19 research outputs found
Mapping healthcare IT
Thesis (S.M.)--Harvard-MIT Division of Health Sciences and Technology, 2010.Cataloged from PDF version of thesis.Includes bibliographical references (p. 56-58).In this thesis I have developed a map of Healthcare Information Technology applications used in the United States for care delivery, healthcare enterprise management, clinical support, research and patient engagement. No attempt has previously been made to develop such a taxonomy for use by healthcare policy makers and on-the-spot decision makers. Using my own fifteen years of experience in HIT, along with an extensive set of literature reviews, interviews and on-site research I assembled lists of applications and organized them into categories based on primary workflows. Seven categories of HIT systems emerged, which are Practice Tools, Advisory Tools, Financial Tools, Remote Healthcare Tools, Clinical Research Tools, Health 2.0 Tools and Enterprise Clinical Analytics, each of which have different operational characteristics and user communities. The results of this pilot study demonstrate that a map is possible. The draft map presented here will allow researchers and investors to focus on developing the next generation of HIT tools, including software platforms that orchestrate a variety of healthcare transactions, and will support policy makers as they consider the impact of Federal funding for HIT deployment and adoption. Further studies will refine the map, adding an additional level of detail below the seven categories established here, thus supporting tactical decision making at the hospital and medical practice level.by William Charles Richards Crawford.S.M
Exploring data sharing obligations in the technology sector
This report addresses the question: What is the role of data in the technology sector and what are the opportunities and risks of mandatory data sharing? The answer provides insights into costs and benefits of variants of data sharing obligations with and between technology companies
An investigation of electronic Protected Health Information (e-PHI) privacy policy legislation in California for seniors using in-home health monitoring systems
This study examined privacy legislation in California to identify those electronic Protected Health Information (e-PHI) privacy policies that are suited to seniors using in-home health monitoring systems. Personal freedom and independence are essential to a person\u27s physical and mental health, and mobile technology applications provide a convenient and economical method for monitoring personal health. Many of these apps are written by third parties, however, which poses serious risks to patient privacy. Current federal regulations only cover applications and systems developed for use by covered entities and their business partners. As a result, the responsibility for protecting the privacy of the individual using health monitoring apps obtained from the open market falls squarely on the states.
The goal of this study was to conduct an exploratory study of existing legislation to learn what was being done at the legislative level to protect the security and privacy of users using in-home mobile health monitoring systems. Specifically, those developed and maintained by organizations or individuals not classified as covered entities under the Health Insurance Portability and Accountability Act of 1996 (HIPAA). The researcher chose California due to its reputation for groundbreaking privacy laws and high population of seniors.
The researcher conducted a content analysis of California state legislation, federal and industry best practices, and extant literature to identify current and proposed legislation regarding the protection of e-PHI data of those using in-home health monitoring systems.
The results revealed that in-home health monitoring systems show promise, but they are not without risk. The use of smartphones, home networks, and downloadable apps puts patient privacy at risk, and combining systems that were not initially intended to function together carries additional concerns. Factors such as different privacy-protection profiles, opt-in/opt-out defaults, and privacy policies that are difficult to read or are not adhered to by the application also put user data at risk.
While this examination showed that there is legislative support governing the development of the technology of individual components of the in-home health monitoring systems, it appears that the in-home health monitoring system as a whole is an immature technology and not in wide enough use to warrant legislative attention. In addition â unlike the challenges posed by the development and maintenance of the technology of in-home health monitoring systems â there is ample legislation to protect user privacy in mobile in-home health monitoring systems developed and maintained by those not classified as covered entities under HIPAA. Indeed, the volume of privacy law covering the individual components of the system is sufficient to ensure that the privacy of the system as a whole would not be compromised if deployed as suggested in this study. Furthermore, the legislation evaluated over the course of this study demonstrated consistent balance between technical, theoretical, and legal stakeholders.
This study contributes to the body of knowledge in this area by conducting an in-depth review of current and proposed legislation in the state of California for the past five years. The results will help provide future direction for researchers and developers as they struggle to meet the current and future needs of patients using this technology as it matures. There are practical applications for this study as well. The seven themes identified during this study can serve as a valuable starting point for state legislators to evaluate existing and proposed legislation within the context of medical data to identify the need for legislation to assist in protecting user data against fraud, identity theft, and other damaging consequences that occur because of a data breach
Access Anytime Anyplace: An Empircal Investigation of Patterns of Technology Use in Nomadic Computing Environments
With the increasing pervasiveness of mobile technologies such as cellular phones, personal digital assistants and hand held computers, mobile technologies promise the next major technological and cultural shift. Like the Internet, it is predicted that the greatest impact will not come from hardware devices or software programs, but from emerging social practices, which were not possible before. To capitalize on the benefits of mobile technologies, organizations have begun to implement nomadic computing environments. Nomadic computing environments make available the systems support needed to provide computing and communication capabilities and services to the mobile work force as they move from place to place in a manner that is transparent, integrated, convenient and adaptive. Already, anecdotes suggest that within organizations there are social implications occurring with both unintended and intended consequences being perpetuated. The problems of nomadic computing users have widely been described in terms of the challenges presented by the interplay of time, space and context, yet a theory has yet to be developed which analyzes this interplay in a single effort. A temporal human agency perspective proposes that stakeholdersâ actions are influenced by their ability to recall the past, respond to the present and imagine the future. By extending the temporal human agency perspective through the recognition of the combined influence of space and context on human action, I investigated how the individual practices of eleven nomadic computing users changed after implementation. Under the umbrella of the interpretive paradigm, and using a cross case methodology this research develops a theoretical account of how several stakeholders engaged with different nomadic computing environments and explores the context of their effectiveness. Applying a literal and theoretical replication strategy to multiple longitudinal and retrospective cases, six months were spent in the field interviewing and observing participants. Data analysis included three types of coding: descriptive, interpretive and pattern coding. The findings reveal that patterns of technology use in nomadic computing environments are influenced by stakeholdersâ temporal orientations; their ability to remember the past, imagine the future and respond to the present. As stakeholders all have different temporal orientations and experiences, they exhibit different practices even when engaging initially with the same organizational and technical environments. Opposing forces emerge as users attempt to be effective by resolving the benefits and disadvantages of the environment as they undergo different temporal, contextual and spatial experiences. Insights about the ability to predict future use suggest that because they are difficult to envisage in advance, social processes inhibit the predictability of what technologies users will adopt. The framework presented highlights the need to focus on understanding the diversity in nomadic computing use practices by examining how they are influenced by individual circumstances as well as shared meanings across individuals
From geospatial data capture to the delivery of GIS-ready information : improved management within a GIS environment
This thesis presents the research undertaken to investigate how geospatial data handling techniques and technology can be potentially used to enhance the existing management of entire survey datasets from their captured stage to a GIS-ready state and the delivery of this to the user. Discovery of the current systems for managing survey data and information in the Survey and Mapping Department Malaysia (JUPEM) has been presented. In addition, the surveying practice and processes carried out have been examined, especially the different type of data and information existed within the raw data capture right through to the production of GIS-ready information. The current GIS technology and techniques for managing geospatial data have been inspected to gain an in-depth understanding of them. Geospatial object as an approach to model reality of the world has been discovered and used to model the raw, processed, the GIS-ready information. To implement the management, a prototype Database Management System (DBMS) has been implemented, and a trial data population and processing steps have been carried out. An enhancement of the managemenot f the datasetsf rom geospatiald ata capturet o the GIS-ready infori-nation has beend emonstratedT. o deliver online the final product, demonstrationo f available methods were illustrated, and then contrasted. A range of datasets around Malaysian context were used in the research. The investigation revealed that raw, processed and GIS-ready information can be successfully modelled as object in an object-relational spatial database. Using inherent GIS tools, survey datasets management and processing steps within the same system are evidently achieved in a prototype implemented DBMS. An improved management showing the capability of 'drill-down search' and 'two-way traceability' to access and search spatial and non-spatial information in the system is effectively illustrated. Demonstration of the vendor specific and open source technology for the GIS-ready information delivery leads to the comparison between them. The thesis concludes by recognising that a management for raw captured data, processed set of data and GIS-ready information, and the delivery of this, within GIS environment is possible. The inherent GIS tools and DBMS have presented a single-view system for geospatial data management providing superior interfaces that are easy to learn and use, and users are able to specify and perform the desired tasks efficiently. Delivery of data has some constraints that need to be considered before embarking into either vendor specific application or open source technology. In JUPEM, time and cost can be reduced by applying and implementing the suggested GIS application for cadastral and topographic surveys right up to the creation of GIS-ready information, as detailed in the thesis. The research also finds that the in-depth understanding and experience, practically and theoretically, of all aspects of current GIS technologies and techniques gained through this research has achieved an overarching inspiration: equalisation of a high level of awareness and ability of staff in handling GIS project development within currently developing countries with those in the developed countries, and within the national survey and mapping department with those of other government departments and commercial GIS contractors.EThOS - Electronic Theses Online ServicePublic Service Department of Malaysia : Department of Survey and Mapping Malaysia : University of Newcastle upon TyneGBUnited Kingdo
e-Skills: The International dimension and the Impact of Globalisation - Final Report 2014
In todayâs increasingly knowledge-based economies, new information and communication technologies are a key engine for growth fuelled by the innovative ideas of highly - skilled workers. However, obtaining adequate quantities of employees
with the necessary e-skills is a challenge. This is a growing
international problem with many countries having an insufficient numbers of workers with the right e-Skills.
For example:
Australia: âEven though thereâs 10,000 jobs a year created in IT, there are only 4500 students studying IT at university, and not all of them graduateâ (Talevski and Osman, 2013).
Brazil: âBrazilâs ICT sector requires about 78,000 [new] people by 2014. But, according to Brasscom, there are only 33,000 youths studying ICT related courses in the countryâ (Ammachchi, 2012).
Canada: âIt is widely acknowledged that it is becoming inc
reasingly difficult to recruit for a variety of critical ICT occupations
âfrom entry level to seasonedâ (Ticoll and Nordicity, 2012).
Europe: It is estimated that there will be an e-skills gap within Europe of up to 900,000 (main forecast scenario) ICT pr
actitioners by 2020â (Empirica, 2014).
Japan: It is reported that 80% of IT and user companies report an e-skills shortage (IPA, IT HR White Paper, 2013)
United States: âUnlike the fiscal cliff where we are still peering over the edge, we careened over the âIT Skills Cliffâ some years ago as our economy digitalized, mobilized and further âtechnologizedâ, and our IT skilled labour supply failed to keep upâ (Miano, 2013)
Understanding the acceptability, utilisation and current evidence base of mHealth and online interventions: a traditional and non-traditional approach.
Introduction: There is an increased acceptance and demand for online and mobile
health (mHealth) interventions to support physical and mental health problems.
However, the uptake and engagement of these interventions is relatively low and the
evidence base for these interventions requires continual updating in line with
technological advances. A systematic review was conducted, focusing on anxiety and
depression, to explore the existing evidence base of both physical health and mental
health mobile applications. The first research paper explores the acceptability of
mHealth interventions for both mental health and physical health problems. The final
research paper explores use and strategies when searching for mental health
information online. Additionally, perceived quality, sentiment and barriers to online
health information was explored.
Methods: Studies were identified by searching for articles published between
January 2008 and January 2016. Databases included: PsycINFO, MEDLINE,
CINAHL PLUS and the Cochrane Central Register of Controlled Trials for 2016. In
the research articles, 218 people completed an online survey in January 2016
exploring, online health seeking for mental health and physical health problems, and
acceptability of mHealth interventions. Sentiment of online health resources was
explored by extracting 432 individual tweets from Twitter.
Results: The systematic review revealed twenty-seven studies for inclusion; 10 with
a physical health focus and 17 with a mental health focus. Targeted depression
applications have the superior evidence base; however, no firm conclusions can be
made regarding interventions that targeted physical health, or those measuring anxiety.
The first research paper found that face-to-face therapy would more likely meet
expectations for treatment of both physical and mental health problems compared to
mHealth interventions. Computerised interventions were more likely to meet
expectations than mobile applications. Expectations of treatment were higher for the
treatment of mental health problems than physical health problems.
The second research paper found that a large proportion of the public use the internet
to search for information on mental health, with half citing it as their primary source
for mental health information. The online survey found that the quality of mental
health information available on the internet was rated favourably, compared to mobile
applications. Overall, the sentiment towards specific online mental health resources
was generally positive.
Conclusions: Research into online and mHealth interventions has developed
considerably in recent years in line with advances in technology. These interventions
have the potential to be an effective treatment of common mental health problems.
The systematic review highlighted that depression applications are more established
and effective than applications targeting anxiety. The first research paper suggests that
mHealth interventions fall short of public expectations for treatment of health
problems. The final research paper reflects that the perceived quality of online mental
health information is rated favourably. However, many barriers still limit uptake.
Future research could focus on continually developing and evaluating evidence based
online and mHealth interventions and the outcome of this study suggests that
incorporating them more widely into existing care systems, alongside face to face
interventions could increase the publicâs confidence in these interventions