Recommendation for a Medical System Concept of Operations for Gateway Missions

NASAs exploration missions to cis-lunar space will establish a permanent gateway to future transport missions to Mars. These missions mandate a significant paradigm change for mission planning, spacecraft design, human systems integration, and in-flight medical care due to constraints on mass, volume, power, resupply, and medical evacuation capability. These constraints require medical system development to be tightly integrated with mission and habitat design to provide a sufficient medical infrastructure and enable mission success. This concept of operations provides a vision of medical care needs that will be used to guide the development of a medical system for the cis-lunar Gateway Habitat. This medical system will serve as the precursor to what is implemented in future exploration missions to Mars. This concept of operations documents an overview of the stakeholder needs and system goals of a medical system and provides examples of the types of activities for which the system will be used during the mission. This concept of operations informs the ExMC systems engineering effort to define the Gateway Habitat Medical System by documenting the medical activities and capabilities relevant to Gateway missions, as identified by the ExMC clinician community. In addition, this concept of operations will inform the subsequent systems engineering process of developing technical requirements, system architectures, interfaces, and verification and validation approaches for the medical system. This document supports the closure of ExMC Gap Med01: We do not have a concept of operations for medical care during exploration missions, corresponding to the ExMC-managed human system risk: Risk of Adverse Health Outcomes & Decrements in Performance due to Inflight Medical Conditions

Information Systems and Health Care XIII: Examining the Critical Requirements, Design Approaches and Evaluation Methods for a Public Health Emergency Response System

Research pertaining to emergency response systems has accelerated over the past few years, particularly since 9/11 events, and more recently due to Hurricane Katrina and concern of the avian flu pandemic. This study examines the requirements that are the most demanding with respect to software and hardware, and the associated design strategies for a public health emergency response system (ERS) for electronic laboratory diagnostics consultation. In addition, this study illustrates ways to evaluate the design decisions. An important goal of a public health ERS is to improve the communication and notification of life-threatening diseases and harmful agents. The system under study is called Secure Telecommunications Application Terminal Package or STATPack. STATPack supports distributed laboratories to communicate information and make decisions regarding biosecurity situations. The intent of the system is to help hospital laboratories enhance their preparedness for a bioterrorism event or other public health emergency. The practical nature of this research concerns how an ERS diagnostic and consultation system was designed to alert and support first responders and Subject Matter Experts (SMEs). The academic nature of the research centers on the critical requirements of an ERS and how these unique needs can be met through careful design. Understanding the critical requirements will assist developers to better meet the expectations of the users. Specifically, I conducted a thirteen month study analyzing the requirements, design, and implementation of the system

Designing the Health-related Internet of Things: Ethical Principles and Guidelines

The conjunction of wireless computing, ubiquitous Internet access, and the miniaturisation of sensors have opened the door for technological applications that can monitor health and well-being outside of formal healthcare systems. The health-related Internet of Things (H-IoT) increasingly plays a key role in health management by providing real-time tele-monitoring of patients, testing of treatments, actuation of medical devices, and fitness and well-being monitoring. Given its numerous applications and proposed benefits, adoption by medical and social care institutions and consumers may be rapid. However, a host of ethical concerns are also raised that must be addressed. The inherent sensitivity of health-related data being generated and latent risks of Internet-enabled devices pose serious challenges. Users, already in a vulnerable position as patients, face a seemingly impossible task to retain control over their data due to the scale, scope and complexity of systems that create, aggregate, and analyse personal health data. In response, the H-IoT must be designed to be technologically robust and scientifically reliable, while also remaining ethically responsible, trustworthy, and respectful of user rights and interests. To assist developers of the H-IoT, this paper describes nine principles and nine guidelines for ethical design of H-IoT devices and data protocols

Automated attendance management and alert system

“Automated Attendance Management and Alert System (AAMAS)” was developed to help UiTM lecturers and Academic Affairs Department in monitoring students’ absenteeism and improving the absenteeism record management. AAMAS provides various functions, from managing and recording students’ attendance record, to sending automatic alerts to students with high absenteeism via short messaging system (SMS) and email. The system is also able to track the number of alerts sent. Through AAMAS, a significant amount of time and money can be saved, for instance time needed to fill out forms and issue notification letters manually can be minimized significantly. Besides, message interception, human resources and human errors can also be reduced. AAMAS which was tailored to UiTM could be also enhanced and custom-made to cater other learning institutions’ requirements throughout Malaysia.Keywords: automated system; attendance management; system development

Biomedical Informatics Research Network (BIRN) Data Repository

The primary goal of this project was to streamline the submission process for researchers to categorize, approve, curate, and publish these data sets. By supporting the sharing and exchange of these data types in fulfillment of the National Institute of Health guidelines the BIRN Data Repository will have the ability to grow as the need develops for these researchers to easily share information

Antibiotic resistance information exchanges : interim guidance

Antibiotic resistance (AR) is a major clinical and public health threat with potential to unravel more than half a century of human health advances offered by modern medical care. Unfortunately, modern healthcare delivery is notably contributory to the spread of antibiotic-resistant organisms, as patients who have become colonized with resistant organisms often receive care across multiple healthcare settings (e.g., ambulatory care, acute care hospitals (ACHs), and various long-term care (LTC) settings, including long-term acute care hospitals (LTACHs) and skilled nursing facilities (SNFs)).Although the threat of antibiotic-resistant organism transmission from a colonized patient to physically proximate patients remains for the duration of colonization, the lack of information sharing between healthcare facilities often results in the colonized status of a patient being unknown to a receiving or admitting facility. When this occurs, the appropriate infection control precautions are less likely to be used from the start of patient care, which increases the likelihood that resistant organisms will spread to other patients.The need for improved AR situational awareness is a major challenge to the U.S. Centers for Disease Control and Prevention\u2019s (CDC\u2019s) strategy to contain the most threatening forms of resistance and the genes responsible for such phenotypes. To fulfill their central role in implementing the CDC\u2019s containment strategy, some state health departments have developed systems (Multidrug-Resistant Organism (MDRO) Registries or MDRO Alert Systems, referred to herein as AR Information Exchanges (ARIEs)) that track patients previously colonized or infected with specific MDROs and then alert healthcare providers when these patients are admitted to a facility. The term AR Information Exchange emphasizes the importance of multidirectional information flow amongst healthcare facilities and public health authorities, as opposed to unidirectional data collection and storage.This interim guidance is intended for operational use by individuals and organizations responsible for developing or enhancing an ARIE; however, it does not constitute legal advice. Public health agencies should follow applicable laws, statues, and/or regulations when developing ARIEs with questions about directed to the entity\u2019s legal counsel.CS 324851-AARIE-Interim-Guidance-508.pdf20211158

Combating Alarm Fatigue: The Quest for More Accurate and Safer Clinical Monitoring Equipment

As the demand for health-care services continues to increase, clinically efficient and cost-effective patient monitoring takes on a critically important role. Key considerations inherent to this area of concern include patient safety, reliability, ease of use, and cost containment. Unfortunately, even the most modern patient monitoring systems carry significant drawbacks that limit their effectiveness and/or applicability. Major opportunities for improvement in both equipment design and monitor utilization have been identified, including the presence of excessive false and nuisance alarms. When poorly optimized, clinical alarm activity can affect patient safety and may have a negative impact on care providers, leading to inappropriate alarm response time due to the so-called alarm fatigue (AF). Ultimately, consequences of AF include missed alerts of clinical significance, with substantial risk for patient harm and potentially fatal outcomes. Targeted quality improvement initiatives and staff training, as well as the proactive incorporation of technological improvements, are the best approaches to address key barriers to the optimal utilization of clinical alarms, AF reduction, better patient care, and improved provider job satisfaction

Increasing Chlamydia Screening in the High-Risk Population using Electronic Notification and Targeted Education: A Primary Care Approach

The primary care office is an ideal setting and the front gate for screening young adults for chlamydia infection. Chlamydia is the most common sexually transmitted infection in the US and sexually active women aged 24 and younger are at the highest risk for having it (Centers for Disease Control and Prevention [CDC], 2016). Screening is simple and effective and can be completed through a urine test. Treatment is straightforward and involves a one-time dose of antibiotic medicine. Untreated infections in women can lead to pelvic inflammatory disease (PID), chronic pelvic pain, infertility, and life-threatening ectopic pregnancies (Papp, Schachter, Gaydos, & Pol, 2014). Despite the simplicity of managing this specific sexually transmitted infections, screening occurs in only about half of these women (CDC, 2013). The advent of the electronic medical record (EMR) has helped to improve healthcare, for example medication errors have drastically improved (The Office of the National Coordinator for Health Information Technology, (ONC), 2019). For my DNP project, I leveraged the technologic potential of the EMR’s in order to improve chlamydia screening. This technology stands to identify more infections and earlier, facilitate prompt treatment with a simple and cheap medication, improve the quality of lives of US citizens, and preserve precious healthcare resources by reducing the incidence of chronic conditions