Steps towards interoperability in healthcare environment

Tese doutoramento - Programa Doutoral em Engenharia Biomédica, Informática MédicaHealthcare units have complex Information Systems (IS) made up from heterogeneous data sources, which speak di erent languages and with di erent objectives. Nevertheless, all these sources have indeed important information that can contribute in an active way to provide a healthcare system of excellence. The evolution that has been noticed in Health IS has promoted the development of new methodologies and tools that are intended to solve this complicated problem. In this manner, one of the main paradigms that arises is the interoperability among systems and its capability to allow a general and simpli ed access to relevant information. Another aspect that should be kept in mind, given the constrains of the global economic situation, is the reduction in the investment in national healthcare systems. This thesis is based on a set of studies performed at the Centro Hospitalar do T^amega e Sousa (CHTS) in which the main goals are promoting an improvement in the relation patient-hospital, having in consideration the reduction of implementation costs, but preserving the quality of information. The last one should be accessible everywhere and at anytime to help with clinical decision and, in the future, be available for clinical studies through data computationally interpretable. To do so, an Electronic Semantic Health Record was formalized and implemented, with the help of the clinical sta , which collects all the information considered important and relevant. This Health Record was delivered through a platform for the distribution and archive of clinical information, named Agency for the Integration, Di usion and Archive (AIDA), which is supported by intelligent agents that treat data in an ex-haustive and structured way. To test the proposed model and system and in order to strengthen the relation between the patient and the hospital, an appointment alert system based on SMS and electronic mail was developed, which allowed the reduction of non-programmed misses and that provided a decrease of costs by better re-distributed appointment schedules, and allocate human resources and physical spaces in a more e ective manner. Finally, to reduce stopping periods of systems and to promote the user's con dence on Information Systems, an open-source tool was developed that enables the scheduling of preventive actions according to a mathematical model. These tools allowed for a continuous improvement of systems and are currently well accepted by clinicians and Information Technologies (IT) specialists inside the healthcare unit, proving in real clinical situation the e ectiveness and usability of the model.As unidades de saúde possuem Sistemas de Informação (SI) complexos, compostos por fontes de dados heterogéneas com objectivos distintos. Por em, toda a informação e importante e pode contribuir de forma ativa para a prestação de cuidados de saúde de excelência. Com a evolução dos SI na Saúde novas metodologias têm sido desenvolvidas com o intuito de solucionar este problema complicado. Nesta perspectiva, um dos principais paradigmas que se coloca e a interoperabilidade entre sistemas e a sua capacidade para permitir um acesso simples a informação relevante. Outro factor relevante relaciona-se com os constrangimentos financeiros que toda a economia global atravessa e que se reflete numa diminuição no investimento nos servi cos nacionais de saúde. Esta tese tem como base um conjunto de estudos realizados no Centro Hospitalar do Tâmega e Sousa cujos principais objetivos se prendem com um esforço orientado para a melhoria da relação paciente-hospital, tendo em conta a redução de custos de implementação, mas garantindo sobretudo a qualidade de informação. Esta dever a estar disponível em qualquer lugar e a qualquer altura para o auxílio a decisão clinica e, em última instancia, disponível para estudos cl nicos através de dados interpretáveis computacionalmente. Para tal, recorreu-se a ajuda de pessoal clinico para a implementação de um Processo Clínico Eletrónico Semântico que recolhe toda a informação considerada relevante. Este Processo Clínico foi potenciado através de uma plataforma para a distribuição e arquivo de informação clinica, denominada de Agencia para a Interoperação, Difusão e Arquivo (AIDA), baseada em agentes inteligentes que tratam os dados de forma estruturada. Para testar o modelo e de forma a fortalecer a relação paciente-hospital foi desenvolvido um sistema de alertas para consulta via mensagens escritas e e-mail, que diminuiu o numero de faltas não programadas, proporcionando uma redução de custos através de uma redistribuição dos tempos de consulta alocando recursos humanos e físicos de forma mais eficaz. Por fim, com vista a redução dos tempos de paragem de sistemas, e potenciar a confiança dos utilizadores nos mesmos, foi desenvolvida uma ferramenta baseada em tecnologia open-source que permite o agendamento de intervenções preventivas de acordo com um modelo matemático. Esta ferramenta proporcionou uma melhoria contínua dos sistemas e está globalmente aceite por cl nicos e especialistas de Tecnologias de Informação (TI), provando em situações clínicas reais a usabilidade e eficácia do modelo

Rural Health

Rural health is the study of healthcare systems in rural settings. This book presents a comprehensive overview of rural health care and addresses such topics as human resources, maternal mortality in developing countries, safety of healthcare workers, zoonotic and veterinary diseases, and much more. Chapters include case studies and research in the field of rural health

Permissão para partilha seletiva em ambientes IoT

The increasing use of smart devices for monitoring spaces has caused an increase in concerns about the privacy of users of these spaces. Given this problem, the legislation on the right to privacy has been worked to ensure that the existing laws on this subject are sufficiently comprehensive to preserve the privacy of users. In this way, research on this topic evolves in the sense of creating systems that ensure compliance with these laws, that is, increase transparency in the treatment of user data. In the context of this dissertation, a demonstrator-based strategy is presented to provide users control over their stored data during the temporary use of an intelligent environment. In addition, this strategy includes transparency guarantees, highlights the right to forgetting, provides the ability to consent and proof of that consent. A strategy for privacy control in such environments is also mentioned in this paper. This dissertation was developed within the CASSIOPEIA project where the case study focuses on the SmartBnB problem where a user rents a smart home for a limited time. This paper presents the developed system that ensures the user’s privacy and control over their data.O uso crescente de dispositivos inteligentes para monitorização de espaços tem provocado um aumento das preocupações sobre a privacidade dos utilizadores destes espaços. Face a este problema, a legislação sobre o direito à privacidade tem sido trabalhada de forma a garantir que as leis existentes sobre este tema são suficientemente abrangentes para preservar a privacidade dos utilizadores. Desta forma, a investigação neste tópico evolui no sentido de criar sistemas que garantam o cumprimento destas leis, ou seja aumentam a transparência no tratamentos dos dados dos utilizadores. No contexto desta dissertação, é apresentada uma estratégia baseado num demonstrador para fornecer um controlo ao utilizador sobre os seus dados armazenados durante a utilização temporária de um ambiente inteligente. Para além disso, esta estratégia inclui garantias de transparência, evidencia o direito ao esquecimento, fornece a capacidade de consentimento e prova desse consentimento. É também mencionada neste documento uma estratégia para um controlo de privacidade neste tipo de ambientes. Esta dissertação foi desenvolvida no âmbito do projeto CASSIOPEIA onde o caso de estudo se foca no SmartBnB problem onde um utilizador arrenda uma casa inteligente durante um tempo limitado. Este documento apresenta o sistema desenvolvido que garante a privacidade e controlo do utilizador sobre os seus próprios dados.This work is partially funded by NGI Trust, with number 3.85, Pro-ject CASSIOPEIA.Mestrado em Engenharia de Computadores e Telemátic

Holistic Approach Framework for Cloud Computing Strategic Decision-Making in the Healthcare Sector (HAF-CCS)

Cloud Computing is an evolving information technology paradigm that impacts many sectors in many countries. Cloud Computing offers IT services anytime, anywhere via any device and is applicable to healthcare organisations, offering a potential cost saving of 15% to 37%. This research investigates Cloud Computing as a facilitating technology to solve some of the challenges experienced by healthcare organisations such as the high cost of implementing IT solutions. The purpose of this research is to develop and apply an Holistic Approach Framework for Cloud Computing Strategic Decision-Making in the Healthcare Sector (HAF-CCS) to provide a systematic approach to the adoption of Cloud Computing that considers different perspectives. Although, Cloud Computing is becoming widely used, there is limited evidence in the literature concerning its application in the Saudi healthcare sector. In the thesis, current cloud adoption decision-making frameworks are analysed and the need to develop a strategic framework for Cloud Computing decision-making processes which emphasises a multidisciplinary holistic approach is identified. Understanding the different strategic aspects of Cloud Computing is important and could encourage organisations to adopt this model of computing since the decision regarding whether to adopt Cloud Computing is potentially a complex process; there are many perspectives to be considered, and studying this process requires a multiple perspective framework. The framework developed in this thesis aims to support decision-makers in healthcare organisations by covering five perspectives of Cloud Computing adoption: Organisation, Technology, Environment, Human and Business. The framework integrates the TOE (Technology-Organisation-Environment) framework with the Information Systems Strategy Triangle (IS Triangle) and the HOT-fit (Human- Organisation-Technology) model to support an holistic evaluation of the determinants of Cloud Computing adoption in healthcare organisations. The factors that will affect Cloud Computing adoption in healthcare organisations in Saudi Arabia have been identified using quantitative and qualitative methods, and a case study approach was implemented to validate the framework. The results of the validation showed that the framework can support decision-makers in understanding an organisation’s position regarding Cloud Computing and identifying any gaps that may hinder Cloud Computing adoption. The framework can also provide healthcare organisations with a strategic assessment tool to help in gaining the advantages of Cloud Computing

Governance and Empowerment in Clinical Encounters: An Ethnography of Toronto's Sexual Health Landscape

This dissertation is an ethnography of the clinic. My fieldsite was a sexual health organization, comprised of what I call The Centre and The Mobile. Created in the 1970s, The Centre was a pioneering force in the history of sexual health care and the women’s health movement in Toronto, Ontario, Canada. This organization was created by and for immigrant women with the goal of providing free and accessible sexual health care. However, providing sexual health care to these populations in Canada’s public health care system needs to be understood in terms of the increasing emphasis placed on the managerial tasks of reporting as a form of accountability. I use the conceptual framework of sexual health governance to examine the delivery of sexual health care in Toronto. Sexual health governance is an assemblage of institutions, social actors, and expert knowledge, which regulates, counts, and fosters sexual health via technologies of care, surveillance, and metrics. In this dissertation, I ask: How is the sexual health landscape organized, and how does the sexual health governance shape everyday practices and experiences of care? I carried out participant observation in The Mobile and The Centre. I interviewed an array of sexual health social actors, including counsellors, physicians, administrative staff, executive directors, volunteers, sexual health promoters, and clients. In this dissertation, I argue that both The Centre and The Mobile were a part of, and were shaped by, sexual health governance. While their funding requirements meant they had to carefully manage their metric data (counting clients and services), they also remained productive spaces for meaningful forms of care. I argue that sexual health social actors were invested in biomedicine while also seeking to do it differently via valuing choice, bodily autonomy, and agency. Clients, too, exercised agency-within-compliance as they accessed sexual health care, both desiring biomedical information and care while also challenging it, revealing nuance in the operations of neoliberal disciplinary power. This is a dissertation about entanglements—highlighting the tension between care and surveillance, empowerment and governance—through an ethnographic study of sexual health clinical encounters and the meaning this held for the landscape’s social actors

Congress UPV Proceedings of the 21ST International Conference on Science and Technology Indicators

This is the book of proceedings of the 21st Science and Technology Indicators Conference that took place in València (Spain) from 14th to 16th of September 2016. The conference theme for this year, ‘Peripheries, frontiers and beyond’ aimed to study the development and use of Science, Technology and Innovation indicators in spaces that have not been the focus of current indicator development, for example, in the Global South, or the Social Sciences and Humanities. The exploration to the margins and beyond proposed by the theme has brought to the STI Conference an interesting array of new contributors from a variety of fields and geographies. This year’s conference had a record 382 registered participants from 40 different countries, including 23 European, 9 American, 4 Asia-Pacific, 4 Africa and Near East. About 26% of participants came from outside of Europe. There were also many participants (17%) from organisations outside academia including governments (8%), businesses (5%), foundations (2%) and international organisations (2%). This is particularly important in a field that is practice-oriented. The chapters of the proceedings attest to the breadth of issues discussed. Infrastructure, benchmarking and use of innovation indicators, societal impact and mission oriented-research, mobility and careers, social sciences and the humanities, participation and culture, gender, and altmetrics, among others. We hope that the diversity of this Conference has fostered productive dialogues and synergistic ideas and made a contribution, small as it may be, to the development and use of indicators that, being more inclusive, will foster a more inclusive and fair world

IFPOC Symposium:Discovering antecedents and consequences of complex change recipients' reactions to organizational change.

IFPOC symposium: Discovering antecedents and consequences of complex change recipients' reactions to organizational change Chairs: Maria Vakola (Athens University of Economics and Business) & Karen Van Dam (Open University) Discussant: Mel Fugate (American University, Washington, D.C) State of the art Organisations are required to continuously change and develop but there is a high failure rate associated with change implementation success. In the past two decades, change researchers have started to investigate change recipients' reactions to change recognizing the crucial role of these reactions for successful change. This symposium aims at identifying and discussing the complex processes that underlie the relationships among antecedents, reactions and outcomes associated with organizational change. New perspective / contributions This symposium consists of five studies that extend our knowledge in the field by (i) providing an analysis of change recipients' reactions going beyond the dichotomous approaches (acceptance or resistance) (ii) revealing understudied antecedents-reactions and reactions-consequences patterns and relationships (iii) shedding light on the role of contextual factors i.e team climate and individual factors i.e emotion regulation on the adaptation to change. This symposium is based on a combination of both quantitative (i.e diary, survey) and qualitative (i.e interviews) research methodology. Research / practical implications This symposium aims to increase our understanding of the complex processes associated with change recipients' reactions to change. Discovering how these reactions are created and what are their results may reveal important contingencies that can explain how positive organizational outcomes during times of change can be stimulated which is beneficial for both researchers and practitioners

Qigong at Work: Where East Meets West

State of the Art Qigong is part of Traditional Chinese Medicine (TMC) and aims to balance body and mind. The roots of Qigong lie in China, where Confucian and Daoist scholars (500-400 B.C.) noted that one must learn to balance and relax one’s thoughts and emotions to avoid illness (Yang, 1997). In the Western world, Qigong is best known for its slow and coordinated movements. According to TCM, these movements will help regulate one’s ‘qi’, or life energy, through the body to improve the health and harmony of mind and body. During the practice of Qigong, one’s breathing, attention and movement are aligned. As such, Qigong is sometimes considered Mindfulness in movement (although there are many important differences). New perspectives / contributionsQigong has many positive outcomes on health and wellness. In both patient groups and healthy individuals, Qigong has been shown to improve psychological well-being, quality of life, immune function, balance and related risk-factors, and bone density (Jahnke et al., 2010). As such, Qigong offers a validated way to reduce the physical and mental activation that results from a person's work. While recent research has demonstrated how important it is to take short breaks at work, there is still little attention for Qigong exercises as a means to recover at work.Practical Implications In this presentation, we will explain and practice several Qigong exercises. These movements can be used at work (and at home) to recover from (hormonal) activation, ‘empty’ one’s head, and restore the body-mind balance. <br/