Global Telemedicine and eHealth

This chapter is about the intersections taking place globally in the delivery of healthcare. In today's world, quality health is about access: access to transportation to the hospital, access to the right people, doctors, nurses, and specialists, and the doctor's access to the latest lab tests and equipment. But in our future, all of this goes away. You do not need transportation, as medical ecosystems are becoming ubiquitous. Access to the best medical care available means access to the hospital system living in the cloud. The best labs are built into our phones whereby today's array of sensors can be focused on prevention and delivery systems designed for keeping people healthy. Behind this is the driving vision that medicine will be transformed from reactive and generic to predictive and personalized, reaching patients from the cloud through their telephones in their own homes, making up for a coming shortage in doctors and nurses. Where this brings us is that there is an abundance of confusion as to what Telehealth and eHealth is or what it will be. This chapter addresses an eHealth definition for review, thoughts on eHealth systems, resistance to change issues to be considered, the CVS Minute Clinic's introduction of innovation and disruptive eHealth care models and systems, a Systems Engineering Management proof of concept project with the Kansas Department of Corrections, and globally oriented conclusions and recommendations. (Diamandis & Kotler, 2012).

Modernization of Healthcare and Medical Diagnosis System Using Multi Agent System (MAS)

The healthcare system that prevailed some years ago was a mere pen and paper based system. A number of workers, staff, and written records were the main components of the prevailing system of healthcare. This had a number of drawbacks, and a number of mishaps occurred due to mismanagement of data and information. There was a need for development. Then, the concept of telemedicine came, which revolutionized the healthcare paradigm to a great extent. With the advancement of telemedicine, many major problems of the prevailing system were removed. But, still there were many other aspects which could be further improved to make healthcare facilities more enhanced. Keeping this in mind, the concept of Multi Agent System (MAS) was introduced in the healthcare system later. MASes are considered as the best and most appropriate technology that can be used in the development of applications in healthcare paradigm where the presence of multiple agents, heterogeneous and loosely coupled components, the data management in a dynamic and distributed environment, and multi-user collaborations are considered the most pertinent requirements for healthcare system. This chapter focuses mainly about MAS, its applications, and some systems that were developed by the authors.

Performance Studies of Integrated Network Scenarios in a Hospital Environment

Hospital network is evolving towards a more integrated approach by interconnecting wireless technologies into backbone networks. Although various integrated network scenarios have been published in the networking literature, a generic hospital model has not yet been fully explored and it remains a challenging topic in practice. One of the problems encountered by network practitioners is the seamless integration of network components into healthcare delivery. A good understanding of the performance of integrated networks is required for efficient design and deployment of such technologies in hospital environments. This research paper discuss on the modelling and evaluation of integrated network scenarios in hospital environments. The impact of traffic types (e.g. data, voice and video), traffic load, network size and signal strength on network performance is investigated by simulation. Three piloted case studies look at client performance in radiology Accident and Emergency (A & E and Intensive Care Unit (ICU)) scenarios. Each scenario reflects the need for various traffic types that end up distinct network behaviours. In the radiology scenario, email and File Transfer Protocol (FTP) traffic is found to perform well for medium-to-large networks. In the A & E scenario, Voice over Internet Protocol (VoIP) traffic is shown to generate very limited jitter and data loss. The performance is aligned with the Quality of Service (QoS) requirements. In the ICU scenario, the performance of video conference degrades with network size, thus, a QoS-enabled device is recommended to reduce the packet delay and data loss. IEEE 802.11a suits in hospital environment because it mitigates interference on the 2.4GHz band where most wireless devices operate.

Conceptualizing Emergency Department Scenarios

To handle problems and trends in emergency department (ED) operations, designers and decision makers often simulate and evaluate various case-specific scenarios before testing them in a real-life environment. However, conceptualizing broad possible scenarios for ED operations prior to simulation operationalization is usually neglected. The authors developed a methodology that integrates design of simulation experiments (DSE) as follows: 1) From a literature survey, they culled generic factors whose varying levels determine possible scenarios; 2) the authors drew up a set of generic interactions among these generic factors; 3) a questionnaire was constructed to serve as an instrument to gather the relevant information from management staff about relevant factors, their levels and interactions for a specific ED. Questionnaire responses support a schematic conceptualization of scenarios that should be simulated for a specific ED. They illustrate the application of the authors' methodology for conceptualization of ED simulation scenarios in two different EDs.

Concept and Types of Organizational Cultures of Hospitals

This chapter sets out to analyze the problem of defining the concept of organizational culture as well as models and typologies used in reference materials. It presents various issues of organizational culture: paradigms of organizational culture, definitions of organizational culture, and two-dimensional typologies of organizational culture. The single-dimensional classifications present the following dichotomies: 1) weak culture – strong culture, 2) positive culture – negative culture, 3) pragmatic culture – bureaucratic culture, 4) introvert culture – extrovert culture, 5) conservative culture – innovative culture, 6) hierarchic culture – egalitarian culture, 7) individualist culture – collectivist culture. Furthermore, this chapter includes: multidimensional typologies of organizational culture, corporate identity – alternative approach to organizational culture and relations between culture, and structure, strategy, and organization setting. Moreover, based on the quality pilot study, it strives to explain peculiarity of this concept in relation to Polish hospitals. Results of pilot studies of organizational cultures of hospitals in Poland relate to four hospitals in Lodz Province.

The Role of ICTs in the Management of Rare Chronic Diseases

This chapter outlines a study that examines the role of Information and Communication Technologies (ICTs) in management of a rare and chronic disease, hemophilia. Evidence in literature shows how the adoption of ICTs can improve the management of chronic conditions. Furthermore, these tools may also give response to rare diseases' needs, while greatly improving the quality of life of those patients. A Web-based application that was developed to facilitate communication between Healthcare Professionals (HCPs) and patients in a specific Hemophilia Treatment Center (HTC), to improve the utility and quality of clinical data and treatment information, as well as to help the management of resources involved in a specific rare chronic disease, represents a practical case presented in this chapter. This technological solution allows the management of inherited bleeding disorders, integrating, diffusing, and archiving large sets of data relating to the clinical practice of hemophilia care, more specifically the clinical practice at the Hematology Service of Coimbra Hospital Center.

The Sociotechnical Challenge of Integrating Telehealth and Telecare into Health and Social Care for the Elderly

Telehealth and telecare have been heralded as major mechanisms by which frail elderly people can continue to live at home but numerous pilot studies have not led to the adoption of these technologies as mainstream contributors to the health and social care of people in the community. This paper reviews why dissemination has proved difficult and concludes that one problem is that these technologies require considerable organisational changes if they are to be effective: successful implementation is not just a technical design issue but is a sociotechnical design challenge. The paper reviews the plans of 25 health communities in England to introduce integrated health and social care for the elderly. It concludes that these plans when implemented will produce organisational environments conducive to the mainstream deployment of telehealth and telecare. However, the plans focus on different kinds of integrated care and each makes different demands on telehealth and telecare. Progress on getting mainstream benefits from telehealth and telecare will therefore depend on building a number of different sociotechnical systems geared to different forms of integrated care and incorporating different forms of telehealth and telecare.

Utilization of Primary Health Services in Hong Kong

This chapter analyzes the issue of primary health care utilization in Hong Kong and introduces the case of Hong Kong where a special division between public and private sectors has developed in the field of primary health services. The chapter argues that in the foreseeable future, it is likely that the division of health care between the public and private sector will be maintained. In recent years, more and more individuals and families have purchased private health insurance so as to gain more options. The idea of universal health insurance was rejected by the public in recent consultations; the current alternative is government-regulated private insurance. Although private primary health services will continue as usual in the near future, public primary health services should be maintained or even expanded. Given the costliness of private services (especially specialist services), it is recommended that more resources should be invested in corresponding public health services.

Customer Strategy Definition in Elderly Care

With an aging global population, it is important that clinicians empower their patients. Empowering the patient-physician interaction leads to a more positive health outcome. This chapter discusses the potential of adopting Customer Relationship Management (CRM) as a way of guiding non-critical care services (i.e. linking the problems of customer-focused care expectation and resource allocation management). Implementation of CRM solutions would create value for patients by supporting trust and service creation; however, the chapter highlights a need for a common and systematic way to implement CRM solutions in the healthcare domain.

Resuscitating Team Roles within Wayburn Health System

Administrative leadership of Wayburn Health System decided to move forward with a training program to address communication between healthcare professionals within their emergency center. After a few sentinel events where errors had occurred that compromised patient safety due to miscommunication amongst healthcare team members, hospital administration decided that communication processes needed to be standardized within the emergency center during trauma resuscitations. Four hundred employees from various departments and disciplines would require training. An instructional designer was brought onto the project to ensure that training was customized to fit the specific needs of the trauma resuscitation team.