Search results for: healthcare organisations

Authors: Itamir de Morais Barroca Filho, Cephas A. S. Barreto, Ramon Malaquias, Cezar Miranda Paula de Souza, Arthur Costa Gorgônio, João C. Xavier-Júnior, Mateus Firmino, Fellipe Matheus Costa Barbosa

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Information and Communication Technologies (ICT) in healthcare are crucial for efficiently delivering medical healthcare services to patients. These ICTs are also known as e-health and comprise technologies such as electronic record systems, telemedicine systems, and personalized devices for diagnosis. The focus of e-health is to improve the quality of health information, strengthen national health systems, and ensure accessible, high-quality health care for all. All the data gathered by these technologies make it possible to help clinical staff with automated decisions using machine learning. In this context, we collected patient data, such as heart rate, oxygen saturation (SpO2), blood pressure, respiration, and others. With this data, we were able to develop machine learning models for patients’ risk of death and estimate the length of stay in ICU beds. Thus, this paper presents the methodology for applying machine learning techniques to develop these models. As a result, although we implemented these models on an IoT healthcare platform, helping clinical staff in healthcare in an ICU, it is essential to create a robust clinical validation process and monitoring of the proposed models.

Keywords: ICT, e-health, machine learning, ICU, healthcare

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Authors: Nihar Bheda

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Protecting digital assets such as networks, systems, and data from advanced cyber threats is the aim of Digital Immunity Systems (DIS), which are a subset of cybersecurity. With features like continuous monitoring, coordinated reactions, and long-term adaptation, DIS seeks to mimic biological immunity. This minimizes downtime by automatically identifying and eliminating threats. Traditional security measures, such as firewalls and antivirus software, are insufficient for enterprises, such as healthcare providers, given the rapid evolution of cyber threats. The number of medical record breaches that have occurred in recent years is proof that attackers are finding healthcare data to be an increasingly valuable target. However, obstacles to enhancing security include outdated systems, financial limitations, and a lack of knowledge. DIS is an advancement in cyber defenses designed specifically for healthcare settings. Protection akin to an "immune system" is produced by core capabilities such as anomaly detection, access controls, and policy enforcement. Coordination of responses across IT infrastructure to contain attacks is made possible by automation and orchestration. Massive amounts of data are analyzed by AI and machine learning to find new threats. After an incident, self-healing enables services to resume quickly. The implementation of DIS is consistent with the healthcare industry's urgent requirement for resilient data security in light of evolving risks and strict guidelines. With resilient systems, it can help organizations lower business risk, minimize the effects of breaches, and preserve patient care continuity. DIS will be essential for protecting a variety of environments, including cloud computing and the Internet of medical devices, as healthcare providers quickly adopt new technologies. DIS lowers traditional security overhead for IT departments and offers automated protection, even though it requires an initial investment. In the near future, DIS may prove to be essential for small clinics, blood banks, imaging centers, large hospitals, and other healthcare organizations. Cyber resilience can become attainable for the whole healthcare ecosystem with customized DIS implementations.

Keywords: digital immunity system, cybersecurity, healthcare data, emerging technology

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Authors: Tianyi Wang, Hieyong Jeong, An Guo, Yuko Ohno

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Healthcare robot for assisting sit-to-stand (STS) performance had aroused numerous research interests. To author’s best knowledge, knowledge about how evaluating healthcare robot is still unknown. Robot should be labeled as fault if users feel demanding during STS when they are assisted by robot. In this research, we aim to propose a method to evaluate sit-to-stand assist robot through center of pressure (CoP), then classify different STS performance. Experiments were executed five times with ten healthy subjects under four conditions: two self-performed STSs with chair heights of 62 cm and 43 cm, and two robot-assisted STSs with chair heights of 43 cm and robot end-effect speed of 2 s and 5 s. CoP was measured using a Wii Balance Board (WBB). Bayesian classification was utilized to classify STS performance. The results showed that faults occurred when decreased the chair height and slowed robot assist speed. Proposed method for fault classification showed high probability of classifying fault classes form others. It was concluded that faults for STS assist robot could be detected by inspecting center of pressure and be classified through proposed classification algorithm.

Keywords: center of pressure, fault classification, healthcare robot, sit-to-stand movement

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Authors: Qing Wu, Xuchun Ye, Kirsten Corazzini

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Objective: It is increasingly recognized that patients’ rational and meaningful engagement in healthcare could make important contributions to their health care and safety management. However, recent evidence indicated that patients' actual roles in healthcare didn’t match their desired roles, and many patients reported a less active role than desired, which suggested that patient engagement in healthcare may be influenced by various factors. This study aimed to analyze influencing factors on patient engagement and explore the influence mechanism, which will be expected to contribute to the strategy development of patient engagement in healthcare. Methods: On the basis of analyzing the literature and theory study, the research framework was developed. According to the research framework, a cross-sectional survey was employed using the behavior and willingness of patient engagement in healthcare questionnaire, Chinese version All Aspects of Health Literacy Scale, Facilitation of Patient Involvement Scale and Wake Forest Physician Trust Scale, and other influencing factor related scales. A convenience sample of 580 patients was recruited from 8 general hospitals in Shanghai, Jiangsu Province, and Zhejiang Province. Results: The results of the cross-sectional survey indicated that the mean score for the patient engagement behavior was (4.146 ± 0.496), and the mean score for the willingness was (4.387 ± 0.459). The level of patient engagement behavior was inferior to their willingness to be involved in healthcare (t = 14.928, P ＜ 0.01). The influencing mechanism model of patient engagement in healthcare was constructed by the path analysis. The path analysis revealed that patient attitude toward engagement, patients’ perception of facilitation of patient engagement and health literacy played direct prediction on the patients’ willingness of engagement, and standard estimated values of path coefficient were 0.341, 0.199, 0.291, respectively. Patients’ trust in physician and the willingness of engagement played direct prediction on the patient engagement, and standard estimated values of path coefficient were 0.211, 0.641, respectively. Patient attitude toward engagement, patients’ perception of facilitation and health literacy played indirect prediction on patient engagement, and standard estimated values of path coefficient were 0.219, 0.128, 0.187, respectively. Conclusions: Patients engagement behavior did not match their willingness to be involved in healthcare. The influencing mechanism model of patient engagement in healthcare was constructed. Patient attitude toward engagement, patients’ perception of facilitation of engagement and health literacy posed indirect positive influence on patient engagement through the patients’ willingness of engagement. Patients’ trust in physician and the willingness of engagement had direct positive influence on the patient engagement. Patient attitude toward engagement, patients’ perception of physician facilitation of engagement and health literacy were the factors influencing the patients’ willingness of engagement. The results of this study provided valuable evidence on guiding the development of strategies for promoting patient rational and meaningful engagement in healthcare.

Keywords: healthcare, patient engagement, influencing factor, the mechanism

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Authors: Helene Eller

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The aim of non-profit organizations (NPO) is to provide services and goods for its clientele, with profit being a minor objective. By having this definition as the basic purpose of doing business, it is obvious that the goal of an organisation is to serve several bottom lines and not only the financial one. This approach is underpinned by the non-distribution constraint which means that NPO are allowed to make profits to a certain extent, but not to distribute them. The advantage is that there are no single shareholders who might have an interest in the prosperity of the organisation: there is no pie to divide. The gained profits remain within the organisation and will be reinvested in purposeful projects. Good governance is mandatory to support the aim of NPOs. Looking for a measure of good governance the principals of corporate governance (CG) will come in mind. The purpose of CG is direction and control, and in the field of NPO, CG is enlarged to consider the relationship to all important stakeholders who have an impact on the organisation. The recognition of more relevant parties than the shareholder is the link to corporate social responsibility (CSR). It supports a broader view of the bottom line: It is no longer enough to know how profits are used but rather how they are made. Besides, CSR addresses the responsibility of organisations for their impact on society. When transferring the concept of CSR to the non-profit area it will become obvious that CSR with its distinctive features will match the aims of NPOs. As a consequence, NPOs who apply CG apply also CSR to a certain extent. The research is designed as a comprehensive theoretical and empirical analysis. First, the investigation focuses on the theoretical basis of both concepts. Second, the similarities and differences are outlined and as a result the interconnection of both concepts will show up. The contribution of this research is manifold: The interconnection of both concepts when applied to NPOs has not got any attention in science yet. CSR and governance as integrated concept provides a lot of advantages for NPOs compared to for-profit organisations which are in a steady justification to show the impact they might have on the society. NPOs, however, integrate economic and social aspects as starting point. For NPOs CG is not a mere concept of compliance but rather an enhanced concept integrating a lot of aspects of CSR. There is no “either-nor” between the concepts for NPOs.

Keywords: business ethics, corporate governance, corporate social responsibility, non-profit organisations

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Authors: Hend Albassam, Nouf Alrumaih

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Nowadays we are in the age of technologies and communication and there is no doubt that technologies such as the Internet can offer many advantages for many business fields, and the health field is no execution. In fact, using the Internet provide us with a new path to improve the quality of health care throughout the world. The e-healthcare offers many advantages such as: efficiency by reducing the cost and avoiding duplicate diagnostics, empowerment of patients by enabling them to access their medical records, enhancing the quality of healthcare and enabling information exchange and communication between healthcare organizations. There are many problems that result from using papers as a way of communication, for example, paper-based prescriptions. Usually, the doctor writes a prescription and gives it to the patient who in turn carries it to the pharmacy. After that, the pharmacist takes the prescription to fill it and give it to the patient. Sometimes the pharmacist might find difficulty in reading the doctor’s handwriting; the patient could change and counterfeit the prescription. These existing problems and many others heighten the need to improve the quality of the healthcare. This project is set out to develop a distributed e-healthcare system that offers some features of e-health and addresses some of the above-mentioned problems. The developed system provides an electronic health record (EHR) and enables communication between separate health care organizations such as the clinic, pharmacy and laboratory. To develop this system, the Service Oriented Architecture (SOA) is adopted as a design approach, which helps to design several independent modules that communicate by using web services. The layering design pattern is used in designing each module as it provides reusability that allows the business logic layer to be reused by different higher layers such as the web service or the website in our system. The experimental analysis has shown that the project has successfully achieved its aims toward solving the problems related to the paper-based healthcare systems and it enables different health organization to communicate effectively. It implements four independent modules including healthcare provider, pharmacy, laboratory and medication information provider. Each module provides different functionalities and is used by a different type of user. These modules interoperate with each other using a set of web services.

Keywords: e-health, services oriented architecture (SOA), web services, interoperability

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Authors: Abdessamad Dali-Ali, Houaria Beldjillali, Fouzia Agag, Asmaa Oukebdane, Ramzi Tidjani, Arslane Bettayeb, Khadidja Meddeber, Radia Dali-Yahia, Nori Midoun

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Healthcare-associated infections are a real public health problem, especially in intensive care units. The aim of our study was to describe the epidemiological profile and to estimate the incidence of these infections at the intensive care unit of our teaching hospital. A prospective study was conducted, from June 2012 to December 2013. During this period, 305 patients having a duration of hospitalization equal or more than 48 hours were included in the study. In terms of the incidence of healthcare associated infections, nosocomial pneumonia occupied the first position with a cumulative incidence rate of 20.0%, followed by bacteremia (5.6%), central venous catheter infections (4%), and urinary tract infections (3%). In the case of isolated microorganisms, Gram-negative bacilli not enterobacteriaceae occupied the first place with 48.5%, followed by enterobacteria (32.1%). Acinetobacter baumannii was the most common germ (27.6%). Our study showed that the rate of health-care-associated infections was relatively high in the intensive care unit. A control program to reduce all infections is a priority for the Infection Control Associated Committee.

Keywords: epidemiological profile, healthcare associated infections, intensive care units, teaching hospital of Oran, Algeria

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Authors: Manirath Wongsim

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Information technology management has become important for the achievement of organisations. An increase in the pace of technological change has revolutionised the way accountants perform their jobs. In response to this challenge, the identification of a new comprehensive set of information technology competencies combined with information technology skills and other skills (namely, soft skills) are necessary. Thus, this study aims to investigate IT competencies among professional accountants to enhance firm performance. This research was conducted with 42 respondents at ten organisations in Thailand. This research used qualitative, interpretive evidence.The results indicate that the factor IT competencies within the organizational issues defines19 factors. Specifically, these new factors, based on the research findings and the literature and unique to IT competences for professional accountants, include ERP software skills, BI software skills and accounting law and legal skills. The evidence in this study suggests that ERP software, spreadsheets, BI software and accounting software were ranked as much-needed skills to be acquired by accountants while communication skills were ranked as the most required skills, and delegation skills as the least required. The findings of the research’s empirical evidence suggest that organizations should understand appropriate into developing information technology related competencies for knowledge workers in general and professional accountants in particular and provide assistance in all processes of decision making.

Keywords: IT competencies, IT competencies for accountants, IT skills for accounting, soft skills for accountants

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Authors: Mohd Zuhair, Ram Babu Roy

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This paper presents an overview of the accessibility, design, and functioning of health insurance plans launched by state governments in India. In recent years, the governments of several states in India have come forward to provide health insurance coverage for the low-income group and rural population to reduce the out of pocket expenditure (OPE) on healthcare. Different health insurance schemes have different structures and offerings which differ in the different demographic factors. This study will portray a comparative analysis of the various health insurance schemes by analyzing different offerings and finance generation of the schemes. The comparative analysis will explain the lesson to be learned from these schemes and extend the existing knowledge of the health insurance in India. This would help in recognizing tension between various drivers and identifying issues pertaining to the sustainability of health insurance schemes in India.

Keywords: health insurance, out of pocket expenditure, universal healthcare, sustainability

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Authors: Rusne Kregzdaite

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The value of the cultural sector stems from the symbolic exploration that differentiates cultural organisations from other product or service organisations. As a result, the cultural sector has a dual impact on the socio-economic system: the economic value (expressed in terms of market relations) created influences the dynamics of the country's financial indicators, while the cultural (non-market) value indirectly contributes to the welfare of the state through changes in societal values, creativity transformations and cultural needs of the country. Measurement of indirect (cultural value) impacts is difficult, but in the case of the cultural sector (especially when it comes to economically inefficient state-funded culture), it helps to reveal the essential characteristics of the sector. The study aims to analyze the value of cultural organisations that are invisible in market processes and to base it on quantified calculations. This was be done by analyzing the usefulness of the consumer, incorporating not only the price paid but also the social and cultural decision-making factors that determine the spectator's choice (time dedicated for a visit, additional costs, content, previous experiences, corporate image). This may reflect the consumer's real choice to consume (all the costs he incurs may be considered the financial equivalent of his experience with the cultural establishment). The research methodology was tested by analyzing the performing arts sector and applying methods to the Lithuanian national drama theatre case. The empirical research consisted of a survey (more than 800 participants) of Lithuanian national drama theatre visitors to different performances. The willingness to pay and travel costs methods were used. Analysis of different performances lets identifies the factor that increases willingness to pay for the performance and affects theatre attendance. The research stresses the importance of cultural value and social perspective of the cultural sector and relates it to the discussions of public funding of culture.

Keywords: cultural economics, performing arts, willingness to pay, travel cost analysis, performing arts management

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Authors: Umair Shafique, Hafiz Usman Zia, Fiaz Majeed, Samina Naz, Javeria Ahmed, Maleeha Zainab

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The Internet of Things (IoT) has become a hot topic for the last couple of years. This innovative technology has shown promising progress in various areas, and the world has witnessed exponential growth in multiple application domains. Researchers are working to investigate its aptitudes to get the best from it by harnessing its true potential. But at the same time, IoT networks open up a new aspect of vulnerability and physical threats to data integrity, privacy, and confidentiality. It's is due to centralized control, data silos approach for handling information, and a lack of standardization in the IoT networks. As we know, blockchain is a new technology that involves creating secure distributed ledgers to store and communicate data. Some of the benefits include resiliency, integrity, anonymity, decentralization, and autonomous control. The potential for blockchain technology to provide the key to managing and controlling IoT has created a new wave of excitement around the idea of putting that data back into the hands of the end-users. In this manuscript, we have proposed a model that combines blockchain and IoT networks to address potential security and privacy issues in the healthcare domain. Then we try to describe various application areas, challenges, and future directions in the healthcare sector where blockchain platforms merge with IoT networks.

Keywords: IoT, blockchain, cryptocurrency, healthcare, consensus, data

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Authors: Ruzanna Muradyan

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Medical data mining is a crucial field in contemporary healthcare that offers cutting-edge tactics with enormous potential to transform patient care. This abstract examines how sophisticated data mining techniques could transform the healthcare industry, with a special focus on how they might improve patient outcomes. Healthcare data repositories have dynamically evolved, producing a rich tapestry of different, multi-dimensional information that includes genetic profiles, lifestyle markers, electronic health records, and more. By utilizing data mining techniques inside this vast library, a variety of prospects for precision medicine, predictive analytics, and insight production become visible. Predictive modeling for illness prediction, risk stratification, and therapy efficacy evaluations are important points of focus. Healthcare providers may use this abundance of data to tailor treatment plans, identify high-risk patient populations, and forecast disease trajectories by applying machine learning algorithms and predictive analytics. Better patient outcomes, more efficient use of resources, and early treatments are made possible by this proactive strategy. Furthermore, data mining techniques act as catalysts to reveal complex relationships between apparently unrelated data pieces, providing enhanced insights into the cause of disease, genetic susceptibilities, and environmental factors. Healthcare practitioners can get practical insights that guide disease prevention, customized patient counseling, and focused therapies by analyzing these associations. The abstract explores the problems and ethical issues that come with using data mining techniques in the healthcare industry. In order to properly use these approaches, it is essential to find a balance between data privacy, security issues, and the interpretability of complex models. Finally, this abstract demonstrates the revolutionary power of modern data mining methodologies in transforming the healthcare sector. Healthcare practitioners and researchers can uncover unique insights, enhance clinical decision-making, and ultimately elevate patient care to unprecedented levels of precision and efficacy by employing cutting-edge methodologies.

Keywords: data mining, healthcare, patient care, predictive analytics, precision medicine, electronic health records, machine learning, predictive modeling, disease prognosis, risk stratification, treatment efficacy, genetic profiles, precision health

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Authors: Abhay Vir Singh Kanwar

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The pharmaceutical industry today is a multi-billion dollar business and yet disadvantages people in many corners of the globe who are still dying in large numbers from curable illnesses for lack of access to drugs. The astronomical prices of essential and life-saving drugs is not just an economic problem that can be settled through clever market strategies but is an ethical issue, given the accumulated wealth of today’s humanity and the sense of global justice that it increasingly comes to share. In this paper, I make a very practical argument for what I shall call ‘the ethical healthcare paradigm’, which, I propose, can replace the economistic paradigm that can still drive the healthcare sector without creating spillover effects on the market. Taking off from the ethical-philosophical argument for recognizing every individual’s right to capability to be healthy, I shall come to the focused practical proposal of the cost-rationalization and universal availability of essential, life-saving drugs through the undertaking of research and development funding for drug innovation by the business establishment as such in terms of the concept of CSR. The paper will first expose the concepts of basic and fundamental capabilities in relation to education and health, after which it will focus on the right to capability to be healthy of every person. In the third section, it will discuss the ‘ethical healthcare paradigm’ as opposed to the economistic health paradigm and will argue that the patient will have to be considered the primary stakeholder of this paradigm or the very ‘subject’ of healthcare. The next section will be on an ethical-historical critique of the pharmaceutical industry’s profit driven economism. The section after that will look at the business operation and the stages in the life cycle of a drug that comes to the market in order to understand the risks, strengths and problems of the pharmaceutical industry. Finally, the paper will discuss the concept of CSR in relation to the ethical healthcare paradigm in order to propose CSR funding in research and development for innovation on drugs so that life-saving drugs can be made available to every sick person cost-effectively.

Keywords: capability approach, healthcare, CSR, patient

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Authors: Barry Ardley, Abi Hunt, Nick Taylor

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As a theoretical and practical framework, this study uses the student-as-producer approach to learning in higher education, as adopted by the Lincoln International Business School, University of Lincoln, UK. Students as producer positions learners as skilled and capable agents, able to participate as partners with tutors in live research projects. To illuminate the nature of this approach to learning and to highlight its critical issues, the authors report on two guided student consultancy projects. These were set up with the assistance of two local organisations in the city of Lincoln, UK. Using the student as a producer model to deliver the projects enabled learners to acquire and develop a range of key skills and knowledge not easily accessible in more traditional educational settings. This paper presents a systematic case study analysis of the eight organising principles of the student-as-producer model, as adopted by university tutors. The experience of tutors implementing students as producers suggests that the model can be widely applied to benefit not only the learning and teaching experiences of higher education students and staff but additionally a university’s research programme and its community partners.

Keywords: consultancy, learning, student as producer, research

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Authors: Mrigakshi Das

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The private sector investments and quantum of money required in this sector critically hinges on the financial risk and returns the sector offers to providers of capital. Therefore, it becomes important to understand financial performance of hospitals. Financial Analysis is useful for decision makers in a variety of settings. Consider the small proprietary hospitals, say, Physicians Clinic. The managers of such clinic need the information that financial statements provide. Attention to Financial Statements of healthcare Organizations can provide answers to questions like: How are they doing? What is their rate of profit? What is their solvency and liquidity position? What are their sources and application of funds? What is their Operational Efficiency? The researcher has studied Financial Statements of 5 Private Healthcare Organizations in Guwahati City.

Keywords: not-for-profit organizations, financial analysis, ratio analysis, profitability analysis, liquidity analysis, operational efficiency, capital structure analysis

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Authors: Sandeep Reddy, Sonia Allan, Simon Coghlan, Paul Cooper

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Artificial Intelligence (AI) and its application in medicine has generated ample interest amongst policymakers and clinicians. Successes with AI in medical imaging interpretation and clinical decision support are paving the way for its incorporation into routine healthcare delivery. While there has been a focus on the development of ethical principles to guide its application in healthcare, challenges of this application go beyond what ethics principles can address thus requiring robust governance frameworks. Also, while ethical challenges of medical artificial intelligence are being discussed, the ethics of deploying AI in lower-income countries receive less attention than in other developed economies. This creates an imperative not only for sound ethical guidelines but also for robust governance frameworks to regulate AI in medicine around the world. In this article, we discuss what components need to be considered in developing these governance frameworks and who should lead this worldwide effort.

Keywords: artificial intelligence, global health, governance, ethics

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Authors: Y. Atilgan Şengül

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Health information technologies promise higher quality, safer care and much more for both patients and professionals. Despite their promise, they are costly to develop and difficult to implement. On the other hand, user acceptance and usage determine the success of implemented information technology in healthcare. This study provides a model to understand health professionals’ perception and expectation of health information technology. Extensive literature review has been conducted to determine the main factors to be measured. A questionnaire has been designed as a measurement model and submitted to the personnel of an in vitro fertilization clinic. The respondents’ degree of agreement according to five-point Likert scale was 72% for convenient access to data and 69.4% for the importance of data security. There was a significant difference in acceptance of electronic data storage for female respondents. Also, other significant differences between professions were obtained.

Keywords: healthcare, health informatics, medical record system, questionnaire

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Authors: Nasser M. Amaitik, Ngwan F. Elsagzli

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The Lean technique is very important in the service and industrial fields. It is defined as an effective tool to eliminate the wastes. In lean the wastes are defined as anything which does not add value to the end product. There are wastes that can be avoided, but some are unavoidable to many reasons. The present study aims to apply the principles of lean in two different sectors, healthcare, and industry. Two case studies have been selected to apply the experimental work. The first case was Al-Jalaa Hospital while the second case study was the Technical Company of Aluminum Sections in Benghazi, Libya. In both case studies the Value Stream Map (VSM) of the current state has been constructed. The proposed plans have been implemented by merging or eliminating procedures or processes. The results obtained from both case studies showed improvement in capacity, idle time and utilized time.

Keywords: healthcare service delivery, idle time, lean principles, utilized time, value stream mapping, wastes

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Authors: S. Cheng, C. Catallo

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Introduction: Canada's healthcare and social services systems are failing high risk, vulnerable older adults. Care for vulnerable older Canadians (65 and older) is not optimal in Canada. It does not address the care needs of vulnerable, high risk adults using a holistic approach. Given the growing aging population, and the care needs for seniors with complex conditions is one of the highest in Canada's health care system, there is a sense of urgency to optimize care. Integration of health and social services is an emerging trend in Canada when compared to European countries. There is no common and universal understanding of healthcare and social services integration within the country. Consequently, a clear understanding and definition of integrated health and social services are absent in Canada. Objectives: A study was undertaken to develop a case definition for integrated health and social care initiatives that serve older adults, which was then tested against three Canadian integrated initiatives. Methodology: A limited literature review was undertaken to identify common characteristics of integrated health and social care initiatives that serve older adults, and comprised both scientific and grey literature, in order to develop a case definition. Three Canadian integrated initiatives that are located in the province of Ontario, were identified using an online search and a screening process. They were surveyed to determine if the literature-based integration definition applied to them. Results: The literature showed that there were 24 common healthcare and social services integration characteristics that could be categorized into ten themes: 1) patient-care approach; 2) program goals; 3) measurement; 4) service and care quality; 5) accountability and responsibility; 6) information sharing; 7) Decision-making and problem-solving; 8) culture; 9) leadership; and 10) staff and professional interaction. The three initiatives showed agreement on all the integration characteristics except for those characteristics associated with healthcare and social care professional interaction, collaborative leadership and shared culture. This disagreement may be due to several reasons, including the existing governance divide between the healthcare and social services sectors within the province of Ontario that has created a ripple effect in how professions in the two different sectors interact. In addition, the three initiatives may be at maturing levels of integration, which may explain disagreement on the characteristics associated with leadership and culture. Conclusions: The development of a case definition for healthcare and social services integration that incorporates common integration characteristics can act as a useful instrument in identifying integrated healthcare and social services, particularly given the emerging and evolutionary state of this phenomenon within Canada.

Keywords: Canada, case definition, healthcare and social services integration, integration, seniors health, services delivery

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Authors: Esther Paul, Ibrahim A. M. Alzaydani, Al Hakami, Caryl Beynon

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Research Objectives and Goal: The main aim of the current study was to explore the perspectives of healthcare workers on Healthcare-associated infections (HAI) and infection control measures in a tertiary care Hospital in Abha, Saudi Arabia. As per our knowledge, this is perhaps the first qualitative study on HAI to be done in Saudi Arabia. The goal of the study was to understand the perspectives of the healthcare workers on the current protocol and guidelines for HAI and infections control measures in the hospital, the effectiveness of the current protocol for HAI and infection control measures and ways of reducing the incidence of HAI and improve infection control measures. Methods used: A qualitative research design was used to collect the data from 25 healthcare workers consisting of doctors and nurses, recruited by Snowball strategy via semi-structured interviews which were audio-recorded and transcribed verbatim immediately. An interview guide consisting of open-ended questions about the existing HAI and infection control practices in the healthcare facility, the awareness of the healthcare workers about HAI and the need for safe infection control measures were used to collect the data. The transcribed data were analyzed using the thematic analysis method. Results: Using thematic analysis four themes were identified.1.Knowledge of HAI and infection control 2. Infection control measures in practice 3. The gap in infection control measures and HAI 4. Required Implementations. The first theme covered the participants' knowledge on HAI, its definition, the types of HAI and the infection control measures.Most of the participants were aware of HAI and had some idea of the definition of HAI, its significance and the dangers posed by HAI, but few residents had no idea of the types of HAI. The second theme was focussed on the infection control measures in practice. Most of the participants were aware of the importance of infection control measures like hand hygiene, catheter care, and waste disposal. The nurses were responsible for most of the disinfection and sterilization measures and practiced it effectively. However, some doctors and residents had no inkling about these measures. The third theme emphasized that although most of the participants were aware of HAI and infection control measures and were in practice. There were some lacunae regarding their knowledge of the different types of HAI, Personal Protective Equipment practices, communication among the healthcare personnel and the hospital administrations and the means of waste disposal. The fourth and the final theme identified that most of the participants felt the need for implementations of changes regarding existing protocols, workshops/seminars, methods of waste disposal and sterilization and disinfection practices. Conclusion: The current qualitative study concluded that there is a need for better educational programs and hands-on training for all the healthcare personnel including the paramedical staff as well. The residents should have adequate knowledge of infection control practices to guide the nurses and should share the responsibility with the nurses in the practice of effective infection control measures

Keywords: healthcare-associated infections, infection control measures, perspectives, qualitative

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Authors: Constantinos Adamides, Petros Petrikkos

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In the era of growing hybrid threats, small states find themselves in need to re-evaluate existing foreign and defense policies. The pressure to establishing or maintain a status of a reliable partner in the community in which they belong to, vis-à-vis their multilateral relations with other organisations and entities, small states may need to shift their policies in the field to accommodate security needs that are not only pertinent to their security, but also to that of the organisations (bloc) in which they interact. Unlike potential shortcomings in a small state’s mainstream security and defence framework where the threat would be limited to the state itself, in more contemporary times with dominating hybrid threats, the small states’ security shortcomings may also become a security problem for the bloc in which these states belong to. An indicative example is small states like Cyprus and Malta, which belong and 'interact' in the European Union. As a result, the nature of hybrid threats can be utilised to hurt bigger states in a bloc by exploiting the small states’ vulnerabilities and security gaps. Inevitably, both the defensive and foreign policy collaborations of small states with bigger states have been and are constantly re-evaluated to tackle and prevent such problems. In essence, the goal of this ‘re-evaluation’ aims to achieve a twofold goal: The first is the small states’ quest to appear as a reliable partner within the bloc, while the second is to avoid being the weakest security link in the bloc’s defence against hybrid threats. Indeed, the hybrid arena is a security area where they can excel in the bloc, despite the potential and expected conventional military deficiencies. This new environment prompts us to think security from the perspective of small states differently and in relation to their role as members or big organisations. The paper focuses on the case of Cyprus following its accession to the European Union and examines how a country that has had a very focused security orientation –not least due to its ongoing security problems– altered its foreign and defence policies within the European Union to ensure compliance with the rest of the bloc, while at the same time maximizing its role as a security player. Specifically, it examines the methods through which the country shifted its policies as well as the challenges and opportunities that emerged from these security shifts.

Keywords: Cyprus, defence, foreign policy, hybrid threats, ontological security, small states

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Authors: Shishir Kumar, Chhaya Gangwal, Seema Raj

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Public health informatics (PHI) which has seen successful implementation in the developed world, become the buzzword in the developing countries in providing improved healthcare with enhanced access. In rural areas especially, where a huge gap exists between demand and supply of healthcare facilities, PHI is being seen as a major solution. There are factors such as growing network infrastructure and the technological adoption by the health fraternity which provide support to these claims. Public health informatics has opportunities in healthcare by providing opportunities to diagnose patients, provide intra-operative assistance and consultation from a remote site. It also has certain barriers in the awareness, adaptation, network infrastructure, funding and policy related areas. There are certain medico-legal aspects involving all the stakeholders which need to be standardized to enable a working system. This paper aims to analyze the potential and challenges of public health informatics services in rural communities.

Keywords: PHI, e-health, public health, health informatics

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Authors: S. Chandrasekaran, S. Nandita, M. Shivathmika, Srikrishnan Shivakumar

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The objective of the research work is to analyze the computational chemical-composition of carbohydrates in the context of healthcare informatics. The computation involves the representation of complex chemical molecular structure of carbohydrate using graph theory and in a deployable Chemical Markup Language (CML). The parallel molecular structure of the chemical molecules with or without other adulterants for the sake of business profit can be analyzed in terms of robustness and derivatization measures. The rural healthcare program should create awareness in malnutrition to reduce ill-effect of decomposition and help the consumers to know the level of such energy storage mixtures in a quantitative way. The earlier works were based on the empirical and wet data which can vary from time to time but cannot be made to reuse the results of mining. The work is carried out on the quantitative computational chemistry on carbohydrates to provide a safe and secure right to food act and its regulations.

Keywords: carbohydrates, chemical-composition, chemical markup, robustness, food safety

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Authors: Changaiz Khan

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Pakistan has the highest rates of maternal mortality in South Asia. From the year 2000 to 2017 the global rate of maternal mortality has decreased up to 39 %. In the context of South Asia, it has decreased by 59% since 2000s. Pakistan has also reduced the rate of maternal mortality, but there is a difference on the provincial level. According to the report of the National Institute of Population Studies (NIPS) conducted in 2020, the MMR in Balochistan has crossed the ratio of most of the South Asian countries, i.e., 298 maternal deaths per 100,000 live births. In comparison, the province of Punjab has the lowest maternal mortality rate i.e. 157 deaths (per 100,000 live births). The rate of maternal mortality is much higher in Balochistan as compared to the other provinces. This research is aimed to discuss the supply side barriers and utilization of maternal healthcare services in the District Gwadar. Likert scale survey method has been used to collect data from the Healthcare Professionals from hospitals -private and government- and the maternal healthcare receiver, that is patient. Semi-structured interviews of healthcare professionals such as doctors, nurses, and Lab technicians have also been conducted. It has been found in this research study that the hospitals in Gwadar district are lagging behind in providing modern maternal healthcare to women due to the lack of staff training, medicine supply, and Laboratories. Moreover, the system of the lady health worker is also not catering to the needs of the women in District Gwadar. It has been recommended in the study that first of all the government should fulfill the supply of the medicine in the hospital. Secondly, the government should open laboratories in the hospitals. Thirdly, the government should increase the funding of the government hospital and the allocation of lady health workers in District Gwadar, Balochistan should be increased.

Keywords: maternal mortality, neonatal, postnatal, supply barriers, patients, healthcare professionals, laboratory, medical supply, training

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Authors: Debolina Chatterjee, Suhita Chopra Chatterjee

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Imprisonment is an expansive concept, as it is regulated by laws under criminal justice system of the state. The state sets principles of punishment to control offenders and also puts limits to excess punitive control. One significant way through which it exercises control is through rules governing healthcare of imprisoned population. Prisons signify specialized settings which accommodate both medical and legal concerns. The provision of care operates within the institutional paradigm of punishment. This requires the state to negotiate adequately between goals of punishment and fulfilment of basic human rights of offenders. The present study is based on a critical analysis of prison healthcare standards in India, which include government policies and guidelines. It also demonstrates how healthcare is delivered by drawing insights from a primary study conducted in a correctional home in the state of West Bengal, India, which houses both male and female inmates. Forty women were interviewed through semi-structured interviews, followed by focus group discussions. Doctors and administrative personnel were also interviewed. Findings show how institutional practices control women through subversion of the role of doctors to prison administration. Also, poor healthcare infrastructure, unavailability of specialized services, hierarchies between personnel and inmates make prisons unlikely sites for therapeutic intervention. The paper further discusses how institutional practices foster gender-based discriminatory practices.

Keywords: imprisonment, Indian prisons, prison healthcare, punishment

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Authors: M. Zayoud, S. Oueida, S. Ionescu, P. AbiChar

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Background: Wireless sensor network is encompassed of diversified tools of information technology, which is widely applied in a range of domains, including military surveillance, weather forecasting, and earthquake forecasting. Strengthened grounds are always developed for wireless sensor networks, which usually emerges security issues during professional application. Thus, essential technological tools are necessary to be assessed for secure aggregation of data. Moreover, such practices have to be incorporated in the healthcare practices that shall be serving in the best of the mutual interest Objective: Aggregation of encrypted data has been assessed through homomorphic stream cipher to assure its effectiveness along with providing the optimum solutions to the field of healthcare. Methods: An experimental design has been incorporated, which utilized newly developed cipher along with CPU-constrained devices. Modular additions have also been employed to evaluate the nature of aggregated data. The processes of homomorphic stream cipher have been highlighted through different sensors and modular additions. Results: Homomorphic stream cipher has been recognized as simple and secure process, which has allowed efficient aggregation of encrypted data. In addition, the application has led its way to the improvisation of the healthcare practices. Statistical values can be easily computed through the aggregation on the basis of selected cipher. Sensed data in accordance with variance, mean, and standard deviation has also been computed through the selected tool. Conclusion: It can be concluded that homomorphic stream cipher can be an ideal tool for appropriate aggregation of data. Alongside, it shall also provide the best solutions to the healthcare sector.

Keywords: aggregation, cipher, homomorphic stream, encryption

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Authors: Henok Asfaw Hailu, P. D. Rwelamila

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Creating a suitable environment for successful projects needs a rethink of the organisational design of the parent organisations. A Project-based organisation (PBO) is a unique organizational form suitable for implementing and managing business activities around projects. A construction firm is inherently a PBO as it executes most of its activities through projects. PBO design and development require an empirical foundation. This study aimed to fill this gap by developing a conceptual model to help transform Ethiopian construction firms (ECFs) into full-fledged PBOs by assimilating the required PBO characteristics. The study used an exploratory QUAL-quant research design approach. A thematic content analysis was performed to analyse the qualitative (Interviews) research data. Means, standard deviations, frequencies, percentages, one-way ANOVA, and Pearson correlation were used to analyse the quantitative data. A transformational conceptual model was proposed and illustrated that transformation needs to begin by assessing the environment, strategic documents, and PBO characteristics. Assimilating missing PBO characteristics into ECFs is vital to realise organisations’ transformation into full-fledged PBOs.

Keywords: project-based organization, organizational design, dimensions, construction firms

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Authors: R. Cooper, M. Kurien

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Background: Coeliac Disease affects around 1 in 100 people. Untreated, it can result in serious morbidity such as malabsorption and cancers. The only treatment is to adhere to a gluten free diet (GFD). International guidelines recommend that people with the coeliac disease receive follow-up healthcare annually to detect complications early and support their adherence to a GFD. However, there is a finite amount of healthcare in the UK, and as such, not all patients receive follow-up care as recommended by the guidelines. Furthermore, there is an increasing number of patients being diagnosed with coeliac disease. Given the potential severe morbidity that non-adherence to a GFD could result in, alongside reports that the rate of non- GFD adherence could be as high as 91%, it is imperative that action is taken. One potential solution to this would be to provide follow-up care digitally through utilising technology. This abstract reports on a rapid review undertaken to explore the existing evidence in this area. Methods: In June 2020, 11 bibliographic databases were searched to find any pertinent studies. The inclusion criteria required the study to be written in the English language and report on the use of digital healthcare interventions for people with Coeliac Disease. Results: A small amount of evidence (n=8) was found which met our inclusion criteria and pertained to the provision of CD follow-up digitally. These studies focussed either on educating and supporting patients to adhere to a GFD or providing consultation remotely with a focus on detecting complications early. These studies showed that there is potential for digital healthcare interventions to positively impact people with coeliac disease. However, it is suggested that the effectiveness of these interventions may depend on local circumstances, individual knowledge of CD and general attitudes. Conclusion: The above studies suggest that providing follow-up care digitally may offer a potential solution; however, the evidence about how this should be done and in what circumstances this will work for individuals is scarce. In the light of the COVID-19 pandemic, the introduction of digital healthcare interventions appears to be highly topical, and as such, this review may benefit from being refreshed in the future.

Keywords: coeliac disease, follow-up, gluten free diet, digital healthcare interventions

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Authors: Minna Pikkarainen, Yueqiang Xu

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The integration of digital technology with existing healthcare processes has been painfully slow, a huge gap exists between the fields of strictly regulated official medical care and the quickly moving field of health and wellness technology. We claim that the promises of preventive healthcare can only be fulfilled when this gap is closed – health care and self-care becomes seamless continuum “correct information, in the correct hands, at the correct time allowing individuals and professionals to make better decisions” what we call connected health approach. Currently, the issues related to security, privacy, consumer consent and data sharing are hindering the implementation of this new paradigm of healthcare. This could be solved by following MyData principles stating that: Individuals should have the right and practical means to manage their data and privacy. MyData infrastructure enables decentralized management of personal data, improves interoperability, makes it easier for companies to comply with tightening data protection regulations, and allows individuals to change service providers without proprietary data lock-ins. This paper tackles today’s unprecedented challenges of enabling and stimulating multiple healthcare data providers and stakeholders to have more active participation in the digital health ecosystem. First, the paper systematically proposes the MyData approach for healthcare and preventive health data ecosystem. In this research, the work is targeted for health and wellness ecosystems. Each ecosystem consists of key actors, such as 1) individual (citizen or professional controlling/using the services) i.e. data subject, 2) services providing personal data (e.g. startups providing data collection apps or data collection devices), 3) health and wellness services utilizing aforementioned data and 4) services authorizing the access to this data under individual’s provided explicit consent. Second, the research extends the existing four archetypes of orchestrator-driven healthcare data business models for the healthcare industry and proposes the fifth type of healthcare data model, the MyData Blockchain Platform. This new architecture is developed by the Action Design Research approach, which is a prominent research methodology in the information system domain. The key novelty of the paper is to expand the health data value chain architecture and design from centralization and pseudo-decentralization to full decentralization, enabled by blockchain, thus the MyData blockchain platform. The study not only broadens the healthcare informatics literature but also contributes to the theoretical development of digital healthcare and blockchain research domains with a systemic approach.

Keywords: blockchain, health data, platform, action design

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Authors: Mona Nikidehaghani, Freda Hui

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In Australia, one-third of mental health carers provide 40 hours or more of unpaid care per week. These hidden workers contribute significantly to the Australian mental health workforce by providing unpaid services both direct and indirect to people in their care. However, carers are often neglected in the healthcare system because Government services focus on those with a mental health condition rather than those supporting them. The aim of this study is to evaluate the perceptions of mental health carers on the effectiveness of community services designed for carers and how these services could be improved. We collaborated with One Door Mental Health, a community organisation that supports mental health carers. Through semi-structured interviews with 27 mental health carers residing in the Illawarra region (NSW), we documented their daily challenges and evaluated outcomes of the current programs for carers. Our findings demonstrate that services such as education programs enable capacity building and improve the social life and mental health of carers. Drawing on the perceptions of mental health carers, this study maps pathways for making meaningful changes in the lives of carers and proposes an outcome framework to evaluate the impact of a community organisation on the lives of their clients. The framework prepared by this project would be replicable, allowing other community organisations to measure the outcomes and improve their services.

Keywords: capacity building, community development, community service, mental health carers

Procedia PDF Downloads 136