A SWOT Analysis of the Various Backup Scenarios Used in Electronic Medical Record Systems

Objectives: Electronic medical records (EMRs) are increasingly being used by health care services. Currently, if an EMR shutdown occurs, even for a moment, patient safety and care can be seriously impacted. Our goal was to determine the methodology needed to develop an effective and reliable EMR backup system. Methods: Our "independent backup system by medical organizations " paradigm implies that individual medical organizations develop their own EMR backup systems within their organizations. A "personal independent backup system " is defined as an individual privately managing his/her own medical records, whereas in a "central backup system by the government " the government controls all the data. A "central backup system by private enterprises " implies that individual companies retain control over their own data. A "cooperative backup system among medical organizations " refers to a networked system established through mutual agreement. The "backup system based on mutual trust between an individual and an organization " means that the medical information backup system at the organizational level is established through mutual trust. Results: Through the use of SWOT analysis it can be shown that cooperative backup among medical organizations is possible to be established through a network composed of various medical agencies and that it can be managed systematically. An owner of medical information only grants data access to the specific person who gave the authorization for backup based on the mutual trust between an individual and an organization. Conclusions: By employing SWOT analysis, we concluded that a linkage among medical organizations or between a

The anatomy of collective failure in the Netherlands

A review of evaluation findings on Dutch policy successes and failures points to the influence of political culture on policy effectiveness

Inter-rater reliability of welfare outcomeassessment by an expert and farmers of SouthTyrolean dairy farming

The implementation of an animal welfare assurance programme for dairy cattle in South Tyrol (Eastern Italian Alps) faces particular feasibility constraints due to the outstanding volume of travel associated with routine on-farm audits of remote mountain farms. Therefore, this study aims to estimate the inter-rater reliability of the expert’s and farmers’ welfare outcome assessment regarding recommendations to involve milk producers in animal welfare assurance within South Tyrolean dairy farming. A formal training programme containing a classroom session and an on-farm observation became mandatory for all 188 participating farmers, which was offered by the expert, applied as reference standard. On-farm data collected on the farmers’ cows (dataset of 1719 dairy cows) were compared at animal level. Cohen’s kappa, respectively, weighted kappa, examined for several welfare indicators, range from slight to moderate agreement(k=0.018-0.416;Kw=0.163-0.310). These findings are further confirmed by results at farmlevel (ICC=0.018-0.577). Continuous repeatability checks as part of routine audits are therefore proposed to substantially reduce the variability between the raters and to avoid significant bias in the welfare outcome assessment. In this way, the competence for regular and standardised monitoring could be increasingly transferred to dairy farmers in order to reduce the need for costly and time-consuming inspections by external auditors, which are in long-term perspective also harmful to the alpine environment. Additionally, the promotion of welfare assessment as an instructive management tool would intensify farmers’ commitment to the assessment process

The current shortage and future surplus of doctors: a projection of the future growth of the Japanese medical workforce

<p>Abstract</p> <p>Background</p> <p>Starting in the late 1980s, the Japanese government decreased the number of students accepted into medical school each year in order to reduce healthcare spending. The result of this policy is a serious shortage of doctors in Japan today, which has become a social problem in recent years. In an attempt to solve this problem, the Japanese government decided in 2007 to increase the medical student quota from 7625 to 8848. Furthermore, the Democratic Party of Japan (DPJ), Japan's ruling party after the 2009 election, promised in their manifesto to increase the medical student quota to 1.5 times what it was in 2007, in order to raise the number of medical doctors to more than 3.0 per 1000 persons. It should be noted, however, that this rapid increase in the medical student quota may bring about a serious doctor surplus in the future, especially because the population of Japan is decreasing.</p> <p>The purpose of this research is to project the future growth of the Japanese medical doctor workforce from 2008 to 2050 and to forecast whether the proposed additional increase in the student quota will cause a doctor surplus.</p> <p>Methods</p> <p>Simulation modeling of the Japanese medical workforce.</p> <p>Results</p> <p>Even if the additional increase in the medical student quota promised by the DPJ fails, the number of practitioners is projected to increase from 286 699 (2.25 per 1000 persons) in 2008 to 365 533 (over the national numerical goal of 3.0 per 1000) in 2024. The number of practitioners per 1000 persons is projected to further increase to 3.10 in 2025, to 3.71 in 2035, and to 4.69 in 2050. If the additional increase in the medical student quota promised by the DPJ is realized, the total workforce is projected to rise to 392 331 (3.29 per 1000 persons) in 2025, 464 296 (4.20 per 1,000 persons) in 2035, and 545 230 (5.73 per 1000 persons) in 2050.</p> <p>Conclusions</p> <p>The plan to increase the medical student quota will bring about a serious doctor surplus in the long run.</p

Transition to Specialty Practice Program characteristics and professional development outcomes

publisher: Elsevier articletitle: Transition to Specialty Practice Program characteristics and professional development outcomes journaltitle: Nurse Education Today articlelink: http://dx.doi.org/10.1016/j.nedt.2016.05.017 content_type: article copyright: © 2016 The Author(s). Published by Elsevier Ltd

Public health in Thailand: Emerging focus on non‐communicable diseases

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/86815/1/hpm1078.pd

Service network analysis for agricultural mental health

<p>Abstract</p> <p>Background</p> <p>Farmers represent a subgroup of rural and remote communities at higher risk of suicide attributed to insecure economic futures, self-reliant cultures and poor access to health services. Early intervention models are required that tap into existing farming networks. This study describes service networks in rural shires that relate to the mental health needs of farming families. This serves as a baseline to inform service network improvements.</p> <p>Methods</p> <p>A network survey of mental health related links between agricultural support, health and other human services in four drought declared shires in comparable districts in rural New South Wales, Australia. Mental health links covered information exchange, referral recommendations and program development.</p> <p>Results</p> <p>87 agencies from 111 (78%) completed a survey. 79% indicated that two thirds of their clients needed assistance for mental health related problems. The highest mean number of interagency links concerned information exchange and the frequency of these links between sectors was monthly to three monthly. The effectiveness of agricultural support and health sector links were rated as less effective by the agricultural support sector than by the health sector (p < .05). The most highly linked across all areas of activity were Rural Financial Counsellors, the Department of Primary Industry Drought Support Workers and Community Health Centres. Hence for a mental health service network targeting farming families these are three key agencies across the spectrum of case work to program development. The study limitations in describing service networks relate to the accuracy of network bounding, self report bias and missing data from non participants.</p> <p>Conclusion</p> <p>Aligning with agricultural agencies is important to build effective mental health service pathways to address the needs of farming populations. Work is required to ensure that these agricultural support agencies have operational and effective links to primary mental health care services. Network analysis provides a baseline to inform this work. With interventions such as local mental health training and joint service planning to promote network development we would expect to see over time an increase in the mean number of links, the frequency in which these links are used and the rated effectiveness of these links.</p

Sources of Community Health Worker Motivation: A Qualitative Study in Morogoro Region, Tanzania.

There is a renewed interest in community health workers (CHWs) in Tanzania, but also a concern that low motivation of CHWs may decrease the benefits of investments in CHW programs. This study aimed to explore sources of CHW motivation to inform programs in Tanzania and similar contexts. We conducted semi-structured interviews with 20 CHWs in Morogoro Region, Tanzania. Interviews were digitally recorded, transcribed, and coded prior to translation and thematic analysis. The authors then conducted a literature review on CHW motivation and a framework that aligned with our findings was modified to guide the presentation of results. Sources of CHW motivation were identified at the individual, family, community, and organizational levels. At the individual level, CHWs are predisposed to volunteer work and apply knowledge gained to their own problems and those of their families and communities. Families and communities supplement other sources of motivation by providing moral, financial, and material support, including service fees, supplies, money for transportation, and help with farm work and CHW tasks. Resistance to CHW work exhibited by families and community members is limited. The organizational level (the government and its development partners) provides motivation in the form of stipends, potential employment, materials, training, and supervision, but inadequate remuneration and supplies discourage CHWs. Supervision can also be dis-incentivizing if perceived as a sign of poor performance. Tanzanian CHWs who work despite not receiving a salary have an intrinsic desire to volunteer, and their motivation often derives from support received from their families when other sources of motivation are insufficient. Policy-makers and program managers should consider the burden that a lack of remuneration imposes on the families of CHWs. In addition, CHWs' intrinsic desire to volunteer does not preclude a desire for external rewards. Rather, adequate and formal financial incentives and in-kind alternatives would allow already-motivated CHWs to increase their commitment to their work