Bringing Anglo-governmentality into public management scholarship : the case of evidence-based medicine in UK health care

The field of public administration and management exhibits a limited number of favored themes and theories, including influential New Public Management and Network Governance accounts of contemporary government. Can additional social science–based perspectives enrich its theoretical base, in particular, analyzing a long-term shift to indirect governance evident in the field? We suggest that a variant of Foucauldian analysis is helpful, namely “Anglo-governmentality.” Having reviewed the literatures, we apply this Anglo-governmentality perspective to two case studies of “post hierarchical” UK health care settings: first, the National Institute for Health and Clinical Excellence (NICE), responsible for producing evidence-based guidelines nationally, and the second, a local network tasked with enacting such guidelines into practice. Compared with the Network Governance narrative, the Anglo-governmentality perspective distinctively highlights (a) a power–knowledge nexus giving strong technical advice; (b) pervasive grey sciences, which produce such evidence-based guidelines; (c) the “subjectification” of local governing agents, herein analyzed using Foucauldian concepts of the “technology of the self” and “pastoral power”; and (d) the continuing indirect steering role of the advanced neoliberal health care State. We add to Anglo-governmentality literature by highlighting hybrid “grey sciences,” which include clinical elements and energetic self-directed clinical–managerial hybrids as local governing agents. These findings suggest that the State and segments of the medical profession form a loose ensemble and that professionals retain scope for colonizing these new arenas. We finally suggest that Anglo-governmentality theory warrants further exploration within knowledge-based public organizations

Big Data Knowledge System in Healthcare

The health care systems are rapidly adopting large amounts of data, driven by record keeping, compliance and regulatory requirements, and patient care. The advances in healthcare system will rapidly enlarge the size of the health records that are accessible electronically. Concurrently, fast progress has been made in clinical analytics. For example, new techniques for analyzing large size of data and gleaning new business insights from that analysis is part of what is known as big data. Big data also hold the promise of supporting a wide range of medical and healthcare functions, including among others disease surveillance, clinical decision support and population health management. Hence, effective big data based knowledge management system is needed for monitoring of patients and identify the clinical decisions to the doctor. The chapter proposes a big data based knowledge management system to develop the clinical decisions. The proposed knowledge system is developed based on variety of databases such as Electronic Health Record (EHR), Medical Imaging Data, Unstructured Clinical Notes and Genetic Data. The proposed methodology asynchronously communicates with different data sources and produces many alternative decisions to the doctor

Data Mining in Health-Care: Issues and a Research Agenda

While data mining has become a much-lauded tool in business and related fields, its role in the healthcare arena is still being explored. Currently, most applications of data mining in healthcare can be categorized into two areas: decision support for clinical practice, and policy planning/decision making. However, it is challenging to find empirical literature in this area since a substantial amount of existing work in data mining for health care is conceptual in nature. In this paper, we review the challenges that limit the progress made in this area and present considerations for the future of data mining in healthcare

Nanoinformatics: developing new computing applications for nanomedicine

Nanoinformatics has recently emerged to address the need of computing applications at the nano level. In this regard, the authors have participated in various initiatives to identify its concepts, foundations and challenges. While nanomaterials open up the possibility for developing new devices in many industrial and scientific areas, they also offer breakthrough perspectives for the prevention, diagnosis and treatment of diseases. In this paper, we analyze the different aspects of nanoinformatics and suggest five research topics to help catalyze new research and development in the area, particularly focused on nanomedicine. We also encompass the use of informatics to further the biological and clinical applications of basic research in nanoscience and nanotechnology, and the related concept of an extended ?nanotype? to coalesce information related to nanoparticles. We suggest how nanoinformatics could accelerate developments in nanomedicine, similarly to what happened with the Human Genome and other -omics projects, on issues like exchanging modeling and simulation methods and tools, linking toxicity information to clinical and personal databases or developing new approaches for scientific ontologies, among many others

Applications of the ACGT Master Ontology on Cancer

In this paper we present applications of the ACGT Master Ontology (MO) which is a new terminology resource for a transnational network providing data exchange in oncology, emphasizing the integration of both clinical and molecular data. The development of a new ontology was necessary due to problems with existing biomedical ontologies in oncology. The ACGT MO is a test case for the application of best practices in ontology development. This paper provides an overview of the application of the ontology within the ACGT project thus far

The Requirements for Ontologies in Medical Data Integration: A Case Study

Evidence-based medicine is critically dependent on three sources of information: a medical knowledge base, the patients medical record and knowledge of available resources, including where appropriate, clinical protocols. Patient data is often scattered in a variety of databases and may, in a distributed model, be held across several disparate repositories. Consequently addressing the needs of an evidence-based medicine community presents issues of biomedical data integration, clinical interpretation and knowledge management. This paper outlines how the Health-e-Child project has approached the challenge of requirements specification for (bio-) medical data integration, from the level of cellular data, through disease to that of patient and population. The approach is illuminated through the requirements elicitation and analysis of Juvenile Idiopathic Arthritis (JIA), one of three diseases being studied in the EC-funded Health-e-Child project.Comment: 6 pages, 1 figure. Presented at the 11th International Database Engineering & Applications Symposium (Ideas2007). Banff, Canada September 200

Thesauri on the Web: current developments and trends

This article provides an overview of recent developments relating to the application of thesauri in information organisation and retrieval on the World Wide Web. It describes some recent thesaurus projects undertaken to facilitate resource description and discovery and access to wide-ranging information resources on the Internet. Types of thesauri available on the Web, thesauri integrated in databases and information retrieval systems, and multiple-thesaurus systems for cross-database searching are also discussed. Collective efforts and events in addressing the standardisation and novel applications of thesauri are briefly reviewed