Holistic System Design for Distributed National eHealth Services

publishedVersio

Towards a Conceptual Framework for Persistent Use: A Technical Plan to Achieve Semantic Interoperability within Electronic Health Record Systems

Semantic interoperability within the health care sector requires that patient data be fully available and shared without ambiguity across participating health facilities. Ongoing discussions to achieve interoperability within the health care industry continue to emphasize the need for healthcare facilities to successfully adopt and implement Electronic Health Record (EHR) systems. Reluctance by the healthcare industry to implement these EHRs for the purpose of achieving interoperability has led to the proposed research problem where it was determined that there is no existing single data standardization structure that can effectively share and interpret patient data within heterogeneous systems. \ \ The proposed research proposes a master data standardization and translation (MDST) model – XDataRDF -- which incorporates the use of the Resource Description Framework (RDF) that will allow for the seamless exchange of healthcare data among multiple facilities. Using RDF will allow multiple data models and vocabularies to be easily combined and interrelated within a single environment thereby reducing data definition ambiguity.

The Promise of Health Information Technology: Ensuring that Florida's Children Benefit

Substantial policy interest in supporting the adoption of Health Information Technology (HIT) by the public and private sectors over the last 5 -- 7 years, was spurred in particular by the release of multiple Institute of Medicine reports documenting the widespread occurrence of medical errors and poor quality of care (Institute of Medicine, 1999 & 2001). However, efforts to focus on issues unique to children's health have been left out of many of initiatives. The purpose of this report is to identify strategies that can be taken by public and private entities to promote the use of HIT among providers who serve children in Florida

Adaptive software architecture based on confident HCI for the deployment of sensitive services in smart homes

Smart spaces foster the development of natural and appropriate forms of human-computer interaction by taking advantage of home customization. The interaction potential of the Smart Home, which is a special type of smart space, is of particular interest in fields in which the acceptance of new technologies is limited and restrictive. The integration of smart home design patterns with sensitive solutions can increase user acceptance. In this paper, we present the main challenges that have been identified in the literature for the successful deployment of sensitive services (e.g., telemedicine and assistive services) in smart spaces and a software architecture that models the functionalities of a Smart Home platform that are required to maintain and support such sensitive services. This architecture emphasizes user interaction as a key concept to facilitate the acceptance of sensitive services by end-users and utilizes activity theory to support its innovative design. The application of activity theory to the architecture eases the handling of novel concepts, such as understanding of the system by patients at home or the affordability of assistive services. Finally, we provide a proof-of-concept implementation of the architecture and compare the results with other architectures from the literature

Integration of Patient Health Portals into the German Healthcare Telematics Infrastructure

In this paper we describe a generic model of a patient health portal, which is suitable to implement patient access to the evolving German healthcare telematics infrastructure. The portal uses the telematics as a communication infrastructure to ensure the concise and secure exchange of medical data between professional medical personnel and patients. We aim at providing patients an application platform model for using and enhancing their data by processing or extending them with medical services offered via the internet or with local medical appliances. We show that a) specific functionalities (such as data import/export from/to the telematics) for patient health portals can be derived from the legal foundation in the German law b) the portal is conceptually suited to provide a link between the public health information infrastructure and other (maybe commercial) applications in the e-health environment via Personal Health Records (PHR) and c) patients’ rights can be mapped with a common data model

Design Requirements for a Patient Administered Personal Electronic Health Record

Published version of a chapter in the book: Biomedical engineering, trends in electronics, communications and software. Intech, 2011 Open Acces

The adoption of ICT in Malaysian public hospitals: the interoperability of electronic health records and health information systems

There have been a number of researches that investigated ICT adoption in Malaysian healthcare. With the small number of hospitals that adopt ICT in their daily clinical and administrative operations, the possibility to enable data exchange across 131 public hospitals in Malaysia is still a long journey. In addition to those studies, this research was framed under six objectives, which aim to critically review existing literature on the subject matter, identify barriers of ICT adoption in Malaysia, understand the administrative context during the pre and post-ICT adoption, and recommend possible solutions to the Ministry of Health of Malaysia (MoHM) in its efforts to implement interoperable electronic health records (EHR) and health information systems (HTIS). Specifically, this research aimed to identify the factors that had significant impacts to the processes of implementing interoperable EHR and HTIS by the MoHM. Furthermore, it also aimed to propose relevant actors who should involve in the implementation phases. These factors and actors were used to develop a model for implementing interoperable EHR and HTIS in Malaysia. To gather the needed data, series of interviews were conducted with three groups of participants. They were ICT administrators of MoHM, ICT and medical record administrators of three hospitals, and physicians of three hospitals. To ensure the interview feedback was representing the context of EHR and HTIS implementation in Malaysia, two hospital categories were selected, which included the hospitals with HTIS and non-HTIS hospitals. The government documents were then used to triangulate the feedback to ensure dependability, credibility, transferability and conformity of the findings. Two techniques were used to analyse the data, which were thematic analysis and theme matching. These two techniques were modified from its original method, known as pattern matching. The originality of this research was presented in the findings and methods to transform them into solutions and provide recommendation to the MoHM. In general, the results showed that the technological factors contributed less to the success of the implementation of interoperable EHR and HTIS compared to the managerial and administrative factors. Four main practical and social contributions were identified from this research, which included synchronisation of managerial elements, political determination and change management transformation, optimisation of use of existing legacy system (Patient Management System) and finally the roles of actors. Nevertheless, the findings of this research would be more dependable and transferable if more participants had been willing to participate especially among the physicians and those who managed the ICT adoptions under the MoHM

An Integrated and Distributed Framework for a Malaysian Telemedicine System (MyTel)

The overall aim of the research was to produce a validated framework for a Malaysian integrated and distributed telemedicine system. The framework was constructed so that it was capable of being useful in retrieving and storing a patient's lifetime health record continuously and seamlessly during the downtime of the computer system and the unavailability of a landline telecommunication network. The research methodology suitable for this research was identified including the verification and validation strategies. A case study approach was selected for facilitating the processes and development of this research. The empirical data regarding the Malaysian health system and telemedicine context were gathered through a case study carried out at the Ministry of Health Malaysia (MOHM). The telemedicine approach in other countries was also analysed through a literature review and was compared and contrasted with that in the Malaysian context. A critical appraisal of the collated data resulted in the development of the proposed framework (MyTel) a flexible telemedicine framework for the continuous upkeep o f patients' lifetime health records. Further data were collected through another case study (by way of a structured interview in the outpatient clinics/departments of MOHM) for developing and proposing a lifetime health record (LHR) dataset for supporting the implementation of the MyTel framework. The LHR dataset was developed after having conducted a critical analysis of the findings of the clinical consultation workflow and the usage o f patients' demographic and clinical records in the outpatient clinics. At the end of the analysis, the LHR components, LHR structures and LHR messages were created and proposed. A common LHR dataset may assist in making the proposed framework more flexible and interoperable. The first draft of the framework was validated in the three divisions of MOHM that were involved directly in the development of the National Health JCT project. The division includes the Telehealth Division, Public and Family Health Division and Planning and Development Division. The three divisions are directly involved in managing and developing the telehealth application, the teleprimary care application and the total hospital information system respectively. The feedback and responses from the validation process were analysed. The observations and suggestions made and experiences gained advocated that some modifications were essential for making the MyTel framework more functional, resulting in a revised/ final framework. The proposed framework may assist in achieving continual access to a patient's lifetime health record and for the provision of seamless and continuous care. The lifetime health record, which correlates each episode of care of an individual into a continuous health record, is the central key to delivery of the Malaysian integrated telehealth application. The important consideration, however, is that the lifetime health record should contain not only longitudinal health summary information but also the possibility of on-line retrieval of all of the patient's health history whenever required, even during the computer system's downtime and the unavailability of the landline telecommunication network

A high-speed wireless network used for telemedicine

Nowadays, there is growing interest in using telemedicine to provide non-face-to-face healthcare for patients. The emergence and development of WLAN (Wireless Local Area Network) technology, which supports high-speed wireless communications within the existing Intranet that covers the healthcare system, makes it possible to provide routine body check-ups for patients who need long-term monitoring. In this thesis, we present the design of a wireless telemedicine system using WLAN technology. [Continues.