Computerization of workflows, guidelines and care pathways: a review of implementation challenges for process-oriented health information systems

There is a need to integrate the various theoretical frameworks and formalisms for modeling clinical guidelines, workflows, and pathways, in order to move beyond providing support for individual clinical decisions and toward the provision of process-oriented, patient-centered, health information systems (HIS). In this review, we analyze the challenges in developing process-oriented HIS that formally model guidelines, workflows, and care pathways. A qualitative meta-synthesis was performed on studies published in English between 1995 and 2010 that addressed the modeling process and reported the exposition of a new methodology, model, system implementation, or system architecture. Thematic analysis, principal component analysis (PCA) and data visualisation techniques were used to identify and cluster the underlying implementation ‘challenge’ themes. One hundred and eight relevant studies were selected for review. Twenty-five underlying ‘challenge’ themes were identified. These were clustered into 10 distinct groups, from which a conceptual model of the implementation process was developed. We found that the development of systems supporting individual clinical decisions is evolving toward the implementation of adaptable care pathways on the semantic web, incorporating formal, clinical, and organizational ontologies, and the use of workflow management systems. These architectures now need to be implemented and evaluated on a wider scale within clinical settings

The Union and Médecins Sans Frontières approach to operational research.

Operational research (OR) has become a hot topic at national meetings, international conferences and donor fora. The International Union Against Tuberculosis and Lung Disease (The Union) and Médecins Sans Frontières (MSF) Operational Centre Brussels strongly promote and implement OR with colleagues in low- and middle-income countries. Here we describe how the two organisations define OR, and explain the guiding principles and methodology that underpin the strategy for developing and expanding OR in those countries. We articulate The Union's and MSF's approach to supporting OR, highlighting the main synergies and differences. Then, using the Malawi National Tuberculosis Control Programme as an example, we show how OR can be embedded within tuberculosis control activities, leading to changes in policy and practice at the national level. We discuss the difficult, yet vitally important, issue of capacity building, and share our vision of a new paradigm of product-related training and performance-based OR fellowships as two ways of developing the necessary skills at country level to ensure research is actually performed. Finally, we highlight the need to consider and incorporate into practice the ethical components of OR. This is a key moment to be involved in OR. We are confident that in partnership with interested stakeholders, including the World Health Organization, we can stimulate the implementation of quality, relevant OR as an integral part of health service delivery that in turn will lead to better health for people, particularly for those living in the poorer parts of the world

Hyperspectral Analysis of Pine Wilt Disease to Determine an Optimal Detection Index

Bursaphelenchus xylophilus, the pine wood nematode (PWN) which causes pine wilt disease, is currently a serious problem in East Asia, including in Japan, Korea, and China. This paper investigates the hyperspectral analysis of pine wilt disease to determine the optimal detection indices for measuring changes in the spectral reflectance characteristics and leaf reflectance in the Pinus thunbergii (black pine) forest on Geoje Island, South Korea. In the present study, we collected the leaf reflectance spectra of pine trees infected with pine wilt disease using a hyperspectrometer. We used 10 existing vegetation indices (based on hyperspectral data) and introduced the green-red spectral area index (GRSAI). We made comparisons between non-infected and infected trees over time. A t-test was then performed to find the most appropriate index for detecting pine wilt disease-infected pine trees. Our main result is that, in most of the infected trees, the reflectance changed in the red and mid-infrared wavelengths within two months after pine wilt infection. The vegetation atmospherically resistant index (VARI), vegetation index green (VIgreen), normalized wilt index (NWI), and GRSAI indices detected pine wilt disease infection faster than the other indices used. Importantly, the GRSAI results showed less variability than the results of the other indices. This optimal index for detecting pine wilt disease is generated by combining red and green wavelength bands. These results are expected to be useful in the early detection of pine wilt disease-infected trees

Critical Success Factors to Improve the Game Development Process from a Developer\u27s Perspective

The growth of the software game development industry is enormous and is gaining importance day by day. This growth imposes severe pressure and a number of issues and challenges on the game development community. Game development is a complex process, and one important game development choice is to consider the developer’s perspective to produce good-quality software games by improving the game development process. The objective of this study is to provide a better understanding of the developer’s dimension as a factor in software game success. It focuses mainly on an empirical investigation of the effect of key developer’s factors on the software game development process and eventually on the quality of the resulting game. A quantitative survey was developed and conducted to identify key developer’s factors for an enhanced game development process. For this study, the developed survey was used to test the research model and hypotheses. The results provide evidence that game development organizations must deal with multiple key factors to remain competitive and to handle high pressure in the software game industry. The main contribution of this paper is to investigate empirically the influence of key developer’s factors on the game development process