Communications satellites in the national and global health care information infrastructure: their role, impact, and issues

Health care services delivered from a distance, known collectively as telemedicine, are being increasingly demonstrated on various transmission media. Telemedicine activities have included diagnosis by a doctor at a remote location, emergency and disaster medical assistance, medical education, and medical informatics. The ability of communications satellites to offer communication channels and bandwidth on demand, connectivity to mobile, remote and under served regions, and global access will afford them a critical role for telemedicine applications within the National and Global Information Infrastructure (NII/GII). The importance that communications satellites will have in telemedicine applications within the NII/GII the differences in requirements for NII vs. GII, the major issues such as interoperability, confidentiality, quality, availability, and costs, and preliminary conclusions for future usability based on the review of several recent trails at national and global levels are presented

Toward privacy-preserving emergency access in EHR systems with data auditing

Widespread adoption of health information sharing is claimed to improve healthcare quality at reduced cost due to the ability for providers to share healthcare information rapidly, reliably, and securely. During emergency access, however, such sharing may affect patient privacy adversely and steps must be taken to ensure privacy is preserved. Australia and the US have taken different approaches toward health information sharing. The Australian approach broadly uses a push model where a summary record is extracted from local health records, and pushed into a centralized system accessed by providers. Under the US approach, providers during emergency access generally pull health records from a centralized system that typically replicates local health records. On the other hand, the centralized repository most likely will be a third party cloud provider that offers on demand availability of high quality and cost effective services. These features make cloud computing a perfect infrastructure for EHR systems. The fact that medical data are handled and managed by a third party cloud provider, however, requires additional security mechanisms, i.e. auditing, to preserve data confidentiality, integrity, and privacy. This thesis contrasts the Australian and US approaches to information sharing during emergency access, focusing on patient privacy preservation. It develops a generalized approach to enhance patient privacy during emergency access using push and pull approaches. It presents an auditing service implementation over a multi-cloud data repository. It finally shows preliminary results from a proof-of-concept EHR system

Foggy clouds and cloudy fogs: a real need for coordinated management of fog-to-cloud computing systems

The recent advances in cloud services technology are fueling a plethora of information technology innovation, including networking, storage, and computing. Today, various flavors have evolved of IoT, cloud computing, and so-called fog computing, a concept referring to capabilities of edge devices and users' clients to compute, store, and exchange data among each other and with the cloud. Although the rapid pace of this evolution was not easily foreseeable, today each piece of it facilitates and enables the deployment of what we commonly refer to as a smart scenario, including smart cities, smart transportation, and smart homes. As most current cloud, fog, and network services run simultaneously in each scenario, we observe that we are at the dawn of what may be the next big step in the cloud computing and networking evolution, whereby services might be executed at the network edge, both in parallel and in a coordinated fashion, as well as supported by the unstoppable technology evolution. As edge devices become richer in functionality and smarter, embedding capacities such as storage or processing, as well as new functionalities, such as decision making, data collection, forwarding, and sharing, a real need is emerging for coordinated management of fog-to-cloud (F2C) computing systems. This article introduces a layered F2C architecture, its benefits and strengths, as well as the arising open and research challenges, making the case for the real need for their coordinated management. Our architecture, the illustrative use case presented, and a comparative performance analysis, albeit conceptual, all clearly show the way forward toward a new IoT scenario with a set of existing and unforeseen services provided on highly distributed and dynamic compute, storage, and networking resources, bringing together heterogeneous and commodity edge devices, emerging fogs, as well as conventional clouds.Peer ReviewedPostprint (author's final draft

Research Directions in Information Systems for Humanitarian Logistics

This article systematically reviews the literature on using IT (Information Technology) in humanitarian logistics focusing on disaster relief operations. We first discuss problems in humanitarian relief logistics. We then identify the stage and disaster type for each article as well as the article’s research methodology and research contribution. Finally, we identify potential future research directions

Investigating the status of disaster management within a world-wide context: a case study analysis

Disasters can be described as feats of spontaneous occurrences, in that they can happen at any minute at any time. There are two classifications of disasters, which are, natural disasters that cannot be predicted and continuously occur throughout society. While the other classification of disaster is that of man-made disasters, where disasters are caused not by natural phenomena, but by man's or society's actions, involuntary or voluntary, sudden or slow, with grave consequences to the population and the environment (Hays, 2008). Both these types of disasters can be controlled to a certain extent through appropriate disaster management plans and if managed efficiently have the potential to reduce the likelihood of overwhelming loss of lives and property. The Disaster Management cycle is split into four elements of response, recovery, mitigation and preparedness which contribute to emergency protocols of a nation when disaster strikes. Therefore, nations should incorporate them in their development plans and ensure efficient follow-up measures at community, national and international levels. This paper investigates worldwide disasters in order to examine how these disasters were managed and to identify the lessons learned. It provides an analysis of five worldwide case studies of recent disasters (Tsunami in Sri Lanka, Hurricane Katrina in New Orleans, Earthquake in Pakistan, Summer floods in the UK and Flooding of the West-Link in Northern Ireland) mapping those to the four staged disaster management cycle. The paper analyses in detail the strategies adopted at each stage of the cycle comparing strengths and weaknesses of each case. It concludes that there had been satisfactory progress in both response and recovery phases but more attention is needed for disaster mitigation and preparedness

A baseline review of the ability of hospitals in Kenya to provide emergency and critical care services for COVID-19 patients

Introduction: As the Coronavirus Disease 2019 (COVID-19) cases in Kenya begin to rise, the number of severe and critical COVID-19 patients has the potential to quickly overload the local healthcare system beyond its capacity to treat people. Objective: The purpose of this study was to gather information about the ability of hospitals in Kenya to provide emergency and critical care services and to identify priority actions for use by policymakers and other stakeholders as a roadmap toward strengthening the COVID-19 response in the country. Methods: This was a comprehensive review of the published and grey literature on emergency and critical care services in Kenya published in the last three years through April 2020. Screening of articles was conducted independently by the authors and the final decision for inclusion was made collaboratively. A total of 15 papers and documents were included in the review. Key recommendations: There is an urgent need to strengthen prehospital emergency care in Kenya by establishing a single toll-free ambulance access number and an integrated public Emergency Medical Services (EMS) system to respond to severe and critical COVID-19 patients in the community and other emergency cases. Functional 24-h emergency centres (ECs) need to be established in all the level 4, 5 and 6 hospitals in the country to ensure these patients receive immediate lifesaving emergency care when they arrive at the hospitals. The ECs should be equipped with pulse oximeters and functioning oxygen systems and have the necessary resources and skills to perform endotracheal intubation to manage COVID-19-induced respiratory distress and hypoxia. Additional intensive care unit (ICU) beds and ventilators are also needed to ensure continuity of care for the critically ill patients seen in the EC. Appropriate practical interventions should be instituted to limit the spread of COVID-19 to healthcare personnel and other patients within the healthcare system. Further research with individual facility levels of assessment around infrastructure and service provision is necessary to more narrowly define areas with significant shortfalls in emergency and critical care services as the number of COVID-19 cases in the country increase

Developing Targeted Interventions to Advance Maternal Health in a Geographic Medicaid Accountable Care Organization: Lessons From the Implementation of Camden Delivers

Through the design and launch of Camden Delivers the Coalition developed targeted interventions within an ACO infrastructure to advance maternal health in a Medicaid-covered population. Key insights from this process include the need to:* Utilize data to understand community need and design interventions around that need* Establish a population health surveillance system to produce actionable data to intervene with a complex population* Institute a tiered intervention system targeted to identified need, and* Leverage and coordinate across existing resources in the community to reduce duplication.Going forward, with the infrastructure developed by the Coalition to collect and review health data, along with the intricate web of community partners and resources, the next step in this program is to enhance feedback loops between partners and to help navigate patients seamlessly between partners during the highly fragmented experience of managing a pregnancy and healthcare during the interconception period. A formal network of communication between patients, case workers, care managers, providers and community resources through more sophisticated use of data and convening will allow us to support vulnerable patients in an even more effective manner. The Coalition looks forward to playing this convener role and working across groups to the end of better care management services and improved health for women of maternal age in Camden