Sharing and viewing segments of electronic patient records service (SVSEPRS) using multidimensional database model

This thesis was submitted for the degree of Doctor of Philosophy and awarded by Brunel University.The concentration on healthcare information technology has never been determined than it is today. This awareness arises from the efforts to accomplish the extreme utilization of Electronic Health Record (EHR). Due to the greater mobility of the population, EHR will be constructed and continuously updated from the contribution of one or many EPRs that are created and stored at different healthcare locations such as acute Hospitals, community services, Mental Health and Social Services. The challenge is to provide healthcare professionals, remotely among heterogeneous interoperable systems, with a complete view of the selective relevant and vital EPRs fragments of each patient during their care. Obtaining extensive EPRs at the point of delivery, together with ability to search for and view vital, valuable, accurate and relevant EPRs fragments can be still challenging. It is needed to reduce redundancy, enhance the quality of medical decision making, decrease the time needed to navigate through very high number of EPRs, which consequently promote the workflow and ease the extra work needed by clinicians. These demands was evaluated through introducing a system model named SVSEPRS (Searching and Viewing Segments of Electronic Patient Records Service) to enable healthcare providers supply high quality and more efficient services, redundant clinical diagnostic tests. Also inappropriate medical decision making process should be avoided via allowing all patients‟ previous clinical tests and healthcare information to be shared between various healthcare organizations. Multidimensional data model, which lie at the core of On-Line Analytical Processing (OLAP) systems can handle the duplication of healthcare services. This is done by allowing quick search and access to vital and relevant fragments from scattered EPRs to view more comprehensive picture and promote advances in the diagnosis and treatment of illnesses. SVSEPRS is a web based system model that helps participant to search for and view virtual EPR segments, using an endowed and well structured Centralised Multidimensional Search Mapping (CMDSM). This defines different quantitative values (measures), and descriptive categories (dimensions) allows clinicians to slice and dice or drill down to more detailed levels or roll up to higher levels to meet clinicians required fragment

Platforms for big data business models in the healthcare context

Abstract. The profitability of the business opportunity is defined by the level of owned data and its insights to the business organization. However, the existing literature has not identified how to link between different business models in the data-oriented systems. The previous research efforts focused on the technical aspects of data including data monetization, clustering, and data lifecycle. The purpose of this research is to understand how to link big data and business model thinking in the healthcare context. The main argument of this study provides a novel way to the modularity in the big data business models, which enables the system customers to control the system Studies show if there is a kind of data-oriented platform that remind patients to do certain tasks (ex. nutrition and medicine reminders) before going to doctors and nurses; the patients would like to use it. In addition, around 90% of the platform users will recommend it to other patients and so on. This pushes the operators in the healthcare industry to transform their traditional human-based data systems into a computer-to-computer system. In the data-intensive systems like the healthcare industry, the value creation is done by monetizing data between system actors to analyze the data and develop extensive knowledge about the end customer. For example, the hospitals have the right to own and anonymize the patient data to ensure the privacy and security of patient information. Then hospitals monetize the patient data with their business partner who has the technical and analytical capability to analyze data. Later, they provide the system with useful insights gained from data analytics. This is an exploratory phase of research where the qualitative case study approach is applied to examine the possibility of having a common platform for the integrated solutions in the data-oriented systems. To approach these platforms, an empirical study has been conducted over three case companies working in the healthcare context. The data were collected using semi-structured interview discussion. Similar qualitative approaches have been used in some prior studies to examine the value creation in the data-oriented systems and identify the future business models for the digital environments and IoT. This research contributes to the existing literature by identifying four main platforms for big data business models. The modular platform is done due to the lack of knowledge about the end-customer, it grants system partners the right to control over their platforms. The partnership platform guarantees the continuity of the business process, the Ecosystemic platform gives the end customer the possibility to select what they need from the overall ecosystem. The ownership platform is related to the centralized control over the data source, enabling consistency of the business process

Mapping the Path to a Health Data Marketplace in Norway: An Exploratory Case Study

This Master's thesis explores the complex dynamics of health data in the digital age, focusing on its secure and efficient management and ethical considerations. It investigates the potential of implementing a Health Data Marketplace (HDM) in the Norwegian e-health sector, aiming to construct a seamless health data exchange platform. This study proposes the integration of an existing health data gateway, the Egde Health Gateway (EHG), with the HDM. The research offers an in-depth analysis of existing limitations in health data exchange systems in Norway. It addresses current research gaps in Data Marketplace, Business Models, Gateways, and the Norwegian e-health context. Guided by two central research questions, this thesis delves into identifying essential components required to successfully implement an HDM in Norway and how this marketplace could be established using an existing data platform. Significantly, the thesis underscores the pivotal role of primary stakeholders in the HDM - Platform Operators, Platform Users, and Legal Authorities. The exploration reveals that Platform Operators are vital influencers, fostering collaboration and innovation within the ecosystem, while Platform Users and Legal Authorities ensure the marketplace's innovative and compliance aspects. Additionally, this study identifies essential components for successfully integrating an HDM into an existing health data platform, including Data Standardization, Interoperability, Integration, Security, Trust, and Legal Frameworks, among others. The thesis marks a significant step towards realizing an HDM in the Norwegian e-health sector. It invites future research to broaden stakeholder perspectives, examine economic aspects of the HDM, and delve into ethical considerations and technological innovations. The findings from this exploration serve as a catalyst for leveraging health data effectively, securely, and ethically, contributing to improved healthcare outcomes, research, and innovation in Norway and beyon

Mapping the Path to a Health Data Marketplace in Norway: An Exploratory Case Study

This Master's thesis explores the complex dynamics of health data in the digital age, focusing on its secure and efficient management and ethical considerations. It investigates the potential of implementing a Health Data Marketplace (HDM) in the Norwegian e-health sector, aiming to construct a seamless health data exchange platform. This study proposes the integration of an existing health data gateway, the Egde Health Gateway (EHG), with the HDM. The research offers an in-depth analysis of existing limitations in health data exchange systems in Norway. It addresses current research gaps in Data Marketplace, Business Models, Gateways, and the Norwegian e-health context. Guided by two central research questions, this thesis delves into identifying essential components required to successfully implement an HDM in Norway and how this marketplace could be established using an existing data platform. Significantly, the thesis underscores the pivotal role of primary stakeholders in the HDM - Platform Operators, Platform Users, and Legal Authorities. The exploration reveals that Platform Operators are vital influencers, fostering collaboration and innovation within the ecosystem, while Platform Users and Legal Authorities ensure the marketplace's innovative and compliance aspects. Additionally, this study identifies essential components for successfully integrating an HDM into an existing health data platform, including Data Standardization, Interoperability, Integration, Security, Trust, and Legal Frameworks, among others. The thesis marks a significant step towards realizing an HDM in the Norwegian e-health sector. It invites future research to broaden stakeholder perspectives, examine economic aspects of the HDM, and delve into ethical considerations and technological innovations. The findings from this exploration serve as a catalyst for leveraging health data effectively, securely, and ethically, contributing to improved healthcare outcomes, research, and innovation in Norway and beyond

Communication in Healthcare: Opportunities for information technology and concerns for patient safety

Understanding healthcare workflow is fundamental for design and implementation of information systems. Communication and information exchange between healthcare professionals plays a pivotal role in developing smooth workflow within and between healthcare organizations. The study in this thesis analyzes the interaction between Information Technology (IT) and the medication process within and between healthcare organizations. The focus is on the interactions that lead to communication problems and as a result lead to unintended negative consequences on patient safety. The thesis examines several cases of IT intervention to improve intra- and inter-organizational communication. It raises important implications on how to design and implement IT systems that support healthcare processes without jeopardizing patient safety. The author concludes for IT to improve healthcare communication and patient safety, at intra-organizational level, it has to support the highly integrated nature of the shared healthcare work. At inter-organizational level the main challenge is that different pieces of the shared work are not sufficiently integrated

The influence of cultural values on Enterprise System adoption, towards a culture – Enterprise System alignment theory

During the last decades, organizations worldwide have replaced their fragmented and home-grown information systems with standardized Enterprise Systems that span the entire organization. The logics embedded in Enterprise Systems, such as a centralized and integrated view on the firm, standardized organization-wide working processes, and data sharing, may or may not be congruent with the cultural context of the user organization. Especially in case of a limited alignment, the adoption and full use of the Enterprise System will require specific attention from implementers. By developing a theoretical explanation of how responses to Enterprise Systems are influenced by cultural values, we contribute to the development of a cultural alignment theory of Enterprise Systems. Drawing on Hofstede’s cultural values framework, we analysed 85 published cases from firms operating in different cultural contexts, which resulted in the modelling of two contrasting archetypical cultural profiles: one that is more, and one that is less, receptive to the logics embedded in Enterprise Systems. Our model provides implementers with the necessary insights to develop implementation strategies that take the cultural context into account

Liberian health system resilience: lessons from the 2014–2015 West African Ebola epidemic

I. BACKGROUND: Following a review of donor funding priorities and concepts of health system strengthening (HSS) and resilience, this dissertation documents health system resilience factors existing in the Liberian health system in late 2014/early 2015 as the Ebola epidemic flared. The effectiveness of the WHO health system building blocks framework in addressing resilience was assessed, and specific factors that can promote health system resilience for Liberia going forward were identified. II. METHODS: Methods applied as part of this intrinsic case study include document and literature review, analysis of health facility and population-level statistics, and key informant and group interviews at the county and national levels. The methodology allowed for an in-depth assessment of how HSS (using the WHO health system building blocks) and resilience factors (using the WHO-defined key aspects of emergency preparedness) exist (or could exist) within the Liberian institutional and cultural context, and for tentative conclusions to be drawn about the importance of system factors to building specific health system capacities and overall health system resilience. III. FINDINGS: While dealing with myriad other public health priorities, public health preparedness went largely unaddressed in pre-Ebola Liberia where effectively none of the 16 key components or their 51 essential attributes listed in the WHO table of emergency preparedness were in place. The lack of integration of public health preparedness into HSS interventions left the country vulnerable to public health emergencies. There are two limitations to the government’s Ebola recovery and investment plan: (1) lack of a holistic approach to addressing emergency preparedness; and (2) not integrating emergency preparedness needs and corresponding activities into the existing national HSS framework. IV. CONCLUSION: By integrating emergency preparedness and response initiatives into HSS activities, health systems in Liberia and elsewhere can be strengthened to be more resilient, and thus better able to anticipate and adapt to challenges, and ultimately improve the system to be able to anticipate new future challenges. However, strengthening health systems so that they are resilient takes resources, including sector-wide, HSS resources that can be used to build functioning, integrated systems and skilled, networked individuals and groups across sectors

Biomedical Pollutants and Urban Waste Management in the Accra Metropolitan Area, Ghana: A Framework for Urban Management of the Environment (FUME)

Ecosystems provide essential necessities required for the sustenance of life including food, water, medicine, aesthetics, recreational and spiritual outlets. Preserving and maintaining the integrity, carrying capacity, diversity and functions of ecosystems is therefore necessary for sustainability. Naturally, ecosystems are resilient and have the ability to bend and flex with various stressors while retaining their integrity, provided the challenges are not overwhelming. On the other hand, consistent mismanagement can result in the transformation of pulse disturbances into chronic and compounded perturbations. Ultimately, this can result in the dilapidation, alteration and in some case, removal of ecosystems. In many developing countries, ineffective management of urban wastes contributes to the magnification of risks to ecosystems and public health. Particularly perturbing is the mismanagement of biomedical pollutants generated during the course of healthcare activities. Biomedical wastes are known to contain infectious, toxic and radioactive substances that carry a greater risk for the environment and public health than regular urban wastes. In spite of the risk factors, mismanagement of biomedical pollutants is widespread in many developing countries. Predicated primarily on post-positivist epistemology, this case study research investigated systemic and institutional arrangements pertaining to the management of urban wastes including biomedical pollutants in the Accra Metropolitan Area (AMA), Ghana. The research uncovered major deficiencies in management of urban wastes and biomedical pollutants which contributes to elevated risks to the environment and public health. The underlying causes of the problems were found to be embedded in deficiencies relating to weak governance, feckless regulations, resource constraints, corruption, technological limitations, service delivery and a general lack of awareness. As part of the research, an eclectic Framework for Urban Management of the Environment (FUME) was developed to address gaps in existing environmental planning and decision-making approaches. The FUME model consists of salient features of the precautionary principle, ecosystem approach, adaptive management, co-management, environmental risk management and integrated waste management

Governance:Governance Frameworks for Wastewater Management

MVZ specimen catalog numbers and views represented. (XLSX 495 kb