospitals. The study indicated the significance of accurate and appropriate management of telesurgery information as the first step for appropriate implementation of telesurgery programs in Iran

Social, Organizational, and Technological Factors Impacting Clinicians’ Adoption of Mobile Health Tools: A Systematic Literature Review

Background: There is a growing body of evidence highlighting the potential of mobile health (mHealth) in reducing health care costs, enhancing access, and improving the quality of patient care. However, user acceptance and adoption are key prerequisites to harness this potential; hence, a deeper understanding of the factors impacting this adoption is crucial for its success. Objective: The aim of this review was to systematically explore relevant published literature to synthesize the current understanding of the factors impacting clinicians’ adoption of mHealth tools, not only from a technological perspective but also from social and organizational perspectives. Methods: A structured search was carried out of MEDLINE, PubMed, the Cochrane Library, and the SAGE database for studies published between January 2008 and July 2018 in the English language, yielding 4993 results, of which 171 met the inclusion criteria. The Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines and the Cochrane handbook were followed to ensure a systematic process. Results: The technological factors impacting clinicians’ adoption of mHealth tools were categorized into eight key themes: usefulness, ease of use, design, compatibility, technical issues, content, personalization, and convenience, which were in turn divided into 14 subthemes altogether. Social and organizational factors were much more prevalent and were categorized into eight key themes: workflow related, patient related, policy and regulations, culture or attitude or social influence, monetary factors, evidence base, awareness, and user engagement. These were divided into 41 subthemes, highlighting the importance of considering these factors when addressing potential barriers to mHealth adoption and how to overcome them. Conclusions: The study results can help inform mHealth providers and policymakers regarding the key factors impacting mHealth adoption, guiding them into making educated decisions to foster this adoption and harness the potential benefits

A Review on Provisioning Quality of Service of Wireless Telemedicine for E-Health Services

In general, on-line medical consultation reduces time required for medical consultation induces improvement in the quality and efficiency of healthcare services. All major types of current e-health applications such as ECG, X-ray, video, diagnosis images and other common applications have been included in the scope of the study. In addition, the provision of Quality of Service (QoS) for the application of specific healthcare services in e-health, the scheme of priority for e-health services and the support of QoS in wireless networks and techniques or methods for IEEE 802.11 to guarantee the provision of QoS has also been assessed. In e-health, medical services in remote locations such as rural healthcare centers, ambulances, ships as well as home healthcare services can be supported through the applications of e-health services such as medical databases, electronic health records and the routing of text, audio, video and images. Given this, an adaptive resource allocation for a wireless network with multiple service types and multiple priorities have been proposed. For the provision of an acceptable QoS level to users of e-health services, prioritization is an important criterion in a multi-traffic network. The requirement for QoS provisioning in wireless broadband medical networks have paved the pathway for bandwidth requirements and the real-time or live transmission of medical applications. From the study, good performance of the proposed scheme has been validated by the results obtained. The proposed wireless network is capable of handling medical applications for both normal and life-threatening conditions as characterized by the level of emergencies. In addition, the bandwidth allocation and admission control algorithm for IEEE 802.16- based design specifically for wireless telemedicine/e-health services have also been presented in the study. It has been concluded that under busy traffic conditions, the proposed architecture can used as a feasible and reliable infrastructure network for telemedicine

Factors Impacting Clinicians’ Adoption of a Clinical Photo Documentation App and its Implications for Clinical Workflows and Quality of Care: Qualitative Case Study

Background: Mobile health (mHealth) tools have shown promise in clinical photo and wound documentation for their potential to improve workflows, expand access to care, and improve the quality of patient care. However, some barriers to adoption persist. Objective: This study aims to understand the social, organizational, and technical factors affecting clinicians’ adoption of a clinical photo documentation mHealth app and its implications for clinical workflows and quality of care. Methods: A qualitative case study of a clinical photo and wound documentation app called imitoCam was conducted. The data were collected through 20 in-depth interviews with mHealth providers, clinicians, and medical informatics experts from 8 clinics and hospitals in Switzerland and Germany. Results: According to the study participants, the use of mHealth in clinical photo and wound documentation provides numerous benefits such as time-saving and efficacy, better patient safety and quality of care, enhanced data security and validation, and better accessibility. The clinical workflow may also improve when the app is a good fit, resulting in better collaboration and transparency, streamlined daily work, clinician empowerment, and improved quality of care. The findings included important factors that may contribute to or hinder adoption. Factors may be related to the material nature of the tool, such as the perceived usefulness, ease of use, interoperability, cost, or security of the app, or social aspects such as personal experience, attitudes, awareness, or culture. Organizational and policy barriers include the available clinical practice infrastructure, workload and resources, the complexity of decision making, training, and ambiguity or lack of regulations. User engagement in the development and implementation process is a vital contributor to the successful adoption of mHealth apps. Conclusions: The promising potential of mHealth in clinical photo and wound documentation is clear and may enhance clinical workflow and quality of care; however, the factors affecting adoption go beyond the technical features of the tool itself to embrace significant social and organizational elements. Technology providers, clinicians, and decision makers should work together to carefully address any barriers to improve adoption and harness the potential of these tools