Organizing the U.S. Health Care Delivery System for High Performance

Analyzes the fragmentation of the healthcare delivery system and makes policy recommendations -- including payment reform, regulatory changes, and infrastructure -- for creating mechanisms to coordinate care across providers and settings

Enhancing Ontario’s Rural Infrastructure Preparedness: Inter-Community Service Sharing in a Changing Climate — Environmental Scan

Given the research that has been done in this environmental scan and the gaps found in this research, it is our aim to find out: What types of service sharing are going on in Ontario municipalities, particularly in rural/remote areas? How can inter-community service sharing (ICSS) benefit the asset management planning process in these rural/remote areas to enhance capacities for climate change resilience? Climate change (CC) will exacerbate deterioration to existing infrastructure and increase replacement costs. Improved preparedness reduces risks and increases efficiency, readiness and coping capacity. To increase the preparedness of Ontario rural communities, this project develops CC-Prepared Inter-Community Service Sharing (ICSS) as an innovative strategy that expands cost-effective solutions within Ontario’s standardized Asset Management Planning (AMP) process. Overseen by a Project Advisory Board (PAB), it identifies a suite of best practice ICSS processes and principles and a range of factors and indicators that influence the uptake of ICSS as a viable and practical opportunity targeted to enhance rural infrastructure preparedness for CC. It utilizes a multimethod, interdisciplinary approach involving an environmental scan, interviews, a survey and case studies and develops an ICSS Toolkit consisting of reports, workbook, policy brief and media kit. Knowledge translation and transfer (KTT) includes blogs, teleconferences, articles, presentations and a workshop. For small rural Ontario communities, this study enhances management of CC impacts on infrastructure through the development of a CC-Prepared ICSS strategy, increasing anticipatory, collective actions that reduce dam age and increase efficiencies. It informs sound municipal/provincial level programs and policies about innovative ICSS that benefit rural communities through the identification of Ontario-wide trends, case study best practises and action-oriented recommendations

Supporting research and development in ambulance services: research for better healthcare in prehospital settings

Background This paper discusses recent developments in research support for ambulance trusts in England and Wales and how this could be designed to lead to better implementation, collaboration in and initiation of high-quality research to support a truly evidence-based service. Method The National Ambulance Research Steering Group was set up in 2007 to establish the strategic direction for involvement of regional ambulance services in developing relevant and well-designed research for improving the quality of services to patients. Results Ambulance services have been working together and with academic partners to implement research and to participate, collaborate and lead the design of research that is relevant for patients and ambulance services. Conclusion New structures to support the strategic development of ambulance and prehospital research will help address gaps in the evidence for health interventions and service delivery in prehospital and ambulance care and ensure that ambulance services can increase their capacity and capability for high-quality research

Training of Crisis Mappers and Map Production from Multi-sensor Data: Vernazza Case Study (Cinque Terre National Park, Italy)

This aim of paper is to presents the development of a multidisciplinary project carried out by the cooperation between Politecnico di Torino and ITHACA (Information Technology for Humanitarian Assistance, Cooperation and Action). The goal of the project was the training in geospatial data acquiring and processing for students attending Architecture and Engineering Courses, in order to start up a team of "volunteer mappers". Indeed, the project is aimed to document the environmental and built heritage subject to disaster; the purpose is to improve the capabilities of the actors involved in the activities connected in geospatial data collection, integration and sharing. The proposed area for testing the training activities is the Cinque Terre National Park, registered in the World Heritage List since 1997. The area was affected by flood on the 25th of October 2011. According to other international experiences, the group is expected to be active after emergencies in order to upgrade maps, using data acquired by typical geomatic methods and techniques such as terrestrial and aerial Lidar, close-range and aerial photogrammetry, topographic and GNSS instruments etc.; or by non conventional systems and instruments such us UAV, mobile mapping etc. The ultimate goal is to implement a WebGIS platform to share all the data collected with local authorities and the Civil Protectio

Protecting Patient Privacy: Strategies for Regulating Electronic Health Records Exchange

The report offers policymakers 10 recommendations to protect patient privacy as New York state develops a centralized system for sharing electronic medical records. Those recommendations include:Require that the electronic systems employed by HIEs have the capability to sort and segregate medical information in order to comply with guaranteed privacy protections of New York and federal law. Presently, they do not.Offer patients the right to opt-out of the system altogether. Currently, people's records can be uploaded to the system without their consent.Require that patient consent forms offer clear information-sharing options. The forms should give patients three options: to opt-in and allow providers access to their electronic medical records, to opt-out except in the event of a medical emergency, or to opt-out altogether.Prohibit and sanction the misuse of medical information. New York must protect patients from potential bad actors--that small minority of providers who may abuse information out of fear, prejudice or malice.Prohibit the health information-sharing networks from selling data. The State Legislature should pass legislation prohibiting the networks from selling patients' private health information

An agent-based architecture for managing the provision of community care - the INCA (Intelligent Community Alarm) experience

Community Care is an area that requires extensive cooperation between independent agencies, each of which needs to meet its own objectives and targets. None are engaged solely in the delivery of community care, and need to integrate the service with their other responsibilities in a coherent and efficient manner. Agent technology provides the means by which effective cooperation can take place without compromising the essential security of both the client and the agencies involved as the appropriate set of responses can be generated through negotiation between the parties without the need for access to the main information repositories that would be necessary with conventional collaboration models. The autonomous nature of agents also means that a variety of agents can cooperate together with various local capabilities, so long as they conform to the relevant messaging requirements. This allows a variety of agents, with capabilities tailored to the carers to which they are attached to be developed so that cost-effective solutions can be provided. </p

Mobile support in CSCW applications and groupware development frameworks

Computer Supported Cooperative Work (CSCW) is an established subset of the field of Human Computer Interaction that deals with the how people use computing technology to enhance group interaction and collaboration. Mobile CSCW has emerged as a result of the progression from personal desktop computing to the mobile device platforms that are ubiquitous today. CSCW aims to not only connect people and facilitate communication through using computers; it aims to provide conceptual models coupled with technology to manage, mediate, and assist collaborative processes. Mobile CSCW research looks to fulfil these aims through the adoption of mobile technology and consideration for the mobile user. Facilitating collaboration using mobile devices brings new challenges. Some of these challenges are inherent to the nature of the device hardware, while others focus on the understanding of how to engineer software to maximize effectiveness for the end-users. This paper reviews seminal and state-of-the-art cooperative software applications and development frameworks, and their support for mobile devices

Why Information Matters: A Foundation for Resilience

Embracing Change: The Critical Role of Information, a research project by the Internews' Center for Innovation & Learning, supported by the Rockefeller Foundation, combines Internews' longstanding effort to highlight the important role ofinformation with Rockefeller's groundbreaking work on resilience. The project focuses on three major aspects:- Building knowledge around the role of information in empowering communities to understand and adapt to different types of change: slow onset, long-term, and rapid onset / disruptive;- Identifying strategies and techniques for strengthening information ecosystems to support behavioral adaptation to disruptive change; and- Disseminating knowledge and principles to individuals, communities, the private sector, policymakers, and other partners so that they can incorporate healthy information ecosystems as a core element of their social resilience strategies

Strengthening Primary and Chronic Care: State Innovations to Transform and Link Small Practices

Presents case studies of state policies for reorganizing and improving primary and chronic care delivery among small practices, including leadership and convening, payment incentives, infrastructure support, feedback and monitoring, and certification