A framework for development of android mobile electronic prescription transfer applications in compliance with security requirements mandated by the Australian healthcare industry

This thesis investigates mobile electronic transfer of prescription (ETP) in compliance with the security requirements mandated by the Australian healthcare industry and proposes a framework for the development of an Android mobile electronic prescription transfer application. Furthermore, and based upon the findings and knowledge from constructing this framework, another framework is also derived for assessing Android mobile ETP applications for their security compliance. The centralised exchange model-based ETP solution currently used in the Australian healthcare industry is an expensive solution for on-going use. With challenges such as an aging population and the rising burden of chronic disease, the cost of the current ETP solution’s operational infrastructure is certain to rise in the future. In an environment where it is increasingly beneficial for patients to engage in and manage their own information and subsequent care, this current solution fails to offer the patient direct access to their electronic prescription information. The current system also fails to incorporate certain features that would dramatically improve the quality of the patient’s care and safety, i.e. alerts for the patient’s drug allergies, harmful dosage and script expiration. Over a decade old, the current ETP solution was essentially designed and built to meet legislation and regulatory requirements, with change-averting its highest priority. With little, if any, provision for future growth and innovation, it was not designed to cater to the needs of the ETP process. This research identifies the gap within the current ETP implementation (i.e. dependency on infrastructure, significant on-going cost and limited availability of the patient’s medication history) and proposes a framework for building a secure mobile ETP solution on the Android mobile operating system platform which will address the identified gap. The literature review part of this thesis examined the significance of ETP for the nation’s larger initiative to provide an improved and better maintainable healthcare system. The literature review also revealed the stance of each jurisdiction, from legislative and regulatory perspectives, in transitioning to the use of a fully electronic ETP solution. It identified the regulatory mandates of each jurisdiction for ETP as well as the security standards by which the current ETP implementation is iii governed so as to conform to those regulatory mandates. The literature review part of the thesis essentially identified and established how the Australian healthcare industry’s various prescription-related legislations and regulations are constructed, and the complexity of this construction for eTP. The jurisdictional regulatory mandates identified in the literature review translate into a set of security requirements. These requirements establish the basis of the guiding framework for the development of a security-compliant Android mobile ETP application. A number of experimentations were conducted focusing on the native security features of the Android operating system, as well as wireless communication technologies such as NFC and Bluetooth, in order to propose an alternative mobile ETP solution with security assurance comparable to the current ETP implementation. The employment of a proof-of-concept prototype such as this alongside / coupled with a series of iterative experimentations strengthens the validity and practicality of the proposed framework. The first experiment successfully proved that the Android operating system has sufficient encryption capabilities, in compliance with the security mandates, to secure the electronic prescription information from the data at rest perspective. The second experiment indicated that the use of NFC technology to implement the alternative transfer mechanism for exchanging electronic prescription information between ETP participating devices is not practical. The next iteration of the experimentation using Bluetooth technology proved that it can be utilised as an alternative electronic prescription transfer mechanism to the current approach using the Internet. These experiment outcomes concluded the partial but sufficient proofof- concept prototype for this research. Extensive document analysis and iterative experimentations showed that the framework constructed by this research can guide the development of an alternative mobile ETP solution with both comparable security assurance to and better access to the patient’s medication history than the current solution. This alternative solution would present no operational dependence upon infrastructure and its associated, ongoing cost to the nation’s healthcare expenditure. In addition, use of this mobile ETP alternative has the potential to change the public’s perception (i.e. acceptance from regulatory and security perspectives) of mobile healthcare solutions, thereby paving the way for further innovation and future enhancements in eHealth

The hare and the hortoise [sic]: The potential versus the reality of eTP implementation

In a health system increasingly driven by cost constraints, there is a focus on improved electronic transfer of information to support healthcare delivery. One area of healthcare that has moved more quickly than others to achieve this is prescribing in the primary care environment. Whilst the move to electronic transfer of prescriptions has reduced transcription errors, the regulatory environment persists with handwritten signatures. This constraint, whilst addressed slowly with technology solutions, needs support from legislative change. The ultimate step is to have a secure mobile model, which would support the move to a fully-electronic, paperless transaction model

Analysis and design of base-isolated suspension bridge under seismic loads

Suspension bridges have been firmly established as the most efficient and cost effective structural form in the 500-ft to 1500-ft span range. Today, the suspension bridge is most suitable type for very long-span bridge and actually represents 20 or more of all the longest span bridges in the world. Behavior of suspension bridge is great importance as the influence of moving loads, seismic and wind forces on these structures. Seismic isolation introduces to avoid resonance with the typical predominant frequencies of earthquakes, in order to reduce the shear forces, deflections, and floor accelerations of a building, and, consequently, prevent damage of its structural and non-structural elements. In this study damper is used as isolation and energy dissipation devices for bridge subjected to earthquake loads. The simplified model is three-span continuous and main span has 260-ft and each side span has 120-ft with a steel bridge deck. Main cables are parallel-wire strands and pylons are Portal type. The bridge is designed for equivalent traffic loads of HS 20-44 trucks specified by American Association of State Highway and Transportation Officials (AASHTO). A realistic analytical suspension bridge model is developed by using STAAD.Pro finite element program. The response spectrum analysis method is used from UBC 1997 code. This paper discusses the effect of base-isolator on design of suspension bridge. Then, compared the analysis results in different between normal support condition and spring support condition. From the comparison results, the axial force in main cable is reduced by 22.6 %. Axial forces in girder are reduced about 40 % in all members of girder under spring support condition

Future of Australia’s ETP: Script exchange, script vault or secure mobile alternative

Electronic transfer of prescriptions is an essential element of electronic medications management. Unfortunately, current manual and preliminary electronic transfer of prescription methods are not patient focussed, leading to a suboptimal solution for the patient. This is increasingly relevant in the push for more patient engagement in their own healthcare. The area is highly controlled by legislation and regulation. Through research and an analysis of the possible methods to improve and personalise electronic transfer of prescriptions, this paper provides an overview of these conclusions, and presents an alternative technical solution. The solution has been derived from a number of experiments in data transfer techniques using a mobile phone. The paper explains how this meets the current regulations and legislation, as well as providing a patient centred approach to the problem. Ultimately, healthcare outcomes will improve where patients are given the opportunity and the tools to better engage in their own healthcare management, and secure electronic transfer of prescriptions with patient access to their own medication lists may improve compliance and reduce healthcare costs

Security of eprescription: Security of data at rest in prescription exchange services vs on mobile devices

One area of healthcare that has moved more quickly than others in adopting electronic transfer of information is prescribing in the primary care environment. Several Acts and Regulations have been repealed and amended at Commonwealth and State levels to enable this progress over the past decade, as medication provision is a strictly controlled area of healthcare. Further, numerous standards and specifications have been developed and adopted to support and safeguard the regulatory changes and facilitate the electronic transfer of prescriptions. However, the current model of electronic prescription transfer comes with a substantial price tag for ongoing use. With the Nation’s growing and aging population, the number of prescriptions will increase annually, and thus it is necessary to find more cost-effective alternatives with comparable security and privacy assurances. An obvious potential solution lies in using devices that have been a part of our daily lives for well over a decade - mobile smartphones. An investigation was conducted to determine whether or not such technology is capable of meeting legislative requirements for prescribing whilst providing a cost-effective alternative prescription transfer model. Using technology such as near field communication for transfer process together with existing encryption technique demonstrates this can meet the security requirements of data at rest. This investigation established that although the proposed alternative is a work in progress and not a flawless one, it indeed opens up opportunities to incorporate many useful features in addition to eliminating the associated ongoing costs while providing comparable privacy and security assurances

Threatened ecosystems of Myanmar. An IUCN Red List of ecosystems assessment. Version 1.0.

[Excerpt:] Myanmar's Red List of Ecosystems is a tool to understand our threats and plan for conservation and sustainable management. Forests constitute the dominant ecosystems in Myanmar, and we are blessed with high forest cover (42.92%) and diversity, with 36 of our 64 ecosystems identified as forest and mangrove. These forests and biodiversity underpin a range of ecosystem services which are central to Myanmar’s sustainable development, supporting human and resource needs, and contributing to a more stable climate. The loss of forests and our biodiversity leads to degradation and deterioration of ecosystem services and threatens Myanmar’s irreplaceable ecological heritage. We often discuss ecosystem services but this study documents Myanmar’s terrestrial ecosystem typology and spatial distribution for the first time. This is one of the first ecosystem red lists developed within ASEAN and this will inform our implementation for decades to come to inform legislation, land-use planning, protected area expansion, monitoring and reporting, and ecosystem management. To sustain our forests and our biodiversity we need to sustainably manage all of these incredible ecosystems

A STUDY ON HEALTH SEEKING BEHAVIORS AND BARRIERS TO SERVICE ACCESS OF SEXUALLY TRANSMITTED DISEASES AMONG MEN WHO HAVE SEX WITH MEN (YANGON REGION)

Yangon Region is home for nearly 20% of Myanmar’s population of men who have sex with men (MSM) and high HIV/AIDS prevalence and new HIV/AIDS infection rate. Sexually Transmitted Infections (STIs) have long been recognized as a major health problem in Myanmar because STIs and their sequelae contribute significantly to morbidity and mortality in the community. This study identified the level of awareness for STDs and STD treatment seeking behaviour among MSM in Yangon and assessed their barriers and challenges affecting STD treatment-seeking behaviour. This study is a quantitative research study which was conducted by collecting data using the quantitative cross-sectional questionnaire survey to explore the health seeking behaviour in relation to sexually transmitted disease among men who have sex with men in Yangon, Myanmar. 200 respondents form each township of Yangon are conducted for study. Most of the respondents received STD knowledge from health personels and social network. Awareness score is especially lowest in ‘Tha-nge’ MSM category. Mean period of treatment seeking interval was 12.4 days among 59 respondents of the 200 sample having an STD history within 6 months, and all took treatment from healthcare workers for their last STD episode. Awareness raising activities should be targeted on all MSM, especially to the “Tha-nge”. Healthcare personals should be trained for providing proper health education and appropriate STD care and treatment, including unique behaviour and needs of the MSM community

Myanmar's terrestrial ecosystems: Status, threats and conservation opportunities

Myanmar is highly biodiverse, with more than 16,000 plant, 314 mammal, 1131 bird, 293 reptile, and 139 amphibian species. Supporting this biodiversity is a variety of natural ecosystems—mostly undescribed—including tropical and subtropical forests, savannas, seasonally inundated wetlands, extensive shoreline and tidal systems, and alpine ecosystems. Although Myanmar contains some of the largest intact natural ecosystems in Southeast Asia, remaining ecosystems are under threat from accelerating land use intensification and over-exploitation. In this period of rapid change, a systematic risk assessment is urgently needed to estimate the extent and magnitude of human impacts and identify ecosystems most at risk to help guide strategic conservation action. Here we provide the first comprehensive conservation assessment of Myanmar's natural terrestrial ecosystems using the IUCN Red List of Ecosystems categories and criteria. We identified 64 ecosystem types for the assessment, and used models of ecosystem distributions and syntheses of existing data to estimate declines in distribution, range size, and functioning of each ecosystem. We found that more than a third (36.9%) of Myanmar's area has been converted to anthropogenic ecosystems over the last 2–3 centuries, leaving nearly half of Myanmar's ecosystems threatened (29 of 64 ecosystems). A quarter of Myanmar's ecosystems were identified as Data Deficient, reflecting a paucity of studies and an urgency for future research. Our results show that, with nearly two-thirds of Myanmar still covered in natural ecosystems, there is a crucial opportunity to develop a comprehensive protected area network that sufficiently represents Myanmar's terrestrial ecosystem diversity

Boxplot comparing mean canopy cover as measured by Hansen et al. (2013) for intact and degraded forests in different forest regions of Myanmar between 2002 and 2014.

<p>Northern Sagaing = mostly mixed deciduous and evergreen forest; Southern Sagaing = mixed deciduous and dry dipterocarp forest; Tanintharyi = tropical evergreen forest. (A) Canopy cover values for intact forest; (B) Canopy Cover values for degraded forest; (C) Location of Landsat tiles used for comparison.</p