Evidence-based multi-sensor information fusion for remote health care systems

2013 ◽  
Vol 204 ◽  
pp. 1-19 ◽  
Author(s):  
Wen-Tsai Sung ◽  
Kuo-Yi Chang
2012 ◽  
pp. 1273-1302
Author(s):  
Kerry Johnson ◽  
Jayshiro Tashiro

Health care systems are complex and often approach a deterministic chaos in the number and types of interactions that occur among health care providers and patients, as well as among the providers themselves. Such complexity may be an important barrier as North American health care systems are evolving into care-giving settings in which providers work to improve patient outcomes though interprofessional collaborative patient-centred care. The research on evidence-based learning and how to build new models of professional development opportunities for health information management (HIM) professionals is explored. Additionally, creating new and more effective undergraduate training programs in HIM is examined. From the perspective of interprofessional care, the authors provide a core set of interprofessional competencies and discuss how these competencies may be sensibly integrated into, and evaluated within, undergraduate curricular structures as well as professional development programs. A special emphasis of the chapter is an analysis of two case studies that highlight the barriers inherent within complex health care systems. Such barriers inhibit evidence-based education and professional development designed to improve interprofessional care.


2019 ◽  
Vol 10 ◽  
pp. 215145931987294 ◽  
Author(s):  
Cliodhna E. Murray ◽  
Andreas Fuchs ◽  
Heide Grünewald ◽  
Owen Godkin ◽  
Norbert P. Südkamp ◽  
...  

Introduction: This study investigates the management of hip fractures in a German maximum care hospital and compares these data to evidence-based standard and practice in 180 hospitals participating in the UK National Hip Fracture Database (NHFD) and 16 hospitals participating in the Irish Hip Fracture Database (IHFD). This is the first study directly comparing the management of hip fractures between 3 separate health-care systems within Europe. Methods: Electronic medical data were collected retrospectively describing the care pathway of elderly patients with a hip fracture admitted to a large trauma unit in the south of Germany “University Hospital Freiburg” (UHF). The audit evaluated demographics, postoperative outcome, and the adherence to the 6 “Blue Book” standards of care. These data were directly compared with the data from the UK NHFD and the IHFD acquired from 180 and 16 hospitals, respectively. Results: At 36 hours, 95.8% of patients had received surgery in UHF, compared to 71.5% in the NHFD and 58% of patients in the IHFD. The rate of in-hospital mortality was 4.7% compared to 7.1% in the NHFD and 5% in the IHFD. The mean average acute length of stay was 13.4 days compared to 16.4 days in the NHFD and 20 days in the IHFD. Reoperation rates are 3.3% compared to 1% in the NHFD and 1.1% in the IHFD; 50.5% of patients were discharged on bone protection medication, compared to 47% in the IHFD and 79.3% in the UK NHFD. Discussion: Despite uniformly acknowledged evidence-based treatment guidelines, the management of hip fractures remains heterogeneous within Europe. Conclusion: These data show that different areas of the hip fracture care pathway in Germany, England, and Ireland, respectively, show room for improvement in light of the growing socioeconomic burden these countries are expected to face.


Author(s):  
Kerry Johnson ◽  
Jay Shiro Tashiro

Health care systems are complex and often approach a deterministic chaos in the number and types of interactions that occur among health care providers and patients, as well as among the providers themselves. Such complexity may be an important barrier as North American health care systems are evolving into care-giving settings in which providers work to improve patient outcomes though interprofessional collaborative patient-centred care. The research on evidence-based learning and how to build new models of professional development opportunities for health information management (HIM) professionals is explored. Additionally, creating new and more effective undergraduate training programs in HIM is examined. From the perspective of interprofessional care, the authors provide a core set of interprofessional competencies and discuss how these competencies may be sensibly integrated into, and evaluated within, undergraduate curricular structures as well as professional development programs. A special emphasis of the chapter is an analysis of two case studies that highlight the barriers inherent within complex health care systems. Such barriers inhibit evidence-based education and professional development designed to improve interprofessional care.


2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S439-S440
Author(s):  
Jinmyoung Cho ◽  
Alan B Stevens

Abstract Family caregiving of an older adult has become an essential element of the U.S. health care system, with 83 percent of long-term care provided to older adults coming from family members or other unpaid helpers. With the amount and type of care provided by families expected to increase, caregiving demands should be coupled with community and health care systems-based supports. While scientific research has demonstrated the value of providing education, skills training and support to family caregivers, health care and social service providers do not systematically include these interventions in their services. Thus, for the vast majority of family caregivers, caregiving support services remain extremely fragmented, if not elusive. This symposium provides four examples of how health care systems that frequently see patients with dementia and community-based organizations who provide ongoing supportive services to family caregivers, have adapted evidence-based caregiver interventions into branded service programs. Dr. Jinmyoung Cho will present racial/ethnic comparisons on the impact of community-based implementation of a caregiver education program, REACH-TX. Dr. Leah Hanson will introduce the implementation of Mindfulness-Based Dementia-Care (MBDC) within a health care system. Dr. Christine Jensen will address how caregivers can benefit from evidence-driven programs in health care settings. Lastly, Dr. David Coon will present two different approaches to translation of evidence-based programs through community-based organizations, with CarePRO embedded after completion of a clinical trial and EPIC embedded from the program’s initial pilot phase. The discussant, Dr. Alan Stevens, will highlight the needs of caregivers and support services recognized by all key stakeholders.


2020 ◽  
pp. 002073142097771
Author(s):  
Howard Waitzkin

According to the official narrative of COVID-19, the pandemic has caused the global capitalist economy to collapse, or at least to enter a deep recession and possibly a great depression. Assigning blame to a virus takes attention away from the structural contradictions and instabilities of capitalism that would have led to a crash in any case. This narrative also helps justify non-evidence-based public health policies, including lockdowns, travel bans, closed schools and factories, and forced quarantines of large populations rather than individuals and clustered groups who harbor the infection. Advantages of such drastic measures happen primarily in countries that did not prepare adequately, that did not respond quickly enough with more focused measures to test and isolate people infected with the virus, and that have health care systems either organized by capitalist principles or suffering cutbacks and privatization as a result of capitalist economic ideologies, such as austerity. Authoritarian tactics purportedly intended to protect public health pave the way to antidemocratic rule, militarism, and fascism. These harsh policies also exert their most adverse effects on poor, minority, incarcerated, immigrant, and otherwise marginalized populations, who already suffer from the worsening economic inequality that global, financialized capitalism has fostered.


2017 ◽  
Vol 22 (4) ◽  
pp. 211-217 ◽  
Author(s):  
Massimiliano Panella ◽  
Carmela Rinaldi ◽  
Fabrizio Leigheb ◽  
Sanita Knesse ◽  
Chiara Donnarumma ◽  
...  

Objective To identify the prevalence of the practice of defensive medicine among Italian hospital physicians, its costs and the reasons for practising defensive medicine and possible solutions to reduce the practice of defensive medicine. Methods Cross-sectional web survey. Main outcome measures Number of physicians reporting having engaged in any defensive medicine behaviour in the previous year. Results A total of 1313 physicians completed the survey. Ninety-five per cent believed that defensive medicine would increase in the near future. The practice of defensive medicine accounted for approximately 10% of total annual Italian national health expenditure. Conclusions Defensive medicine is a significant factor in health care costs without adding any benefit to patients. The economic burden of defensive medicine on health care systems should provide a substantial stimulus for a prompt review of this situation in a time of economic crisis. Malpractice reform, together with a systematic use of evidence-based clinical guidelines, is likely to be the most effective way to reduce defensive medicine.


2018 ◽  
Vol 15 ◽  
Author(s):  
Amy DeGroff ◽  
Krishna Sharma ◽  
Anamika Satsangi ◽  
Kristy Kenney ◽  
Djenaba Joseph ◽  
...  

2021 ◽  
pp. 813-818
Author(s):  
Jeff Dunn ◽  
Melissa Henry ◽  
Maggie Watson

Low-middle-income (LMI) countries are emerging as a priority target for the development of psycho-oncology care. This chapter describes some well-recognized barriers to progress along with ideas on how evidence-based practice can be imported from developed health care systems into the LMI context. Important to this process is the need to tailor care services to national, regional, and cultural needs in order to take account of communication issues that are idiosyncratic to different LMI health care contexts. The use of low-cost technologies to support implementation of psycho-oncology care services is discussed as well as the need for training resources to be made available to local/national psycho-oncology professionals as the most important future resource. In this way key leaders within LMI countries can be upskilled and provide snowball dissemination of skills to professionals in their own countries. Future priorities are described along with ideas for implementation.


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