A framework for development of android mobile electronic prescription transfer applications in compliance with security requirements mandated by the Australian healthcare industry

This thesis investigates mobile electronic transfer of prescription (ETP) in compliance with the security requirements mandated by the Australian healthcare industry and proposes a framework for the development of an Android mobile electronic prescription transfer application. Furthermore, and based upon the findings and knowledge from constructing this framework, another framework is also derived for assessing Android mobile ETP applications for their security compliance. The centralised exchange model-based ETP solution currently used in the Australian healthcare industry is an expensive solution for on-going use. With challenges such as an aging population and the rising burden of chronic disease, the cost of the current ETP solution’s operational infrastructure is certain to rise in the future. In an environment where it is increasingly beneficial for patients to engage in and manage their own information and subsequent care, this current solution fails to offer the patient direct access to their electronic prescription information. The current system also fails to incorporate certain features that would dramatically improve the quality of the patient’s care and safety, i.e. alerts for the patient’s drug allergies, harmful dosage and script expiration. Over a decade old, the current ETP solution was essentially designed and built to meet legislation and regulatory requirements, with change-averting its highest priority. With little, if any, provision for future growth and innovation, it was not designed to cater to the needs of the ETP process. This research identifies the gap within the current ETP implementation (i.e. dependency on infrastructure, significant on-going cost and limited availability of the patient’s medication history) and proposes a framework for building a secure mobile ETP solution on the Android mobile operating system platform which will address the identified gap. The literature review part of this thesis examined the significance of ETP for the nation’s larger initiative to provide an improved and better maintainable healthcare system. The literature review also revealed the stance of each jurisdiction, from legislative and regulatory perspectives, in transitioning to the use of a fully electronic ETP solution. It identified the regulatory mandates of each jurisdiction for ETP as well as the security standards by which the current ETP implementation is iii governed so as to conform to those regulatory mandates. The literature review part of the thesis essentially identified and established how the Australian healthcare industry’s various prescription-related legislations and regulations are constructed, and the complexity of this construction for eTP. The jurisdictional regulatory mandates identified in the literature review translate into a set of security requirements. These requirements establish the basis of the guiding framework for the development of a security-compliant Android mobile ETP application. A number of experimentations were conducted focusing on the native security features of the Android operating system, as well as wireless communication technologies such as NFC and Bluetooth, in order to propose an alternative mobile ETP solution with security assurance comparable to the current ETP implementation. The employment of a proof-of-concept prototype such as this alongside / coupled with a series of iterative experimentations strengthens the validity and practicality of the proposed framework. The first experiment successfully proved that the Android operating system has sufficient encryption capabilities, in compliance with the security mandates, to secure the electronic prescription information from the data at rest perspective. The second experiment indicated that the use of NFC technology to implement the alternative transfer mechanism for exchanging electronic prescription information between ETP participating devices is not practical. The next iteration of the experimentation using Bluetooth technology proved that it can be utilised as an alternative electronic prescription transfer mechanism to the current approach using the Internet. These experiment outcomes concluded the partial but sufficient proofof- concept prototype for this research. Extensive document analysis and iterative experimentations showed that the framework constructed by this research can guide the development of an alternative mobile ETP solution with both comparable security assurance to and better access to the patient’s medication history than the current solution. This alternative solution would present no operational dependence upon infrastructure and its associated, ongoing cost to the nation’s healthcare expenditure. In addition, use of this mobile ETP alternative has the potential to change the public’s perception (i.e. acceptance from regulatory and security perspectives) of mobile healthcare solutions, thereby paving the way for further innovation and future enhancements in eHealth

A review of activity trackers for senior citizens: research perspectives, commercial landscape and the role of the insurance industry

The objective assessment of physical activity levels through wearable inertial-based motion detectors for the automatic, continuous and long-term monitoring of people in free-living environments is a well-known research area in the literature. However, their application to older adults can present particular constraints. This paper reviews the adoption of wearable devices in senior citizens by describing various researches for monitoring physical activity indicators, such as energy expenditure, posture transitions, activity classification, fall detection and prediction, gait and balance analysis, also by adopting consumer-grade fitness trackers with the associated limitations regarding acceptability. This review also describes and compares existing commercial products encompassing activity trackers tailored for older adults, thus providing a comprehensive outlook of the status of commercially available motion tracking systems. Finally, the impact of wearable devices on life and health insurance companies, with a description of the potential benefits for the industry and the wearables market, was analyzed as an example of the potential emerging market drivers for such technology in the future

Developing a Medically Informative and Socially Supportive Interactive Online Network (MISSION)

This thesis discusses virtual communities and social networks and their current and potential uses in health and medicine, proposing a novel virtual health network called a \u27Medically Informative and Socially Supportive Interactive Online Network\u27 (MISSION). The purposes of a MISSION are to 1) serve as an information resource for patients, 2) to facilitate conversation between patient and provider, 3) to potentially aid in office tasks (such as scheduling, billing, etc.), and 4) to aid in community-building acts in patients\u27 own local, physical communities. In this thesis, the concept of virtual communities and social networks are explored, the legal and ethical ramifications of a MISSION are surveyed, current applications similar to a MISSION are analyzed, and recommendations for designing a MISSION are offered. This thesis is intended for an audience of health care communication and information systems professionals who can help put a MISSION into action through working with health care providers and organizations

Drug Development--Stuck in a State of Puberty?: Regulatory Reform of Human Clinical Research to Raise Responsiveness to the Reality of Human Variability

Scathing critiques of the Food and Drug Administration\u27s (“FDA”) performance by the Government Accountability Office and Institutes of Medicine, a plummet in innovative new drug approvals in spite of significant annual investment increases in biopharmaceutical research and development (“R&D”), and market controversies such as the painkiller Vioxx and the diabetes drug Avandia (both associated with significantly escalated risks of heart attacks and strokes) have raised doubts about the sufficiency of FDA *364 regulation. This Article questions how prescription medicines reach the market and proposes law-policy reforms to enhance the FDA\u27s science standard for human clinical trials and new drug approvals. The core message is that relying too heavily on clinical research data generated through the global “gold standard” of group experimental design--reliance on statistical analysis to compile and compare group averages--risks predicting little about the actual impact of prescription medicines on individuals, including members of the groups under study. This Article introduces a law-policy methodology based upon commercial incentives and intervention by Congress and the FDA to raise the science standard for human clinical research, and to make drug development more closely parallel the reality of drug delivery in the practice of medicine. The objectives of this proposal are to promote several pressing needs: maximize drug performance and minimize adverse events; end the pattern of putting new prescription medications on the market with too much dependence on the medical profession to introduce meaningful clinical understanding of drugs through patient use over time; improve biopharmaceutical R&D decision making; align the regulatory standard with the infusion of added precision associated with contemporary genetics-based R&D; and realize more sound scientific information directly through the regulatory process to support the integrity of science in an age of academia-industry integration, aggressive commercialization, secrecy in science, and constantly, rapidly evolving technology

Performance/outcomes data and physician process challenges for practical big data efforts in radiation oncology

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/146290/1/mp13136.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/146290/2/mp13136_am.pd

Aligning Theory and Evidence-Based Practices to Enhance Human Flourishing in Nurse Executives

Today’s nurse executives lead highly complex and bureaucratic organizations undergoing sweeping reform at an unprecedented rate of change. Change and high levels of stress are the norm in health care, and ineffective stress management can hinder organizational performance and adversely impact personal wellbeing. The risks of nurse executive burnout and unprecedented turnover led to the development of a 4-hour program to teach theory-guided and evidence-based stress management techniques. The program was intended to increase awareness, enhance effective stress management skills, and improve the nurse executive’s ability to flourish in high stress environments. A pre-intervention and 6-month post-intervention assessment (n=12) was conducted, and the results for 12 matched pairs were statistically significant for improved personal and organizational indicators of stress over time, indicating improved vitality, engagement, and sustainability. Findings validated concerns regarding the prevalence of stress in the nurse executive group and demonstrated positive outcomes for key performance indicators that support personal wellbeing, resilience, retention, and success. One nurse executive identified she no longer felt like leaving the organization and nurse executive leader turnover has decreased measurably following the intervention. The relative low costs, positive outcomes, and flexible format of this program make it feasible to support spread and enculturation of improved stress management practices that benefit both employee and organization through existing orientation and ongoing professional development strategies

From Team Huddle to Team Cuddle: Rekindling Caring, Self-Compassion, and Joy in Work!

Problem: The healthcare industry suffers from a high level of burnout and unhealthy work environments, which has been heightened by the COVID-19 pandemic. The consequences of burnout may be expressed in both individuals and teams as a lack of caring, disengagement, incivility, and staff turnover. Context: One department in an integrated healthcare organization displayed a pattern of annual low employee engagement scores and alleged workplace bullying. Team members also observed that employees failed to speak up when experiencing incivility. The Clinical Nurse Leader (CNL) student determined that an improvement initiative was needed to create a culture of caring to improve team cohesion and resilience and potentially reduce burnout and prevent incivility. As described by Watson (2012) and Perlo et al. (2017), healthy work environments include intentional change behaviors that promote mutual caring, positive values, trustworthiness, loving-kindness, and self-reflection. Intervention: To improve the team dynamics and vitality, a new 13-week program (From Team Huddle to Team Cuddle, a.k.a. Team Cuddles) was created and implemented. The Team Cuddles program was guided by evidence-based practices to cultivate a positive work environment and culture of caring to support individuals and the team. Each weekly session included Caring Science practices and HeartMath exercises. Measures: Quantitative and qualitative measures were assessed. The primary outcome measures included overall employee attendance and engagement. The process measures evaluated participation, engagement, and improvement in several multi-dimensional surveys. Qualitative themes were captured through direct observation and open-ended survey questions during implementation. Results: The improvement project recruited 18 volunteer team members to participate. The pre-intervention survey response rate was low (16%); however, there was a significant increase to 50% in the post-intervention surveys. The final survey results showed a high degree of improvement in caring, team cohesion, and to connect with others; in alignment with some of the common themes observed. A majority of responders wanted the program to continue. Conclusions: Leadership must pay close attention to the signs and symptoms of burnout at all levels of the organization to foster healthy work environments. Creating and sustaining a culture of caring is multifaceted and requires leadership support. Team interventions that are intentionally implemented and based on evidence from Caring Science are vital. When team huddles are transformed into team cuddles, they should improve employee resilience, self-compassion, and joy in work