SNOMED CT standard ontology based on the ontology for general medical science

Background: Systematized Nomenclature of Medicine—Clinical Terms (SNOMED CT, hereafter abbreviated SCT) is acomprehensive medical terminology used for standardizing the storage, retrieval, and exchange of electronic healthdata. Some efforts have been made to capture the contents of SCT as Web Ontology Language (OWL), but theseefforts have been hampered by the size and complexity of SCT. Method: Our proposal here is to develop an upper-level ontology and to use it as the basis for defining the termsin SCT in a way that will support quality assurance of SCT, for example, by allowing consistency checks ofdefinitions and the identification and elimination of redundancies in the SCT vocabulary. Our proposed upper-levelSCT ontology (SCTO) is based on the Ontology for General Medical Science (OGMS). Results: The SCTO is implemented in OWL 2, to support automatic inference and consistency checking. Theapproach will allow integration of SCT data with data annotated using Open Biomedical Ontologies (OBO) Foundryontologies, since the use of OGMS will ensure consistency with the Basic Formal Ontology, which is the top-levelontology of the OBO Foundry. Currently, the SCTO contains 304 classes, 28 properties, 2400 axioms, and 1555annotations. It is publicly available through the bioportal athttp://bioportal.bioontology.org/ontologies/SCTO/. Conclusion: The resulting ontology can enhance the semantics of clinical decision support systems and semanticinteroperability among distributed electronic health records. In addition, the populated ontology can be used forthe automation of mobile health applications

Information systems and healthcare XXIV: Factors affecting the EAI adoption in the healthcare sector

Recent developments in the field of integration technologies like Enterprise Application Integration (EAI) have emerged to support organizations towards improving the quality of services and reducing integration costs. Despite the importance of EAI, there is limited empirical research reported on its adoption in the healthcare sector. Khoumbati et al. [2006] developed a model for the evaluation of EAI in healthcare organizations. In doing so, the causal interrelationship of EAI adoption factors was identified by using fuzzy cognitive mapping. This paper is a progression of previous work in the area and seeks to contribute by validating the model through a different case environment. Thus, this paper contributes by deriving and proposing the MAESTRO model for EAI adoption. MAESTRO identifies a set of factors that influence EAI adoption and it is evaluated through a real-life case study. It provides an understanding of the EAI adoption process through its grounding on empirical data. In doing so, the MAESTRO model supports the management of healthcare organizations during the decision-making process for EAI adoption

Current Developments in Services for People with Intellectual Disabilities

[Taken from Executive Summary] This literature review is the culmination of the Saskatchewan Community Living Division jurisdictional study which began in the autumn of 2003. Following a brief survey of developments in providing services to people with intellectual disabilities (hitherto the People) for creating the questionnaire for this study, information was gleaned from the provinces and territories on their services. The CLD Jurisdictional Project was completed in the spring of 2005. Subsequently, a thorough search and examination of pertinent resources for serving this People and for policy development was conducted. From over 800 documents about 350 were selected for this literature review. The material is recorded in the following chapters: Public Consultation and Policy Development; Social Philosophy: the philosophical influence on contemporary social issues; Definition of disabilities; Needs assessment systems; Human Rights; Advocacy; Community services & Deinstitutionalization; Issues and Influences; Citizenship; Inclusion; Self-determination; Person-centered planning; Supports; Respite; Individualized funding; Canadian governmental initiatives; Provincial Services

Out-of-Pocket Costs and the Flexible Benefits Decision: Do Employees Make Effective Health Care Choices?

This study analyzes employees\u27 ability to select health insurance benefits that fit their needs.The study analyzes both the actual choices and the implications of those choices for employees, measured as out-of-pocket costs (OPC). By introducing OPC as a measure of decision quality, this study demonstrates its advantages over measuring only employee choice. Results from a sample of manufacturing employees suggest that most employees made cost-optimizing decisions, out-performing recommendations from a linear model. Employees also were financially better off overall with choice than they would have been had they all been placed into either medical plan option available to them. This study supports the value of choice, but does not support the assertion that employees always make benefits decisions that best fit their needs

Towards an evaluation framework for medical web applications

Copyright @ 2013 EMCIS.The main aim of this study is to review and analyse various evaluation frameworks used to assess the operational effectiveness of various Information Technology (IT) processes/applications and identify their strengths in order to form a new holistic framework for economic evaluation of web applications. This research aims to address the need for a new holistic evaluation framework for the purpose of the evaluation of the medical web applications. Over the last decade more and more, companies used accountancy techniques such as the frameworks analysed in this research. This new holistic framework that was developed will include also steps regarding the indirect and intangible costs and benefits identification and their incorporation in the evaluation process. Moreover the new emerging market of the medical websites and the embedded on them web applications requires also a new evaluation framework that will provide accurate results in the estimation of the efficiency of an investment on them. The paper first presents an introduction about why economic evaluation is important when evaluating the Information Technology in organizations. Various studies are reviewed, which highlight the ever increasing importance of integrating economic evaluation processes, such as Cost Benefit Analysis (CBA) and Return on Investment (ROI), into systems and processes of organizations and economic organizations, and analyse the factors that govern their role. Finally, the evaluation frameworks and methods that are found in these studies should be used as a part of a proactive systematic action plan that the organizations could use to avoid budget reduction due to incorrect planning. The next part of this study includes a comprehensive presentation and review of past frameworks used to evaluate Information Technology. The frameworks that are reviewed are the Framework for evaluation of information systems, the Information Technology Adoption Model (ITAM), the Total Evaluation and Acceptance Methodology (TEAM) framework, the ROI Process Model and HOT-fit evaluation framework for Health Information Systems

The illusion of competency versus the desirability of expertise: Seeking a common standard for support professions in sport

In this paper we examine and challenge the competency-based models which currently dominate accreditation and development systems in sport support disciplines, largely the sciences and coaching. Through consideration of exemplar shortcomings, the limitations of competency-based systems are presented as failing to cater for the complexity of decision making and the need for proactive experimentation essential to effective practice. To provide a better fit with the challenges of the various disciplines in their work with performers, an alternative approach is presented which focuses on the promotion, evaluation and elaboration of expertise. Such an approach resonates with important characteristics of professions, whilst also providing for the essential ‘shades of grey’ inherent in work with human participants. Key differences between the approaches are considered through exemplars of evaluation processes. The expertise-focused method, although inherently more complex, is seen as offering a less ambiguous and more positive route, both through more accurate representation of essential professional competence and through facilitation of future growth in proficiency and evolution of expertise in practice. Examples from the literature are also presented, offering further support for the practicalities of this approach

Occupational injuries among construction workers at the Chep Lap Kok Airport construction site, Hong Kong : analysis of accident rates, and the association between injuries, error types and their contributing factors : a thesis presented in partial fulfilment of the requirements for the degree of Master of Aviation at Massey University, Palmerston North, New Zealand

Accidents on construction sites are a major cause of morbidity and mortality in Hong Kong. This study investigated the likely causes of occupational injuries that were present among the construction workers during the construction of the new Chep Lap Kok (CLK) Airport in Hong Kong. In order to accumulate the requisite information, 1648 accident investigation reports in a four-year period (1993-1996) were reviewed. The first part of the study described the pattern and magnitude of occupational injuries among the CLK construction workers and compared the accident rates of the CLK workers with those of the construction industry as a whole in Hong Kong. The study examined the effects of the workplace infrastructure at CLK in order to explain why this site presented fewer work place injuries and accidents than other workplaces. The second part of the research used these injury and accident occurrences as the basis to construct the causes of accidents and injuries within an error causation classification system. The results showed that at CLK, the commonest workplace injury was contusion & crushing which appeared to be due to mistakes made through lapses in memory often caused by pressure of work being imposed on the employee. This section also indicated what types of errors were most closely associated with what kinds of injuries and what conditions were most likely to trigger these types of events. Among the major associations were links between contusion and crushing and violation error, perceptual error; between memory lapse and work pressure, equipment deficiencies, poor working environment, fatigue, and between violation error and work pressure. The research suggested that work pressure was an important contributing factor to construction injury and it increased the prevalence of a human error type namely, memory lapse many fold. The outcomes from this study provide important new information on the causes and types of errors which have led to occupational injuries among construction workers in Hong Kong. A better understanding of the human factors-based causes of accidents and injuries in the construction industry and an inculcation of a safety culture on construction sites are critically important in the reduction of the rate of construction accidents and improvement of workers' human performance. The results should assist the construction industry in the designing accident prevention training and education strategies, estimating human error probabilities, and the monitoring organizational safety performance

Can acquisition of expertise be supported by technology?

Professional trainees in the workplace are increasingly required to demonstrate specific standards of competence. Yet, empirical evidence of how professionals acquire competence in practice is lacking. The danger, then, is that efforts to support learning processes may be misguided. We hypothesised that a systemic view of how expertise is acquired would support more timely and appropriate development of technology to support workplace learning. The aims of this study were to provide an empirically based understanding of workplace learning and explore how learning could be facilitated through suitable application of technology. We have used the medical specialist trainee as an exemplar of how professionals acquire expertise within a complex working environment. We describe our methodological approach, based on the amalgam of systems analysis and qualitative research methods. We present the development of a framework for analysis and early findings from qualitative data analysis. Based on our findings so far, we present a tentative schema representing how technology can support learning with suggestions for the types of technology that could be used

The organizational implications of medical imaging in the context of Malaysian hospitals

This research investigated the implementation and use of medical imaging in the context of Malaysian hospitals. In this report medical imaging refers to PACS, RIS/HIS and imaging modalities which are linked through a computer network. The study examined how the internal context of a hospital and its external context together influenced the implementation of medical imaging, and how this in turn shaped organizational roles and relationships within the hospital itself. It further investigated how the implementation of the technology in one hospital affected its implementation in another hospital. The research used systems theory as the theoretical framework for the study. Methodologically, the study used a case-based approach and multiple methods to obtain data. The case studies included two hospital-based radiology departments in Malaysia. The outcomes of the research suggest that the implementation of medical imaging in community hospitals is shaped by the external context particularly the role played by the Ministry of Health. Furthermore, influences from both the internal and external contexts have a substantial impact on the process of implementing medical imaging and the extent of the benefits that the organization can gain. In the context of roles and social relationships, the findings revealed that the routine use of medical imaging has substantially affected radiographers’ roles, and the social relationships between non clinical personnel and clinicians. This study found no change in the relationship between radiographers and radiologists. Finally, the approaches to implementation taken in the hospitals studied were found to influence those taken by other hospitals. Overall, this study makes three important contributions. Firstly, it extends Barley’s (1986, 1990) research by explicitly demonstrating that the organization’s internal and external contexts together shape the implementation and use of technology, that the processes of implementing and using technology impact upon roles, relationships and networks and that a role-based approach alone is inadequate to examine the outcomes of deploying an advanced technology. Secondly, this study contends that scalability of technology in the context of developing countries is not necessarily linear. Finally, this study offers practical contributions that can benefit healthcare organizations in Malaysia

Systematic review of transition models for young people with long-term conditions: A report for NHS Diabetes.

Aims For many young people with Type 1 diabetes, transition from paediatric to adult care can result in a marked deterioration in glycaemic control. A systematic review assessed the effectiveness of transition models, or components of models, for managing the transition process in young people with long-term conditions, including Type 1 diabetes. This involved identifying (i) the main barriers and facilitators in implementing a successful transition programme, and (ii) the key issues for young people with long-term conditions and professionals involved in the transition process. Methods The following databases were searched from inception to August 2012: MEDLINE, EMBASE, PsychINFO, CINAHL, ASSIA, Social Services Abstracts, Academic Search Complete, Social Science Citation Index, Cochrane and Campbell Libraries. Selected studies included young people aged 11 to 25 diagnosed with long-term conditions who were in transition from paediatric to adult secondary health care services. Results 16 systematic reviews and 13 primary studies were included from 9992 records retrieved. No single transition model was uniquely effective. The most successful transitions centred around: young person-focused; age and developmentally appropriate content and delivery; self-management education; family participation; paediatric and adult collaboration; designated transition clinics; transition co-ordinator; young person’s portfolio; specific professionals training; multidisciplinary approach; structured process embedded in service delivery. There were no distinctive characteristics of condition-specific Type 1 diabetes services. Conclusion This important and timely review summarises the key factors that need to be considered for the development of transition programmes for young people with long-term conditions, including those with Type 1 diabetes