583 research outputs found
Active and assisted living ecosystem for the elderly
A novel ecosystem to promote the physical, emotional and psychic health and well-being of the elderly is presented. Our proposal was designed to add several services developed to meet the needs of the senior population, namely services to improve social inclusion and increase contribution to society. Moreover, the solution monitors the vital signs of elderly individuals, as well as environmental parameters and behavior patterns, in order to seek eminent danger situations and predict potential hazardous issues, acting in accordance with the various alert levels specified for each individual. The platform was tested by seniors in a real scenario. The experimental results demonstrated that the proposed ecosystem was well accepted and is easy to use by seniors
Rethink Digital Health Innovation: Understanding Socio-Technical Interoperability as Guiding Concept
Diese Dissertation sucht nach einem theoretischem GrundgerĂŒst, um komplexe, digitale Gesundheitsinnovationen so zu entwickeln, dass sie bessere Erfolgsaussichten haben, auch in der alltĂ€glichen Versorgungspraxis anzukommen. Denn obwohl es weder am Bedarf von noch an Ideen fĂŒr digitale Gesundheitsinnovationen mangelt, bleibt die Flut an erfolgreich in der Praxis etablierten Lösungen leider aus. Dieser unzureichende Diffusionserfolg einer entwickelten Lösung - gern auch als Pilotitis pathologisiert - offenbart sich insbesondere dann, wenn die geplante Innovation mit gröĂeren Ambitionen und KomplexitĂ€t verbunden ist. Dem geĂŒbten Kritiker werden sofort ketzerische Gegenfragen in den Sinn kommen. Beispielsweise was denn unter komplexen, digitalen Gesundheitsinnovationen verstanden werden soll und ob es ĂŒberhaupt möglich ist, eine universale Lösungsformel zu finden, die eine erfolgreiche Diffusion digitaler Gesundheitsinnovationen garantieren kann. Beide Fragen sind nicht nur berechtigt, sondern mĂŒnden letztlich auch in zwei ForschungsstrĂ€nge, welchen ich mich in dieser Dissertation explizit widme.
In einem ersten Block erarbeite ich eine Abgrenzung jener digitalen Gesundheitsinnovationen, welche derzeit in Literatur und Praxis besondere Aufmerksamkeit aufgrund ihres hohen Potentials zur Versorgungsverbesserung und ihrer resultierenden KomplexitĂ€t gewidmet ist. Genauer gesagt untersuche ich dominante Zielstellungen und welche Herausforderung mit ihnen einhergehen. Innerhalb der Arbeiten in diesem Forschungsstrang kristallisieren sich vier Zielstellungen heraus: 1. die UnterstĂŒtzung kontinuierlicher, gemeinschaftlicher Versorgungsprozesse ĂŒber diverse Leistungserbringer (auch als inter-organisationale Versorgungspfade bekannt); 2. die aktive Einbeziehung der Patient:innen in ihre Versorgungsprozesse (auch als Patient Empowerment oder Patient Engagement bekannt); 3. die StĂ€rkung der sektoren-ĂŒbergreifenden Zusammenarbeit zwischen Wissenschaft und Versorgungpraxis bis hin zu lernenden Gesundheitssystemen und 4. die Etablierung daten-zentrierter Wertschöpfung fĂŒr das Gesundheitswesen aufgrund steigender bzgl. VerfĂŒgbarkeit valider Daten, neuen Verarbeitungsmethoden (Stichwort KĂŒnstliche Intelligenz) sowie den zahlreichen Nutzungsmöglichkeiten. Im Fokus dieser Dissertation stehen daher weniger die autarken, klar abgrenzbaren Innovationen (bspw. eine Symptomtagebuch-App zur Beschwerdedokumentation). Vielmehr adressiert diese Doktorarbeit jene Innovationsvorhaben, welche eine oder mehrere der o.g. Zielstellung verfolgen, ein weiteres technologisches Puzzleteil in komplexe Informationssystemlandschaften hinzufĂŒgen und somit im Zusammenspiel mit diversen weiteren IT-Systemen zur Verbesserung der Gesundheitsversorgung und/ oder ihrer Organisation beitragen.
In der Auseinandersetzung mit diesen Zielstellungen und verbundenen Herausforderungen der Systementwicklung rĂŒckte das Problem fragmentierter IT-Systemlandschaften des Gesundheitswesens in den Mittelpunkt. Darunter wird der unerfreuliche Zustand verstanden, dass unterschiedliche Informations- und Anwendungssysteme nicht wie gewĂŒnscht miteinander interagieren können. So kommt es zu Unterbrechungen von InformationsflĂŒssen und Versorgungsprozessen, welche anderweitig durch fehleranfĂ€llige ZusatzaufwĂ€nde (bspw. Doppeldokumentation) aufgefangen werden mĂŒssen. Um diesen EinschrĂ€nkungen der EffektivitĂ€t und Effizienz zu begegnen, mĂŒssen eben jene IT-System-Silos abgebaut werden. Alle o.g. Zielstellungen ordnen sich dieser defragmentierenden Wirkung unter, in dem sie 1. verschiedene Leistungserbringer, 2. Versorgungsteams und Patient:innen, 3. Wissenschaft und Versorgung oder 4. diverse Datenquellen und moderne Auswertungstechnologien zusammenfĂŒhren wollen. Doch nun kommt es zu einem komplexen Ringschluss. Einerseits suchen die in dieser Arbeit thematisierten digitalen Gesundheitsinnovationen Wege zur Defragmentierung der Informationssystemlandschaften.
Andererseits ist ihre eingeschrĂ€nkte Erfolgsquote u.a. in eben jener bestehenden Fragmentierung begrĂŒndet, die sie aufzulösen suchen.
Mit diesem Erkenntnisgewinn eröffnet sich der zweite Forschungsstrang dieser Arbeit, der sich mit der Eigenschaft der 'InteroperabilitĂ€t' intensiv auseinandersetzt. Er untersucht, wie diese Eigenschaft eine zentrale Rolle fĂŒr Innovationsvorhaben in der Digital Health DomĂ€ne einnehmen soll. Denn InteroperabilitĂ€t beschreibt, vereinfacht ausgedrĂŒckt, die FĂ€higkeit von zwei oder mehreren Systemen miteinander gemeinsame Aufgaben zu erfĂŒllen. Sie reprĂ€sentiert somit das Kernanliegen der identifizierten Zielstellungen und ist Dreh- und Angelpunkt, wenn eine entwickelte Lösung in eine konkrete Zielumgebung integriert werden soll. Von einem technisch-dominierten Blickwinkel aus betrachtet, geht es hierbei um die GewĂ€hrleistung von validen, performanten und sicheren Kommunikationsszenarien, sodass die o.g. InformationsflussbrĂŒche zwischen technischen Teilsystemen abgebaut werden. Ein rein technisches InteroperabilitĂ€tsverstĂ€ndnis genĂŒgt jedoch nicht, um die Vielfalt an Diffusionsbarrieren von digitalen Gesundheitsinnovationen zu umfassen. Denn beispielsweise das Fehlen adĂ€quater VergĂŒtungsoptionen innerhalb der gesetzlichen Rahmenbedingungen oder eine mangelhafte PassfĂ€higkeit fĂŒr den bestimmten Versorgungsprozess sind keine rein technischen Probleme. Vielmehr kommt hier eine Grundhaltung der Wirtschaftsinformatik zum Tragen, die Informationssysteme - auch die des Gesundheitswesens - als sozio-technische Systeme begreift und dabei Technologie stets im Zusammenhang mit Menschen, die sie nutzen, von ihr beeinflusst werden oder sie organisieren, betrachtet. Soll eine digitale Gesundheitsinnovation, die einen Mehrwert gemÀà der o.g. Zielstellungen verspricht, in eine existierende Informationssystemlandschaft der Gesundheitsversorgung integriert werden, so muss sie aus technischen sowie nicht-technischen Gesichtspunkten 'interoperabel' sein.
Zwar ist die Notwendigkeit von InteroperabilitĂ€t in der Wissenschaft, Politik und Praxis bekannt und auch positive Bewegungen der DomĂ€ne hin zu mehr InteroperabilitĂ€t sind zu verspĂŒren. Jedoch dominiert dabei einerseits ein technisches VerstĂ€ndnis und andererseits bleibt das Potential dieser Eigenschaft als Leitmotiv fĂŒr das Innovationsmanagement bislang weitestgehend ungenutzt. An genau dieser Stelle knĂŒpft nun der Hauptbeitrag dieser Doktorarbeit an, in dem sie eine sozio-technische Konzeptualisierung und Kontextualisierung von InteroperabilitĂ€t fĂŒr kĂŒnftige digitale Gesundheitsinnovationen vorschlĂ€gt. Literatur- und expertenbasiert wird ein Rahmenwerk erarbeitet - das Digital Health Innovation Interoperability Framework - das insbesondere Innovatoren und Innovationsfördernde dabei unterstĂŒtzen soll, die Diffusionswahrscheinlichkeit in die Praxis zu erhöhen. Nun sind mit diesem Framework viele Erkenntnisse und Botschaften verbunden, die ich fĂŒr diesen Prolog wie folgt zusammenfassen möchte:
1. Um die Entwicklung digitaler Gesundheitsinnovationen bestmöglich auf eine erfolgreiche
Integration in eine bestimmte Zielumgebung auszurichten, sind die Realisierung
eines neuartigen Wertversprechens sowie die GewÀhrleistung sozio-technischer InteroperabilitÀt
die zwei zusammenhÀngenden Hauptaufgaben eines Innovationsprozesses.
2. Die GewÀhrleistung von InteroperabilitÀt ist eine aktiv zu verantwortende Managementaufgabe
und wird durch projektspezifische Bedingungen sowie von externen und internen Dynamiken beeinflusst.
3. Sozio-technische InteroperabilitÀt im Kontext digitaler Gesundheitsinnovationen kann
ĂŒber sieben, interdependente Ebenen definiert werden: Politische und regulatorische Bedingungen;
Vertragsbedingungen; Versorgungs- und GeschÀftsprozesse; Nutzung; Information; Anwendungen; IT-Infrastruktur.
4. Um InteroperabilitÀt auf jeder dieser Ebenen zu gewÀhrleisten, sind Strategien differenziert
zu definieren, welche auf einem Kontinuum zwischen KompatibilitÀtsanforderungen
aufseiten der Innovation und der Motivation von Anpassungen aufseiten der Zielumgebung
verortet werden können.
5. Das Streben nach mehr InteroperabilitÀt fördert sowohl den nachhaltigen Erfolg der einzelnen digitalen
Gesundheitsinnovation als auch die Defragmentierung existierender Informationssystemlandschaften und
trÀgt somit zur Verbesserung des Gesundheitswesens bei.
Zugegeben: die letzte dieser fĂŒnf Botschaften trĂ€gt eher die FĂ€rbung einer Ăberzeugung, als dass sie ein Ergebnis wissenschaftlicher BeweisfĂŒhrung ist. Dennoch empfinde ich diese, wenn auch persönliche Erkenntnis als Maxim der DomĂ€ne, der ich mich zugehörig fĂŒhle - der IT-Systementwicklung des Gesundheitswesens
Plug-in healthcare:Development, ruination, and repair in health information exchange
This dissertation explores the work done by people and things in emerging infrastructures for health information exchange. It shows how this work relates to processes of development, production, and growth, as well as to abandonment, ruination, and loss. It argues for a revaluation of repair work: a form of articulation work that attends to gaps and disruptions in the margins of technological development. Often ignored by engineers, policy makers, and researchers, repair sensitizes us to different ways of caring for people and things that do not fit, fall in between categories, and resist social norms and conventions. It reminds us that infrastructures emerge in messy and unevenly distributed sociotechnical configurations, and that technological solutions cannot be simply âplugged inâ at will, but require all kinds of work. With that, repair emphasizes the need for more democratic, critical, and reflexive engagements with (and interventions in) health information exchange. Empirically, this study aims to understand how âintegrationâ in health information exchange is done in practice, and to develop concepts and insights that may help us to rethink technological development accordingly. It starts from the premise that the introduction of IT in healthcare is all too often regarded as a neutral process, and as a rational implementation challenge. These widespread views among professionals, managers, and policy makers need to be addressed, as they have very real â and mostly undesirable â consequences. Spanning a period of more than ten years, this study traces the birth and demise of an online regional health portal in the Netherlands (2009-2019). Combining ethnographic research with an experimental form of archive work, it describes sociotechnical networks that expanded, collapsed, and reconfigured around a variety of problems â from access to information and data ownership to business cases, financial sustainability, and regional care. It puts a spotlight on the integration of standards, infrastructures, and users in the portal project, and on elements of collapsing networks that quietly resurfaced elsewhere. The reconstruction of these processes foregrounds different instances of repair work in the portalâs development and subsequent abandonment, repurposing, and erasure. Conceptually, this study contributes to academic debates in health information exchange, including the politics of technology, practices of participatory design, and the role of language in emerging information infrastructures. It latches on to ethnographic studies on information systems and infrastructural work, and brings together insights from actor-network theory, science and technology studies, and figurational sociology to rethink and extend current (reflexive and critical) understandings of technological development. It raises three questions: What work is done in the development and demise of an online health portal? How are relations between people and things shaped in that process? And how can insights from this study help us to understand changing sociotechnical figurations in health information exchange? The final analysis includes five key concepts: the act of building network extensions, the method of tracing phantom networks, the notion of sociotechnical figurations, the logic of plug-in healthcare, and repair as a heuristic device.<br/
FUTURE-ORIENTED AND PATIENT-CENTRIC? A QUALITATIVE ANALYSIS OF DIGITAL THERAPEUTICS AND THEIR INTEROPERABILITY
This paper focuses on the integration of digital therapeutics (DTx) into future-oriented and patient-centric care pathways. Based on a workshop series and problem-centered interviews in Germany, the current state-of-the-art of regulatory and technical integration of DTx was mapped as a landscape of DTx interoperability. The results focus on key interfaces of DTx, namely with Electronic Health Records (EHRs), devices, and other digital health innovations such as telemedicine, and highlight current challenges and potentials for future development. On a broader level, the results point to unresolved issues of care coordination, the optional role of the EHRs as regulated platforms for care, and the importance of integrating DTx data into public data spaces for research
Service-Oriented Framework for Developing Interoperable e-Health Systems in a Low-Income Country
e-Health solutions in low-income countries are fragmented, address institution-specific needs, and do little to address the strategic need for inter-institutional exchange of health data. Although various e-health interoperability frameworks exist, contextual factors often hinder their effective adoption in low-income countries. This underlines the need to investigate such factors and to use findings to adapt existing e-health interoperability models. Following a design science approach, this research involved conducting an exploratory survey among 90 medical and Information Technology personnel from 67 health facilities in Uganda. Findings were used to derive requirements for e-health interoperability, and to orchestrate elements of a service oriented framework for developing interoperable e-health systems in a low-income country (SOFIEH). A service-oriented approach yields reusable, flexible, robust, and interoperable services that support communication through well-defined interfaces. SOFIEH was evaluated using structured walkthroughs, and findings indicate that it scored well regarding applicability, usability, and understandability
Interoperability barriers for interorganizational data exchange: A case study in the military sector
Implementation of e-health interoperability in developing country contexts : the case of Zimbabwe
The provision of information technology-enabled healthcare services (e-health) has been adopted by numerous public and private facilities in both developing nations and advanced nations. However, one of the obstacles to the adoption of health information systems has been cited as their lack of interoperability resulting in their reduced effectiveness. In view of this, the study sought to explore the interoperability of health information systems employed in the country and then propose a framework to direct the process of implementing e-health interoperability. The studyâs methodology was qualitative and a case study was undertaken. Semi-structured interviews were employed to gather data from e-health stakeholders in state-owned institutions and private enterprises. Document review was also conducted to substantiate findings from interviews. Data was analysed using thematic analysis and NVivo 12 software. The studyâs findings revealed that several health information systems were implemented and their interoperability was low. Technological, terminology, organizational as well as regulatory and legal barriers were identified as hindrances to interoperability. The enablers for implementing e-health interoperability also revealed by this study include: development of re-usable software components, train the trainer approach to transfer of skills and regional conformance testing. The consequences of lack of interoperability among health information systems reported by this study include: burden on the worker, wastage of resources and high cost. The study also proposed a dual framework to guide the implementation of e-health interoperability. The studyâs recommendations include the development of an e-health policy, an e-health strategy and the upgrade of ICT and telecommunication infrastructure to facilitate health information exchange.School of ComputingD. Phil. (Information Systems
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Examining university student satisfaction and barriers to taking online remote exams
Recent years have seen a surge in the popularity of online exams at universities, due to the greater convenience and flexibility they offer both students and institutions. Driven by the dearth of empirical data on distance learning students' satisfaction levels and the difficulties they face when taking online exams, a survey with 562 students at The Open University (UK) was conducted to gain insights into their experiences with this type of exam. Satisfaction was reported with the environment and exams, while work commitments and technical difficulties presented the greatest barriers. Gender, race and disability were also associated with different levels of satisfaction and barriers. This study adds to the increasing number of studies into online exams, demonstrating how this type of exam can still have a substantial effect on students experienced in online learning systems and
technologies
Understanding, assessing, and facilitating entrepreneurship competence in the digital age
Entrepreneurship and entrepreneurship education become mainstream inside and outside business schools after scholarships and educators from this field made efforts in the past two decades. Nutrition of entrepreneurship competence is an emergency task for the economy and society especially during economic shock and uncertainty. Digital entrepreneurship competence brings new possibilities for learners living in this digital world. This study facilitates digital entrepreneurship and digital entrepreneurship competence as 21st-century skills at the higher education level, experimenting in Chinese universities and colleges. In addition, this research will help stakeholders in Germany and other countries whose learners lack such knowledge and skills. I propose a methodology set consisting of three main ingredients. Initially, a systematic review was undertaken by the researcher in collaboration with two educators who specialized in entrepreneurship theories and practice to extract insights on the utilization of educational technologies in the context of entrepreneurship education. In response to the current trend of educational technology, a comprehensive examination was conducted to scrutinize the regulations and potential of AI within entrepreneurship learning and teaching. Secondly, the present study endeavored to assess the effectiveness of virtual team learning in online entrepreneurship education during the COVID-19 pandemic, taking into consideration the dimensions of teamwork, taskwork, and information and communication technology. In the final investigation, a digital entrepreneurship training program was administered through an online platform, with the aim of obtaining both quantitative and qualitative feedback regarding the programâs effectiveness and assessing the participantsâ digital entrepreneurship competence. The following presents a summary of each study:
Regarding the systematic review on the utilization of educational technologies in entrepreneurship education, Study 1 uncovered that social media, serious games, and digital platforms emerged as three prominent technological approaches. In light of extensive application of artificial intelligence in various educational domains, Study 2 delved into its utilization within the context of entrepreneurship education. The findings indicated the prevalence of machine learning, big data analysis, and adaptive learning systems in this field. Meanwhile, the investigation identified potential prospects for the integration of natural language processing and chatbots in entrepreneurship teaching and learning.
I evaluated online entrepreneurship education courses, supported by virtual teams from existing freely available learning content and multimedia materials. Evaluation of the content and materials is whether they fit the needs of educators and learners with various demographic backgrounds. Specifically, we evaluated the influence of gender and other demographic backgrounds on virtual team learning and its impact on entrepreneurship competence.
Furthermore, experiential learning in online settings was explored in the field of entrepreneurship, focusing on the evaluation of an online practical entrepreneurship training program using the digital entrepreneurship competence framework. The research showed that digital opportunity identification competence is apparently improved from a complete novice to a nascent entrepreneur who understands the theory and practice of digital entrepreneurship. However, the effectiveness of online practical learning is limited because of participantsâ isolation. If possible, tutorials and project guides are conducted online whereas experiential learning is partly moved into face-to-face contexts.
To analyze entrepreneurship competence in the digital age, this thesis construct and discuss theoretical frameworks, namely entrepreneurship education, educational technology, and digital entrepreneurship competence. The current studies seldom analyze entrepreneurship competence in online entrepreneurship education programs. Therefore, this research attempts to understand, assess, and facilitate entrepreneurship competence and digital entrepreneurship competence in the digital age. The thesis consists of two qualitative studies (Study 1 and 3) and two quantitative studies (Study 2 and 4).
This research aims to offer valuable insights for developing countries engaging in entrepreneurship education with limited resources, enabling the younger generation to navigate the path of venture creation. It holds practical and theoretical implications, establishing a solid foundation for online entrepreneurship education and fostering digital entrepreneurship competence. It is hoped that this thesis will inspire scholars and policy-makers to actively contribute to this field and work collaboratively
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