Enabling an Agile Information Supply Chain in Service Oriented Architectures with Web Services

The Information Systems (IS) leadership in enterprises share common pervasive agility issues associated with corporate data management, such as providing access when and where needed, data validation and integrity issues, analyzing data housed in disparate systems, and reporting consolidated data to applicable parties. To address these problems some organizations are employing Service-Oriented Architectures (SOA) as a paradigm, which is enhanced by the use of web services, to provide a lightweight means of leveraging resources. The Federal Financial Institutions Examinations Council (FFIEC) is one such organization and we use the traditional systems analysis and design (SAD) approach to frame how the FFIEC employed SOA as a new paradigm of conducting business with web services. We provide lessons learned that are concerned with initiating SOA with web services in order to achieve an agile information supply chain

The Veterans Administration’s Care and Coordination Home Telehealth Program (CCHT) in Action: Merging “Home” and “Health”

This article discusses a home telehealth project that employs innovative informatics and telemedicine technologies to meet the needs of a Veterans Affairs Medical Center (VAMC). We provide background information concerning the project and program management issues inclusive of the methods for patient selection process, the decision support system used in this process, and descriptions of the home telehealth technologies. Our goal is to articulate program management insights incurred in the implementation of the project to provide useful information to other healthcare systems considering home telehealth as a contemporary option for care delivery

Integrating Self-Service Kiosks into Healthcare Delivery Organizations

Self-service kiosks in healthcare delivery organizations (HDOs) have the potential to provide operational efficiencies and customer service benefits. Yet to date there has been little research on how organizations can effectively integrate these self-service technologies into the point-of-service to achieve these potential benefits. This research-in-progress study addresses this research gap by studying a multi-phase pilot project being conducted within an integrated U.S. healthcare system. The same kiosk hardware and software is being deployed within several outpatient clinics at four medical centers, and adoption by several interdependent user groups is needed to achieve administrative and clinical benefits. Qualitative research methods are used to analyze interview data collected from key stakeholders. Pre- and post- implementation findings are presented as well as a preliminary model that details influential variables specific to the HDO context

Studying the Role of Human Nature in Technology Acceptance

Humans are complex, evolved, social and cognitive beings. Thus, understanding their behavior is a complex task that requires a comprehensive theoretical repertoire. In this paper, we study the role of human nature in technology acceptance. We come to understand that by expanding our theoretical ontology and blending theories of evolutionary psychology, social, and cognitive psychology into a single frame, we gain a more comprehensive view that helps to better explain what drives humans to form reactions toward technology and to exhibit various usage behaviors. We situate the study in four different hospital settings using a case study method. By examining acceptance of mobile information technology (MICT) amongst nurses, we find that human nature in form of four drives has a bearing on technology acceptance and use in a manner that has not been adequately addressed in traditional IS literature

Healthcare IT Adoption under Different Government Models: Debating the HITECH Impacts

Governments around the world are investing in healthcare as they attempt to increase access to care and the quality of care, while simultaneously lowering the costs of providing care. Many of these investments are in healthcare IT (HIT). The IT software industry is preparing for intensive competition for their HIT packages and workers in response to government and private industry investments. Yet different national healthcare models have produced widely differing healthcare outcomes and HIT adoption rates, with the U.S. performing poorly on both. The objective of this panel is to provide insights based on HIT research conducted in multiple healthcare contexts under different national government models, and then to engage the panel audience in debating the prospects for success of three IT-enabled healthcare delivery reforms being government-funded in the U.S. over the next 5 years. Our larger goal is to provide a forum for information sharing that will motivate other IS researchers across the global IS research community to contribute to the design of solutions and the capturing of best practices that will address some of the key goals of IT-enabled healthcare reform: improved access and quality, and decreased costs

Stress Evolution in Composite Silicon Electrodes during Lithiation/Delithiation

We report real-time average stress measurements on composite silicon electrodes made with two different binders [Carboxymethyl cellulose (CMC), and polyvinylidene fluoride (PVDF)] during electrochemical lithiation and delithiation. During galvanostatic lithiation at very slow rates, the stress in a CMC-based electrode becomes compressive and increases to 70 MPa, where it reaches a plateau and increases slowly thereafter with capacity. The PVDF-based electrode exhibits similar behavior, although with lower peak compressive stress of about 12 MPa. These initial experiments indicate that the stress evolution in a Si composite electrode depends strongly on the mechanical properties of the binder. Stress data obtained from a series of lithiation/delithiation cycles suggests plasticity induced irreversible shape changes in contacting Si particles, and as a result, the stress response of the system during any given lithiation/delithiation cycle depends on the cycling history of the electrode. While these results constitute the first in-situ stress measurements on composite Si electrodes during electrochemical cycling, the diagnostic technique described herein can be used to assess the mechanical response of a composite electrode made with other active material/binder combinations.Comment: 22 pages, 8 figure

A Call for a Rational Polypharmacy Policy: International Insights From Psychiatrists

OBJECTIVE: Recently, rational polypharmacy approaches have been proposed, regardless of the lower risk and cost of monotherapy. Considering monotherapy as first-line treatment and polypharmacy as rational treatment, a balanced attitude toward polypharmacy is recommended. However, the high prevalence of polypharmacy led the Japanese government to establish a polypharmacy reduction policy. Based on this, the association between the policy and psychiatrists' attitude toward polypharmacy has been under debate. METHODS: We developed an original questionnaire about Psychiatrists' attitudes toward polypharmacy (PAP). We compared the PAP scores with the treatment decision-making in clinical case vignettes. Multiple regression analyses were performed to quantify associations of explanatory variables including policy factors and PAP scores. The anonymous questionnaires were administered to psychiatrists worldwide. RESULTS: The study included 347 psychiatrists from 34 countries. Decision-making toward polypharmacy was associated with high PAP scores. Multiple regression analysis revealed that low PAP scores were associated with the policy factor (β=-0.20, p=0.004). The culture in Korea was associated with high PAP scores (β=0.34, p<0.001), whereas the culture in India and Nepal were associated with low scores (β=-0.15, p=0.01, and β=-0.17, p=0.006, respectively). CONCLUSION: Policy on polypharmacy may influence psychiatrists' decision-making. Thus, policies considering rational polypharmacy should be established

Determining the Best Immunization Strategy for Protecting African Children Against Invasive Salmonella Disease.

BACKGROUND: The World Health Organization recently prequalified a typhoid conjugate vaccine (TCV), recommending its use in persons ≥6 months to 45 years residing in typhoid fever (TF)-endemic areas. We now need to consider how TCVs can have the greatest impact in the most vulnerable populations. METHODS: The Typhoid Fever Surveillance in Africa Program (TSAP) was a blood culture-based surveillance of febrile patients from defined populations presenting at healthcare facilities in 10 African countries. TF and invasive non-typhoidal Salmonella (iNTS) disease incidences were estimated for 0-10 year-olds in one-year age increments. RESULTS: Salmonella Typhi and iNTS were the most frequently isolated pathogens; 135 and 94 cases were identified, respectively. Analysis from three countries was excluded (incomplete person-years of observation (PYO) data). Thirty-seven of 123 TF cases (30.1%) and 71/90 iNTS disease cases (78.9%) occurred in children aged <5 years. No TF and 8/90 iNTS infections (8.9%) were observed in infants aged <9 months. The TF incidences (/100 000 PYO) for children aged <1 year and 1 to <2 years were 5 and 39, respectively; the highest incidence was 304 per 100 000 PYO in 4 to <5 year-olds. The iNTS disease incidence in the defined age groups ranged between 81 and 233 per 100 000 PYO, highest in 1 to <2 year-olds. TF and iNTS disease incidences were higher in West Africa. CONCLUSIONS: High burden of TF detected in young children strengthens the need for TCV introduction. Given the concurrent iNTS disease burden, development of a trivalent vaccine against S. Typhi, S. Typhimurium, and S. Enteritidis may be timely in this region

Carboplatin in BRCA1/2-mutated and triple-negative breast cancer BRCAness subgroups: the TNT Trial

Germline mutations in BRCA1/2 predispose individuals to breast cancer (termed germline-mutated BRCA1/2 breast cancer, gBRCA-BC) by impairing homologous recombination (HR) and causing genomic instability. HR also repairs DNA lesions caused by platinum agents and PARP inhibitors. Triple-negative breast cancers (TNBCs) harbor subpopulations with BRCA1/2 mutations, hypothesized to be especially platinum-sensitive. Cancers in putative ‘BRCAness’ subgroups—tumors with BRCA1 methylation; low levels of BRCA1 mRNA (BRCA1 mRNA-low); or mutational signatures for HR deficiency and those with basal phenotypes—may also be sensitive to platinum. We assessed the efficacy of carboplatin and another mechanistically distinct therapy, docetaxel, in a phase 3 trial in subjects with unselected advanced TNBC. A prespecified protocol enabled biomarker–treatment interaction analyses in gBRCA-BC and BRCAness subgroups. The primary endpoint was objective response rate (ORR). In the unselected population (376 subjects; 188 carboplatin, 188 docetaxel), carboplatin was not more active than docetaxel (ORR, 31.4% versus 34.0%, respectively; P = 0.66). In contrast, in subjects with gBRCA-BC, carboplatin had double the ORR of docetaxel (68% versus 33%, respectively; biomarker, treatment interaction P = 0.01). Such benefit was not observed for subjects with BRCA1 methylation, BRCA1 mRNA-low tumors or a high score in a Myriad HRD assay. Significant interaction between treatment and the basal-like subtype was driven by high docetaxel response in the nonbasal subgroup. We conclude that patients with advanced TNBC benefit from characterization of BRCA1/2 mutations, but not BRCA1 methylation or Myriad HRD analyses, to inform choices on platinum-based chemotherapy. Additionally, gene expression analysis of basal-like cancers may also influence treatment selection