scholarly journals Driving digital transformation of comprehensive primary health services at scale in India: an enterprise architecture framework

2021 ◽  
Vol 6 (Suppl 5) ◽  
pp. e005242
Author(s):  
Sunita Nadhamuni ◽  
Oommen John ◽  
Mallari Kulkarni ◽  
Eshan Nanda ◽  
Sethuraman Venkatraman ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Services ◽  
Primary Healthcare ◽  
Enterprise Architecture ◽  
Digital Health ◽  
Security And Privacy ◽  
Primary Health ◽  
Architecture Framework ◽  
Primary Health Services ◽  
Enterprise Architecture Framework

In its commitment towards Sustainable Development Goals, India envisages comprehensive primary health services as a key pillar in achieving universal health coverage. Embedded in siloed vertical programmes, their lack of interoperability and standardisation limits sustainability and hence their benefits have not been realised yet. We propose an enterprise architecture framework that overcomes these challenges and outline a robust futuristic digital health infrastructure for delivery of efficient and effective comprehensive primary healthcare. Core principles of an enterprise platform architecture covering four platform levers to facilitate seamless service delivery, monitor programmatic performance and facilitate research in the context of primary healthcare are listed. A federated architecture supports the custom needs of states and health programmes through standardisation and decentralisation techniques. Interoperability design principles enable integration between disparate information technology systems to ensure continuum of care across referral pathways. A responsive data architecture meets high volume and quality requirements of data accessibility in compliance with regulatory requirements. Security and privacy by design underscore the importance of building trust through role-based access, strong user authentication mechanisms, robust data management practices and consent. The proposed framework will empower programme managers with a ready reference toolkit for designing, implementing and evaluating primary care platforms for large-scale deployment. In the context of health and wellness centres, building a responsive, resilient and reliable enterprise architecture would be a fundamental path towards strengthening health systems leveraging digital health interventions. An enterprise architecture for primary care is the foundational building block for an efficient national digital health ecosystem. As citizens take ownership of their health, futuristic digital infrastructure at the primary care level will determine the health-seeking behaviour and utilisation trajectory of the nation.

An Analysis of Privacy and Security in the Zachman and Federal Enterprise Architecture Frameworks

2009 ◽  
pp. 183-194
Author(s):  
Richard V. McCarthy
Keyword(s):  
Enterprise Architecture ◽  
Business Processes ◽  
The United States ◽  
Security And Privacy ◽  
United States Government ◽  
Privacy And Security ◽  
The Past ◽  
Architecture Framework ◽  
Architecture Frameworks ◽  
Enterprise Architecture Framework

Enterprise architecture has had a resurgence of interest in the IT community in the past ten year; in part because of a mandate for federal agencies of the United States government and in part because of the complexity of managing today’s information systems environments. It has become a critical component of an overall IT governance program to provide structure and documentation to describe the business processes, information flows, technical infrastructure and organizational management of an information technology organization. Many different enterprise architecture frameworks have emerged over the past ten years. Two of the most widely used enterprise architecture frameworks (the Zachman Framework and the Federal enterprise architecture framework) are described and their ability to meet the security and privacy needs of an organization is discussed. These frameworks represent a contrast of industry and government perspectives in addressing issues of key importance to senior IT leadership.

scholarly journals Integrative literature review: access to primary healthcare services

2018 ◽  
Vol 71 (3) ◽  
pp. 1178-1188 ◽  
Author(s):  
Maura Cristiane e Silva Figueira ◽  
Wellington Pereira da Silva ◽  
Eliete Maria Silva
Keyword(s):  
Primary Care ◽  
Health Services ◽  
Primary Healthcare ◽  
Healthcare Services ◽  
Health Plans ◽  
Access To Health Services ◽  
Primary Health ◽  
Study Selection ◽  
Access To Health ◽  
Access To Primary Care

ABSTRACT Objective: Analyze the scientific production that describes the type of access to primary healthcare services and identify specific populations that have differentiated access to health services. Method: An integrative review. For study selection, the following databases were used: PubMed, Scopus, Bireme, and Cinahl. The sample included 22 national and international articles. Results: The results describe the access of specific populations to health services, the access to primary care through health plans and proposed improvements to the access to primary care. Conclusion: The access to services is a challenge in many countries and some strategies and policies are implemented to solve and improve primary health care.

An Analysis of Privacy and Security in the Zachman and Federal Enterprise Architecture Frameworks

Cyber Crime ◽  
2013 ◽  
pp. 363-374
Author(s):  
Richard V. McCarthy
Keyword(s):  
Enterprise Architecture ◽  
Business Processes ◽  
The United States ◽  
Security And Privacy ◽  
United States Government ◽  
Privacy And Security ◽  
The Past ◽  
Architecture Framework ◽  
Architecture Frameworks ◽  
Enterprise Architecture Framework

Enterprise architecture has had a resurgence of interest in the IT community in the past ten year; in part because of a mandate for federal agencies of the United States government and in part because of the complexity of managing today’s information systems environments. It has become a critical component of an overall IT governance program to provide structure and documentation to describe the business processes, information flows, technical infrastructure and organizational management of an information technology organization. Many different enterprise architecture frameworks have emerged over the past ten years. Two of the most widely used enterprise architecture frameworks (the Zachman Framework and the Federal enterprise architecture framework) are described and their ability to meet the security and privacy needs of an organization is discussed. These frameworks represent a contrast of industry and government perspectives in addressing issues of key importance to senior IT leadership.

scholarly journals Primary Health Services Utilization in Greece: Studying the Past for Planning the Future

2016 ◽  
Vol 9 (1) ◽  
Author(s):  
Dimitris Zavras ◽  
Mary Geitona ◽  
John Kyriopoulos
Keyword(s):  
Chronic Disease ◽  
Health Services ◽  
Healthcare Utilization ◽  
Primary Healthcare ◽  
Health Condition ◽  
Perceived Threat ◽  
Services Utilization ◽  
Primary Health ◽  
Primary Health Services ◽  
Health Need

The objective of this paper is to study healthcare utilization in Greece. The<br />data were derived from a national survey conducted in 2006, and analysed through Logistic and Linear Regression. The likelihood of primary healthcare utilization is determined by the gender, the existence of a chronic disease, the self-rated health and the age, while the logarithm of the visits<br />to primary health services is determined by the gender, the existence of a chronic disease, the income, the geographical region and the perceived threat from the health condition. Thus, primary healthcare utilization is determined by beliefs, health need as well as socioeconomic factors.

Privacy and Security

2008 ◽  
pp. 180-194
Author(s):  
Richard V. McCarthy ◽  
Martin Grossman
Keyword(s):  
Information Technology ◽  
Enterprise Architecture ◽  
Business Processes ◽  
Security And Privacy ◽  
Information Flows ◽  
Critical Component ◽  
Privacy And Security ◽  
Architecture Framework ◽  
Architecture Frameworks ◽  
Enterprise Architecture Framework

Enterprise Architecture is a relatively new concept that has been adopted by large organizations for legal, economic, and strategic reasons. It has become a critical component of an overall IT governance program to provide structure and documentation to describe the business processes, information flows, technical infrastructure, and organizational management of an information technology organization. Many different enterprise architecture frameworks have emerged over the past 10 years. Two of the most widely used enterprise architecture frameworks (the Zachman Framework and the Federal Enterprise Architecture Framework) are described and their ability to meet the security and privacy needs of an organization is discussed.

scholarly journals "Going the Extra Mile": A descriptive exploratory study of Primary Health Services based on the experiences of Pacific Primary Health Organisation Service managers and providers

2018 ◽  
Vol 30 (2) ◽  
pp. 57-67
Author(s):  
Margaret Pack
Keyword(s):  
New Zealand ◽  
Health Services ◽  
Primary Healthcare ◽  
Exploratory Study ◽  
Service Providers ◽  
Research Approach ◽  
Health Providers ◽  
Primary Health ◽  
Primary Health Services ◽  
Service Managers

INTRODUCTION: This exploratory study is part of a larger evaluation of the primary health care strategy (PHCS) in Aotearoa New Zealand, using a mixed methods research approach. The aims of this qualitative arm of the research were to explore the extent of use and satisfaction with the PHCS through the operation of Pacific-led Primary Health Organisations (PHOs) in relation to service provision and delivery from the service providers’ and managers’ perspectives.METHOD: The exploratory study was conducted using a case study design and in-depth interviews with service managers and health providers at six Pacific-led PHOs. A review of the literature on primary healthcare was conducted prior to undertaking the research. In this literature review, several themes were noted from the review of policy documents providing background to the development of primary healthcare in New Zealand. CONCLUSION: The themes from interviews suggest a core tension between the business model, Ministry reporting requirements, and more altruistic values of both managers and service providers in their delivery of services. Overall, there was a positive response to the lowered cost of healthcare from the providers and managers interviewed in the Pacific-led primary health services, mirroring the findings of the larger evaluation report of PHOs (Cumming et al., 2005). The availability of wrap-around, holistically based, accessible services delivered by culturally responsive health providers who were considered to “go the extra mile” for their clients was the predominant theme accounting for an increased uptake and use of the services. The implications for health social work are discussed.

scholarly journals Decentralisation and urban primary health services: a case study of Delhi’s Mohalla Clinics

2020 ◽  
Author(s):  
Sejal Patel ◽  
Priyankita Pant
Keyword(s):  
Health Services ◽  
Primary Healthcare ◽  
Urban Poor ◽  
Current Form ◽  
Healthcare Facilities ◽  
Primary Health ◽  
National Capital ◽  
Primary Health Services ◽  
The Government ◽  
City State

The Indian political party Aam Aadmi, which assumed power in the city-state of Delhi in 2015, introduced Mohalla Clinics (i.e. neighbourhood clinics) to provide free primary health services for all, as a response to the rising inaccessibility of primary healthcare facilities for the urban poor. These clinics were to be governed through Mohalla Sabhas (i.e. neighbourhood committees), which are instruments of participatory governance within the neighbourhood. The research compares promises and practice for Mohalla Clinics, especially focusing on governance and the politics surrounding it. The authors find that in their current form Mohalla Clinics are limited to providing primary curative healthcare and have shown limited success, although Mohalla Clinic users do save time and expenditure on primary healthcare, and the clinics have led to a more comprehensive form of primary healthcare than in the past. However, Mohalla Clinics are governed in a top-down fashion by the Government of the National Capital Territory-Delhi, and not by urban local bodies or the envisaged neighbourhood committees. As a result, they face problems that may inhibit their functioning in the long term.

scholarly journals Primary care organizational model mix and avoidable hospitalization: an ecological study in Portugal

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
A Pinto ◽  
J V Santos ◽  
M Lobo ◽  
J Viana ◽  
J Souza ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Primary Healthcare ◽  
Pay For Performance ◽  
Care Quality ◽  
Organizational Model ◽  
Avoidable Hospitalizations ◽  
Primary Health ◽  
Age And Sex

Abstract Background In Portugal, there are different organizational models in primary health care (PHC), mainly regarding the payment scheme. USF-B is the only type with financial incentives to the professional (pay-for-performance). Our goal was to assess the relationship between groups of primary healthcare centres (ACES) with higher proportion of patients within USF-B model and the rate of avoidable hospitalizations, as proxy of primary care quality. Methods We conducted a cross-sectional study considering the 55 ACES from mainland Portugal, in 2017. We used data from public hospitalizations to calculate the prevention quality indicator (avoidable hospitalizations) adjusted for age and sex, using direct standardization. The main independent variable was the proportion of patients in one ACES registered in the USF-B model. Unemployment rate, proportion of patients with family doctor and presence of Local Health Unit (different organization model) within ACES were also considered. The association was assessed by means of a linear regression model. Results Age-sex adjusted PQI value varied between 490 and 1715 hospitalizations per 100,000 inhabitants across ACES. We observed a significant effect of the proportion of patients within USF-B in the crude PQI rate (p = 0.001). However, using the age-sex adjusted PQI, there was not a statistical significant association (p = 0.504). This last model was also adjusted for confounding variables and the association remains non-significant (p = 0.865). Conclusions Our findings suggest that, when adjusting for age and sex, there is no evidence that ACES with more patients enrolled in a pay-for-performance model is associated with higher quality of PHC (using avoidable hospitalizations as proxy). Further studies addressing individual data should be performed. This work was financed by FEDER funds through the COMPETE 2020 - POCI, and by Portuguese funds through FCT in the framework of the project POCI-01-0145-FEDER-030766 “1st.IndiQare”. Key messages Adjusting PQI to sex and age seems to influence its value more than the type of organizational model of primary health care. Groups of primary healthcare centres with more units under the pay-for-performance scheme was not associated with different rate of avoidable hospitalizations.

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