17 research outputs found
Front-Line Physicians' Satisfaction with Information Systems in Hospitals
Day-to-day operations management in hospital units is difficult due to continuously varying situations, several actors involved and a vast number of information systems in use. The aim of this study was to describe front-line physicians' satisfaction with existing information systems needed to support the day-to-day operations management in hospitals. A cross-sectional survey was used and data chosen with stratified random sampling were collected in nine hospitals. Data were analyzed with descriptive and inferential statistical methods. The response rate was 65 % (n = 111). The physicians reported that information systems support their decision making to some extent, but they do not improve access to information nor are they tailored for physicians. The respondents also reported that they need to use several information systems to support decision making and that they would prefer one information system to access important information. Improved information access would better support physicians' decision making and has the potential to improve the quality of decisions and speed up the decision making process.Peer reviewe
Managing healthcare transformation towards P5 medicine (Published in Frontiers in Medicine)
Health and social care systems around the world are facing radical organizational, methodological and technological paradigm changes to meet the requirements for improving quality and safety of care as well as efficiency and efficacy of care processes. In this they’re trying to manage the challenges of ongoing demographic changes towards aging, multi-diseased societies, development of human resources, a health and social services consumerism, medical and biomedical progress, and exploding costs for health-related R&D as well as health services delivery. Furthermore, they intend to achieve sustainability of global health systems by transforming them towards intelligent, adaptive and proactive systems focusing on health and wellness with optimized quality and safety outcomes.
The outcome is a transformed health and wellness ecosystem combining the approaches of translational medicine, 5P medicine (personalized, preventive, predictive, participative precision medicine) and digital health towards ubiquitous personalized health services realized independent of time and location. It considers individual health status, conditions, genetic and genomic dispositions in personal social, occupational, environmental and behavioural context, thus turning health and social care from reactive to proactive. This requires the advancement communication and cooperation among the business actors from different domains (disciplines) with different methodologies, terminologies/ontologies, education, skills and experiences from data level (data sharing) to concept/knowledge level (knowledge sharing). The challenge here is the understanding and the formal as well as consistent representation of the world of sciences and practices, i.e. of multidisciplinary and dynamic systems in variable context, for enabling mapping between the different disciplines, methodologies, perspectives, intentions, languages, etc. Based on a framework for dynamically, use-case-specifically and context aware representing multi-domain ecosystems including their development process, systems, models and artefacts can be consistently represented, harmonized and integrated. The response to that problem is the formal representation of health and social care ecosystems through an system-oriented, architecture-centric, ontology-based and policy-driven model and framework, addressing all domains and development process views contributing to the system and context in question.
Accordingly, this Research Topic would like to address this change towards 5P medicine. Specifically, areas of interest include, but are not limited:
• A multidisciplinary approach to the transformation of health and social systems
• Success factors for sustainable P5 ecosystems
• AI and robotics in transformed health ecosystems
• Transformed health ecosystems challenges for security, privacy and trust
• Modelling digital health systems
• Ethical challenges of personalized digital health
• Knowledge representation and management of transformed health ecosystems
Table of Contents:
04 Editorial: Managing healthcare transformation towards P5
medicine
Bernd Blobel and Dipak Kalra
06 Transformation of Health and Social Care Systems—An
Interdisciplinary Approach Toward a Foundational
Architecture
Bernd Blobel, Frank Oemig, Pekka Ruotsalainen and Diego M. Lopez
26 Transformed Health Ecosystems—Challenges for Security,
Privacy, and Trust
Pekka Ruotsalainen and Bernd Blobel
36 Success Factors for Scaling Up the Adoption of Digital
Therapeutics Towards the Realization of P5 Medicine
Alexandra Prodan, Lucas Deimel, Johannes Ahlqvist, Strahil Birov,
Rainer Thiel, Meeri Toivanen, Zoi Kolitsi and Dipak Kalra
49 EU-Funded Telemedicine Projects – Assessment of, and
Lessons Learned From, in the Light of the SARS-CoV-2
Pandemic
Laura Paleari, Virginia Malini, Gabriella Paoli, Stefano Scillieri,
Claudia Bighin, Bernd Blobel and Mauro Giacomini
60 A Review of Artificial Intelligence and Robotics in
Transformed Health Ecosystems
Kerstin Denecke and Claude R. Baudoin
73 Modeling digital health systems to foster interoperability
Frank Oemig and Bernd Blobel
89 Challenges and solutions for transforming health ecosystems
in low- and middle-income countries through artificial
intelligence
Diego M. LĂłpez, Carolina Rico-Olarte, Bernd Blobel and Carol Hullin
111 Linguistic and ontological challenges of multiple domains
contributing to transformed health ecosystems
Markus Kreuzthaler, Mathias Brochhausen, Cilia Zayas, Bernd Blobel
and Stefan Schulz
126 The ethical challenges of personalized digital health
Els Maeckelberghe, Kinga Zdunek, Sara Marceglia, Bobbie Farsides
and Michael Rigb
Clinical foundations and information architecture for the implementation of a federated health record service
Clinical care increasingly requires healthcare professionals to access patient record information that
may be distributed across multiple sites, held in a variety of paper and electronic formats, and
represented as mixtures of narrative, structured, coded and multi-media entries. A longitudinal
person-centred electronic health record (EHR) is a much-anticipated solution to this problem, but
its realisation is proving to be a long and complex journey.
This Thesis explores the history and evolution of clinical information systems, and establishes a set
of clinical and ethico-legal requirements for a generic EHR server. A federation approach (FHR) to
harmonising distributed heterogeneous electronic clinical databases is advocated as the basis for
meeting these requirements.
A set of information models and middleware services, needed to implement a Federated Health
Record server, are then described, thereby supporting access by clinical applications to a distributed
set of feeder systems holding patient record information. The overall information architecture thus
defined provides a generic means of combining such feeder system data to create a virtual
electronic health record. Active collaboration in a wide range of clinical contexts, across the whole
of Europe, has been central to the evolution of the approach taken.
A federated health record server based on this architecture has been implemented by the author
and colleagues and deployed in a live clinical environment in the Department of Cardiovascular
Medicine at the Whittington Hospital in North London. This implementation experience has fed
back into the conceptual development of the approach and has provided "proof-of-concept"
verification of its completeness and practical utility.
This research has benefited from collaboration with a wide range of healthcare sites, informatics
organisations and industry across Europe though several EU Health Telematics projects: GEHR,
Synapses, EHCR-SupA, SynEx, Medicate and 6WINIT.
The information models published here have been placed in the public domain and have
substantially contributed to two generations of CEN health informatics standards, including CEN
TC/251 ENV 13606
Modeling medical devices for plug-and-play interoperability
Thesis (M. Eng.)--Massachusetts Institute of Technology, Dept. of Electrical Engineering and Computer Science, 2007.Includes bibliographical references (p. 181-187).One of the challenges faced by clinical engineers is to support the connectivity and interoperability of medical-electrical point-of-care devices. A system that could enable plug-and-play connectivity and interoperability for medical devices would improve patient safety, save hospitals time and money, and provide data for electronic medical records. However, existing medical device connectivity standards, such as IEEE 11073, have not been widely adopted by medical device manufacturers. This lack of adoption is likely due to the complexity of the existing standards and their poor support for legacy devices. We attempted to design a simpler, more flexible standard for an integrated clinical environment manager. Our standard, called the ICEMAN standard, provides a meta-model for describing medical devices and a communication protocol to enable plug-and-play connectivity for compliant devices. To demonstrate the capabilities of ICEMAN standard, we implemented a service-oriented system that can pair application requirements with device capabilities, based on the ICEMAN device meta-model. This system enables medical devices to interoperate with the manager in a driverless fashion. The system was tested using simulated medical devices.by Robert Matthew Hofmann.M.Eng
Data infrastructures and digital labour : the case of teleradiology
In this thesis, I investigate the effects of digitalisation in teleradiology, the practice of outsourcing radiology diagnosis, through an analysis of the role of infrastructures that enable the transfer, storage, and processing of digital medical data. Consisting of standards, code, protocols and hardware, these infrastructures contribute to the making of complex supply chains that intervene into existing labour processes and produce interdependent relations among radiologists, patients, data engineers, and auxiliary workers. My analysis focuses on three key infrastructures that facilitate teleradiology: Picture Archiving and Communication Systems (PACS), the Digital Imaging and Communication in Medicine (DICOM) standard, and the Health Level 7 (HL7) standard. PACS is a system of four interconnected components: imaging hardware, a secure network, viewing stations for reading images, and data storage facilities. All of these components use DICOM, which specifies data formats and network protocols for the transfer of data within PACS. HL7 is a standard that defines data structures for the purposes of transfer between medical information systems. My research draws on fieldwork in teleradiology companies in Sydney, Australia, and Bangalore, India, which specialise in international outsourcing of medical imaging diagnostics and provide services for hospitals in Europe, USA, and Singapore, among others. I argue that PACS, DICOM, and HL7 establish a technopolitical context that erodes boundaries between social institutions of labour management and material infrastructures of data control. This intertwining of bureaucratic and infrastructural modes of regulation gives rise to a variety of strategies deployed by companies for maximising productivity, as well as counter-strategies of workers in leveraging mobility and qualifications to their advantage