26,248 research outputs found

    Pick-n-mix approaches to technology supply : XML as a standard “glue” linking universalised locals

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    We report on our experiences in a participatory design project to develop ICTs in a hospital ward working with deliberate self-harm patients. This project involves the creation and constant re-creation of sociotechnical ensembles in which XML-related technologies may come to play vital roles. The importance of these technologies arises from the aim underlying the project of creating systems that are shaped in locally meaningful ways but reach beyond their immediate context to gain wider importance. We argue that XML is well placed to play the role of "glue" that binds multiple such systems together. We analyse the implications of localised systems development for technology supply and argue that inscriptions that are evident in XML-related standards are and will be very important for the uptake of XML technologies

    A strategic approach to making sense of the “wicked” problem of ERM

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    Purpose – The purpose of this paper is to provide an approach to viewing the “wicked” problem of electronic records management (ERM), using the Cynefin framework, a sense-making tool. It re-conceptualises the ERM challenge by understanding the nature of the people issues. This supports decision making about the most appropriate tactics to adopt to effect positive change. Design/methodology/approach – Cynefin was used to synthesise qualitative data from an empirical research project that investigated strategies and tactics for improving ERM. Findings – ERM may be thought of as a dynamic, complex challenge but, viewed through the Cynefin framework, many issues are not complex; they are simple or complicated and can be addressed using best or good practice. The truly complex issues need a different approach, described as emergent practice. Cynefin provides a different lens through which to view, make sense of and re-perceive the ERM challenge and offers a strategic approach to accelerating change. Research limitations/implications – Since Cynefin has been applied to one data set, the findings are transferrable not generalisable. They, and/or the approach, can be used to further test the propositions. Practical implications – The resultant ERM framework provides a practical example for information and records managers to exploit or use as a starting point to explore the situation in particular organisational contexts. It could also be used in other practical, teaching and/or research-related records contexts. Originality/value – This paper provides a new strategic approach to addressing the wicked problem of ERM, which is applicable for any organisational context

    The Serums Tool-Chain:Ensuring Security and Privacy of Medical Data in Smart Patient-Centric Healthcare Systems

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    Digital technology is permeating all aspects of human society and life. This leads to humans becoming highly dependent on digital devices, including upon digital: assistance, intelligence, and decisions. A major concern of this digital dependence is the lack of human oversight or intervention in many of the ways humans use this technology. This dependence and reliance on digital technology raises concerns in how humans trust such systems, and how to ensure digital technology behaves appropriately. This works considers recent developments and projects that combine digital technology and artificial intelligence with human society. The focus is on critical scenarios where failure of digital technology can lead to significant harm or even death. We explore how to build trust for users of digital technology in such scenarios and considering many different challenges for digital technology. The approaches applied and proposed here address user trust along many dimensions and aim to build collaborative and empowering use of digital technologies in critical aspects of human society

    Electronic health record standards

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    Objectives: This paper seeks to provide an overview of the initiatives that are proceeding internationally to develop standards for the exchange of electronic health record (EHR) information between EHR systems.Methods: The paper reviews the clinical and ethico-legal requirements and research background on the representation and communication of EHR data, which primarily originates from Europe through a series of EU funded Health Telematics projects over the post thirteen years. The major concept that underpin the information models and knowledge models are summarised. These provide the requirements and the best evidential basis from which HER communications standards should be developed.Results. The main focus of EHR communications standardisation is presently occurring at a European level, through the Committee for European Normalisation (CEN). The major constructs of the CEN 13606 model ate outlined. Complementary activity is taking place in ISO and in HL7, and some of these efforts are also summarised.Conclusior: There is a strong prospect that a generic EHR interoperability standard can be agreed at a European (and hopefully international) level. Parts of the challenge of EHR i interoperability cannot yet he standardised, because good solutions to the preservation of clinical meaning across heterogeneous systems remain to be explored. Further research and empirical projects are therefore also needed

    A critical examination of the effectiveness of faculty-based student learning support

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    This thesis presents an investigation into the effectiveness of faculty-based student learning support and comprises three volumes. Volume 1 provides an overview of the background literature, research methodology, ethical and reliability considerations linked to two projects whose overarching theme is the support and improvement of the student experience. The overview begins with an outline of the aim of this thesis, followed by a synopsis of the literature concerning student support in higher education and the use of technology to support learners. The methodological framework is then discussed and a brief introduction to the projects is provided. The overview concludes with an exploration of the effectiveness of faculty-based student learning support and the presentation of a new blended approach to the organisation, delivery and typology of advising. This seeks to demonstrate the strength of a blended approach and thus makes a contribution to the practice, theory and method of supporting student learning. Volume 2 discusses the Advice Shop project and considers the processes, methods and ethics of this student learning support. A summary of eight interventions is presented together with details of how the project was subsequently rolled out across the University. A consideration of the organisational model and personnel involved in student advising is also offered. The volume concludes with student and staff feedback and a discussion of how the project aims have been achieved. Evidence of the research output and components of practice relating to Project 1 can be found in Volume2 Part 2. Volume 3 presents a discussion of Project 2 - the use of technology to support learners. The project presents two technology-enhanced interventions - an electronic student attendance monitoring scheme, and the development of two online learner support tools using QuestionMark Perception as the delivery software. The methods and ethical considerations used to establish and implement these interventions are present together with feedback from students and staff. The volume concludes with a discussion of how the aims of the project have been achieved. Evidence of the research output and components of practice relating to Project 2 can be found in Volume 3 Part 2

    Sharing and viewing segments of electronic patient records service (SVSEPRS) using multidimensional database model

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    This thesis was submitted for the degree of Doctor of Philosophy and awarded by Brunel University.The concentration on healthcare information technology has never been determined than it is today. This awareness arises from the efforts to accomplish the extreme utilization of Electronic Health Record (EHR). Due to the greater mobility of the population, EHR will be constructed and continuously updated from the contribution of one or many EPRs that are created and stored at different healthcare locations such as acute Hospitals, community services, Mental Health and Social Services. The challenge is to provide healthcare professionals, remotely among heterogeneous interoperable systems, with a complete view of the selective relevant and vital EPRs fragments of each patient during their care. Obtaining extensive EPRs at the point of delivery, together with ability to search for and view vital, valuable, accurate and relevant EPRs fragments can be still challenging. It is needed to reduce redundancy, enhance the quality of medical decision making, decrease the time needed to navigate through very high number of EPRs, which consequently promote the workflow and ease the extra work needed by clinicians. These demands was evaluated through introducing a system model named SVSEPRS (Searching and Viewing Segments of Electronic Patient Records Service) to enable healthcare providers supply high quality and more efficient services, redundant clinical diagnostic tests. Also inappropriate medical decision making process should be avoided via allowing all patients‟ previous clinical tests and healthcare information to be shared between various healthcare organizations. Multidimensional data model, which lie at the core of On-Line Analytical Processing (OLAP) systems can handle the duplication of healthcare services. This is done by allowing quick search and access to vital and relevant fragments from scattered EPRs to view more comprehensive picture and promote advances in the diagnosis and treatment of illnesses. SVSEPRS is a web based system model that helps participant to search for and view virtual EPR segments, using an endowed and well structured Centralised Multidimensional Search Mapping (CMDSM). This defines different quantitative values (measures), and descriptive categories (dimensions) allows clinicians to slice and dice or drill down to more detailed levels or roll up to higher levels to meet clinicians required fragment

    Assessment of the EU Member States' rules on health data in the light of GDPR

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    In the context of the Single Framework Contract Chafea/2018/Health/03 between the EUHealthSupport Consortium and the Consumers, Health and Food Executive Agency (Chafea), a study was conducted with the objective to examine and present the EU Member States’ rules governing the processing of health data in light of the GDPR, with the objective of highlighting possible differences and identifying elements that might affect the cross-border exchange of health data in the EU, and examining the potential for EU level action to support health data use and re-use. We distinguish between using health data for primary purposes (for treatment of the patient) and secondary purposes (for research, registries and management of the healthcare system). The study provides an evidence-based comparison of the state of play regarding health data governance within the EU. This will help to assess in what areas EU intervention might be needed and if so, through which types of measures, be it measures such as a Code of Conduct for data processing in the health area, which could be supported by an EU level implementing act or more direct legislative action, taking into account the particularities of the health systems in the Member States. The study uses a mixed-methods approach, consisting of the following elements: - Literature review to provide an overview of best practices, bottlenecks, policy options and possible solutions already identified in the literature. - Mapping legal and technical aspects of health data usage at national level to provide an overview of the differences among countries in legislation, regulation and governance models regarding processing health data. - In-depth case studies of national governance models for health data sharing. - Workshops held with MoH representatives, experts, stakeholder representatives and experts from national data protection offices. - Stakeholder Survey to cross validate and supplement the topics addressed and identified in the Member State legal and technical aspects mapping. The results of this study allow for a detailed assessment of possible elements at Member States/EU level that might affect the movement of health data across borders. It also identifies practices that could facilitate this exchange of data, as well as possible policy options for strategies in this area. Finally, we explored possibilities for sustainable governance structures for health data collection, processing and transfer, as well as measures empowering citizens to have more control of their own health data and to ensure portability and interoperability of these data

    Security oriented e-infrastructures supporting neurological research and clinical trials

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    The neurological and wider clinical domains stand to gain greatly from the vision of the grid in providing seamless yet secure access to distributed, heterogeneous computational resources and data sets. Whilst a wealth of clinical data exists within local, regional and national healthcare boundaries, access to and usage of these data sets demands that fine grained security is supported and subsequently enforced. This paper explores the security challenges of the e-health domain, focusing in particular on authorization. The context of these explorations is the MRC funded VOTES (Virtual Organisations for Trials and Epidemiological Studies) and the JISC funded GLASS (Glasgow early adoption of Shibboleth project) which are developing Grid infrastructures for clinical trials with case studies in the brain trauma domain
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