A web-based information system for a regional public mental healthcare service network in Brazil

Acknowledgements We would like to thank all the participating representatives of public mental health services for their invaluable contribution to this system development and implementation and the XIII Regional Health Department of Sao Paulo state for their support. Funding: This study was funded by the ‘Conselho Nacional de Desenvolvimento Científico e Tecnológico’ (CNPq) and ‘Coordenação de Aperfeiçoamento de Pessoal de Nível Superior’ (CAPES)—Science Without Borders Programme.Peer reviewedPublisher PD

Interoperability between health information systems in the hospital context

The information systems had a positive effect on the health service by reducing the physical documentation, more available information to monitor the patient and safer data storage. On the other hand, there was a negative impact due to an increase of diverse systems operating which demanded more training and support to hospitals structure aligned with the lack of interoperability standards that promote the patient´s data sharing between them. Therefore, this dissertation focused on analysing the existent interoperability between information systems in the Portuguese health service, determine the key aspects to establish communication among them, and the consequences it has on the healthcare professional´s routines. Interviews were conducted with healthcare professionals and hospital suppliers to collect their experience on interacting with this technology, their opinion about the influence it has on the hospital´s routine, and the potential measures to improve the current situation. This research concluded that the lack of interoperability and an unfriendly interface generates a complex use of the systems with a high number of clicks and slower navigation to execute the tasks that can cause loss of time for healthcare professionals. Besides, the public hospital demonstrated to have a higher number of IS suppliers and lower levels of integration between systems compared with private hospitals. Lastly, it was demonstrated that an organisational culture oriented to the technology change and a strategic plan to adapt to the hospital's approach is necessary to a successful implementation of health information systems.Os sistemas de informação tiveram um efeito positivo no serviço de saúde com redução na documentação em papel, maior disponibilidade de informação sobre o paciente e segurança no armazenamento de dados. Por outro lado, houve um impacto negativo devido ao aumento na diversidade de sistemas a operar, que exigiram mais treino e apoio à estrutura hospitalar, associado à falta de padrões de interoperabilidade que promovam a partilha de dados do paciente. Assim, esta dissertação centra-se na análise da interoperabilidade existente entre os sistemas de informação no serviço de saúde português, em determinar os aspetos fundamentais para estabelecer a comunicação entre os mesmos e as consequências que têm na rotina do profissional de saúde. Foram realizadas entrevistas com profissionais da área e fornecedores hospitalares para recolher informação sobre a experiência na interação com esta tecnologia, a opinião sobre a influência que ela exerce na rotina hospitalar e as possíveis medidas para melhorar a atual situação. Esta investigação concluiu que a falta de interoperabilidade e uma interface pouco apelativo determinam um uso complexo destes sistemas com um elevado número de cliques e uma navegação mais lenta para executar as tarefas, que podem causar perda de tempo aos profissionais de saúde. Além disso, os hospitais públicos demonstram ter um maior número de fornecedores e menores níveis de integração entre os sistemas em comparação com os privados. Por fim, expõem-se que uma cultura organizacional direcionada para a mudança tecnológica e um plano estratégico de adaptação são necessários para o sucesso da implantação destes sistemas

A proof of concept of a mobile health application to support professionals in a portuguese nursing home

Over the past few years, the rapidly aging population has been posing several challenges to healthcare systems worldwide. Consequently, in Portugal, nursing homes have been getting a higher demand, and health professionals working in these facilities are overloaded with work. Moreover, the lack of health information and communication technology (HICT) and the use of unsophisticated methods, such as paper, in nursing homes to clinically manage residents lead to more errors and are time-consuming. Thus, this article proposes a proof of concept of a mobile health (mHealth) application developed for the health professionals working in a Portuguese nursing home to support them at the point-of-care, namely to manage and have access to information and to help them schedule, perform, and digitally record their tasks. Additionally, clinical and performance business intelligence (BI) indicators to assist the decision-making process are also defined. Thereby, this solution aims to introduce technological improvements into the facility to improve healthcare delivery and, by taking advantage of the benefits provided by these improvements, lessen some of the workload experienced by health professionals, reduce time-waste and errors, and, ultimately, enhance elders’ quality of life and improve the quality of the services provided.This work has been supported by FCT – Fundação para a Ciência e Tecnologia within the Project Scope: UID/CEC/00319/2019

The reform of the NHS in Portugal

The objective of this article is to describe the Portuguese National Healthcare Service, giving a special emphasis to the recent reforms that have been introduced since the beginning of 2002. Its main argument is that there are two different (but connected) rationales that underpin the orientation of the current reforms. One the one hand, the explicit rationale that refers mainly to the ‘visible’ and stated causes and motivations of the reforms. On the other hand, the implicit rationale, whose influence over the government’s actions is not expressed as such, either because it is not perceived, or because it is not assumed. For this purpose, it is essential to start by giving an historical account of how the NHS started in Portugal and in which direction it has been evolving in the last four decades. This section has particular interest considering that it gives meaning, together with other arguments, to the implicit rationale, to the extent that the current reforms are product of the historical context in which the NHS was created and its subsequent developments. In the second part, the focus is on the reformation period, that started in 2002 and that is still going on at the moment. The main reforms that are being conducted are analysed, being this section mainly of a descriptive nature. What is considered to be important in this section is to give the government’s account of the reforms, in order to make clear what are its motivations and its goals. Furthermore, by doing this analysis it makes it possible to put forward what is meant by explicit rationale and identify its features. In section three, the reforms described in section two are analysed individually in a critical way. The objective of this section is to ‘make sense’ of the reforms being undertaken by the government and consider some aspects that are still unclear and that need further reflection. It is throughout this section that the main argument of this article is explored, by discussing, when applicable, what is the rationale underpinning the different reforms

The reform of the NHS in Portugal

The objective of this article is to describe the Portuguese National Healthcare Service, giving a special emphasis to the recent reforms that have been introduced since the beginning of 2002. Its main argument is that there are two different (but connected) rationales that underpin the orientation of the current reforms. One the one hand, the explicit rationale that refers mainly to the ‘visible’ and stated causes and motivations of the reforms. On the other hand, the implicit rationale, whose influence over the government’s actions is not expressed as such, either because it is not perceived, or because it is not assumed. For this purpose, it is essential to start by giving an historical account of how the NHS started in Portugal and in which direction it has been evolving in the last four decades. This section has particular interest considering that it gives meaning, together with other arguments, to the implicit rationale, to the extent that the current reforms are product of the historical context in which the NHS was created and its subsequent developments. In the second part, the focus is on the reformation period, that started in 2002 and that is still going on at the moment. The main reforms that are being conducted are analysed, being this section mainly of a descriptive nature. What is considered to be important in this section is to give the government’s account of the reforms, in order to make clear what are its motivations and its goals. Furthermore, by doing this analysis it makes it possible to put forward what is meant by explicit rationale and identify its features. In section three, the reforms described in section two are analysed individually in a critical way. The objective of this section is to ‘make sense’ of the reforms being undertaken by the government and consider some aspects that are still unclear and that need further reflection. It is throughout this section that the main argument of this article is explored, by discussing, when applicable, what is the rationale underpinning the different reforms

The next generation of interoperability agents in healthcare

Interoperability in health information systems is increasingly a requirement rather than an option. Standards and technologies, such as multi-agent systems, have proven to be powerful tools in interoperability issues. In the last few years, the authors have worked on developing the Agency for Integration, Diffusion and Archive of Medical Information (AIDA), which is an intelligent, agent-based platform to ensure interoperability in healthcare units. It is increasingly important to ensure the high availability and reliability of systems. The functions provided by the systems that treat interoperability cannot fail. This paper shows the importance of monitoring and controlling intelligent agents as a tool to anticipate problems in health information systems. The interaction between humans and agents through an interface that allows the user to create new agents easily and to monitor their activities in real time is also an important feature, as health systems evolve by adopting more features and solving new problems. A module was installed in Centro Hospitalar do Porto, increasing the functionality and the overall usability of AIDA.This work is funded by National Funds through the FCT-Fundacao para a Ciencia e a Tecnologia (Portuguese Foundation for Science and Technology) within project PEst-OE/EEI/UI0752/2014. PEst-OE means in Portuguese "Strategic Project by National Funds" and "EEI" means "Informatics and Electronic Engineering"

7th International Conference on Ethics Education: Conference Proceedings

info:eu-repo/semantics/publishedVersio