Designing and Visualising Healthcare Delivery Systems

The effective delivery of information within health care is essential in a clinical setting but the healthcare domain is littered with poorly designed, developed, and implemented systems that do not meet the expectations of the clinicians, administrators or patients. To address design, development and implementation of health information systems issues safety and quality must be ‘engineered in’ a holistic, integrated and quality approach using the guiding principles of Total Quality Management, TQM. Technology can improve health care delivery but must be understood by all stakeholders and a consistent view of the role it plays must be achieved. This paper describes a novel approach to viewing the operations of a healthcare provider where electronic means could be used to distribute information. Specifically, an approach called the “triple pair flow” model is used to provide a view of healthcare delivery that considers the issues of safety and quality that is integrated, yet detailed, and that combines the strategic enterprise view with a business process view

Unresolved Issues in RNA Therapeutics in Vascular Diseases With a Focus on Aneurysm Disease

New technologies have greatly shaped the scientific and medical landscape within the last years. The unprecedented expansion of data and information on RNA biology has led to the discovery of new RNA classes with unique functions and unexpected modifications. Today, the biggest challenge is to transfer the large number of findings in basic RNA biology into corresponding clinical RNA-based therapeutics. Lately, this research begins to yield positive outcomes. RNA drugs advance to the final phases of clinical trials or even receive FDA approval. Furthermore, the introduction of the RNA-guided gene-editing technology CRISPR and advances in the delivery ofmessenger RNAs have triggered a major progression in the field of RNA-therapeutics. Especially short interfering RNAs and antisense oligonucleotides are promising examples for novel categories of therapeutics. However, several issues need to be addressed including intracellular delivery, toxicity, and immune responses before utilizing RNAs in a clinical setting. In this review, we provide an overview on opportunities and challenges for clinical translation of RNA-based therapeutics, with an emphasis on advances in novel delivery technologies and abdominal aortic aneurysm disease where non-coding RNAs have been shown to play a crucial regulatory role

Peer review : organisational learning for nurses : a thesis presented in partial fulfilment of the requirements for the degree of Master of Arts in Nursing at Massey University

Organisational learning as it relates to the development of a peer review system within a clinical area of nursing practice is the focus of this study. Sixteen Public Health Nurses, with the manager of their service, and three key managers from the employing Crown Health Enterprise in provincial New Zealand, took part with the researcher in this praxis-oriented participatory action research process. A framework of the learning organisation was created to direct the research inquiry and evaluate data in relation to the developing peer review system. Through the use of critically reflexive discussions in an ongoing spiral of planning, implementing, observing, and assessing, this study illuminates the growth of the learning organisation and the building of a peer review system. within a cost-conscious healthcare service delivery environment. The account of the research process includes factors facilitative of, and critical to, the learning organisation. Use of many direct quotes from participants creates a context against which to visualise problems and constraints faced by the research group, and offers the reader a decision trail with which to resolve issues of credibility. Use of the peer process, it is suggested, will generate vital information about organisational performance, which will enable nurses to assume legitimate control of clinical nursing workplaces. Conclusions derived from this study suggest that peer review and the learning organisation are important tools for both assuring the quality of clinical nursing performance and securing organisational goals

Long axial field of view PET scanners:a road map to implementation and new possibilities

In this contribution, several opportunities and challenges for long axial field of view (LAFOV) PET are described. It is an anthology in which the main issues have been highlighted. A consolidated overview of the camera system implementation, business and financial plan, opportunities and challenges is provided. What the nuclear medicine and molecular imaging community can expect from these new PET/CT scanners is the delivery of more comprehensive information to the clinicians for advancing diagnosis, therapy evaluation and clinical research

Current Management Issues in Health Information Technology

Health information technology can improve quality care delivery, thereby boosting the healthcare business reputation. However, it can negatively affect quality care delivery and lead to a negative business reputation if not efficiently managed. This single qualitative study aimed to explore the causes of the inefficiencies in managing health information technology and strategies that healthcare organizations use to ensure its efficiencies. In a purposive sample, the researcher conducted telephone interviews with twenty-one participants from Lancaster General Hospital. The participants comprised medical doctors, Doctor of Nursing practitioners, managers of health informatics, and informatics specialists working in various divisions and E-health operations. Other participants included the director of quality improvement within Epic Solutions and clinical applications, the director of health information management, the entity and privacy officer, the risk department manager, the executive director of ACO inter-community care, the pharmacist, and the director of operations. Data collected and analyzed yielded four themes: Users face various management challenges leading to HIT management efficiencies, primarily due to a need for adequate training. Strategies used to ensure the efficient management of health information technology comprised the use of robust policies and procedures, Management issues leading to the disruption of health information technology due to the issues with the design of tools of HIT, and Users reported more potential than actual impact on business reputation as judged through external organization ratings. This study could positively impact social change by fostering efficiencies in its adoption, implementation, and use, which could enhance better care delivery

An investigation into the use of the internet for medical informatics

The rapid evolution and popularity of the Internet technologies, and the World Wide Web, have resulted in unrestricted worldwide access to medical and health information. This has provided the medical profession with the ability to access up to date research more immediately than by traditional means, and has created the potential for advanced information collation. Also the availability of medical literature, previously difficult to obtain for the general public, is having an effect that is both a benefit and a burden to the medical profession. Whilst benefits exist in the use of the Internet in General Practice for clinical support, communication and education, there are also barriers to its inclusion in daily clinical practice. These include the issues of security, access availability, quality, time, research experience and Internet navigation familiarity. Questions remain as to whether or not the Internet can be used in General Practice efficiently, in order to provide a significant advantage over traditional information dissemination methods. This issue is also relevant for other primary health care providers such as pharmacists. In Australia, there has been a relatively slow adoption of both the technology and the use of the Internet for acquiring clinical and medical information. This thesis investigates the current issues surrounding the use of the Internet in general practice and pharmacy in Western Australia. The underlying assumption that the Internet is a useful tool for such information retrieval is examined in terms of useability and usefulness in clinical practice. Further the attitudes to the use of the Internet technology as an effective medium of information delivery were sought

Taming the RHINo:Interorganizational Implementation Issues ofRegional Health Information Networks

Mounting pressures for health care reform are driving a variety of changes in the health care industry. The traditional model of isolated health care entities is giving way to the formation of integrated health care delivery systems (Peters, 1994). The success of these systems rests in part on their ability to tie together geographically dispersed players and integrate operations to provide economic incentives for all participants. In this evolving health care environment, information provides the power to control and manage patient care and to substantially reduce health care delivery costs. Movement away from traditional, extensive paper processes to electronic, interactive systems is expected to generate significant savings and overall improvement in care due to improved availability and timeliness of information (Marcoux, 1994). Unfortunately, broadly-based information systems to support the administrative and clinical information needs of integrated delivery systems are rarely found. Regional health information networks (RHINs), also referred to as community health information networks, are an emergent form of interorganizational information system (IOS) currently under development as one answer to the information needs of the changing health care industry (Bergman, 1994). A RHIN is an integrated collection of computer and telecommunications capabilities that transport patient clinical and financial information among health care entities within a specific geographic area. RHINs provide the capability for data access and sharing across a widespectrum of health care industry participants. This paper presents an exploratory study of one of the first RHINs to be developed and implemented in the United States. The purpose of the study was to identify the current status of the network in terms of user information satisfaction and utilization, and to identify key implementation issues of the RHIN. Prior research on the development/implementation of interorganizational systems and the adoption of innovations formed the basis for interpretation of thestudy finding