Semantic Health Mediation and Access Control Manager for Interoperability Among Healthcare Systems

2018 ◽  
Vol 11 (4) ◽  
pp. 87-98
Author(s):  
Abdullah Alamri
Keyword(s):  
Medical Information ◽  
Clinical Information ◽  
Healthcare Systems ◽  
Patient Data ◽  
Dual Model ◽  
Healthcare Organizations ◽  
Reference Information ◽  
Proposed Model ◽  
Definition Of ◽  
Semantic Mediation

Healthcare systems have evolved to become more patient-centric. Many efforts have been made to transform paper-based patient data to automated medical information by developing electronic healthcare records (EHRs). Several international EHRs standards have been enabling healthcare interoperability and communication among a wide variety of medical centres. It is a dual-model methodology which comprises a reference information model and an archetype model. The archetype is responsible for the definition of clinical concepts which has limitations in terms of supporting complex reasoning and knowledge discovery requirements. The objective of this article is to propose a semantic-mediation architecture to support semantic interoperability among healthcare organizations. It provides an intermediate semantic layer to exploit clinical information based on richer ontological representations to create a “model of meaning” for enabling semantic mediation. The proposed model also provides secure mechanisms to allow interoperable sharing of patient data between healthcare organizations.

Semantic Health Mediation and Access Control Manager for Interoperability Among Healthcare Systems

2020 ◽  
pp. 169-181
Author(s):  
Abdullah Alamri
Keyword(s):  
Medical Information ◽  
Clinical Information ◽  
Healthcare Systems ◽  
Patient Data ◽  
Dual Model ◽  
Healthcare Organizations ◽  
Reference Information ◽  
Proposed Model ◽  
Definition Of ◽  
Semantic Mediation

Healthcare systems have evolved to become more patient-centric. Many efforts have been made to transform paper-based patient data to automated medical information by developing electronic healthcare records (EHRs). Several international EHRs standards have been enabling healthcare interoperability and communication among a wide variety of medical centres. It is a dual-model methodology which comprises a reference information model and an archetype model. The archetype is responsible for the definition of clinical concepts which has limitations in terms of supporting complex reasoning and knowledge discovery requirements. The objective of this article is to propose a semantic-mediation architecture to support semantic interoperability among healthcare organizations. It provides an intermediate semantic layer to exploit clinical information based on richer ontological representations to create a “model of meaning” for enabling semantic mediation. The proposed model also provides secure mechanisms to allow interoperable sharing of patient data between healthcare organizations.

In defence of our model for just healthcare systems: why an explicit philosophy is needed in addition to the law, and how Scanlon helps derive just policies

2021 ◽  
pp. medethics-2021-107633
Author(s):  
Caitríona L Cox ◽  
Zoë Fritz
Keyword(s):  
Judicial Review ◽  
Capability Approach ◽  
Healthcare Systems ◽  
Reasonable Person ◽  
Proposed Model ◽  
Philosophical Framework ◽  
The Law ◽  
Definition Of ◽  
The Relationship ◽  
Sen’S Capability Approach

In a recent response to our paper on developing a philosophical framework to guide the design and delivery of a just health service, Sarela raises several objections. We feel that although Sarela makes points which are worthy of discussion, his critique does not undermine either the need for, or the worth of, our proposed model. First, the law does not negate the need for ethics in determining just healthcare policy. Reliance on legal processes can drive inappropriate focus on ensuring policies avoid judicial review, as opposed to ensuring they are truly just; the law affords protection against unjust policies but does not put a commitment to avoiding them at the heart of policy-making. We defend the need for Scanlonian supplementation by emphasising the practical value of adding a step based on reasonable rejection, particularly in ensuring that the views of vulnerable stakeholders are robustly considered. We discuss the similarities and differences between the work of Daniels and Sen in considering the relationship between health and opportunity, concluding that Sen’s capability approach is both valuable and compatible with our proposed model. Finally, the practical use of our model requires consideration of what constitutes a reasonable person. Our model is explicitly intended to help develop a healthcare system which is just to all its users. With this in mind, we suggest that those involved in decision-making should meet Scanlon’s definition of reasonable: they should be motivated to justify their actions to, and seek agreement with, others.

scholarly journals Security framework for cloud based electronic health record (EHR) system

2020 ◽  
Vol 10 (1) ◽  
pp. 455 ◽  
Author(s):  
Raghavendra Ganiga ◽  
Radhika M. Pai ◽  
Manohara Pai M. M. ◽  
Rajesh Kumar Sinha
Keyword(s):  
Medical Records ◽  
Medical Information ◽  
National Health System ◽  
Patient Data ◽  
High Tech ◽  
Mass Storage ◽  
Security Framework ◽  
Healthcare Organizations ◽  
Health Records ◽  
Electronic Health

Health records are an integral aspect of any Hospital Management System. With newer innovations in technology, there has been a shift in the way of recording health information. Medical records which used to be managed using various paper charts have now become easier to organize and maintain, thereby increasing the efficiency of medical staff. The Electronic Health Records (EHR) System is becoming a high-tech medical management technology developed for the economic or emerging economic countries like India. In a national health system, the EHR integrates the Electronic Medical Records (EMR) in all collaborating hospitals through different networks. EHR gives healthcare professionals a way to share and manage patient data quickly and effectively. Due to the mass storage of confidential patient data, healthcare organizations are considered as one of the most targeted sectors by intruders. This paper proposes a security framework for EHR system, which takes into consideration the integrity, availability, and confidentiality of health records. The threats posed to the EHR system are modeled by STRIDE modeling tool, and the amount of risk is calculated using DREAD. The paper also suggests the security mechanism and countermeasures based on security standards, which can be utilized in an EHR environment. The paper shows that the utilization of the proposed methods effectively addresses security concerns such as breach of sensitive medical information.

Incorporating Human Factors Into a Healthcare System’s COVID-19 Communication Strategy

2021 ◽  
Vol 10 (1) ◽  
pp. 175-179
Author(s):  
Rebecca L. Butler ◽  
Ann Katherine Hoobler ◽  
Lucy C. Stein ◽  
Erica S. Hoenig ◽  
Laura M. Lee ◽  
...  
Keyword(s):  
Human Factors ◽  
Healthcare System ◽  
Communication Strategies ◽  
Clinical Information ◽  
Effective Communication ◽  
Healthcare Systems ◽  
User Feedback ◽  
Communication Strategy ◽  
Successful Communication

The COVID-19 era has been an age of change for healthcare systems worldwide. At the beginning of the pandemic in particular, there was a huge need to rapidly communicate new and constantly changing information with critical safety implications. Previously successful communication strategies were not adequate for this unprecedented challenge. At MedStar Health, the Quality & Safety team led a unique partnership between human factors experts, clinical teams, and the communications department to develop a three-pronged strategy for effective communication during the pandemic. This strategy incorporated the following components: 1) Using human factors and usability concepts to distill complex clinical information into easy-to-understand infographics for frontline associates; 2) Creating regular, succinct messaging to distribute the information and provide frequent updates throughout the healthcare system; and 3) Designing and maintaining a usable webpage where associates could access up-to-date information relevant to their specialty at any time, on or off the hospital network. This strategy, which was dynamic and adapted to user feedback, was supported by associates as a streamlined method for communicating important information throughout the pandemic.

A Global Socio-economic-medico-legal Model for the Sustainability of Longitudinal Electronic Health Records

2006 ◽  
Vol 45 (03) ◽  
pp. 240-245 ◽  
Author(s):  
A. Shabo
Keyword(s):  
Electronic Health Records ◽  
Healthcare Providers ◽  
Financial Assets ◽  
Healthcare Organizations ◽  
Health Records ◽  
Record Keeping ◽  
Proposed Model ◽  
Legal Model ◽  
Electronic Health

Summary Objectives: This paper pursues the challenge of sustaining lifetime electronic health records (EHRs) based on a comprehensive socio-economic-medico-legal model. The notion of a lifetime EHR extends the emerging concept of a longitudinal and cross-institutional EHR and is invaluable information for increasing patient safety and quality of care. Methods: The challenge is how to compile and sustain a coherent EHR across the lifetime of an individual. Several existing and hypothetical models are described, analyzed and compared in an attempt to suggest a preferred approach. Results: The vision is that lifetime EHRs should be sustained by new players in the healthcare arena, who will function as independent health record banks (IHRBs). Multiple competing IHRBs would be established and regulated following preemptive legislation. They should be neither owned by healthcare providers nor by health insurer/payers or government agencies. The new legislation should also stipulate that the records located in these banks be considered the medico-legal copies of an individual’s records, and that healthcare providers no longer serve as the legal record keepers. Conclusions: The proposed model is not centered on any of the current players in the field; instead, it is focussed on the objective service of sustaining individual EHRs, much like financial banks maintain and manage financial assets. This revolutionary structure provides two main benefits: 1) Healthcare organizations will be able to cut the costs of long-term record keeping, and 2) healthcare providers will be able to provide better care based on the availability of a lifelong EHR of their new patients.

Influence of Clearances and Thermal Effects on the Dynamic Behavior of Gear-Hydrodynamic Journal Bearing Systems

2013 ◽  
Vol 135 (6) ◽  
Author(s):  
R. Fargère ◽  
P. Velex
Keyword(s):  
Degrees Of Freedom ◽  
Integration Scheme ◽  
Time Step ◽  
Specific Element ◽  
Normal Contact ◽  
Contact Algorithm ◽  
Gear Teeth ◽  
Proposed Model ◽  
Elastic Couplings ◽  
Definition Of

A global model of mechanical transmissions is introduced which deals with most of the possible interactions between gears, shafts, and hydrodynamic journal bearings. A specific element for wide-faced gears with nonlinear time-varying mesh stiffness and tooth shape deviations is combined with shaft finite elements, whereas the bearing contributions are introduced based on the direct solution of Reynolds' equation. Because of the large bearing clearances, particular attention has been paid to the definition of the degrees-of-freedom and their datum. Solutions are derived by combining a time step integration scheme, a Newton–Raphson method, and a normal contact algorithm in such a way that the contact conditions in the bearings and on the gear teeth are simultaneously dealt with. A series of comparisons with the experimental results obtained on a test rig are given which prove that the proposed model is sound. Finally, a number of results are presented which show that parameters often discarded in global models such as the location of the oil inlet area, the oil temperature in the bearings, the clearance/elastic couplings interactions, etc. can be influential on static and dynamic tooth loading.

The Facets of Cultural Competence

2001 ◽  
Vol 29 (6) ◽  
pp. 842-849 ◽  
Author(s):  
Lisa A. Suzuki ◽  
Mary B. McRae ◽  
Ellen L. Short
Keyword(s):  
Clinical Practice ◽  
Cultural Competence ◽  
Counseling Psychology ◽  
Past Research ◽  
Current Clinical Practice ◽  
Multidimensional Model ◽  
Proposed Model ◽  
Innovative Thinking ◽  
Definition Of

Sue’s proposed model is based on a critique of the Eurocentric assumptions underlying current clinical practice and reflects his innovative thinking and unique synthesis of past research. The specific areas addressed in this article focus on an examination of the multidimensional model of cultural competence (MDCC) and issues related to the definition of competence and its measurement. Areas of needed elaboration in the model include complexities related to power hierarchies (i.e., authority, authorization, and leadership) and implications for training and practice. Particular emphasis is placed on the complexities of cultural competence and the important contributions of Sue’s MDCC as an important step in making cultural competence a reality in the practice of counseling psychology.

Chinese Intellectuals as Represented in ‘New Era’ Fictional Dialogues

2017 ◽  
Author(s):  
Hui Lai
Keyword(s):  
Key Words ◽  
Stylistic Analysis ◽  
Dual Model ◽  
New Era ◽  
Qualitative Approaches ◽  
Diachronic Change ◽  
The Status ◽  
Diachronic Study ◽  
Chinese Intellectuals ◽  
Definition Of

This book explores the status of Chinese intellectuals from 1980 to 2005 and its diachronic change in this period, as represented by dialogues between intellectuals and their leaders in fiction. June 1989 serves as a historical dividing line on which to base this diachronic study. In order to carry out the study, first, the direct speech of intellectuals and their leaders is extracted and compiled into corpora for a ‘key key-words’ analysis (see section 3.3.2 for a definition of key key-words). Second, a stylistic analysis is undertaken with the aim of conducting a more detailed qualitative investigation of the dialogues. Three dialogues in each of the two periods are selected for the stylistic analysis. The key-words derived from this analysis describe features of the speech of intellectuals, the speech of intellectuals as compared to the speech of leaders and the speech of leaders as compared to that of intellectuals. The study shows that the key key-words indicating topics of the speech and those characterising the style of the speech represent the social identity of intellectuals. A comparison of these key keywords between the two periods uncovers the diachronic change in the status of intellectuals. The corpus approach is complemented by a stylistic analysis, which explores dialogues selected from different years to emphasise the diachronic change. A dual model is formulated to incorporate dialogue analysis into a larger structure of goal development analysis. The study shows how speakers use discursive strategies to manage relationships and have their situational goals achieved in interaction. Negotiation of goals invokes the institutional and social identities of speakers, bringing out their status. The research shows that the corpus approach and the stylistic analysis can be combined to present a more comprehensive description of data. It is hoped that this will shed some light on studies of post-Cultural Revolution Chinese intellectuals and on how quantitative and qualitative approaches merge in the investigation of interaction between superiors and subordinates.

Analytical Model for Rockfall Protection Galleries - a Blind Prediction of Test Results and Conclusion

2011 ◽  
Vol 82 ◽  
pp. 722-727 ◽  
Author(s):  
Kristian Schellenberg ◽  
Norimitsu Kishi ◽  
Hisashi Kon-No
Keyword(s):  
Degrees Of Freedom ◽  
Large Scale ◽  
Test Results ◽  
Blind Prediction ◽  
Proposed Model ◽  
Input Parameters ◽  
Scale Test ◽  
Definition Of ◽  
Protective Structures ◽  
Cushion Layer

A system of multiple degrees of freedom composed out of three masses and three springs has been presented in 2008 for analyzing rockfall impacts on protective structures covered by a cushion layer. The model has then been used for a blind prediction of a large-scale test carried out in Sapporo, Japan, in November 2009. The test results showed substantial deviations from the blind predictions, which led to a deeper evaluation of the model input parameters showing a significant influence of the modeling properties for the cushion layer on the overall results. The cushion properties include also assumptions for the loading geometry and the definition of the parameters can be challenging. This paper introduces the test setup and the selected parameters in the proposed model for the blind prediction. After comparison with the test results, adjustments in the input parameters in order to match the test results have been evaluated. Conclusions for the application of the model as well as for further model improvements are drawn.

scholarly journals Myelodysplastic syndrome: classification and prognostic systems

2011 ◽  
pp. 25-33
Author(s):  
Rosangela Invernizzi ◽  
Agnese Filocco
Keyword(s):  
Clinical Information ◽  
Scoring Systems ◽  
Classification Systems ◽  
World Health ◽  
Individual Risk ◽  
Information Classification ◽  
Definition Of ◽  
Health Organization ◽  
The Individual ◽  
Prognostic Scoring Systems

Myelodysplastic syndromes (MDS) are acquired clonal disorders of hematopoiesis, that are characterized most frequently by normocellular or hypercellular bone marrow specimens, and maturation that is morphologically and functionally dysplastic. MDS constitute a complex hematological problem: differences in disease presentation, progression and outcome have made it necessary to use classification systems to improve diagnosis, prognostication and treatment selection. On the basis of new scientific and clinical information, classification and prognostic systems have recently been updated and minimal diagnostic criteria forMDS have been proposed by expert panels. In addition, in the last few years our ability to define the prognosis of the individual patient with MDS has improved. In this paper World Health Organization (WHO) classification refinements and recent prognostic scoring systems for the definition of individual risk are highlighted and current criteria are discussed. The recommendations should facilitate diagnostic and prognostic evaluations in MDS and selection of patients for new effective targeted therapies.

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