Impact of Radio-Frequency Identification (RFID) Technologies on the Hospital Supply Chain: A Literature Review

Supply costs account for more than one-third of the average operating budget and constitute the second largest expenditure in hospitals. As hospitals have sought to reduce these costs, radio-frequency identification (RFID) technology has emerged as a solution. This study reviews existing literature to gauge the recent and potential impact and direction of the implementation of RFID in the hospital supply chain to determine current benefits and barriers of adoption. Findings show that the application of RFID to medical equipment and supplies tracking has resulted in efficiency increases in hospitals with lower costs and increased service quality. RFID technology can reduce costs, improve patient safety, and improve supply chain management effectiveness by increasing the ability to track and locate equipment, as well as monitoring theft prevention, distribution management, and patient billing. Despite ongoing RFID implementation in the hospital supply chain, barriers to widespread and rapid adoption include significant total expenditures, unclear return on investment, and competition with other strategic imperatives

Real-time locating systems (RTLS) in healthcare: a condensed primer

Real-time locating systems (RTLS, also known as real-time location systems) have become an important component of many existing ubiquitous location aware systems. While GPS (global positioning system) has been quite successful as an outdoor real-time locating solution, it fails to repeat this success indoors. A number of RTLS technologies have been used to solve indoor tracking problems. The ability to accurately track the location of assets and individuals indoors has many applications in healthcare. This paper provides a condensed primer of RTLS in healthcare, briefly covering the many options and technologies that are involved, as well as the various possible applications of RTLS in healthcare facilities and their potential benefits, including capital expenditure reduction and workflow and patient throughput improvements. The key to a successful RTLS deployment lies in picking the right RTLS option(s) and solution(s) for the application(s) or problem(s) at hand. Where this application-technology match has not been carefully thought of, any technology will be doomed to failure or to achieving less than optimal results

Influence of Information System on Emergency Department Shift Leaders’ Mobility

Emergency departments are hospital units for patients, who need emergency and acute care. Due to the state of patients, shift leader nurses and physicians need to do important decisions concerning patients’ treatment and care, quickly and efficiently. To be able to do that, they have to get needed information easily and efficiently. That is called knowledge-based leadership. When knowledge-based leadership is successful, the organisations’ information and knowledge are processed in a way, that they may be exploited in a best possible way. Unfortunately, nowadays the situation is not ideal in emergency departments, even though a lot of money has been invested in new information systems. Staff dissatisfaction with existing information systems have been reported and can be seen on staff satisfaction. On the other hand, there is not much research on how the information systems impact on shift leader nurses’ and physicians’ work. A quasi-experimental study was done in the years 2015 – 2016 in emergency departments in three central hospitals in Finland exploring the movement patterns of the shift leader professionals before and after implementation of a new information system in on unit, called intervention unit. Data was collected with Bluetooth beacons installed in different hospital rooms and corridors and with smartphones carried by shift leader nurses and physicians. Improving the knowledge management of leaders with new information systems, it is expected, that it decreases the effort needed to seek information to support decision-making. However, the result was not so unambiguous. The movement patterns changed, but they changed also in control units. A new information system can influence on hospital leader shift personnel mobility. Unfortunately, the lack of data made it impossible to count and compare actual walked distances. There should be more data – that is – from every day, every shift and every shift leader professional around the clock. Only that way, the comparison would be reliable. The mobility data from hospitals was already collected, when this thesis was written, so collecting the data was not part of this thesis. Keywords: information system evaluation, indoor positioning, Bluetooth beaco

Advancing the objective measurement of physical activity and sedentary behaviour context

Objective data from national surveillance programmes show that, on average, individuals accumulate high amounts of sedentary time per day and only a small minority of adults achieve physical activity guidelines. One potential explanation for the failure of interventions to increase population levels of physical activity or decrease sedentary time is that research to date has been unable to identify the specific behavioural levers in specific contexts needed to change behaviour. Novel technology is emerging with the potential to elucidate these specific behavioural contexts and thus identify these specific behavioural levers. Therefore the aims of this four study thesis were to identify novel technologies capable of measuring the behavioural context, to evaluate and validate the most promising technology and to then pilot this technology to assess the behavioural context of older adults, shown by surveillance programmes to be the least physically active and most sedentary age group. Study one Purpose: To identify, via a systematic review, technologies which have been used or could be used to measure the location of physical activity or sedentary behaviour. Methods: Four electronic databases were searched using key terms built around behaviour, technology and location. To be eligible for inclusion papers were required to be published in English and describe a wearable or portable technology or device capable of measuring location. Searches were performed from the inception of the database up to 04/02/2015. Searches were also performed using three internet search engines. Specialised software was used to download search results and thus mitigate the potential pitfalls of changing search algorithms. Results: 188 research papers met the inclusion criteria. Global positioning systems were the most widely used location technology in the published research, followed by wearable cameras and Radio-frequency identification. Internet search engines identified 81 global positioning systems, 35 real-time locating systems and 21 wearable cameras. Conclusion: The addition of location information to existing measures of physical activity and sedentary behaviour will provide important behavioural information. Study Two Purpose: This study investigated the Actigraph proximity feature across three experiments. The aim of Experiment One was to assess the basic characteristics of the Actigraph RSSI signal across a range of straight line distances. Experiment Two aimed to assess the level of receiver device signal detection in a single room under unobstructed conditions, when various obstructions are introduced and the impacts these obstructions have on the intra and inter unit variability of the RSSI signal. Finally, Experiment Three aimed to assess signal contamination across multiple rooms (i.e. one beacon being detected in multiple rooms). Methods: Across all experiments, the receiver(s) collected data at 10 second epochs, the highest resolution possible. In Experiment One two devices, one receiver and one beacon, were placed opposite each other at 10cm increments for one minute at each distance. The RSSI-distance relationship was then visually assessed for linearity. In Experiment Two, a test room was demarcated into 0.5 x 0.5 m grids with receivers simultaneously placed in each demarcated grid. This process was then repeated under wood, metal and human obstruction conditions. Descriptive tallies were used to assess the signal detection achieved for each receiver from each beacon in each grid. Mean RSSI signal was calculated for each condition alongside intra and inter-unit standard deviation, coefficient of variation and standard error of the measurement. In Experiment Three, a test apartment was used with three beacons placed across two rooms. The researcher then completed simulated conditions for 10 minutes each across the two rooms. The percentage of epochs where a signal was detected from each of the three beacons across each test condition was then calculated. Results: In Experiment One, the relationship between RSSI and distance was found to be non-linear. In Experiment Two, high signal detection was achieved in all conditions; however, there was a large degree of intra and inter-unit variability in RSSI. In Experiment Three, there was a large degree of multi-room signal contamination. Conclusion: The Actigraph proximity feature can provide a binary indicator of room level location. Study Three Purpose: To use novel technology in three small feasibility trials to ascertain where the greatest utility can be demonstrated. Methods: Feasibility Trial One assessed the concurrent validity of electrical energy monitoring and wearable cameras as measures of television viewing. Feasibility Trial Two utilised indoor location monitoring to assess where older adult care home residents accumulate their sedentary time. Lastly, Feasibility Trial Three investigated the use of proximity sensors to quantify exposure to a height adjustable desk Results: Feasibility Trial One found that on average the television is switched on for 202 minutes per day but is visible in just 90 minutes of wearable camera images with a further 52 minutes where the participant is in their living room but the television is not visible in the image. Feasibility Trial Two found that residents were highly sedentary (sitting for an average of 720 minutes per day) and spent the majority of their time in their own rooms with more time spent in communal areas in the morning than in the afternoon. Feasibility Trial Three found a discrepancy between self-reported work hours and objectively measured office dwell time. Conclusion: The feasibility trials outlined in this study show the utility of objectively measuring context to provide more detailed and refined data. Study Four Purpose: To objectively measure the context of sedentary behaviour in the most sedentary age group, older adults. Methods: 26 residents and 13 staff were recruited from two care homes. Each participant wore an Actigraph GT9X on their non-dominant wrist and a LumoBack posture sensor on their lower back for one week. The Actigraph recorded proximity every 10 seconds and acceleration at 100 Hz. LumoBack data were provided as summaries per 5 minutes. Beacon Actigraphs were placed around each care home in the resident s rooms, communal areas and corridors. Proximity and posture data were combined in 5 minute epochs with descriptive analysis of average time spent sitting in each area produced. Acceleration data were summarised into 10 second epochs and combined with proximity data to show the average count per epoch in each area of the care home. Mann-Whitney tests were performed to test for differences between care homes. Results: No significant differences were found between Care Home One and Care Home Two in the amount of time spent sitting in communal areas of the care home (301 minutes per day and 39 minutes per day respectively, U=23, p=0.057) or in the amount of time residents spent sitting in their own room (215 minutes per day and 337 minutes per day in Care Home One and Two respectively, U=32, p=0.238). In both care homes, accelerometer measured average movement increases with the number of residents in the communal area. Conclusion: The Actigraph proximity system was able to quantify the context of sedentary behaviour in older adults. This enabled the identification of levers for behaviour change which can be used to reduce sedentary time in this group. Overall conclusion: There are a large number of technologies available with the potential to measure the context of physical activity or sedentary time. The Actigraph proximity feature is one such technology. This technology is able to provide a binary measure of proximity via the detection or non-detection of Bluetooth signal: however, the variability of the signal prohibits distance estimation. The Actigraph proximity feature, in combination with a posture sensor, is able to elucidate the context of physical activity and sedentary time

Technology Acceptance, Acceptabilty and Appropriation in Professionnal Bureaucracies : The Case of RFID for Improving Mobile Assets Management in Hospitals

RÉSUMÉ : Les hôpitaux, même ceux de petite taille, peuvent gérer sur une base quotidienne plusieurs milliers d’actifs fixes et mobiles. Les actifs mobiles sont très diversifiés et incluent des pompes à infusion, du matériel chirurgical, des électrocardiogrammes, des machines portables à rayons X, des défibrillateurs, etc. Ces actifs circulent en permanence entre les différents services et les divers départements. Pratiquement tous les patients dépendent d'un ou plusieurs actifs mobiles lors de leur hospitalisation. Ces actifs sont également indispensables à la prestation des soins de santé et le personnel clinique consacre une partie importante de leur temps pour chercher ces actifs lorsque requis. L'incapacité de retrouver ces actifs en cas d’urgence peut mettre la vie des patients en danger. La technologie RFID (Radio Frequency Identification) a le potentiel de retracer et d’effectuer le suivi, et ce, de façon unique et transparente, les actifs mobiles et, par conséquent, d’en améliorer leur gestion dans les hôpitaux. Comparé à d’autres secteurs d’activité, le secteur de la santé adopte RFID à un rythme beaucoup plus lent, ce qui se traduit par un nombre limité d'études empiriques portant sur l’implantation de RFID dans ce secteur. Cette thèse se propose donc de contribuer à ce vide empirique par une analyse en profondeur d’une implantation réelle de RFID. Cette implantation vise à améliorer la gestion d'un type d’actifs mobiles, nommément les pompes à infusion dans un hôpital. Les données empiriques ont été recueillies pendant une période de 25 mois, de la phase de préfaisabilité jusqu’à la phase de post-implantation. Huit organisations (incluant l'hôpital qui est le principal site d'observation) et 35 participants ont été impliqués. Les résultats de la recherche peuvent être résumés comme suit. À la question, pourquoi RFID est implanté? La réduction des inefficacités existantes liées à la gestion des actifs mobiles en est la principale raison. De plus, la familiarité avec les technologies de l’information au sein de l'hôpital, la compatibilité de l’infrastructure existante (l'hôpital est presque 100% Wi-Fi) et l'expérience des partenaires technologiques sont des facteurs positifs reliés à l’implantation RFID. Comment l’implantation RFID est-elle effectuée? Les résultats montrent que le processus d’implantation est fortement itératif : les participants reviennent en effet sur les phases précédentes et modifient les décisions approuvées antérieurement. L'amélioration continue des services de soins est sans aucun doute la préoccupation principale exprimée par tous les participants de l'hôpital. Toutefois, les attentes et les exigences diffèrent entre les différents groupes de participants. Les résultats démontrent un clivage entre les points de vue de l’administration et ceux du côté clinique. Des divergences sont notées entre les infirmières et les médecins, et, entre les techniciens de l'hôpital (responsables des TIC, ingénieurs biomédicaux, et spécialistes de la maintenance) et les administrateurs. Les enjeux les plus importants ne sont pas technologiques, mais sont principalement organisationnels, ce qui semble découler de la présence de points de vue divergents. Est-ce que la RFID améliore la gestion des actifs mobiles? Les résultats suggèrent que les avantages identifiés et évalués lors l’implantation de RFID appartiennent aux catégories suivantes: amélioration de la visibilité des actifs, augmentation de l'efficacité opérationnelle, réduction de certains coûts et émergence de processus intelligents. Ce dernier point apparait comme particulièrement important. Les processus intelligents misent principalement sur les capacités d'auto-identification et de sensibilité au contexte (context-awareness) de RFID, sur le changement automatique de statuts, et sur la mise à jour automatique des applications d’hôpital (par exemple, WMS). Les résultats démontrent également que les processus intelligents améliorent la planification et la prise de décision. Est-ce que les caractéristiques intrinsèques des organisations dans lesquelles la technologie RFID est envisagée posent des contraintes à son implantation? Les hôpitaux, qualifiés de bureaucraties professionnelles, constituent un ensemble unique de contraintes dont on doit tenir compte lors d’une implantation RFID. En particulier, l'inertie, la complexité et la rigidité organisationnelles ne sont pas favorables à des changements à grande échelle dans l’hôpital et affectent la façon dont RFID est implanté. En outre, l'existence d'une structure à double pouvoir et les pièges liés à une culture forte (culture entrapment)ont un impact profond sur l'importance des avantages découlant de RFID. Est-ce que l’acceptation de la technologie, son acceptabilité et son appropriation représentent des concepts clés pour comprendre l’implantation de la RFID? Ces trois concepts ont été explorés lors de cette recherche et ont conduit à deux observations principales. Tout d'abord, on peut affirmer que si la technologie est acceptée, acceptable et appropriée, elle est utilisée, de façon partielle ou plus large. Par extension, l'acceptation, l'acceptabilité et l'appropriation pourraient être importantes non seulement pour expliquer l'ampleur de l'utilisation d'une technologie (utilisation partielle par rapport à la pleine utilisation), mais aussi pour expliquer les raisons pour lesquelles une technologie a été initialement adoptée, puis ensuite rejetée. Deuxièmement, les résultats empiriques ne confirment pas un ordre chronologique entre ces trois concepts. Par exemple, l'appropriation ne suit pas l'acceptation, même au début de l’implantation. Au contraire, l'acceptation, l'acceptabilité et l'appropriation coexistent à tout moment pendant le processus d’implantation. Cependant, l’ordre chronologique joue quand même un rôle puisque les niveaux d'acceptation, l'acceptabilité et l'appropriation varient au fil du temps. En outre, ces trois concepts sont sensibles à la fois à la technologie (dans ce cas, RFID) et au contexte dans lequel cette technologie est utilisée (l'hôpital), qui continuent de leur côté à changer au fil du temps. La thèse se termine en examinant les limites de la recherche, en proposant quelques pistes de recherche. Les contributions de cette thèse peuvent être pertinentes pour les chercheurs, les décideurs du secteur de la santé, les administrateurs d'hôpitaux, et les spécialistes et consultants en TI.----------ABSTRACT : Hospitals, even small ones, handle on a daily basis several thousands of mobile and fixed assets. Mobile assets are very diverse, ranging from infusion pumps, surgical equipment, electrocardiograms, portable x-ray machines, defibrillators to wheelchairs and rotate constantly between different medical wards. Since virtually every patient depends on one or more mobile assets during his or her hospital stay, they are also indispensable in healthcare delivery. Clinical staff spends a significant share of their working time searching for these essential, but commonly misplaced assets. Locating mobile assets is not only a time consuming activity, but the inability to find them when needed is remarkably costly, and possibly life threatening. RFID (Radio Frequency Identification) holds the potential to uniquely and seamlessly track and trace mobile assets and, thus, to improve mobile asset management in hospitals. Compared to other sectors, healthcare organizations adopt RFID at a much slower pace and only a limited number of empirical studies address RFID adoption and implementation in the context of healthcare. This thesis intends to contribute the research arena by analysing a real-life RFID implementation in order improve the management activities of one type of mobile assets, namely infusion pumps in hospital settings. The research focuses on a real-life RFID implementation in one European hospital. Empirical data was collected for a 25 month period from the pre-feasibility stage to post-implementation stage from eight organizations (including the hospital as the main observation site) and from thirty-five participants. Research results can be summarized as follows. To the question why RFID is implemented? The most straightforward answer is to reduce the existing inefficiencies related to mobile assets management. Technological preparedness and readiness drive RFID implementation: This includes familiarity with IT innovations within the hospital, compatibility with existing IT infrastructure (the hospital is almost 100% Wi-Fi enabled), and experience of technological partners with RFID implementation in various sectors. How RFID implementation is carried out? The answer seems to be through a highly iterative five stage process where participants revisited and modified previously agreed steps. The continuous improvement of care services was without a doubt the superseding concern expressed by all participants from the hospital. However, expectations and requirements differ among different groups of participants. The empirical evidence demonstrates not only a cleavage between the administrative and clinical perspectives, but also within the clinical perspective. Divergences run deep within each perspective (for instance, nurses vs. doctors) and between the technologists in the hospital (ICT managers, biomedical engineers, and maintenance specialists) and the administrators. The most significant issues related to such implementation are not technological but are mainly organizational, as they seem to arise from the presence of diverging perspectives. Does RFID really improve mobile assets management? Results suggest that the benefits identified and evaluated during the real life RFID implementation belong to the following broad categories: improving assets visibility, promoting operational efficiency, reducing costs and facilitating the emergence of intelligent processes. Intelligent processes are mainly derived from the RFID capabilities for auto-identification and context-awareness, process automatic status change, and automatic update in hospital’s enterprise applications (i.e. WMS). Results further demonstrate that intelligent processes improve planning and decision-making. Do the intrinsic characteristics of organizations play a role in RFID implementation? The very characteristics of hospitals, qualified as complex professional bureaucracies, constitute a unique set of constraints to be taken into account for RFID implementation. In particular, organizational inertia, complexity and inflexibility are not conductive to hospital-wide changes and affect how RFID is implemented. Moreover, the existence of a dual power structure and a tendency to culture entrapment may have a profound impact on the importance of the benefits derived from RFID. Do technology acceptance, acceptability and appropriation represent key concepts that should be considered to understand the implementation of RFID? These three concepts were explored in the research. This leads to two main observations. First, it could be stated that if technology is accepted, acceptable and appropriated, then it is fully used. By extension, acceptance, acceptability and appropriation could be significant not only in explaining the extent of use of a technology (partial use vs. full use), but also the reasons why a technology was initially adopted and then discarded. Second, empirical results reject the presence of a chronological order between the three concepts. For instance, appropriation does not follow acceptance, even initially. Rather, acceptance, acceptability and appropriation coexist at any time during the implementation process. However, chronology still matters since the levels of acceptance, acceptability and appropriation vary over time. Furthermore, these three concepts are sensitive to both the technology (in this case RFID) and to the context where it is use (the hospital), which are also changing over time. The thesis examines research limitations, proposes some research avenues and outlines contributions that may be relevant for researchers, healthcare policy makers, hospital administrators, IT specialists and IT consultants

Multidimensional embedded MEMS motion detectors for wearable mechanocardiography and 4D medical imaging

Background: Cardiovascular diseases are the number one cause of death. Of these deaths, almost 80% are due to coronary artery disease (CAD) and cerebrovascular disease. Multidimensional microelectromechanical systems (MEMS) sensors allow measuring the mechanical movement of the heart muscle offering an entirely new and innovative solution to evaluate cardiac rhythm and function. Recent advances in miniaturized motion sensors present an exciting opportunity to study novel device-driven and functional motion detection systems in the areas of both cardiac monitoring and biomedical imaging, for example, in computed tomography (CT) and positron emission tomography (PET). Methods: This Ph.D. work describes a new cardiac motion detection paradigm and measurement technology based on multimodal measuring tools — by tracking the heart’s kinetic activity using micro-sized MEMS sensors — and novel computational approaches — by deploying signal processing and machine learning techniques—for detecting cardiac pathological disorders. In particular, this study focuses on the capability of joint gyrocardiography (GCG) and seismocardiography (SCG) techniques that constitute the mechanocardiography (MCG) concept representing the mechanical characteristics of the cardiac precordial surface vibrations. Results: Experimental analyses showed that integrating multisource sensory data resulted in precise estimation of heart rate with an accuracy of 99% (healthy, n=29), detection of heart arrhythmia (n=435) with an accuracy of 95-97%, ischemic disease indication with approximately 75% accuracy (n=22), as well as significantly improved quality of four-dimensional (4D) cardiac PET images by eliminating motion related inaccuracies using MEMS dual gating approach. Tissue Doppler imaging (TDI) analysis of GCG (healthy, n=9) showed promising results for measuring the cardiac timing intervals and myocardial deformation changes. Conclusion: The findings of this study demonstrate clinical potential of MEMS motion sensors in cardiology that may facilitate in time diagnosis of cardiac abnormalities. Multidimensional MCG can effectively contribute to detecting atrial fibrillation (AFib), myocardial infarction (MI), and CAD. Additionally, MEMS motion sensing improves the reliability and quality of cardiac PET imaging.Moniulotteisten sulautettujen MEMS-liiketunnistimien käyttö sydänkardiografiassa sekä lääketieteellisessä 4D-kuvantamisessa Tausta: Sydän- ja verisuonitaudit ovat yleisin kuolinsyy. Näistä kuolemantapauksista lähes 80% johtuu sepelvaltimotaudista (CAD) ja aivoverenkierron häiriöistä. Moniulotteiset mikroelektromekaaniset järjestelmät (MEMS) mahdollistavat sydänlihaksen mekaanisen liikkeen mittaamisen, mikä puolestaan tarjoaa täysin uudenlaisen ja innovatiivisen ratkaisun sydämen rytmin ja toiminnan arvioimiseksi. Viimeaikaiset teknologiset edistysaskeleet mahdollistavat uusien pienikokoisten liiketunnistusjärjestelmien käyttämisen sydämen toiminnan tutkimuksessa sekä lääketieteellisen kuvantamisen, kuten esimerkiksi tietokonetomografian (CT) ja positroniemissiotomografian (PET), tarkkuuden parantamisessa. Menetelmät: Tämä väitöskirjatyö esittelee uuden sydämen kineettisen toiminnan mittaustekniikan, joka pohjautuu MEMS-anturien käyttöön. Uudet laskennalliset lähestymistavat, jotka perustuvat signaalinkäsittelyyn ja koneoppimiseen, mahdollistavat sydämen patologisten häiriöiden havaitsemisen MEMS-antureista saatavista signaaleista. Tässä tutkimuksessa keskitytään erityisesti mekanokardiografiaan (MCG), joihin kuuluvat gyrokardiografia (GCG) ja seismokardiografia (SCG). Näiden tekniikoiden avulla voidaan mitata kardiorespiratorisen järjestelmän mekaanisia ominaisuuksia. Tulokset: Kokeelliset analyysit osoittivat, että integroimalla usean sensorin dataa voidaan mitata syketiheyttä 99% (terveillä n=29) tarkkuudella, havaita sydämen rytmihäiriöt (n=435) 95-97%, tarkkuudella, sekä havaita iskeeminen sairaus noin 75% tarkkuudella (n=22). Lisäksi MEMS-kaksoistahdistuksen avulla voidaan parantaa sydämen 4D PET-kuvan laatua, kun liikeepätarkkuudet voidaan eliminoida paremmin. Doppler-kuvantamisessa (TDI, Tissue Doppler Imaging) GCG-analyysi (terveillä, n=9) osoitti lupaavia tuloksia sydänsykkeen ajoituksen ja intervallien sekä sydänlihasmuutosten mittaamisessa. Päätelmä: Tämän tutkimuksen tulokset osoittavat, että kardiologisilla MEMS-liikeantureilla on kliinistä potentiaalia sydämen toiminnallisten poikkeavuuksien diagnostisoinnissa. Moniuloitteinen MCG voi edistää eteisvärinän (AFib), sydäninfarktin (MI) ja CAD:n havaitsemista. Lisäksi MEMS-liiketunnistus parantaa sydämen PET-kuvantamisen luotettavuutta ja laatua

Optimal Supply Network with Vendor Managed Inventory in a Healthcare System with RFID Investment Consideration

Supply Chain Management in the healthcare sector faces several significant challenges, including complexity in healthcare systems, high supply chain costs, balancing quality and costs, delay in delivery, product availability from vendors, inventory waste, and unpredictability and uncertainty. Among those challenges, having an effective inventory management system with an optimal supply network is important to improve the match between supply and demand, which would improve the performance of for healthcare firms. Vendor Managed Inventory (VMI) system is a replenishment solution in which the vendor monitors and decides the time and the quantity of the inventory replenishment of their customers subject to their demand information exchange. A VMI contract in the location-inventory assignment problem is a decision tool for management in the healthcare industry, in which it enables the management to have a cost and service effective decision tool to critically re-evaluate and examine all areas of operations in a SC network looking for avenues of optimization. This dissertation is based on a real-world problem arising from one of the world\u27s leading medical implant supply company applied to a chain of hospitals in the province of Ontario. The chain of hospitals under study consists of 147 hospitals located in Ontario, Canada. The vendor is a supplier of three types of medical implants (a heart valve, an artificial knee, and a hip). In Chapter 2 of this dissertation, we present an optimal supply healthcare network with VMI and with RFID consideration, in which we shed light on the role of the VMI contract in the location-inventory assignment problem and integrate it with both the replenishment policy assignment and the Radio Frequency Identification (RFID) investment allocation assignment in healthcare SC networks using both VMI and direct delivery policies. A numerical solution approach is developed in the case of the deterministic demand environment, and we end up with computational results and sensitivity analysis for a real-world problem to highlight the usefulness and validate the proposed model. We extend our research of integrating the VMI contract in the location-inventory assignment problem with the replenishment policy assignment under a deterministic demand environment to include the stochastic demand environment. The impact of the uncertainty of the demand as a random variable following two types of distributions, normal and uniform distributions, is studied in Chapter 3. Motivated by the lack of investigations and comparative studies dealing with the preference of dealing with VMI contracts to other traditional Retailer Managed Inventory (RMI) systems, we provide in Chapter 4 of this dissertation a comparative study in which we compare the total cost of the VMI system with another two situations of traditional RMI systems: first, a traditional RMI system with a continuous replenishment policy for all hospitals and with assigned storage facilities and second, a traditional RMI system with a direct delivery policy for all hospitals without assigning a storage facility. Computational results, managerial insights, sensitivity analysis, and solution methodologies are provided in this dissertation. Keywords: Vendor Managed Inventory, healthcare system, location-inventory, RFID technology, supply-chain network, stochastic demand, location-inventory assignment problem, and retailer managed Inventory

Quantifying Quality of Life

Describes technological methods and tools for objective and quantitative assessment of QoL Appraises technology-enabled methods for incorporating QoL measurements in medicine Highlights the success factors for adoption and scaling of technology-enabled methods This open access book presents the rise of technology-enabled methods and tools for objective, quantitative assessment of Quality of Life (QoL), while following the WHOQOL model. It is an in-depth resource describing and examining state-of-the-art, minimally obtrusive, ubiquitous technologies. Highlighting the required factors for adoption and scaling of technology-enabled methods and tools for QoL assessment, it also describes how these technologies can be leveraged for behavior change, disease prevention, health management and long-term QoL enhancement in populations at large. Quantifying Quality of Life: Incorporating Daily Life into Medicine fills a gap in the field of QoL by providing assessment methods, techniques and tools. These assessments differ from the current methods that are now mostly infrequent, subjective, qualitative, memory-based, context-poor and sparse. Therefore, it is an ideal resource for physicians, physicians in training, software and hardware developers, computer scientists, data scientists, behavioural scientists, entrepreneurs, healthcare leaders and administrators who are seeking an up-to-date resource on this subject