A Simple Model for a Complex Issue

System dynamics models can facilitate the understanding of complex and dynamic biomedical systems such as in HIV/AIDS. Untangling the dynamics among various population stocks (e.g., susceptible population, infected population, HIV population, AIDS population) can be used to investigate the effective points of interventions in the HIV/AIDS cycle. With that in mind, the authors have developed a system dynamics model that can be used to examine various policy decisions for the prevention and the treatment of HIV/AIDS. The specific objectives of their study was to examine the growing number of AIDS-related deaths in Canada. They used the authors’ dynamic simulation model to evaluate the impact of various HIV/AIDS policy intervention scenarios centred on the reduction of the number of AIDS deaths in Canada. Their analysis suggests that more lives will be saved if effective preventive and treatment programs are implemented simultaneously. A simultaneous implementation of these programs will also result in a much smaller HIV-infected and AIDS populations.

Predicting Diabetes amongst Native American Elders

One in three Americans will be diabetic by 2050, and the rate of diabetes is disproportionately high among Native Americans, especially among Native elders age 55 and older. Early identification and prevention strategies have been regarded as the cornerstone of preventative medicine. The objective of the authors’ research was to identify factors related to diabetes and their interactions specifically among Native elders and develop a simple prediction model which can be used by healthcare professionals while interacting with Native elders in remote or rural areas. Data from a survey of 18,078 Native American elders was used in their study. After eliminating outliers using Pearson’s residuals and Cook’s distance, the area under the receiver operating characteristic curve was 0.7812 for men and 0.7230 for women. The results from the authors’ analysis provide additional perspective on how diabetes affects Native elders thus helping healthcare providers and policy makers when dealing with these community members.

The Telematics Infrastructure

Today all OECD (Organization for Economic Cooperation and Development) countries are faced with the challenge of escalating healthcare costs. Most are agreed that e-health appears to offer a solution and thus we are witnessing the design, development and implementation of various e-health solutions. This is also true in Germany where the current focus is on the new e-health card concept. It is anticipated that the introduction of this e-health card will totally change the current healthcare system within Germany, primarily because it offers several new functions. Some of these functions are mandatory, while other functions are optional. Such an initiative however, brings with it several advantages and disadvantages. A particularly sensitive aspect here concerns data protection and data security. To address this consideration, the development of a new telematics infrastructure is critical and in some respects the backbone for the e-health card. Thus, the following provides an assessment of the telematics infrastructure behind the German e-health card.

Clinical Commissioning Groups in the UK

This paper investigates whether Knowledge Management (KM) tools and techniques would be useful to General Practitioners within the new UK Commissioning Consortia when they adopt the role of General Practitioners commissioners from the current Primary Care Trusts. Empirical data based on questionnaires were sent to a small sample group made up of General Practitioners, Primary Care Staff and Academics in addition to data collected from a set of one to one interviews with some of the sample group. The authors’ findings show that stakeholders (n=30) are not accustomed to using KM as a way to maximize existing knowledge of commissioning of services within the Primary Care Trust but it does show that they are not too far away from possibly realizing that some type of KM strategy would probably work for them. General Practitioners are already using some of the knowledge management tools under different guises. A lot of resources will be saved if General Practitioners can capture as much of the knowledge already available within the Primary Care Trust by incorporating KM tools and techniques.

PPP’s Application in Greek Health Infrastructure and Personnel’s Response

Financial crisis is particularly acute in Greece. Public Private Partnerships (PPPs), under these conditions, appear as a “reasonable” strategic decision. A PPP’s project implementation requires a high level of preparation, especially in the sensitive area of the National Health System (NHS). The implementation of PPPs projects in Health Sector, has recently initiated in Greece, while the relevant legal framework has been already voted since 2005. Many people express reservations about the extent and the content of this implementation. The aim of the current survey was to measure the satisfaction of health professionals in the public sector from the existing infrastructures and the assessment of their attitude to the prospect of PPP’s application to upgrade health infrastructure and health services. Results focus on the response of the hospital executive personnel towards PPP’s implementation. The research found a generally positive response to PPPs, while at the same time this approach is being characterized as a last resort. The positive reaction was identified in the involvement of the private sector, in providing support services during the contract, according to the current legislative framework. On the other hand, there is a significant opposition towards any prospect of transferring to the private investor, services related to medical and nursing care.

Situational Analysis of E-Health Initiative using ICT in Emergency Care Services

India, with its billion inhabitants, requires better emergency services to meet the growing demand for faster critical care facilitation. The scientific advances in the field of information and communication technology have contributed to the implementation of various e-health initiatives by various state governments within the country to improve the quality, access, and delivery of emergency care. “108 Emergency Response Service” is an e-health project established by the government of Tamilnadu state in India to render emergency services to the people. A qualitative study of the effectiveness of Information and Communication technologies in this Emergency Response Service (108 Emergency Service) in Coimbatore district of Tamilnadu state (http://www.coimbatore.tn.nic) was done and recommendations to increase the effectiveness were provided. The results reveal that the efficiency and effectiveness of 108 ERS could be greatly enhanced by providing better telecommunication facilities in rural areas and by deploying Global Positioning System (GPS) and Geographic Information System (GIS) and Automatic Vehicle Location (AVL) technologies to reduce the response time of the emergency vehicles.

Quality Assurance and Evaluation of Healthcare Reform Initiatives

This article describes a model of health-care services that ensure the high quality of health-care service and effective brand creation for a hospital. The problems described here that are connected to improving the quality of health care in Poland indicates that high quality of health care builds a positive and strong image of a health-care unit on the medical market. The contents of this article involve basic definitions of quality in health care and also the way the quality is understood and perceived from patient’s and hospital’s point of view. The article also describes a health care quality model, to which health care units should aspire in order to create a positive picture of said units, simultaneously improving and maintaining high quality of health care services. The article investigates the quality factors of health care services, which influence the healthcare units’ brand, its functioning on the market and patient-perceived quality of services. The described management model, which ensures efficient brand-building of healthcare units through services’ quality, takes into account changes in healthcare system and does so in order to ensure the improvement in healthcare units’ functioning.

The Implementation and Future Directions of e-Health Information Policy

Information technology has the potential to transform working procedure in the health care sector. Clinicians have used Health Information Management and Technology (HIM&T) for more than two decades to assist in achieving better healthcare delivery outcomes. Medical knowledge is too complex for humans to master in a single mind, and to remember everything about each patient. Medical data consist of many kinds of data from different sources, requiring the development of many medical decision support systems. Creating and indexing records for hospitals and health systems present difficult challenges, because the medical records contain sensitive information. Increased computerization and other policy factors have contributed to privacy risks. Transforming from paper-based to Electronic Medical Records (EMR) allows healthcare providers to share information across their care ecosystem. Access to this digital lifeline, connecting the EMR to the digital web platforma, is critical to saving lives, preventing medical errors and improving efficiency of healthcare delivery. Choosing the international classification systems for patients, ICD, DRGs, grouped patients according to the resources consumption required for treatment and other clinical characteristics. Information Technology provides solutions to this problem. A vital element of healthcare delivery is to ensure that the patient is always at the centre of everything clinicians do.

Analysis of Slot Allocation Strategies and their Impacts on Appointment Waiting Time in Context of Outpatient Clinics

One prevailing problem in outpatient clinics with appointment systems in Singapore is that patients have to wait a long time for an available slot once they make requests. Such a long wait may negatively impact on the access to healthcare facilities, patient safety and satisfaction, etc. In recent years, such a problem is becoming worse due to the aging society and growing population. Besides the pressure of increasing demand, healthcare service providers in outpatient clinics are facing other challenges such as the complexity of patient request types, e.g., urgent or normal requests, requests for new or follow-up visit, etc. How to allocate the limited slots to meet the requirements of different requests is one of the performance measurements in outpatient clinics. In this paper, discrete event simulation is applied to study different slot allocation strategies and their impacts on waiting time. The dynamics between new visits and follow-up visits are analyzed as well.