90 research outputs found
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
An Infrastructure for Cost-Effective Testing of Operational Support Algorithms Based on Colored Petri Nets
Operational support is a specific type of process mining that assists users while process instances are being executed. Examples are predicting the remaining processing time of a running insurance claim and recommending the action that minimizes the treatment costs of a particular patient. Whereas it is easy to evaluate prediction techniques using cross validation, the evaluation of recommendation techniques is challenging as the recommender influences the execution of the process. It is therefore impossible to simply use historic event data. Therefore, we present an approach where we use a colored Petri net model of user behavior to drive a real workflow system and real implementations of operational support, thereby providing a way of evaluating algorithms for operational support before implementation and a costly test using real users. In this paper, we evaluate algorithms for operational support using different user models. We have implemented our approach using Access/CPN 2.0
Predictive factors for sustained pain after (sub)acute osteoporotic vertebral fractures:Combined results from the VERTOS II and VERTOS IV trial
PURPOSE: Osteoporotic vertebral compression fractures are treated conservatively or in selected cases with percutaneous vertebroplasty (PV). The purpose of this retrospective analysis is to determine predictive factors for a high visual analogue scale (VAS) pain score after conservative, sham or PV and is based on previously published randomized trials. METHODS: The VERTOS II compared conservative versus PV, and VERTOS IV compared sham versus PV treatment. The conservative group received pain medication. The sham and PV group received subcutaneous lidocaine/bupivacaine. In addition, the PV group received cementation, which was simulated in the sham group. Nineteen different predictors of high (≥ 5) versus low ( 8, long-term baseline pain, mild/severe Genant and new fractures. CONCLUSIONS: Statistically significant more patients had a high pain score at 12 months in the sham and conservative group when compared with the PV group. Five predictors were identified for sustained high local back pain, regardless of the received treatment. Patients with moderate fracture deformity were less likely to have high pain scores at 12 months if they received PV than if they had sham or conservative therapy. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00270-022-03170-7
What Shall I Do Next? Intention Mining for Flexible Process Enactment
International audienceBesides the benefits of flexible processes, practical implementations of process aware information systems have also revealed difficulties encountered by process participants during enactment. Several support and guidance solutions based on process mining have been proposed, but they lack a suitable semantics for human reasoning and decisions making as they mainly rely on low level activities. Applying design science, we created FlexPAISSeer, an intention mining oriented approach, with its component artifacts: 1) IntentMiner which discovers the intentional model of the executable process in an unsupervised manner; 2) In-tentRecommender which generates recommendations as intentions and confidence factors, based on the mined intentional process model and probabilistic calculus. The artifacts were evaluated in a case study with a Netherlands software company, using a Childcare system that allows flexible data-driven process enactment
Enriching Business Process Models with Decision Rules
Making the right decisions in time is one of the key tasks in every business. In this context, decision theory fosters decision-making based on well-defined decision rules. The latter evaluate a given set of input parameters and utilize evidenced data in order to determine an optimal alternative out of a given set of choices. In particular, decision rules are relevant in the context business processes as well. Contemporary process modeling languages, however, have not incorporated decision theory yet, but mainly consider rather simple, guard-based decisions that refer to process-relevant data. To remedy this drawback, this paper introduces an approach that allows embedding decision problems in business process models and applying decision rules to deal with them. As a major benefit, it becomes possible to automatically determine optimal execution paths during run time
Polarization effects in the ionization cross section of Ar, Kr, and Xe by laser-excited Ne**[(2p)5(3p);J=3,M] atoms
Evaluation of integrated care services in Catalonia: Population-based and service-based real-life deployment protocols
Background: Comprehensive assessment of integrated care deployment constitutes a major challenge to ensure quality, sustainability and transferability of both healthcare policies and services in the transition toward a coordinated service delivery scenario. To this end, the manuscript articulates four different protocols aiming at assessing large-scale implementation of integrated care, which are being developed within the umbrella of the regional project Nextcare (2016-2019), undertaken to foster innovation in technologically-supported services for chronic multimorbid patients in Catalonia (ES) (7.5 M inhabitants). Whereas one of the assessment protocols is designed to evaluate population-based deployment of care coordination at regional level during the period 2011-2017, the other three are service-based protocols addressing: i) Home hospitalization; ii) Prehabilitation for major surgery; and, iii) Community-based interventions for frail elderly chronic patients. All three services have demonstrated efficacy and potential for health value generation. They reflect different implementation maturity levels. While full coverage of the entire urban health district of Barcelona-Esquerra (52
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