Known and unknown requirements in healthcare

We report experience in requirements elicitation of domain knowledge from experts in clinical and cognitive neurosciences. The elicitation target was a causal model for early signs of dementia indicated by changes in user behaviour and errors apparent in logs of computer activity. A Delphi-style process consisting of workshops with experts followed by a questionnaire was adopted. The paper describes how the elicitation process had to be adapted to deal with problems encountered in terminology and limited consensus among the experts. In spite of the difficulties encountered, a partial causal model of user behavioural pathologies and errors was elicited. This informed requirements for configuring data- and text-mining tools to search for the specific data patterns. Lessons learned for elicitation from experts are presented, and the implications for requirements are discussed as “unknown unknowns”, as well as configuration requirements for directing data-/text-mining tools towards refining awareness requirements in healthcare applications

Health Service Providers\u27 Preferences in ICT Use for Health Service Delivery in Namibia

Health service providers (HSP) in both the private and public health service institutions in Namibia have adopted information and communication technologies (ICT) for health service delivery (HSD). The extent to which ICT are currently being used is, however, not yet fully known. Also unknown are the preferences of the HSPs in the use of different types of ICT applications and hardware. Lastly, the perception of HSPs on various issues on the use of ICT for health service delivery is also unknown. Without a clear understanding of these issues, it is difficult for government to formulate strategies and policies to promote the effective adoption of ICT in the healthcare sector. Patients are also likely to make a sub-optimal use of the available ICT to improve their access to health services in Namibia. A study was conducted to address these unknown points. The study highlights the importance of ICT use by HSPs and the imperative to align the ICT use expectations, needs and requirements of patients with those of HSPs in Namibia to ensure effective use. The results of the experiment are reported in this paper

Going Rogue: Mobile Research Applications and the Right to Privacy

This Article investigates whether nonsectoral state laws may serve as a viable source of privacy and security standards for mobile health research participants and other health data subjects until new federal laws are created or enforced. In particular, this Article (1) catalogues and analyzes the nonsectoral data privacy, security, and breach notification statutes of all fifty states and the District of Columbia; (2) applies these statutes to mobile-app-mediated health research conducted by independent scientists, citizen scientists, and patient researchers; and (3) proposes substantive amendments to state law that could help protect the privacy and security of all health data subjects, including mobile-app-mediated health research participants

Healthcare Ethics During a Pandemic

As clinicians and support personnel struggle with their responsibilities to treat during the current COVID-19 pandemic, several ethical issues have emerged. Will healthcare workers and support staff fulfill their duty to treat in the face of high risks? Will institutional and government leaders at all levels do the right things to help alleviate healthcare workers risks and fears? Will physicians be willing to make hard, resource-allocation decisions if they cannot first husband or improvise alternatives? With our healthcare facilities and governments unprepared for this inevitable disaster, front-line doctors, advanced providers, nurses, EMS, and support personnel  struggle with acute shortages of equipment—both to treat patients and  protect themselves. With their personal and possibly their family’s lives and health at risk, they must weigh the option of continuing to work or retreat to safety. This decision, made daily, is based on professional and personal values, how they perceive existing risks—including available protective measures, and their perception of the level and transparency of information they receive. Often, while clinicians get this information, support personnel do not, leading to absenteeism and deteriorating healthcare services. Leadership can use good risk communication (complete, widely transmitted, and transparent) to align healthcare workers’ risk perceptions with reality. They also can address the common problems healthcare workers must overcome to continue working (ie, risk mitigation techniques). Physicians, if they cannot sufficiently husband or improvise lifesaving resources, will have to face difficult triage decisions. Ideally, they will use a predetermined plan, probably based on the principles of Utilitarianism (maximizing the greatest good) and derived from professional and community input. Unfortunately, none of these plans is optimal

Alcuni abstract di articoli che trattano argomenti relativi all'eHealth

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A Context-Oriented Extension of F#

Context-Oriented programming languages provide us with primitive constructs to adapt program behaviour depending on the evolution of their operational environment, namely the context. In previous work we proposed ML_CoDa, a context-oriented language with two-components: a declarative constituent for programming the context and a functional one for computing. This paper describes the implementation of ML_CoDa as an extension of F#.Comment: In Proceedings FOCLASA 2015, arXiv:1512.0694

Incorporation of genuine prior information in cost-effectiveness analysis of clinical trial data

The Bayesian approach to statistics has been growing rapidly in popularity as an alternative to the frequentist approach in the appraisal of heathcare technologies in clinical trials. Bayesian methods have significant advantages over classical frequentist statistical methods and the presentation of evidence to decision makers. A fundamental feature of a Bayesian analysis is the use of prior information as well as the clinical trial data in the final analysis. However, the incorporation of prior information remains a controversial subject that provides a potential barrier to the acceptance of practical uses of Bayesian methods. The pur pose of this paper is to stimulate a debate on the use of prior information in evidence submitted to decision makers. We discuss the advantages of incorporating genuine prior information in cost-effectiveness analyses of clinical trial data and explore mechanisms to safeguard scientific rigor in the use of such prior information

Analyzing recommender systems for health promotion using a multidisciplinary taxonomy: A scoping review

Background: Recommender systems are information retrieval systems that provide users with relevant items (e.g., through messages). Despite their extensive use in the e-commerce and leisure domains, their application in healthcare is still in its infancy. These systems may be used to create tailored health interventions, thus reducing the cost of healthcare and fostering a healthier lifestyle in the population. Objective: This paper identifies, categorizes, and analyzes the existing knowledge in terms of the literature published over the past 10 years on the use of health recommender systems for patient interventions. The aim of this study is to understand the scientific evidence generated about health recommender systems, to identify any gaps in this field to achieve the United Nations Sustainable Development Goal 3 (SDG3) (namely, “Ensure healthy lives and promote well-being for all at all ages”), and to suggest possible reasons for these gaps as well as to propose some solutions. Methods: We conducted a scoping review, which consisted of a keyword search of the literature related to health recommender systems for patients in the following databases: ScienceDirect, PsycInfo, Association for Computing Machinery, IEEExplore, and Pubmed. Further, we limited our search to consider only English-lan-guage journal articles published in the last 10 years. The reviewing process comprised three researchers who filtered the results simultaneously. The quantitative synthesis was conducted in parallel by two researchers, who classified each paper in terms of four aspects—the domain, the methodological and procedural aspects, the health promotion theoretical factors and behavior change theories, and the technical aspects—using a new multidisciplinary taxonomy. Results: Nineteen papers met the inclusion criteria and were included in the data analysis, for which thirty-three features were assessed. The nine features associated with the health promotion theoretical factors and behavior change theories were not observed in any of the selected studies, did not use principles of tailoring, and did not assess (cost)-effectiveness. Discussion: Health recommender systems may be further improved by using relevant behavior change strategies and by implementing essential characteristics of tailored interventions. In addition, many of the features required to assess each of the domain aspects, the methodological and procedural aspects, and technical aspects were not reported in the studies. Conclusions: The studies analyzed presented few evidence in support of the positive effects of using health recommender systems in terms of cost-effectiveness and patient health outcomes. This is why future studies should ensure that all the proposed features are covered in our multidisciplinary taxonomy, including integration with electronic health records and the incorporation of health promotion theoretical factors and behavior change theories. This will render those studies more useful for policymakers since they will cover all aspects needed to determine their impact toward meeting SDG3.European Union's Horizon 2020 No 68112

Addendum to Informatics for Health 2017: Advancing both science and practice

This article presents presentation and poster abstracts that were mistakenly omitted from the original publication

Transparency and Innuendo: An Alternative to Reactive Over-Disclosure

Lassman examines the tension between transparency and other public health interests in the context of the FDA\u27s proposed Drug Watch web site. He argues that although the FDA proposal seeks to achieve a laudable goal--the prompt communication of important useful safety information about drug products to physicians and patients-- it fails to properly balance transparency and other legitimate public health interests