125,794 research outputs found
Citizens’ Juries: When Older Adults Deliberate on the Benefits and Risks of Smart Health and Smart Homes
open access articleBackground: Technology-enabled healthcare or smart health has provided a wealth of
products and services to enable older people to monitor and manage their own health conditions at
home, thereby maintaining independence, whilst also reducing healthcare costs. However, despite
the growing ubiquity of smart health, innovations are often technically driven, and the older user does
not often have input into design. The purpose of the current study was to facilitate a debate about
the positive and negative perceptions and attitudes towards digital health technologies. Methods:
We conducted citizens’ juries to enable a deliberative inquiry into the benefits and risks of smart health
technologies and systems. Transcriptions of group discussions were interpreted from a perspective
of life-worlds versus systems-worlds. Results: Twenty-three participants of diverse demographics
contributed to the debate. Views of older people were felt to be frequently ignored by organisations
implementing systems and technologies. Participants demonstrated diverse levels of digital literacy
and a range of concerns about misuse of technology. Conclusion: Our interpretation contrasted
the life-world of experiences, hopes, and fears with the systems-world of surveillance, e ciencies,
and risks. This interpretation o ers new perspectives on involving older people in co-design and
governance of smart health and smart homes
A systematic literature review of cloud computing in eHealth
Cloud computing in eHealth is an emerging area for only few years. There
needs to identify the state of the art and pinpoint challenges and possible
directions for researchers and applications developers. Based on this need, we
have conducted a systematic review of cloud computing in eHealth. We searched
ACM Digital Library, IEEE Xplore, Inspec, ISI Web of Science and Springer as
well as relevant open-access journals for relevant articles. A total of 237
studies were first searched, of which 44 papers met the Include Criteria. The
studies identified three types of studied areas about cloud computing in
eHealth, namely (1) cloud-based eHealth framework design (n=13); (2)
applications of cloud computing (n=17); and (3) security or privacy control
mechanisms of healthcare data in the cloud (n=14). Most of the studies in the
review were about designs and concept-proof. Only very few studies have
evaluated their research in the real world, which may indicate that the
application of cloud computing in eHealth is still very immature. However, our
presented review could pinpoint that a hybrid cloud platform with mixed access
control and security protection mechanisms will be a main research area for
developing citizen centred home-based healthcare applications
Designing the Health-related Internet of Things: Ethical Principles and Guidelines
The conjunction of wireless computing, ubiquitous Internet access, and the miniaturisation of sensors have opened the door for technological applications that can monitor health and well-being outside of formal healthcare systems. The health-related Internet of Things (H-IoT) increasingly plays a key role in health management by providing real-time tele-monitoring of patients, testing of treatments, actuation of medical devices, and fitness and well-being monitoring. Given its numerous applications and proposed benefits, adoption by medical and social care institutions and consumers may be rapid. However, a host of ethical concerns are also raised that must be addressed. The inherent sensitivity of health-related data being generated and latent risks of Internet-enabled devices pose serious challenges. Users, already in a vulnerable position as patients, face a seemingly impossible task to retain control over their data due to the scale, scope and complexity of systems that create, aggregate, and analyse personal health data. In response, the H-IoT must be designed to be technologically robust and scientifically reliable, while also remaining ethically responsible, trustworthy, and respectful of user rights and interests. To assist developers of the H-IoT, this paper describes nine principles and nine guidelines for ethical design of H-IoT devices and data protocols
Sun Devils Together: Breaking Stigmas on Student Homelessness
abstract: In universities, such as Arizona State, students are becoming homeless at an alarming rate. These homeless ASU students are often invisible, as seen through the lack of information on who they are and what resources the university has developed to help them. Typically, students arrive at university campuses with most of the resources required for them to pursue a degree. However, several economic factors such as unemployment or financial instability can impact these resources which influence students ability to stay enrolled in classes. This feature is reflected in the well understood concept of the starving student. Despite this paradigm, the fact remains that students under this stress are attending classes and are under financial stress to do so while being unable to meet their basic needs. These intertwined elements result in ASU students becoming exposed to cyclical needs-insecurities including homelessness.
Therefore, the team decided to develop a project called Sun Devils Together which addresses the needs of ASUs students facing homelessness and overall aims to help increase the accessibility of available resources through reducing the silo effect that occurs due to lack of communication between different departments and increases faculty, staff, and student awareness regarding the issue. In order to achieve this, the team has collaborated with the Assistant Dean of Students to produce a training module for ASU faculty, professional staff, and students. The team is contributing information to the creation of a new website that will have all the resources available to students in one place. In addition, the team will create a coded pamphlet with a map of resources that will be given out to different departments around campus that students may potentially reach out to for help while informing those departments regarding the existence of other departments that work towards the same cause
A safer place for patients: learning to improve patient safety
1 Every day over one million people are treated
successfully by National Health Service (NHS) acute,
ambulance and mental health trusts. However, healthcare
relies on a range of complex interactions of people,
skills, technologies and drugs, and sometimes things do
go wrong. For most countries, patient safety is now the
key issue in healthcare quality and risk management.
The Department of Health (the Department) estimates
that one in ten patients admitted to NHS hospitals will be
unintentionally harmed, a rate similar to other developed
countries. Around 50 per cent of these patient safety
incidentsa could have been avoided, if only lessons from
previous incidents had been learned.
2
There are numerous stakeholders with a role in
keeping patients safe in the NHS, many of whom require
trusts to report details of patient safety incidents and near
misses to them (Figure 2). However, a number of previous
National Audit Office reports have highlighted concerns
that the NHS has limited information on the extent and
impact of clinical and non-clinical incidents and trusts need
to learn from these incidents and share good practice across
the NHS more effectively (Appendix 1).
3 In 2000, the Chief Medical Officer’s report An
organisation with a memory
1
, identified that the key
barriers to reducing the number of patient safety incidents
were an organisational culture that inhibited reporting and
the lack of a cohesive national system for identifying and
sharing lessons learnt.
4 In response, the Department published Building a
safer NHS for patients3 detailing plans and a timetable
for promoting patient safety. The goal was to encourage
improvements in reporting and learning through the
development of a new mandatory national reporting
scheme for patient safety incidents and near misses. Central
to the plan was establishing the National Patient Safety
Agency to improve patient safety by reducing the risk of
harm through error. The National Patient Safety Agency was
expected to: collect and analyse information; assimilate
other safety-related information from a variety of existing
reporting systems; learn lessons and produce solutions.
5 We therefore examined whether the NHS has
been successful in improving the patient safety culture,
encouraging reporting and learning from patient safety
incidents. Key parts of our approach were a census of
267 NHS acute, ambulance and mental health trusts in
Autumn 2004, followed by a re-survey in August 2005
and an omnibus survey of patients (Appendix 2). We also
reviewed practices in other industries (Appendix 3) and
international healthcare systems (Appendix 4), and the
National Patient Safety Agency’s progress in developing its
National Reporting and Learning System (Appendix 5) and
other related activities (Appendix 6).
6 An organisation with a memory1
was an important
milestone in the NHS’s patient safety agenda and marked
the drive to improve reporting and learning. At the
local level the vast majority of trusts have developed a
predominantly open and fair reporting culture but with
pockets of blame and scope to improve their strategies for
sharing good practice. Indeed in our re-survey we found
that local performance had continued to improve with more
trusts reporting having an open and fair reporting culture,
more trusts with open reporting systems and improvements
in perceptions of the levels of under-reporting. At the
national level, progress on developing the national reporting
system for learning has been slower than set out in the
Department’s strategy of 2001
3
and there is a need to
improve evaluation and sharing of lessons and solutions by
all organisations with a stake in patient safety. There is also
no clear system for monitoring that lessons are learned at the
local level. Specifically:
a The safety culture within trusts is improving, driven
largely by the Department’s clinical governance
initiative
4
and the development of more effective risk
management systems in response to incentives under
initiatives such as the NHS Litigation Authority’s
Clinical Negligence Scheme for Trusts (Appendix 7).
However, trusts are still predominantly reactive in
their response to patient safety issues and parts of
some organisations still operate a blame culture.
b All trusts have established effective reporting systems
at the local level, although under-reporting remains
a problem within some groups of staff, types of
incidents and near misses. The National Patient Safety
Agency did not develop and roll out the National
Reporting and Learning System by December 2002
as originally envisaged. All trusts were linked to the
system by 31 December 2004. By August 2005, at
least 35 trusts still had not submitted any data to the
National Reporting and Learning System.
c Most trusts pointed to specific improvements
derived from lessons learnt from their local incident
reporting systems, but these are still not widely
promulgated, either within or between trusts.
The National Patient Safety Agency has provided
only limited feedback to trusts of evidence-based
solutions or actions derived from the national
reporting system. It published its first feedback report
from the Patient Safety Observatory in July 2005
What does it take to make integrated care work? A ‘cookbook’ for large-scale deployment of coordinated care and telehealth
The Advancing Care Coordination & Telehealth Deployment (ACT) Programme is the first to explore the organisational and structural processes needed to successfully implement care coordination and telehealth (CC&TH) services on a large scale. A number of insights and conclusions were identified by the ACT programme. These will prove useful and valuable in supporting the large-scale deployment of CC&TH. Targeted at populations of chronic patients and elderly people, these insights and conclusions are a useful benchmark for implementing and exchanging best practices across the EU. Examples are: Perceptions between managers, frontline staff and patients do not always match; Organisational structure does influence the views and experiences of patients: a dedicated contact person is considered both important and helpful; Successful patient adherence happens when staff are engaged; There is a willingness by patients to participate in healthcare programmes; Patients overestimate their level of knowledge and adherence behaviour; The responsibility for adherence must be shared between patients and health care providers; Awareness of the adherence concept is an important factor for adherence promotion; The ability to track the use of resources is a useful feature of a stratification strategy, however, current regional case finding tools are difficult to benchmark and evaluate; Data availability and homogeneity are the biggest challenges when evaluating the performance of the programmes
The Importance Of Health Insurance Policy On Purchase Intention / Continuance – An Empirical Study In Malaysia
Penduduk seluruh dunia menyedari kepentingan polisi insurans kesihatan untuk menangani isu yang tidak diduga kepastiannya pada masa ini.
People all of over the world realized the importance of health insurance policy as the unforeseen uncertainties has become the order of the day
Leadership of healthcare commissioning networks in England : a mixed-methods study on clinical commissioning groups
Objective: To explore the relational challenges for general practitioner (GP) leaders setting up new network-centric commissioning organisations in the recent health policy reform in England, we use innovation network theory to identify key network leadership practices that facilitate healthcare innovation.
Design: Mixed-method, multisite and case study research.
Setting: Six clinical commissioning groups and local clusters in the East of England area, covering in total 208 GPs and 1 662 000 population.
Methods: Semistructured interviews with 56 lead GPs, practice managers and staff from the local health authorities (primary care trusts, PCT) as well as various healthcare professionals; 21 observations of clinical commissioning group (CCG) board and executive meetings; electronic survey of 58 CCG board members (these included GPs, practice managers, PCT employees, nurses and patient representatives) and subsequent social network analysis.
Main outcome measures: Collaborative relationships between CCG board members and stakeholders from their healthcare network; clarifying the role of GPs as network leaders; strengths and areas for development of CCGs.
Results: Drawing upon innovation network theory provides unique insights of the CCG leaders’ activities in establishing best practices and introducing new clinical pathways. In this context we identified three network leadership roles: managing knowledge flows, managing network coherence and managing network stability. Knowledge sharing and effective collaboration among GPs enable network stability and the alignment of CCG objectives with those of the wider health system (network coherence). Even though activities varied between commissioning groups, collaborative initiatives were common. However, there was significant variation among CCGs around the level of engagement with providers, patients and local authorities. Locality (sub) groups played an important role because they linked commissioning decisions with patient needs and brought the leaders closer to frontline stakeholders.
Conclusions: With the new commissioning arrangements, the leaders should seek to move away from dyadic and transactional relationships to a network structure, thereby emphasising on the emerging relational focus of their roles. Managing knowledge mobility, healthcare network coherence and network stability are the three clinical leadership processes that CCG leaders need to consider in coordinating their network and facilitating the development of good clinical commissioning decisions, best practices and innovative services. To successfully manage these processes, CCG leaders need to leverage the relational capabilities of their network as well as their clinical expertise to establish appropriate collaborations that may improve the healthcare services in England. Lack of local GP engagement adds uncertainty to the system and increases the risk of commissioning decisions being irrelevant and inefficient from patient and provider perspectives
Link Before You Share: Managing Privacy Policies through Blockchain
With the advent of numerous online content providers, utilities and
applications, each with their own specific version of privacy policies and its
associated overhead, it is becoming increasingly difficult for concerned users
to manage and track the confidential information that they share with the
providers. Users consent to providers to gather and share their Personally
Identifiable Information (PII). We have developed a novel framework to
automatically track details about how a users' PII data is stored, used and
shared by the provider. We have integrated our Data Privacy ontology with the
properties of blockchain, to develop an automated access control and audit
mechanism that enforces users' data privacy policies when sharing their data
across third parties. We have also validated this framework by implementing a
working system LinkShare. In this paper, we describe our framework on detail
along with the LinkShare system. Our approach can be adopted by Big Data users
to automatically apply their privacy policy on data operations and track the
flow of that data across various stakeholders.Comment: 10 pages, 6 figures, Published in: 4th International Workshop on
Privacy and Security of Big Data (PSBD 2017) in conjunction with 2017 IEEE
International Conference on Big Data (IEEE BigData 2017) December 14, 2017,
Boston, MA, US
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