Search results for: Electronic Healthcare Records

Authors: Majid Saaly, Shahriar Tavousi Tafreshi, Mehdi Nazari Afshar

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Most reinforced concrete structures are designed only under heavy loads have large transverse reinforcement spacing values, and therefore suffer severe failure after intense ground movements. The main goal of this paper is to compare the shear- and axial failure of concrete bending frames available in Tehran using Incremental Dynamic Analysis (IDA) under near- and far-field records. For this purpose, IDA of 5, 10, and 15-story concrete structures were done under seven far-fault records and five near-faults records. The results show that in two-dimensional models of short-rise, mid-rise and high-rise reinforced concrete frames located on Type-3 soil, increasing the distance of the transverse reinforcement can increase the maximum inter-story drift ratio values up to 37%. According to the existing results on 5, 10, and 15-story reinforced concrete models located on Type-3 soil, records with characteristics such as fling-step and directivity create maximum drift values between floors more than far-fault earthquakes. The results indicated that in the case of seismic excitation modes under earthquake encompassing directivity or fling-step, the probability values of failure and failure possibility increasing rate values are much smaller than the corresponding values of far-fault earthquakes. However, in near-fault frame records, the probability of exceedance occurs at lower seismic intensities compared to far-fault records.

Keywords: Directivity, fling-step, fragility curve, IDA, inter story drift ratio.v

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Authors: Theodosios Tsiakis, George Stephanides, George Pekos

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The growth of open networks created the interest to commercialise it. The establishment of an electronic business mechanism must be accompanied by a digital – electronic payment system to transfer the value of transactions. Financial organizations are requested to offer a secure e-payment synthesis with equivalent level of security served in conventional paper-based payment transactions. PKI, which is functioning as a chain of trust in security architecture, can enable security services of cryptography to epayments, in order to take advantage of the wider base either of customer or of trading partners and the reduction of cost transaction achieved by the use of Internet channels. The paper addresses the possibilities and the implementation suggestions of PKI in relevance to electronic payments by suggesting a framework that should be followed.

Keywords: Electronic Payment, Security, Trust

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Authors: E. Asgharizadeh, M. Ajalli Geshlajoughi, S. R. Safavi Mirmahalleh

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Amazing development of the information technology, communications and internet expansion as well as the requirements of the city managers to new ideas to run the city and higher participation of the citizens encourage us to complete the electronic city as soon as possible. The foundations of this electronic city are in information technology. People-s participation in metropolitan management is a crucial topic. Information technology does not impede this matter. It can ameliorate populace-s participation and better interactions between the citizens and the city managers. Citizens can proffer their ideas, beliefs and votes through digital mass media based upon the internet and computerization plexuses on the topical matters to receive appropriate replies and services. They can participate in urban projects by becoming cognizant of the city views. The most significant challenges are as follows: information and communicative management, altering citizens- views, as well as legal and office documents Electronic city obstacles have been identified in this research. The required data were forgathered through questionnaires to identify the barriers from a statistical community comprising specialists and practitioners of the ministry of information technology and communication, the municipality information technology organization. The conclusions demonstrate that the prioritized electronic city application barriers in Iran are as follows: The support quandaries (non-financial ones), behavioral, cultural and educational plights, the security, legal and license predicaments, the hardware, orismological and infrastructural curbs, the software and fiscal problems.

Keywords: Electronic city, urban management, populace's participation, electronic government, electronic services, electronic organization, electronic infrastructure.

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Authors: Rusyaizila Ramli, Nasriah Zakaria, Putra Sumari

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Privacy issues commonly discussed among researchers, practitioners, and end-users in pervasive healthcare. Pervasive healthcare systems are applications that can support patient-s need anytime and anywhere. However, pervasive healthcare raises privacy concerns since it can lead to situations where patients may not be aware that their private information is being shared and becomes vulnerable to threat. We have systematically analyzed the privacy issues and present a summary in tabular form to show the relationship among the issues. The six issues identified are medical information misuse, prescription leakage, medical information eavesdropping, social implications for the patient, patient difficulties in managing privacy settings, and lack of support in designing privacy-sensitive applications. We narrow down the issues and chose to focus on the issue of 'lack of support in designing privacysensitive applications' by proposing a privacy-sensitive architecture specifically designed for pervasive healthcare monitoring systems.

Keywords: Human Factors, Pervasive Healthcare, PrivacyIssues

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Authors: Wanida Suwunniponth

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The purpose of this research was to study the factors of characteristic of business, website quality and trust affected intention to use electronic payment systems for online purchasing. This survey research used questionnaire as a tool to collect the data of 300 customers who purchased online products and used an electronic payment system. The descriptive statistics and multiple regression analysis were used to analyze data. The results revealed that customers had a good opinion towards the characteristic of the business and website quality. However, they have a moderate opinion towards trust and intention to repurchase. In addition, the characteristics of the business affected the purchase intention the most, followed by website quality and the trust with statistical significance at 0.05 level. For particular, the terms of reputation, communication, information quality, perceived risk and word of mouth affected the intention to use the electronic payment system. In contrast, the terms of size, system quality and service quality did not affect intention to use an electronic payment system.

Keywords: Electronic payment, intention, online purchasing, trust.

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Authors: Osamah M. Al-Qershi, Khoo Bee Ee

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In recent years image watermarking has become an important research area in data security, confidentiality and image integrity. Many watermarking techniques were proposed for medical images. However, medical images, unlike most of images, require extreme care when embedding additional data within them because the additional information must not affect the image quality and readability. Also the medical records, electronic or not, are linked to the medical secrecy, for that reason, the records must be confidential. To fulfill those requirements, this paper presents a lossless watermarking scheme for DICOM images. The proposed a fragile scheme combines two reversible techniques based on difference expansion for patient's data hiding and protecting the region of interest (ROI) with tamper detection and recovery capability. Patient's data are embedded into ROI, while recovery data are embedded into region of non-interest (RONI). The experimental results show that the original image can be exactly extracted from the watermarked one in case of no tampering. In case of tampered ROI, tampered area can be localized and recovered with a high quality version of the original area.

Keywords: DICOM, reversible, ROI-based, watermarking.

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Authors: Amirali Shirazibeheshti, Tarik Radwan, Alireza Ettefaghian, Farbod Khanizadeh, George Wilson, Cristina Luca

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Anticholinergic medication has been associated with events such as falls, delirium, and cognitive impairment in older patients. To further assess this, anticholinergic burden scores have been developed to quantify risk. A risk model based on clustering was deployed in a healthcare management system to cluster patients into multiple risk groups according to anticholinergic burden scores of multiple medicines prescribed to patients to facilitate clinical decision-making. To do so, anticholinergic burden scores of drugs were extracted from the literature which categorizes the risk on a scale of 1 to 3. Given the patients’ prescription data on the healthcare database, a weighted anticholinergic risk score was derived per patient based on the prescription of multiple anticholinergic drugs. This study was conducted on 300,000 records of patients currently registered with a major regional UK-based healthcare provider. The weighted risk scores were used as inputs to an unsupervised learning algorithm (mean-shift clustering) that groups patients into clusters that represent different levels of anticholinergic risk. This work evaluates the association between the average risk score and measures of socioeconomic status (index of multiple deprivation) and health (index of health and disability). The clustering identifies a group of 15 patients at the highest risk from multiple anticholinergic medication. Our findings show that this group of patients is located within more deprived areas of London compared to the population of other risk groups. Furthermore, the prescription of anticholinergic medicines is more skewed to female than male patients, suggesting that females are more at risk from this kind of multiple medication. The risk may be monitored and controlled in a healthcare management system that is well-equipped with tools implementing appropriate techniques of artificial intelligence.

Keywords: Anticholinergic medication, socioeconomic status, deprivation, clustering, risk analysis.

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Authors: Muhibul Haque Bhuyan, Sher Shermin Azmiri Khan

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At present, it is an imperative and stimulating task to grow the concepts and skills of undergraduate students in any course. Educators must build up students' higher-order complex and critical thinking abilities. But many of them find it difficult to assess and evaluate these abilities of students who undertake their courses during undergraduate studies. In this research work, a simple assessment and evaluation process for the electrical circuit course of the undergraduate Electrical and Electronic Engineering (EEE) program is reported using the Outcome-Based Education (OBE) approach. The methodology of the work, course contents design, course outcomes (COs) preparation and mapping it with program outcomes (POs), question setting following Bloom's taxonomy, assessment strategy of the students, CO and PO evaluation records, statistics, and charts have been reported for a student-cohort of electrical circuit course taken in Spring 2019 Semester at EEE Department of Southeast University (SEU). It is found that the benchmark fixed by the course instructor has been achieved by the students of that course through CO assessment and evaluation. Recommendations of the course teacher for further quality enhancement based on CO achievement are also presented.

Keywords: OBE, COs, POs, assessment and evaluation, electrical circuit course.

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Authors: T. Thulare, M. Herselman, A. Botha

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Poor system use, including inappropriate design of health information systems, causes difficulties in communication with patients and increased time spent by healthcare professionals in recording the necessary health information for medical records. System features like pop-up reminders, complex menus, and poor user interfaces can make medical records far more time consuming than paper cards as well as affect decision-making processes. Although errors associated with health information and their real and likely effect on the quality of care and patient safety have been documented for many years, more research is needed to measure the occurrence of these errors and determine the causes to implement solutions. Therefore, the purpose of this paper is to identify data integrity challenges in hospital information systems through a scoping review and based on the results provide recommendations on how to manage these. Only 34 papers were found to be most suitable out of 297 publications initially identified in the field. The results indicated that human and computerized systems are the most common challenges associated with data integrity and factors such as policy, environment, health workforce, and lack of awareness attribute to these challenges but if measures are taken the data integrity challenges can be managed.

Keywords: Data integrity, data integrity challenges, hospital information systems, South Africa.

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Authors: Erika Ruiz, Nestor Ortiz

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Lean philosophy has evolved over time and has been implemented both in manufacturing and services, more recently lean has been integrated in the companies of the health sector. Currently it is important to understand the successful way to implement this philosophy and try to identify barriers and enablers to the sustainability of lean healthcare. The main purpose of this research is to identify the barriers and enablers in the implementation of Lean Healthcare based on case studies of Colombian healthcare centers. In order to do so, we conducted semi-structured interviews based on a maturity model. The main results indicate that the success of Lean implementation depends on its adaptation to contextual factors. In addition, in the Colombian context were identified new factors such as organizational culture, management models, integration of the care and administrative departments and triple helix relationship.

Keywords: Barriers, enablers, implementation, lean healthcare, sustainability.

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Authors: F. Bendahma, S. Bentata, S. Cherid, A. Zitouni, S. Terkhi, T. Lantri, Y. Sefir, Z. F. Meghoufel

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We examine the electronic transport properties in Al_xGa_1-xAs/GaAs superlattices. Using the transfer-matrix technique and the exact Airy function formalism, we investigate theoretically the effect of structural parameters on the electronic energy spectra of trimer thickness barrier (TTB). Our numerical calculations showed that the localization length of the states becomes more extended when the disorder is correlated (trimer case). We have also found that the resonant tunneling time (RTT) is of the order of several femtoseconds.

Keywords: Electronic transport properties, structural parameters, superlattice, transfer-matrix technique.

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Authors: Khamis Al-Gharbi, Said M. Gattoufi, Ali H. Al-Badi, Ali Al-Hashmi

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The case study presents the progression of a project management of Al-Shifa, a healthcare information system in Oman. The case study describes the evolution of the implementation of a healthcare information system tailored to meet the needs of the healthcare units under the supervision of the Ministry of Health (MOH) in Oman. A focus group methodology was used for collecting the relevant information from the main project's stakeholders. In addition reports about the project made available for the researchers. The case analysis is made based on the Project Management approach developed by the Project Management Institute (PMI). The main finding that there was no formal project management approach adopted by the MOH for the development and implementation of the herewith mentioned healthcare information system project. Furthermore, the project had suffered a scope creep in terms of features, cost and time-schedule. The recommendations of the authors, for the rescue of the project from its current dilemma, consist of technological, administrative and human resources development actions.

Keywords: Al-Shifa, Information system, Healthcare, Oman, Project Management.

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Authors: Saleh Alumaran, Giampaolo Bella, Feng Chen

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The study of organisations’ information security cultures has attracted scholars as well as healthcare services industry to research the topic and find appropriate tools and approaches to develop a positive culture. The vast majority of studies in Saudi national health services are on the use of technology to protect and secure health services information. On the other hand, there is a lack of research on the role and impact of an organisation’s cultural dimensions on information security. This research investigated and analysed the role and impact of cultural dimensions on information security in Saudi Arabia health service. Hypotheses were tested and two surveys were carried out in order to collect data and information from three major hospitals in Saudi Arabia (SA). The first survey identified the main cultural-dimension problems in SA health services and developed an initial information security culture framework model. The second survey evaluated and tested the developed framework model to test its usefulness, reliability and applicability. The model is based on human behaviour theory, where the individual’s attitude is the key element of the individual’s intention to behave as well as of his or her actual behaviour. The research identified a set of cultural and sub-cultural dimensions in SA health information security and services.

Keywords: Behaviour theory, Culture dimensions, Electronic health records, Information security.

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Authors: M. Emmanouilidou

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The Internet of Things (IoT) is a disruptive technological paradigm that is at the center of the digital evolution by integrating physical and virtual worlds leading to the creation of extended interconnected ecosystems that are characterized as smart environments. The concept of the IoT has a broad range of applications in different industries including the healthcare sector. The Internet of Healthcare Things (IoHT), a branch of the IoT, is expected to bring promising benefits to all involved stakeholders and accelerate the revolution of the healthcare sector through a transition towards preventive and personalized medicine. The socio-economic challenges that the healthcare sector is facing further emphasize the need for a radical transformation of healthcare systems in both developed and developing countries with the role of pervasive technological innovations, such as IoHT, recognized as key to counteract the relevant challenges. Besides the number of potential opportunities that IoHT presents, there are fundamental ethical concerns that need to be considered and addressed in relation to the application of IoHT. This paper contributes to the discussion of the emerging topic of IoHT by providing an overview of the role and potential of IoHT, highlighting the characteristics of the current and future healthcare landscape, reporting on the up-to-date status of IoHT in Europe and reflecting upon existing research in the ethics of IoHT by incorporating additional ethical dimensions that have been ignored which can provide pathways for future research in the field.

Keywords: Ethics, Europe, healthcare, internet of things.

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Authors: Lynn. J. MacFarlane. A

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Within the healthcare system, training and continued professional development although essential, can be effected by cost and logistical restraints due to the nature of healthcare provision e.g employee shift patterns, access to expertise, cost factors in releasing staff to attend training etc. The use of multimedia technology for the development of e-learning applications is also a major cost consideration for healthcare management staff, and this type of media whether optical or on line requires careful planning in order to remain inclusive of all staff with potentially varied access to multimedia computing. This paper discusses a project in which the use of DVD authoring technology has been successfully implemented to meet the needs of distance learning and user considerations, and is based on film production techniques and reduced product turnaround deadlines.

Keywords: DVD, healthcare, distance learning, cost.

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Authors: R. Poonsuph

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Technological innovation plays a crucial role in virtual healthcare services. A growing number of telehealth platforms are concentrating on using digital tools to improve the quality and availability of care. As a result, telehealth represents an opportunity to redesign the way health services are delivered. The research objective is to discover a new business model for digital health services and related industries to participate with telehealth solutions. The business opportunity is valuable for healthcare investors as a startup company to further investigations or implement the telehealth platform. The paper presents a digital healthcare business model and business opportunities to related industries. These include digital healthcare services extending from a traditional business model and use cases of business opportunities to related industries. Although there are enormous business opportunities, telehealth is still challenging due to the patient adaption and digital transformation process within a healthcare organization.

Keywords: telehealth, Internet hospital, HealthTech, InsurTech

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Authors: Ahmad Salman

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Electronic Response Systems such as Kahoot, Poll Everywhere, and Google Classroom are gaining a lot of popularity when surveying audiences in events, meetings, and classroom. The reason is mainly because of the ease of use and the convenience these tools bring since they provide mobile applications with a simple user interface. In this paper, we present a case study on the effectiveness of using Electronic Response Systems on student participation and learning experience in a classroom. We use a polling application for class exercises in two different technology-oriented classes. We evaluate the effectiveness of the usage of the polling applications through statistical analysis of the students performance in these two classes and compare them to the performances of students who took the same classes without using the polling application for class participation. Our results show an increase in the performances of the students who used the Electronic Response System when compared to those who did not by an average of 11%.

Keywords: Interactive learning, classroom technology, electronic response systems, polling applications, learning evaluation.

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Authors: Gülfem Alptekin, S. Emre Alptekin

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Global competitiveness has recently become the biggest concern of both manufacturing and service companies. Electronic commerce, as a key technology enables the firms to reach all the potential consumers from all over the world. In this study, we have presented commonly used electronic payment systems, and then we have shown the evaluation of these systems in respect to different criteria. The payment systems which are included in this research are the credit card, the virtual credit card, the electronic money, the mobile payment, the credit transfer and the debit instruments. We have realized a systematic comparison of these systems in respect to three main criteria: Technical, economical and social. We have conducted a fuzzy multi-criteria decision making procedure to deal with the multi-attribute nature of the problem. The subjectiveness and imprecision of the evaluation process are modeled using triangular fuzzy numbers.

Keywords: Electronic payment systems, fuzzy multi-criteriadecision making, analytical hierarchy process.

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Authors: Helena Kovačič, Andrej Rus

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The authors of this paper compared ratings for leadership competences of managers in the healthcare sector and professional managers in Slovenia. Managers’ competence scores were analyzed for Slovenia and compared with some other EU countries. Comparisons of correlations yielded significant differences in leader/non-leader healthcare professionals in their relational competences. Cross-cultural comparisons also point to these differences in many countries included in the survey. Comparing these managers with the professional managers, one of the relational competences significantly distinguishes the two groups, namely the competence of taking initiative in establishing contacts with experts outside the organization. What is surprising from our analysis is the high number of competences that significantly differentiate leaders in healthcare from professional managers. Empirically based assessment provided a robust method for assessing and comparing leadership competences and point out significant results for leadership development.

Keywords: Leadership, competences, healthcare.

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Authors: Fahad Shahbaz Khan, Rao Muhammad Anwer, Olof Torgersson, Göran Falkman

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Data mining has been used very frequently to extract hidden information from large databases. This paper suggests the use of decision trees for continuously extracting the clinical reasoning in the form of medical expert-s actions that is inherent in large number of EMRs (Electronic Medical records). In this way the extracted data could be used to teach students of oral medicine a number of orderly processes for dealing with patients who represent with different problems within the practice context over time.

Keywords: Data mining, Oral Medicine, Decision Trees, WEKA.

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Authors: Miroslav H. Hristov, Velizar A. Vassilev, Georgi K. Dukendjiev

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Due to the constant development of measurement systems and the aim for computerization, unavoidable improvements are made for the main disadvantages of air gauges. With the appearance of the air-electronic measuring devices, some of their disadvantages are solved. The output electrical signal allows them to be included in the modern systems for measuring information processing and process management. Producer efforts are aimed at reducing the influence of supply pressure and measurement system setup errors. Increased accuracy requirements and preventive error measures are due to the main uses of air electronic systems - measurement of geometric dimensions in the automotive industry where they are applied as modules in measuring systems to measure geometric parameters, form, orientation and location of the elements.

Keywords: Air-electronic, geometrical parameters, improvement, measurement systems.

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Authors: Yi-Fan Lin, Peter P. Howley, Frank A. Tuyl

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Quality measurement and reporting systems are used in healthcare internationally. In Australia, the Australian Council on Healthcare Standards records and reports hundreds of clinical indicators (CIs) nationally across the healthcare system. These CIs are measures of performance in the clinical setting, and are used as a screening tool to help assess whether a standard of care is being met. Existing analysis and reporting of these CIs incorporate Bayesian methods to address sampling variation; however, such assessments are retrospective in nature, reporting upon the previous six or twelve months of data. The use of Bayesian methods within statistical process control for monitoring systems is an important pursuit to support more timely decision-making. Our research has developed and assessed a new graphical monitoring tool, similar to a control chart, based on the beta-binomial posterior predictive (BBPP) distribution to facilitate the real-time assessment of health care organizational performance via CIs. The BBPP charts have been compared with the traditional Bernoulli CUSUM (BC) chart by simulation. The more traditional “central” and “highest posterior density” (HPD) interval approaches were each considered to define the limits, and the multiple charts were compared via in-control and out-of-control average run lengths (ARLs), assuming that the parameter representing the underlying CI rate (proportion of cases with an event of interest) required estimation. Preliminary results have identified that the BBPP chart with HPD-based control limits provides better out-of-control run length performance than the central interval-based and BC charts. Further, the BC chart’s performance may be improved by using Bayesian parameter estimation of the underlying CI rate.

Keywords: Average run length, Bernoulli CUSUM chart, beta binomial posterior predictive distribution, clinical indicator, health care organization, highest posterior density interval.

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Authors: T. Hui Teo, Wee Tiong Tan, Pradeep K. Gopalakrishnan, Victor K. H. Phay, Ma Su M. M. Shwe

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A healthcare monitoring system is presented in this paper. This system is based on ultra-low power sensor nodes and a personal server, which is based on hardware and software extensions to a Personal Digital Assistant (PDA)/Smartphone. The sensor node collects data from the body of a patient and sends it to the personal server where the data is processed, displayed and made ready to be sent to a healthcare network, if necessary. The personal server consists of a compact low power receiver module and equipped with a Smartphone software. The receiver module takes less than 30 × 30 mm board size and consumes approximately 25 mA in active mode.

Keywords: healthcare monitoring, sensor node, personal server, wireless.

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Authors: Erin Lynne Plettenberg, Jeremy Vickery

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In an access-control situation, the role of a user determines whether a data request is appropriate. This paper combines vetted web mining and logic modeling to build a lightweight system for determining the role of a health care provider based only on their prior authorized requests. The model identifies provider roles with 100% recall from very little data. This shows the value of vetted web mining in AI systems, and suggests the impact of the ICD classification on medical practice.

Keywords: Ontology, logic modeling, electronic medical records, information extraction, vetted web mining.

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Authors: Jie Cai, David C. Levy

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Electronic nose (array of chemical sensors) are widely used in food industry and pollution control. Also it could be used to locate or detect the direction of the source of emission odors. Usually this task is performed by electronic nose (ENose) cooperated with mobile vehicles, but when a source is instantaneous or surrounding is hard for vehicles to reach, problem occurs. Thus a method for stationary ENose to detect the direction of the source and locate the source will be required. A novel method which uses the ratio between the responses of different sensors as a discriminant to determine the direction of source in natural wind surroundings is presented in this paper. The result shows that the method is accurate and easily to be implemented. This method could be also used in movably, as an optimized algorithm for robot tracking source location.

Keywords: Electronic nose, Nature wind situation, Source direction detection.

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Authors: Shogo Kato, Daisuke Okamoto, Satoko Tsuru, Yoshinori Iizuka, Ryoko Shimono

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Healthcare safety has been perceived important. It is essential to prevent troubles in healthcare processes for healthcare safety. Trouble prevention is based on trouble prediction using accumulated knowledge on processes, troubles, and countermeasures. However, information on troubles has not been accumulated in hospitals in the appropriate structure, and it has not been utilized effectively to prevent troubles. In the previous study, however a detailed knowledge acquisition process for trouble prediction was proposed, the knowledgebase for countermeasures was not involved. In this paper, we aim to propose the structure of the knowledgebase for countermeasures, in the knowledge acquisition process for trouble prediction in healthcare process. We first design the structure of countermeasures and propose the knowledge representation form on countermeasures. Then, we evaluate the validity of the proposal, by applying it into an actual hospital.

Keywords: Trouble prevention, knowledge structure, structured knowledge, reusable knowledge.

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Authors: Salem Alajmi, Bader Altaweel

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Kuwait, like many parts of the world, has started facing the dangerous growth of electrical and electronic waste. This growth has been noted in last two decades, emerging with the development of mobile phones, computers, TVs, as well as other electronic devices and electrical equipment. Kuwait is already among the highest global producers of electronic waste (e-waste) in kg per capita. Furthermore, Kuwait is among the global countries that set high-level future targets in renewable energy projects. Accumulation of this electronic waste, as well as accelerated renewable energy projects, will lead to the increase of future threats to the country. In this research, factors that lead to the increase the e-waste in Kuwait are presented. Also, the current situations of dealing with e-waste in the country as well as the associated challenges are examined. The impact of renewable energy projects on future e-waste accumulation is considered. Moreover, this research proposes the best strategies and practices toward successfully dealing with the waste of electronic devices and renewable energy technologies.

Keywords: E-waste, landfill, environmental management, valuable metals, hazardous materials.

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Authors: Tal Ben-Zvi, Donald N. Lombardi

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This study uses a simulation to establish a realistic environment for laboratory research on Accountable Care Organizations. We study network attributes in order to gain insights regarding healthcare providers- conduct and performance. Our findings indicate how network structure creates significant differences in organizational performance. We demonstrate how healthcare providers positioning themselves at the central, pivotal point of the network while maintaining their alliances with their partners produce better outcomes.

Keywords: Social Networks, Decision-Making, Accountable Care Organizations, Performance

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Authors: Jih-Rue Pan, Feng-Chuan Pan

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Today-s healthcare industries had become more patient-centric than profession-centric, from which the issues of quality of healthcare and the patient safety are the major concerns in the modern healthcare facilities. An unplanned extubation (UE) may be detrimental to the patient-s life, and thus is one of the major indexes of patient safety and healthcare quality. A high UE rate not only defeated the healthcare quality as well as the patient safety policy but also the nurses- morality, and job satisfaction. The UE problem in a psychiatric hospital is unique and may be a tough challenge for the healthcare professionals for the patients were mostly lacking communication capabilities. We reported with this essay a particular project that was organized to reduce the UE rate from the current 2.3% to a lower and satisfactory level in the long-term care units of a psychiatric hospital. The project was conducted between March 1st, 2011 and August 31st, 2011. Based on the error information gathered from varied units of the hospital, the team analyzed the root causes with possible solutions proposed to the meetings. Four solutions were then concluded with consensus and launched to the units in question. The UE rate was now reduced to a level of 0.17%. Experience from this project, the procedure and the tools adopted would be good reference to other hospitals.

Keywords: Unplanned extubation, patient safety, error information

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Authors: Abdolghani Ebrahimi, Diego Klabjan, Chenxi Ge, Daniela Ladner, Parker Stride

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In this work, we use machine learning and data analysis techniques to predict the one-year mortality of cirrhotic patients. Data from 2,322 patients with liver cirrhosis are collected at a single medical center. Different machine learning models are applied to predict one-year mortality. A comprehensive feature space including demographic information, comorbidity, clinical procedure and laboratory tests is being analyzed. A temporal pattern mining technic called Frequent Subgraph Mining (FSM) is being used. Model for End-stage liver disease (MELD) prediction of mortality is used as a comparator. All of our models statistically significantly outperform the MELD-score model and show an average 10% improvement of the area under the curve (AUC). The FSM technic itself does not improve the model significantly, but FSM, together with a machine learning technique called an ensemble, further improves the model performance. With the abundance of data available in healthcare through electronic health records (EHR), existing predictive models can be refined to identify and treat patients at risk for higher mortality. However, due to the sparsity of the temporal information needed by FSM, the FSM model does not yield significant improvements. Our work applies modern machine learning algorithms and data analysis methods on predicting one-year mortality of cirrhotic patients and builds a model that predicts one-year mortality significantly more accurate than the MELD score. We have also tested the potential of FSM and provided a new perspective of the importance of clinical features.

Keywords: machine learning, liver cirrhosis, subgraph mining, supervised learning

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