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Dissertations / Theses on the topic 'Health systems'
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Liu, Zifan. "Complex systems and health systems, computational challenges." Thesis, Versailles-St Quentin en Yvelines, 2015. http://www.theses.fr/2015VERS001V/document.
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Le calcul des valeurs propres intervient dans des modèles de maladies d’épidémiques et pourrait être utilisé comme un allié des campagnes de vac- cination dans les actions menées par les organisations de soins de santé. La modélisation épidémique peut être considérée, par analogie, comme celle des viruses d’ordinateur qui dépendent de l’état de graphe sous-jacent à un moment donné. Nous utilisons PageRank comme méthode pour étudier la propagation de l’épidémie et d’envisager son calcul dans le cadre de phé- nomène petit-monde. Une mise en œuvre parallèle de méthode multiple de "implicitly restar- ted Arnoldi method" (MIRAM) est proposé pour calculer le vecteur propre dominant de matrices stochastiques issus de très grands réseaux réels. La grande valeur de "damping factor" pour ce problème fait de nombreux algo- rithmes existants moins efficace, tandis que MIRAM pourrait être promet- teuse. Nous proposons également dans cette thèse un générateur de graphe parallèle qui peut être utilisé pour générer des réseaux synthétisés distri- bués qui présentent des structures "scale-free" et petit-monde. Ce générateur pourrait servir de donnée pour d’autres algorithmes de graphes également. MIRAM est mis en œuvre dans le cadre de trilinos, en ciblant les grandes données et matrices creuses représentant des réseaux sans échelle, aussi connu comme les réseaux de loi de puissance. Hypergraphe approche de partitionnement est utilisé pour minimiser le temps de communication. L’al- gorithme est testé sur un grille national de Grid5000. Les expériences sur les très grands réseaux tels que Twitter et Yahoo avec plus de 1 milliard de nœuds sont exécutées. Avec notre mise en œuvre parallèle, une accélération de 27× est satisfaite par rapport au solveur séquentielThe eigenvalue equation intervenes in models of infectious disease prop- agation and could be used as an ally of vaccination campaigns in the ac- tions carried out by health care organizations. The epidemiological model- ing techniques can be considered by analogy, as computer viral propagation which depends on the underlying graph status at a given time. We point out PageRank as method to study the epidemic spread and consider its calcula- tion in the context of small-world phenomenon. A parallel implementation of multiple implicitly restarted Arnoldi method (MIRAM) is proposed for calculating dominant eigenpair of stochastic matrices derived from very large real networks. Their high damp- ing factor makes many existing algorithms less efficient, while MIRAM could be promising. We also propose in this thesis a parallel graph gen- erator that can be used to generate distributed synthesized networks that display scale-free and small-world structures. This generator could serve as a testbed for graph related algorithms. MIRAM is implemented within the framework of Trilinos, targeting big data and sparse matrices representing scale-free networks, also known as power law networks. Hypergraph partitioning approach is employed to minimize the communication overhead. The algorithm is tested on a nation wide cluster of clusters Grid5000. Experiments on very large networks such as twitter and yahoo with over 1 billion nodes are conducted. With our parallel implementation, a speedup of 27× is met compared to the sequential solver
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Eivazzadeh, Shahryar. "Health Information Systems Evaluation." Licentiate thesis, Karlskrona, 2015. http://urn.kb.se/resolve?urn=urn:nbn:se:bth-10910.
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Background Health information systems have emerged as a major component in our response to the trends of rising demands in health care. The insight being gained from the evaluation of those systems can critically influence the shaping of the response. Summative or formative evaluation of health information systems assesses their quality, acceptance, and usefulness, creates insight for improvement, discriminates between options, and refines future development strategies. But the evaluation of health information systems can be challenging due to the propagation of their impacts through multiple socio-technological layers till the ultimate recipients, their heterogeneity and fast evolvement, and the complexity of health care settings and systems. Aim This thesis tries to explain the challenges of evaluation of health information systems with a narrow down on determining evaluation aspects and to propose relevant solutions. The thesis goes for solutions that mitigate heterogeneity and incomparability, recruit or extend available evaluation models, embrace a wide context of application, and promote automation. Method The literature on health information systems evaluation, methods of dealing with heterogeneity in other disciplines of information systems, and ontology engineering were surveyed. Based on the literature survey, the UVON method, based on ontology engineering, was first developed in study 1. The method was applied in FI-STAR, a European Union project in e-Health with 7 use-cases, for summative evaluation of the individual and whole e-health applications. Study 2, extended the UVON method for a formative evaluation during the design phase. Results Application of the UVON method resulted in evaluation aspects that were delivered to the seven use-cases of the FI-STAR project in the form of questionnaires. The resulted evaluation aspects were considered sensible and with a confirming overlap with another highly used method in this field (MAST). No significant negative feedback from the FI-STAR use-case owners (n=7) or the respondents (n=87 patients and n=30 health professionals) was received or observed. Conclusion In the evaluation of health information systems --possibly also in other similarly characterized systems-- ontology engineering methods, such as the proposed UVON method, can be applied to create a flexible degree of unification across a heterogeneous set of evaluation aspects, import evaluation aspects from other evaluation methods, and prioritize between quality aspects in design phase. Ontologies, through their semantic network structures, can capture the extracted knowledge required for evaluation, facilitate computation of that knowledge, promote automation of evaluation, and accommodate further extensions of the related evaluation methods by adding new features to their network structure.
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Henriksson, Dorcus Kiwanuka. "Health systems bottlenecks and evidence-based district health planning : Experiences from the district health system in Uganda." Doctoral thesis, Uppsala universitet, Internationell mödra- och barnhälsovård (IMCH), 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-329082.
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In low-income countries where maternal and child mortality remains high, there is limited use of context-specific evidence for decision making and prioritization of interventions in the planning process at the sub-national level, such as the district level. Knowledge on the utility of tools and interventions to promote use of district-specific evidence in the planning process is limited, yet it could contribute to the prioritization of high-impact interventions for women and children. This thesis aims to investigate, in the planning process, the use of district-specific evidence to identify gaps in service delivery in the district health system in Uganda in order to contribute to improving health services for women and children. Study I evaluated the use of the modified Tanahashi model to identify bottlenecks for service delivery of maternal and newborn interventions. Study II and III used qualitative methods to document the experiences of district managers in adopting tools to facilitate the utilization of district-specific evidence, and the barriers and enablers to the use of these tools in the planning process. Study IV used qualitative methods, and analysis of district annual health work plans and reports. District managers were able to adopt tools for the utilization of district-specific evidence in the planning process. Governance and leadership were a major influence on the use of district-specific evidence. Limited decision space and fiscal space, and limited financial resources, and inadequate routine health information systems were also barriers to the utilization of district-specific evidence. Use of district-specific evidence in the planning process is not an end in itself but part of a process to improve the prioritization of interventions for women and children. In order to prioritize high impact interventions at the district level, a multifaceted approach needs to be taken that not only focuses on use of evidence, but also focuses on broader health system aspects like governance and leadership, the decision and fiscal space available to the district managers, limited resources, and inadequate routine health information systems.
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Gopal, Thania. "Health systems in the news: The influence of media representations on health system functioning in the Western Cape health system." Master's thesis, Faculty of Health Sciences, 2018. http://hdl.handle.net/11427/30152.
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Health systems are complex systems characterised by constant change and a web of interwoven relationships, connections, and interactions. Health Policy and Systems Research has called for multidisciplinary approaches to understanding health systems. Like health systems, the media has also been described as an important social institution in modern society that is deeply embedded within the sociocultural and political context. The role of the media as societal watchdog; as a mechanism to improve accountability; as a platform for debate; and as a facilitator of community engagement has been recognised. Within public health, the role of mass media as a tool in health promotion and health communication campaigns is well-established. Media representation research involves the analysis of discourses in media and has been used to study a range of public health issues. However, there is a major gap in representation studies of health systems, in high-, middle- and low income countries. This mixed methods study aimed to describe representations of the South African Western Cape provincial health system by analysing dominant discourses emerging from the English-language mainstream print and online news media (1994-2018). A media content analysis was first conducted to highlight the main themes, followed by a discourse analysis to provide a deeper interrogation of underlying issues. This study suggests that the way a health system is represented in the media potentially influences health system functioning in a variety of ways – for example, how ‘people’ in the system make meaning of discourses, which in turn influences decision-making. ‘Negative’ representations (for example, of a weak or stressed health system), may contribute to a lack of both health worker and patient trust in the health system with a host of undesirable repercussions, such as low health worker morale, health workers failing to speak up for patients, or poor quality of care. The study recommends capacity building of a diversity of people (such as citizens, communities, health workers, civil society) at different levels of the health system to enable them to engage with the media, and mitigate the less desirable repercussions. Further research is needed to, a) consider the effects of media on health systems more carefully, more frequently, and in more contexts; b) find more effective ways to think of media as part of the health system, rather than an instrumental tool, or an external influence; c) to understand how media architecture (the social, political and economic environment in which media are situated) may influence emerging discourses; and d) to understand how media can influence people’s agency and community participation, particularly in the context of responsive and people-centred health systems.
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Fosmoe, Kristofer D. "A systems perspective on army health and discipline." Thesis, Massachusetts Institute of Technology, 2015. http://hdl.handle.net/1721.1/100371.
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Thesis: S.M. in Engineering and Management, Massachusetts Institute of Technology, Engineering Systems Division, System Design and Management Program, 2015.Cataloged from PDF version of thesis.
Includes bibliographical references.
Healthy and Disciplined Soldiers provide a unique competitive advantage to the United States Army that cannot be replaced by the acquisition of technological weapons systems. The United States Army system for managing health and discipline has historically been robust; however, the prolonged conflicts in Iraq and Afghanistan have highlighted the need to reexamine the system of health and discipline policies, its architecture, and the dynamic effects on junior leader behavior. This thesis provides an analysis of this system by exploring the dynamic relationship between leader development, health and discipline, and an emphasis on warfighting mission capabilities. The author demonstrates the tradeoffs between mission capabilities, and leader development of Soldier health and discipline through a mixed methods approach that combines quantitative analysis of the published Army literature and qualitative field interviews. This thesis analyzes the architecture of the Army Health Promotion system, highlighting risks to capability development if the system architecture is not consistently managed across installations. The author applies the object-process method to describing architectural models of policy systems and system dynamics causal loop diagrams to explain the evolution of the system during the post 9-11 war period. The author also uses quantitative article subject search to validate qualitative descriptions of the system behaviors. The author suggests that there is some risk in the Army failing to more effectively manage Soldier health and discipline due to failing to properly describe the intended architecture of the Army Health Promotion system, resulting in architectural differences between installations. The author also recommends several potential system changes to affect the dynamics of the leader development.
by Kristofer D. Fosmoe.
S.M. in Engineering and Management
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Najafizada, Said Ahmad Maisam. "The Afghan Community Health Worker Program: A Health Systems Analysis of a Population Health Intervention." Thesis, Université d'Ottawa / University of Ottawa, 2016. http://hdl.handle.net/10393/35044.
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To tackle one of the world’s worst maternal, neonatal and child health outcomes and a chronic shortage of human resources for health, the Afghan Ministry of Public Health deployed volunteer Community Health Workers (CHW) in rural areas of Afghanistan in 2003. This thesis documents the Afghan CHW program, exploring organizational and community contexts. The research design in this study is a mixed methods case study.
The actual Afghan CHW program was situated with an Afghan complex adapative health system, mainly guided by the policy of the health system but was also largely influenced by the power and gender dynamics of the community context in which it was implemented. The tasks of CHWs were numerous but CHWs role was more than just the sum of their tasks; they occupied a unique location juxtaposed between formal and informal HRH systems. It is important to acknowledge the assembly of so many national and international organizations in achieving a shared goal of providing health services to a large population in an unstable and partially insecure environment. The shared goal in the Afghan context may have been interpreted only in terms availability of services, though the goal carries with it, either explicitly or implicitly, the values of effectiveness, efficiency, timeliness, and costliness – known as quality by some participants of this study. The community component was another layer of the complex adaptive system that made up the Afghan CHW program. Political-ethnic power in the community and legal-rational authority of the health system influenced the way communities were mapped in an inequitable manner, in turn, contributed to the unfair distribution of resources to the populations. Finally, the intersection of the gender equity approach and the gendered nature of the work as a cross-cutting layer added to the complexity of the Afghan health system.
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Zwama, Gimenne. "Improving health care provider - health committee working relationships for responsive, people-centred health systems." Master's thesis, University of Cape Town, 2016. http://hdl.handle.net/11427/23422.
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As community-based governance structures in the service delivery of primary health care, health committees can promote the quality, accessibility and responsiveness of service delivery. More specifically, health committees provide a platform for community members to advocate for their health needs and meaningfully participate in decision-making, oversight and monitoring of service delivery. Hence, health committees provide a bottom-up strategy to realise the right to health and a people-centred health system. Previous research has found that Health Committees in the Cape Metropole of South Africa face similar challenges as their counterparts globally. In South Africa health committees' role and mandate often seem to be unclear and weak policy frameworks have resulted in wide variations in health committee functionality. Health care providers, particularly health facility managers, have been identified to play a key role in creating a supportive environment for health committees' genuine and effective participation. Particularly, health care providers' misunderstandings of health committees' roles and responsibilities as well as their lack of engagement with health committees can form barriers to health committee's functioning. A gap in understanding exists on the impact training of health care providers could have on health committees' meaningful participation. While many health committee members in the Cape Metropole of the Western Cape Province were already trained, health care providers had not been trained until May 2015. Present realist evaluation sought to describe and explore the immediate and short-term impact of this pilot training on health care providers' responsiveness towards health committees. Pre- and post-training questionnaires, direct observations and semi-structured interviews were employed as research methods. The training evaluation was enriched by participants' diverse professional positions and work environments as well as their various experiences and relationships with health committees. The study reveals that the training played a role in increasing health care providers' responsiveness towards health committees' roles and functions. Health care providers demonstrated understandings and intentions towards building effective working relationships with health committees. However, training is recommended to be followed up on and to be continuous to ensure intentions are translated into practice and to account for the dynamic nature of health facilities, health committees and the health system in which they reside. In this manner, health care providers can increasingly contribute to building sustainable relationships with health committees to promote meaningful and effective community participation, the strengthening of people-centred health systems and the progressive realisation of the right to health.
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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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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.
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.
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.
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Zhang, Yanzhen. "Health care systems in China /." This resource online, 1994. http://scholar.lib.vt.edu/theses/available/etd-07102009-040227/.
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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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Chikonde, Nkandu. "Training clinic health committees: a vehicle for improving community participation in health." Master's thesis, University of Cape Town, 2017. http://hdl.handle.net/11427/27060.
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Objectives: In South Africa, and globally, community participation has become a key feature in the health system. In order for meaningful participation to occur within the health system several mechanisms have been identified as critical and this includes formation of health committees (HCs) at health facility level. Previous research indicates that health committees are imperative in both actualizing community participation and realisation of right to health. However, few studies have been undertaken to understand the impact training health committees has on community participation and right to health. This study sought to evaluate the impact training clinic health committees in community participation, health and human rights has on participation and right to health. The training been evaluated was led by Learning Network on Health and Human Rights and targeted four clinics in Cape Town Metropole of Western Cape, South Africa. The Learning Network is a grouping of five civil society organisations (CSOs) in Western Cape, South Africa at four universities which was launched in 2008 after the recognition of a gap in documented knowledge that CSOs had on health and human rights. The study explored health committees' changes in knowledge, perceived competencies, documented member's understanding of roles and HCs sustainability as well as the trainings impact on relationship between HCs and health service providers. Methods: The study was a multiple case study with multiple qualitative methods for data collection. Narrative data was collected through twelve in-depth interviews with health committee members, one facility manager, two focus group discussions and three physical observations across four health facilities. Health facilities were purposively selected from a list of health facilities trained by the Learning Network in 2014. Inclusion criteria also included English speaking health facilities and those in close proximity to each other. 2 Results: The study revealed that training HCs contributed to improved competencies, awareness and knowledge of community participation and the right to health. After the training, HC members were perceived to be more aware and responsive to their roles and responsibilities at the health facility. It was also noted that the training aided improved HCs perspectives on sustainability and roles, improved interpersonal skills and self-esteem. Conversely, the study revealed that despite the training improving participation and right to health, power imbalances between HC members and facility staff/managers who hold authority has a bearing on when and how participation occurs. Conclusion: The study demonstrates that training health committees contributed to improving the levels of community participation such as planning, consultation and advise [Arnstein, Rifkin and Loewenson] in the realisation of right to health. It is recommended for wider community participation that trainings of such magnitude are conducted together with facility managers/staff.
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Yang, Hui, and h. yang@latrobe edu au. "Priorities and Strategies for Health Information System Development in China - How Provincial Health Inforamtion Systems Support Regional Health Planning." La Trobe University. Public Health, 2004. http://www.lib.latrobe.edu.au./thesis/public/adt-LTU20050818.135812.
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China is moving towards a market economy. The greater use of market forces has made China richer, accelerated modernisation and increased productive efficiency but has created new problems, including, in the health sector, problems of inequity and allocative inefficiency. From 1997, the Chinese government committed to a national policy of regional health planning (RHP), as part of a broader commitment to harmonising social and economic development. However, RHP has been slow to impact on the equity and efficiency problems in health care.
Planning requires information; better health decision-making requires better health information. Information systems constitute a resource that is vital for the health planning and the management of the health system. Properly developed, managed and used, health information systems are a highly cost-effective resource for the nation and its regions. Bureaucratic resistance, one of critical reasons is that regional health planners gained insufficient support from information system. Health information needs to adopt into the new way of government health management.
The objective of the study is to contribute to the development of China�s health information system (HIS) over the next 5-10 years, in particular to suggest how provincial health information systems could be made more useful as a basis for RHP. The existing HIS is examined in relation to its support for and relevance to RHP, including policy framework, institutional structures and resources, networks and relationships, data collection, analysis, quality and accessibility of information as well as the use of information in support of health planning. Data sources include key informant interviews, a questionnaire survey and various policy documents. Qualitative (questionnaire survey on provincial HIS) and quantitative (key informant interviews) approaches are used in this study. Document analysis is also conducted.
The research examines information for planning within the macro and historical context of health planning in China, in particular having regard to the impacts and implications of the transition to a market economy. It is evident that the implementation of RHP has been retarded by poor performance of information system, particularly at the provincial level. However, the implementation of RHP has also been complicated by fragmented administrative hierarchies, weak implementation mechanisms and contradictions between different policies, for example, between improved planning and the encouragement of market forces in health care.
To support RHP which is needs based, has a focus on improving allocative efficiency and is adapted to the new market development will require new information products and supports including infrastructure reform and capacity development. Provincial HIS needs to move from being data generators and transmitters to becoming information producers and providers. Health planning has moved to greater use of population-based benchmark and demand-side control. Therefore, information products should be widened from supply side data collection (in particular assets and resources) to include demand-side collection and analysis (including utilisation patterns and community surveys of opinion and experience). The interaction between users (the planners) and producers (the HIS) should be strengthened and regional networks of information producers and planners should be established.
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Schira, Norma. "A Survey of Health Promotion Activities of Health Systems Agencies." TopSCHOLAR®, 1986. http://digitalcommons.wku.edu/theses/1980.
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The National Health Planning and Resources Development Act. Public Law 93-641, the last major step in the regulation of the health care system, created a network of health system agencies and state level health planning agencies. Subsequent legislation, the Health Planning and Resources Development Amendment 1929, Public Law 96-79, amended 1974 Law and changed the role and function of health systems agencies to include more regulatory activities. By 1981, the activities of Health System Agencies were being curtained by the action of the Reagan administration.
The Health promotion/wellness movement which seeks to improve health has been developing as a compliment to medical medicine for several years. Previous research has determined that health systems agencies were active in health promotion and identified several planning and implementation activities related to this involvement. This is a survey of health systems agencies to determine their efforts in healthy promotions. Resources allocated to these activities, and opinions of the director relevant to agency involvement in health promotion.
All active healthy system agencies listed in the 1980. Directory of Health System Agencies (DHSH) were surveyed by a mailed questionnaire. Reponses were receive from 112 agencies (57%) and the respondents were found to be representative of the population.
The results revealed health systems agencies to be involved in health promotion. More than 90 percent of the responders listed some type of health promotion activity in their Healthy System Plans for the 1979-1980 planning year. Approximately half of the responders reported some community activity in health promotion. The majority of executive directors saw health systems agencies as being only moderately effective in controlling health care costs: considered healthy promotion as a viable means of controlling health care cost: and believed that modifications of individual life-styles had the greatest potential for improving health status.
The survey revealed that Healthy System Agencies did not restrict the wellness/health promotion activities to traditional health facilities, but were defining health broadly and working with a variety of agencies to develop services.
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Friedman, Nicole Lisa. "Impactful Care: Addressing Social Determinants of Health Across Health Systems." PDXScholar, 2019. https://pdxscholar.library.pdx.edu/open_access_etds/5073.
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There is emerging evidence that addressing health-related social needs through enhanced clinical-community linkages can improve health outcomes and reduce costs. Unmet health-related social needs, such as food insecurity, inadequate or unstable housing, and lack of access to transportation may increase the risk of developing chronic conditions, reduce an individual's ability to manage these conditions, increase health care costs, and lead to avoidable health care utilization. In response, work on social needs is happening across large health systems in the United States, but the pace of progress is slow and accountability is diffuse.
The goal of this applied research project is to examine Kaiser Permanente Northwest's patient navigator program as a case study for how health systems can transform into organizations that bridge clinical, social and behavioral health and redefine what it means to be a prevention-oriented delivery system. Kaiser Permanente Northwest (KPNW) provides high quality, patient-centered care to over 550,000 medical members and 240,000 dental members in Oregon and Southwest Washington. In conjunction with the Care Management Institute, KPNW created a patient navigator administered, social needs screening tool called "Your Current Life Situation" (YCLS). This thesis focuses on the data collected from this screening tool with an emphasis on operations management, workflows, and the technical tools that have been supported to do this work. The analysis also uses semi-structured qualitative interviews from patient navigators, physicians, social workers, community organizations and members to better understand the experience of social needs screening in clinical practice and its impact on members and community partners as they receive referrals for services outside the health care delivery system. Through using anthropological theory and methods, I seek to help health systems think and act differently by elevating the voice and experience of the community and translating vulnerable populations' needs into a language that can be integrated into multiple systems of care.
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Toth-Pal, Eva. "Computer decision support systems for opportunistic health screening and for chronic heart failure management in primary health care /." Stockholm, 2007. http://diss.kib.ki.se/2007/978-91-7357-435-8/.
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Lyan, Dmitriy Eduard. "Performance dynamics in military behavioral health clinics." Thesis, Massachusetts Institute of Technology, 2012. http://hdl.handle.net/1721.1/90690.
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Thesis: S.M. in Engineering and Management, Massachusetts Institute of Technology, Engineering Systems Division, System Design and Management Program, June 2013.Cataloged from PDF version of thesis. "June 2012."
Includes bibliographical references (pages 113-116).
The prevalence of Post Traumatic Stress Disorder (PTSD) and other related behavioral health conditions among active duty service members and their families has grown over 100% in the past six years and are now estimated to afflict 18% of the total military force. A 2007 DoD task force on mental health concluded that the current military psychological health care system is insufficient to meet the needs of the served population. In spite of billions of dollars committed to hundreds of programs and improvement initiatives since then, the system continues to experience provider shortages, surging costs, poor access to and quality of care as well as persistently high service-related suicide rates. We developed a model to study how the resourcing policies and incentive structures interact with the operations of military behavioral health clinics and contribute to their ability to provide effective care. We show that policies and incentives skewed towards increased patient loads and improvement in access to initial care result in a number of vicious cycles that reinforce provider shortages, increase costs and decrease access to care. Additionally we argue that insufficient informational feedback contributes to incorrect attributions and the persistence of ineffective policies. Finally we propose a set of policies and enabling performance metrics that can contribute to sustained improvement in system performance by turning death spirals into virtuous cycles leading to higher provider and patient satisfaction, better quality of care and more efficient resource utilization contributing to better healthcare outcomes and increased levels of medical readiness.
by Dmitriy Eduard Lyan.
S.M. in Engineering and Management
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Rosen, Ceruolo Melissa Beth. "Data driven health system." Thesis, Massachusetts Institute of Technology, 2013. http://hdl.handle.net/1721.1/79531.
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Thesis (S.M.)--Massachusetts Institute of Technology, Engineering Systems Division, 2013.Cataloged from PDF version of thesis.
Includes bibliographical references (p. 106-110).
Effective use of data is believed to be the key to address systemic inefficiencies in health innovation and delivery, and to significantly enhance value creation for patients and all stakeholders. However, there is no definition for health data. Rather, data in health is an assortment of observations and reports varying from science to clinical notes and reimbursement claims that emerge from practice rather than design. What is health data? In this thesis we try to answer that question by looking at the system of health almost exclusively as a system that generates, transforms, and interprets data. We overview the different meanings data has throughout the health system, we analyze systematically the inefficiencies and trends as they emerge from data, and propose a new architecture for the system of health in which data is not present by accident. The result of this thesis is a new architecture for the system of health that is consistent with its present state but also consistent with a future learning system and a redefinition of value in health care that is patient and information centric.
by Melissa Beth Rosen Ceruolo.
S.M.
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Sharma, Raju Prasad. "Integrative Systems Toxicology For Human Health." Doctoral thesis, Universitat Rovira i Virgili, 2018. http://hdl.handle.net/10803/665621.
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Els disruptors endocrins (DE) són substàncies naturals o antropogèniques presents el ambient, aliments o productes de consum que poden alterar els equilibris hormonals en humans i animals i produir efectes adversos per a la salut fins i tot a dosis baixes. S'han desenvolupat nombrosos mètodes, sota l'orientació de la UE i OCD, amb l'objectiu de realitzar avaluacions de riscos quantitatius per a aquests substàncies, tanmateix, aquests mètodes encara no tenen la confiança en el nivell de seguretat per a l'exposició humana. La predicció quantitativa dels efectes adversos dels DE en la salut humana planteja diversos reptes associats a la seva complexa exposició, cinètica no lineal, metabolisme(s) i mecanisme complex o la resposta complexa d'organismes en diferents etapes de vida o escales de temps. L'anàlisi d'alta capacitat emergent ,(OMICS), in-silico, com la farmacocinética-dinàmica fisiològica (PBPK /PD), la biologia de sistemes i les vies d'èxit adverses (AOPs) faciliten la comprensió de la complexitat biològica i la seva connectivitat multinivell. L'objectiu d'aquesta tesi és construir un model de toxicologia de sistemes integradors per predir els efectes adversos induïts a la salut humana per exposició a DE. La primera part d'aquest treball es centra en el desenvolupament i la validació del model detallat de dosimetria tisular que integra espècies i dades fisiològiques específiques de la població, dades in vitro i in-silico. La segona part es centra en el desenvolupament i la validació del model de toxicologia de sistemes integradors que inclou la biologia de sistemes, la senyalització del desenvolupament i la validació del model de la ruta de la xarxa / AOP, i l'acoblament d'aquests amb el model PBPK detallat. Aquest model de toxicologia de sistemes integrat proporcionarà així una plataforma de models predictius robusta per a productes químics / DE qualificats per donar suport als requisits regulatoris.Los disruptores endocrinos (DE) son sustancias naturales o antropogénicas presentes en el ambiente, alimentos o productos de consumo que pueden alterar los equilibrios hormonales en los humanos y animales, y producir efectos adversos a la salud incluso a bajas dosis. Se han desarrollado numerosos métodos bajo la guía de la UE y la OCDE con el objeto de realizar Evaluaciones Cuantitativas de Riesgos para estas sustancias, sin embargo, estos métodos aún carecen de la confianza en el nivel de seguridad de exposición a humanos. La predicción cuantitativa de los efectos adversos de los DC en la salud plantea desafíos que están asociados a: su compleja exposición, cinética no lineal, metabolito (s) y complejas respuestas de organismos en su ciclo de vida o en escalas de tiempo. El análisis de alto rendimiento emergente (OMICS) y herramientas in silico como la farmacocinética-dinamia basada en fisiología (PBPK/PD), la biología de los sistemas y las vías de resultados adversas (AOP), facilitan la compresión de la complejidad biológica y su conectividad multinivel. El objetivo de esta tesis es construir un modelo de toxicología de sistemas integrados para predecir los efectos adversos a la salud por la exposición a los DE. La primera parte de este trabajo se centra en el desarrollo y la validación del modelo detallado de dosimetría tisular que integra especies y datos fisiológicos específicos de la población, datos in vitro e in silico. La segunda parte se centra en el desarrollo y validación del modelo de toxicología de sistemas integrados que incluye: la biología, red de señalización/desarrollo y validación del modelo vía AOPs, y el acoplamiento de éstos con el modelo detallado de PBPK. Este modelo de toxicología de sistemas integrados proporcionará una sólida plataforma de modelos predictivos para compuestos químicos/DC calificados para el respaldo de los requisitos reglamentarios.
Endocrine disrupting chemicals (EDCs) are natural or anthropogenic substances in the environment, food, or consumer products that can disrupt hormonal balances in humans and wildlife, and result in adverse health effects even at low dosages. To date, many test methods have been developed under EU and OECD guidance with the aim to perform Quantitative Risk Assessments for these chemicals. However, these methods still lack the confidence on their safety level of exposure to human. Quantitative Prediction of EDCs' adverse effect on human health poses several challenges associated with their complex exposure, nonlinear kinetics, metabolite (s), and complex mechanism or the complex response of organisms over different life stages or time scales. Emerging high-throughput analysis (OMICS) and in-silico tools such as physiologically based pharmacokinetic/pharmacodynamics (PBPK/PD), Systems biology and Adverse Outcome Pathways (AOPs) offer an opportunity to understand the biological complexity and their multilevel connectivity. The objective of this thesis is to build an integrative systems toxicology model for predicting EDCs-induced adverse effects on human health. The first part of this work focuses on the development and the validation of the detailed tissue-dosimetry model integrating species and population specific physiological data, in-vitro and in-silico derived data. The second part focuses on the development and validation of integrative systems toxicology model that includes Systems biology, signalling network/AOPs pathway model development and validation, and coupling of these models with detailed PBPK model. This integrative systems toxicology model will thereby provide a robust predictive models platform for chemicals/EDCs qualified to support regulatory requirements.
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Rajani, Kanth T. V. "GERASOS-A Wireless Health Care Systems." Thesis, Halmstad University, School of Information Science, Computer and Electrical Engineering (IDE), 2007. http://urn.kb.se/resolve?urn=urn:nbn:se:hh:diva-963.
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The present development of the demography of elderly people in the western world will generate a shortage of caregiver’s for elderly people in the near future. There are major risk that the lack of qualified caregivers will result in deterioration in the quality of elderly care. One possible
solution is the use of modern information and communication technology (ICT) to enable staff to work more efficiently. However, if ICT system is introduced into the elderly care it must done in a way which is acceptable from a humane perspective while at the same time increasing the efficiency of the personal that working in elderly care centers. This thesis investigates the
technical feasibility of using a wireless mesh network for a social alarm system, in the elderly care. The System as such is not intended to replace the staff at an elderly care center but instead is intended to reduce staff workloads while providing more time for elderly care.
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Kennedy, Catherine. "Welfare and health : systems in tension." Thesis, University of Glasgow, 1998. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.297521.
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Mani, Girindra N. "Structural Health Monitoring of Rotordynamic Systems." University of Akron / OhioLINK, 2006. http://rave.ohiolink.edu/etdc/view?acc_num=akron1144522032.
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Singh, Kalvinder. "Security for Mobile Health Care Systems." Thesis, Griffith University, 2013. http://hdl.handle.net/10072/367683.
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The ageing population and the increase in chronic diseases have placed a considerable
financial burden on health care services. Mobile health care systems can play an important
role in reducing the costs. The pervasiveness of smart phones and the evolution of Internetof-
Things are increasing the potential for mobile health care systems to remotely manage
the health of a patient or the elderly. Smart phones and small devices, such as body sensors,
are used to remotely monitor patients suffering from chronic diseases and allow them to
have relatively independent lives. A mobile health care system may require a degree of
real-time monitoring or data collection. For instance, a medical emergency will require
data sent to medical staff as quickly as possible, rather than the data sent after a few
hours or days. The problem will be more complex if there is a requirement that commands
sent to body sensors need to be in real-time. If the system recognises a possible medical
emergency, it may need to notify other devices immediately to start recording data or to
actuate (for example, an insulin pump and a defibrillator).Thesis (PhD Doctorate)
Doctor of Philosophy (PhD)
School of Information and Communication Technology
Science, Environment, Engineering and Technology
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Saddiq, Muhammad Ibrahim. "Reconceptualising health systems : a case study of lived health systems in urban informal setting in northern Nigeria." Thesis, University of Sheffield, 2015. http://etheses.whiterose.ac.uk/9974/.
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Despite growing interest in health systems strengthening among key global health actors, there is considerable debate about how to conceptualise health systems and about what the best strategies are to strengthen them. Existing conceptualisations of health systems are usually presented as static models in which the formal provision of services is central. Yet it is increasingly apparent that these conceptualisations do not constitute a complete model of how existing health systems work, and fail to capture the complex interactions between people, families, households, health services, and the wider societal context, particularly in urban informal settings in low and middle income countries where formal (state-regulated) health systems are relatively absent. This thesis critiques existing conceptualisations of health systems and develops an alternative understanding, based on detailed empirical research and the ‘lived’ experiences and perspectives of people experiencing health problems in one particular case study of an urban informal setting – Tudun Jukun in northern Nigeria. The thesis is underpinned by critical realism, integrates ideas and methods from a range of empirical studies about health and health seeking practices from the fields of medical anthropology and sociology, and draws on fieldwork conducted in Tudun Jukun between June-September 2012, which used a variety of qualitative methods (observations, interviews, focus groups, and document sampling). Using an innovative analytical approach, which involved developing detailed narratives about episodes of health problems, the thesis explains how people in this urban informal setting understand and experience health problems; the strategies they apply (or do not apply) in solving these problems; the factors that influence (enables/prevents) the choice of strategies and how they are negotiated; and, based on people’s ‘systems of meaning' and expectations, what strategies worked. The thesis presents an alternative conceptualisation of health systems as a ‘landscape’, in which health systems are structured by conceptualisations of health, context, prevailing beliefs or value systems, and power dynamics among individuals in a given context, which are all themselves intimately connected and inter-dependent. The thesis argues that power dynamics and existing forms of knowledge or expertise in solving health problem are crucial in defining health systems in a given context. These knowledge and expertise are distributed among different actors and access is governed by the different kinds of relationships that exist (family ties, friendship or market transactions) and networks of resources that individuals can draw upon. Distinct processes take place as people work to access knowledge and expertise: interpretation, decision-making, enabling and provision. It is argued that units of accountability or collectivity are fundamental in shaping how all elements within a health systems landscape are organised. In Tudun Jukun, the home is the most common unit of collective action on health issues. These findings raise questions about current policy action to strengthen health systems such as relying on (the relatively ineffective) state-led institutions and the uncritical use of existing theoretical conceptual frameworks. This study suggests alternative forms of action that are needed in order to design more context relevant health systems strengthening interventions through recognising what people value or not value and why. This can result in, for example, broadening the scope of health systems to recognise landscapes such as the home and patent medicine vendors as legitimate health systems landscapes and make them safer and more effective. It can also involve recognising and creating wider supporting networks for collective action on health issues in places where such collectivity is non-existent or too small to deal with prevailing health problems.
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Hsieh, Sheau-Ling 1952. "Distributed multimedia collaborative system framework for tele-healthcare remote consultation systems." Diss., The University of Arizona, 1998. http://hdl.handle.net/10150/284034.
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The Remote Consultation and Diagnosis (RCD) in Global Picture Archiving and Communication System (Global PACS) is a unique suite of multimedia telemedicine applications developed at the University of Arizona. The applications support real-time patients' data, image files, audio and video consultation and diagnosis annotation exchanges. The RCD enables joint collaboration between pathologists, radiologists, or physicians while they are at distant geographical locations. This project provides four RCD scenarios, i.e., Case Review, Case Acquire, Store and Forward Analysis, as well as Interactive Diagnosis and Consultation. The RCD Global PACS environment consists of heterogeneous, autonomous, and legacy resources. The Common Object Request Broker Architecture (CORBA), Java Database Connectivity (JDBC), and Java language provide the capability to combine the RCD Global PACS resources into an integrated, interoperable, and scalable system. The underneath technology, including IDL, ORB, Event Service, IIOP, JDBC/ODBC, legacy system wrapping and Java implementation are explored. This distributed collaborative CORBA/JDBC based framework will challenge the advanced, medical information management requirements. It also makes the RCD Global PACS both hardware and software technologically independent. As our research and development extend, we will continue to incorporate the latest advances in computer technology. RCD Global PACS is not another new tool in telemedicine, but rather a new paradigm for the delivery of health services that requires process reengineering, cultural changes, as well as organizational changes. It is a whole new way of practicing in telemedicine. We ensure that the RCD Global PACS project has long-term, comprehensive solutions for today and tomorrow's healthcare needs.
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Adekunle, Toluwani E. "Towards Health System Strengthening: Analyzing the adoption of the WHO Health Systems Thinking Framework in the Nigerian and Botswana National Health Policies." Ohio University / OhioLINK, 2015. http://rave.ohiolink.edu/etdc/view?acc_num=ohiou1430146924.
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Newbury, Brian. "Integrated health, safety and environmental management systems." Thesis, University of South Wales, 2000. https://pure.southwales.ac.uk/en/studentthesis/integrated-health-safety-and-environmental-management-systems(6a947bb5-bda0-4466-9cb6-f02ad514cb9a).html.
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The continued rise in accident and ill health statistics throughout the member states of the European Union indicate that the standards of occupational health, safety and environmental control require further improvement to minimise the current level of loss. Management systems are regarded as an effective means of reducing this loss by continuously improving standards. Whilst there is much discussion and debate about the possibilities of integrating management systems, at present, there are no national or international published integrated management standards, although some multi-national companies have introduced their own internal integrated standards. The research explored the development of an integrated health, safety and environmental (HSE) management system within a range of industrial organisations. This included the development of tools for successful implementation of integrated systems, specifically for significance review, risk assessment and auditing. Resources and accreditation constraints precluded exhaustive testing of all clauses within the proposed integrated management standard. However, analysis of key aspects of the standard revealed: 1. The introduction and use of separate health, safety and environmental (HSE) management systems improved the standards of risk control within organisations. 2. Organisations perceived that there were clear business advantages in some form of integration of existing standards. 3. The developed integrated HSE standard was technically possible in the area of policy development, process operations, working instructions and documentation. However, the integration of risk assessment and audit tools gave limited advantages compared to existing separate systems. 4. The proposed integrated HSE standard complied with both individual European member states national legislative requirements and European/World-wide management standard criteria. In summary this thesis represents an original contribution to the field of integrated management systems. The thesis also identifies areas of further work that will increase the knowledge base, scope of application of the work carried out.
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Al-Haque, Shahed. "Responding to traveling patients' seasonal demands for health care services in the Veterans Health Administration." Thesis, Massachusetts Institute of Technology, 2013. http://hdl.handle.net/1721.1/81112.
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Thesis (S.M. in Technology and Policy)--Massachusetts Institute of Technology, Engineering Systems Division, 2013.Cataloged from PDF version of thesis.
Includes bibliographical references (p. 60-62).
The Veterans Health Administration (VHA) provides care to over eight million Veterans and operates over 1,700 sites of care distributed across twenty-one regional networks in the United States. Health care providers within VHA report large seasonal variation in the demand for services, especially in healthcare systems located in the southern U.S. that experience a large influx of "snowbirds" during the winter. Since the majority of resource allocation activities are carried out through a single annual budgeting process at the start of the fiscal year, the seasonal load imposed by "traveling Veterans," defined as Veterans that seek care at VHA sites outside of their home network, make providing high quality services more difficult. This work constitutes the first major effort within VHA to understand the impact of traveling Veterans. We found a significant traveling Veteran population (6.6% of the total number of appointments), distributed disproportionately across the VHA networks. Strong seasonal fluctuations in demand were also discovered, particularly for the VA Bay Pines Healthcare System, in Bay Pines, Florida. Our analysis further indicated that traveling Veterans imposed a large seasonal load (up to 46%) on the Module A clinic at Bay Pines. We developed seasonal autoregressive integrated moving average (SARIMA) models to help the clinic better forecast demand for its services by traveling Veterans. Our models were able to project demand, in terms of encounters and unique patients, with significantly less error than the traditional historical average methods. The SARIMA model for uniques was then used in a Monte Carlo simulation to understand how clinic resources are utilized over time. The simulation revealed that physicians at Module A are over-utilized, ranging from a minimum of 92.6% (June 2013) to maximum 207.4% (January 2013). These results evince the need to reevaluate how the clinic is currently staffed. More broadly, this research presents an example of how simple operations management methods can be deployed to aid operational decision-making at other clinics, facilities, and medical centers both within and outside VHA.
by Shahed Al-Haque.
S.M.in Technology and Policy
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Lam, Lawrence G. "Digital Health-Data platforms : biometric data aggregation and their potential impact to centralize Digital Health-Data." Thesis, Massachusetts Institute of Technology, 2015. http://hdl.handle.net/1721.1/106235.
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Thesis: S.M. in Engineering and Management, Massachusetts Institute of Technology, School of Engineering, System Design and Management Program, Engineering and Management Program, 2015.Cataloged from PDF version of thesis.
Includes bibliographical references (page 81).
Digital Health-Data is being collected at unprecedented rates today as biometric micro sensors continue to diffuse into our lives in the form of smart devices, wearables, and even clothing. From this data, we hope to learn more about preventative health so that we can spend less money on the doctor. To help users aggregate this perpetual growth of biometric "big" data, Apple HealthKit, Google Fit, and Samsung SAMI were each created with the hope of becoming the dominant design platform for Digital Health-Data. The research for this paper consists of citings from technology strategy literature and relevant journalism articles regarding recent and past developments that pertain to the wearables market and the digitization movement of electronic health records (EHR) and protected health information (PHI) along with their rules and regulations. The culmination of these citations will contribute to my hypothesis where the analysis will attempt to support my recommendations for Apple, Google, and Samsung. The ending chapters will encompass discussions around network effects and costs associated with multi-homing user data across multiple platforms and finally ending with my conclusion based on my hypothesis.
by Lawrence G. Lam.
S.M. in Engineering and Management
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Zhang, Peng. "Multi-agent Systems in Diabetic Health Care." Licentiate thesis, Karlskrona : Blekinge Institute of Technology, 2005. http://urn.kb.se/resolve?urn=urn:nbn:se:bth-00263.
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This thesis discusses how Multi-agent Systems (MAS) should be designed in the context of diabetic health care. Three fields are touched: computer science, socio-psychology and systems science. Agent Technology is the core technology in the research. Theories from socio-psychology and systems science are applied to facilitate the discussion about computer agents. As the integration of socio-psychology and systems science, Activity Systems Theory is introduced to give a synthesized description of MAS. Laws and models are introduced with benefits on both individual agent and agent communities. Cybernetics from systems science and knowledge engineering from computer science are introduced to approach the design and implementation of the individual agent architecture. A computer agent is considered intelligent if it is capable of reactivity, proactivity and social activity. Reactivity and proactivity can be realized through a cybernetic approach. Social activity is much more complex, since it considers MAS coordination. In this thesis, I discuss it from the perspectives of socio-psychology. The hierarchy and motivation thinking from Activity Systems Theory is introduced to the MAS coordination. To behave intelligent, computer agents should work with knowledge. Knowledge is considered as a run-time property of a group of agents (MAS). During the MAS coordination, agents generate new information through exchanging the information they have. A knowledge component is needed in agent’s architecture for the knowledge related tasks. In my research, I adopt CommonKADS methodology for the design and implementation of agent’s knowledge component. The contribution of this research is twofold: first, MAS coordination is described with perspectives from socio-psychology. According to Activity Systems Theory, MAS is hierarchically organized and driven by the motivation. This thesis introduces a motivation-driven mechanism for the MAS coordination. Second, the research project Integrated Mobile Information Systems for health care (IMIS) indicates that the diabetic health care can be improved by introducing agent-based services to the care-providers and care-receivers. IMIS agents are designed with capabilities of information sharing, organization coordination and task delegation. To perform these tasks, the IMIS agents interact with each other based on the coordination mechanism that is discussed above.
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Fotuhi-Firuzabad, Mahmud. "Operating health analysis of electric power systems." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1998. http://www.collectionscanada.ca/obj/s4/f2/dsk2/tape17/PQDD_0012/NQ27407.pdf.
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Onsy, Ahmed Mahmoud Helmy. "Intelligent health monitoring of power transmission systems." Thesis, University of Newcastle Upon Tyne, 2009. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.577153.
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Power transmissions are one of the most important parts of any mechanical system and in order to achieve the reliable operation of these systems, effective maintenance strategies must be used. Condition based maintenance strategies (CBM) are currently gaining in popularity due to their effectiveness in reducing maintenance costs; however, these require reliable monitoring techniques. Vibration, acoustic emission, and oil debris analysis have been studied to establish which can best support the operation of CBM in tracking the condition of the operating system, classifying faults, and predicting the onset of failure. These studies have shown it is necessary to adapt an intelligent approach to solving the problem. This study presents a novel approach to monitoring gear fatigue failures by combining (fusing) vibration, acoustic emission, and oil debris analysis using fuzzy logic. An 'intelligent health monitoring system' (lHMS) has been implemented on a back-to-back gearbox which can be adapted to monitor the behaviour of transmission systems in automotive, aircraft, wind turbine, and industrial machinery. The study describes the design and operation of the online IHMS, and demonstrates its ability in detecting transmission gear defects, thus preventing sudden unexpected failures. The results support the recent trend in using IHMSs in CBM strategies. KEY WORDS: Transmission, Intelligent Health Monitoring, Condition Based Maintenance, Acoustic Emission, Vibration, Oil Analysis, Fuzzy Logic, Sensors Fusion.
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Ödman, Torbjörn. "Wireless measurement systems for health and safety." Licentiate thesis, Mälardalens högskola, Inbyggda system, 2015. http://urn.kb.se/resolve?urn=urn:nbn:se:mdh:diva-28765.
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This licentiate thesis presents an advanced wireless system, built on a single hardware platform, for applications in medicine and health. In order to design a single system, adaptable for different context, an accurate system specification is required. The technical requirements are authenticated by actual tests in the environment where the system is intended to be used. The results of these measurements give an understanding of the possibilities of designing a real system but also acts as a base for deriving the empirical formulas to be used as the basis of the development and verification. In summary, this work has included a larger measurement campaign and a verification of subsystems to support the development of wireless systems on a single hardware platform. This can be used for different measurements in medical healthcare and rescue work. Previous systems for endurance tests have limitations in that they are not adapted to different sizes of mammals and they also have shortcomings in the quantification of data and scalability. The developed system was validated on mice and humans. On mice the measurement parameters was the hormone dopamine and locomotion. For humans it was measured time for given distances. Both validation tests showed high correlation with the respective reference methods. The correlation coefficients of mice between the developed system and the former system ranged from 0.916 to 0.967. In the validation with humans, runners were clocked by the system clock and a manual stop watch. The lowest correlation coefficient was 0.864. Advantages with the developed system is that it is scalable and measures the activity level quantitatively in the unit meters and it can also be used for different sizes of mammals in different environments. In tracking devices for rescue it is important that the transmitted signal can be detected at distances as large as possible. A support in the design work is to simulate path loss. This requires a path loss exponent, which was calculated after the measurement campaign. The results showed that the exponent of the height dependency decreases with antenna height above water. For the frequency 200 MHz, the exponent for the antenna height is 0.4 (vertical polarization) and 1.5 (horizontal polarization). For the distance dependency, the exponent was 3.59 (vertical polarization) and 3.22 (horizontal polarization). The path loss exponent is 2 for both the free space- and the ground reflection model. An antenna’s physical dimension is to a large extent dependent on the lowest frequency. The research’s aim was to reduce the physical size by introducing a resonance frequency. The physical length was from the beginning 0.43 meter given by the lowest frequency used (0.7 GHz) and the antenna was reduced in size to 0.22 meter.
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Abdulabbas, Gatea Al-Khafaji Ali. "Health monitoring of feedback controlled mechatronic systems." Thesis, Cardiff University, 2017. http://orca.cf.ac.uk/112940/.
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Health monitoring is essential in guaranteeing the safe, efficient, and correct operation of complex engineering systems. This PhD thesis presents a simulation of a non-linear, experimental-based model of a coupled tank apparatus CE105 under LabVIEW environment. The consideration of a traditional simple tank system is extended via the inclusion of non-linear elements. The simulation is used to accelerate the timescales of the monitoring and controller signals for nominal and faulty behaviour for several operating scenarios. In this study, a detailed simulation with several sources of fault was produced and run with the variety of operating scenarios to study the nominal and faulty behaviour of such mechatronic system. It is concluded that the liquid level will not be affected by fault nature and intensity in the presence of PID controller that covers hidden faults until its signal reaches a certain threshold. Hence, the end of useful life can be predicted by tracking the PID signal at any stage of the operating scenario. Technology advances have impacted upon monitoring, diagnostics and prognostics activities for increasingly sophisticated industrial systems and their operations. In particular, for integrated mechatronic systems, the facility provided by dynamic simulation models in presence of deteriorating faults has been investigated. For informed data-driven prognostic extrapolations, the long-term, time-varying operational profile of the mechatronic system requires recording and analysis. The contribution reported in this study relates to the simulation and experimentally validated, of a CE105 coupled-tank liquid level control system and three individual-thank liquid level system. A Sign Chart Algorithm (SCA) was developed and utilised as a novel controller-based health monitored (CBHM) system. Moreover, from the SCA and the PID signal trend, the remaining useful life of the system has been estimated. Results are reported and discussed for leakage or blockage and pump performance deterioration faults.
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Roman, Tamlyn. "Universal health coverage: a systems thinking approach." Master's thesis, University of Cape Town, 2012. http://hdl.handle.net/11427/11976.
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Includes abstract.Includes bibliographical references.
This dissertation uses a systems thinking approach to investigate how current health system frameworks conceive of universal coverage schemes and the conditions which led to their implementation and sustainability.
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Collins, Jonathan D. "Remote monitoring systems for substructural health monitoring." [Tampa, Fla] : University of South Florida, 2008. http://purl.fcla.edu/usf/dc/et/SFE0002605.
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Patterson, Jan. "Consumers and complaints systems in health care /." Title page, contents and summary only, 1996. http://web4.library.adelaide.edu.au/theses/09PH/09php3174.pdf.
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Al, Osman Hussein. "Ubiquitous Biofeedback Multimedia Systems." Thesis, Université d'Ottawa / University of Ottawa, 2014. http://hdl.handle.net/10393/31229.
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Human wellbeing, in a large component, relies on the harmony between the body and the mind. Unfortunately, we often miss or ignore important signals from our bodies, and sometimes this can negatively impact our health. Therefore, the use of intelligent systems that grasp such signals and convey them in an intuitive manner to our minds can result in great health benefits. In this Thesis, we introduce a family of multimedia technologies and techniques aimed at realizing such systems. We call them: Ubiquitous Biofeedback Multimedia Systems. Although the notion of clinical biofeedback has been around for years, we introduce the concept of Ubiquitous Biofeedback where the biofeedback operation is given geographical and temporal ubiquity attributes. A Ubiquitous Biofeedback reference model is introduced in the Thesis to provide an abstract structural representation of the various components at play in a typical non-clinical biofeedback environment. Two systems that implement the reference model’s components are presented. These systems implement the concept of Ubiquitous Biofeedback through the introduction of innovative stress management methods. An important component of these systems guides users through a relaxation routine. Therefore, a mathematical model is developed in the goal of personalizing the relaxation process. Its objective is to suggest relaxation techniques to a user during a stressful episode based on her or his preferences, history of what worked well and appropriateness for the context. The mental stress monitoring mechanism built into the Ubiquitous Biofeedback systems presented in this Thesis relies on the measurement of Heart Rate Variability (HRV). Therefore, HRV based methods for tracking mental stress accumulation and acute manifestations during long term monitoring have been devised. Also, since HRV signals can be plagued by artifacts, several algorithms are contributed to the effort of correcting such occurrences.
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Wolfe, Ingrid. "Child Health, Health Services and Systems in UK and other European countries." Doctoral thesis, Karlstads universitet, Institutionen för hälsovetenskaper, 2015. http://urn.kb.se/resolve?urn=urn:nbn:se:kau:diva-35856.
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Background This work in child population medicine describes child health problems, increases knowledge of health services, systems, and wider determinants, and makes recommendations for improvements. Aims To explore trends in UK child health and health service quality and highlight policy lessons from the UK and other European countries To study child health and health services in western Europe and derive lessons from different approaches to common challenges To enhance knowledge on child to adult transition care To describe trends in UK and EU15+ child and adolescent mortality and seek explanations for deteriorating UK health system performance, and make recommendations for improving survival Methods Population level measures of health status and system performance; primary and secondary research on policies and practice for health system assessments. Quantitative: mortality rate trends, excess deaths, DALYs, healthcare processes Qualitative: case reports, system descriptions, analyses Results European child survival has improved, but variably between countries. The UK has not matched recent EU mortality gains. There are 6,000 excess deaths annually in children under 15 years in EU14 countries. There are child survival inequities; countries investing in social protection have lower mortality. Children in the UK, compared with other EU countries, are more likely to be poor than adults. Non-communicable diseases are now dominant causes of child death, disease, and disability. Mortality, processes, and outcomes of healthcare amenable conditions varies between countries. Better outcomes seem to be associated with flexible health care models promoting cooperation, team working, and transition. Conclusions Child health in Europe is improving, but unevenly. Child health systems are not adapting sufficiently to meet needs. Recommendations are made for improving health systems and services.How do European countries compare when it comes to child health statistics? How do different child health services, systems, and wider determinants impact long term influences for good or harm? Why do some countries seem to do better than others in safeguarding their children’s and young people’s health and wellbeing? And what can we do to make things better for children? This thesis explores some of these difficult but important issues, and despite describing some serious signals of concern about child health, offers recommendations and clear ways forward for countries to ensure healthier futures for children.
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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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Liu, Zongchang. "Cyber-Physical System Augmented Prognostics and Health Management for Fleet-Based Systems." University of Cincinnati / OhioLINK, 2018. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1522321192371536.
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Erdil, Nadiye Özlem. "Systems analysis of electronic health record adoption in the U.S. healthcare system." Diss., Online access via UMI:, 2009.
Find full textAbstract:
Thesis (Ph. D.)--State University of New York at Binghamton, Thomas J. Watson School of Engineering and Applied Science, Department of Systems Science and Industrial Engineering, 2009.Includes bibliographical references.
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Bennett, Cudjoe A. "Urban Health Systems Strengthening| The Community Defined Health System for HIV/AIDS and Diabetes Services in Korogocho, Kenya." Thesis, The George Washington University, 2016. http://pqdtopen.proquest.com/#viewpdf?dispub=10146927.
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Background: Low- and middle-income countries have been experiencing unprecedented rates of urbanization. Rapid urbanization has attributed to an upsurge in non-communicable diseases, such as diabetes, cardiovascular diseases, and cancers in these countries. Most low- and middle-income countries are also still struggling to control communicable diseases such as HIV/AIDS, tuberculosis, and malaria. This phenomenon, described as the double burden of disease, places greater strains on urban health systems and vulnerable urban populations, such as slum dwellers, who are likely to bear the brunt of any negative health outcomes. Given the potential impacts of urbanization and quality of health services on poverty and disease in the urban poor, there is urgent need to study urban health systems and the ways in which services can be made more available, accessible, and acceptable to socioeconomically disadvantaged and culturally/ethnically diverse populations.
Objectives: This dissertation is a case study that investigated the community-defined health system for Korogocho slum residents in Nairobi, Kenya. Specifically, the purpose of the research study was to (1) determine the readiness of health workers to provide HIV- and diabetes-related services, (2) define the components of the health system as perceived by Korogocho residents; that is, determine the community-defined health system, (3) assess the factors that affect health service utilization with respect to HIV/AIDS and diabetes prevention, care, and treatment, and (4) make recommendations for improving the availability, accessibility, and acceptability of health services for Korogocho residents.
Methods: The case study research employed both quantitative and qualitative methods. Three complementary peer-review quality manuscripts were developed. Manuscript 1 presents results from one of the first assessments of health provider readiness to provide HIV/AIDS- and diabetes-related services using data from the Demographic and Health Survey’s Kenya Service Provision Assessment. A cross-sectional quantitative study was conducted. Readiness was defined as health workers having the training to provide the minimum HIV/AIDS services as prescribed by key government policies. Data analysis was conducted using STATA version 13 to assess the readiness of health workers in terms of a weighted proportion of providers from facility levels 2-4 who were trained in essential HIV/AIDS- and diabetes-related services according to Kenya’s national guidelines. Manuscript 2 details the results of a qualitative inquiry to understand the community-defined health system and identify factors that influence Korogocho residents’ health utilization behavior, especially in relation to HIV/AIDS and diabetes services. Manuscript 3 utilized a qualitative assessment to determine the role of informal health providers (those who have not received a Western biomedical model of medical training) in health service delivery to the Korogocho community. In both Manuscripts 2 and 3, semi-structured interviews were conducted with community members and informal health providers, respectively. Qualitative sampling was conducted with the purpose of generating a conceptual model of the urban health system for slum residents. Analysis of semi-structured qualitative interviews with community members and informal health providers in Manuscripts 2 and 3 was completed through an iterative process using NVivo 11 for Mac.
Results: The results of this research demonstrate the complexity of urban health systems. Korogocho residents utilize health services from a variety of facilities and providers from both the formal and informal sectors. Their health utilization behavior is primarily influenced by the availability, accessibility, and acceptability of health services, health facilities, and health providers. Informal health providers play a critical role in terms of expanding the availability and accessibility of health services to Korogocho residents. The results of this case study also reveal that training levels of health providers in Nairobi for the delivery of HIV- and diabetes-related services are low. On average, 12% of health workers interviewed in the 2010 Kenya service provision assessment reported having training in the previous 2 years in the full complement of essential HIV-related services as prescribed by Kenyan Government policies. There were similar low proportions of training for the provision of diabetes-related services among the three health worker cadres included in this analysis of the 2010 Kenya service provision assessment. Moreover, the community’s perceptions of the availability and accessibility of diabetes services lagged behind HIV services.
Conclusions: The results of this research reveal key information that can impact the health systems strengthening agenda, particularly for improving the availability and accessibility of health services to the urban poor. It is also clear from this research that there is an urgent need to scale up the training of health providers to handle the current double burden of disease. Further, among socioeconomically disadvantaged populations, such as urban slums, the intentional incorporation of informal providers into the health system is a key step towards ensuring that much needed health services reach the urban poor.
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Napierala, Christoph. "Finance equity in comparison of health systems : discussion of the current overall ranking of health systems by clustering these in their way of financing and equity /." Bühl, 2008. http://www.public-health-edu.ch/new/Abstracts/NC_15.12.08.pdf.
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Clernon, George. "Exploring the wireless sensor node tradespace within Structural Health Monitoring." Thesis, Massachusetts Institute of Technology, 2015. http://hdl.handle.net/1721.1/100370.
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Thesis: S.M. in Engineering and Management, Massachusetts Institute of Technology, Engineering Systems Division, System Design and Management Program, 2015.Cataloged from PDF version of thesis.
Includes bibliographical references (pages 69-74).
Historically, Structural Health Monitoring (SHM) involved visually or acoustically observing a structure and if damage was detected, remedial action was undertaken to repair or replace it. For example, as early as 6,500 BC, potters were known to listen for audible sounds during the cooling of their ceramics, signifying structural failure. In 1864 the UK parliament legislated for dam monitoring after a dam failure lead to the deaths of 254 people. The Golden Gate and Bay Bridges in San Francisco were monitored by Dean S. Carder in 1937 to determine "the probabilities of damage due to resonance" during an earthquake. Given the technological limitations of the last century, the predominant focus of SHM has been on identifying and understanding the global modal properties of a structure. However, the promise of SHM is the detection of any damage to infrastructure at the earliest possible moment from an array of sensors and actuators. To achieve this goal, not only global but local facets of the structure must be monitored. If this promise is realized, it will be possible to design bridges closer to their tolerances, to extend their operational lives, and to switch servicing to more cost-effective condition based maintenance. Such changes will reduce construction and maintenance costs while still providing the same level of service. This thesis will explore the wireless sensor node tradespace with the specific intent of delving into the areas limiting large scale, high density, localized coverage of structural health monitoring of bridges.
by George Clernon.
S.M. in Engineering and Management
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Begin, Michael P. "Systems Engineering Processes for the Acquisition of Prognostic and Health Management Systems." Thesis, Monterey, California. Naval Postgraduate School, 2012. http://hdl.handle.net/10945/17323.
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Prognostic and Health Management (PHM) systems often experience delayed fielding and lengthened maturation cycles due to their relative immaturity and the fact that they are regarded as non-flight critical systems. The national fiscal crisis and rising debt of the U.S. have each placed increased scrutiny on military systems acquisition and procurement practices. The Defense Department is pushing for greater emphasis on fundamental systems engineering practices earlier in the acquisition phase, with the expectation of fewer schedule slips and budget overruns. The acquisition of PHM systems could also benefit from increased systems engineering rigor early in their development. A 2007 directive from the DoD states that PHM systems be implemented into current weapon systems equipment, and materiel sustainment programs where technically feasible and beneficial. This research examines the definition of PHM requirements and a method for developing a solution neutral architecture for PHM systems. The thesis also identifies software development practices and acquisition processes for military propulsion PHM systems. The conclusion of this research is that the Defense Department can deliver the warfighter a capable PHM system on-time and within budget through the establishment of better procurement and systems engineering practices.
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BELGA, ILZA MARIA FRANCO. "PROCESS OF INTEGRATION AND IMPLEMENTATION OF QUALITY MANAGEMENT SYSTEM, ENVIRONMENTAL MANAGEMENT SYSTEMS AND SECURITY AND OCCUPATIONAL HEALTH SYSTEMS." PONTIFÍCIA UNIVERSIDADE CATÓLICA DO RIO DE JANEIRO, 2007. http://www.maxwell.vrac.puc-rio.br/Busca_etds.php?strSecao=resultado&nrSeq=10666@1.
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Esta dissertação propõe um processo de integração e
implantação dos
sistemas de gestão da qualidade, meio-ambiente e segurança
e saúde ocupacional,
os quais, atualmente, operam de forma isolada numa
empresa. O negócio da
empresa em questão é a produção de gases industriais e
pretende que o processo
de integração considere a cultura da organização e os
esforços movidos nesta
direção. A metodologia utilizada para a integração da
gestão dos sistemas já é de
uso e conhecimento das organizações e da academia e foi
selecionada conforme
equipe experiente e designada para este propósito,
partindo do princípio que não
se optaria pela reestruturação e sim pela adequação dos
sistemas já existentes. São
ainda comentados os pontos fracos identificados no
programa de implantação dos
sistemas isolados e que deveriam ser considerados quando
da integração dos
mesmos, assim como as necessidades que direcionam a
integração e a expectativa
com relação a responsividade, abrangência, resultados
coletados, além da
mudança cultural promovida. A estratégia é considerada
diferencial na decisão da
integração dos sistemas e a metodologia Seis Sigma a
ferramenta que possibilita a
mensuração de custos e a implantação da filosofia da
melhoria contínua na busca
em exceder as expectativas do cliente.This dissertation proposes an integration process and the implementation of quality management systems, environmental and safety policies, and occupational health. These systems are presently operating separately in the company. The company´s core business is the production of industrial gases and its internal policies establish that the integration process should take into consideration the culture of the organization and also the efforts already taken to move in this direction. The methodology applied for the systems integration management is under knowledge domain and it is being used by organizations and by the academy. It was selected and adopted by a skilled team assigned for this purpose, and it was defined that, instead of restructuring, adjustments would be made to existing systems. There are also comments about weak points identified in the program of implementation of isolated systems that should be considered for the integration process, as well as the needs that drive the integration and expectations related to responsiveness, scope of work, collected results and also the outcome in terms of cultural change. The strategy is considered relevant when deciding for systems integration and for the methodology Six Sigma, which is the tool that allows costs measurement and the implementation of the philosophy of continuous improvement to exceed customer´s expectations.
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Almalohi, Mussaad. "Implementing Health Information Exchange System: Saudi Arabia." Digital Commons at Loyola Marymount University and Loyola Law School, 2015. https://digitalcommons.lmu.edu/etd/350.
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In Saudi Arabia, medical errors are at an alarming level. Lack of a Health Information Exchange (HIE) system is one the greatest reasons for medical errors in the Kingdom. Health care in many countries has evolved with the invention of electronic health information exchange system, henceforth HIE. This research paper purposes to implement HIE in Saudi Arabia, which entirely does not have a system of the sort. It is imperative instill HIE in the health care system in Saudi to allow physicians, nurses, health care facilities as well as patients to electronically share medical information in a safe and secure manner.
Many countries such as United States, New Zealand and Germany have had great success with the HIE system and have reported vast benefits. Benefits of HIE are such as reduction of health care cost as well as decreasing medical errors. For Saudi Arabia to reach the same heights, many stakeholders will be involved in the triumph of the HIE system in the Kingdom of Saudi Arabia. The biggest contributor will be the Ministry of Health, which will be in charge of implementing as well as making the system mandatory in the main four hospitals in the country: Shomasy, Kind Saud University Hospital, Ministry of interior Hospital and Ministry of Defense Hospital. Each hospital having their own current medical information recording system, will now have one universal system that is made sure to be secure and safe for patients as well as other participating organizations who have access to the HIE system.
The main concentration of the HIE system in Saudi Arabia will be in the emergency care of these four hospitals. It is crucial to have an organized and controlled way of recording as well as accessing patient medical records electronically, in a fast and effective way. This paper proposes that an HIE system in Saudi Arabia will reduce the cost of medical care and decrease medical errors. Through the use of Lean thinking and the use of quality tools, the HIE system will be able to change and increase the reliably as well as effectiveness of Urgent Care in the country and therefore have consequent benefits as well. Also, understanding who is going to play a great role in the triumph of the HIE system, such as the Ministry of Health and knowing what stakeholders will need to be affiliated and contribute will lead the project to a better success.
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Mohammad, Yara Mahmoud. "Information security strategy in telemedicine and e-health systems : a case study of England’s shared electronic health record system." Thesis, Brunel University, 2010. http://bura.brunel.ac.uk/handle/2438/4669.
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Shared electronic health record (EHR) systems constitute an important Telemedicine and e-Health application. Successful implementation of shared health records calls for a satisfactory level of security. This is invariably achieved through applying and enforcing strict, and often quite complicated, rules and procedures in the access process. For this reason, information security strategy for EHR systems is needed to be in place. This research reviewed the definition of different terms that related to electronically stored and shared health records and delineated related information security terms leading to a definition of an information security strategy. This research also made a contribution to understanding information security strategy as a significant need in EHR systems. A major case study of the National Programme for IT (NPfIT) in England is used to be the container of other two sub-case studies in two different Acute Trusts. Different research methods used: participant observation and networking, semi-structured interviews, and documentary analysis. This research aimed to provide a comprehensive understanding to the information security strategy of England’s EHR system by presenting its different information security issues such as consent mechanisms, access control, sharing level, and related legal and regulatory documents. Six factors that influence the building of an information security strategy in EHR systems, were identified in this research, political, social, financial, technical, clinical and legal. Those factors are considered to be driving the strategy directly or indirectly. EHR systems are technical-clinical systems, but having other factors (than technical and clinical) that drive this technical-clinical system is a big concern. This research makes a significant contribution by identifying these factors, and in addition, this research shows not only how these factors can influence building the information security strategy, but also how they can influence each other. The study of the mutual influence among the six factors led to the argument that the most powerful factor is the political factor, as it directly or indirectly influences the remaining five factors. Finally, this research proposes guidelines for building an information security strategy in EHR systems. These guidelines are presented and discussed in the form of a framework. This framework was designed after literature analysis and after completing the whole research journey. It provides a tool to help putting the strategy in line by minimising the influence of various factors that may steer the strategy to undesirable directions.
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Magill, Elizabeth. "The Myth of Integration: Diffusion of Health Systems Strengthening Norm in Global Health." Thesis, Boston College, 2017. http://hdl.handle.net/2345/bc-ir:107443.
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Thesis advisor: Sarah BabbSince 2000, the global health management approach of health systems strengthening (HSS) has gained support from many local and international stakeholders. This thesis investigates the diffusion of the HSS norm in the global health community and within two disease programs of malaria and tuberculosis. I show how strong support for HSS by the global health community has been overwhelmed by coercive pressure from resourcewielding funding and governance structures. Drawing on organizational theory, I argue that global health organizations and experts have engaged in strategic social reconstruction and avoidance tactics to rationalize hypocrisy towards the HSS norm
Thesis (BA) — Boston College, 2017
Submitted to: Boston College. College of Arts and Sciences
Discipline: Scholar of the College
Discipline: International Studies
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Atalag, Koray. "Archetype Based Domain Modeling For Health Information Systems." Phd thesis, METU, 2007. http://etd.lib.metu.edu.tr/upload/12608671/index.pdf.
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A major problem to be solved in health informatics is high quality, structured and timely data collection. Standard terminologies and uniform domain conceptual models are important steps to alleviate this problem which are also proposed to enable interoperability among systems. With the aim of contributing to the solution of this problem, this study proposes novel features for the Archetypes and multi-level
modeling technique in health information and knowledge modeling. The study consists of the development of a research prototype for endoscopic data management,
and based on that experience, the extension of Minimal Standard Terminology in Digestive Endoscopy (MST). A major contribution of the study consists of significant extensions to the modeling formalism. The proposed modeling approach may be used in the design and development of health information systems based on archetypes for structured data collection, validation and dynamic user interface creation. The thesis
work is aimed to make considerable contribution to the emerging Electronic Health Records (EHR) standards and specifications.