Search results for: pluralist healthcare system

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.

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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: 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: Niwatchai Namwichisirikul

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Due to the emergence of “Humanized Healthcare" introduced by Professor Dr. Prawase Wasi in 2003[1], the development of this paradigm tends to be widely implemented. The organizations included Healthcare Accreditation Institute (public organization), National Health Foundation, Mahidol University in cooperation with Thai Health Promotion Foundation, and National Health Security Office (Thailand) have selected the hospitals or infirmaries that are qualified for humanized healthcare since 2008- 2010 and 35 of them are chosen to be the outstandingly navigating organizations for the development of humanized healthcare, humanized healthcare award [2]. The research aims to study the current issue, characteristics and patterns of hospital administration contributing to humanized healthcare system in Thailand. The selected case studies are from four hospitals including Dansai Crown Prince Hospital, Leoi; Ubolrattana Hospital, Khon Kaen; Kapho Hospital, Pattani; and Prathai Hospital, Nakhonrachasima. The methodology is in-depth interviewing with 10 staffs working as hospital executive directors, and representatives from leader groups including directors, multidisciplinary hospital committees, personnel development committees, physicians and nurses in each hospital. (Total=40) In addition, focus group discussions between hospital staffs and general people (including patients and their relatives, the community leader, and other people) are held by means of setting 4 groups including 8 people within each group. (Total=128) The observation on the working in each hospital is also implemented. The findings of the study reveal that there are five important aspects found in each hospital including (1) the quality improvement under the mental and spiritual development policy from the chief executives and lead teams, leaders as Role model and they have visionary leadership; (2) the participation hospital administration system focusing on learning process and stakeholder- needs, spiritual human resource management and development; (3) the relationship among people especially staffs, team work skills, mutual understanding, effective communication and personal inner-development; (4) organization culture relevant to the awareness of patients- rights as well as the participation policy including spiritual growth achieving to the same goals, sharing vision, developing public mind, and caring; and (5) healing structures or environment providing warmth and convenience for hospital staffs, patients and their relatives and visitors.

Keywords: Hospital administration, Humanized healthcare.

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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: Micheli Anna Paola, Intrisano Carmelo, Calce Anna Maria

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This research focused on the capability of health tourism to improve the economic and financial performance of healthcare companies. It is assumed that health tourism companies have better profitability and financial efficiency because they can also count on cross-border demand differently from no health tourism companies. A three-level gap analysis was conducted: the first concerns health tourism companies located in Italy and in the other EU28 states; in the second Italian and EU28, no health tourism companies were compared; the third level is about the Italian system with a comparison between health tourism and no health tourism companies. Findings highlighted that Italian healthcare companies have better profitability performance if compared to European ones, but they present weaknesses in the financial position given the illiquidity and excessive leverage. Furthermore, studying the Italian system, we found that health tourism companies are more profitable than no health tourism companies.

Keywords: Financial performance, gap analysis, health tourism, profitability performance, value creation.

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Authors: Pradeep Kumar, Shibashish Chakraborty, Sasadhar Bera

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In the anticipation of demand fluctuations, services cannot be inventoried and hence it creates a difficult problem in marketing of services. The inability to meet customers (patients) requirements in healthcare context has more serious consequences than other service sectors. In order to meet patient requirements in the current uncertain environment, healthcare organizations are seeking ways for improved service delivery. Flexibility provides a mechanism for reducing variability in service encounters and improved performance. Flexibility is defined as the ability of the organization to cope with changing circumstances or instability caused by the environment. Patient satisfaction is an important performance outcome of healthcare organizations. However, the paucity of information exists in healthcare delivery context to examine the impact of flexibility on patient satisfaction and behavioral intention. The present study is an attempt to develop a conceptual foundation for investigating overall impact of flexibility on patient satisfaction and behavioral intention. Several dimensions of flexibility in healthcare context are examined and proposed to have a significant impact on patient satisfaction and intention. Furthermore, the study involves a critical examination of determinants of patient satisfaction and development of a comprehensive view the relationship between flexibility, patient satisfaction and behavioral intention. Finally, theoretical contributions and implications for healthcare professionals are suggested from flexibility perspective.

Keywords: Healthcare, flexibility, patient satisfaction, behavioral intention.

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Authors: Noura Al-Ajmi, Mohammed A. Almulla

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With the increased utilization of technology devices around the world, healthcare and medical diagnosis are critical issues that people worry about these days. Doctors are doing their best to avoid any medical errors while diagnosing diseases and prescribing the wrong medication. Subsequently, artificial intelligence applications that can be installed on mobile devices such as rule-based expert systems facilitate the task of assisting doctors in several ways. Due to their many advantages, the usage of expert systems has increased recently in health sciences. This work presents a backward rule-based expert system that can be used for a headache diagnosis and medication recommendation system. The structure of the system consists of three main modules, namely the input unit, the processing unit, and the output unit.

Keywords: Headache diagnosis system, treatment recommender system, rule-based expert system.

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Authors: Towards Better Quality in Healthcare, Operations Management: A Developmental Literature Review

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This work presents the various perspectives, dimensions, components and definitions given to quality in the operations management (OM) and healthcare services (HCS) literature in time, highlighting gaps and learning opportunities between the two disciplines through a thorough search into their rich and distinct body of knowledge. Greater and new insights about the general nature of quality are obtained with findings such as in OM, quality has been approached in six fairly distinct paradigms (excellence, value, conformity to specifications, attributes, satisfaction and meeting or exceeding customer expectations), whereas in HCS, two approaches are prominent (Donabedian’s structure, process and outcomes model and Lohr and Schroeder’s circumscribed definition). The two disciplines views on quality seem to have progressed much in parallel with little cross-learning from each other. This work then proposes an encompassing definition of quality as a lever and suggests further research and development avenues for a better use of the concept of quality by academics and practitioners alike toward the goals of greater organizational performance and improved management in healthcare and possibly other service domains.

Keywords: Healthcare, management, operations, quality, services.

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Authors: B. Stroetmann, A. Aisenbrey

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The Siemens Healthcare Sector is one of the world's largest suppliers to the healthcare industry and a trendsetter in medical imaging and therapy, laboratory diagnostics, medical information technology, and hearing aids. Siemens offers its customers products and solutions for the entire range of patient care from a single source – from prevention and early detection to diagnosis, and on to treatment and aftercare. By optimizing clinical workflows for the most common diseases, Siemens also makes healthcare faster, better, and more cost effective. The optimization of clinical workflows requires a multidisciplinary focus and a collaborative approach of e.g. medical advisors, researchers and scientists as well as healthcare economists. This new form of collaboration brings together experts with deep technical experience, physicians with specialized medical knowledge as well as people with comprehensive knowledge about health economics. As Charles Darwin is often quoted as saying, “It is neither the strongest of the species that survive, nor the most intelligent, but the one most responsive to change," We believe that those who can successfully manage this change will emerge as winners, with valuable competitive advantage. Current medical information and knowledge are some of the core assets in the healthcare industry. The main issue is to connect knowledge holders and knowledge recipients from various disciplines efficiently in order to spread and distribute knowledge.

Keywords: Business Excellence, Clinical Knowledge, Knowledge Management, Knowledge Services, Learning Organizations, Trust.

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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: Zeynep Sener, Mehtap Dursun

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Supplier evaluation and selection is one of the most important components of an effective supply chain management system. Due to the expanding competition in healthcare, selecting the right medical device suppliers offers great potential for increasing quality while decreasing costs. This paper proposes a fuzzy decision making approach for medical supplier selection. A real-world medical device supplier selection problem is presented to illustrate the application of the proposed decision methodology.

Keywords: Fuzzy decision making, fuzzy multiple objective programming, medical supply chain, supplier selection.

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Authors: Sun K. Yoo, Ki-Chang Nam, Hyun-Young Shin, Ho-Seong Moon, Hee Cheol Kang

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Automated intelligent, clinical decision support systems generally promote to help or to assist physicians and patients regarding to prevention of diseases or treatment of illnesses using computer represented knowledge and information. In this paper, assessment factors affecting the proper design of clinical decision support system were investigated. The required procedure steps for gathering the data from clinical trial and extracting the information from large volume of healthcare repositories were listed, which are necessary for validation and verification of evidence-based implementation of clinical decision support system. The goal of this paper is to extract useful evaluation factors affecting the quality of the clinical decision support system in the design, development, and implementation of a computer-based decision support system.

Keywords: Evaluation, Clinical Decision Support System.

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Authors: Lina Al-Qatawneh, Abdallah Abdallah, Salam Zalloum

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In managing healthcare logistics, cost is not the only factor to be considered. The level of items- criticality used in patient care services plays an important role as well. A stock-out incident of a high critical item could threaten a patient's life. In this paper, the DMAIC (Define-Measure-Analyze-Improve-Control) methodology is used to drive improvement projects based on customer driven critical to quality characteristics at a Jordanian hospital. This paper shows how the application of Six Sigma improves the performance of the case hospital logistics system by reducing the number of stock-out incidents.

Keywords: Criticality level, Healthcare, Logistics, and Six Sigma.

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Authors: Rujijan Vichivanives

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This research aims to create a knowledge-based system as a database for self-healthcare analysis, diagnosis of simple illnesses, and the use of Thai herbs instead of modern medicine by using principles of Thai traditional medication theory. These were disseminated by website network programs within Suan Sunandha Rajabhat University. The population used in this study was divided into two groups: the first group consisted of four experts of Thai traditional medication and the second group was 300 website users. The methods used for collecting data were paper questionnaires and poll questionnaires on the website. The statistics used for analyzing data was at an average level. The results were divided into three parts: the first part was the development of a knowledge-based system and the second part was applied programs on website. Both parts could be fulfilled and achieved according to the set goal. The third part was the evaluation of the study: The evaluation of the viewpoints of the experts towards website designs were evaluated at a good level of 4.20. The satisfaction evaluation of the users was found at a good level of average satisfactory level at 4.24. It was found that the young population of those under the age of 16 had less cares about their health than the population of other teenagers, working age adults and those of older age. The research findings should be extended in order to encourage the lifestyle modifications to people of all ages by using the self-healthcare principles.

Keywords: Developing, Herbs, Knowledge-based system, Medical treatment.

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Authors: Serap Akcan, Ali Kokangul

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We consider a single-echelon, single-item inventory system where both demand and lead-time are stochastic. Continuous review policy is used to control the inventory system. The objective is to calculate the reorder point level under stochastic parameters. A case study is presented in Neonatal Intensive Care Unit.

Keywords: Inventory control system, reorder point level, stochastic demand, stochastic lead time

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Authors: Hariton N. Costin, Sorin Puscoci, Cristian Rotariu, Bogdan Dionisie, Marinela C. Cimpoesu

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TELMES project aims to develop a securized multimedia system devoted to medical consultation teleservices. It will be finalized with a pilot system for a regional telecenters network that connects local telecenters, having as support multimedia platforms. This network will enable the implementation of complex medical teleservices (teleconsulations, telemonitoring, homecare, urgency medicine, etc.) for a broader range of patients and medical professionals, mainly for family doctors and those people living in rural or isolated regions. Thus, a multimedia, scalable network, based on modern IT&C paradigms, will result. It will gather two inter-connected regional telecenters, in Iaşi and Piteşti, Romania, each of them also permitting local connections of hospitals, diagnostic and treatment centers, as well as local networks of family doctors, patients, even educational entities. As communications infrastructure, we aim to develop a combined fixmobile- internet (broadband) links. Other possible communication environments will be GSM/GPRS/3G and radio waves. The electrocardiogram (ECG) acquisition, internet transmission and local analysis, using embedded technologies, was already successfully done for patients- telemonitoring.

Keywords: Healthcare, telemedicine, telemonitoring, ECG analysis.

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Authors: Anass Rahouti, Guillaume Salze, Ruggiero Lovreglio, Sélim Datoussaïd

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In healthcare facilities, training the staff for firefighting and evacuation in real buildings is very challenging due to the presence of a vulnerable population in such an environment. In a standard environment, traditional approaches, such as fire drills, are often used to train the occupants and provide them with information about fire safety procedures. However, those traditional approaches may be inappropriate for a vulnerable population and can be inefficient from an educational viewpoint as it is impossible to expose the occupants to scenarios similar to a real emergency. Immersive serious games could be used as an alternative to traditional approaches to overcome their limitations. Serious games are already being used in different safety domains such as fires, earthquakes and terror attacks for several building types (e.g., office buildings, train stations, tunnels, etc.). In this study, we developed an immersive serious game to improve the fire safety skills of staff in healthcare facilities. An accurate representation of the healthcare environment was built in Unity3D by including visual and audio stimuli inspired from those employed in commercial action games. The serious game is organised in three levels. In each of them, the trainee is presented with a specific fire emergency and s/he can perform protective actions (e.g., firefighting, helping non-ambulant occupants, etc.) or s/he can ignore the opportunity for action and continue the evacuation. In this paper, we describe all the steps required to develop such a prototype, as well as the key questions that need to be answered, to develop a serious game for firefighting and evacuation in healthcare facilities.

Keywords: Fire Safety, healthcare, serious game, training.

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Authors: Cheng-Chia Yang , Yi-Shun Wang , Sue-Ting Chang, Suh-Er Guo, Mei-Fen Huang

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Object: Review recent publications of patient safety culture to investigate the relationship between leadership behavior, safety culture, and safety performance in the healthcare industry. Method: This study is a cross-sectional study, 350 questionnaires were mailed to hospital workers with 195 valid responses obtained, and a 55.7% valid response rate. Confirmatory factor analysis (CFA) was carried out to test the factor structure and determine if the composite reliability was significant with a factor loading of >0.5, resulting in an acceptable model fit. Results: Through the analysis of One-way ANOVA, the results showed that physicians significantly have more negative patient safety culture perceptions and safety performance perceptions than non- physicians. Conclusions: The path analysis results show that leadership behavior affects safety culture and safety performance in the health care industry. Safety performance was affected and improved with contingency leadership and a positive patient safety organization culture. The study suggests improving safety performance by providing a well-managed system that includes: consideration of leadership, hospital worker training courses, and a solid safety reporting system.

Keywords: Leadership Behavior, Patient Safety, Safety Culture, Safety Performance

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Authors: Supunmali Ahangama, Danny Chiang Choon Poo

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Health analytics (HA) is used in healthcare systems for effective decision making, management and planning of healthcare and related activities. However, user resistances, unique position of medical data content and structure (including heterogeneous and unstructured data) and impromptu HA projects have held up the progress in HA applications. Notably, the accuracy of outcomes depends on the skills and the domain knowledge of the data analyst working on the healthcare data. Success of HA depends on having a sound process model, effective project management and availability of supporting tools. Thus, to overcome these challenges through an effective process model, we propose a HA process model with features from rational unified process (RUP) model and agile methodology.

Keywords: Agile methodology, health analytics, unified process model, UML.

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Authors: Nathan C. Lea, Tony Austin, Stephen Hailes, Dipak Kalra

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This paper introduces a tool that is being developed for the expression of information security policy controls that govern electronic healthcare records. By reference to published findings, the paper introduces the theory behind the use of knowledge management for automatic and consistent security policy assertion using the formalism called the Secutype; the development of the tool and functionality is discussed; some examples of Secutypes generated by the tool are provided; proposed integration with existing medical record systems is described. The paper is concluded with a section on further work and critique of the work achieved to date.

Keywords: Information Security Policy, Electronic Healthcare Records, Knowledge Management, Archetypes, Secutypes.

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Authors: Bruce X. B. Yu, Yan Liu, Keith C. C. Chan

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We propose to record Activities of Daily Living (ADLs) of elderly people using a vision-based system so as to provide better assistive and personalization technologies. Current ADL-related research is based on data collected with help from non-elderly subjects in laboratory environments and the activities performed are predetermined for the sole purpose of data collection. To obtain more realistic datasets for the application, we recorded ADLs for the elderly with data collected from real-world environment involving real elderly subjects. Motivated by the need to collect data for more effective research related to elderly care, we chose to collect data in the room of an elderly person. Specifically, we installed Kinect, a vision-based sensor on the ceiling, to capture the activities that the elderly subject performs in the morning every day. Based on the data, we identified 12 morning activities that the elderly person performs daily. To recognize these activities, we created a HARELCARE framework to investigate into the effectiveness of existing Human Activity Recognition (HAR) algorithms and propose the use of a transfer learning algorithm for HAR. We compared the performance, in terms of accuracy, and training progress. Although the collected dataset is relatively small, the proposed algorithm has a good potential to be applied to all daily routine activities for healthcare purposes such as evidence-based diagnosis and treatment.

Keywords: Daily activity recognition, healthcare, IoT sensors, transfer learning.

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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: Walid MOUDANI

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The healthcare environment is generally perceived as being information rich yet knowledge poor. However, there is a lack of effective analysis tools to discover hidden relationships and trends in data. In fact, valuable knowledge can be discovered from application of data mining techniques in healthcare system. In this study, a proficient methodology for the extraction of significant patterns from the Coronary Heart Disease warehouses for heart attack prediction, which unfortunately continues to be a leading cause of mortality in the whole world, has been presented. For this purpose, we propose to enumerate dynamically the optimal subsets of the reduced features of high interest by using rough sets technique associated to dynamic programming. Therefore, we propose to validate the classification using Random Forest (RF) decision tree to identify the risky heart disease cases. This work is based on a large amount of data collected from several clinical institutions based on the medical profile of patient. Moreover, the experts- knowledge in this field has been taken into consideration in order to define the disease, its risk factors, and to establish significant knowledge relationships among the medical factors. A computer-aided system is developed for this purpose based on a population of 525 adults. The performance of the proposed model is analyzed and evaluated based on set of benchmark techniques applied in this classification problem.

Keywords: Multi-Classifier Decisions Tree, Features Reduction, Dynamic Programming, Rough Sets.

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Authors: Van-Quang Trinh, Gi-Soo Chung, Hee-Cheol Kim

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The increasing number of senior population gradually causes to demand the use of information and communication technology for their satisfactory lives. This paper presents the development of an integrated TV based system which offers an opportunity to provide value added services to a large number of elderly citizens, and thus helps improve their quality of life. The design philosophy underlying this paper is to fulfill both technological and human aspects. The balance between these two dimensions has been currently stressed as a crucial element for the design of usable systems in real use, particularly to the elderly who have physical and mental decline. As the first step to achieve it, we have identified human and social factors that affect the elder-s quality of life by a literature review, and based on them, build four fundamental services: information, healthcare, learning and social network services. Secondly, the system architecture, employed technologies and the elderly-friendly system design considerations are presented. This reflects technological and human perspectives in terms of the system design. Finally, we describe some scenarios that illustrate the potentiality of the proposed system to improve elderly people-s quality of life.

Keywords: Elderly people, human computer interaction, quality of life, smart television, user-centered system design

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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: Nasser M. Amaitik, Ngwan F. Elsagzli

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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 for 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: Ogunduyile O. Oluwgbenga

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Recent advancements in sensor technologies and Wireless Body Area Networks (WBANs) have led to the development of cost-effective healthcare devices which can be used to monitor and analyse a person-s physiological parameters from remote locations. These advancements provides a unique opportunity to overcome current healthcare challenges of low quality service provisioning, lack of easy accessibility to service varieties, high costs of services and increasing population of the elderly experienced globally. This paper reports on a prototype implementation of an architecture that seamlessly integrates Wireless Body Area Network (WBAN) with Web services (WS) to proactively collect physiological data of remote patients to recommend diagnostic services. Technologies based upon WBAN and WS can provide ubiquitous accessibility to a variety of services by allowing distributed healthcare resources to be massively reused to provide cost-effective services without individuals physically moving to the locations of those resources. In addition, these technologies can reduce costs of healthcare services by allowing individuals to access services to support their healthcare. The prototype uses WBAN body sensors implemented on arduino fio platforms to be worn by the patient and an android smart phone as a personal server. The physiological data are collected and uploaded through GPRS/internet to the Medical Health Server (MHS) to be analysed. The prototype monitors the activities, location and physiological parameters such as SpO2 and Heart Rate of the elderly and patients in rehabilitation. Medical practitioners would have real time access to the uploaded information through a web application.

Keywords: Android Smart phone, Arduino Fio, Web application server, Wireless Body Area Networks.

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Authors: Peter Newton, Peter Newman, Stephen Glackin, Roman Trubka

Abstract:

Pressures for urban redevelopment are intensifying in all large cities. A new logic for urban development is required – green urbanism – that provides a spatial framework for directing population and investment inwards to brownfields and greyfields precincts, rather than outwards to the greenfields. This represents both a major opportunity and a major challenge for city planners in pluralist liberal democracies. However, plans for more compact forms of urban redevelopment are stalling in the face of community resistance. A new paradigm and spatial planning platform is required that will support timely multi-level and multi-actor stakeholder engagement, resulting in the emergence of consensus plans for precinct-level urban regeneration capable of more rapid implementation. Using Melbourne, Australia as a case study, this paper addresses two of the urban intervention challenges – where and how – via the application of a 21st century planning tool ENVISION created for this purpose.

Keywords: Green urbanism, greyfields, planning tools, urban regeneration.

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