The M-Health Reference Model

2011 ◽  
pp. 455-473
Author(s):  
Phillip Olla ◽  
Joseph Tan

The reference model presented in this article encourages the breakdown of M-Health systems into the following five key dimensions: (1) Communication Infrastructure: a description of mobile telecommunication technologies and networks; (2) Device Type: the type of device being used, such as PDA, sensor, or tablet PC; (3) Data Display: describes how the data will be displayed to the user and transmitted, such as images, email, and textual data; (4) Application Purpose: identification of the objective for the M-Health system; (5) Application Domain: definition of the area in which the system will be implemented. Healthcare stakeholders and system implementer can use the reference model presented in this article to understand the security implications of the proposed system and to identify the technological infrastructure, business requirements, and operational needs of the M-Health systems being implemented. A reference model that encapsulates the emerging M-Health field is needed for cumulative progress in this field. Currently, the M-Health field is disjointed, and it is often unclear what constitutes an M-Health system. In the future, M-Health applications will take advantage of technological advances such as device miniaturizations, device convergence, high-speed mobile networks, and improved medical sensors. This will lead to the increased diffusion of clinical M-Health systems, which will require better understanding of the components that constitute the M-Health system.

Author(s):  
Phillip Olla ◽  
Joseph Tan

The reference model presented in this chapter encourages the breakdown of m-health systems into the following five key dimensions: communication infrastructure: this is a description of the mobile telecommunication technologies and networks; device type: this relates to the type of device being used such as PDA, sensor, or tablet PC; data display: describes how the data will be displayed to the user and transmitted such as images, e-mail and textual data; application purpose: identification of the objective for the m-health system; application domain: definition of the area that the system will be implemented. Healthcare stakeholders and system implementer can use the reference model presented in this chapter to understand the security implications of the proposed system, identify the technological infrastructure, business requirements and operational needs of the m-health systems being implemented. A reference model to encapsulate the emerging m-health field is needed for cumulative progress in this field. Currently, the m-health field is disjointed and it is often unclear what constitutes an m-health system. In the future, m-health applications will take advantage of technological advances such as device miniaturizations, device convergence, high-speed mobile networks, and improved medical sensors. This will lead to the increased diffusion of clinical m-health systems requiring better understanding of the components, which constitute the m-health system.


2009 ◽  
pp. 432-450
Author(s):  
Phillip Olla ◽  
Joseph Tan

The reference model presented in this article encourages the breakdown of M-Health systems into the following five key dimensions: (1) Communication Infrastructure: a description of mobile telecommunication technologies and networks; (2) Device Type: the type of device being used, such as PDA, sensor, or tablet PC; (3) Data Display: describes how the data will be displayed to the user and transmitted, such as images, email, and textual data; (4) Application Purpose: identification of the objective for the M-Health system; (5) Application Domain: definition of the area in which the system will be implemented. Healthcare stakeholders and system implementer can use the reference model presented in this article to understand the security implications of the proposed system and to identify the technological infrastructure, business requirements, and operational needs of the M-Health systems being implemented. A reference model that encapsulates the emerging M-Health field is needed for cumulative progress in this field. Currently, the M-Health field is disjointed, and it is often unclear what constitutes an M-Health system. In the future, M-Health applications will take advantage of technological advances such as device miniaturizations, device convergence, high-speed mobile networks, and improved medical sensors. This will lead to the increased diffusion of clinical M-Health systems, which will require better understanding of the components that constitute the M-Health system.


Public Health ◽  
2020 ◽  
Author(s):  
David Hunter

Within the UK there are four public health systems covering each of four countries making up the UK: England is the largest country, followed by Scotland, Wales, and Northern Ireland. There are many commonalities between the systems in terms of their functions and workforce terms and conditions as well as the challenges each faces. But in keeping with the devolved systems of government enjoyed by each country, the public health systems are organized differently and their structures and priorities reflect the differing contexts in which they are located. Drawing on the three domains outlined by Griffiths, Jewell, and Donnelly in their seminal 2005 paper and comprising health protection, health improvement, and health service delivery and quality, UK public health systems exist to protect and promote health improvement and well-being in the population and do so through devising policies and strategies and providing services as well as contributing to the evidence base in regard to what works to improve health. The definition of a public health system is clearly contingent on the definition and scope of public health. The UK public health systems have adopted the definition of public health advanced by the UK Faculty of Public Health and other bodies and first produced by a former Chief Medical Officer for England, Sir Donald Acheson, in 1998: “Public health is the science and art of preventing disease, prolonging life and promoting health through organised efforts of society.” A slightly extended version appeared in a review of public health carried out for the UK government by its appointed independent adviser, Sir Derek Wanless, in 2004: “Public health is the science and art of preventing disease, prolonging life, and promoting health through the organised efforts and informed choices of society, organisations, public and private, communities and individuals.” These definitions share important characteristics including: public health is both a science and an art, essentially and always a combination of knowledge and action; the core purposes of public health are to prevent disease, prolong life, and promote health; public health is an organized societal function. Several aspects of these definitions can be highlighted as being especially pertinent to public health systems. Notable among these is the desire for closer links across health and the environmental sector; addressing social and political determinants of health as an essential and legitimate public health action; and the importance of health systems for public health improvement. Given these definitions with their whole-of-society focus, a public health system is wider and more inclusive than a health system. An effective public health system can be judged by the extent to which relevant groups, organizations, and sectors work effectively together on specific issues.


2019 ◽  
Vol 8 (9) ◽  
pp. 563-566 ◽  
Author(s):  
Jillian Clare Kohler

In this commentary, I argue that corruption in health systems is a critical and legitimate area for research in order to strengthen health policy goals. This rationale is based partly on citizen demand for more accountable and transparent health systems, along with the fact that the poor and vulnerable suffer the most from the presence of corruption in health systems. What is more, there is a growing body of literature on the impact of corruption in the health system and best practices in terms of anti-corruption, transparency and accountability (ACTA) strategies and tactics within the health system. Still, we need to support ACTA integration into the health system by having a common definition of corruption that is meaningful for health systems and ensure that ACTA strategies and tactics are transparent themselves. The 2019 Consultation on a proposed Global Network on ACTA in Health Systems is promising for these efforts.


Author(s):  
Flora Amato ◽  
Valentina Casola ◽  
Giovanni Cozzolino ◽  
Alessandra De Benedictis ◽  
Nicola Mazzocca ◽  
...  

e-Health applications enable one to acquire, process, and share patient medical data to improve diagnosis, treatment, and patient monitoring. Despite the undeniable benefits brought by the digitization of health systems, the transmission of and access to medical information raises critical issues, mainly related to security and privacy. While several security mechanisms exist that can be applied in an e-Health system, they may not be adequate due to the complexity of involved workflows, and to the possible inherent correlation among health-related concepts that may be exploited by unauthorized subjects. In this article, we propose a novel methodology for the validation of security and privacy policies in a complex e-Health system, that leverages a formal description of clinical workflows and a semantically enriched definition of the data model used by the workflows, in order to build a comprehensive model of the system that can be analyzed with automated model checking and ontology-based reasoning techniques. To validate the proposed methodology, we applied it to two case studies, subjected to the directives of the EU GDPR regulation for the protection of health data, and demonstrated its ability to correctly verify the fulfillment of desired policies in different scenarios.


1996 ◽  
Vol 35 (04/05) ◽  
pp. 334-342 ◽  
Author(s):  
K.-P. Adlassnig ◽  
G. Kolarz ◽  
H. Leitich

Abstract:In 1987, the American Rheumatism Association issued a set of criteria for the classification of rheumatoid arthritis (RA) to provide a uniform definition of RA patients. Fuzzy set theory and fuzzy logic were used to transform this set of criteria into a diagnostic tool that offers diagnoses at different levels of confidence: a definite level, which was consistent with the original criteria definition, as well as several possible and superdefinite levels. Two fuzzy models and a reference model which provided results at a definite level only were applied to 292 clinical cases from a hospital for rheumatic diseases. At the definite level, all models yielded a sensitivity rate of 72.6% and a specificity rate of 87.0%. Sensitivity and specificity rates at the possible levels ranged from 73.3% to 85.6% and from 83.6% to 87.0%. At the superdefinite levels, sensitivity rates ranged from 39.0% to 63.7% and specificity rates from 90.4% to 95.2%. Fuzzy techniques were helpful to add flexibility to preexisting diagnostic criteria in order to obtain diagnoses at the desired level of confidence.


2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
M Suhrcke ◽  
M Pinna Pintor ◽  
C Hamelmann

Abstract Background Economic sanctions, understood as measures taken by one state or a group of states to coerce another into a desired conduct (eg by restricting trade and financial flows) do not primarily seek to adversely affect the health or health system of the target country's population. Yet, there may be indirect or unintended health and health system consequences that ought to be borne in mind when assessing the full set of effects of sanctions. We take stock of the evidence to date in terms of whether - and if so, how - economic sanctions impact health and health systems in LMICs. Methods We undertook a structured literature review (using MEDLINE and Google Scholar), covering the peer-reviewed and grey literature published from 1970-2019, with a specific focus on quantitative assessments. Results Most studies (23/27) that met our inclusion criteria focus on the relationship between sanctions and health outcomes, ranging from infant or child mortality as the most frequent case over viral hepatitis to diabetes and HIV, among others. Fewer studies (9/27) examined health system related indicators, either as a sole focus or jointly with health outcomes. A minority of studies explicitly addressed some of the methodological challenges, incl. control for relevant confounders and the endogeneity of sanctions. Taking the results at face value, the evidence is almost unanimous in highlighting the adverse health and health system effects of economic sanctions. Conclusions Quantitatively assessing the impact of economic sanctions on health or health systems is a challenging task, not least as it is persistently difficult to disentangle the effect of sanctions from many other, potentially major factors at work that matter for health (as, for instance, war). In addition, in times of severe economic and political crisis (which often coincide with sanctions), the collection of accurate and comprehensive data that could allow appropriate measurement is typically not a priority. Key messages The existing evidence is almost unanimous in highlighting the adverse health and health system effects of economic sanctions. There is preciously little good quality evidence on the health (system) impact of economic sanctions.


2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
◽  

Abstract The European Commission's State of Health in the EU (SoHEU) initiative aims to provide factual, comparative data and insights into health and health systems in EU countries. The resulting Country Health Profiles, published every two years (current editions: November 2019) are the joint work of the European Observatory on Health Systems and Policies and the OECD, in cooperation with the European Commission. They are designed to support the efforts of Member States in their evidence-based policy making and to contribute to health care systems' strengthening. In addition to short syntheses of population health status, determinants of health and the organisation of the health system, the Country Profiles provide an assessment of the health system, looking at its effectiveness, accessibility and resilience. The idea of resilient health systems has been gaining traction among policy makers. The framework developed for the Country Profiles template sets out three dimensions and associated policy strategies and indicators as building blocks for assessing resilience. The framework adopts a broader definition of resilience, covering the ability to respond to extreme shocks as well as measures to address more predictable and chronic health system strains, such as population ageing or multimorbidity. However, the current framework predates the onset of the novel coronavirus pandemic as well as new work on resilience being done by the SoHEU project partners. This workshop aims to present resilience-enhancing strategies and challenges to a wide audience and to explore how using the evidence from the Country Profiles can contribute to strengthening health systems and improving their performance. A brief introduction on the SoHEU initiative will be followed by the main presentation on the analytical framework on resilience used for the Country Profiles. Along with country examples, we will present the wider results of an audit of the most common health system resilience strategies and challenges emerging from the 30 Country Profiles in 2019. A roundtable discussion will follow, incorporating audience contributions online. The Panel will discuss the results on resilience actions from the 2019 Country Profiles evidence, including: Why is resilience important as a practical objective and how is it related to health system strengthening and performance? How can countries use their resilience-related findings to steer national reform efforts? In addition, panellists will outline how lessons learned from country responses to the Covid-19 pandemic and new work on resilience by the Observatory (resilience policy briefs), OECD (2020 Health at a Glance) and the EC (Expert Group on Health Systems Performance Assessment (HSPA) Report on Resilience) can feed in and improve the resilience framework that will be used in the 2021 Country Profiles. Key messages Knowing what makes health systems resilient can improve their performance and ability to meet the current and future needs of their populations. The State of Health in the EU country profiles generate EU-wide evidence on the common resilience challenges facing countries’ health systems and the strategies being employed to address them.


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