Secure Blockchain Transactions for Electronic Health Records based on an Improved Attribute-Based Signature Scheme (IASS)

Electronic Health Records (EHRs) are entirely controlled by hospitals, not patients, making it difficult to obtain medical advice from individual hospitals. Patients need to keep tabs on their health details and take back control of their medical data. The rapid development of blockchain technology has facilitated large-scale healthcare, including medical records and patient-related data. The technology provides comprehensive and immutable patient records and free access to electronic medical records for providers and treatment portals. To ensure the validity of the blockchain-connected EHR, the Improved Attribute-Based Signature Scheme (IASS) has considerable powers, allowing patients to approve messages based on attributes but not validated. In addition, it avoids the problem of having multiple authorities without a single or central source of trust for generating and distributing patient public/private keys and fits into the blockchain model for distributed data storage. By sharing a secret, pseudo-random activity seed between authorities, the protocol resists collusive attacks by corrupt officials. The technology provides patients with a comprehensive, immutable record and free access to their EHR from providers and treatment portals. To ensure the validity of blockchain-connected EHRs, propose an attribute-based multi-authority signature scheme that authorizes messages based on their attributes without revealing any information

New Trends in Development of Services in the Modern Economy

The services sector strategic development unites a multitude of economic and managerial aspects and is one of the most important problems of economic management. Many researches devoted to this industry study are available. Most of them are performed in the traditional aspect of the voluminous calendar approach to strategic management, characteristic of the national scientific school. Such an approach seems archaic, forming false strategic benchmarks. The services sector is of special scientific interest in this context due to the fact that the social production structure to the services development model attraction in many countries suggests transition to postindustrial economy type where the services sector is a system-supporting sector of the economy. Actively influencing the economy, the services sector in the developed countries dominates in the GDP formation, primary capital accumulation, labor, households final consumption and, finally, citizens comfort of living. However, a clear understanding of the services sector as a hyper-sector permeating all spheres of human activity has not yet been fully developed, although interest in this issue continues to grow among many authors. Target of strategic management of the industry development setting requires substantive content and the services sector target value assessment

Nurse Practitioners Use of Clinical Decision Support Tools in Heart Failure

Abstract Background: Heart failure (HF) is a progressive disorder which results in poor patient outcomes for those affected. Although there are evidence-based medications to alter the progression and improve outcomes, provider adherence to these medications has been suboptimal. Clinical decision support tools (CDS) within the electronic medical record are effective tools in medical management. Objective: The primary objective was to evaluate the use of CDS to nurse practitioners (NPs) adherence of guideline-directed medical therapy in HF patients in the outpatient setting. The secondary objective was to assess the NPs perception of facilitators and barriers that may affect the use of CDS. Methods: A retrospective chart review was performed to extract HF measures and preventative care processes documented during an 18-month period by two NPs at two local primary care clinics in Southeast U.S. Descriptive analysis of the chart data was performed to compare the results of the Centers for Medicare and Medicaid (CMS) National performance quality indicators. Additional data was obtained from questionnaires that assess NPs perceptions and factors that affect the use of CDS. Results: Collectively, the NPs performance fell below CMS results. However, one NP exceeded CMS indicators in all areas except blood pressure control. Although the NPs had some knowledge of CDS, CDS was not used with each patient contact. The satisfaction of CDS among the NPs was mixed. Conclusion: CDS use was not verified as a driving factor to the low-performance results as the use of CDS among the NPs was low. Initiation or adjustment of HF therapy by the NPs could not be verified within this QIP. Provider education of GDMT and CDS is key to improving HF outcomes. Further research using pre- and post-intervention analysis is warranted