scholarly journals No big data without small data: learning health care systems begin and end with the individual patient

2015 ◽  
Vol 21 (6) ◽  
pp. 1014-1017 ◽  
Author(s):  
José A. Sacristán ◽  
Tatiana Dilla
Author(s):  
Stephen C. L. Gough

The increasing worldwide incidence and prevalence of diabetes is placing substantial pressures on health care systems and economies. As a consequence individuals involved in the care of people with diabetes are looking at services currently being provided and examining ways in which care can be organized in the most cost-effective manner. Whilst the degree to which diabetes care is delivered differs from country to country, similar fundamental questions are being asked by those involved in the delivery of care, including: What are we currently providing? What do we need to provide? What are we able to provide? Although the answers to these questions are quite different not just between countries but often within specific localities within a country, the ultimate aim is the same: to provide the best possible care to as many people with diabetes as possible. The global diversity of diabetes health care need is enormous and while the solutions will be equally diverse, the approach to the development of a diabetes service will, for many organizations, be similar. The main focus of this chapter is based upon the model or the strategic approach developed in the UK, but many of the individual component parts are present in most health care settings.


2018 ◽  
Vol 10 (12) ◽  
pp. 4439 ◽  
Author(s):  
Elio Borgonovi ◽  
Paola Adinolfi ◽  
Rocco Palumbo ◽  
Gabriella Piscopo

Sustainability is momentous for the appropriate functioning of health care systems. In fact, health and sustainability are two strictly related values, which could not be separately sought. While studies discussing the contextualization of this issue with respect to the distinguishing attributes of health care systems are rapidly blooming, there is still little agreement about what is ultimately meant by sustainability in the health care arena. On the one hand, attention is primarily focused on the proper use of available financial resources; on the other hand, people engagement and empowerment are gradually arising as a crucial step to enhance the viability of the health care system. This paper tries to identify, from a conceptual point of view inspired by the European integrative movement, the different shades of sustainability in health care and proposes a recipe to strengthen the long-term viability of health care organizations. The balanced mix of financial, economic, political, and social sustainability is compelling to increase the ability of health care organizations to create meaningful value for the population served. However, the focus on a single dimension of sustainability is thought to engender several side effects, which compromise the capability of health care organizations to guarantee health gains at the individual and collective levels. From this standpoint, further conceptual and practical developments are envisioned, paving the way for a full-fledged understanding of sustainability in the health care environment.


2014 ◽  
Vol 9 (3) ◽  
pp. 231-249 ◽  
Author(s):  
Federico Toth

AbstractThe Italian National Health Service began experimenting with a significant regionalisation process during the 1990s. The purpose of this article is to assess the effects that this regionalisation process is having on the rift between the north and the south of the country. Has the gap between the health care systems of the northern and southern regions been increasing or decreasing during the 1999–2009 decade? Three indicators will be utilised to answer this question: (1) the level of satisfaction expressed by the citizens towards the regional hospital system; (2) the mobility of the patients among regions; (3) the health care deficit accumulated by the individual regions. On the basis of these three indicators, there is evidence to conclude that, during the decade under study, the gap between the North and the South, already significant, has increased further.


2019 ◽  
Vol 7 (3) ◽  
pp. 241-258
Author(s):  
Andrea Martani ◽  
Georg Starke

Fostering the personal responsibility of patients is often considered a potential remedy for the problem of resource allocation in health care systems. In political and ethical debates, systems of rewards and punishments based on personal responsibility have proved very divisive. However, regardless of the controversies it has sparked, the implementation of personal responsibility in concrete policies has always encountered the problem of practical enforceability, i.e.how causally relevant behaviour can be tracked, allowing policies of this kind to be applied in a fine-grained, economically viable and accurate fashion. In this paper, we show how this hurdle can be seemingly overcome with the advent of digitalisation in health and delineate the potential impact of digitalisation on personal responsibility for health. We discuss how digitalisation – by datafying health and making patients transparent – promises to close the loophole of practical enforceability by allowing to trace health-related lifestyle choices of individuals as well as their exposure to avoidable risk factors. Digitalisation in health care thereby reinforces what Gerald Dworkin has called the causal aspect of personal responsibility and strengthens the implicit syllogism that – since exposure to risk factors happens at the individual level – responsibility for health should be ascribed to the individual. We conclude by addressing the limitations of this approach and suggest that there are other ways in which the potential of digitalisation can help with the allocation of resources in health care.


1985 ◽  
Vol 4 (1) ◽  
pp. 5-13
Author(s):  
Elaine Newman

The paper poses a challenge to the medical and legal professions. Our Charter of Rights and Freedoms defines the standard for government intervention in the lives of the citizens of Canada. It has an immediate and significant impact upon involuntary admissions to psychiatric facilities, in as much as those admissions constitute a deprivation of liberty to the individual. The challenge to our professions is one of reviewing present practice in the field, and of reconciling the need for effective administration of health care systems with the protective standards set by the Charter.


The unpredictable amount of data generated everyday by smart phones, social networks, health care systems etc. is really mind blowing. Smart phones alone generate 335exabytes of data ineveryyear that is really big data.Thus, the storage industry is facing several challenges in providing high magnitude of storage and retrieval devices at lowest costs which help to fulfill the requirements of big data and even technologies like de-duplication on storage devices are also becoming very important. Similarly, in recent days storing and retrieving the health care information in biomedical area is also becoming a great challenge in providing the best optimum data because of its huge amount of biomedical datasets. In order to achieve efficiency in providing highest quality health care information, an optimized index scheme is needed for big data which is based on accuracy and timelines. The existing indexing and optimization solutions are not enough to meet the emerging grow of index size and seek time. The objective of this paper is to identify better indexing solutions by investigating the basic big data requirements on indexing and optimization. This also includes a comparative study of various indexing and optimization techniques along with a taxonomy which contains Artificial Intelligence (AI) and Non Artificial Intelligence (NAI) based indexing techniques, optimization enhancement techniques which improves the performance efficiency of big data health care informatics.


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