Savana: Re-using Electronic Health Records with Artificial Intelligence

Health information grows exponentially (doubling every 5 years), thus generating a sort of inflation of science, i.e. the generation of more knowledge than we can leverage. In an unprecedented data-driven shift, today doctors have no longer time to keep updated. This fact explains why only one in every five medical decisions is based strictly on evidence, which inevitably leads to variability. A good solution lies on clinical decision support systems, based on big data analysis. As the processing of large amounts of information gains relevance, automatic approaches become increasingly capable to see and correlate information further and better than the human mind can. In this context, healthcare professionals are increasingly counting on a new set of tools in order to deal with the growing information that becomes available to them on a daily basis. By allowing the grouping of collective knowledge and prioritizing “mindlines” against “guidelines”, these support systems are among the most promising applications of big data in health. In this demo paper we introduce Savana, an AI-enabled system based on Natural Language Processing (NLP) and Neural Networks, capable of, for instance, the automatic expansion of medical terminologies, thus enabling the re-use of information expressed in natural language in clinical reports. This automatized and precise digital extraction allows the generation of a real time information engine, which is currently being deployed in healthcare institutions, as well as clinical research and management

The Business Case for Quality: Ending Business as Usual in American Health Care

Examines some of the reasons why establishing a business case for improving health care is so difficult, and considers possible solutions. Includes comments on quality provisions of the Medicare Prescription Drug Improvement and Modernization Act of 2003

A study of general practitioners' perspectives on electronic medical records systems in NHS Scotland

<b>Background</b> Primary care doctors in NHSScotland have been using electronic medical records within their practices routinely for many years. The Scottish Health Executive eHealth strategy (2008-2011) has recently brought radical changes to the primary care computing landscape in Scotland: an information system (GPASS) which was provided free-of-charge by NHSScotland to a majority of GP practices has now been replaced by systems provided by two approved commercial providers. The transition to new electronic medical records had to be completed nationally across all health-boards by March 2012. <p></p><b> Methods</b> We carried out 25 in-depth semi-structured interviews with primary care doctors to elucidate GPs' perspectives on their practice information systems and collect more general information on management processes in the patient surgical pathway in NHSScotland. We undertook a thematic analysis of interviewees' responses, using Normalisation Process Theory as the underpinning conceptual framework. <p></p> <b>Results</b> The majority of GPs' interviewed considered that electronic medical records are an integral and essential element of their work during the consultation, playing a key role in facilitating integrated and continuity of care for patients and making clinical information more accessible. However, GPs expressed a number of reservations about various system functionalities - for example: in relation to usability, system navigation and information visualisation. <b>Conclusion </b>Our study highlights that while electronic information systems are perceived as having important benefits, there remains substantial scope to improve GPs' interaction and overall satisfaction with these systems. Iterative user-centred improvements combined with additional training in the use of technology would promote an increased understanding, familiarity and command of the range of functionalities of electronic medical records among primary care doctors

Alternative Dispute Resolution [ADR] for Workers Compensation in Collective Bargaining Agreements: An Overview

This paper addresses the argued benefits for cost savings and efficiency of alternative dispute resolution [ADR] procedures for workers compensation. Particular focus is on legislative “carve-outs” that authorize collectively-bargained ADR procedures for the construction industry in New York and other states. Given the particular pressure to contain rising workers’ compensation costs—and the burden that these costs represent for the construction industry— ADR procedures are one of the most important advantages of unionized construction and, in particular, Project Labor Agreements [PLAs]. The negotiated alternative procedures, subject to Workers’ Compensation Board [WCB] approval, use an expedited and non-adversarial process that can potentially save considerable project time and costs

Cultural Transformation in Health Care

Describes the role of organizational culture in healthcare organizations. Recommends strategies for innovative approaches to improve the overall performance of the U.S. healthcare system

How Labor-Management Partnerships Improve Patient Care, Cost Control, and Labor Relations: Case Studies of Fletcher Allen Health Care, Kaiser Permanente, and Montefiore Medical Center’s Care Management Corporation

[Excerpt] This paper explores the ways in which healthcare unions and their members are strategically engaging with management through partnership to control costs and improve the patient experience, clinical outcomes, workplace environment, and labor relations. These initiatives depend on making use of the knowledge of front-line healthcare workers, improving communication between all staff members, and increasing transparency. In turn, these initiatives can also lead to more robust and dynamic local unions. Through participating in joint work activities, many union members note feeling more respected in their workplace and more connected to their union. Unions can benefit from these activities by offering their members the ability to inform decisions about how work gets done

Clinical guidelines as plans: An ontological theory

Clinical guidelines are special types of plans realized by collective agents. We provide an ontological theory of such plans that is designed to support the construction of a framework in which guideline-based information systems can be employed in the management of workflow in health care organizations. The framework we propose allows us to represent in formal terms how clinical guidelines are realized through the actions of are realized through the actions of individuals organized into teams. We provide various levels of implementation representing different levels of conformity on the part of health care organizations. Implementations built in conformity with our framework are marked by two dimensions of flexibility that are designed to make them more likely to be accepted by health care professionals than standard guideline-based management systems. They do justice to the fact 1) that responsibilities within a health care organization are widely shared, and 2) that health care professionals may on different occasions be non-compliant with guidelines for a variety of well justified reasons. The advantage of the framework lies in its built-in flexibility, its sensitivity to clinical context, and its ability to use inference tools based on a robust ontology. One disadvantage lies in its complicated implementation

Labour Administration Reforms in China

[Excerpt] This publication provides an explanation of the comprehensive labour administration system in China, including its recent advances, with emphasis on its public services functions, such as public employment, labour inspection and social insurance services. With the recent improvements to both the legal framework and the institutions of labour administration, it is believed that these public services will play bigger and more active roles in ensuring compliance with legislation and protecting the legitimate rights and interests of employers and workers alike