Emerging Insights of Health Informatics Research: A Literature Analysis for Outlining New Themes

This paper presents a contemporary literature review to provide insights into the current health informatics literature. The objective of this study is to identify emerging directions of current health informatics research from the latest and existing studies in the health informatics domain. We analyse existing health informatics studies using a thematic analysis, so that justified sets of research agenda can be outlined on the basis of these findings. We selected articles that are published in the Science Direct online database. The selected 73 sample articles (published from 2014 to 2018 in premier health informatics journals) are considered as representative samples of health informatics studies. The analysis revealed ten topic areas and themes that would be of paramount importance for researchers and practitioners to follow. The findings provide an important foundational understanding for new health informatics studies

Designing sustainable business models for telehealthcare services adoption: A critical realism informed case study approach

A rising elderly population in England, together with the prevalence of long-term chronic health conditions and higher demands for social care, raise significant issues in terms of financing the provision of telehealthcare services. These emerging technologies can potentially provide more meaningful opportunities for operational efficiency and cost savings by supporting ‘ageing in place’, as opposed to an increasing reliance on commissioning expensive institutional provisions such as care homes. Accordingly, policymakers advocate the provision and implementation of telehealthcare services on an increased population scale. This study employs an investigative framework that brings together two interdisciplinary and complementary theoretical frames, synthesised from the existing literature on business models and service innovation. Using the principles of Critical Realism (CR) to inform a qualitative case study research design, we empirically contextualise our value-driven investigative framework and present our findings that identify four main themes, namely (i) Nature of the service, (ii) Advocacy and collaborations, (iii) Organisational characteristics, and (iv) Technology and Information systems. These four themes emerging from the empirical investigation concern value proposition, value co-creation and value realisation within a service and inform our next stage of CR analysis – to unearth the hidden structures and causal mechanisms and to better explain the underlying reality within a service ecosystem

Service-Oriented Architecture for Patient-Centric eHealth Solutions

The world is in shortage of about 7.2 million healthcare workers in 2013, and the figure is estimated to grow to 12.9 million by 2035, according to the World Health Organization (WHO). On the other hand, the median age of the world’s population was predicted to increase from 26.6 years in 2000 to 37.3 years in 2050, and then to 45.6 years in 2100. Thus further escalating the need for new and efficient healthcare solutions. Telehealth, telecare, and Ambient Assisted Living (AAL) solutions promise to make healthcare services more sustainable, and to enable patients to live more independently and with a higher quality of life at their homes. Smart homes will host intelligent, connected devices that integrate with the Internet of Things (IoT) to form the basis of new and advanced healthcare systems. However, a number of challenges needs to be addressed before this vision can be actualised. These challenges include flexible integration, rapid service development and deployment, mobility, unified abstraction, scalability and high availability, security and privacy. This thesis presents an integration architecture based on Service-Oriented Architecture (SOA) that enables novel healthcare services to be developed rapidly by utilising capabilities of various devices in the patients’ surroundings. Special attention is given to a service broker component, the Information Integration Platform (IIP), that has been developed to bridge communications between everyday objects and Internet-based services following the Enterprise Service Bus (ESB) principles. It exposes its functionalities through a set of RESTfulWeb services, and maintains a unified information model which enables various applications to access in a uniform way. The IIP breaks the traditional vertical “silo” approach of integration, and handles information dissemination task between information providers and consumers by adopting a publish/subscribe messaging pattern. The feasibility of the IIP solution is evaluated both through prototyping and testing the platform’s representative healthcare services, e.g., remote health monitoring and emergency alarms. Experiments conducted on the IIP reveal how performance aspects are affected by needs for security, privacy, high availability, and scalability

Maintaining the integrity of XML signatures by using the manifest element

One of the aims of providing 'security of data' in e-commerce transactions is making sure that the receiver receives the same data which the sender sends, that is the data has not been tampered in any way. To achieve this aim digital signatures are used. A digital signature helps in providing integrity, message authentication, and signer authentication for the signed data. An XML signature can contain or point to the data that is being signed. In this paper we discuss a possible solution of avoiding a signature from breaking when there is a change in the location of the document after it has been signed

An Advanced Conceptual Diagnostic Healthcare Framework for Diabetes and Cardiovascular Disorders

The data mining along with emerging computing techniques have astonishingly influenced the healthcare industry. Researchers have used different Data Mining and Internet of Things (IoT) for enrooting a programmed solution for diabetes and heart patients. However, still, more advanced and united solution is needed that can offer a therapeutic opinion to individual diabetic and cardio patients. Therefore, here, a smart data mining and IoT (SMDIoT) based advanced healthcare system for proficient diabetes and cardiovascular diseases have been proposed. The hybridization of data mining and IoT with other emerging computing techniques is supposed to give an effective and economical solution to diabetes and cardio patients. SMDIoT hybridized the ideas of data mining, Internet of Things, chatbots, contextual entity search (CES), bio-sensors, semantic analysis and granular computing (GC). The bio-sensors of the proposed system assist in getting the current and precise status of the concerned patients so that in case of an emergency, the needful medical assistance can be provided. The novelty lies in the hybrid framework and the adequate support of chatbots, granular computing, context entity search and semantic analysis. The practical implementation of this system is very challenging and costly. However, it appears to be more operative and economical solution for diabetes and cardio patients.Comment: 11 PAGE

Toward a Discourse Community for Telemedicine: A Domain Analytic View of Published Scholarship

In the past 20 years, the use of telemedicine has increased, with telemedicine programs increasingly being conducted through the Internet and ISDN technologies. The purpose of this dissertation is to examine the discourse community of telemedicine. This study examined the published literature on telemedicine as it pertains to quality of care, defined as correct diagnosis and treatment (Bynum and Irwin 2011). Content analysis and bibliometrics were conducted on the scholarly discourse, and the most prominent authors and journals were documented to paint and depict the epistemological map of the discourse community of telemedicine. A taxonomy based on grounded research of scholarly literature was developed and validated against other existing taxonomies. Telemedicine has been found to increase the quality and access of health care and decrease health care costs (Heinzelmann, Williams, Lugn and Kvedar 2005 and Wootton and Craig 1999). Patients in rural areas where there is no specialist or patients who find it difficult to get to a doctor’s office benefit from telemedicine. Little research thus far has examined scholarly journals in order to aggregate and analyze the prevalent issues in the discourse community of telemedicine. The purpose of this dissertation is to empiricallydocument the prominent topics and issues in telemedicine by examining the related published scholarly discourse of telemedicine during a snapshot in time. This study contributes to the field of telemedicine by offering a comprehensive taxonomy of the leading authors and journals in telemedicine, and informs clinicians, librarians and other stakeholders, including those who may want to implement telemedicine in their institution, about issues telemedicine

Designing value creating and sustainable business models: An investigation of telehealthcare service ecosystem in North East England

A rising elderly population in England, together with the prevalence of long-term chronic health conditions and higher demands for social care, is creating significant challenges for both the English National Health Service (NHS), and for Local Authorities. These challenges relate to the effective planning, commissioning and provisioning of services for people with complex social and health care needs, amidst a predominantly public-funded health and care system. Digital technology innovations, such as telecare and telehealth (telehealthcare) can facilitate assisted living through technology-mediated preventions, early detections of risks, timely interventions, and self-directed care. Policymakers acknowledge the potential of these technologies to drive greater operational efficiency and cost savings by supporting the policy agenda of ‘ageing in place’, as opposed to an increasing reliance on commissioning expensive institutional provisions such as care homes. In order to realise the opportunities of technology-enabled care, policymakers have started advocating faster adoption, provisioning and implementation of telehealthcare services on an increased population scale. A review of the relevant health technology and systems literature indicates that prior and current research does not sufficiently address the business model and service perspectives, which are considered critical to the practical justification and adoption of complex health service innovations such as telehealthcare. This research study and thesis brings together two interdisciplinary and complementary theoretical frames, synthesised from the extant literature on business models and service innovation. A new theoretical framework is developed in order to examine, interrogate and explain the phenomena of value creation and value realisation within a telehealthcare service ecosystem. Conventional business model-based thinking focuses on value propositions and the financial realisation of value. In contrast, service-dominant logic offers more relational and systemic insights on value co-creation (emphasising social as well as economic factors) through stakeholders’ resource integration within the entire service ecosystem. Using the principles of Critical Realism (CR) to inform a case study approach, this qualitative study employs a multiple case-based research design, resulting in five case studies of telehealthcare services (including one pilot) in the North East of England. The analysis of empirical data collected from the case studies, including a representative sample comprising forty key-informant stakeholder interviews, combined with documentary and observational evidence, reveals four main themes. In the next stage of analysis, following a critical realist perspective, abduction and retroduction based reasoning are applied, leading to a theoretical explanation concerning the underlying structures and their causal powers (mechanisms). Three most significant causal mechanisms, namely Organisational Inertia, Fragmented Ecosystem, and Quasi-market Characteristics, have been identified to explain the stratified reality within a telehealthcare service ecosystem. This research analysis results in both theoretical, and practitioner related contributions concerning the development of a typology for telehealthcare service business models with illustrations of three archetype business models and their related elements. These archetype models signify the dynamic possibilities or potential variations of business models and new service designs contingent upon the operational contexts in which the business models are to be situated

Central monitoring system for ambient assisted living

Smart homes for aged care enable the elderly to stay in their own homes longer. By means of various types of ambient and wearable sensors information is gathered on people living in smart homes for aged care. This information is then processed to determine the activities of daily living (ADL) and provide vital information to carers. Many examples of smart homes for aged care can be found in literature, however, little or no evidence can be found with respect to interoperability of various sensors and devices along with associated functions. One key element with respect to interoperability is the central monitoring system in a smart home. This thesis analyses and presents key functions and requirements of a central monitoring system. The outcomes of this thesis may benefit developers of smart homes for aged care