SHELDON Smart habitat for the elderly.

An insightful document concerning active and assisted living under different perspectives: Furniture and habitat, ICT solutions and Healthcare

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

The impact of institutional and information systems strategy alignment on academic computing divisions with higher education.

Thesis (MBA)-University of KwaZulu-Natal, Westville, 2011.Information Systems play a vital and dominating role in business today by enabling as well as supporting business objectives and goals. As a result, the alignment of Information Systems strategy and business strategy has become a core concept in many organisations. The question that naturally arises is whether this is also true for Higher Education institutions in developing countries. This study examined the alignment of institutional and Information Systems strategy and its impact on Academic Computing divisions within Higher Education. It set out to determine if there was a link between the vision and mission of Information Systems and institutional vision and mission. This was achieved by critically evaluating current Information Systems strategy in relation to the institutional strategy and by determining the effectiveness of the current Information Systems strategy in the area of Academic Computing. In order to fulfil the objectives of the study, questionnaires were sent to a population of 22 Information and Communication Technology directors/managers at 22 universities in South Africa. In-depth interviews were conducted with senior Information and Communication Technology directors from two universities that reflected strong alignment between Information Systems Strategy and institutional strategy. Both universities also possessed strong and effective Information Systems strategy in the Academic Computing component. It was evident that alignment was the key to their effective Information Systems strategy. The overall findings of the study show that there is a strong link between the vision and mission of the Information Systems and institutional mission and vision. The Information Systems strategy in place was effective for the various institutions; however, it was not effective in the area of Academic Computing in most institutions. The need for a more enhanced Information Systems strategy in Academic Computing was acknowledged. Institutions should emulate leading universities in South Africa and first-world countries in respect of continuously adjusting and evaluating alignment between Information Systems and institutional strategy. An enhanced Information Systems strategy in Academic Computing is also required

A Usability Evaluation Framework for

Currently, more than two billions people access the Web for various purposes. The majority are people without programming or modelling background. Part of these people (called end-users) also likes to create their own Web applications to meet their daily needs. Mashup Makers are tools to create such end-user’s Web applications. As such, Mashup Makers could become the dominant environment for end-user development of Web applications. Existing Mashup Makers promise that creating a Web Mashup is very easy and just a matter of a few mouse clicks. However, there is no evidence that this is indeed the case. On the contrary, research has already revealed usability problems with Mashup Makers. Therefore, this thesis concentrates on the usability of Mashup Makers as development environments for Web applications for end-users. Usability is a key issue for the success of software artifacts, and especially if the artifacts are intended for non-technical users. Therefore, we target the achievement of a consolidated approach, model, and framework for the evaluation of the usability of Mashup Makers for end-users. Such a framework will not only allow evaluating the usability of existing Mashup Makers, but it will also provide key issues concerning usability (ie usability impact factors) that developers of Mashup Makers and of other future end-user development tools can take into consideration when developing new tools

Assessing the readiness of public healthcare facilities to adopt health information technology (hit)/e-health: a case study of Komfo Anokye Teaching Hospital, Ghana

Most health information technology (HIT)/e-Health initiatives in developing countries are still in project phases and few have become part of routine healthcare delivery due to the lack of clear implementation roadmap. Ghana has been piloting a number of e-Health initiatives, which have not guaranteed a sustainable implementation of such systems. The objective of this research study was to explore the information technology (IT) readiness of public healthcare institutions (primary, secondary and tertiary) in Ghana to adopt e-Health in order to develop a standard HIT/e-Health readiness assessment model. For a population of 28,678,251 people there are only 2,615 medical doctors on the Ministry of Health’s (MoH) payroll as at 2013 and 1818 public hospitals. Consequently, the doctor to population ratio is extremely low as compared to other developing countries, which falls far below the WHO revised standard of 1:600. Under these circumstances there is evidence in developed countries that adoption of health informatics technologies can contribute to improving the situation. An extensive review of literature on e-health in developing countries has identified a general lack of adoption due to a lack of readiness to incorporate the technology into the healthcare environment. Literature provides myriad but fragmented models/frameworks of health information technology (HIT)/e-Health adoption readiness assessment limited measuring tools to assess factors of HIT readiness. This risks the outcomes of HIT/e-Health readiness assessment, which eventually limits knowledge about the strategic gaps warranting the need for the implementation of HIT/e-Health systems in public healthcare institutions in Ghana. Whiles previous studies acknowledge the existence of HIT readiness assessment factors, there exist very limited measuring items for these factors. Simply put, there is not just limited studies on HIT readiness assessment, but there is also no standard guiding readiness assessment model. This study has identified the lack of standard assessment model/framework as well as their accompanying measuring tools for effective outcomes as major gaps. Thus, there was the need for gaining a deeper understanding of existing readiness factors and their applicability in the context of the readiness of public healthcare facilities in Ghana and how they promote or impede HIT/e-Health adoption in order to develop standard HIT readiness assessment model, which comprises readiness factors and most importantly their measuring tools. This study used a mixed method approach, specifically the exploratory sequential design (the exploratory design) where the outcome of qualitative data collected from 13 senior health CIOs and leaders of e-Health initiatives in Ghana analysed built to quantitative data collection instrument. The survey instrument was used to collect quantitative data from 298 clinical and non-clinical staff (Administration/Management leadership) Komfo Anokye Teaching Hospital (KATH) in a form of case study to confirm the findings of the initial exploratory study. This was because the mixed method is rooted in the pragmatism of philosophical assumptions, which guide the direction of the collection and analysis of data and the mixture of qualitative and quantitative approaches in many phases of the research process. Furthermore, mixed research methods design strategy provides a powerful mechanism for IS researchers in dealing with the rapidly changing environment of ICT. An initial standard regression analysis using IBM SPSS version 23 established that five factors (Technology readiness (TR); Operational resource readiness (ORR); Organizational cultural readiness (OCR); Regulatory policy readiness (RPR); and Core readiness (CR)) and 63 indicators (measuring tools) promote and/or impede HIT/e-Health adoption readiness in public healthcare facilities in Ghana. Consequently, these factors were used in developing a standard HIT readiness assessment model. Whiles these five factors all proved to have strong association with the dependent variable Health Information Technology readiness (HITR) in the standard regression, (R2 = 0.971) the findings of a latter PLS-SEM, an advanced regression analysis deployed suggest that Regulatory policy readiness (RPR) and remarkably Core readiness (CR) did not impact on the readiness of KATH to adopt e-Health/HIT. As many public healthcare organizations in Ghana have already begun the process of implementing various HIT/e-Health systems without any reliable HIT/e-Health regulatory policy in place, there is a critical need for reliable HIT/e-Health regulatory policies (RPR) and some improvement in HIT/e-Health strategic planning (core readiness). The final model (R2 = 0.558 and Q2= 0.378) suggest that TR, ORR, and OCR explained 55.8% of the total amount of variance in health information technology/e-Health readiness in the case of KATH, partially supporting the hypotheses of this study. Although no formal hypotheses were proposed for the relationships/effects, which exist between exogenous/independent constructs in the model structure, the SmartPLS3 model path analysis did show that there exist such relationships. For instance, the significant paths from regulatory policy readiness (RPR) to organizational resource readiness (ORR) (t = 23.891; Beta = 0.774) and from technological readiness (TR) to operational resource readiness (ORR) (t = 11.667; Beta = 0.624) obtained from SmartPLS3 bootstrap procedure indicate the presence of mediation. Fit values (SRMR = 0.054; NFI = 0.739). Generally, the GoF for this SEM are encouraging and can substantially be improved when public healthcare facilities in Ghana intending to implement HIT/e-Health pay equal attention to relevant regulatory policies and strategic planning. The readiness assessment model developed this study essentially offers a useful basis for healthcare organizations to enhance the conditions under which HIT/eHealth is launched in order to achieve successful and sustainable adoption with particularly attention being paid to HIT/e-Health regulatory policies and strategic planning. When evaluations such as this are carried out effectively, there could be a circumvention of large losses in money effort and time, delays and disappointments among planners, staff and users of services whiles facilitating the process of change in the institutions and communities involved. This study was conducted with selected subjects and selected public healthcare facilities in the southern cities/parts of Ghana. Therefore, a replication or transfer of this study to other parts of Ghana especially the rural areas and the private healthcare environment should consider the potential differences resulting from varying cultural, socioeconomic and political backgrounds since healthcare is a much-institutionalised industry. The same caution must be exercise when replicating this study in other developing countries and across the globe

Assessing the readiness of public healthcare facilities to adopt health information technology (hit)/e-health: a case study of Komfo Anokye Teaching Hospital, Ghana

Most health information technology (HIT)/e-Health initiatives in developing countries are still in project phases and few have become part of routine healthcare delivery due to the lack of clear implementation roadmap. Ghana has been piloting a number of e-Health initiatives, which have not guaranteed a sustainable implementation of such systems. The objective of this research study was to explore the information technology (IT) readiness of public healthcare institutions (primary, secondary and tertiary) in Ghana to adopt e-Health in order to develop a standard HIT/e-Health readiness assessment model. For a population of 28,678,251 people there are only 2,615 medical doctors on the Ministry of Health’s (MoH) payroll as at 2013 and 1818 public hospitals. Consequently, the doctor to population ratio is extremely low as compared to other developing countries, which falls far below the WHO revised standard of 1:600. Under these circumstances there is evidence in developed countries that adoption of health informatics technologies can contribute to improving the situation. An extensive review of literature on e-health in developing countries has identified a general lack of adoption due to a lack of readiness to incorporate the technology into the healthcare environment. Literature provides myriad but fragmented models/frameworks of health information technology (HIT)/e-Health adoption readiness assessment limited measuring tools to assess factors of HIT readiness. This risks the outcomes of HIT/e-Health readiness assessment, which eventually limits knowledge about the strategic gaps warranting the need for the implementation of HIT/e-Health systems in public healthcare institutions in Ghana. Whiles previous studies acknowledge the existence of HIT readiness assessment factors, there exist very limited measuring items for these factors. Simply put, there is not just limited studies on HIT readiness assessment, but there is also no standard guiding readiness assessment model. This study has identified the lack of standard assessment model/framework as well as their accompanying measuring tools for effective outcomes as major gaps. Thus, there was the need for gaining a deeper understanding of existing readiness factors and their applicability in the context of the readiness of public healthcare facilities in Ghana and how they promote or impede HIT/e-Health adoption in order to develop standard HIT readiness assessment model, which comprises readiness factors and most importantly their measuring tools. This study used a mixed method approach, specifically the exploratory sequential design (the exploratory design) where the outcome of qualitative data collected from 13 senior health CIOs and leaders of e-Health initiatives in Ghana analysed built to quantitative data collection instrument. The survey instrument was used to collect quantitative data from 298 clinical and non-clinical staff (Administration/Management leadership) Komfo Anokye Teaching Hospital (KATH) in a form of case study to confirm the findings of the initial exploratory study. This was because the mixed method is rooted in the pragmatism of philosophical assumptions, which guide the direction of the collection and analysis of data and the mixture of qualitative and quantitative approaches in many phases of the research process. Furthermore, mixed research methods design strategy provides a powerful mechanism for IS researchers in dealing with the rapidly changing environment of ICT. An initial standard regression analysis using IBM SPSS version 23 established that five factors (Technology readiness (TR); Operational resource readiness (ORR); Organizational cultural readiness (OCR); Regulatory policy readiness (RPR); and Core readiness (CR)) and 63 indicators (measuring tools) promote and/or impede HIT/e-Health adoption readiness in public healthcare facilities in Ghana. Consequently, these factors were used in developing a standard HIT readiness assessment model. Whiles these five factors all proved to have strong association with the dependent variable Health Information Technology readiness (HITR) in the standard regression, (R2 = 0.971) the findings of a latter PLS-SEM, an advanced regression analysis deployed suggest that Regulatory policy readiness (RPR) and remarkably Core readiness (CR) did not impact on the readiness of KATH to adopt e-Health/HIT. As many public healthcare organizations in Ghana have already begun the process of implementing various HIT/e-Health systems without any reliable HIT/e-Health regulatory policy in place, there is a critical need for reliable HIT/e-Health regulatory policies (RPR) and some improvement in HIT/e-Health strategic planning (core readiness). The final model (R2 = 0.558 and Q2= 0.378) suggest that TR, ORR, and OCR explained 55.8% of the total amount of variance in health information technology/e-Health readiness in the case of KATH, partially supporting the hypotheses of this study. Although no formal hypotheses were proposed for the relationships/effects, which exist between exogenous/independent constructs in the model structure, the SmartPLS3 model path analysis did show that there exist such relationships. For instance, the significant paths from regulatory policy readiness (RPR) to organizational resource readiness (ORR) (t = 23.891; Beta = 0.774) and from technological readiness (TR) to operational resource readiness (ORR) (t = 11.667; Beta = 0.624) obtained from SmartPLS3 bootstrap procedure indicate the presence of mediation. Fit values (SRMR = 0.054; NFI = 0.739). Generally, the GoF for this SEM are encouraging and can substantially be improved when public healthcare facilities in Ghana intending to implement HIT/e-Health pay equal attention to relevant regulatory policies and strategic planning. The readiness assessment model developed this study essentially offers a useful basis for healthcare organizations to enhance the conditions under which HIT/eHealth is launched in order to achieve successful and sustainable adoption with particularly attention being paid to HIT/e-Health regulatory policies and strategic planning. When evaluations such as this are carried out effectively, there could be a circumvention of large losses in money effort and time, delays and disappointments among planners, staff and users of services whiles facilitating the process of change in the institutions and communities involved. This study was conducted with selected subjects and selected public healthcare facilities in the southern cities/parts of Ghana. Therefore, a replication or transfer of this study to other parts of Ghana especially the rural areas and the private healthcare environment should consider the potential differences resulting from varying cultural, socioeconomic and political backgrounds since healthcare is a much-institutionalised industry. The same caution must be exercise when replicating this study in other developing countries and across the globe

DETAILED CLINICAL MODELS AND THEIR RELATION WITH ELECTRONIC HEALTH RECORDS

Tesis por compendio[EN] Healthcare domain produces and consumes big quantities of people's health data. Although data exchange is the norm rather than the exception, being able to access to all patient data is still far from achieved. Current developments such as personal health records will introduce even more data and complexity to the Electronic Health Records (EHR). Achieving semantic interoperability is one of the biggest challenges to overcome in order to benefit from all the information contained in the distributed EHR. This requires that the semantics of the information can be understood by all involved parties. It has been stablished that three layers are needed to achieve semantic interoperability: Reference models, clinical models (archetypes), and clinical terminologies. As seen in the literature, information models (reference models and clinical models) are lacking methodologies and tools to improve EHR systems and to develop new systems that can be semantically interoperable. The purpose of this thesis is to provide methodologies and tools for advancing the use of archetypes in three different scenarios: - Archetype definition over specifications with no dual model architecture native support. Any EHR architecture that directly or indirectly has the notion of detailed clinical models (such as HL7 CDA templates) can be potentially used as a reference model for archetype definition. This allows transforming single-model architectures (which contain only a reference model) into dual-model architectures (reference model with archetypes). A set of methodologies and tools has been developed to support the definition of archetypes from multiple reference models. - Data transformation. A complete methodology and tools are proposed to deal with the transformation of legacy data into XML documents compliant with the archetype and the underlying reference model. If the reference model is a standard then the transformation is a standardization process. The methodologies and tools allow both the transformation of legacy data and the transformation of data between different EHR standards. - Automatic generation of implementation guides and reference materials from archetypes. A methodology for the automatic generation of a set of reference materials is provided. These materials are useful for the development and use of EHR systems. These reference materials include data validators, example instances, implementation guides, human-readable formal rules, sample forms, mindmaps, etc. These reference materials can be combined and organized in different ways to adapt to different types of users (clinical or information technology staff). This way, users can include the detailed clinical model in their organization workflow and cooperate in the model definition. These methodologies and tools put clinical models as a key part of the system. The set of presented methodologies and tools ease the achievement of semantic interoperability by providing means for the semantic description, normalization, and validation of existing and new systems.[ES] El sector sanitario produce y consume una gran cantidad de datos sobre la salud de las personas. La necesidad de intercambiar esta información es una norma más que una excepción, aunque este objetivo está lejos de ser alcanzado. Actualmente estamos viviendo avances como la medicina personalizada que incrementarán aún más el tamaño y complejidad de la Historia Clínica Electrónica (HCE). La consecución de altos grados de interoperabilidad semántica es uno de los principales retos para aprovechar al máximo toda la información contenida en las HCEs. Esto a su vez requiere una representación fiel de la información de tal forma que asegure la consistencia de su significado entre todos los agentes involucrados. Actualmente está reconocido que para la representación del significado clínico necesitamos tres tipos de artefactos: modelos de referencia, modelos clínicos (arquetipos) y terminologías. En el caso concreto de los modelos de información (modelos de referencia y modelos clínicos) se observa en la literatura una falta de metodologías y herramientas que faciliten su uso tanto para la mejora de sistemas de HCE ya existentes como en el desarrollo de nuevos sistemas con altos niveles de interoperabilidad semántica. Esta tesis tiene como propósito proporcionar metodologías y herramientas para el uso avanzado de arquetipos en tres escenarios diferentes: - Definición de arquetipos sobre especificaciones sin soporte nativo al modelo dual. Cualquier arquitectura de HCE que posea directa o indirectamente la noción de modelos clínicos detallados (por ejemplo, las plantillas en HL7 CDA) puede ser potencialmente usada como modelo de referencia para la definición de arquetipos. Con esto se consigue transformar arquitecturas de HCE de modelo único (solo con modelo de referencia) en arquitecturas de doble modelo (modelo de referencia + arquetipos). Se han desarrollado metodologías y herramientas que faciliten a los editores de arquetipos el soporte a múltiples modelos de referencia. - Transformación de datos. Se propone una metodología y herramientas para la transformación de datos ya existentes a documentos XML conformes con los arquetipos y el modelo de referencia subyacente. Si el modelo de referencia es un estándar entonces la transformación será un proceso de estandarización de datos. La metodología y herramientas permiten tanto la transformación de datos no estandarizados como la transformación de datos entre diferentes estándares. - Generación automática de guías de implementación y artefactos procesables a partir de arquetipos. Se aporta una metodología para la generación automática de un conjunto de materiales de referencia de utilidad en el desarrollo y uso de sistemas de HCE, concretamente validadores de datos, instancias de ejemplo, guías de implementación , reglas formales legibles por humanos, formularios de ejemplo, mindmaps, etc. Estos materiales pueden ser combinados y organizados de diferentes modos para facilitar que los diferentes tipos de usuarios (clínicos, técnicos) puedan incluir los modelos clínicos detallados en el flujo de trabajo de su sistema y colaborar en su definición. Estas metodologías y herramientas ponen los modelos clínicos como una parte clave en el sistema. El conjunto de las metodologías y herramientas presentadas facilitan la consecución de la interoperabilidad semántica al proveer medios para la descripción semántica, normalización y validación tanto de sistemas nuevos como ya existentes.[CA] El sector sanitari produeix i consumeix una gran quantitat de dades sobre la salut de les persones. La necessitat d'intercanviar aquesta informació és una norma més que una excepció, encara que aquest objectiu està lluny de ser aconseguit. Actualment estem vivint avanços com la medicina personalitzada que incrementaran encara més la grandària i complexitat de la Història Clínica Electrònica (HCE). La consecució d'alts graus d'interoperabilitat semàntica és un dels principals reptes per a aprofitar al màxim tota la informació continguda en les HCEs. Açò, per la seua banda, requereix una representació fidel de la informació de tal forma que assegure la consistència del seu significat entre tots els agents involucrats. Actualment està reconegut que per a la representació del significat clínic necessitem tres tipus d'artefactes: models de referència, models clínics (arquetips) i terminologies. En el cas concret dels models d'informació (models de referència i models clínics) s'observa en la literatura una mancança de metodologies i eines que en faciliten l'ús tant per a la millora de sistemes de HCE ja existents com per al desenvolupament de nous sistemes amb alts nivells d'interoperabilitat semàntica. Aquesta tesi té com a propòsit proporcionar metodologies i eines per a l'ús avançat d'arquetips en tres escenaris diferents: - Definició d'arquetips sobre especificacions sense suport natiu al model dual. Qualsevol arquitectura de HCE que posseïsca directa o indirectament la noció de models clínics detallats (per exemple, les plantilles en HL7 CDA) pot ser potencialment usada com a model de referència per a la definició d'arquetips. Amb açò s'aconsegueix transformar arquitectures de HCE de model únic (solament amb model de referència) en arquitectures de doble model (model de referència + arquetips). S'han desenvolupat metodologies i eines que faciliten als editors d'arquetips el suport a múltiples models de referència. - Transformació de dades. Es proposa una metodologia i eines per a la transformació de dades ja existents a documents XML conformes amb els arquetips i el model de referència subjacent. Si el model de referència és un estàndard llavors la transformació serà un procés d'estandardització de dades. La metodologia i eines permeten tant la transformació de dades no estandarditzades com la transformació de dades entre diferents estàndards. - Generació automàtica de guies d'implementació i artefactes processables a partir d'arquetips. S'hi inclou una metodologia per a la generació automàtica d'un conjunt de materials de referència d'utilitat en el desenvolupament i ús de sistemes de HCE, concretament validadors de dades, instàncies d'exemple, guies d'implementació, regles formals llegibles per humans, formularis d'exemple, mapes mentals, etc. Aquests materials poden ser combinats i organitzats de diferents maneres per a facilitar que els diferents tipus d'usuaris (clínics, tècnics) puguen incloure els models clínics detallats en el flux de treball del seu sistema i col·laborar en la seua definició. Aquestes metodologies i eines posen els models clínics com una part clau del sistemes. El conjunt de les metodologies i eines presentades faciliten la consecució de la interoperabilitat semàntica en proveir mitjans per a la seua descripció semàntica, normalització i validació tant de sistemes nous com ja existents.Boscá Tomás, D. (2016). DETAILED CLINICAL MODELS AND THEIR RELATION WITH ELECTRONIC HEALTH RECORDS [Tesis doctoral no publicada]. Universitat Politècnica de València. https://doi.org/10.4995/Thesis/10251/62174TESISCompendi