Identifying common problems in the acquisition and deployment of large-scale software projects in the US and UK healthcare systems

Public and private organizations are investing increasing amounts into the development of healthcare information technology. These applications are perceived to offer numerous benefits. Software systems can improve the exchange of information between healthcare facilities. They support standardised procedures that can help to increase consistency between different service providers. Electronic patient records ensure minimum standards across the trajectory of care when patients move between different specializations. Healthcare information systems also offer economic benefits through efficiency savings; for example by providing the data that helps to identify potential bottlenecks in the provision and administration of care. However, a number of high-profile failures reveal the problems that arise when staff must cope with the loss of these applications. In particular, teams have to retrieve paper based records that often lack the detail on electronic systems. Individuals who have only used electronic information systems face particular problems in learning how to apply paper-based fallbacks. The following pages compare two different failures of Healthcare Information Systems in the UK and North America. The intention is to ensure that future initiatives to extend the integration of electronic patient records will build on the ‘lessons learned’ from previous systems

Y2K Interruption: Can the Doomsday Scenario Be Averted?

The management philosophy until recent years has been to replace the workers with computers, which are available 24 hours a day, need no benefits, no insurance and never complain. But as the year 2000 approached, along with it came the fear of the millennium bug, generally known as Y2K, and the computers threatened to strike!!!! Y2K, though an abbreviation of year 2000, generally refers to the computer glitches which are associated with the year 2000. Computer companies, in order to save memory and money, adopted a voluntary standard in the beginning of the computer era that all computers automatically convert any year designated by two numbers such as 99 into 1999 by adding the digits 19. This saved enormous amount of memory, and thus money, because large databases containing birth dates or other dates only needed to contain the last two digits such as 65 or 86. But it also created a built in flaw that could make the computers inoperable from January 2000. The problem is that most of these old computers are programmed to convert 00 (for the year 2000) into 1900 and not 2000. The trouble could therefore, arise when the systems had to deal with dates outside the 1900s. In 2000, for example a programme that calculates the age of a person born in 1965 will subtract 65 from 00 and get -65. The problem is most acute in mainframe systems, but that does not mean PCs, UNIX and other computing environments are trouble free. Any computer system that relies on date calculations must be tested because the Y2K or the millennium bug arises because of a potential for “date discontinuity” which occurs when the time expressed by a system, or any of its components, does not move in consonance with real time. Though attention has been focused on the potential problems linked with change from 1999 to 2000, date discontinuity may occur at other times in and around this period.

Federal Employees Health Benefits (FEHB) Program: An Overview

[Excerpt] The Federal Employees Health Benefits (FEHB) Program provides health insurance to federal employees, retirees, and their dependents. This report provides a general overview of FEHB. It describes the structure of FEHB, including eligibility for the program and coverage options available to enrollees, as well as premiums, benefits and cost sharing, and general financing of FEHB. The report also describes the role of the Office of Personnel Management (OPM) in administering the program

Responsibility modelling for civil emergency planning

This paper presents a new approach to analysing and understanding civil emergency planning based on the notion of responsibility modelling combined with HAZOPS-style analysis of information requirements. Our goal is to represent complex contingency plans so that they can be more readily understood, so that inconsistencies can be highlighted and vulnerabilities discovered. In this paper, we outline the framework for contingency planning in the United Kingdom and introduce the notion of responsibility models as a means of representing the key features of contingency plans. Using a case study of a flooding emergency, we illustrate our approach to responsibility modelling and suggest how it adds value to current textual contingency plans

Federal Employees Health Benefits Program (FEHBP): Available Health Insurance Options

FEHBP is generally available to employees, annuitants, and their dependents. Eligible individuals may elect coverage in an approved health benefits plan for either individual or family coverage. For the 2013 plan year, there are about 230 different plan choices, including all regionally available options. As a practical matter, an individual’s choice of plans is often limited to 10 to 15 different plans, depending on where the individual resides. While enrollees have a range of choices, they typically decide which options best match their needs, the amount of their wages they will contribute to health insurance, and how risk-averse they are to potential out-of-pocket costs. While most federal employees or annuitants reaching age 65 are automatically entitled to Medicare Part A, Medicare-eligible employees may also voluntarily choose to enroll in Medicare Part B and Part D. For individuals covered under a FEHBP plan as an annuitant, Medicare is the primary payer and FEHBP is the secondary payer. As a secondary payer, FEHBP could cover a share of Medicare deductibles and coinsurance for any services that are covered by both plans, and FEHBP would continue to reimburse for its covered services that are not covered by Medicare. FEHBP is administered by the Office of Personnel Management (OPM), which is statutorily given the authority to contract with qualified carriers offering plans and to prescribe regulations necessary to carry out the statute, among other duties. Some of OPM’s additional duties include coordinating the administration of FEHBP with employing offices, managing contingency reserve funds for the plans, and applying sanctions to health care providers according to the prescribed regulations

Smart hospital emergency system via mobile-based requesting services

In recent years, the UK’s emergency call and response has shown elements of great strain as of today. The strain on emergency call systems estimated by a 9 million calls (including both landline and mobile) made in 2014 alone. Coupled with an increasing population and cuts in government funding, this has resulted in lower percentages of emergency response vehicles at hand and longer response times. In this paper, we highlight the main challenges of emergency services and overview of previous solutions. In addition, we propose a new system call Smart Hospital Emergency System (SHES). The main aim of SHES is to save lives through improving communications between patient and emergency services. Utilising the latest of technologies and algorithms within SHES is aiming to increase emergency communication throughput, while reducing emergency call systems issues and making the process of emergency response more efficient. Utilising health data held within a personal smartphone, and internal tracked data (GPU, Accelerometer, Gyroscope etc.), SHES aims to process the mentioned data efficiently, and securely, through automatic communications with emergency services, ultimately reducing communication bottlenecks. Live video-streaming through real-time video communication protocols is also a focus of SHES to improve initial communications between emergency services and patients. A prototype of this system has been developed. The system has been evaluated by a preliminary usability, reliability, and communication performance study

Health care information systems management: Structure and infrastructure

The practice of medicine is inextricably entwined with the management of health care information system (HCIS). Major problems with HCIS are that it has not evolved from the needs of end users, and lacks of an organizational base^ to manage the HCIS in the health care environment. The object of this paper is to examine a direction to effectively support and enhance the health care activities through managing HCIS. An integrated focus is provided through a framework for analyzing the structure and infrastructure of HCIS in hospitals

Without a Net: A Study of Early Impacts of Supplemental Security Income Benefits Elimination for Persons with Disabilities due to Drug and Alcohol Abuse in Cook County, Illinois

This is the first published study of its kind attempting to track the impact of the cuts in SSI/DI on the drug and alcohol addicted. Many of the findings in this study confirm the predictions of advocates. Ironically, much of what we learned flies in the face of stated goals of welfare reform - moving people into work and promoting self-sufficiency. In addition to the loss of cash benefits, beneficiaries also lost eligibility for both Medicaid and Medicare because their primary disability was substance abuse

Parameterization, Analysis, and Risk Management in a Comprehensive Management System with Emphasis on Energy and Performance (ISO 50001: 2018)

[EN] The future of business development relies on the effective management of risks, opportunities, and energy and water resources. Here, we evaluate the application of best practices to identify, analyze, address, monitor, and control risks and opportunities (R/O) according to ISO 31000 and 50000. Furthermore, we shed light on tools, templates, ISO guides, and international documents that contribute to classifying, identifying, formulating control, and managing R/O parameterization in a comprehensive management system model, namely CMS QHSE3+, which consists of quality (Q), health and safety (HS), environmental management (E), energy efficiency (E2), and other risk components (+) that include comprehensive biosecurity and biosafety. By focusing on the deployment of R/O-based thinking (ROBT) at strategic and operational levels, we show vulnerability reduction in CMS QHSE3+ by managing energy, efficiency, and sustainability.We express our gratitude for the support from Cajacopi Atlantico, QUARA Technology, ASTEQ Technology, Universidad Simon Bolivar, Universitat Politecnica de Valencia and to all the personnel and companies who offered us their contributions and their valuable points of view.Poveda-Orjuela, PP.; García-Díaz, JC.; Pulido-Rojano, A.; Cañón-Zabala, G. (2020). Parameterization, Analysis, and Risk Management in a Comprehensive Management System with Emphasis on Energy and Performance (ISO 50001: 2018). Energies. 13(21):1-44. https://doi.org/10.3390/en13215579S1441321SDBS Business Demography Indicatorshttps://stats.oecd.org/index.aspx?queryid=70734The World Economy on a Tightrope. 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