پرونده سلامت و ثبت خدمات ارائه شده در مراکز مجری طرح پزشک خانواده و بیمه روستایی استان‌های شمالی ایران

زمینه و هدف: یکی از وظایف اصلی پزشک خانواده تشکیل پرونده سلامت و ثبت کلیه خدمات ارائه شده می‌باشد. این مطالعه به منظور بررسی کمیت و کیفیت تشکیل پرونده سلامت و ثبت خدمات ارائه شده در برنامه پزشک خانواده در استان‌های شمالی ایران انجام گرفت. مواد و روش‌ها: این مطالعه مقطعی در شش ماهه دوم 1391 انجام گرفت. 139 مرکز مجری طرح پزشک خانواده و بیمه روستایی در سه استان گلستان، مازندران و گیلان بصورت تصادفی منظم به عنوان نمونه پژوهش انتخاب و در مراکز منتخب عملکرد ثبتی کلیه پزشکان خانواده بررسی شد. ابزار جمع‌آوری داده‌ها پرسشنامه محقق ساخته بوده که روایی و پایایی آن مورد تائید قرار گرفت. داده‌ها در SPSS18 در سطح معنی‌داری P<0.05 تحلیل شد. نتایج: از 189 پزشک خانواده مورد مطالعه، 43 پزشک (23 درصد) مشخصات بیماران ارجاع داده شده به سطح2 و نتایج آن را در فرم سابقه ارجاع ثبت می‌کردند. از 1890 خانوار بررسی شده، 1559 خانوار دارای پرونده سلامت بودند که پرونده سلامت 892 خانوار (57 درصد) بطورکامل تکمیل شد. از 5869 نفر اعضای خانوار بررسی شده، 4229 نفر حداقل یکبار توسط پزشک خانواده خود معاینات دوره‌ای شدند که نتایج معاینات دوره‌ای انجام شده 1919 نفر (46 درصد) بطور کامل ثبت گردید. میزان ثبت فرم سابقه ارجاع به پزشک متخصص در استان‌های شمالی ایران تفاوت معنی‌دار وجود داشت (P=0.001). نتیجه‌گیری: کمیت و کیفیت تشکیل پرونده سلامت و ثبت خدمات ارائه شده در سطح مورد انتظار نبوده و نیاز به مداخلات متناسب دارد

Consumer acceptance of biometrics for identity verification in financial transactions

Biometrics can unequivocally verify a person’s identity and, thus, have significant potential to curb the crime of identity theft, which costs individuals, organizations, and society billions of dollars annually. While financial institutions may be highly motivated to examine the feasibility of adopting biometrics for identity verification, research regarding consumer acceptance of this technology is limited. This paper proposes and empirically validates a research model for consumer acceptance of biometric identity verification for financial transactions. Additionally, conditions of voluntariness and user control are explored for their effects on user attitudes within this context. Implications for theory, practice, and future research are outlined

Patient Health Record Systems Scope and Functionalities: Literature Review and Future Directions

Background: A new generation of user-centric information systems is emerging in health care as patient health record (PHR) systems. These systems create a platform supporting the new vision of health services that empowers patients and enables patient-provider communication, with the goal of improving health outcomes and reducing costs. This evolution has generated new sets of data and capabilities, providing opportunities and challenges at the user, system, and industry levels. Objective: The objective of our study was to assess PHR data types and functionalities through a review of the literature to inform the health care informatics community, and to provide recommendations for PHR design, research, and practice. Methods: We conducted a review of the literature to assess PHR data types and functionalities. We searched PubMed, Embase, and MEDLINE databases from 1966 to 2015 for studies of PHRs, resulting in 1822 articles, from which we selected a total of 106 articles for a detailed review of PHR data content. Results: We present several key findings related to the scope and functionalities in PHR systems. We also present a functional taxonomy and chronological analysis of PHR data types and functionalities, to improve understanding and provide insights for future directions. Functional taxonomy analysis of the extracted data revealed the presence of new PHR data sources such as tracking devices and data types such as time-series data. Chronological data analysis showed an evolution of PHR system functionalities over time, from simple data access to data modification and, more recently, automated assessment, prediction, and recommendation. Conclusions: Efforts are needed to improve (1) PHR data quality through patient-centered user interface design and standardized patient-generated data guidelines, (2) data integrity through consolidation of various types and sources, (3) PHR functionality through application of new data analytics methods, and (4) metrics to evaluate clinical outcomes associated with automated PHR system use, and costs associated with PHR data storage and analytics

PRONTUARIO ELECTRÓNICO DEL PACIENTE: EVALUACIÓN DE USABILIDAD POR EL EQUIPO DE ENFERMERÍA

El objetivo de este trabajo fue evaluar la usabilidad y las dificultades halladas por 99 profesionales de enfermería en el manoseo de prontuario electrónico del paciente. Investigación exploratoria cuantitativa hecha por medio de la obtención de datos en el periodo de julio a noviembre de 2013. Los resultados apuntan que 71% de los auxiliares/técnicos y 70% de los enfermeros no tuvieron entrenamiento específico; siendo que 56% del equipo, que contestó no tener entrenamiento, presenta dificultad en el uso. Entre las características evaluadas de usabilidad del prontuario electrónico del paciente se destacan positivamente la adecuación a la tarea y, negativamente, la adecuación al aprendizaje. Por lo tanto, el sistema evaluado, a pesar de los avances, todavía se presenta complejo para el usuario que no tuvo entrenamiento, a pesar de poseir interfaz consistente e interactiva.This work aimed to evaluate the usability and the difficulties met by 99 nursing professionals using electronic health records. It is exploratory quantitative research, based on data collected in July – November 2013. The results show that 71% of the auxiliary nurses/nursing technicians and 70% of the nurses had not received specific training; 56% of the team, who stated that they had not received training experienced difficulty in using the system. Among the characteristics of usability of the electronic health record evaluated, suitability to the task stood out positively, while suitability to learning stood out negatively. The system evaluated, therefore, in spite of the advances arising from it, is still presented as complex to the user who has not received training, in spite of its having a consistent and interactive interface.O objetivo deste trabalho foi avaliar a usabilidade e as dificuldades encontradas por 99 profissionais de enfermagem no manuseio de prontuário eletrônico do paciente. Pesquisa exploratória quantitativa a partir da coleta de dados no período de julho a novembro de 2013. Os resultados demostram que 71% dos auxiliares/técnicos e 70% dos enfermeiros não receberam treinamento específico; sendo que 56% da equipe, que respondeu não ter recebido treinamento, apresenta dificuldade no uso. Dentre as características avaliadas de usabilidade do prontuário eletrônico do paciente destacam-se positivamente a adequação à tarefa e negativamente à adequação ao aprendizado. Portanto, o sistema avaliado, apesar dos avanços advindos, ainda se apresenta complexo para o usuário que não recebeu treinamento, apesar de possuir interface consistente e interativa

Where is Patient in EHR Project?

In this paper, we do a literature review on electronic health records (EHR) and patient involvement. It seems that patients are not included as much as one would presume. After our analysis of both literature and ethical nature, we suggest that research on why this is so and whether they should be included needs to be done.</p

An Approach for Managing Access to Personal Information Using Ontology-Based Chains

The importance of electronic healthcare has caused numerous changes in both substantive and procedural aspects of healthcare processes. These changes have produced new challenges to patient privacy and information secrecy. Traditional privacy policies cannot respond to rapidly increased privacy needs of patients in electronic healthcare. Technically enforceable privacy policies are needed in order to protect patient privacy in modern healthcare with its cross organisational information sharing and decision making. This thesis proposes a personal information flow model that specifies a limited number of acts on this type of information. Ontology classified Chains of these acts can be used instead of the "intended/business purposes" used in privacy access control to seamlessly imbuing current healthcare applications and their supporting infrastructure with security and privacy functionality. In this thesis, we first introduce an integrated basic architecture, design principles, and implementation techniques for privacy-preserving data mining systems. We then discuss the key methods of privacypreserving data mining systems which include four main methods: Role based access control (RBAC), Hippocratic database, Chain method and eXtensible Access Control Markup Language (XACML). We found out that the traditional methods suffer from two main problems: complexity of privacy policy design and the lack of context flexibility that is needed while working in critical situations such as the one we find in hospitals. We present and compare strategies for realising these methods. Theoretical analysis and experimental evaluation show that our new method can generate accurate data mining models and safe data access management while protecting the privacy of the data being mined. The experiments followed comparative kind of experiments, to show the ease of the design first and then follow real scenarios to show the context flexibility in saving personal information privacy of our investigated method

Intention To Use A Personal Health Record (phr) A Cross Sectional View Of The Characteristics And Opinions Of Patients Of One Internal Medicine Practice

A personal health record (PHR) allows a patient to exert control over his/her healthcare by enhancing communication with healthcare providers. According to research, patients find value in having access to information contained in their medical records. Often a glossary is required to aid in interpreting the information and understanding the content. However, giving patients the ability to speak with providers about their medical conditions empowers them to participate as informed healthcare consumers. The majority of patients (75%) at Medical Specialists expressed their intention to adopt the PHR if it is made available to them. Although the perceived usefulness of a PHR was a significant determining factor, comfort level with technology, health literacy, and socioeconomic status were indirectly related to intention to adopt as well. Perceived health status was not found to be a significant factor in this population for determining intention to adopt a PHR. The majority of patients in each category of gender, age, marital status, and race/ethnicity (except American Indian/Alaska Native) expressed interest in adopting a PHR, with most categories being above 70%. Findings indicate a broad acceptance of this new technology by the patients of Medical Specialists. Improvement of adoption and use rates may depend on availability of office staff for hands-on training as well as assistance with interpretation of medical information. Hopefully, over time technology barriers will disappear, and usefulness of the information will promote increased demand

Animating the Ethical Demand:Exploring user dispositions in industry innovation cases through animation-based sketching

This paper addresses the challenge of attaining ethical user stances during the design process of products and services and proposes animation-based sketching as a design method, which supports elaborating and examining different ethical stances towards the user. The discussion is qualified by an empirical study of Responsible Research and Innovation (RRI) in a Triple Helix constellation. Using a three-week long innovation workshop, UCrAc, involving 16 Danish companies and organisations and 142 students as empirical data, we discuss how animation-based sketching can explore not yet existing user dispositions, as well as create an incentive for ethical conduct in development and innovation processes. The ethical fulcrum evolves around Løgstrup's Ethical Demand and his notion of spontaneous life manifestations. From this, three ethical stances are developed; apathy, sympathy and empathy. By exploring both apathetic and sympathetic views, the ethical reflections are more nuanced as a result of actually seeing the user experience simulated through different user dispositions. Exploring the three ethical stances by visualising real use cases with the technologies simulated as already being implemented makes the life manifestations of the users in context visible. We present and discuss how animation-based sketching can support the elaboration and examination of different ethical stances towards the user in the product and service development process. Finally we present a framework for creating narrative representations of emerging technology use cases, which invite to reflection upon the ethics of the user experience.</jats:p

Perspectiva social del fenómeno de la inclusión digital: Una aproximación desde la Complejidad

La inclusión digital es un fenómeno cuyo objetivo es reducir la brecha digital existente en una región determinada; brecha entendida como la diferencia en el acceso, uso, adopción y apropiación de las herramientas tecnológicas. Se encuentra a partir de la revisión del estado del arte que; por un lado, los proyectos-programas que intentan promover este fenómeno, se gestionan de manera reducida; y por el otro, que es relevante definir y aproximarse a dicho fenómeno desde la complejidad, para una posterior representación desde las ciencias de la complejidad. En el presente documento se muestra el desarrollo de la tesis doctoral cuyo objetivo es conformar una propuesta desde el pensamiento complejo y las ciencias de la complejidad que permita relevar la perspectiva social en el fenómeno complejo de la Inclusión digital. Se resalta en este punto, como a pesar de realizar en la literatura menciones acerca de la necesidad de un abordaje más social a los procesos de inclusión digital, estos son tratados sólo de forma superficial, dejándolos de forma implícita a los aspectos cuantitativos de carácter demográfico que se usan tanto para formular como para evaluar los diferentes programas-proyectos para inclusión digital. Como conclusión general e inicial se menciona que en el ambiente académico y para la gestión de programas-proyectos, existe interés de abordar el fenómeno de la inclusión digital desde la complejidad y sus principios. Y que este fenómenos puede explicarse desde este enfoqu para analizar el comportamiento de los procesos de adopción y apropiación de TICAbstract: Digital inclusion is a phenomenon whose objective is to reduce the existing digital divide in a given region; gap understood as the difference in access, use, adoption and appropriation of technological tools. It is found from the review of the state of the art that; On the one hand, the projects-programs that try to promote this phenomenon, are managed in a reduced way; and on the other, that it is relevant to define and approach this phenomenon from complexity, for a later representation from the complexity sciences. The present document shows the development of the doctoral thesis whose objective is to conform a proposal from the complex thought and the complexity sciences that allows to relieve the social perspective in the complex phenomenon of the digital Inclusion. It is highlighted in this point, as despite making references in the literature about the need for a more social approach to digital inclusion processes, these are treated only superficially, leaving them implicitly to the quantitative aspects of a demographic nature which are used both to formulate and to evaluate the different program-projects for digital inclusion. As a general and initial conclusion, it is mentioned that in the academic environment and for the management of program-projects, there is interest in addressing the phenomenon of digital inclusion from complexity and its principles. And that this phenomenon can be explained from this approach to analyze the behavior of the processes of adoption and appropriation of ICTDoctorad

pHealth 2021. Proc. of the 18th Internat. Conf. on Wearable Micro and Nano Technologies for Personalised Health, 8-10 November 2021, Genoa, Italy

Smart mobile systems – microsystems, smart textiles, smart implants, sensor-controlled medical devices – together with related body, local and wide-area networks up to cloud services, have become important enablers for telemedicine and the next generation of healthcare services. The multilateral benefits of pHealth technologies offer enormous potential for all stakeholder communities, not only in terms of improvements in medical quality and industrial competitiveness, but also for the management of healthcare costs and, last but not least, the improvement of patient experience. This book presents the proceedings of pHealth 2021, the 18th in a series of conferences on wearable micro and nano technologies for personalized health with personal health management systems, hosted by the University of Genoa, Italy, and held as an online event from 8 – 10 November 2021. The conference focused on digital health ecosystems in the transformation of healthcare towards personalized, participative, preventive, predictive precision medicine (5P medicine). The book contains 46 peer-reviewed papers (1 keynote, 5 invited papers, 33 full papers, and 7 poster papers). Subjects covered include the deployment of mobile technologies, micro-nano-bio smart systems, bio-data management and analytics, autonomous and intelligent systems, the Health Internet of Things (HIoT), as well as potential risks for security and privacy, and the motivation and empowerment of patients in care processes. Providing an overview of current advances in personalized health and health management, the book will be of interest to all those working in the field of healthcare today