Quality Based on a Spatial SERVQUAL Model in Healthcare

The main purpose of this work is to represent an alternative effective model for measuring the quality of healthcare (SERVQUAL) considering the geographical location of the under examination healthcare sectors. Based on that consideration, a new modeling is taking place introducing a spatial interaction between neighboring regions (spatial-SERVQUAL model). New directions are analyzed implementing specific questionnaires taking advantage of the spatial information given by the evaluation of the model. Moreover the role of spatial information in the health sector in relation to, for example, local health improvement performance management, is analyzed to support needs assessment and resource targeting as one of the principal action points in healthcare policies. Finally, the benefits of the GIS systems are illustrated, combined with the spatial assumptions, introducing a real-time health and disease monitoring tool to identify significant health trends in real-time data streams and geographic information systems.

Bifurcation Analysis of a Model Accounting for the 14-3-3s Signalling Compartmentalisation

Bifurcation theory studies the qualitative changes in the phase portrait when we vary the parameters of the system. In this book chapter we adapt and extend a mathematical model accounting for the subcellular localisation of 14-3-3s, a protein involved in cell cycle arrest and the regulation of apoptosis. The model is analysed with analytical tools coming from Lyapunov-Andronov theory, and our analytical calculations predict that soft (reversible) loss of stability takes place.

Role of Information Technology in Healthcare Quality Assessment

Quantifying and improving the quality of health care is an increasingly important goal in medicine. Because quality of life is difficult to define and even more difficult to measure - particularly with physically and mentally vulnerable people - outcomes from nursing in continuing care are not easily articulated. The focus of the nursing assessment tool is therefore on increasing quality of life, rather than perceiving health gain simply as increased longevity. Assessment is considered to be the first step in the process of individualized nursing care. It provides information that is critical to the development of a plan of action that enhances personal health status. It also decreases the potential for, or the severity of, chronic conditions and helps the individual to gain control over their health through self-care. In this chapter the authors try to describe how important is the role of information and especially of the Information Technology in healthcare quality assessment.

Intelligent System to Quality Assurance in Drugs Delivery

Improving quality assurance and providing effective healthcare are some of the most important aims of information and communication technologies (ICT). This chapter presents a novel solution to improve quality assurance in drugs delivery, i.e., reduce clinical errors caused by drug interaction and dose. For that purpose, we have proposed an innovative system based on Internet of things for the drugs identification. Internet of things (IoT) is one of the latest advances in ICT, providing a global connectivity and management of sensors, devices, users, and information. Our contribution is a solution to examine drug related problems based on IoT technologies, i.e. smart phones and Web, to support ubiquitous access, 6LoWPAN technology to support ubiquitous data collection of patients, sensors and hospitals, and RFID/NFC to support global identification. These technologies offer a wide range of applications in healthcare, which improves the quality of services, reduces mistakes, and even detects health anomalies from vital signs. This chapter presents how IoT technology is applied in a pharmaceutical system to examine drugs in order to detect Adverse Drug Reactions (ADRs), harmful effects of pharmaceutical excipients, allergies, complications and contraindications related with liver and renal defects, and harmful side effects during pregnancy or lactation. Thereby, the system provides an enhanced approach assisting physicians in clinical decisions and drug prescribing. The solution presented is based on NFC (Near Field Communication), RFID (Radio Frequency Identification), and barcode identification technologies, which have been integrated in common devices such as smart-phones, PDAs, and PCs. In addition, a remote knowledge-based system based ontologies and rules-engine, has been built to define an intelligent drugs checker, which we have defined as Pharmaceutical Intelligent Information System, where the drug identifies collected from the RFID/NFC tag or barcode is checked, in order to detect whether the identified drug is suitable with respect to the patient’s health record.

The Social Role of Technology in Healthcare Quality Improvement

The aim of this study is to describe the social role of technology in healthcare quality improvement. Methodologically, the study was based on a review of the relevant literature, Greek and foreign, as well as Internet sources related to the social role of technology in healthcare quality improvement. The main conclusions drawn were the following: a) The development of new technologies in the field of health and their involvement within the social context is today a fast accelerating process; b) The presentday expansion of health-oriented technology is of vital importance because of current trends in the field of healthcare and of the social evolution on healthcare services; c) Information technology is capable of profoundly contributing to the improvement of the quality of health, and thus to the wellbeing of the citizens in a society; d) By the use of health technology, more efficient and productive financial management is achieved with numerous benefits for the economy; e) Electronic health can improve the quality of healthcare thereby facilitating the work of health professionals; f) Greek society is being increasingly influenced by both international and domestic scientific and technological advances in health technology despite the existence of significant legal barriers; g) Current trends in the European Union as far as health technology is concerned are intimately connected with expanding citizen participation in the electronic revolution and their increasing access to the Information Society.

From Non-Invasive Hemodynamic Measurements towards Patient-Specific Cardiovascular Diagnosis

The past two decades have seen impressive success in medical technology, generating novel experimental data at an unexpected rate. However, current computational methods cannot sufficiently manage the data analysis for interpretation, so clinical application is hindered, and the benefit for the patient is still small. Even though numerous physiological models have been developed to describe complex dynamical mechanisms, their clinical application is limited, because parameterization is crucial, and most problems are ill-posed and do not have unique solutions. However, this information deficit is imminent to physiological data, because the measurement process always contains contamination like artifacts or noise and is limited by a finite measurement precision. The lack of information in hemodynamic data measured at the outlet of the left ventricle, for example, induces an infinite number of solutions to the hemodynamic inverse problem (possible vascular morphologies that can represent the hemodynamic conditions) (Quick, 2001). Within this work, we propose that, despite these problems, the assimilation of morphological constraints, and the usage of statistical prior knowledge from clinical observations, reveals diagnostically useful information. If the morphology of the vascular network, for example, is constrained by a set of time series measurements taken at specific places of the cardiovascular system, it is possible to solve the hemodynamic inverse problem by a carefully designed mathematical forward model in combination with a Bayesian inference technique. The proposed cardiovascular system identification procedure allows us to deduce patient-specific information that can be used to diagnose a variety of cardiovascular diseases in an early state. In contrast to traditional inversion approaches, the novel method produces a distribution of physiologically interpretable models (patient-specific parameters and model states) that allow the identification of disease specific patterns that correspond to clinical diagnoses, enabling a probabilistic assessment of human health condition on the basis of a broad patient population. In the ongoing work we use this technique to identify arterial stenosis and aneurisms from anomalous patterns in signal and parameter space. The novel data mining procedure provides useful clinical information about the location of vascular defects like aneurisms and stenosis. We conclude that the Bayesian inference approach is able to solve the cardiovascular inverse problem and to interpret clinical data to allow a patient-specific model-based diagnosis of cardiovascular diseases. We think that the information-based approach provides a useful link between mathematical physiology and clinical diagnoses and that it will become constituent in the medical decision process in near future.

Improving Quality of Care through Risk Management Knowledge Transfer and Quality Assurance in Nursing Care

The purpose of this chapter is to provide innovative knowledge and creative ideas of improving quality of care and to explore how risk management and Knowledge transfer and quality assurance can improve health care. Under careful consideration, our purpose is to summarize which factors improve and promote the quality of care and which factors diminish quality. There are forms of ongoing efforts to make performance better. Quality improvement must be a long-term, continuous effort, reducing errors and providing a safe trust environment for health professionals and patients. After reading this chapter, you should know the answer to these questions: What role can risk management and knowledge transfer play in quality of care? How can risk management and knowledge transfer work together? What are the factors that improve risk management and quality assurance in health care? How does knowledge transfer support, inform, and improve care?

Personalized Experience Sharing of Cai’s TCM Gynecology

This chapter introduces experience sharing of Cai’s gynecology in Traditional Chinese Medicine (TCM). It argues that Cai’s family in China are experts in TCM gynecology, whose seventh generation Xiaosun Cai is a TCM master. Therefore, inheriting experience of Xiaosun is a critical business in the present TCM field. The authors demonstrate a novel system (named TCM-PMES) for preserving the diagnostic processes of veteran practitioners like Xiaosun in a personalized way. Based on the summarized Cai’s diagnostic template, a custom input system embracing the particular expressions of the specialist is set up in the platform. Unique and unfiltered experience of veteran practitioner is maintained as complete as possible. Various approaches on exploring relationships among TCM components and speculating syndrome types from clinical symptoms are also studied. This work provides a new way for keeping and researching the personalized factors in the diagnostic process of Cai’s TCM gynecology.

Bayesian Ontologies in Spatial Integrating Medical Information Systems

Geographical Information Systems (GIS) play a major role in all areas of health research, especially for the understanding of spatial variations concerning disease monitoring. The information produced by the spatial analysis can be modelled and displayed using maps. Spatial analysis (as an alternative statistical technique) may be used in order to suggest health patterns for describing the spreading of various diseases. Areas where GIS can be of benefit include the point mapping of patients and aggregated analyses within different geographical areas. The incorporation of GIS sections in Healthcare Information Systems aims towards the efficient and automated follow-up of prevalence of various diseases in diverse geographic regions. A very important feature of the current system is the integration of queries for the extraction of specific information regarding the above parameters. The queries have been developed through the ontologies of the system. Each ontology refers to each of the correlations that are being explored. The appropriate ontology design techniques have been used to assure the validity of the query output. This work describes the methodological approach for the development of a real time electronic health record, for the statistical analysis of geographic information and graphical representation for disease monitoring. Uncertainty of the ontology system may be achieved by proposing Bayesian type statistical techniques like Bayesian network and Markov logic. Implementation of the proposed techniques will be illustrated considering real accident data.

Quality in Telemedicine Services

Technology advances have brought forward new and evolved services and technical infrastructure that promote and enhance quality healthcare services, such as telepresence and wearable technology. Nevertheless, there are several obstacles in telemedicine performance that need to be resolved.