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Dissertations / Theses on the topic 'Health informatics'
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Karlsson, Johan. "Information structures and workflows in health care informatics." Doctoral thesis, Umeå universitet, Institutionen för datavetenskap, 2010. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-33829.
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Patient data in health care have traditionally been used to support direct patient care. Although there is great potential in combining such data with genetic information from patients to improve diagnosis and therapy decisions (i.e. personalized medicine) and in secondary uses such as data mining, this is complex to realize due to technical, commercial and legal issues related with combining and refining patient data. Clinical decision support systems (CDSS) are great catalysts for enabling evidence-based medicine in clinical practice. Although patient data can be the base for CDSS logic, it is often scattered among heterogenous data sources (even in different health care centers). Data integration and subsequent data mining must consider codification of patient data with terminology systems in addition to legal and ethical aspects of using such data. Although computerization of the patient record systems has been underway for a long time, some data is still unstructured. Investigation regarding the feasibility of using electronic patient records (EPR) as data sources for data mining is therefore important. Association rules can be used as a base for CDSS development. Logic representation affect the usability of the systems and the possibility of providing explanations of the generated advice. Several properties of these rules are relatively easy to explain (such as support and confidence), which in itself can improve end-user confidence in advice from CDSS. Information from information sources other than the EPR can also be important for diagnosis and/or treatment decisions. Drug prescription is a process that is particularly dependent on reliable information regarding, among other things, drug-drug interactions which can have serious effects. CDSS and other information systems are not useful unless they are available at the time and location of patient care. This motivates using mobile devices for CDSS. Information structures of interactions affect representation in informatics systems. These structures can be represented using a category theory based implementation of rough sets (rough monads). Development of guidelines and CDSS can be based on existing guidelines with connections to external information systems that validate advice given the particular patient situation (for example, previously prescribed drugs may interact with recommended drugs by CDSS). Rules for CDSS can also be generated directly from patient data but this assumes that such data is structured and representative. Although there is great potential in CDSS to improve the quality and efficiency of health care, these systems must be properly integrated with existing processes in health care (workflows) and with other information systems. Health care workflows manage physical resources such as patients and doctors and can help to standardize care processes and support management decisions through workflow simulation. Such simulations allow information bottle-necks or insufficient resources (equipment, personnel) to be identified. As personalized medicine using genetic information of patients become economically feasible, computational requirements increase. In this sense, distributing computations through web services and system-oriented workflows can complement human-oriented workflows. Issues related to dynamic service discovery, semantic annotations of data, service inputs/outputs affect the feasibility of system-oriented workflow construction and sharing. Additionally, sharing of system-oriented workflows increase the possibilities of peer-review and workflow re-usage.
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Ebenezer, Catherine. "Health informatics on the Web." Free Pint Ltd, 2002. http://hdl.handle.net/10150/106500.
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Koopman, Bevan Raymond. "Semantic search as inference : applications in health informatics." Thesis, Queensland University of Technology, 2014. https://eprints.qut.edu.au/71385/1/Bevan_Koopman_Thesis.pdf.
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This thesis developed new search engine models that elicit the meaning behind the words found in documents and queries, rather than simply matching keywords. These new models were applied to searching medical records: an area where search is particularly challenging yet can have significant benefits to our society.
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Lin, Yu-Kai. "Health Analytics and Predictive Modeling: Four Essays on Health Informatics." Diss., The University of Arizona, 2015. http://hdl.handle.net/10150/555987.
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There is a marked trend of using information technologies to improve healthcare. Among all the health IT, electronic health record (EHR) systems hold great promises as they modernize the paradigm and practice of care provision. However, empirical studies in the literature found mixed evidence on whether EHRs improve quality of care. I posit two explanations for the mixed evidence. First, most prior studies failed to account for system use and only focused on EHR purchase or adoption. Second, most existing EHR systems provide inadequate clinical decision support and hence, fail to reveal the full potential of digital health. In this dissertation I address two broad research questions: a) Does meaningful use of EHRs improve quality of care? and b) How do we advance clinical decision making through innovative computational techniques of healthcare analytics? To these ends, the dissertation comprises four essays. The first essay examines whether meaningful use of EHRs improve quality of care through a natural experiment. I found that meaningful use significantly improve quality of care, and this effect is greater in historically disadvantaged hospitals such as small, non-teaching, or rural hospitals. These empirical findings present salient practical and policy implications about the role of health IT. On the other hand, in the other three essays I work with real-world EHR data sets and propose healthcare analytics frameworks and methods to better utilize clinical text (Essay II), integrate clinical guidelines and EHR data for risk prediction (Essay III), and develop a principled approach for multifaceted risk profiling (Essay IV). Models, frameworks, and design principles proposed in these essays advance not only health IT research, but also more broadly contribute to business analytics, design science, and predictive modeling research.
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Hägglund, Maria. "Sharing is Caring : Integrating Health Information Systems to Support Patient-Centred Shared Homecare." Doctoral thesis, Uppsala universitet, Institutionen för medicinska vetenskaper, 2009. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-9527.
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In the light of an ageing society with shrinking economic resources, deinstitutionalization of elderly care is a general trend. As a result, homecare is increasing, and increasingly shared between different health and social care organizations. To provide a holistic overview about the patient care process, i.e. to be patient-centred, shared homecare needs to be integrated. This requires improved support for information sharing and cooperation between different actors, such as care professionals, patients and their relatives. The research objectives of this thesis are therefore to study information and communication needs for patient-centered shared homecare, to explore how integrated information and communication technology (ICT) can support information sharing, and to analyze how current standards for continuity of care and semantic interoperability meet requirements of patient-centered shared homecare. An action research approach, characterized by an iterative cycle, an emphasis on change and close collaboration with practitioners, patients and their relatives, was used. Studying one specific homecare setting closely, intersection points between involved actors and specific needs for information sharing were identified and described as shared information objects. An integration architecture making shared information objects available through integration of existing systems was designed and implemented. Mobile virtual health record (VHR) applications thereby enable a seamless flow of information between involved actors. These applications were tested and validated in the OLD@HOME-project. Moreover, the underlying information model for a shared care plan was mapped against current standards. Some important discrepancies were identified between these results and current standards for continuity of care, stressing the importance of evaluating standardized models against requirements of evolving healthcare contexts. In conclusion, this thesis gives important insights into the needs and requirements of shared homecare, enabling a shift towards patient-centered homecare through mobile access to aggregated information from current feeder systems and documentation at the point of need.
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Houston, Andrea Lynn 1954. "Knowledge integration for medical informatics: An experiment on a cancer information system." Diss., The University of Arizona, 1998. http://hdl.handle.net/10150/288868.
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This research investigated the question of whether automatic or system-generated information classification methods can help humans better manage information. A series of four experiments were conducted; they investigated the usability (i.e., usefulness) of two automatic approaches to information classification, the concept space approach and a Kohonen-based SOM approach in the context of information retrieval. The concept space approach was evaluated in three different domains: Electronic Brainstorming (EBS) sessions, the Internet, and medical literature (the CancerLit collection). The Kohonen-based SOM approach was evaluated in the Internet and medical literature (CancerLit) domains only. In each case, the approach under investigation was compared with existing systems in order to demonstrate performance viability. The basic premise that information management, in particular information retrieval, can be successfully supported by system-based information classification techniques and that humans would find such techniques viable and useful was supported by the experiments. The concept space approach was more successful than the Kohonen-based SOM approach. After modifications to the algorithms based on user feedback from the EBS experiments had been made, users found the concept space approach results to be comparable (in the Internet study) or superior (in the CancerLit study) to existing information classification systems. The key future enhancement will be incorporation of better ways to identify document descriptors through syntactic and semantic front-end processing. The Kohonen-based SOM approach was considered difficult to use in all but one specialized case (the dynamic SOM created as part of the CancerLit prototype). This can probably be attributed to the fact that its associative organization does not match with the standard mental models (hierarchical and alphabetic) for information classification.
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Takahashi, Yoshimitsu. "Usefulness of network analysis in health informatics: Application to public health issues." 京都大学 (Kyoto University), 2010. http://hdl.handle.net/2433/97938.
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Nikopoulou-Smyrni, Panagiota. "A model of clinical reasoning in health informatics." Thesis, Keele University, 2003. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.401075.
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Katule, Ntwa. "Utilization of personal health informatics through intermediary users." Doctoral thesis, University of Cape Town, 2018. http://hdl.handle.net/11427/29358.
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Personal informatics are important tools in health self-management as they support individuals to quantify and self-reflect on their lifestyle. Human-computer interaction researchers have devoted resources on studying how to design such tools. Various motivational strategies have been explored for their capabilities in improving user engagement. However, such strategies are developed with an assumption that the targeted consumer of information is the one directly manipulating user interfaces of the system that has information. This may not always be the case for users in developing regions. As a result, such systems may not scale well in contexts where a targeted consumer (beneficiary) may use technology through the facilitation of another person (intermediary) whom is responsible for manipulating user interfaces, because such facilitators are not recognized as part of the system, hence motivational strategies don't cater for them. In order to uncover design implications for intermediated technology use in the context of personal health informatics (PHI), the researcher started with the theoretical framing of the work followed by a contextual enquiry which led to development of mobile applications' prototypes for tracking nutrition and physical activity. Evaluation of the prototypes revealed that a familial relationship is a prerequisite for such an intervention. The most promising combination involves family members, possibly a child and a parent working together. The study used self-determination theory to understand how a collaborative gamified system can increase engagement. The result revealed that gamification as the source of a significant increase in perceived competence in intermediary users whom also tended to consider themselves as co-owners of the interaction experience. Therefore, gamification was found to be a catalyst for increasing collaboration between an intermediary and beneficiary user of technology, provided that the two users that formed a pair had a prior social relationship. In the absence of gamification, intermediary users tended to be less engaged in the intervention. The study highlights both the positive and negative aspects of gamification in promoting collaboration in intermediated use and its general implications in health settings. Design considerations required in order to improve the overall user experience of both users involved are proposed. In general, this work contributes to both theory and empirical validation of factors for, supporting proximate-enabled intermediated use of personal health informatics.
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Richards, Janise Elaine. "Public health informatics : a consensus on core competencies /." Digital version accessible at:, 2000. http://wwwlib.umi.com/cr/utexas/main.
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Gremu, Chikumbutso David. "Building an E-health system for health awareness campaigns in poor areas." Thesis, Rhodes University, 2015. http://hdl.handle.net/10962/d1017930.
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Appropriate e-services as well as revenue generation capabilities are key to the deployment and the sustainability for ICT installations in poor areas, particularly common in developing country. The area of e-Health is a promising area for e-services that are both important to the population in those areas and potentially of direct interest to National Health Organizations, which already spend money for Health campaigns there. This thesis focuses on the design, implementation, and full functional testing of HealthAware, an application that allows health organization to set up targeted awareness campaigns for poor areas. Requirements for such application are very specific, starting from the fact that the preparation of the campaign and its execution/consumption happen in two different environments from a technological and social point of view. Part of the research work done for this thesis was to make the above requirements explicit and then use them in the design. This phase of the research was facilitated by the fact that the thesis' work was executed within the context of the Siyakhula Living Lab (SLL; www.siyakhulaLL.org), which has accumulated multi-year experience of ICT deployment in such areas. As a result of the found requirements, HealthAware comprises two components, which are web-based, Java applications that run in a peer-to-peer fashion. The first component, the Dashboard, is used to create, manage, and publish information for conducting awareness campaigns or surveys. The second component, HealthMessenger, facilitates users' access to the campaigns or surveys that were created using the Dashboard. The HealthMessenger was designed to be hosted on TeleWeaver while the Dashboard is hosted independently of TeleWeaver and simply communicates with the HealthMessenger through webservices. TeleWeaver is an application integration platform developed within the SLL to host software applications for poor areas. Using a core service of TeleWeaver, the profile service, where all the users' defining elements are contained, campaigns and surveys can be easily and effectively targeted, for example to match specific demographics or geographic locations. Revenue generation is attained via the logging of the interactions of the target users in the communities with the applications in TeleWeaver, from which billing data is generated according to the specific contractual agreements with the National Health Organization. From a general point of view, HealthAware contributes to the concrete realizations of a bidirectional access channel between Health Organizations and users in poor communities, which not only allows the communication of appropriate content in both directions, but get 'monetized' and in so doing becomes a revenue generator.
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Yip, Ying-ting, and 葉鎣婷. "A systematic review : cost-effectiveness of health informatics adoption for health care delivery." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2013. http://hdl.handle.net/10722/193814.
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BACKGROUND: Health Information Technology (HIT) enhances patient safety, which can also help to reduce health care costs. When it is used to replace the paper-based records, it will alter the workflow of front line workers and facilitate the management of care. The data captured can be shared in a seamless manner throughout the whole patient care journey. Since a significant upfront investment is required in the implementation and the use of the Electronic Health Record (EHR), it is still recognized as one of the major barriers. Despite these factors, governments and private health care provider organizations are all moving to implement a myriad of HITs. Therefore, meaningful use (MU) is an important criterion when assessing HIT utilization. This study focuses on the review and synthesis of evidence relating to the cost and effectiveness of health informatics adoption for health care delivery. Taking these findings into account may increase the likelihood of successful and cost-effective HIT implementation.
METHODS: Literature searches of BMJ, Science Direct, and PubMed as well as a manual search for grey literature via Google scholar were performed. The inclusion criteria were any studies, both quantitative and qualitative, that describe the cost-effectiveness of informatics via any type of HIT used during the provision of health care services. English publications from 2003 to 2013 with any type of study setting were included. Through this search, nine articles were chosen for the final analysis.
RESULTS: Among the nine selected studies, eight of them concluded that the adoption of HIT may-be-cost-effective to health care delivery. One study found the adoption of HIT not effective. The studies did not provide sufficient and concrete evidence to prove cost-effectiveness of HIT adoption.
DISCUSSION: There is insufficient evidence to support the cost-effectiveness of HIT adoption. The cost data from these studies are not available. Data quality, system design, and physician behavior are other concern for MU of health informatics. Health care organization and governments should engage with the end-users (e.g. medical & paramedical personnel and patients) during system design (or selection), adaptation and implementation.
CONCLUSION: Stakeholders should be aware of the tradeoffs throughout the implementation process. HIT scope, design, development, implementation, and performance monitoring should be well planned right from the start. In the foreseeable future, formal economics evaluation reports of Cost-Effectiveness Analysis (CEA) should be compulsory for stakeholders investing in Health Information Technologies.<br>published_or_final_version<br>Public Health<br>Master<br>Master of Public Health
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Crain, Steven P. "Personalized search and recommendation for health information resources." Diss., Georgia Institute of Technology, 2012. http://hdl.handle.net/1853/45805.
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Consumers face several challenges using the Internet to fill health-related needs. (1) In many cases, they face a language gap as they look for information that is written in unfamiliar technical language. (2) Medical information in social media is of variable quality and may be appealing even when it is dangerous. (3) Discussion groups provide valuable social support for necessary lifestyle changes, but are variable in their levels of activity. (4) Finding less popular groups is tedious. We present solutions to these challenges.
We use a novel adaptation of topic models to address the language gap. Conventional topic models discover a set of unrelated topics that together explain the combinations of words in a collection of documents. We add additional structure that provides relationships between topics corresponding to relationships between consumer and technical medical topics. This allows us to support search for technical information using informal consumer medical questions.
We also analyze social media related to eating disorders. A third of these videos promote eating disorders and consumers are twice as engaged by these dangerous videos. We study the interactions of two communities in a photo-sharing site. There, a community that encourages recovery from eating disorders interacts with the pro-eating disorder community in an attempt to persuade them, but we found that this attempt entrenches the pro-eating disorder community more firmly in its position.
We study the process by which consumers participate in discussion groups in an online diabetes community. We develop novel event history analysis techniques to identify the characteristics of groups in a diabetes community that are correlated with consumer activity. This analysis reveals that uniformly advertise the popular groups to all consumers impairs the diversity of the groups and limits their value to the community.
To help consumers find interesting discussion groups, we develop a system for personalized recommendation for social connections. We extend matrix factorization techniques that are effective for product recommendation so that they become suitable for implicit power-law-distributed social ratings. We identify the best approaches for recommendation of a variety of social connections involving consumers, discussion groups and discussions.
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Scandurra, Isabella. "Building Usability into Health Informatics : Development and Evaluation of Information Systems for Shared Homecare." Doctoral thesis, Uppsala : Acta universitatis Upsaliensis, 2007. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-8403.
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Smith, Kane. "A Multi-Objective Framework for Information Security Public Policy: The Case of Health Informatics." VCU Scholars Compass, 2018. https://scholarscompass.vcu.edu/etd/5320.
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Detailed holistic patient data is critical for healthcare organizations to better serve their patient populations. This information allows healthcare organizations to create a detailed and holistic record of a patient’s health. However, this large aggregation of personally identifiable patient data raises serious privacy and security concerns amongst patients. For this reason, patient concerns around the privacy and security of information retained by healthcare organizations must be addressed through the development of effective public policy. This research, therefore argues that any decision making process aimed at developing public policy dealing with patient data privacy and security concerns should not only address regulatory concerns, but also patient-centric values. To accomplish this task, multi-objective decision analytic techniques, with Nissenbaum’s (2004) contextual integrity as a normative framework are used. This is done to elicit patient-centric preferences to assist organizations and governmental institutions alike in dealing with their privacy and security concerns around patient data stored by Healthcare Systems.
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Donati, Lorenzo. "Domain Adaptation through Deep Neural Networks for Health Informatics." Master's thesis, Alma Mater Studiorum - Università di Bologna, 2017. http://amslaurea.unibo.it/14888/.
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The PreventIT project is an EU Horizon 2020 project aimed at preventing early functional decline at younger old age. The analysis of causal links between risk factors and functional decline has been made possible by the cooperation of several research institutes' studies. However, since each research institute collects and delivers different kinds of data in different formats, so far the analysis has been assisted by expert geriatricians whose role is to detect the best candidates among hundreds of fields and offer a semantic interpretation of the values. This manual data harmonization approach is very common in both scientific and industrial environments.
In this thesis project an alternative method for parsing heterogeneous data is proposed. Since all the datasets represent semantically related data, being all made from longitudinal studies on aging-related metrics, it is possible to train an artificial neural network to perform an automatic domain adaptation. To achieve this goal, a Stacked Denoising Autoencoder has been implemented and trained to extract a domain-invariant representation of the data. Then, from this high-level representation, multiple classifiers have been trained to validate the model and ultimately to predict the probability of functional decline of the patient. This innovative approach to the domain adaptation process can provide an easy and fast solution to many research fields that now rely on human interaction to analyze the semantic data model and perform cross-dataset analysis.
Functional decline classifiers show a great improvement in their performance when trained on the domain-invariant features extracted by the Stacked Denoising Autoencoder. Furthermore, this project applies multiple deep neural network classifiers on top of the Stacked Denoising Autoencoder representation, achieving excellent results for the prediction of functional decline in a real case study that involves two different datasets.
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Ellis, Jeremy Charles. "Medical informatics : the generic interchange of comprehensive health data." Thesis, University of Hull, 1999. http://hydra.hull.ac.uk/resources/hull:4636.
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The objective of this project was to study the area of generic transfer of comprehensive medical data.The work presented in this thesis had as its main premise the belief that generic transfer of comprehensive medical data will help towards the goal of better healthcare particularly in an environment of shared care. It studied the main methods of data transfer available at present, and as a result carried out an in depth review of one such method adopted by the National Health Service (NHS). Criticism of this method was made. These criticisms lead on to the development of an alternative method of generic data transfer based on an emerging European standard for the storage of medical data. This in turn led on to the consideration of data in legacy systems. Finally, an evaluation of the developed method was undertaken.
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Rahimi, Bahol. "Implementation of Health Information Systems." Licentiate thesis, Linköping University, Linköping University, MDA - Human Computer Interfaces, 2008. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-15677.
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<p>Healthcare organizations now consider increased efficiency, reduced costs, improved patient care and quality of services, and safety when they are planning to implement new information and communication technology (ICT) based applications. However, in spite of enormous investment in health information systems (HIS), no convincing evidence of the overall benefits of HISs yet exists. The publishing of studies that capture the effects of the implementation and use of ICT-based applications in healthcare may contribute to the emergence of an evidence-based health informatics which can be used as a platform for decisions made by policy makers, executives, and clinicians. Health informatics needs further studies identifying the factors affecting successful HIS implementation and capturing the effects of HIS implementation. The purpose of the work presented in this thesis is to increase the available knowledge about the impact of the implementation and use of HISs in healthcare organizations. All the studies included in this thesis used qualitative research methods. A case study design and literature review were performed to collect data.</p><p>This thesis’s results highlight an increasing need to share knowledge, find methods to evaluate the impact of investments, and formulate indicators for success. It makes suggestions for developing or extending evaluation methods that can be applied to this area with a multi-actor perspective in order to understand the effects, consequences, and prerequisites that have to be achieved for the successful implementation and use of IT in healthcare. The results also propose that HIS, particularly integrated computer-based patient records (ICPR), be introduced to fulfill a high number of organizational, individualbased, and socio-technical goals at different levels. It is therefore necessary to link the goals that HIS systems are to fulfill in relation to short-term, middle-term, and long-term strategic goals. Another suggestion is that implementers and vendors should direct more attention to what has been published in the area to avoid future failures.</p><p>This thesis’s findings outline an updated structure for implementation planning. When implementing HISs in hospital and primary-care environments, this thesis suggests that such strategic actions as management involvement and resource allocation, such tactical action as integrating HIS with healthcare workflow, and such operational actions as user involvement, establishing compatibility between software and hardware, and education and training should be taken into consideration.</p>
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Morton, Mary Elizabeth Wiedenbeck Susan McCain Katherine Wootton. "Use and acceptance of an electronic health record : factors affecting physician attitudes /." Philadelphia, Pa. : Drexel University, 2008. http://hdl.handle.net/1860/2905.
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Sarker, Md Mostafa Kamal. "Efficient Deep Learning Models and Their Applications to Health Informatics." Doctoral thesis, Universitat Rovira i Virgili, 2019. http://hdl.handle.net/10803/668480.
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This thesis designed and implemented efficient deep learning methods to solve classification and segmentation problems in two major health informatics domains, namely pervasive sensing and medical imaging. In the area of pervasive sensing, this thesis focuses only on food and related scene classification for health and nutrition analysis. This thesis used deep learning models to find the answer of two important two questions, “where we eat?’’ and ‘’what we eat?’’ for properly monitoring our health and nutrition condition. This is a new research domain, so this thesis presented entire scenarios from the scratch (e.g. create a dataset, model selection, parameter optimization, etc.). To answer the first question, “where we eat?”, it introduced two new datasets, ``FoodPlaces'', ``EgoFoodPlaces'' and models, “MACNet”, “MACNet+SA” based on multi-scale atrous convolutional networks with the self-attention mechanism. To answer the second question, “what we eat?”, it presented a new dataset, ``Yummly48K'' and model, ``CuisineNet'‘, designed by aggregating convolution layers with various kernel sizes followed by residual and pyramid pooling module with two fully connected pathway. The proposed models performed state-of-the-art classification accuracy on their related datasets. In the field of medical imaging, this thesis targets skin lesion segmentation problem in the dermoscopic images. This thesis introduced two novel deep learning models to accurately segment the skin lesions, “SLSDeep” and “MobileGAN” based on dilated residual with pyramid pooling network and conditional Generative Adversarial Networks (cGANs). Both models show excellent performance on public benchmark datasets.
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Yamuah, Lawrence Kweku. "Healthcare provision in The Gambia : the role of health informatics." Thesis, City University London, 2003. http://openaccess.city.ac.uk/7646/.
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While technological advances in computing and telecommunications are revolutionising the way many organisations work, healthcare systems in The Gambia are very much lagging behind. No proper patient records or filing systems are in place. Delivery of effective healthcare depends on availability of routinely collected, good quality health data to provide useful information that is accessible when and where it is needed. Presently, in The Gambia, there is considerable scope for improvement in relation to such data. Electronic patient record system is long overdue. This research, focuses on the development of a Health Information System (HIS) capable of providing doctors, nurses and other healthcare professionals with quick and easy access to the appropriate information needed to care for their patients. A systems analysis has been undertaken to identify the full need for patient health data, the range of users and the extent of present paper-based provision. From this analysis, a requirements specification has been produced for a proposed health information and administration system (HIAS) to become operational and also successful in terms of efficiency and effectiveness. The requirements specification has taken the form of a series of precise statements of needs, buttressed with a corresponding justification in each case. By assessing what information and communication technology (lCT) is required and feasible, affordable and available in The Gambia, based on the extensive fieldwork involving interviews, observational study and questionnaires, a design specification (the logical and physical framework for the proposed ,IUAS) has also been produced as a precursor to the development of the proposed HIAS prototype. The approach,used will aid any implementor to progress from the proposed system to a fully functional one in an efficient and timely manner. Constraints in the programme of research were such that it was not possible to continue on with a prototype implementation based on this design. Hence it is now for The Gambia government to study and implement the proposed system. Several recommendations have been made in the areas of policies to be implemented, resources needed and training and motivation. In conclusion, the study has demonstrated the value or role of health informatics in the provision of health care in a developing country. It has contributed in the understanding of the complexities of the problems in The Gambia and developing countries, building this understanding in terms of requirements analysis and design specification and in methodological issues.
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Bussone, Adrian. "Reflection and personal health informatics for people living with HIV." Thesis, City, University of London, 2018. http://openaccess.city.ac.uk/20935/.
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Recent advances in medicine mean that millions of people who are living with the Human Immunodeficiency Virus (HIV) can expect to live normal life spans. However, HIV, the medication prescribed to control the virus, and living with a stigmatized disease, are each associated with a wide array of negative impacts on the body and mind, and these present a challenge in an individual’s ability to self-manage their health information. A key aspect of self-management is self-understanding, and Personal Health Informatics (PHI) has the potential to help those living with HIV in understanding their health through reflection. However, there is little indication of the needs of people living with HIV and how PHI systems can best support them in reflecting on their health information. In order to fill this gap, this thesis aims to answer the overall research question: How can Personal Health Informatics systems support people living with HIV in reflecting on their personal health information? Answering this research question was approached in four parts: • The development of a synthesized model of the process of PHI, as means of understanding the context of PHI. • Interviews with HIV+ individuals were conducted to understand where there were opportunities for supporting reflection. • An analysis of an online forum was conducted to determine what people living with HIV were trying to reflect upon, what health information was being asked about, and how the community attempts to support them in reflecting on their health. • Two visual prototypes were designed to simulate community-aided reflection and support people living with HIV in reflecting on their personal health information. These were used during a user study to understand how reflection occurred. My research is the first to explore how to support HIV+ people in reflecting on their personal health information. The main contribution of this research is a detailed understanding of how PHI systems can support people living with HIV in reflecting on their health information. This main contribution is comprised of four smaller ones: • A six-stage process model of Personal Health Informatics • A detailed understanding of how people living with HIV currently track and reflect on their personal health information, and design implications for PHI systems to support them in reflection • An empirical understanding of community-aided reflection as it occurs in an online forum, alongside the identification of five common questions that people living with HIV seek help in online forums for reflecting upon, the information asked about, and how the community attempts to address the questions • A detailed depiction of how reflection occurs when using a prototype designed to simulate community-aided reflection.
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Sabbagh, A. O. "A novel model for managing health informatics in Saudi Arabia." Thesis, Coventry University, 2015. http://curve.coventry.ac.uk/open/items/6a19f00c-e199-49e6-b0c6-4e71d853fa35/1.
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Application of Health Informatics (HI) is becoming more pervasive in the Saudi Arabian health organisations (SAHOs) with the aim of exploiting its potential for better healthcare delivery. Yet, to date, the management of HI has not been fully digested in the Saudi health environment. Therefore, adoption of imported models has become a common practice for managing HI. Consequently, most implemented systems fall short of meeting objectives or tackling key existing issues. The aim of the study is to develop a model for HI management that not only deals with key prevailing issues but also should be compatible with the Saudi Arabian health environment. The research contends that the key to success in exploiting the potential of HI is the use of appropriate local models that fully integrate with the Saudi Arabian health environment. The research design was mainly guided by pragmatic philosophy which incorporated both quantitative and qualitative research. It was inductive in nature and used a field research methodology to accomplish the research objectives. Empirical data was collected via questionnaires and interviews in the collaborating health organisations. Literature review, data analyses of the questionnaires and interviews yielded the initial framework for the Health Informatics Management Model (HIMM). A first round evaluation of the HIMM was conducted yielding a revised version. Later, data was also gathered from participants in a second round of evaluating the HIMM. The second round was to reassess the compatibility of HIMM with the Saudi Arabian health organisations, and to update the model in order to match the current application of HI in these organisations. The analysis of the data gleaned from the second stage evaluation yielded a revised (and final) HIMM, contemplated by participants. Based on the above empirical data, the research study introduces the HIMM, the first holistic and systematic HI framework that should enable the Saudi health providers and managers to better comprehend the multi-faceted perspectives that form the HI management paradigm, and guide them in its management. It can allow them to decide how best to manage HI projects in a way that ensures an optimum use of HI resources for effective and efficient delivery of healthcare and services. This work is of considerable utility in the Kingdom of Saudi Arabia and the Gulf States, where HI management and its application are regarded as an area of high priority.
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O'Neill, Braden Gregory. "Examining the role of health literacy in online health information." Thesis, University of Oxford, 2014. http://ora.ox.ac.uk/objects/uuid:e2bff1e7-f377-4ce2-ad2f-b2d563d378a6.
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The internet has radically changed the way people obtain and interact with information about diseases, treatments, and conditions. Yet, our understanding of how people access and use health information to make decisions- in other words, their health literacy- has not progressed. The overall aim of this thesis is to assess the extent to which health literacy is a valid and useful construct for policy and practice related to online health resources. A mixed-methods research programme of five studies was undertaken, influenced by realist evaluation methodology. First, to ascertain engagement with user-generated online health content (UGC) in the UK, analysis of a large European survey was undertaken. Then, the uncertainty regarding the relationship between health literacy and outcomes was addressed by a systematic review and qualitative analysis of health literacy measures. Results of these two studies informed interviews carried out with 13 'key informants': policymakers and primary care clinicians in the UK with a particular interest in health literacy and/or online information. A systematic review, incorporating a traditional narrative review and a realist review, evaluated existing trials addressing how effects of online resources vary by health literacy level. Finally, data were analysed from a feasibility randomized controlled trial, comparing usage and outcomes of accessing a 'personal experiences'-based asthma website (representing curated user-generated content) versus a 'facts and figures'-based website. Participant health literacy was assessed using an index identified from the systematic review of measures, and website usage was tracked. Approximately 25% of UK internet users engage with UGC at least monthly. The most frequent users were younger, more likely to be male, and to be carers for someone with a long-term illness. Three themes were identified from health literacy measurement: 'appropriate health decisions', 'ability to obtain healthcare services', and 'confidence'. Key informants noted the lack of clarity about how health literacy influences outcomes, and suggested that personal preferences and digital access and skills may be more relevant than health literacy for policy and practice. Existing trials of online resources in which participant health literacy was measured were mostly at high risk of bias; some possible explanations of how these interventions should work in people with low health literacy were that they may experience higher data entry burden related to chronic diseases, and that they may prefer simulated face-to-face communication. Finally, there were no differences between health literacy groups in the feasibility trial regarding usage or outcomes related to either the 'facts and figures' or 'personal experiences' websites. Taken together, these results question the validity and appropriateness of health literacy as a key objective or consideration in the development or use of online resources. While health literacy has value as a general idea, this thesis demonstrates that it may no longer be the right construct to guide intervention development and implementation to improve health outcomes.
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Ölvingson, Christina. "On development of information systems with GIS functionality in public health informatics : a requirements engineering approach /." Linköping : Univ, 2003. http://www.bibl.liu.se/liupubl/disp/disp2003/tek823s.pdf.
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Kirby, Bradley. "Data linkage for pharmacovigilance using routinely acquired electronic health data." Thesis, University of Aberdeen, 2014. http://digitool.abdn.ac.uk:80/webclient/DeliveryManager?pid=215567.
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Introduction: Despite the establishment of pharmacovigilance systems, there is a recognised paucity of information specifically on the safety of paediatric medicines. Data linkage techniques offer real potential for linking routinely collected population based primary and secondary care datasets, using the Community Health Index (CHI) as a patient linkage key, to monitor the safety of new drugs and treatments. Aim: To explore the validity of routinely acquired NHS data and the utility of linking this data to support a routine mechanism for post-marketing surveillance of paediatric medicines. Methods: The internal and external validity of the Scottish national Prescribing Information System (PIS) was assessed using retrospective cohort studies combined with data linkage techniques. This PhD programme assesses the consistency of unique patient identifiers; the completeness and accuracy of the data; and the extent to which well established associations between drugs and adverse events can be reproduced using routinely collected NHS data. Results: For routine prescribing data a CHI number was found present on nearly 95% of dispensed items. In the first cohort study, insulin prescriptions within PIS were identified for 96% (95% CI 0.96-0.97) of children hospitalised for type 1 diabetes (SMR01). The rates of newly prescribed insulin were concordant with published rates in both Scottish and non-Scottish populations. In the second study asthma prescribing in children was observed to be complete (sensitivity 0.96 (95% CI 0.95-0.98)) and accurate (PPV 0.87 (95% CI 0.83-0.9)) when compared with a gold standard patient registry. Finally, patients newly prescribed NSAID therapy were observed to be 1.51 (95% CI 1.24-1.85) to 3.97 (95% CI 1.27 – 12.46) times more likely to experience first time hospitalisation for a gastrointestinal event than unexposed. Significant risk factors for a GI event were age and concurrent use of antiplatelet and anticoagulant therapy. These results are concordant with the published literature. Conclusions: Routine Scottish prescribing data is consistent, complete and accurate; however several key variables such as indication, dose and frequency, which are essential for robust pharmacovigilance, are currently missing from routinely collected data.
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Dikweni, Lulama. "An assessment of the health channel broadcasting multimedia for communication and dissemination of information in the health sector." Thesis, Stellenbosch : University of Stellenbosch, 2006. http://hdl.handle.net/10019.1/17349.
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Thesis (MPhil)--University of Stellenbosch, 2006.<br>ENGLISH ABSTRACT: The study reported on here was conducted between December 2003 and April 2004. The aim of the study was to assess the use of Health Channel Broadcast Multimedia (HCBM) in order to maximise its success. The HCBM is an Information Technology method that was used to disseminate health information in public health facilities. HCBM was installed in health facilities and was used as an education tool. This was done by further developing the clinical skills of the health care workers (HCWs) and to inform the patients, including the community members on HIV/AIDS and related communicable diseases.
The study was conducted in eight health facilities in seven provinces where HCBM was piloted. Facilities and forty-nine health professionals (HCWs) were selected conveniently and one hundred and twenty-eight patients were sampled using a systematic random method. The convenient sampling method was relevant since these were key facilities with HCBM. There were very few HCWs who did view HCBM and they were drawn into the study. HCBM used programmes disseminating messages in Afrikaans, English, sePedi, seSotho, siSwati, isiXhosa and isiZulu. The Rapid Assessment Response (RAR) approach was used to give a quick appraisal of the study. The report focuses on the cross-sectional reporting of the quantitative technique of the RAR.
Of the HCWs, 86% had viewed the broadcast content, 70% were satisfied with the broadcast mode of service delivery; 56% indicated that the messages were good and added educational value to their professional work, while 52% chose to use the IP box content with HIV/AIDS topics. Ninety-two percent of HCWs stated that HCBM targeted patients and young people, 48% said HCBM had the ability to convey information and 48% said it was capable of addressing health problem. When HCBM was being set up, 62% HCWs engaged in decision making.
Patients mentioned that HCBM as a method of information dissemination was educative (62%) and informative (52%). They reported that they did hear messages on HIV/AIDS telling them that medication was available for free to treat within 72 hours after being raped (72%); they had the right to say no to unsafe sex (92%); and 76% said the broadcast had the ability to change people’s behaviour. Respondents reported that the messages were easily understood (44%).
The conclusion is that the findings will be useful to inform the government and managers of HCBM programmes on how to maximise the success of HCBM, especially at the implementation phase.<br>AFRIKAANSE OPSOMMING: Hierdie verslag doen verslag oor die resultate van ’n ondersoek wat tussen Desember 2003 en April 2004 onderneem is. Die doel van die verslag is om die doeltreffendheid van die gebruik van ’n multimedia gesondheidsuitsendingkanaal, Health Channel Broadcast Multimedia (HCBM) te bepaal. Hierdie is nuwe tegnologie wat gebruik word om gesondheidsinligting slegs in die openbare gesondheidsektor te versprei.
Die studie is by agt openbare gesondheidsfasiliteite in sewe provinsies waar die HCBM volledig gevestig was, onderneem. Nege-en-veertig gesondheidskundiges (HPW’s) is volgens ’n gerieflikheidsteekproef geselekteer, en 128 pasiënte is met behulp van ’n sistematiese ewekansige steekproef geselekteer. Die HCBM het programme gebruik wat boodskappe in Afrikaans, Engels, sePedi, seSotho, siSwati, isiXhosa en isiZulu uitgesaai het. ’n Benadering bekend as die Rapid Assessment Response (RAR) is gebruik om ’n vinnige evaluering van die studie te maak. Die verslag konsentreer op die deursneerapportering van die kwantitatiewe tegniek van die RAR.
Van die HPW’s het 85% na die inhoud van die uitsending gekyk, 70% was tevrede met die uitsendingmodus van dienslewering, 56% het aangedui dat die boodskappe goed was en van opvoedkundige waarde in hulle professionele werk, terwyl 52% verkies het om die Internet Platform-inhoud met MIV/Vigs-temas te gebruik. Twee-en-negentig persent van die HPW’s het te kenne gegee die HCBM is gerig op pasiënte en die jeug, 48% het gesê HCBM het die vermoë om inligting oor te dra, en 48% het gesê dit is geskik om na die gesondheidsprobleem om te sien. Tydens die instelling van die HCBM het 62% HPW’s aan besluitneming deelgeneem. Van die pasiënte met grade 0–6 as opvoedingspeil het 75% verkies om brosjures te gebruik bo enige ander massamedia, en 72% mans en 67% vrouens het na boodskappe oor die behandeling van MIV/Vigs-simptome geluister. Inligting oor vrywillige berading en toetsing voor swangerskap is deur 66% van die vrouens gehoor. Meer as 90% van hulle was bewus van die reg om nee te sê vir seks of onveilige seks. Pasiënte oor die hele residensiële gebied was dit eens dat die taalgebruik in die uitsendings maklik verstaanbaar was. Oor al die opvoedkundige grade heen is saamgestem dat die HCBM die voorgenome boodskap oorgedra het.
Die gevolgtrekking is dat die bevindings waardevol is om die regering en bestuurders van die uitsendingsprogram in te lig oor hoe om die ander fases te verbeter. Dit sluit Fase 2 in, wat die uitvoering van die HCBM behels.
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Moreno, Conde A. "Quality framework for semantic interoperability in health informatics : definition and implementation." Thesis, University College London (University of London), 2016. http://discovery.ucl.ac.uk/1529311/.
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Aligned with the increased adoption of Electronic Health Record (EHR) systems, it is recognized that semantic interoperability provides benefits for promoting patient safety and continuity of care. This thesis proposes a framework of quality metrics and recommendations for developing semantic interoperability resources specially focused on clinical information models, which are defined as formal specifications of structure and semantics for representing EHR information for a specific domain or use case. This research started with an exploratory stage that performed a systematic literature review with an international survey about the clinical information modelling best practice and barriers. The results obtained were used to define a set of quality models that were validated through Delphi study methodologies and end user survey, and also compared with related quality standards in those areas that standardization bodies had a related work programme. According to the obtained research results, the defined framework is based in the following models: Development process quality model: evaluates the alignment with the best practice in clinical information modelling and defines metrics for evaluating the tools applied as part of this process. Product quality model: evaluates the semantic interoperability capabilities of clinical information models based on the defined meta-data, data elements and terminology bindings. Quality in use model: evaluates the suitability of adopting semantic interoperability resources by end users in their local projects and organisations. Finally, the quality in use model was implemented within the European Interoperability Asset register developed by the EXPAND project with the aim of applying this quality model in a broader scope to contain any relevant material for guiding the definition, development and implementation of interoperable eHealth systems in our continent. Several European projects already expressed interest in using the register, which will now be sustained by the European Institute for Innovation through Health Data.
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Mitchell, Donna J. "A Model of Information Therapy: Definition and Empirical Application." Thesis, University of North Texas, 1999. https://digital.library.unt.edu/ark:/67531/metadc277931/.
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This study involves the investigation of the basis and validity of considering health information as therapeutic, the definition of Information Therapy, and whether the therapeutic nature of information can be measured empirically. The purpose of the study is to determine if there are any significant differences in the therapeutic effect of Information Therapy through the different delivery modes of support groups communicating face-to-face and those utilizing computer-mediated communication on the Internet. The comparison of these groups revealed no significant differences on three measures of health: physical, mental, and social support. Because one communication medium is not found to be advantageous over the other, the use of the computer can extend the benefits of Information Therapy to the home-bound, to those in remote areas, to people with time restraints, and those who may be shy. The validity of the therapeutic nature of information was verified by participant report of the effect of a health information search. Results demonstrated that the primary source for information is the physician, followed by the Internet, and 77% of participants reported a positive or therapeutic effect when health information was found. These results are significant because individuals who are in positions to deliver Information Therapy can better meet needs by identification of the sources to which people look for information and can have a major impact on patient care and the general health of the population. Providing people with information can empower them to take an active role in their health, can increase confidence in self-care, and should provide coping and disease management skills thus decreasing the utilization of healthcare resources and preventing costly acute and chronic health complications.
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Forster, Mary Ekundayo Lucretia. "Health informatics in developing countries : an analysis and two African case studies." Thesis, London School of Economics and Political Science (University of London), 1990. http://etheses.lse.ac.uk/1211/.
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This thesis relates informatics to the problems of health and medicine experienced in less developed countries. It evaluates the potential of health informatics and investigates the issues that constrain successful implementations. This serves as a basis for establishing a generic description of viable computer applications in the developing world. The thesis contains two case studies from sub-Saharan Africa. The first, undertaken in The Gambia, is based on a computer-assisted data collection system used in a longitudinal child health survey. The second, undertaken in Kenya, relates to a medical decision-aid system used in an out-patient clinic of a district hospital. In each case, an outline is given of the background to the application domain, and an analysis is made of some comparable prior systems that have been developed and evaluated. The two case studies provide interesting investigatory comparisons since both systems are used by health personnel with little computer experience, and exploit some state-of-the-art technologies despite the identified constraints that exist in developing countries. The context, system design, methods, and results of each case are described. A generalised evaluation approach is proposed and is used to summarise the case study findings. The evaluation framework employed includes components related to functional and human perspectives as well as the anticipated benefits to the health care system. The thesis concludes by suggesting some guidelines for the design and evaluation of future health information systems.
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MacLean, Fiona M. "Health informatics and the delivery of pharmaceutical care to patients with cancer." Thesis, University of Strathclyde, 2018. http://digitool.lib.strath.ac.uk:80/R/?func=dbin-jump-full&object_id=29532.
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This research was conducted to investigate how e-health technologies can contribute to the delivery of pharmaceutical care throughout the patient's journey and across traditional care boundaries. The hypothesis was that e-health technologies are enablers of efficient seamless delivery of pharmaceutical care. Qualitative and quantitative methods were used to examine how hospital clinical pharmacists work; to find out which toxicities were experienced by patients prescribed systemic anticancer therapy (SACT) and what their pharmaceutical care issues were; and to investigate the views of both cancer patients and community pharmacists relating to delivery of pharmaceutical care. The main findings were: access to mobile technology improved the efficiency of hospital clinical pharmacists; patients receiving SACT experienced a range of toxicity, some of which could be managed in primary care; patients would be happy to receive more from their community pharmacist; and community pharmacists should have access to electronic patient records (EPR) to safely deliver pharmaceutical care. Most patients who receive SACT experience toxicity in the community. Community pharmacists are ideally placed to support these patients but pharmacists require training and access to EPR to improve their confidence in managing SACT toxicity. Cancer care specialist pharmacists can contribute to the education and training of community pharmacists and initiatives to do so were implemented in NHS Greater Glasgow & Clyde (NHSGGC). Health and wellbeing Smartphone Apps can support patients and the Wellness Tracker, designed in this study, aimed to be an innovative technological aid for patients with cancer. Feedback from teenage patients was positive. XPost-study initiatives implemented in NHSGGC included electronic referral from hospital to GP-based pharmacists as step one. Two-way sharing of the electronic cancer pharmaceutical care plan; electronic referral to community pharmacists (step two) once access to EPR is granted; and clinical vignettes to support community pharmacists in providing advice to patients who have SACT toxicity will follow. Scottish cancer care pharmacists, in collaboration with the Scottish Directors of Pharmacy, have started development of nationally agreed pharmaceutical care bundles for community pharmacists to enable local delivery of pharmaceutical care to patients prescribed SACT.
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Horner, Vincent Zion. "Developing a consumer health informatics decision support system using formal concept analysis." Diss., Pretoria : [s.n.], 2007. http://upetd.up.ac.za/thesis/available/etd-05052008-112403/.
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Adejare, Adeboye A. Jr. "Equiformatics: Informatics Methods and Tools to Investigate and Address Health Disparities and Inequities." University of Cincinnati / OhioLINK, 2021. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1623164833455566.
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Li, Kit-ling Carol, and 李潔寧. "m-Health smartphone applications on chronic disease monitoring : development and regulatory considerations." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2014. http://hdl.handle.net/10722/206932.
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Introduction: The market for chronic disease management apps for patients is growing from year to year. However, policy and regulation of app use for medical purposes in Asia Pacific are not developed. Methods: 1) A systematic review of randomized-controlled trials of diabetes management apps for patients are assessed as to determine whether using the app (intervention group) leads to significant reductions in HbA1c levels ; 2) A comparison of paid and free apps based on number of group functions between Apple iTunes App Store and Google Play for Android. Results: 1) A reduction in HbA1c in both the intervention (m-Health) and control (usual care) group, although two studies identified the changes as statistically insignificant; 2) Apple iTunes App store included 95 free diabetes management apps for patients and 86 paid apps at an average cost of $19.91. Google Play offered 80 free apps and 31 paid apps at an average cost of $4.31. The largest HbA1c reductions could be found when clinical, social, behavioural, and affective factors are taken into account in the app’s supporting system (e.g. WellDoc™ System (WDS). Discussion: There is some evidence to suggest that mobile apps for diabetes management for patients show reductions in HbA1c similar to usual care. In Hong Kong, some progress has been made regarding the promotion of the use of m-Health for the elderly and disabled, but policies on app development, approval, and regulation are absent. Future expansion of ICT may consider m-Health for chronic disease management based on international lessons on medical device and medical apps guidelines.<br>published_or_final_version<br>Public Health<br>Master<br>Master of Public Health
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Bhattacharya, Sanmitra. "Computational methods for mining health communications in web 2.0." Diss., University of Iowa, 2014. https://ir.uiowa.edu/etd/4576.
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Data from social media platforms are being actively mined for trends and patterns of interests. Problems such as sentiment analysis and prediction of election outcomes have become tremendously popular due to the unprecedented availability of social interactivity data of different types. In this thesis we address two problems that have been relatively unexplored. The first problem relates to mining beliefs, in particular health beliefs, and their surveillance using social media. The second problem relates to investigation of factors associated with engagement of U.S. Federal Health Agencies via Twitter and Facebook.
In addressing the first problem we propose a novel computational framework for belief surveillance. This framework can be used for 1) surveillance of any given belief in the form of a probe, and 2) automatically harvesting health-related probes. We present our estimates of support, opposition and doubt for these probes some of which represent true information, in the sense that they are supported by scientific evidence, others represent false information and the remaining represent debatable propositions. We show for example that the levels of support in false and debatable probes are surprisingly high. We also study the scientific novelty of these probes and find that some of the harvested probes with sparse scientific evidence may indicate novel hypothesis. We also show the suitability of off-the-shelf classifiers for belief surveillance. We find these classifiers are quite generalizable and can be used for classifying newly harvested probes. Finally, we show the ability of harvesting and tracking probes over time. Although our work is focused in health care, the approach is broadly applicable to other domains as well.
For the second problem, our specific goals are to study factors associated with the amount and duration of engagement of organizations. We use negative binomial hurdle regression models and Cox proportional hazards survival models for these. For Twitter, the hurdle analysis shows that presence of user-mention is positively associated with the amount of engagement while negative sentiment has inverse association. Content of tweets is also equally important for engagement. The survival analyses indicate that engagement duration is positively associated with follower count. For Facebook, both hurdle and survival analyses show that number of page likes and positive sentiment are correlated with higher and prolonged engagement while few content types are negatively correlated with engagement. We also find patterns of engagement that are consistent across Twitter and Facebook.
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Liu, Yin-Miao (Vicky). "An architecture for enhanced assurance in e-health systems." Thesis, Queensland University of Technology, 2011. https://eprints.qut.edu.au/47051/1/Vicky_Liu_Thesis.pdf.
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Notwithstanding the obvious potential advantages of information and communications technology (ICT) in the enhanced provision of healthcare services, there are some concerns associated with integration of and access to electronic health records. A security violation in health records, such as an unauthorised disclosure or unauthorised alteration of an individual's health information, can significantly undermine both healthcare providers' and consumers' confidence and trust in e-health systems. A crisis in confidence in any national level e-health system could seriously degrade the realisation of the system's potential benefits. In response to the privacy and security requirements for the protection of health information, this research project investigated national and international e-health development activities to identify the necessary requirements for the creation of a trusted health information system architecture consistent with legislative and regulatory requirements and relevant health informatics standards. The research examined the appropriateness and sustainability of the current approaches for the protection of health information. It then proposed an architecture to facilitate the viable and sustainable enforcement of privacy and security in health information systems under the project title "Open and Trusted Health Information Systems (OTHIS)". OTHIS addresses necessary security controls to protect sensitive health information when such data is at rest, during processing and in transit with three separate and achievable security function-based concepts and modules: a) Health Informatics Application Security (HIAS); b) Health Informatics Access Control (HIAC); and c) Health Informatics Network Security (HINS). The outcome of this research is a roadmap for a viable and sustainable architecture for providing robust protection and security of health information including elucidations of three achievable security control subsystem requirements within the proposed architecture. The successful completion of two proof-of-concept prototypes demonstrated the comprehensibility, feasibility and practicality of the HIAC and HIAS models for the development and assessment of trusted health systems. Meanwhile, the OTHIS architecture has provided guidance for technical and security design appropriate to the development and implementation of trusted health information systems whilst simultaneously offering guidance for ongoing research projects. The socio-economic implications of this research can be summarised in the fact that this research embraces the need for low cost security strategies against economic realities by using open-source technologies for overall test implementation. This allows the proposed architecture to be publicly accessible, providing a platform for interoperability to meet real-world application security demands. On the whole, the OTHIS architecture sets a high level of security standard for the establishment and maintenance of both current and future health information systems. This thereby increases healthcare providers‘ and consumers‘ trust in the adoption of electronic health records to realise the associated benefits.
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Chitondo, Pepukayi David Junior. "Data policies for big health data and personal health data." Thesis, Cape Peninsula University of Technology, 2016. http://hdl.handle.net/20.500.11838/2479.
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Thesis (MTech (Information Technology))--Cape Peninsula University of Technology, 2016.<br>Health information policies are constantly becoming a key feature in directing information
usage in healthcare. After the passing of the Health Information Technology for
Economic and Clinical Health (HITECH) Act in 2009 and the Affordable Care Act (ACA)
passed in 2010, in the United States, there has been an increase in health systems
innovations. Coupling this health systems hype is the current buzz concept in Information
Technology, „Big data‟. The prospects of big data are full of potential, even more so in the
healthcare field where the accuracy of data is life critical. How big health data can be
used to achieve improved health is now the goal of the current health informatics
practitioner. Even more exciting is the amount of health data being generated by patients
via personal handheld devices and other forms of technology that exclude the healthcare
practitioner. This patient-generated data is also known as Personal Health Records,
PHR. To achieve meaningful use of PHRs and healthcare data in general through big
data, a couple of hurdles have to be overcome. First and foremost is the issue of privacy
and confidentiality of the patients whose data is in concern. Secondly is the perceived
trustworthiness of PHRs by healthcare practitioners. Other issues to take into context are
data rights and ownership, data suppression, IP protection, data anonymisation and reidentification,
information flow and regulations as well as consent biases. This study
sought to understand the role of data policies in the process of data utilisation in the
healthcare sector with added interest on PHRs utilisation as part of big health data.
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Cheng, Chih-Wen. "Development of integrated informatics analytics for improved evidence-based, personalized, and predictive health." Diss., Georgia Institute of Technology, 2015. http://hdl.handle.net/1853/54872.
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Advanced information technologies promise a massive influx of individual-specific medical data. These rich sources offer great potential for an increased understanding of disease mechanisms and for providing evidence-based and personalized clinical decision support. However, the size, complexity, and biases of the data pose new challenges, which make it difficult to transform the data to useful and actionable knowledge using conventional statistical analysis. The so-called “Big Data” era has created an emerging and urgent need for scalable, computer-based data mining methods that can turn data into useful, personalized decision support knowledge in a flexible, cost-effective, and productive way. The goal of my Ph.D. research is to address some key challenges in current clinical deci-sion support, including (1) the lack of a flexible, evidence-based, and personalized data mining tool, (2) the need for interactive interfaces and visualization to deliver the decision support knowledge in an accurate and effective way, (3) the ability to generate temporal rules based on patient-centric chronological events, and (4) the need for quantitative and progressive clinical predictions to investigate the causality of targeted clinical outcomes. The problem statement of this dissertation is that the size, complexity, and biases of the current clinical data make it very difficult for current informatics technologies to extract individual-specific knowledge for clinical decision support. This dissertation addresses these challenges with four overall specific aims: Evidence-Based and Personalized Decision Support: To develop clinical decision support systems that can generate evidence-based rules based on personalized clinical conditions. The systems should also show flexibility by using data from different clinical settings. Interactive Knowledge Delivery: To develop an interactive graphical user interface that expedites the delivery of discovered decision support knowledge and to propose a new visualiza-tion technique to improve the accuracy and efficiency of knowledge search. Temporal Knowledge Discovery: To improve conventional rule mining techniques for the discovery of relationships among temporal clinical events and to use case-based reasoning to evaluate the quality of discovered rules.
Clinical Casual Analysis: To expand temporal rules with casual and time-after-cause analyses to provide progressive clinical prognostications without prediction time constraints. The research of this dissertation was conducted with frequent collaboration with Children’s Healthcare of Atlanta, Emory Hospital, and Georgia Institute of Technology. It resulted in the development and adoption of concrete application deliverables in different medical settings, including: the neuroARM system in pediatric neuropsychology, the PHARM system in predictive health, and the icuARM, icuARM-II, and icuARM-KM systems in intensive care. The case studies for the evaluation of these systems and the discovered knowledge demonstrate the scope of this research and its potential for future evidence-based and personalized clinical decision support.
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ROMEO, LUCA. "Applied Machine Learning for Health Informatics: Human Motion Analysis and Affective Computing Application." Doctoral thesis, Università Politecnica delle Marche, 2018. http://hdl.handle.net/11566/253031.
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Il monitoraggio della qualità della vita e del benessere della persona rappresenta una sfida
aperta nello scenario sanitario. La necessità di risolvere questo task nella nuova era
dell'Intelligenza Artificiale porta all’applicazione di metodi dal campo del machine learning.
Gli obiettivi e i contributi di questa tesi riflettono le attività di ricerca svolte (i) nell’ambito
dell’analisi del movimento: valutazione e monitoraggio automatico del movimento umano
durante la riabilitazione fisica, e (ii) nell’ambito dell’affective computing: stima dello stato
affettivo del soggetto.
Nel primo tema il candidato presenta un algoritmo in grado di estrarre le caratteristiche di
movimento clinicamente rilevanti dalle traiettorie dello skeleton acquisite da un sensore RGBD,
e fornire un punteggio sulla prestazione del soggetto. L'approccio proposto si basa su
regole derivate da indicazioni cliniche e su un algoritmo di machine learning (i.e., Hidden
Semi-Markov Model). L'affidabilità dell'approccio proposto è studiata su un dataset
collezionato dal candidato rispetto ad un algoritmo gold standard e alla valutazione clinica. I
risultati sostengono l'uso della metodologia proposta per la valutazione quantitativa delle
prestazioni motorie durante la riabilitazione fisica.
Nel secondo topic il candidato propone l’applicazione del framework di Multiple Instance
Learning per l'apprendimento della risposta emotiva in presenza di label continui ed ambigui.
Questa varaibilità è spesso presente nella risposta affettiva ad uno stimolo esterno (e.g.,
interazione multimediale). L'affidabilità dell'approccio di Multiple Instance Learning è
indagata su un database di benchmark e un dataset più vicino alle problematiche del mondo
reale acquisito dal candidato. I risultati ottenuti evidenziano come la metodologia proposta è
consistente per la stima dello stato affettivo.<br>The monitoring of the quality of life and the subject's well-being represent an open challenge
in the healthcare scenario. The emergence of solving this task in the new era of Artificial
Intelligence leads to the application of methods in the machine learning field.
The objectives and the contributions of this thesis reflect the research activities performed on
the topics of (i) human motion analysis: the automatic monitoring and assessment of human
movement during physical rehabilitation and (ii) affective computing: the inferring of the
affective state of the subject.
In the first topic, the author presents an algorithm able to extract clinically relevant motion
features from the RGB-D visual skeleton joints input and provide a related score about
subject’s performance. The proposed approach is respectively based on rules derived by
clinician suggestions and machine learning algorithm (i.e., Hidden Semi Markov Model). The
reliability of the proposed approach is tested over a dataset collected by the author and with
respect to a gold standard algorithm and with respect to the clinical assessment. The results
support the use of the proposed methodology for quantitatively assessing motor performance
during a physical rehabilitation.
In the second topic, the author proposes the application of a Multiple Instance Learning (MIL)
framework for learning emotional response in presence of continuous and ambiguous labels.
This is often the case with affective response to external stimuli (e.g., multimedia interaction).
The reliability of the MIL approach is investigated over a benchmark database and one dataset
closer to real-world problematic collected by the author. The obtained results point out how
the applied methodology is consistent for predicting the human affective response.
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Dunn, Kristina Ann. "Nursing Informatics Competency Program." ScholarWorks, 2017. https://scholarworks.waldenu.edu/dissertations/3985.
Full textAbstract:
Currently, C Hospital lacks a standardized nursing informatics competency program to validate nurses' skills and knowledge in using electronic medical records (EMRs). At the study locale, the organization is about to embark on the implementation of a new, more comprehensive EMR system. All departments will be required to use the new EMR, unlike the current policy that allows some areas to still document on paper. The Institute of Medicine, National League of Nursing, and American Association of Colleges of Nursing support and recommend that information technology be an essential core competency for nurses. Evidence of the need for nursing informatic competencies was found through a literature search using CINHAL, Proquest Nursing, Medline, and Pubmed search lines. Concepts searched were competencies, nursing informatics, health information technology, electronic health record, information technology literacy, nursing education, information technology training, and curriculum. The Staggers Nursing Computer Experience Questionnaire was distributed to 300 nurses practicing within the hospital setting to obtain baseline data on current nursing computer knowledge and skill level. This validated tool was created by Nancy Staggers in 1994 and used in other process improvement efforts similar to this one. The assumption was that nursing competency levels with computers were varied through the hospital. The data obtained from the questionnaire, through Zoho Survey tool, confirmed this assumption and were used to help create the education, support, and competency plan for the future. Data was analyzed through the built-in reports and interactive charts that the Zoho survey tool provides. The new EMR and all the new processes that come with it will be the framework of nursing care. Having competent nurses in the use of the EMR will optimize the quality of patient care delivered.
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Soares, Stephanie Elaine. "An integrated informatics approach to institutional biobanking| EHR utilization in the procurement of research biospecimens." Thesis, University of California, Davis, 2013. http://pqdtopen.proquest.com/#viewpdf?dispub=1539704.
Full textAbstract:
<p> <b>Introduction:</b> Human biospecimens such as surgical tissue and blood are essential for some types of biomedical research because they contain genetic material (genes contained in living organisms). Because of their genetic content, biospecimens are able to add great value to fields of study such as genomics, molecular biology and biological chemistry. Increasing knowledge in these fields holds promise for improving healthcare for individual patients (precision medicine), as well as the broader healthcare community. These genetic materials obtained from patient donors are procured, stored and dispersed through a complex operation called biobanking. Biobanking systems are involved with two primary functions, 1) procure sufficient quantities of human biospecimens allowing researchers the materials required to answer scientific questions, and 2) capture relevant corresponding clinical and phenotypic information for eventual correlation with scientific results. This capture and manipulation of corresponding information (e.g. clinical, pathological, and environmental) are where the value of the biospecimens are maximized for research purposes. The complexity of biobanking requires informatics to integrate the biospecimen-related information with corresponding clinical and phenotypic data. In designing biobanking systems, informatics must be considered as they play a vital role in managing the samples and data in a timely fashion as well as reducing the costs associated with biobanking. </p><p> <b>Background:</b> Biobanks are resources that play a key role in the procurement, processing, storage and dispersal of human biospecimens. Collections of human tissue have been a common place in hospitals and specialist clinics since the nineteenth century when preservation techniques were introduced. Governance concerning these human biobanks has evolved and is set by institutional, regional, national and international policy. They can be public (e.g. non-profit, academic, governmental), private (e.g. for-profit or pharmaceutical industry) or public-private partnerships. Regardless of the governance level or specific research focus of the biobank, the next generation of biobanking resources will require interdisciplinary collaborations and integrated informatics approaches to accelerate the procurement and use of the research biospecimens. </p><p> <b>Methods:</b> A literature search was conducted to explore biobanking informatics configurations and architecture to determine the context and extent of the software applications utilized in current biobanking systems. There were a substantial number of publications describing informatics architecture and their export of data to a Virtual Data Warehouse or Centralized Research Data Repository. However, there was a lack of published literature specifically describing use of an enterprise-wide electronic health record (EHR) in the initial three upstream workflows (i.e. clinical, pathology and biobank) involved with most institutional biobanking systems. Patient data generated/utilized in these three workflows are manually double-entered into separate information applications as there is no direct data exchange/export between EHR and the Laboratory Information System (LIS) or the Biorepository Information Management System (BIMS) specifically to assist with biobank procurement. Therefore, an EHR integrated-access informatics model was designed that would maximize benefits created by the EHRs capabilities in the upstream workflows of an institutional biobanking system. The approach described in the thesis was designed and documented using a model driven UML tool and incorporates an EHR integrated-access approach along with inter-departmental workflow processes. Interoperability gaps were identified that could take advantage of institutional EHR software existing at most large academic healthcare institutions or teaching hospitals. This model synergistically integrates the EHR, LIS and BIMS to maximize information exchange during the upstream biospecimen procurement workflow. This informatics model for institutional biobanking is based on the premise that commercial software applications are already implemented at most large academic healthcare facilities and they can be utilized within their biobanking systems. </p><p> <b>Conclusion:</b> This EHR integrated-access model would enhance sharing of key research data between three software applications (EHR, LIS, BIMS) that are available at most large academic medical centers that perform research biobanking. The informatics model would promote data exchange between processes of three primary biobanking steps in the clinic, pathology department and biobank improving efficiency and increasing biospecimen procurement. Large healthcare facilities who have EHR, LIS and BIMS applications available could utilize this EHR integrated-access model as a first-step in improving their biobanking informatics workflow to increase high-quality biospecimen collections. New methodologies that improve the success of biobanks can eventually lead to institutional biobanking systems playing a major role in a path to personalized medicine.</p>
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Moncur, Wendy. "A model for the provision of adaptive eHealth information across the personal social network." Thesis, University of Aberdeen, 2011. http://digitool.abdn.ac.uk:80/webclient/DeliveryManager?pid=167015.
Full textAbstract:
This thesis describes research into the facilitation of mediated communication of health updates and support needs across the social network, on behalf of individuals experiencing acute or chronic health problems. This led to the user-centred design, development and evaluation of a prototype software tool. Investigatory applied research was conducted with the parents of sick newborn infants who were (or had previously been) cared for in a Neonatal Unit, and their social networks of family, friends, colleagues and neighbours. The thesis makes contributions to knowledge within Social Networks, Health Informatics, Adaptive Systems and User Modelling. The user-centred research was conducted using a Grounded Theory approach, progressively focussing on developing themes. An iterative approach was taken to evaluation of the resulting theory. In the Social Networks domain, a novel, intuitive mechanism for capturing the membership and structure of an individual’s personal social network has been defined and developed, grounded in the work of evolutionary anthropologist Robin Dunbar. Use of the highly visual mechanism requires low levels of literacy and computer skills. It is cross-culturally applicable, and makes no prior assumptions about an individual’s relationships. In the domains of Health Informatics, Adaptive Systems and User Modelling, a model has been defined for adaptive information sharing across the personal social network. This model provides a number of new insights about information sharing choices made by an individual experiencing a health crisis (the ego) and their supporters (alters).
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Owolabi, Kehinde Aboyami. "Access and use of clinical informatics among medical doctors in selected teaching hospitals in Nigeria and South Africa." Thesis, University of Zululand, 2017. http://hdl.handle.net/10530/1529.
Full textAbstract:
A dissertation submitted to the Faculty of Arts in fulfilment of the requirements for the Degree of Doctor of Philosophy (Library and Information Studies) in the Department of Information Studies at the University Of Zululand, 2017<br>This study examined access and use of clinical informatics among medical doctors at University College Hospital, Nigeria and King Edward VIII Hospital, South Africa. The specific objectives of the study were to explain the purposes of using clinical informatics; determine the benefits of using clinical informatics in the selected teaching hospitals; ascertain the availability of clinical informatics infrastructure in the selected teaching hospitals; identify the clinical informatics facilities that are accessible to medical doctors in the selected teaching hospitals; determine the factors that influence the behavioural intention to use clinical informatics by medical doctors in the selected teaching hospitals; determine the policies that guide the effective accessibility and utilisation of clinical informatics among medical doctors in the selected teaching hospitals; and investigate the challenges that faced both the access to and the use of clinical informatics among medical doctors in the selected teaching hospitals. The study adopted the post-positivist paradigm which combines both qualitative and quantitative research methods. The study largely used a survey design. The sample for the study was drawn from medical doctors in two purposively selected teaching hospitals in Nigeria and South Africa. The teaching hospitals were King Edward V111 hospital, Durban, South Africa and University College Hospital, Ibadan, Nigeria. The two teaching hospitals were selected because they belong to the first generation of teaching hospitals in Nigeria and South Africa, among other reasons. It was believed that they would be well established in terms of funding towards infrastructure and human development in their respective countries. Convenience sampling was used to select the respondents for the study. The questionnaire was administered to 413 medical doctors, 258 (63%) of whom returned the questionnaire. Interviews were also conducted with the heads of the ICT units at the University College Hospital in Ibadan, Nigeria, and King Edward VIII Hospital in Durban, South Africa. The quantitative data aspect of the study was analysed using descriptive statistics and Statistical Package for Social Sciences (SPSS), while the qualitative aspect of the data was analysed through the use of qualitative contents analysis. The study was guided by the Unified theory of acceptance and use of technology (UTAUT). The essence of using this theory is to identify the factors that influence the use of clinical informatics. The finding of the study reveals that there was an association between the demographic variables and the use of clinical informatics. It was established that there was a significant association between the medical department and the use of electronic medical records. An assessment of the socio-demographic characteristics and the use of the Clinical Decision Support System revealed that there was a significant association between the years of medical practice and the use of Clinical Decision Support System. The finding also revealed that social demographic variables such as age, years of practice and position were all significant related with the use of diagnostic image archiving. Furthermore, the surveyed medical doctors stated that their main purpose of using clinical informatics is for medical diagnosis. It was also discovered that there is association between the teaching hospitals and the use of clinical informatics for knowledge sharing. In addition, clinical informatics was found to influence the spirit of team work amongst the medical doctors through knowledge sharing with their professional colleagues and their medical students. Similarly, there were association between the teaching hospitals treatment of patients and effective healthcare delivery. In addition, the major benefit of using clinical informatics in the two hospitals was to reduce medical errors.
The most available clinical informatics tools in the selected teaching hospitals were the Diagnosis Image Archiving and Clinical Decision Support System. Performance expectancy and effort expectancy were identified as the factors from the UTAUT that influenced the medical doctors’ behavioural intention to use clinical informatics resources in the selected teaching hospitals. The non-availability of clinical informatics resources was identified as the main challenge facing the effective access to and use of clinical informatics. In addition, the two hospitals relied on the ICT policies of other institutions and did not have their own ICT policies, which was problematic.
The study concluded that the clinical informatics environments in the two teaching hospitals are inadequate and there is poor access to clinical informatics resources among medical doctors in the selected teaching hospitals. Major recommendations of the study include the need to establish ICT policies and increase investment in clinical informatics resources at the surveyed teaching hospitals in order to promote effective and value-based healthcare delivery. In addition, the hospital management should create awareness on the importance and benefits of clinical informatics particularly for the medical doctors through informal and continuing education and training such as workshops and short courses. Moreover, the hospital managements need to partner with relevant stakeholders such as government, corporate bodies, and departments of health. This is for the provision of adequate and suitable environment to support the access and use of clinical informatics. Further studies on the various types of health informatics such as nursing informatics, pharmacy informatics and veterinary informatics are recommended. It is also suggested that the study should be extended to other regions of Africa. The study is significant and makes tangible contributions to technology acceptance and use in clinical medicine from developing country contexts such as Nigeria and South Africa giving the increasing role of information and communication technology in diagnosis, prescription, treatment, monitoring and overall management of patient care in an environment characterized by complex diseases. The study has the potential to inform policy, practises, and also contribute to this research in the general area of social information in Africa.
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Shi, Bin. "Multiscale Statistical Analysis of Self-Similar Processes with Applications in Geophysics and Health Informatics." Diss., Georgia Institute of Technology, 2005. http://hdl.handle.net/1853/6887.
Full textAbstract:
In this dissertation, we address the statistical analysis under
the multiscale framework for the self-similar process. Motivated
by the problems arising from geophysics and health informatics, we
develop a set of statistical measures as discriminative summaries
of the self-similar process. These measures include Multiscale
Schur Monotone (MSM) measures, Geometric Attributes of
Multifractal Spectrum (GAMFS), Quasi-Hurst exponents, Mallat
Model and Tsallis Maxent Model. These measures are used as
methods to quantify the difference (or similarities) or as input
(feature) vectors in the classification model. As the cornstone of
GAMFS, we study the estimation of multifractal spectrum and adopt
a Weighted Least Squares (WLS) schemes in the wavelet domain to
minimize the heteroskedastic effects , which is inherent because
the sample variances of the wavelet coefficients depend on the scale.
We also propose a Combined K-Nearest-Neighbor classifier (Comb-K-NN)
to address the inhomogeneity of the class attributes,
which is indicated by the large variations between subsets of
input vectors. The Comb-K-NN classifier stabilizes the variations
in the sense of reducing the misclassification rates. Bayesian
justifications of Comb-K-NN classifier are provided.
GAMFS, Quasi-Hurst exponents, Mallat Model and Tsallis Maxent
Model are used in the study of assessing the effects of
atmospheric stability on the turbulence measurements in the
inertial subrange. We also formulate the criteria for success in
evaluating how atmospheric stability alters the MFS of a single
flow variable time series as a statistical classification model.
We use the multifractal discriminate model as the solution of this
problem. Also, high frequency pupil-diameter dynamic measurements,
which are well documented as measures of mental workload, are
summarized using both GAMFS and MSM. These summaries are further
used as the feature vector in the Comb-K-NN classifier. The
serious inhomogeneity among subjects in the same user group makes
classification difficult. These difficulties are overcome by using
Comb-K-NN classifier.
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Miller, Andrew D. "Social tools for everyday adolescent health." Diss., Georgia Institute of Technology, 2014. http://hdl.handle.net/1853/52238.
Full textAbstract:
In order to support people's everyday health and wellness goals, health practitioners and organizations are embracing a more holistic approach to medicine---supporting patients both as individuals and members of their families and communities, and meeting people where they are: at home, work, and school. This 'everyday' approach to health has been enabled by new technologies, both dedicated-devices and services designed specifically for health sensing and feedback -- and multipurpose --such as smartphones and broadband-connected computers. Our physical relationship with computing has also become more intimate, and personal health devices can now track and report an unprecedented amount of information about our bodies, following their users around to an extent no doctor, coach or dietitian ever could.
But we still have much to learn about how pervasive health devices can actually help promote the adoption of new health practices in daily life. Once they're `in the wild,' such devices interact with their users, but also the physical, social and political worlds in which those users live. These external factors---such as the walkablity of a person's neighborhood or the social acceptability of exercise and fitness activities---play a significant role in people's ability to change their health behaviors and sustain that change. Specifically, social theories of behavior change suggest that peer support may be critical in changing health attitudes and behaviors. These theories---Social Support Theory, Social Cognitive Theory and Social Comparison Theory among them---offer both larger frameworks for understanding the social influences of health behavior change and specific mechanisms by which that behavior change could be supported through interpersonal interaction. However, we are only beginning to understand the role that pervasive health technologies can play in supporting and mediating social interaction to motivate people's exploration and adoption of healthy behaviors.
In this dissertation I seek to better understand how social computing technologies can help people help each other live healthier lives. I ground my research in a participant-led investigation of a specific population and condition: adolescents and obesity prevention. I want to understand how social behavior change theories from psychology and sociology apply to pervasive social health technology. Which mechanisms work and why? How does introducing a pervasive social health system into a community affect individuals' behaviors and attitudes towards their health? Finally, I want to contribute back to those theories, testing their effectiveness in novel technologically mediated situations.
Adolescent obesity is a particularly salient domain in which to study these issues. In the last 30 years, adolescent obesity rates in the US alone have tripled, and although they have leveled off in recent years they remain elevated compared to historical norms. Habits formed during adolescence can have lifelong effects, and health promotion research shows that even the simple act of walking more each day has lasting benefits. Everyday health and fitness research in HCI has generally focused on social comparison and "gamified" competition. This is especially true in studies focused on adolescents and teens. However, both theory from social psychology and evidence from the health promotion community suggest that these direct egocentric models of behavior change may be limited in scope: they may only work for certain kinds of people, and their effects may be short-lived once the competitive framework is removed. I see an opportunity for a different approach: social tools for everyday adolescent health. These systems, embedded in existing school and community practices, can leverage scalable, non-competitive social interaction to catalyze positive perceptions of physical activity and social support for fitness, while remaining grounded in the local environment.
Over the last several years I have completed a series of field engagements with middle school students in the Atlanta area. I have focused on students in a majority-minority low-income community in the Atlanta metropolitan area facing above-average adult obesity levels, and I have involved the students as informants throughout the design process. In this dissertation, I report findings based on a series of participatory design-based formative explorations; the iterative design of a pedometer-based pervasive health system to test these theories in practice; and the deployment of this system---StepStream---in three configurations: a prototype deployment, a `self-tracking' deployment, and a `social' deployment.
In this dissertation, I test the following thesis: A school-based social fitness approach to everyday adolescent health can positively influence offline health behaviors in real-world settings. Furthermore, a noncompetitive social fitness system can perform comparably in attitude and behavior change to more competitive or direct-comparison systems, especially for those most in need of behavior change}. I make the following contributions: (1) The identification of tensions and priorities for the design of everyday health systems for adolescents; (2) A design overview of StepStream, a social tool for everyday adolescent health;
(3) A description of StepStream's deployment from a socio-technical perspective, describing the intervention as a school-based pervasive computing system; (4) An empirical study of a noncompetitive awareness system for physical activity; (5) A comparison of this system in two configurations in two different middle schools; (6) An analysis of observational learning and collective efficacy in a pervasive health system.
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An, Nan. "Protect Data Privacy in E-Healthcare in Sweden." Thesis, Växjö University, School of Mathematics and Systems Engineering, 2007. http://urn.kb.se/resolve?urn=urn:nbn:se:vxu:diva-1619.
Full textAbstract:
<p>Sweden healthcare adopted much ICT (information and communication technology). It is a highly information intensive place. This thesis gives a brief description of the background of healthcare in Sweden and ICT adoption in healthcare, introduces an Information system security model, describes the technology and law about data privacy and carries out a case through questionnaire and interview.</p>
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Van, der Westhuizen Eldridge Welner. "A framework for personal health records in online social networking." Thesis, Nelson Mandela Metropolitan University, 2012. http://hdl.handle.net/10948/d1012382.
Full textAbstract:
Since the early 20th century, the view has developed that high quality health care can be delivered only when all the pertinent data about the health of a patient is available to the clinician. Various types of health records have emerged to serve the needs of healthcare providers and more recently, patients or consumers. These health records include, but are not limited to, Personal Health Records, Electronic Heath Records, Electronic Medical Records and Payer-Based Health Records. Payer-Based Health Records emerged to serve the needs of medical aids or health care plans. Electronic Medical Records and Electronic Health Records were targeted at the healthcare provider market, whereas a gap developed in the patient market. Personal Health Records were developed to address the patient market, but adoption was slow at first. The success of online social networking reignited the flame that Personal Health Records needed and online consumer-based Personal Health Records were developed. Despite all the various types of health records, there still seems to be a lack of meaningful use of personal health records in modern society. The purpose of this dissertation is to propose a framework for Personal Health Records in online social networking, to address the issue of a lack of a central, accessible repository for health records. In order for a Personal Health Record to serve this need it has to be of meaningful use. The capability of a PHR to be of meaningful use is core to this research. In order to determine whether a Personal Health Record is of meaningful use, a tool is developed to evaluate Personal Health Records. This evaluation tool takes into account all the attributes that a Personal Health Record which is of meaningful use should comprise of. Suitable ratings are allocated to enable measuring of each attribute. A model is compiled to facilitate the selection of six Personal Health Records to be evaluated. One of these six Personal Health Records acts as a pilot site to test the evaluation tool in order to determine the tool’s utility and effect improvements. The other five Personal Health Records are then evaluated to measure their adherence to the attributes of meaningful use. These findings, together with a literature study on the various types of health records and the evaluation tool, inform the building blocks used to present the framework. It is hoped that the framework for Personal Health Records in online social networking proposed in this research, may be of benefit to provide clear guidance for the achievement of a central or integrated, accessible repository for health records through the meaningful use of Personal Health Records.
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Daniel, Gregory Wayne. "An Evaluation of a Payer-Based Electronic Health Record in an Emergency Department on Quality, Efficiency, and Cost of Care." Diss., The University of Arizona, 2008. http://hdl.handle.net/10150/195598.
Full textAbstract:
Background: Health information exchange technologies are currently being implemented in many practice settings with the promise to improve quality, efficiency, and costs of care. The benefits are likely highest in settings where entry into the healthcare system is gained; however, in no setting is the need for timely, accurate, and pertinent information more critical than in the emergency department (ED). This study evaluated the use of a payer-based electronic health record (EHR) in an ED on quality, efficiency, and costs of care among a commercially insured population.Methods: Data came from a large health plan and the ED of a large urban ED. Visits with the use of a payer-based EHR were identified from claims between 9/1/05 and 2/17/06. A historical comparison sample of visits was identified from 11/1/04 to 3/31/05. Outcomes included return visits, ED duration, use of laboratory and diagnostic imaging, total costs during and in the four weeks after, and prescription drug utilization.Results: A total of 2,288 ED visits were analyzed (779 EHR visits and 1,509 comparison visits). Discharged visits were associated with an 18 minute shorter duration (95% CI: 5-33); whereas, the EHR among admitted visits was associated with a 77 minute reduction (95% CI: 28-126). The EHR was also associated with $1,560 (95% CI: $43-$2,910) savings in total plan paid for the visit among admitted visits. No significant differences were observed on return visits, laboratory or diagnostic imaging services and total costs over the four week follow-up. Exploratory analyses suggested that the EHR may be associated with a reduction in the number of prescription drugs used among chronic medication users.Conclusion: The EHR studied was associated with a significant reduction in ED duration. Technologies that can reduce ED lengths of stay can have a substantial impact on the care provided to patients and their satisfaction. The data suggests that the EHR may be associated with lower health plan paid amounts among admitted visits and a reduction in the number of pharmacy claims after the visit among chronic users of prescription drugs. Additional research should be conducted to confirm these findings.
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Nilsson, Lina. "Social Challenges when Implementing Information Systems in a Swedish Healthcare Organization." Doctoral thesis, Blekinge Tekniska Högskola, Institutionen för hälsa, 2014. http://urn.kb.se/resolve?urn=urn:nbn:se:bth-00602.
Full textAbstract:
When the Swedish National IT Strategy for Health and Social Care was introduced in 2006, intensive work started in implementing Information Systems (IS) in Swedish healthcare organizations. To follow up on the requests for more research with a combined socio-technical focus on challenges, the overall aim of this thesis was to identify social challenges when implementing IS in a Swedish healthcare organization. Furthermore, the aim was to understand the impact of identified social challenges when implementing IS in this context by putting them in an interdisciplinary Applied Health Technology theoretical framework. Institutional ethnography and phenomenological hermeneutics influenced the study design. Study 1 aimed to investigate different meanings of accessibility when implementing Health Information Technology in everyday work practice. The results indicate that accessibility depends on working routines, social structures and patient relationship. When an IT strategy and interaction in everyday work use the same word in different ways there will be consequences. Study 2 sets out to describe experience-based reflections on discharge planning as narrated by nursing staff in primary healthcare, along with their concerns about how the introduction of video conferencing might influence the discharge planning situation. It was found that there is a need for improvement in communication and understanding between nursing staff at the hospital and in primary healthcare. The aim of study 3 was to explore social challenges when implementing IS in everyday work in a nursing context. Power (changing the existing hierarchy, alienation), Professional identity (calling on hold, expert becomes novice, changed routines), and Encounter (ignorant introductions, preconceived notions) were categories presented in the findings. The aim of study 4 was to explore and obtain a deeper understanding of how identified social challenges have an influence on the implementation process of IS, based on healthcare staff’s experiences on micro, meso and macro levels of Swedish Healthcare organizations. It was found that the challenges were related to the steps of putting into practice, making IS a part of everyday work routine and establishing an identity in the implementation process. In the thesis’s discussion, social challenges when implementing IS in Swedish healthcare organizations and how they might be met and dealt with constructively are further reflected upon in relation to the interdisciplinary theoretical framework and as possible consequences of the modernity-era. This thesis contributes to the starting up of a discussion of how ingrained professional characteristics are important to feel secure of being part of an established profession. If the characteristics are questioned, the whole professional performance is threatened. One consequence of this insight is the reinforcement of the realization that a basic understanding of IS and IS implementation processes in healthcare organizations needs to be integrated in to the construction of professional identity of nurses already from the start in nursing education.
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Gregory, Judith. "Sorcerer's apprentice : creating the electronic health record, re-inventing medical records and patient care /." Diss., Connect to a 24 p. preview or request complete full text in PDF format. Access restricted to UC campuses, 2000. http://wwwlib.umi.com/cr/ucsd/fullcit?p9992380.
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