Patient choice in the NHS: How critical are facilities services in influencing patient choice?

Purpose – From December 2005, patients in the UK needing an operation will be offered a choice of four or five. These could be NHS trusts, foundation trusts, treatment centres, private hospitals or practitioners with a special interest operating within primary care. This is called “Choose and Book”. The purpose of this research is to discover how critical facilities management service factors are in influencing a choice of hospital. The aim is to find out what the most important influencing factors are to people when making a choice of which hospital to have their operation. If facilities services and the patient environment are influencing factors in the patient experience, which are considered critical. Design/methodology/approach – Focus groups were used as the primary method of data collection. Findings – The study finds that all three focus groups placed more importance on clinical factors than facilities factors. High standards of cleanliness and good hospital food were the two facilities factors that participants in all groups placed most importance on. Cleanliness was highlighted by all three groups as a top facilities priority for the NHS at the moment and there was a general perception that private hospitals have better standards of cleanliness. Practical implications – By understanding how important facilities factors are in influencing patient choice and which ones have a critical impact, it will help NHS trusts focus on where they channel their resources.</p

Using Ubicomp systems for exchanging health information : considering trust and privacy issues

Ambient Intelligence (AmI) and ubiquitous computing allow us to consider a future where computation is embedded into our daily social lives. This vision raises its own important questions and augments the need to understand how people will trust such systems and at the same time achieve and maintain privacy. As a result, we have recently conducted a wide reaching study of people’s attitudes to potential AmI scenarios. This research project investigates the concepts of trust and privacy issues specifically related to the exchange of health, financial, shopping and e-voting information when using AmI system. The method used in the study and findings related to the health scenario will be discussed in this paper and discussed in terms of motivation and social implications

Towards Vision-Based Smart Hospitals: A System for Tracking and Monitoring Hand Hygiene Compliance

One in twenty-five patients admitted to a hospital will suffer from a hospital acquired infection. If we can intelligently track healthcare staff, patients, and visitors, we can better understand the sources of such infections. We envision a smart hospital capable of increasing operational efficiency and improving patient care with less spending. In this paper, we propose a non-intrusive vision-based system for tracking people's activity in hospitals. We evaluate our method for the problem of measuring hand hygiene compliance. Empirically, our method outperforms existing solutions such as proximity-based techniques and covert in-person observational studies. We present intuitive, qualitative results that analyze human movement patterns and conduct spatial analytics which convey our method's interpretability. This work is a step towards a computer-vision based smart hospital and demonstrates promising results for reducing hospital acquired infections.Comment: Machine Learning for Healthcare Conference (MLHC

Design and introduction of a quality of life assessment and practice support system: perspectives from palliative care settings

Background: Quality of life (QOL) assessment instruments, including patient-reported outcome measures (PROMs) and patient-reported experience measures (PREMs), are increasingly promoted as a means of enabling clinicians to enhance person-centered care. However, integration of these instruments into palliative care clinical practice has been inconsistent. This study focused on the design of an electronic Quality of Life and Practice Support System (QPSS) prototype and its initial use in palliative inpatient and home care settings. Our objectives were to ascertain desired features of a QPSS prototype and the experiences of clinicians, patients, and family caregivers in regard to the initial introduction of a QPSS in palliative care, interpreting them in context. Methods: We applied an integrated knowledge translation approach in two stages by engaging a total of 71 clinicians, 18 patients, and 17 family caregivers in palliative inpatient and home care settings. Data for Stage I were collected via 12 focus groups with clinicians to ascertain desirable features of a QPSS. Stage II involved 5 focus groups and 24 interviews with clinicians and 35 interviews with patients or family caregivers during initial implementation of a QPSS. The focus groups and interviews were recorded, transcribed, and analyzed using the qualitative methodology of interpretive description. Results: Desirable features focused on hardware (lightweight, durable, and easy to disinfect), software (simple, user-friendly interface, multi-linguistic, integration with e-health systems), and choice of assessment instruments that would facilitate a holistic assessment. Although patient and family caregiver participants were predominantly enthusiastic, clinicians expressed a mixture of enthusiasm, receptivity, and concern regarding the use of a QPSS. The analyses revealed important contextual considerations, including: (a) logistical, technical, and aesthetic considerations regarding the QPSS as a technology, (b) diversity in knowledge, skills, and attitudes of clinicians, patients, and family caregivers regarding the integration of electronic QOL assessments in care, and (c) the need to understand organizational context and priorities in using QOL assessment data. Conclusion: The process of designing and integrating a QPSS in palliative care for patients with life-limiting conditions and their family caregivers is complex and requires extensive consultation with clinicians, administrators, patients, and family caregivers to inform successful implementation

Ensuring patients privacy in a cryptographic-based-electronic health records using bio-cryptography

Several recent works have proposed and implemented cryptography as a means to preserve privacy and security of patients health data. Nevertheless, the weakest point of electronic health record (EHR) systems that relied on these cryptographic schemes is key management. Thus, this paper presents the development of privacy and security system for cryptography-based-EHR by taking advantage of the uniqueness of fingerprint and iris characteristic features to secure cryptographic keys in a bio-cryptography framework. The results of the system evaluation showed significant improvements in terms of time efficiency of this approach to cryptographic-based-EHR. Both the fuzzy vault and fuzzy commitment demonstrated false acceptance rate (FAR) of 0%, which reduces the likelihood of imposters gaining successful access to the keys protecting patients protected health information. This result also justifies the feasibility of implementing fuzzy key binding scheme in real applications, especially fuzzy vault which demonstrated a better performance during key reconstruction