Business models for sustained ehealth implementation: lessons from two continents

There is general consensus that Computers and Information Technology have the potential to enhance health systems applications, and many good examples of such applications exist all over the world. Unfortunately, with respect to eHealth and telemedicine, there is much disillusionment and scepticism. This paper describes two models that were developed separately, but had the same purpose, namely to facilitate a holistic approach to the development and implementation of eHealth solutions. The roadmap of the Centre for eHealth Research (CeHRes roadmap) was developed in the Netherlands, and the Telemedicine Maturity Model (TMMM) was developed in South Africa. The purpose of this paper is to analyse the commonalities and differences of these approaches, and to explore how they can be used to complement each other. The first part of this paper comprises of a comparison of these models in terms of origin, research domain and design principles. Case comparisons are then presented to illustrate how these models complement one another

Development of a web-based intervention for the indicated prevention of depression

BACKGROUND: To reduce the large public health burden of the high prevalence of depression, preventive interventions targeted at people at risk are essential and can be cost-effective. Web-based interventions are able to provide this care, but there is no agreement on how to best develop these applications and often the technology is seen as a given. This seems to be one of the main reasons that web-based interventions do not reach their full potential. The current study describes the development of a web-based intervention for the indicated prevention of depression, employing the CeHRes (Center for eHealth Research and Disease Management) roadmap. The goals are to create a user-friendly application which fits the values of the stakeholders and to evaluate the process of development. METHODS: The employed methods are a literature scan and discussion in the contextual inquiry; interviews, rapid prototyping and a requirement session in the value specification stage; and user-based usability evaluation, expert-based usability inspection and a requirement session in the design stage. RESULTS: The contextual inquiry indicated that there is a need for easily accessible interventions for the indicated prevention of depression and web-based interventions are seen as potentially meeting this need. The value specification stage yielded expected needs of potential participants, comments on the usefulness of the proposed features and comments on two proposed designs of the web-based intervention. The design stage yielded valuable comments on the system, content and service of the web-based intervention. CONCLUSIONS: Overall, we found that by developing the technology, we successfully (re)designed the system, content and service of the web-based intervention to match the values of stakeholders. This study has shown the importance of a structured development process of a web-based intervention for the indicated prevention of depression because: (1) it allows the development team to clarify the needs that have to be met for the intervention to be of use to the target audience; and (2) it yields feedback on the design of the application that is broader than color and buttons, but encompasses comments on the quality of the service that the application offers

Spatial and environmental assessment of energy potentials for Anaerobic Digestion production systems applied to the Netherlands

Anaerobic digestion (AD) can play an important role in achieving the renewable energy goals set within the European Union. Within this article the focus is placed on reaching the Dutch local renewable production goal set for the year 2020 with locally available biomass waste flows, avoiding intensive farming and long transport distances of biomass and energy carriers. The bio-energy yields, efficiency and environmental sustainability are analyzed for five municipalities in the northern part of the Netherlands, using three utilization pathways: green gas production, combined heat and power, and waste management. Literature has indicated that there is sufficient bio-energy potential in local waste streams to reach the aforementioned goal. However, the average useful energy finally produced by the AD production pathway is significantly lower, often due to poor quality biomass and difficult harvesting conditions. Furthermore, of the potential bio-energy input in the three utilization pathways considered in this article, on average: 73% can be extracted as green gas; 57% as heat and power; and 44% as green gas in the waste management pathway. This demonstrates that the Dutch renewable production goal cannot be reached. The green gas utilization pathway is preferable for reaching production goals as it retains the highest amount of energy from the feedstock. However, environmental sustainability favors the waste management pathway as it has a higher overall efficiency, and lower emissions and environmental impacts. The main lessons drawn from the aforementioned are twofold: there is a substantial gap between bio-energy potential and net energy gain; there is also a gap between top-down regulation and actual emission reduction and sustainability. Therefore, a full life cycle-based understanding of the absolute energy and environmental impact of biogas production and utilization pathways is required to help governments to develop optimal policies serving a broad set of sustainable objectives. Well-founded ideas and decisions are needed on how best to utilize the limited biomass availability most effectively and sustainably in the near and far future, as biogas can play a supportive role for integrating other renewable sources into local decentralized energy systems as a flexible and storable energy source. (C) 2016 Elsevier Ltd. All rights reserved

Evaluation of perceived persuasiveness constructs by combining user tests and expert assessments

To develop effective behaviour change support systems, persuasive technology can be used. The persuasive systems design model offers a framework to identify and operationalize such elements. In this pilot study, we evaluate the questionnaire developed to measure perceived persuasiveness of information technology. We analyzed verbatim user-test transcripts, and performed expert-assessments of the Nurse Antibiotic Information App (NAIA). These data were compared to questionnaire results on this app. Expert-assessment identified task support, perceived persuasiveness, unobtrusiveness, credibility, perceived effort and perceived effectiveness (as defined in the Persuasive Systems Design model) as being present within the NAIA. These constructs also scored satisfactory in the questionnaire. User-test transcripts are in line with questionnaire results. Given the consistent results in this pilot study, our approach seems promising for evaluating the questionnaire and will be applied to other settings and websites/application

Modeling biogas chains

Within the Flexigas project a model has been constructed which can analyze the efficiency, carbon footprint and environmental impact of anaerobic biogas production chains

Gebruik van nieuwe media tijdens een infectieziekte-uitbraak

De opkomst van de nieuwe media (Facebook, Twitter en Wikipedia) biedt nieuwe mogelijkheden om te communiceren met burgers in tijden van een infectieziekte-uitbraak. Op dit moment is het echter onduidelijk welke rol zij kunnen spelen tijdens een uitbraak. Moeten GGD’en bijvoorbeeld gaan twitteren om burgers op de hoogte te houden? In andere crisissituaties, zoals natuurrampen (1) of de Arabische lente (2) bleken sociale media zeer waardevol, wat de indruk wekt dat ook publieke gezondheidsorganisaties deze media moeten meenemen in hun crisiscommunicatieplan. Deze studie wil bijdragen aan het vormgeven van deze communicatieplannen en heeft als hoofdvraag: Gebruiken burgers nieuwe media tijdens een infectieziekte-uitbraak om op de hoogte te blijven en om antwoorden te vinden op hun vragen? En indien dit het geval is, welke nieuwe media gebruiken ze dan en met welk doel