Towards a framework to study influence and accounting use.

The autonomous regions of Spain have responsibility for healthcare. The Galician Health Service aims to achieve a higher level of health for Galicians with an appropriate primary healthcare system. The law requires healthcare to be promoted within a system of participative management directed by an upper level of management. The healthcare system is changing, and the upper level managers are introducing new systems to improve the provision and administration of care. These changes will include the provision of accounting data in the normal course of managing. This paper is before a study of the changes. The paper provides the background to constructing a Framework and then constructs a Framework for our empirical work. It uses the constructs of information and influence with markers of the information areas and styles of influence in the form of an Information–Influence Matrix (Purdy, 1993b). It also uses personal construction (Kelly, 1955) to help create a dynamic approach to change and the use of accounting information. It finally provides a framework of our anticipations of what might happen to a Health Centre Manager and an Upper Manager.

Studying influence and accounting use—empirical evidence about individual managers and organizations with changes in Galician healthcare.

Legislation outlined proposed changes in Galician Health Centres. This allowed us to set down the theory about personal and organizational Information–Influence Matrices and then Frameworks of Issues for the interactions between an individual Financial Manager and a Health Centre Co-ordinator, as well as the proposed organizational changes into a new system [Purdy DE, Gago S. Extending influence and accounting use: developing the frameworks to incorporate Galician legal matters about the proposed healthcare changes with managers and organizations for empirical study. Critical Perspectives on Accounting; in press]. Evidence from a longitudinal study covering January 1997 and December 2001, indicated the suitability of these types of Matrices and Frameworks of Issues to analyse conversational data. Results agreed with anticipations at a personal level—wholly for a co-ordinator and partly for the Financial Manager. Differences between the findings and our anticipated Financial Manager's framework are straightforward and we have amended our Framework accordingly. The organization level has followed our anticipations though only 15% of Health Centres had continued with the new system, 85% remained working with the old system. Galician law contained aspirations for changing healthcare with autonomous Health Centres. Spanish health policies and budget laws have inhibited moves to change, as well as the actions of the professionals involved.Information and influence; Consultation and participation; Autonomy; Managers; Galician Health Centre Management; Personal construct psychology; Information–influence matrix; Organizational change; Accounting data;

Clinico-environmental system for personal monitoring

The ever-growing use of information and communication technologies in the past decades and the proliferation of mobile devices for monitoring vital signs and physical activity is enhancing the emergence of a new healthcare paradigm. More recently, citizens are becoming more sensible to the necessity of monitoring environmental health indicators and to its direct impact on personal health. This article proposes and describes the development of a clinico-environmental system for personal monitoring. The result is ContinuousCare, a personal healthcare information system that integrates personal smart devices with air quality monitors. The solution helps citizens to better understand their health and body activity with environmental context, aiding professional doctors with analysis tools and making available valuable data for external systems.publishe

An Efficient Medical Text Mining in Diseases Diagnoses And its equivalent Data privacy Preservation Policy for Medical Data: A Review

Healthcare systems use a medical text mining which have been increasingly facilitating health condition monitoring and disease modeling. System works on the Personal Health Information (PHI) of the user. Healthcare system grant users access to range of health information and medical knowledge. Benefit of the system is all the information about disease, precautions and healthcare are store at one place. Unfortunately, delegating both storage and computation to the untreated entity would bring a series of security and privacy issues. One of the controversial issues for PHI is how the technology could threaten the privacy of patient health information. The proposed system focused on fine-grained privacy-preserving static medical text access and analysis, which can hardly afford the dynamic health condition fluctuation

A model for an inclusive healthcare information system

Healthcare organisations such as hospitals communicate both public and personal information to citizens. Accessible websites are suited for public information, but personal information (e.g. medical appointment notices) is still sent out by ordinary post in the form of text on a paper. Sometimes a person has to ask repeatedly for accessible information and is forced to adapt to the information system, rather than the other way around. This paper presents a model for adapting information automatically to each individual’s preferences and a list of such preferences resulting from interviews with persons with disabilities. The model facilitates an innovative process where a healthcare organisation and citizens work together in four steps: 1) A person’s information preferences are stored in a database in the hospital’s improved information system and can be updated at any time. 2) When the caregiver sends out information, a notification module retrieves the personal preferences from the database and adapts the information. 3) The person receives individualised information. 4) Preferences stored by citizens, but not yet implemented, can be used for further development of the inclusive information system. A prototype web form was then developed and evaluated by people from disability and elderly organisations

Sharing Medical Profiles for International Students in UUM

One of the most common information technology activities is improvement of healthcare and clinical management systems including personal healthcare records. Personal healthcare records have the potential to help individuals to do a more active role in their health care. It plays a main key in medical diagnosis and therapy. International students in UUM do not have personal healthcare records, which can be shared among medical centers. The aim of this study is to develop a prototype for sharing medical profiles; the prototype is developed by using C# language, and the research design based on general methodology. The evaluation was based on user perception through the use of System Usability Scale (SUS), and the prototype was assessed through a sample questionnaire that consists of thirty-three respondents and the results have been positive

Using Lessons from Health Care to Protect the Privacy of Library Users: Guidelines for the De-Identification of Library Data based on HIPAA

While libraries have employed policies to protect the data about use of their services, these policies are rarely specific or standardized. Since 1996 the U.S. healthcare system has been grappling with the Health Insurance Portability and Accountability Act (HIPAA), which is designed to provide those handling personal health information with standardized, definitive instructions as to the protection of data. In this work, the authors briefly discuss the present situation of privacy policies about library use data, outline the HIPAA guidelines to understand parallels between the two, and finally propose methods to create a de-identified library data warehouse based on HIPAA for the protection of user privacy

'Managing scarcity'- a qualitative study on volunteer-based healthcare for chronically ill, uninsured migrants in Berlin, Germany

OBJECTIVES: In Germany, healthcare for people lacking legal residency status and European Union citizens without health insurance is often provided by non-governmental organisations. Scientific studies assessing the situation of the patients with chronic diseases in this context are scarce. We aimed to characterise medical care for chronically ill migrants without health insurance and outline its possibilities and limitations from the treating physicians' perspective. DESIGN: Qualitative semi-structured interviews; qualitative content analysis. SETTING: Organisations and facilities providing healthcare for uninsured migrants: free clinics, medical practices and public health services. PARTICIPANTS: 14 physicians working regularly in healthcare for uninsured migrants. RESULTS: Delayed contact to the healthcare system was frequently addressed in the interviews. Care was described as constrained by a scarcity of resources that often impedes adequate treatment for many conditions, most pronounced in the case of oncological diseases or chronic viral infections (HIV, hepatitis). For other chronic conditions such as cardiovascular diseases or diabetes, some diagnostics and basic medications were described as partially available, while management of complications or rehabilitative measures are frequently unfeasible. For the patients with mental health problems, attainability of psychotherapeutic treatment is reported as severely limited. Care is predominantly described as fragmented with limitations to information flow and continuity. Which level of care a patient receives appears to depend markedly on the respective non-governmental organisation and the individual commitment, subjective decisions and personal connections of the treating physician. CONCLUSIONS: Restrictions in medical care for uninsured migrants have even more impact on chronically ill patients. Volunteer-based care often constitutes an inadequate compensation for regular access to the healthcare system, as it is strongly influenced by the limitation of its resources and its arbitrariness

Patient Sociotechnical Assemblages: The Distributed Cognition of Health Information Management

Personal health records (PHR) are shifting the capabilities and responsibilities of both patients and providers. Influenced by health IT, concepts like patient-centered care, meaningful use, and patient empowerment are commonplace in the healthcare system. As the popularity of personal health records increases, medical providers, healthcare organizations, and health information system stakeholders require a thorough understanding of how patients use these patient facing information portals in conjunction with other artifacts, objects, and practices to manage and maintain their health. Exploring health information management as a distributed sociotechnical assemblage is the conceptual approach of this research. A distributed cognition perspective lends insight to drawing boundaries and establishing connections of personal health information management practices in conjunction with PHR use. The Department of Veterans Affairs provides a unique setting to further understand PHR use and personal health information management practice through the observation of U.S. military veterans enrolled in the My HealtheVet PHR. This context and conceptual framework lead to the research questions for the proposed study: RQ1a: What are the personal health information management practices of veterans who use a personal health record? RQ1b: What health information management practices become distributed beyond the veteran patient? RQ2a: What health information management assemblages emerge from the distributed work of Veterans that use a personal health record? RQ2b: What are key functions of the health information management assemblages of veterans? Through the use of semi-structured in depth interviews, observations, and surveys, data were collected on 22 patients along with their primary care providers and caretakers. Results from a two cycle qualitative coding analysis and analytical cognitive mapping technique reveal bundles of practices for creating reminders, organizing information, and creating information for asking questions and working with primary care providers. Distributed practices emerged that detail the managing of medication, information that is socially distributed, and patient-provider communication through secure messaging. Three health information management assemblage components emerged from the analysis: health events and experiential information, information techniques, and technology and material practices. Each of these components is understood by the ways they become stabilized or destabilized. This research contributes to implications for the design of patient-focused personal health records and informs clinical practice of patient-centered care. The research also makes conceptual and empirical contributions to the practice of health information management and a patient-centered care model of healthcare delivery