Computerization of workflows, guidelines and care pathways: a review of implementation challenges for process-oriented health information systems

There is a need to integrate the various theoretical frameworks and formalisms for modeling clinical guidelines, workflows, and pathways, in order to move beyond providing support for individual clinical decisions and toward the provision of process-oriented, patient-centered, health information systems (HIS). In this review, we analyze the challenges in developing process-oriented HIS that formally model guidelines, workflows, and care pathways. A qualitative meta-synthesis was performed on studies published in English between 1995 and 2010 that addressed the modeling process and reported the exposition of a new methodology, model, system implementation, or system architecture. Thematic analysis, principal component analysis (PCA) and data visualisation techniques were used to identify and cluster the underlying implementation ‘challenge’ themes. One hundred and eight relevant studies were selected for review. Twenty-five underlying ‘challenge’ themes were identified. These were clustered into 10 distinct groups, from which a conceptual model of the implementation process was developed. We found that the development of systems supporting individual clinical decisions is evolving toward the implementation of adaptable care pathways on the semantic web, incorporating formal, clinical, and organizational ontologies, and the use of workflow management systems. These architectures now need to be implemented and evaluated on a wider scale within clinical settings

Student-Centered Learning: Functional Requirements for Integrated Systems to Optimize Learning

The realities of the 21st-century learner require that schools and educators fundamentally change their practice. "Educators must produce college- and career-ready graduates that reflect the future these students will face. And, they must facilitate learning through means that align with the defining attributes of this generation of learners."Today, we know more than ever about how students learn, acknowledging that the process isn't the same for every student and doesn't remain the same for each individual, depending upon maturation and the content being learned. We know that students want to progress at a pace that allows them to master new concepts and skills, to access a variety of resources, to receive timely feedback on their progress, to demonstrate their knowledge in multiple ways and to get direction, support and feedback from—as well as collaborate with—experts, teachers, tutors and other students.The result is a growing demand for student-centered, transformative digital learning using competency education as an underpinning.iNACOL released this paper to illustrate the technical requirements and functionalities that learning management systems need to shift toward student-centered instructional models. This comprehensive framework will help districts and schools determine what systems to use and integrate as they being their journey toward student-centered learning, as well as how systems integration aligns with their organizational vision, educational goals and strategic plans.Educators can use this report to optimize student learning and promote innovation in their own student-centered learning environments. The report will help school leaders understand the complex technologies needed to optimize personalized learning and how to use data and analytics to improve practices, and can assist technology leaders in re-engineering systems to support the key nuances of student-centered learning

Integrating IVHM and Asset Design

Integrated Vehicle Health Management (IVHM) describes a set of capabilities that enable effective and efficient maintenance and operation of the target vehicle. It accounts for the collection of data, conducting analysis, and supporting the decision-making process for sustainment and operation. The design of IVHM systems endeavours to account for all causes of failure in a disciplined, systems engineering, manner. With industry striving to reduce through-life cost, IVHM is a powerful tool to give forewarning of impending failure and hence control over the outcome. Benefits have been realised from this approach across a number of different sectors but, hindering our ability to realise further benefit from this maturing technology, is the fact that IVHM is still treated as added on to the design of the asset, rather than being a sub-system in its own right, fully integrated with the asset design. The elevation and integration of IVHM in this way will enable architectures to be chosen that accommodate health ready sub-systems from the supply chain and design trade-offs to be made, to name but two major benefits. Barriers to IVHM being integrated with the asset design are examined in this paper. The paper presents progress in overcoming them, and suggests potential solutions for those that remain. It addresses the IVHM system design from a systems engineering perspective and the integration with the asset design will be described within an industrial design process

Architectural implications for context adaptive smart spaces

Buildings and spaces are complex entities containing complex social structures and interactions. A smart space is a composite of the users that inhabit it, the IT infrastructure that supports it, and the sensors and appliances that service it. Rather than separating the IT from the buildings and from the appliances that inhabit them and treating them as separate systems, pervasive computing combines them and allows them to interact. We outline a reactive context architecture that supports this vision of integrated smart spaces and explore some implications for building large-scale pervasive systems

Towards goal-based autonomic networking

The ability to quickly deploy and efficiently manage services is critical to the telecommunications industry. Currently, services are designed and managed by different teams with expertise over a wide range of concerns, from high-level business to low level network aspects. Not only is this approach expensive in terms of time and resources, but it also has problems to scale up to new outsourcing and/or multi-vendor models, where subsystems and teams belong to different organizations. We endorse the idea, upheld among others in the autonomic computing community, that the network and system components involved in the provision of a service must be crafted to facilitate their management. Furthermore, they should help bridge the gap between network and business concerns. In this paper, we sketch an approach based on early work on the hierarchical organization of autonomic entities that possibly belong to different organizations. An autonomic entity governs over other autonomic entities by defining their goals. Thus, it is up to each autonomic entity to decide its line of actions in order to fulfill its goals, and the governing entity needs not know about the internals of its subordinates. We illustrate the approach with a simple but still rich example of a telecom service

Integrating IVHM and asset design

Integrated Vehicle Health Management (IVHM) describes a set of capabilities that enable effective and efficient maintenance and operation of the target vehicle. It accounts for the collecting of data, conducting analysis, and supporting the decision-making process for sustainment and operation. The design of IVHM systems endeavours to account for all causes of failure in a disciplined, systems engineering, manner. With industry striving to reduce through-life cost, IVHM is a powerful tool to give forewarning of impending failure and hence control over the outcome. Benefits have been realised from this approach across a number of different sectors but, hindering our ability to realise further benefit from this maturing technology, is the fact that IVHM is still treated as added on to the design of the asset, rather than being a sub-system in its own right, fully integrated with the asset design. The elevation and integration of IVHM in this way will enable architectures to be chosen that accommodate health ready sub-systems from the supply chain and design trade-offs to be made, to name but two major benefits. Barriers to IVHM being integrated with the asset design are examined in this paper. The paper presents progress in overcoming them, and suggests potential solutions for those that remain. It addresses the IVHM system design from a systems engineering perspective and the integration with the asset design will be described within an industrial design process