Alcuni abstract di articoli che trattano argomenti relativi all'eHealth

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Summary care record early adopter programme: an independent evaluation by University College London.

Benefits The main potential benefit of the SCR is considered to be in emergency and unscheduled care settings, especially for people who are unconscious, confused, unsure of their medical details, or unable to communicate effectively in English. Other benefits may include improved efficiency of care and avoidance of hospital admission, but it is too early for potential benefits to be verified or quantified. Progress As of end April 2008, the SCR of 153,188 patients in the first two Early Adopter sites (Bolton and Bury) had been created. A total of 614,052 patients in four Early Adopter sites had been sent a letter informing them of the programme and their choices for opting out of having a SCR. Staff attitudes and usage The evaluation found that many NHS staff in Early Adopter sites (which had been selected partly for their keenness to innovate in ICT) were enthusiastic about the SCR and keen to see it up and running, but a significant minority of GPs had chosen not to participate in the programme and others had deferred participation until data quality improvement work was completed. Whilst 80 per cent of patients interviewed were either positive about the idea of having a SCR or ?did not mind?, others were strongly opposed ?on principle?. Staff who had attempted to use the SCR when caring for patients felt that the current version was technically immature (describing it as ?clunky? and ?complicated?), and were looking forward to a more definitive version of the technology. A comparable technology (the Emergency Care Summary) introduced in Scotland two years ago is now working well, and over a million records have been accessed in emergency and out-of-hours care. Patient attitudes and awareness Having a SCR is optional (people may opt out if they wish, though fewer than one per cent of people in Early Adopter sites have done so) and technical security is said to be high via a system of password protection and strict access controls. Nevertheless, the evaluation showed that recent stories about data loss by government and NHS organisations had raised concerns amongst both staff and patients that human fallibility could potentially jeopardise the operational security of the system. Despite an extensive information programme to inform the public in Early Adopter sites about the SCR, many patients interviewed by the UCL team were not aware of the programme at all. This raises important questions about the ethics of an ?implied consent? model for creating the SCR. The evaluation recommended that the developers of the SCR should consider a model in which the patient is asked for ?consent to view? whenever a member of staff wishes to access their record. Not a single patient interviewed in the evaluation was confident that the SCR would be 100 per cent secure, but they were philosophical about the risks of security breaches. Typically, people said that the potential benefit of a doctor having access to key medical details in an emergency outweighed the small but real risk of data loss due to human or technical error. Even patients whose medical record contained potentially sensitive data such as mental health problems, HIV or drug use were often (though not always) keen to have a SCR and generally trusted NHS staff to treat sensitive data appropriately. However, they and many other NHS patients wanted to be able to control which staff members were allowed to access their record at the point of care. Some doctors, nurses and receptionists, it seems, are trusted to view a person?s SCR, whereas others are not, and this is a decision which patients would like to make in real time

Lifeline: Tech innovations for maternal and child health - Part 1

At 16% and 27%, India contributes the highest global share of maternal and new-born deaths. Most of these are preventable through simple, proven and low-cost solutions. With close to a billion mobile phones and over a million broadband connections, Information and Communication Technologies (ICTs) can address the key informational and process challenges to RMNCH+A in India.Dasra's report, Life Line, lays out the key challenges and solutions, alongside the work of scalable and impactful social organizations for funders' consideration

Context-Based Access for Infrequent Requests in Tanzania\u27s Health Care System

Access control is an important aspect of any information system. It is a way of ensuring that users can only access what they are authorised to and no more. This can be achieved by granting users access to resources based on pre-defined organisational and legislative rules. Although access control has been extensively studied, and as a result, a wide range of access control models, mechanisms and systems have been proposed, specific access control requirements for healthcare systems that needs to support the continuity of care in an accountable manner have not been addressed. This results in a gap between what is required by the application domain and what is actually practised, and thus access control solutions implemented for the domain become too restrictive. The continuity of care is defined as the delivery of seamless health care services to patients through integration, coordination and sharing of information between providers. This thesis, therefore, designs a context-based access control model that allows healthcare professionals to bypass access rules in an accountable manner in case of an infrequent access request involving an emergency situation. This research uses the Tanzania\u27s healthcare system as a case study domain

An innovative approach for health care delivery to obese patients: from health needs identification to service integration

In Europe, more than half of the population is overweight or obese, and effort to design, validate, and implement innovative approaches is required to address social and health unmet needs of obese patients in terms of health promotion, disease prevention, and integration of services. The challenge is improving the collaboration between the different health and care stakeholders involved in the lives of obese patients, changing the socio-cultural attitude towards food intake and other behaviours leading to a negative impact on their health-related quality of life. The digital transformation of health and care can support changes in healthcare systems, healthy policy, and approaches to patient care and better implementation of the different health promotion and disease prevention strategies between all the stakeholders and support obese patients. Based on the previously experience adopted by Blueprint Partners with the Blueprint persona and user scenario in the context of models of care and prevention, health policies and analysis of risk factors affecting health and quality of life of obese subjects, the study aimed to simulate an integrated care pathway, through a multidisciplinary approach, developing and applying solutions and good clinical practices addressing the social and health unmet needs of obese patients. A pilot study assessed the quality of life (QoL), adherence to the Mediterranean diet, efficacy and interoperability of a digital health platform, Paginemediche. it. A qualitative approach has been adopted to identify and specify key digital solutions and high-impact user scenarios in Active and Healthy Ageing (AHA). To achieve a successful result, an iterative and collaborative approach has been followed to develop a user-centred perspective to the identification of solutions addressing health needs with different complexity along the entire life-course. Four initial key topic areas were chosen and used to identify different digital solutions that may meet the needs of the population segments defined by both age and the complexity of their health status. All data, derived from the industry representatives in the European Innovation Partnership on Active and Healthy Ageing (EIP on AHA), were collected via a survey to how digital solutions best met the needs of the various population segments represented by personas. Subsequently, innovative solutions were designed based on how a user from a target group interacts with technologies, developing "personas" belonging to specific "population segments" with different conditions and needs. Then, a high-impact user scenario, based on the correlation of personas' needs, good clinical practices and digital solutions available targeting needs which playing a role in the health and care delivery for the persona, has been developed. In the end, to evaluate how digital solutions and technologies can support obese patients during their weight loss or management of their related comorbidities in current service provision, ten obese patients were enrolled to evaluate a Digital Health platform, pagininemediche.it, developed. Matilde, the Blueprint persona developed, highlighted some of the main needs (social support, development of a health-friendly environment and educational program on healthy nutrition and physical activity) that may be addressed by integrating innovative solutions in the care of obese patients. Based on her profile, a high-impact user scenario diagram correlates health and social needs with digital solutions and can help key actors in the creation of a well-integrated care approach. Moreover, the evaluation of the digital platform, paginemediche.it, demonstrated how digital solutions can motivate and support obese patients in changing habits towards a healthy lifestyle, although no further statistical significance has been identified in the quality of life assessment because of the limited number of the patients, and short period of observation. Overweight or obese patients tend to be marginalized and the subject of a real social stigma. Digital solutions may be useful to overcome psychological factors that prevent obese patients from starting their journey for a lifestyle change. The suggested approach, which considers health needs, IT skills, socioeconomic context, interoperability, and integration gaps that may influence the adoption of innovative solutions tailored to improve health outcomes is person-centred, and identify what is important for obese patients. The implementation of a persona and user scenario approach may also be useful for the early involvement of end-users in solutions' design and adaptation, increasing adherence, and the effectiveness of digital solutions. Persona profiles, the user scenario, and the related digital solution also consider the potential benefits that can derive for both patients and health system in term of reduced emergency room admissions, waiting lists, and health related expenditures

ICT Framework to Support a Patient-Centric approach in Public Healthcare: A Case Study of Malawi

Although Information and Communication Technologies (ICTs) in the healthcare sector are extensively deployed globally, they are not used effectively in developing countries. Many resource poor countries face numerous challenges in implementing the ICT interventions. For instance, many health applications that have been deployed are not user-centric. As a result, such ICT interventions do not benefit many health consumers. The lack of an ICT framework to support patient-centric healthcare services in Malawi renders the e-health and mhealth interventions less sustainable and less cost effective. The aim of the study was therefore to develop an ICT Framework that could support patient-centric healthcare services in the public health sector in Malawi. The comprehensive literature review and semi-structured interviews highlighted many challenges underlying ICT development in Malawi. An ICT framework for patient-centric healthcare services is therefore proposed to ensure that eHealth and mobile health interventions are more sustainable and cost effective. The framework was validated by five experts selected from different areas of expertise including mhealth application developers, ICT policy makers and public health practitioners. Results show that the framework is relevant, useful and applicable within the setting of Malawi. The framework can also be implemented in various countries with similar settings

A system of concepts to support the integration of Health and social care and assistive domotics services: the Health@Home project.

The main objective of this work is to define a common shared conceptual model that describes the health care environment using the ContSys standard, harmonizing it with the social care and assistive domotics concepts. The development of this model supports the integration of services, the interoperability among systems and the continuity of care across domains.Starting from the identification and extraction of the portion of the ContSys model suitable for the healthcare part, the article provides the methodology adopted to extend it with social and home automation concepts and to integrate them in a unique framework that supports the continuity of care.The integrated model defined in this paper has been adopted in the design phase of an interoperable open platform, called Health@Home, that organizes the provision of a set of health, social and home automation integrated services provided at home.Our model is a starting point to analyze the various determinants of wellbeing able to guarantee a high-level individual's quality of life. At the moment the Health@Home system is at the implementation phase

Supporting active and healthy aging with advanced robotics integrated in smart environment

The technological advances in the robotic and ICT fields represent an effective solution to address specific societal problems to support ageing and independent life. One of the key factors for these technologies is the integration of service robotics for optimising social services and improving quality of life of the elderly population. This chapter aims to underline the barriers of the state of the art, furthermore the authors present their concrete experiences to overcome these barriers gained at the RoboTown Living Lab of Scuola Superiore Sant'Anna within past and current projects. They analyse and discuss the results in order to give recommendations based on their experiences. Furthermore, this work highlights the trend of development from stand-alone solutions to cloud computing architecture, describing the future research directions