Towards a Smarter organization for a Self-servicing Society

Traditional social organizations such as those for the management of healthcare are the result of designs that matched well with an operational context considerably different from the one we are experiencing today. The new context reveals all the fragility of our societies. In this paper, a platform is introduced by combining social-oriented communities and complex-event processing concepts: SELFSERV. Its aim is to complement the "old recipes" with smarter forms of social organization based on the self-service paradigm and by exploring culture-specific aspects and technological challenges.Comment: Final version of a paper published in the Proceedings of International Conference on Software Development and Technologies for Enhancing Accessibility and Fighting Info-exclusion (DSAI'16), special track on Emergent Technologies for Ambient Assisted Living (ETAAL

Data privacy by design: digital infrastructures for clinical collaborations

The clinical sciences have arguably the most stringent security demands on the adoption and roll-out of collaborative e-Infrastructure solutions such as those based upon Grid-based middleware. Experiences from the Medical Research Council (MRC) funded Virtual Organisations for Trials and Epidemiological Studies (VOTES) project and numerous other real world security driven projects at the UK e-Science National e-Science Centre (NeSC – www.nesc.ac.uk) have shown that whilst advanced Grid security and middleware solutions now offer capabilities to address many of the distributed data and security challenges in the clinical domain, the real clinical world as typified by organizations such as the National Health Service (NHS) in the UK are extremely wary of adoption of such technologies: firewalls; ethics; information governance, software validation, and the actual realities of existing infrastructures need to be considered from the outset. Based on these experiences we present a novel data linkage and anonymisation infrastructure that has been developed with close co-operation of the various stakeholders in the clinical domain (including the NHS) that addresses their concerns and satisfies the needs of the academic clinical research community. We demonstrate the implementation of this infrastructure through a representative clinical study on chronic diseases in Scotland

Building Medical Homes in State Medicaid and CHIP Programs

Presents strategies, best practices, and lessons learned from ten states' efforts to advance the medical home model of comprehensive and coordinated care in Medicaid and Children's Health Insurance Programs in order to improve quality and contain costs

A smartphone-based health care chatbot to promote self-management of chronic pain (SELMA) : pilot randomized controlled trial

Background: Ongoing pain is one of the most common diseases and has major physical, psychological, social, and economic impacts. A mobile health intervention utilizing a fully automated text-based health care chatbot (TBHC) may offer an innovative way not only to deliver coping strategies and psychoeducation for pain management but also to build a working alliance between a participant and the TBHC. Objective: The objectives of this study are twofold: (1) to describe the design and implementation to promote the chatbot painSELfMAnagement (SELMA), a 2-month smartphone-based cognitive behavior therapy (CBT) TBHC intervention for pain self-management in patients with ongoing or cyclic pain, and (2) to present findings from a pilot randomized controlled trial, in which effectiveness, influence of intention to change behavior, pain duration, working alliance, acceptance, and adherence were evaluated. Methods: Participants were recruited online and in collaboration with pain experts, and were randomized to interact with SELMA for 8 weeks either every day or every other day concerning CBT-based pain management (n=59), or weekly concerning content not related to pain management (n=43). Pain-related impairment (primary outcome), general well-being, pain intensity, and the bond scale of working alliance were measured at baseline and postintervention. Intention to change behavior and pain duration were measured at baseline only, and acceptance postintervention was assessed via self-reporting instruments. Adherence was assessed via usage data. Results: From May 2018 to August 2018, 311 adults downloaded the SELMA app, 102 of whom consented to participate and met the inclusion criteria. The average age of the women (88/102, 86.4%) and men (14/102, 13.6%) participating was 43.7 (SD 12.7) years. Baseline group comparison did not differ with respect to any demographic or clinical variable. The intervention group reported no significant change in pain-related impairment (P=.68) compared to the control group postintervention. The intention to change behavior was positively related to pain-related impairment (P=.01) and pain intensity (P=.01). Working alliance with the TBHC SELMA was comparable to that obtained in guided internet therapies with human coaches. Participants enjoyed using the app, perceiving it as useful and easy to use. Participants of the intervention group replied with an average answer ratio of 0.71 (SD 0.20) to 200 (SD 58.45) conversations initiated by SELMA. Participants’ comments revealed an appreciation of the empathic and responsible interaction with the TBHC SELMA. A main criticism was that there was no option to enter free text for the patients’ own comments. Conclusions: SELMA is feasible, as revealed mainly by positive feedback and valuable suggestions for future revisions. For example, the participants’ intention to change behavior or a more homogenous sample (eg, with a specific type of chronic pain) should be considered in further tailoring of SELMA

Next generation assisting clinical applications by using semantic-aware electronic health records

The health care sector is no longer imaginable without electronic health records. However; since the original idea of electronic health records was focused on data storage and not on data processing, a lot of current implementations do not take full advantage of the opportunities provided by computerization. This paper introduces the Patient Summary Ontology for the representation of electronic health records and demonstrates the possibility to create next generation assisting clinical applications based on these semantic-aware electronic health records. Also, an architecture to interoperate with electronic health records formatted using other standards is presented

CoachAI: A Conversational Agent Assisted Health Coaching Platform

Poor lifestyle represents a health risk factor and is the leading cause of morbidity and chronic conditions. The impact of poor lifestyle can be significantly altered by individual behavior change. Although the current shift in healthcare towards a long lasting modifiable behavior, however, with increasing caregiver workload and individuals' continuous needs of care, there is a need to ease caregiver's work while ensuring continuous interaction with users. This paper describes the design and validation of CoachAI, a conversational agent assisted health coaching system to support health intervention delivery to individuals and groups. CoachAI instantiates a text based healthcare chatbot system that bridges the remote human coach and the users. This research provides three main contributions to the preventive healthcare and healthy lifestyle promotion: (1) it presents the conversational agent to aid the caregiver; (2) it aims to decrease caregiver's workload and enhance care given to users, by handling (automating) repetitive caregiver tasks; and (3) it presents a domain independent mobile health conversational agent for health intervention delivery. We will discuss our approach and analyze the results of a one month validation study on physical activity, healthy diet and stress management