Rethinking harm reduction in the digital age

Introduction : La démultiplication des substances psychoactives, la transformation des pratiques de consommation, l’inadéquation des services pour les jeunes et le virage technologique pris par les consommateurs, tant pour acheter que s’informer sur les substances, incitent à repenser l’intervention en réduction des méfaits. Objectifs : L’étude vise à explorer l’intérêt et la faisabilité d’utiliser les technologies de l’information et des communications (TIC) pour prévenir des consommations plus intensives et réduire les dommages chez les jeunes adultes consommateurs en situation de grande vulnérabilité sociale. Méthodes : Elle utilise une approche de recherche communautaire basée sur des groupes de discussion menés auprès de jeunes consommateurs de 18 à 29 ans et d’intervenants œuvrant auprès des jeunes en difficultés dans la région de Québec. Résultats : Les TIC constituent un outil privilégié d’approvisionnement et d’échange d’informations sur les substances parmi les jeunes. Elles s’insèrent dans un contexte de lacunes dans les ressources existantes. En réponse, les participants suggèrent le développement d’une plateforme interactive spécialisée et actualisée d’échange d’informations sur les substances en circulation et la façon de gérer leurs consommations et les situations d’urgence. Pour les intervenants, les TIC sont peu exploitées pour des échanges en lien avec les substances illicites et jugées délicates à manipuler sur ces questions sensibles. Elles sont néanmoins perçues comme pouvant pallier un déficit de connaissances et de compétences pour aborder ces sujets complexes avec les jeunes. Des enjeux émergents liés aux inégalités d’accès au numérique, de littératie avec les TIC, éthiques et juridiques. Conclusion : Les TIC sont bien implantées dans le travail des intervenants et la vie des jeunes consommateurs. Elles sont des outils complémentaires, probablement incontournables à l’ère du numérique et de la complexification des marchés et des modes de consommation.Introduction : Ever-changing psychoactive substances, changes in consumption habits, services inadequacy and technological advances stresses the need to innovate in regards of harm reduction interventions. Objectives: This study aims to explore the interest and feasibility of using information and communication technologies (ICT) to prevent intensive drug use and reduce harm in socially vulnerable young adults’ drug users. Methods: Using a community research approach based on focus groups with young drug users aged 18 to 29 years old and community workers working with at-risk youths. Results: Young adults widely use ICT to obtain and exchange information regarding drugs. With regard to further technological development in harm reduction, participants perceive ICT as a mean of filling current gaps in services. Participants suggest developing a specialized interactive information exchange platform about current drugs and substance abuse management, especially emergencies and crisis. Community workers did not think young drug users used ICT regarding drugs for other means than acquiring products and found their adequate use regarding harm reduction rather delicate. Nevertheless, they saw a potential in ICT to spread information and facilitate discussion about complicated issues with youths. Conclusion: ICT are well entranched in the lives of young drug users and in community workers’ practices. ICT are complementary and inevitable in the digital age and in an era of complexification of drug market and habits.Introducción : La desmultiplicación de sustancias psicoactivas, la transformación de las prácticas de consumo, la inadecuación de los servicios para los jóvenes y el viraje tecnológico efectuado por los consumidores ya sea para comprar o para informarse sobre las sustancias, incitan a repensar la intervención en materia de reducción de delitos. Objetivos: El estudio apunta a explorar el interés para utilizar las tecnologías de información y de comunicaciones (TIC) y la factibilidad de su uso para prevenir consumos más intensivos y reducir los daños entre los jóvenes adultos consumidores en situación de gran vulnerabilidad social. Métodos: El estudio utiliza un enfoque de investigación comunitaria basada en grupos de discusión organizados entre jóvenes consumidores de entre 18 y 29 años y con la participación de agentes que actúan entre los jóvenes con dificultades en la región de Quebec. Resultados: Las TIC constituyen una herramienta privilegiada de suministro y de intercambio de informaciones sobre las sustancias entre los jóvenes y se integran en un contexto de lagunas en los recursos existentes, En respuesta, los participantes sugieren el desarrollo de una plataforma interactiva especializada y actualizada de intercambio de información sobre las sustancias en circulación y la manera como los jóvenes pueden manejar su consumo y las situaciones de urgencia. Para los agentes participantes, las TIC son poco exploradas en los intercambios relacionados con las sustancias ilícitas y se las juzga delicadas a manipular en materia de estas cuestiones sensibles. Se percibe sin embargo que podrían paliar un déficit de conocimientos y de competencias para abordar estos temas complejos con los jóvenes. Hay cuestiones emergentes relacionadas con las desigualdades de acceso a las tecnologías digitales, de conocimiento para manejar las TIC y de conocimiento de cuestiones éticas y jurídicas. Conclusión: Las TIC están bien implantadas en el trabajo de los agentes participantes y en la vida de los jóvenes consumidores. Son herramientas complementarias, probablemente inevitables en la era digital y de complejización de los mercados y los modos de consumo

Information Systems and Healthcare XXXIV: Clinical Knowledge Management Systems—Literature Review and Research Issues for Information Systems

Knowledge Management (KM) has emerged as a possible solution to many of the challenges facing U.S. and international healthcare systems. These challenges include concerns regarding the safety and quality of patient care, critical inefficiency, disparate technologies and information standards, rapidly rising costs and clinical information overload. In this paper, we focus on clinical knowledge management systems (CKMS) research. The objectives of the paper are to evaluate the current state of knowledge management systems diffusion in the clinical setting, assess the present status and focus of CKMS research efforts, and identify research gaps and opportunities for future work across the medical informatics and information systems disciplines. The study analyzes the literature along two dimensions: (1) the knowledge management processes of creation, capture, transfer, and application, and (2) the clinical processes of diagnosis, treatment, monitoring and prognosis. The study reveals that the vast majority of CKMS research has been conducted by the medical and health informatics communities. Information systems (IS) researchers have played a limited role in past CKMS research. Overall, the results indicate that there is considerable potential for IS researchers to contribute their expertise to the improvement of clinical process through technology-based KM approaches

Assessing the market and financial potential of selfmed pill dispenser: a start-up aiming to eradicate medication non-adherence in Portugal

Mestrado em IPB-ESTGNon-adherence to medication is a global problem that affect half of the prescription users, resulting in suboptimal therapy outcomes and premature death. The complexity of medication is one of the primary contributing factors for it. To assist with the complex medication regimen, an automatic pill dispenser, SelfMed has been created. This study focuses on studying a future start-up company, SelfMed Lda. The company will operate in the Portuguese market and aims to increase adherence to taking medication according to medical prescription by adults over the age of 60. The aim of this research is to evaluate the market and the financial viability of a project in Portugal called "SelfMed, your medicating partner," which aims to manufacture and market an automatic pill dispenser to healthcare organizations, companies in this sector of activity, and pharmacies (Business to Business). Thus, it is intended to demonstrate to what extent the implementation of the project is possible and capable of replacing the need for personalized care in older individuals for the purpose of managing the taking of medicines. The research was conducted using primary data collected through a questionnaire distributed to users and care institutions/companies in the referenced area. According to the analysis, ~36% of users and 40% of care companies are interested in obtaining SelfMed to simplify the complex medication management and prescription regimen for the end user. Considering an assessment of the 6-year financial plan, a total investment of approximately €239,000 is required to launch the project, consisting mainly of basic equipment and transport, as well as supporting buildings and infrastructure, software, among others. Based on the established assumptions, the project is commercially and financially viable, with positive results from the third year onwards and an NPV of €185,051, IRR of 23.8% and a payback period of approximately 4.47 years.A não adesão à medicação, ou a sua toma de forma errónea traduz um problema global que afeta metade dos utilizadores com prescrições médicas, resultando em consideráveis malefícios para os cidadãos, de onde se destaca a morte prematura. A complexidade da medicação é um dos principais fatores que contribui para esta realidade. Foi face a esta problemática e com o objetivo de contribuir para a sua mitigação que foi proposto um doseador automático de comprimidos, designado por SelfMed. Assim, este estudo centra-se no estudo de uma futura empresa start-up, a SelfMed Lda. A empresa irá operar no mercado português e visa aumentar a adesão à correta toma de medicamentos, de acordo com a prescrição médica, por adultos com mais de 60 anos de idade. O objectivo da presente pesquisa consiste em avaliar o mercado e a viabilidade financeira de um projeto em Portugal denominado "SelfMed, o seu parceiro médico", que pretende fabricar e comercializar um doseador automático de comprimidos destinado a organizações prestadoras de cuidados de saúde, empresas deste setor de atividade, e farmácias (Business to Business). Assim, pretende-se demonstrar até que ponto a implementação do projeto é possível e capaz de substituir a necessidade de cuidados personalizados em indivíduos mais velhos para efeitos de gestão da toma de medicamentos. A investigação foi realizada utilizando dados primários recolhidos através de um inquérito por questionário distribuído a utilizadores e instituições/empresas de prestação de cuidados na área referenciada. De acordo com a análise, ~36% dos utilizadores e 40% das empresas de prestação de cuidados estão interessados em obterem a SelfMed, a fim de simplificar o complexo regime de gestão e toma de medicação do utilizador final. Considerando uma avaliação do plano financeiro quinquenal, é necessário um investimento total de aproximadamente 239.000 euros para lançar o projeto, que consiste, principalmente, em equipamento básico e transporte, bem como edifícios e infraestruturas de apoio, software, entre outros. Com base nos pressupostos estabelecidos, o projeto é comercial e financeiramente viável, com resultados positivos a partir do terceiro ano, um VAL de €185,051, uma TIR de 23.8% e um período de recuperação do investimento de 4.47 anos

User-centered design and evaluation of RxMAGIC: A Prescription Management And General Inventory Control system for free clinic dispensaries

Medication management is a complex and expensive multistage process that covers the prescribing and ordering, order communication, dispensing, administering, and monitoring and use of prescription medications. While challenges in medication management are ubiquitous across all settings, they can be particularly exacerbated in a free clinic that serves a medically vulnerable population. These patients suffer from financial constraints, poor health literacy, multiple chronic conditions, and medication non-adherence. Clinical pharmacists play an integral role in the provision of healthcare services to these patients and could benefit from the use of medication management information technology (MMIT) to provide efficiencies in the tracking, provision, and use of medications. While MMITs exist, they are not designed to support the unique needs of pharmacists in these settings

Usability analysis of contending electronic health record systems

In this paper, we report measured usability of two leading EHR systems during procurement. A total of 18 users participated in paired-usability testing of three scenarios: ordering and managing medications by an outpatient physician, medicine administration by an inpatient nurse and scheduling of appointments by nursing staff. Data for audio, screen capture, satisfaction rating, task success and errors made was collected during testing. We found a clear difference between the systems for percentage of successfully completed tasks, two different satisfaction measures and perceived learnability when looking at the results over all scenarios. We conclude that usability should be evaluated during procurement and the difference in usability between systems could be revealed even with fewer measures than were used in our study. © 2019 American Psychological Association Inc. All rights reserved.Peer reviewe

Medical Informatics

Information technology has been revolutionizing the everyday life of the common man, while medical science has been making rapid strides in understanding disease mechanisms, developing diagnostic techniques and effecting successful treatment regimen, even for those cases which would have been classified as a poor prognosis a decade earlier. The confluence of information technology and biomedicine has brought into its ambit additional dimensions of computerized databases for patient conditions, revolutionizing the way health care and patient information is recorded, processed, interpreted and utilized for improving the quality of life. This book consists of seven chapters dealing with the three primary issues of medical information acquisition from a patient's and health care professional's perspective, translational approaches from a researcher's point of view, and finally the application potential as required by the clinicians/physician. The book covers modern issues in Information Technology, Bioinformatics Methods and Clinical Applications. The chapters describe the basic process of acquisition of information in a health system, recent technological developments in biomedicine and the realistic evaluation of medical informatics