Ambient Intelligence for Patient-Centric Healthcare Delivery: Technologies, Framework, and Applications

2019 ◽  
pp. 223-254
Author(s):  
G. S. Karthick ◽  
P. B. Pankajavalli
Keyword(s):  
Ambient Intelligence ◽  
Healthcare Delivery ◽  
Patient Centric

scholarly journals OPERATIONS THROUGHPUT AS A DETERMINANT OF GOLDEN-HOUR IN MASS-GATHERING MEDICINE

2017 ◽  
Author(s):  
Inam Danish Khan ◽  
Buhra Asima ◽  
Shahbaz Ali Khan
Keyword(s):  
Systems Approach ◽  
Clinical Investigation ◽  
Healthcare Delivery ◽  
Turnaround Time ◽  
Population Based ◽  
Situational Analysis ◽  
Mass Gathering ◽  
Golden Hour ◽  
Mass Gathering Medicine ◽  
Patient Centric

BACKGROUNDGolden-hour, a time-tested concept for trauma-care, involves a systems approach encompassing healthcare, logistics, geographical, environmental and temporal variables. Golden-hour paradigm in mass-gathering-medicine such as the Hajj-pilgrimage entwines along healthcare availability, accessibility, efficiency and interoperability; expanding from the patient-centric to public-health centric approach. The realm of mass-gathering-medicine invokes an opportunity for incorporating operations-throughput as a determinant of golden-hour for overall capacity-building and interoperability.METHODSGolden-hour was evaluated during the Indian-Medical-Mission operations for Hajj-2016; which established, operated and coordinated a strategic network of round-the-clock medical operations. Throughput was evaluated as deliverables/time, against established Standard-Operating-Procedures for various clinical, investigation, drug-dispensing and patient-transfer algorithms. Patient encounter-time, waiting-time, turnaround-time were assessed throughout echeloned healthcare under a patient-centric healthcare-delivery model. Dynamic evaluation was carried out to cater for variation and heterogeneity.RESULTSMassive surge of 3,94,013 patients comprising 2,25,103 males (57.1%) and 1,68,910 females (42.9%) overwhelmed the throughput capacities of outpatient attendance, pharmacy, laboratory, imaging, ambulance, referrals and documentation. There was delay in attendance, suspicion, diagnosis and isolation of patients with communicable infections. The situational-analysis of operations-throughput highlights wasted turnaround-time due to mobilization of medical-team, diverting critical healthcare resources away from emergency situations.CONCLUSIONTime being a crucial factor in the complexity of medical-care, operations-throughput remains an important determinant towards interoperability of bottlenecks, thereby being a determinant of golden-hour in mass-gathering-medicine. Early transportation of patient to definitive-care reduces treatment initiation-time, notwithstanding logistics of communication, evacuation, terrain and weather being deterministic in outcome. Golden-hour needs to be emphasized under a population-based approach targeting the clientele towards administering first-aid and reaching out to hospital within the golden-hour.

scholarly journals A Blockchain and Artificial Intelligence-Based, Patient-Centric Healthcare System for Combating the COVID-19 Pandemic: Opportunities and Applications

Healthcare ◽  
2021 ◽  
Vol 9 (8) ◽  
pp. 1019
Author(s):  
Mohamed Yaseen Jabarulla ◽  
Heung-No Lee
Keyword(s):  
Artificial Intelligence ◽  
Healthcare Delivery ◽  
Healthcare Services ◽  
Future Research ◽  
Public Healthcare ◽  
Healthcare Data ◽  
Disruptive Technologies ◽  
Drug Manufacturing ◽  
Digital Healthcare ◽  
Patient Centric

The world is facing multiple healthcare challenges because of the emergence of the COVID-19 (coronavirus) pandemic. The pandemic has exposed the limitations of handling public healthcare emergencies using existing digital healthcare technologies. Thus, the COVID-19 situation has forced research institutes and countries to rethink healthcare delivery solutions to ensure continuity of services while people stay at home and practice social distancing. Recently, several researchers have focused on disruptive technologies, such as blockchain and artificial intelligence (AI), to improve the digital healthcare workflow during COVID-19. Blockchain could combat pandemics by enabling decentralized healthcare data sharing, protecting users’ privacy, providing data empowerment, and ensuring reliable data management during outbreak tracking. In addition, AI provides intelligent computer-aided solutions by analyzing a patient’s medical images and symptoms caused by coronavirus for efficient treatments, future outbreak prediction, and drug manufacturing. Integrating both blockchain and AI could transform the existing healthcare ecosystem by democratizing and optimizing clinical workflows. In this article, we begin with an overview of digital healthcare services and problems that have arisen during the COVID-19 pandemic. Next, we conceptually propose a decentralized, patient-centric healthcare framework based on blockchain and AI to mitigate COVID-19 challenges. Then, we explore the significant applications of integrated blockchain and AI technologies to augment existing public healthcare strategies for tackling COVID-19. Finally, we highlight the challenges and implications for future research within a patient-centric paradigm.

Exploring enablers of modularity in healthcare service delivery

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Gyan Prakash
Keyword(s):  
Service Delivery ◽  
Healthcare Service ◽  
Professional Competence ◽  
Service Providers ◽  
Healthcare Delivery ◽  
Healthcare Services ◽  
Professional Autonomy ◽  
Equation Modeling ◽  
Content Type ◽  
Patient Centric

PurposeThis paper explores the enablers of modular healthcare services.Design/methodology/approachA survey-based approach was adopted with specialised hospitals as the unit of analysis. A structural model was developed based on a literature review and assessed using a cross-sectional research design. A 23-indicator questionnaire was circulated among service providers in the healthcare system across India, and 286 valid responses were received. The data were analysed using partial least squares-structural equation modeling (PLS-SEM).FindingsThe results reveal that professional competence, technological versatility, clear division of tasks, channelised flow of information and professional autonomy act as enablers that may drive modular service delivery.Research limitations/implicationsBy examining service providers' perspectives, this paper highlights the influence of the identified enablers on modular service delivery in healthcare organisations.Practical implicationsFor practitioners, the study provides suggestions for designing patient-centric healthcare services via modular healthcare delivery. The identified structural relationships can facilitate immediate corrective actions and the formulation of future policies. The findings will help practitioners foresee opportunities for patient participation in value co-creation, meet patients' varying needs, decompose service offerings, mix and match components develop sets of rules as interfaces between service modules and design service packages on an ongoing basis.Social implicationsThis study underscores the emergence of patient-centric care and may aid the design of processes that deliver health to the patient as a person.Originality/valueThis paper identifies and empirically validates relationships between healthcare service delivery processes and modular service delivery.

A patient-derived conceptual framework of lung cancer care priorities.

2018 ◽  
Vol 36 (30_suppl) ◽  
pp. 206-206
Author(s):  
Urvi Mujumdar ◽  
Victoria Lanzarini ◽  
Maria Lowe ◽  
Bjorn Bolinder ◽  
Yunes Doleh
Keyword(s):  
Lung Cancer ◽  
Online Community ◽  
Treatment Options ◽  
Healthcare Delivery ◽  
Hierarchical Cluster ◽  
Well Being ◽  
Research Approach ◽  
Treatment Experience ◽  
Group Concept ◽  
Patient Centric

206 Background: Patient-centric healthcare delivery, where patients are the ultimate decision-makers, warrants care evaluated based on patient priorities. A heterogeneous lung cancer patient population fosters variation in care priorities. This study identified care concept domains in a wholly patient-driven manner. Methods: Group concept mapping was used to assess priorities among patients invited from the PatientsLikeMe online community aged ≥18, US residents, and self-reporting lung cancer. In Phase I, 26 patients generated ideas based on the focus prompt: “ What do you want to achieve when it comes to the treatment you are receiving or are considering receiving for your lung cancer?”. 78 ideas were generated over 2 weeks. Supplementation from literature, editing for relatability, independence, and consistency yielded 78 concepts. In Phase II 67 patients used CSGlobalMax® (Concept Systems, 2018) to rate the concepts for importance (1 = not important to 5 = very important); 64 of which grouped and named the ideas into categories of unrestricted size. Multidimensional scaling and hierarchical cluster analysis generated visual maps, average importance, and categorized concept domains. Domains were compared across all patients and by treatment experience (≤1 or > 1 systemic regimens) and stage at diagnosis. Results: Patients were female (78%), white (93%), and mean age of 62 (SD 8.9). 93% reported non-small cell lung cancer, 70% reported Stage III or IV diagnosis, and 58% were classified as early in treatment experience. 11 unique domains were visually represented. In order of average importance the domains were: managing lifestyle (4.52), care team quality, active participation in treatment, treatment goals, treatment options, side effects, social well-being, physical well-being, future options, fulfillment in daily living, and supportive environment (4.01). There was strong correlation between treatment subgroups (r = 0.89), although relative importance of domains shifted. Generalizability is limited. Conclusions: In this patient-driven research approach, patients developed the focus prompt, generated ideas, and structured concepts. The unique domains may help evaluate care value in patient-centric healthcare delivery.

scholarly journals Stakeholders’ Perceptions of the Implementation of a Patient-Centric Digital Health Application for Primary Healthcare in India

2021 ◽  
Vol 27 (4) ◽  
pp. 315-324
Author(s):  
Dharamjeet Singh Faujdar ◽  
Tarundeep Singh ◽  
Manmeet Kaur ◽  
Sundeep Sahay ◽  
Rajesh Kumar
Keyword(s):  
Health System ◽  
Primary Healthcare ◽  
Work Performance ◽  
Digital Health ◽  
Healthcare Delivery ◽  
Health Information System ◽  
Data Entry ◽  
Healthcare Services ◽  
Health Application ◽  
Patient Centric

Objectives: Health systems are shifting from traditional methods of healthcare delivery to delivery using digital applications. This change was introduced at a primary care centre in Chandigarh, India that served a marginalised population. After establishing the digital health system, we explored stakeholders’ perceptions regarding its implementation.Methods: Ethnographic methods were used to explore stakeholders’ perceptions regarding the implementation of the Integrated Health Information System for Primary Health Care (IHIS4PHC), which was developed as a patient-centric digital health application. Data were collected using focus group discussions and in-depth interviews. Participatory observations were made of day-to-day activities including outpatient visits, outreach field visits, and methods of health practice. The collected information was analysed using thematic coding.Results: Healthcare workers highlighted that working with the digital health system was initially arduous, but they later realised its usefulness, as the digital system made it easier to search records and generate reports, rapidly providing evidence to make decisions. Auxiliary nurse midwives reported that recording information on computers saved time when generating reports; however, systematic and mandatory data entry made recording tedious. Staff were apprehensive about the use of computer-based data for monitoring their work performance. Patients appreciated that their previous records were now available on the computer for easy retrieval.Conclusions: The usefulness of the digital health application was appreciated by various primary healthcare stakeholders. Barriers persisted due to perceived needs for flexibility in delivering healthcare services, and apprehensions continued because of increased transparency, accountability, and dependence on computers and digital technicians.

The Collaborative Network Approach: a model for advancing patient-centric research for Castleman disease and other rare diseases

2019 ◽  
Vol 3 (1) ◽  
pp. 97-105
Author(s):  
Mary Zuccato ◽  
Dustin Shilling ◽  
David C. Fajgenbaum
Keyword(s):  
Rare Diseases ◽  
Treatment Options ◽  
Castleman Disease ◽  
High Impact ◽  
Collaborative Network ◽  
Network Approach ◽  
Grant Applications ◽  
Research Questions ◽  
Novel Strategy ◽  
Patient Centric

Abstract There are ∼7000 rare diseases affecting 30 000 000 individuals in the U.S.A. 95% of these rare diseases do not have a single Food and Drug Administration-approved therapy. Relatively, limited progress has been made to develop new or repurpose existing therapies for these disorders, in part because traditional funding models are not as effective when applied to rare diseases. Due to the suboptimal research infrastructure and treatment options for Castleman disease, the Castleman Disease Collaborative Network (CDCN), founded in 2012, spearheaded a novel strategy for advancing biomedical research, the ‘Collaborative Network Approach’. At its heart, the Collaborative Network Approach leverages and integrates the entire community of stakeholders — patients, physicians and researchers — to identify and prioritize high-impact research questions. It then recruits the most qualified researchers to conduct these studies. In parallel, patients are empowered to fight back by supporting research through fundraising and providing their biospecimens and clinical data. This approach democratizes research, allowing the entire community to identify the most clinically relevant and pressing questions; any idea can be translated into a study rather than limiting research to the ideas proposed by researchers in grant applications. Preliminary results from the CDCN and other organizations that have followed its Collaborative Network Approach suggest that this model is generalizable across rare diseases.

Much Ado About Fried Chicken: Abetting Aspiration or Respecting Autonomy?

2019 ◽  
Vol 28 (3) ◽  
pp. 1356-1362
Author(s):  
Laurence Tan Lean Chin ◽  
Yu Jun Lim ◽  
Wan Ling Choo
Keyword(s):  
Palliative Care ◽  
End Of Life ◽  
Multidisciplinary Team ◽  
Biopsychosocial Model ◽  
Family Members ◽  
Clinical Decisions ◽  
Goals Of Care ◽  
Complex Needs ◽  
Aspiration Risk ◽  
Patient Centric

Purpose Palliative care is a philosophy of care that encompasses holistic, patient-centric care involving patients and their family members and loved ones. Palliative care patients often have complex needs. A common challenge in managing patients near their end of life is the complexity of navigating clinical decisions and finding achievable and realistic goals of care that are in line with the values and wishes of patients. This often results in differing opinions and conflicts within the multidisciplinary team. Conclusion This article describes a tool derived from the biopsychosocial model and the 4-quadrant ethical model. The authors describe the use of this tool in managing a patient who wishes to have fried chicken despite aspiration risk and how this tool was used to encourage discussions and reduce conflict and distress within the multidisciplinary team.

Audiology Service Models in a Family Physician Practice Setting

2010 ◽  
Vol 6 (1) ◽  
pp. 24-32 ◽  
Author(s):  
Sridhar Krishnamurti
Keyword(s):  
Pediatric Patients ◽  
Practice Patterns ◽  
Healthcare Delivery ◽  
Direct Consequence ◽  
Direct Access ◽  
Practice Setting ◽  
Pediatric Populations ◽  
Family Practice Physicians ◽  
Primary Focus ◽  
Balance Problems

This article illustrates the potential of placing audiology services in a family physician’s practice setting to increase referrals of geriatric and pediatric patients to audiologists. The primary focus of family practice physicians is the diagnosis/intervention of critical systemic disorders (e.g., cardiovascular disease, diabetes, cancer). Hence concurrent hearing/balance disorders are likely to be overshadowed in such patients. If audiologists get referrals from these physicians and have direct access to diagnose and manage concurrent hearing/balance problems in these patients, successful audiology practice patterns will emerge, and there will be increased visibility and profitability of audiological services. As a direct consequence, audiological services will move into the mainstream of healthcare delivery, and the profession of audiology will move further towards its goals of early detection and intervention for hearing and balance problems in geriatric and pediatric populations.

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