Mobile Health Services

Today, information and communication technology (ICTs) are influencing health system development across many developing countries, particularly through the application of mobile communications. As such, there has been an initiation of a new paradigm of mobile health services which has made healthcare delivery more accessible, affordable and effective. However, such service delivery platform has been mainly targeted towards the rural population, so there is growing concerns about its acceptance and future use intentions in the urban areas. The aim of this paper is to examine and critically assess the underlying factors that can influence future use intentions of mHealth services in the context of Bangladesh. The conceptual model of the study identifies that information quality, facilitating conditions, trust and effort expectancy plays an important role in capturing users' overall perceptions of mobile health services. Finally, the study highlights the managerial implications, future research directions and limitations from the perspective of Bangladesh.

Enhancing Emergency Response Management using Emergency Description Information Technology (EDIT)

This paper presents a novel approach toward facilitating the effective collection and communication of information during an emergency. Initially, this research examines current emergency response information workflows and emergency responder dispatch criteria. A process for the optimization of these workflows and criteria, along with a suggested method to improve data collection accuracy and emergency response time using a mobile device application, are suggested. Specifically, a design-science approach incorporating the development of an expert system designed to facilitate efficient and effective sharing of emergency information is applied. The resulting benefits could improve emergency communications during large-scale international gatherings, such as sporting events or festivals, as well as the sharing of industry-specific safety incidents. A process model for conducting analyses of additional emergency response processes is also presented. Finally, future research directions are discussed.

Applying Social Aspects in Home Telecare Design to Improve the Safety of Users and Quality of Service

Telecare enables remote and cost-effective home treatment of patients, improving the safety and quality of life of frail individuals. However, despite increased availability of telecare devices, many are not fully used and often ignored due to poor social perception and experience. The research suggests the social aspects of quality and safety related to user experience have not been considered. This can lead to misuse or non-use of telecare devices, reducing patient safety and quality of life. This chapter explores the implications for the lack of social considerations in telecare and develops a series of models and methodologies to integrate the social dimension with the traditional medical intervention focus. By applying semiotics and normative behavioural theory, the authors show how a Normative Home Telecare Framework can improve telecare solution design and ensure take up and use of the devices and increase patient safety and life quality.

Implementation of Electronic Health Record (EHR) System in the Healthcare Industry

The purpose of this research is to demonstrate the efficiency of the Electronic Health Record (EHR) software that is adopted in the healthcare industry to provide better patient care. The authors examine the impact of EHRs on the efficient delivery of healthcare services. More specifically, they detail the origin of EHR, its significance in modern healthcare delivery along with the selection and implementation criteria for EHR software. They present a survey on the extent of adoption of EHR by clinicians. They also highlight the challenges and barriers faced by organizations in adopting EHR software such as cost, workflow impact and data security. Finally, the authors contemplate the future of EHR, its role in the implementation of health information exchange and its implementation in the cloud. They conclude that the implementation of EHR in the cloud is an important step towards better health management across the population with the end-goal of better health outcomes.

Using Virtual Environments to Achieve Learner Outcomes in Interprofessional Healthcare Education

The use of simulation in the training of healthcare professionals has become an essential part of the educational experience. Students and practitioners need to learn a variety of technical, interpersonal, and clinical judgment skills to be effective healthcare practitioners. Virtual simulation can provide an effective training method to facilitate learning and can be targeted to develop specific skills in the area of Interprofessional Education (IPE). This chapter reviews the literature around simulation techniques and outlines a development process that can be used to develop virtual simulations to meet a variety of learning objectives including IPE. Specific issues and solutions are also presented to ensure a successful educational experience.

Medical Data Analytics in the Cloud Using Homomorphic Encryption

Transitioning US healthcare into the digital era is necessary to reduce operational costs at Healthcare Organizations (HCO) and provide better diagnostic tools for healthcare professionals by making digital patient data available in a timely fashion. Such a transition requires that the Personal Health Information (PHI) is protected in three different phases of the manipulation of digital patient data: 1) Acquisition, 2) Storage, and 3) Computation. While being able to perform analytics or using such PHI for long-term health monitoring can have significant positive impacts on the quality of healthcare, securing PHI in each one of these phases presents unique challenges in each phase. While established encryption techniques, such as Advanced Encryption Standard (AES), can secure PHI in Phases 1 (acquisition) and 2 (storage), they can only assure secure storage. Assuring the data privacy in Phase 3 (computation) is much more challenging, since there exists no method to perform computations, such as analytics and long-term health monitoring, on encrypted data efficiently. In this chapter, the authors study one emerging encryption technique, called Fully Homomorphic Encryption (FHE), as a candidate to perform secure analytics and monitoring on PHI in Phase 3. While FHE is in its developing stages and a mainstream application of it to general healthcare applications may take years to be established, the authors conduct a feasibility study of its application to long-term patient monitoring via cloud-based ECG data acquisition through existing ECG acquisition devices.

Information Architecture for Pervasive Healthcare Information Provision with Technological Implementation

The Pervasive Healthcare Information Provision (PHIP) is a concept that ensures patients are covered with healthcare services with the appropriate information provision together with the technical infrastructure when needed. Clinicians can obtain the real-time information by accessing the electronic patient record that supports decision-making in providing health services. PHIP aims to provide comprehensive healthcare services to its stakeholders covering the social and technical aspect. Information architecture is a high-level map of information requirements of an organisation that possesses business processes and information flows. Organisational semiotics, a fundamental theory for information and communication, helps in understanding the nature of information. It deals with information and information systems in a balanced way, taking account of both the physical space (when physical actions take place) and the information space (which are mainly characterised by information and communication using signs, symbols, and data). Information sharing among multi-stakeholders in decision-making is essential for pervasive healthcare. The information architecture can be reflected in information systems implementation such as Electronic Patient Record (EPR) and other forms. The aim of this chapter is to derive a conceptual model of information architecture for PHIP, including technological implementation via wireless technology. The information architecture serves as requirement engine that covers social and technical needs from both patients and clinicians. The contribution of this research is two fold: 1) establishing the theoretical perspective of information architecture, which serves as backbone to support PHIP, and 2) implementing PHIP via wireless technology and agent-based system.

Telemedicine Program for Management and Treatment of Stress Urinary Incontinence in Women

Stress Urinary Incontinence (SUI), defined as involuntary urine leakage caused by physical activity and/or efforts, is a frequently found pathology among women that significantly affects their quality of life. SUI treatments are often less effective than expected because they require a conscious effort by the patient to follow them correctly and usually have drawbacks, such as their high cost, time, and/or schedule requirements. ICT-mediated Physical Therapy treatment programs can be useful to improve Stress Urinary Incontinence symptoms and pelvic floor function in women while maintaining total confidentiality, with an at home treatment, accomplishing a higher adherence to the treatment, keeping a low budget for the patients, and saving the health systems' economic resources.

Evaluating Integrated eCare

Evaluation of projects on integrated eCare is key to implementation and widespread use. The evaluation must, though, be thorough and include research methods from multiple different research traditions simultaneously. This implies a necessity of knowledge from all research paradigms and understanding of proper reporting. In this chapter, guidance for evaluation of integrated eCare is provided, along with discussions of advantages and disadvantages related to certain decisions that must be made during the research process. As an aid for understanding, real-life examples of evaluation are provided to illustrate challenges and possible solutions throughout the chapter.

Organizational Factors Influencing the Use of Clinical Decision Support for Improving Cancer Screening Within Community Health Centers

Adoption of clinical decision support (CDS) systems leads to improved clinical performance through improved clinician decision making, adherence to evidence-based guidelines, medical error reduction, and more efficient information transfer and to reduction in health care disparities in under-resourced settings. However, little information on CDS use in the community health care (CHC) setting exists. This study examines if organizational, provider, or patient level factors can successfully predict the level of CDS use in the CHC setting with regard to breast, cervical, and colorectal cancer screening. This study relied upon 37 summary measures obtained from the 2005 Cancer Health Disparities Collaborative (HDCC) national survey of 44 randomly selected community health centers. A multi-level framework was designed that employed an all-subsets linear regression to discover relationships between organizational/practice setting, provider, and patient characteristics and the outcome variable, a composite measure of community health center CDS intensity-of-use. Several organizational and provider level factors from our conceptual model were identified to be positively associated with CDS level of use in community health centers. The level of CDS use (e.g., computerized reminders, provider prompts at point-of-care) in support of breast, cervical, and colorectal cancer screening rate improvement in vulnerable populations is determined by both organizational/practice setting and provider factors. Such insights can better facilitate the increased uptake of CDS in CHCs that allows for improved patient tracking, disease management, and early detection in cancer prevention and control within vulnerable populations.