Whole-person Care Ministry: a Study of Discordant Attitudes at Loma Linda University Medical Center

Problem. The defining emphasis of Loma Linda University Medical Center is to “Continue the teaching and healing ministry of Jesus” and “Make man whole” through a whole-person care approach. This study aims to determine why a significant number of patients fail to establish rapport with their care providers resulting in less than desirable healing outcomes and longer hospital stays. Method. A Qualitative Research study was conducted with 12 interviewees to ascertain their insight of what comprised an excellent care partnership with their medical providers and, conversely, what constituted unacceptable care in their view. A representative balance of diversities in ethnicity, culture, age, gender, medical diagnosis and religion among the patient participants was achieved by selecting the first 12 former patients who agreed to contribute to the study. Results. Study participants confirmed that effective communication is the basis for the establishment of trust in the provider/patient relationship. They are more apt to comply with recommendations for treatment, experience greater satisfaction with their care and are less inclined to seek legal redress in the event that treatment is unsuccessful if a trusting and responsive relationship with their provider is achieved. Partnership rather than paternalism is their preferred model for the ideal doctor or care provider relationship. Conclusions. Care providers best connect with patients by engaging intentionally with them regarding their medical, emotional, social and spiritual needs. The additional time and effort invested in good communication pays dividends in securing patients’ cooperation and investment in their care. Patients do not appreciate condescension, apparent disinterest in them as persons or being treated just as a case or as a disease to be beaten. A physician or care provider that manifests approachability, listens well, follows up with what is learned and goes above and beyond the call of duty is seen as a valuable asset by the patient and the institution

J Biomed Inform

We followed a systematic approach based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses to identify existing clinical natural language processing (NLP) systems that generate structured information from unstructured free text. Seven literature databases were searched with a query combining the concepts of natural language processing and structured data capture. Two reviewers screened all records for relevance during two screening phases, and information about clinical NLP systems was collected from the final set of papers. A total of 7149 records (after removing duplicates) were retrieved and screened, and 86 were determined to fit the review criteria. These papers contained information about 71 different clinical NLP systems, which were then analyzed. The NLP systems address a wide variety of important clinical and research tasks. Certain tasks are well addressed by the existing systems, while others remain as open challenges that only a small number of systems attempt, such as extraction of temporal information or normalization of concepts to standard terminologies. This review has identified many NLP systems capable of processing clinical free text and generating structured output, and the information collected and evaluated here will be important for prioritizing development of new approaches for clinical NLP.CC999999/ImCDC/Intramural CDC HHS/United States2019-11-20T00:00:00Z28729030PMC6864736694

A constructive view of the non-compliant patient: Understanding barriers to compliance and proposed solutions

The health care industry is currently experiencing many changes. Managed care is altering the way health care is delivered through advances in technology and new approaches in financing. As part of this transition, importance will be placed on patients becoming better consumers and participants in determining their health care service needs. The focus of this study is on the non-compliant patient and the many factors that revolve around this topic

Co-created business models of connected health services

Abstract. Because of the advancement of technology, healthcare has been developed along with different sectors such as education, entertainment, and business. ‘Connected Health’ term comes for changing the patient-provider relationship by using technology which is also called ‘e-health’. As a developed country like Finland who is the pioneer of e-health has been participating a project called inDemand for the purpose of changing healthcare to provide co-created experience for patients. Their main objective to identify and solve the needs relates to health entities by enhancing the capacity of them and creating opportunity for private organization. This thesis is a part of this project. This study aims to find out the process for a co-created business model for connected health services. The study concentrates on two parts- business model and co-creation. It deals with different concepts of business model and co-creation, their way of doing along with components and the impact of them in healthcare. The study has a qualitative nature and it applies the case study method for conducting the research. In this method, empirical data is collected based on semi-structured thematic interviews by face-to-face and Skype. Participants were chosen from those organizations which are the stakeholders of inDemand project for getting overall idea about their way of doing the co-creation process. The findings of the thesis outline that there should be a combination of components from the business model and co-creation for conducting the process of co-creation of business model. The components are-customers, target customer segments, selling, marketing, and distribution channel activities, value proposition, value creation and extraction, value network and competition, products/services, pricing, cost structure and revenue model, processes, resources and practices, dialogue, access, risk benefits and transparency and shared purpose. In this research, the theoretical contribution confirms the results of the study. The results can help the case companies to properly blend the components and at the same time, to motivate all stakeholders along with customers or patients to participate in the co-creation process. Future research will continue to identify the process of co-creation over a large population to see the indifferences among every sample

Designing ubiquitous computing for reflection and learning in diabetes management

This dissertation proposes principles for the design of ubiquitous health monitoring applications that support reflection and learning in context of diabetes management. Due to the high individual differences between diabetes cases, each affected individual must find the optimal combination of lifestyle alterations and medication through reflective analysis of personal diseases history. This dissertation advocates using technology to enable individuals' proactive engagement in monitoring of their health. In particular, it proposes promoting individuals' engagement in reflection by exploiting breakdowns in individuals' routines or understanding; supporting continuity in thinking that leads to a systematic refinement of ideas; and supporting articulation of thoughts and understanding that helps to transform insights into knowledge. The empirical evidence for these principles was gathered thought the deployment studies of three ubiquitous computing applications that help individuals with diabetes in management of their diseases. These deployment studies demonstrated that technology for reflection helps individuals achieve their personal disease management goals, such as diet goals. In addition, they showed that using technology helps individuals embrace a proactive attitude towards their health indicated by their adoption of the internal locus of control.Ph.D.Committee Chair: Elizabeth D. Mynatt; Committee Member: Abowd, Gregory; Committee Member: Bruckman, Amy; Committee Member: Dourish, Paul; Committee Member: Nersessian, Nanc

Context-Aware Software

With the advent of PDAs (Personal Digital Assistants), smart phones, and other forms of mobile and ubiquitous computers, our computing resources are increasingly moving off of our desktops and into our everyday lives. However, the software and user interfaces for these devices are generally very similar to that of their desktop counterparts, despite the radically different and dynamic environments that they face. We propose that to better assist their users, such devices should be able to sense, react to, and utilise, the user's current environment or context. That is, they should become context-aware. In this thesis we investigate context-awareness at three levels: user interfaces, applications, and supporting architectures/frameworks. To promote the use of context-awareness, and to aid its deployment in software, we have developed two supporting frameworks. The first is an application-oriented framework called stick-e notes. Based on an electronic version of the common Post-It Note, stick-e notes enable the attachment of any electronic resource (e.g. a text file, movie, Java program, etc.) to any type of context (e.g. location, temperature, time, etc.). The second framework we devised seeks to provide a more universal support for the capture, manipulation, and representation of context information. We call it the Context Information Service (CIS). It fills a similar role in context-aware software development as GUI libraries do in user interface development. Our applications research explored how context-awareness can be exploited in real environments with real users. In particular, we developed a suite of PDA-based context-aware tools for fieldworkers. These were used extensively by a group of ecologists in Africa to record observations of giraffe and rhinos in a remote Kenyan game reserve. These tools also provided the foundations for our HCI work, in which we developed the concept of the Minimal Attention User Interface (MAUI). The aim of the MAUI is to reduce the attention required by the user in operating a device by carefully selecting input/output modes that are harmonious to their tasks and environment. To evaluate our ideas and applications a field study was conducted in which over forty volunteers used our system for data collection activities over the course of a summer season at the Kenyan game reserve. The PDA-based tools were unanimously preferred to the paper-based alternatives, and the context-aware features were cited as particular reasons for preferring them. In summary, this thesis presents two frameworks to support context-aware software, a set of applications demonstrating how context-awareness can be utilised in the ''real world'', and a set of HCI guidelines and principles that help in creating user interfaces that fit to their context of use