Applied Bimatics - An Informatics & eHealth Blog

Critical Success Factors in Electronic Health Records (EHR) Implementation

2017-02-28T21:28:00.000-05:00

Critical Success Factors in Electronic Health Records (EHR) Implementation: Electronic Health Records (EHR) has been the subject of much academic discussion in recent times. The impact that a successful implementation of EHR can have on a hospital cannot be overstated. Factors which are crucial to successful implementation of an EHR system are commonly known as Critical Success Factors (hereinafter referred to as CSFs). Purpose: The present study investigates the role of CSFs in implementation process of EHR systems in north Indian multispecialty hospitals. Design: The questionnaire has been distributed to 12 hospitals which have been using EHR technology. Findings: It has been concluded that three out of the five CSFs included in the study, play a more important role than the other two factors. Research limitations: The factors have not been considered separately based upon pre-implementation scenario and post-implementation phase. Originality: The study attempts to outline the impact of EHR systems on successful operational performance of hospitals.

A survey on ultra wideband and ultrasonic communication for body area networks

2016-11-07T20:40:00.001-05:00

Emergence of implantable and wearable medical sensors for patient monitoring, diagnosis as well as cure has helped in the development of body area networks (BANs). For networking of these implantable and wearable devices, an appropriate choice of radio technology and communication methodology has to be made. Ultra wideband (UWB) has been identified as a solution for wireless body area networks (WBANs) in IEEE 802.15.6, but there are issues to be addressed such as attenuation inside body for implantable devices, energy efficient networking with low heat dissipation and others. Ultrasonic communication although an emerging technology promises better propagation inside body in watery media. It is known to be used without much health hazard in medical applications. This paper compares and evaluates the above two technologies for WBAN. It provides an extensive survey of existing work on UWB and ultrasonic communication for body area networks and highlights the unaddressed research challenges in using UWB and ultrasonic for WBAN applications.

By Sandipan Basu; Mahasweta Sarkar; Santosh Nagaraj; Suchismita Chinara in International Journal of Ultra Wideband Communications and Systems (IJUWBCS), 2016 Vol. 3 No. 3, pp. 143 - 154

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When Medicare patients move, healthcare spending changes

2016-11-07T20:34:00.001-05:00

Body:

When healthcare spending varies widely from one geographical region to another, including for pricey procedures like imaging exams, which variable is more to blame—provider choices or patient preferences?

Both, and in about equal measure, according to researchers at the Massachusetts Institute of Technology who crunched the numbers on millions of Medicare patients who relocated from one place to another.

MIT economist Heidi Williams, PhD, a co-author of the study, tells MIT News that some geographic spending variations may be explained by provider populations being more skilled at certain procedures—and thus more inclined to order them—in some areas than in others.

The researchers further found that, when Medicare enrollees relocate, most of their healthcare spending happens within the first year after the move.

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Healthcare Economics

Author Reference:

Dave Pearson

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By David Pearson

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Telemedicine for Developing Countries

2016-11-05T21:09:00.001-04:00

Background: Developing countries need telemedicine applications that help in many situations, when physicians are a small number with respect to the population, when specialized physicians are not available, when patients and physicians in rural villages need assistance in the delivery of health care. Moreover, the requirements of telemedicine applications for developing countries are somewhat more demanding than for developed countries. Indeed, further social, organizational, and technical aspects need to be considered for successful telemedicine applications in developing countries. Objective: We consider all the major projects in telemedicine, devoted to developing countries, as described by the proper scientific literature. On the basis of such literature, we want to define a specific taxonomy that allows a proper classification and a fast overview of telemedicine projects in developing countries. Moreover, by considering both the literature and some recent direct experiences, we want to complete such overview by discussing some design issues to be taken into consideration when developing telemedicine software systems. Methods: We considered and reviewed the major conferences and journals in depth, and looked for reports on the telemedicine projects. Results: We provide the reader with a survey of the main projects and systems, from which we derived a taxonomy of features of telemedicine systems for developing countries. We also propose and discuss some classification criteria for design issues, based on the lessons learned in this research area. Conclusions: We highlight some challenges and recommendations to be considered when designing a telemedicine system for developing countries....

By C. Combi (1), G. Pozzani (1), G. Pozzi (2)

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Cognitive security will be available to any hospital within three years, IBM predicts

2016-11-05T20:40:00.001-04:00

The breed of emerging security technologies, which leverage AI and machine learning, can slow down hackers and sift through massive data volumes to help users make actionable decisions.

By Jessica Davis

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REDAlert+

2016-11-02T16:18:00.001-04:00

Each year, thousands of people in developing countries die due to delayed medical response. A common complaint is that emergency vehicles respond late and when they reach the hospital, precious time is lost in understanding the patient trauma before the doctors can get to work. A large number of deaths can be prevented if medical services can be provided to the victims in time, which can happen when the emergency wing of a hospital has advance information about the trauma before the patient reaches the hospital. Most hospitals lack communication infrastructure that allows them to coordinate with emergency vehicles bringing patients to hospital. In developed countries, Vehicular Ad-hoc Networks (VANETs) are prevalent. These networks use vehicles as mobile nodes to create a small-interconnected network on the road. A mobile application based on the principle of VANETs in combination with wireless communication and database management has been devised, that when integrated with emergency vehicles and hospitals, provides a seamless medical response system at times of an emergency.

By Shakdher, Arjun

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Generic feature learning for wireless capsule endoscopy analysis

2016-10-19T20:39:00.001-04:00

The interpretation and analysis of wireless capsule endoscopy (WCE) recordings is a complex task which requires sophisticated computer aided decision (CAD) systems to help physicians with video screening and, finally, with the diagnosis. Most CAD systems used in capsule endoscopy share a common system design, but use very different image and video representations. As a result, each time a new clinical application of WCE appears, a new CAD system has to be designed from scratch. This makes the design of new CAD systems very time consuming.

By Santi Seguí, Michal Drozdzal, Guillem Pascual, Petia Radeva, Carolina Malagelada, Fernando Azpiroz, Jordi Vitrià

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Pokémon Go's immediate impact on public health: 144 billion steps and counting

2016-10-13T22:12:00.001-04:00

The accidental health app bested other tools in engaging patients who stand to benefit most. But whether Pokémon Go or future apps and devices specifically designed to keep people moving will succeed depends on the very big question of design.

By Tom Sullivan

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Improving Patient Safety Reporting with the Common Formats: Common Data Representation for Patient Safety Organizations

2016-10-01T19:37:00.001-04:00

Publication date: Available online 29 September 2016
Source:Journal of Biomedical Informatics
Author(s): Peter L. Elkin, Henry C. Johnson, Michael R. Callahan, David C. Classen
Medical errors and patient safety issues remain a significant problem for the healthcare industry in the United States. The Institute of Medicine report To Err is Human reported that there were as many as 98,000 deaths per year due to medical error as of 1999. Many authors and government officials believe that the first step on the path to improvement in patient safety is more comprehensive collection and analysis of patient safety events. The belief is that this will enable safety improvements based on data showing the nature and frequency of events that occur, and the effectiveness of interventions. This systematization of healthcare practice can be a step in the right direction toward a value based, safety conscious and effective healthcare system. To help standardize this reporting and analysis, AHRQ created Common Formats for Patient Safety data collection and reporting. This manuscript describes the development of patient safety reporting and learning through the Patient Safety Organizations (PSO)s and the Common Formats and gives readers an overview of how the system is expected to function and the breadth of development of the Common Formats to date.

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Open Source Platform for Collaborative Construction of Wearable Sensor Datasets for Human Motion Analysis and an Application for Gait Analysis

2016-09-02T13:57:00.001-04:00

Publication date: Available online 1 September 2016
Source:Journal of Biomedical Informatics
Author(s): César Llamas, Manuel A. González, Cármen Hernández, Jesús Vegas
Nearly every practical improvement in modelling human motion is well founded in a properly designed collection of data or datasets. These datasets must be made publicly available for the community could validate and accept them. It is reasonable to concede that a collective, guided enterprise could serve to devise solid and substantial datasets, as a result of a collaborative effort, in the same sense as the open software community does. In this way datasets could be complemented, extended and expanded in size with, for example, more individuals, samples and human actions. For this to be possible some commitments must be made by the collaborators, being one of them sharing the same data acquisition platform.In this paper, we offer an affordable open source hardware and software platform based on inertial wearable sensors in a way that several groups could cooperate in the construction of datasets through common software suitable for collaboration. Some experimental results about the throughput of the overall system are reported showing the feasibility of acquiring data from up to 6 sensors with a sampling frequency no less than 118Hz. Also, a proof-of-concept dataset is provided comprising sampled data from 12 subjects suitable for gait analysis.

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Mining Balance Disorders′ data for the development of Diagnostic Decision Support Systems

2016-08-27T20:13:00.003-04:00

In this work we present the methodology for the development of the EMBalance diagnostic Decision Support System (DSS) for balance disorders. Medical data from patients with balance disorders have been analysed using data mining techniques for the development of the diagnostic DSS. The proposed methodology uses various data, ranging from demographic characteristics to clinical examination, auditory and vestibular tests, in order to provide an accurate diagnosis. The system aims to provide decision support for general practitioners (GPs) and experts in the diagnosis of balance disorders as well as to provide recommendations for the appropriate information and data to be requested at each step of the diagnostic process.

By T.P. Exarchos, G. Rigas, A. Bibas, D. Kikidis, C. Nikitas, F.L. Wuyts, B. Ihtijarevic, L. Maes, M. Cenciarini, C. Maurer, N. Macdonald, D.-E. Bamiou, L. Luxon, M. Prasinos, G. Spanoudakis, D.D. Koutsouris, D.I. Fotiadis

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Healthcare Data Gateways: Found Healthcare Intelligence on Blockchain with Novel Privacy Risk Control

2016-08-27T20:13:00.001-04:00

Abstract

Healthcare data are a valuable source of healthcare intelligence. Sharing of healthcare data is one essential step to make healthcare system smarter and improve the quality of healthcare service. Healthcare data, one personal asset of patient, should be owned and controlled by patient, instead of being scattered in different healthcare systems, which prevents data sharing and puts patient privacy at risks. Blockchain is demonstrated in the financial field that trusted, auditable computing is possible using a decentralized network of peers accompanied by a public ledger. In this paper, we proposed an App (called Healthcare Data Gateway (HGD)) architecture based on blockchain to enable patient to own, control and share their own data easily and securely without violating privacy, which provides a new potential way to improve the intelligence of healthcare systems while keeping patient data private. Our proposed purpose-centric access model ensures patient own and control their healthcare data; simple unified Indicator-Centric Schema (ICS) makes it possible to organize all kinds of personal healthcare data practically and easily. We also point out that MPC (Secure Multi-Party Computing) is one promising solution to enable untrusted third-party to conduct computation over patient data without violating privacy.

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Increasing Fall Risk Awareness Using Wearables A Fall Risk Awareness Protocol

2016-08-23T13:37:00.001-04:00

Publication date: Available online 17 August 2016
Source:Journal of Biomedical Informatics
Author(s): Asbjørn Danielsen, Hans Olofsen, Bernt Arild Bremdal
Each year about a third of elderly aged 65 or older experience a fall. Many of these falls may have been avoided if fall risk assessment and prevention tools where available in a daily living situation. We identify what kind of information is relevant for doing fall risk assessment and prevention using wearable sensors in a daily living environment by investigating current research, distinguishing between prospective and context-aware fall risk assessment and prevention. Based on our findings, we propose a fall risk awareness protocol as a fall prevention tool integrating both wearables and ambient sensing technology into a single platform.

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Predicting intentions of nurses to adopt patient personal health records: a structural equation modeling approach

2016-08-21T13:36:00.001-04:00

• Personal health records (PHRs) enhance multidisciplinary communication of providers.• No previous evidence was found on predicting nurses' intentions to adopt patient PHRs.• Few studies have used an extended technology acceptance model to explore medical information technology- related factors.• Evidence of how subjective norms influence nurses' attitudes for patient PHRs is provided.• Nurses had positive attitudes of using patient PHRs when it is encouraged by supervisors and colleagues.

By Min-Huey Chung, Cheng-Hsun Ho, Hsyien-Chia Wen

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Big Data in Health: a Literature Review from the Year 2005

2016-08-14T16:37:00.001-04:00

Abstract

The information stored in healthcare systems has increased over the last ten years, leading it to be considered Big Data. There is a wealth of health information ready to be analysed. However, the sheer volume raises a challenge for traditional methods. The aim of this article is to conduct a cutting-edge study on Big Data in healthcare from 2005 to the present. This literature review will help researchers to know how Big Data has developed in the health industry and open up new avenues for research. Information searches have been made on various scientific databases such as Pubmed, Science Direct, Scopus and Web of Science for Big Data in healthcare. The search criteria were “Big Data” and “health” with a date range from 2005 to the present. A total of 9724 articles were found on the databases. 9515 articles were discarded as duplicates or for not having a title of interest to the study. 209 articles were read, with the resulting decision that 46 were useful for this study. 52.6 % of the articles used were found in Science Direct, 23.7 % in Pubmed, 22.1 % through Scopus and the remaining 2.6 % through the Web of Science. Big Data has undergone extremely high growth since 2011 and its use is becoming compulsory in developed nations and in an increasing number of developing nations. Big Data is a step forward and a cost reducer for public and private healthcare.

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To the Cloud: Big Data in a Turbulent World by Vincent Mosco

2016-08-01T21:55:00.001-04:00

Vincent Mosco begins and ends To The Cloud: Big Data in a Turbulent World by exploring metaphors about clouds and applying them to cloud computing. These metaphors offer a way into understanding the history of cloud computing: where it came from, why it began, how its evolved, and the ways it works in our everyday lives. He draws on literature, including a book entitled The Cloud of Unknowing by a medieval English monk (pg. 13). As I write this, I switch over to my streaming music service momentarily and discover it playing a song of the same name, this time by a contemporary artist, James Blackshaw. Given that I’d heard of neither the song nor artist until this very moment, this makes me a bit suspicious about how closely I’m being watched by my music player. Was it reading my email? Did it discover my notes, uploaded to the cloud on Evernote? Does it know this book was shipped to me? It’s almost difficult to believe it is complete coincidence. And yet this is one of the promises of the cloud and big data - a world where what we want (even when we didn’t know we wanted it) is at our finger tips exactly when we want it.

By Alexander Fink

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A Systematic Review for Mobile Monitoring Solutions in M-Health

2016-07-27T13:53:00.001-04:00

Abstract

A systematic review allows us to identify, assess, and interpret all possible relevant work associated with a question in particular or the subject of an area. Different authors can use several methodologies to learn about research related to their own research in different fields. The main objective of this review is to identify work, research and publications made in the field of the mobile monitoring of patients through some application or commercial or non-commercial solutions in m-Health. Next, we compare the different solutions with our solution, MoMo (Mobile Monitoring) Framework. MoMo is a solution that allows for patient mobile monitoring through mobile phones and biometric devices (blood pressure meter, glucometer and others). Our systematic review is based on the methodology of B. Kitchenham. She proposed specific guidelines for carrying out a systematic review in software engineering. We prepare our systematic review base in the selection of primary and secondary research related to mobile monitoring solutions following criteria with a specific weight to compare with each part of our research.

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A model for comparative analysis of medical bone X-ray images using image segmentation

2016-07-26T16:26:00.001-04:00

Image enhancement is the pre-processing stage of the image processing. The objective is to improve the visual effects and the perception of knowledge in images for viewers and to provide a better input for automated image processing technique. It gives emphasis on the whole or part features of the graphics in the designated image applications to enlarge the objects in the graphics. The enhanced image by use of threshold segmentation method identifies bone fracture in medical X-ray images. In this research work, the image is taken as input and after noise removal, the X-ray image of right hand and hairline bone fracture image is being segmented using simple thresholding, multiple thresholding and optimal thresholding method and compared with each other so as to choose the best technique for threshold image segmentation.

By Barnali Sahu; Shweta Jena; Alok Kumar Jagadev in International Journal of Telemedicine and Clinical Practices (IJTMCP), 2016 Vol. 1 No. 3, pp. 199 - 208

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DATA model for a multidimensional decision making in healthcare

2016-07-20T22:27:00.001-04:00

Health technology assessment (HTA) is increasingly used in European countries to inform decision and policy making in the healthcare sector. Several countries have integrated HTA into policy, governance or regulatory processes. The present research aims to propose a new multidisciplinary approach to support and to justify decisions policies in healthcare organisations for the standardisation of HTA information and for the achievement of a more quality decisions under uncertainty, which ultimately determines the success of organisations. A multidimensional model, called DATA model - decision analytic technology assessment model - based on analytic hierarchy process and the Cyert-March-Simon model (aka Carnegie decision model) is developed. The results obtained show the potentiality of the proposed approach in prioritising critical aspects and in supporting management performance quality in healthcare system.

By Antonella Petrillo; Fabio De Felice; Laura Petrillo in International Journal of Multicriteria Decision Making (IJMCDM), 2016 Vol. 6 No. 2, pp. 138 - 156

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Pessimistic multi-granulation rough set-based classification for heart valve disease diagnosis

2016-07-19T22:41:00.001-04:00

The primary contribution of this study relies on proposing a new method, which can detect heart diseases in respective heart valve data. In this work, supervised quick reduct feature selection algorithm is applied for selecting important features from heart valve data. The classification method is applied only for relevant features selected using supervised quick reduct from heart valve data. In this paper, a new classification approach based on pessimistic multi-granulation rough sets (PMGRS) is applied for heart valve disease diagnosis. In multi-granulation rough sets, set approximations are well-defined by multiple equivalence relations on the universe, leading to an effective model for classification. This is confirmed by experimental evaluation, which shows excellent classification performance and also demonstrates that the proposed approach is superior to other benchmark classification algorithms including naïve Bayes, multi-layer perceptron (MLP), and J48 and decision table classifiers.

By Ahmad Taher Azar; S. Senthil Kumar; H. Hannah Inbarani; Aboul Ella Hassanien in International Journal of Modelling, Identification and Control (IJMIC), 2016 Vol. 26 No. 1, pp. 42 - 51

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Prediction of nocturnal hypoglycemia by an aggregation of previously known prediction approaches: proof of concept for clinical application

2016-07-10T13:43:00.001-04:00

• We propose a method of combining several predictors into a new one that will perform at the level of the best involved one, or even outperform all individual candidates.• Portability of the method. This feature of the method allows its simple implementation in the form of a diabetic Smartphone app.• The potential for everyday use by any patient who performs self-monitoring of blood glucose.• The idea is based on the linear functional strategy for regularized ranking.

By Pavlo Tkachenko, Galyna Kriukova, Marharyta Aleksandrova, Oleg Chertov, Eric Renard, Sergei V. Pereverzyev

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Coming soon to a living room near you: home-based imaging?

2016-06-30T16:00:00.001-04:00

Body:

In the not-so-distant future, patients bearing imaging-capable smartphones will put doctors’ offices out of business. Oh, the docs themselves will still have jobs. But many will be working from home.

So says the cardiologist and healthcare futurist Eric Topol, MD, author of the influential bestseller The Creative Destruction of Medicine.

Speaking at a gathering of the Healthcare Financial Management Association in Las Vegas this week, Topol displayed diagnostic-quality images of himself acquired by ultrasound at his home.

“130 million ultrasounds are done in the U.S. per year,” he said. “Why shouldn't they be done during the physical exam with modern digital equipment, saving a $100 billion a year?”

Healthcare Finance covered the session:

Topic:

Healthcare Economics

Author Reference:

Dave Pearson

Content Type:

Referenced Content

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By David Pearson

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How HIPAA applies to the burgeoning world of mobile health

2016-05-12T23:04:00.001-04:00

The federal regulatory environment has not kept pace with the progress of mobile health, which is driven by consumers who expect to have all sorts of information, including health data, on their phones.

By Bill Siwicki

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An Ontological Model of the Practice Transformation Process

2016-05-10T17:19:00.003-04:00

Publication date: Available online 10 May 2016
Source:Journal of Biomedical Informatics
Author(s): Arun Sen, Atish P. Sinha
Patient-centered medical home is defined as an approach for providing comprehensive primary care that facilitates partnerships between individual patients and their personal providers. The current state of the practice transformation process is ad hoc and no methodological basis exists for transforming a practice into a patient-centered medical home. Practices and hospitals somehow accomplish the transformation and send the transformation information to a certification agency, such as the National Committee for Quality Assurance, completely ignoring the development and maintenance of the processes that keep the medical home concept alive. Many recent studies point out that such a transformation is hard as it requires an ambitious whole-practice reengineering and redesign. As a result, the practices suffer change fatigue in getting the transformation done. In this paper, we focus on the complexities of the practice transformation process and present a robust ontological model for practice transformation. The objective of the model is to create an understanding of the practice transformation process in terms of key process areas and their activities. We describe how our ontology captures the knowledge of the practice transformation process, elicited from domain experts, and also discuss how, in the future, that knowledge could be diffused across stakeholders in a healthcare organization. Our research is the first effort in practice transformation process modeling. To build an ontological model for practice transformation, we adopt the Methontology approach. Based on the literature, we first identify the key process areas essential for a practice transformation process to achieve certification status. Next, we develop the practice transformation ontology by creating key activities and precedence relationships among the key process areas using process maturity concepts. At each step, we employ a panel of domain experts to verify the intermediate representations of the ontology. Finally, we implement a prototype of the practice transformation ontology using Protégé.

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Telepharmacy software helps free up workflow, lets pharmacists focus on patients

2016-05-10T17:19:00.001-04:00

Getting pharmacists involved in patient-centric activities, including being part of clinical care teams, is a little easier thanks to telepharmacy technology. When Dartmouth-Hitchcock Medical Center in Lebanon, New Hampshire, needed to optimize its pharmacy workflow with the goal of improving patient care, it turned to PowergridRx, a cloud-based HIPAA–compliant telepharmacy platform from San Francisco-based PipelineRx.

By Anthony Vecchione

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