Abstract: This study used Item Analysis, Exploratory Factor
Analysis (EFA) and Reliability Analysis (Cronbach-s α value) to
exam the Questions which selected by the Delphi method based on the
issue of “Socio-technical system (STS)" and user-centered
perspective. A structure questionnaire with seventy-four questions
which could be categorized into nine dimensions (healthcare
environment, organization behaviour, system quality, medical data
quality, service quality, safety quality, user usage, user satisfaction,
and organization net benefits) was provided to evaluate EMR of the
Taiwanese healthcare environment.
Abstract: Medical services are usually provided in hospitals; however, in developing country, some rural residences have fewer opportunities to access in healthcare services due to the limitation of transportation communication. Therefore, in Thailand, there are charitable organizations operating to provide medical treatments to these people by shifting the medical services to operation sites; this is commonly known as mobile medical service. Operation routing is important for the organization to reduce its transportation cost in order to focus more on other important activities; for instance, the development of medical apparatus. VRP is applied to solve the problem of high transportation cost of the studied organization with the searching techniques of saving algorithm to find the minimum total distance of operation route and satisfy available time constraints of voluntary medical staffs.
Abstract: Expert systems are used extensively in many domains.
This paper discusses the use of medical expert systems in Pakistan.
Countries all over the world pay special attention on health facilities.
A country like Pakistan faces a lot of trouble in health sector.
Several attempts have been made in Pakistan to improve the health
conditions of the people but the situation is still not encouraging.
There is a shortage of doctors and other trained personnel in
Pakistan. Expert systems can play a vital role in such cases where the
medical expert is not readily available. The purpose of this paper is
to analyze the role that such systems can play in improving the health
conditions of the people in Pakistan.
Abstract: Evidence-based medicine is a new direction in modern healthcare. Its task is to prevent, diagnose and medicate diseases using medical evidence. Medical data about a large patient population is analyzed to perform healthcare management and medical research. In order to obtain the best evidence for a given disease, external clinical expertise as well as internal clinical experience must be available to the healthcare practitioners at right time and in the right manner. External evidence-based knowledge can not be applied directly to the patient without adjusting it to the patient-s health condition. We propose a data warehouse based approach as a suitable solution for the integration of external evidence-based data sources into the existing clinical information system and data mining techniques for finding appropriate therapy for a given patient and a given disease. Through integration of data warehousing, OLAP and data mining techniques in the healthcare area, an easy to use decision support platform, which supports decision making process of care givers and clinical managers, is built. We present three case studies, which show, that a clinical data warehouse that facilitates evidence-based medicine is a reliable, powerful and user-friendly platform for strategic decision making, which has a great relevance for the practice and acceptance of evidence-based medicine.
Abstract: Background, measuring an individual-s Health
Literacy is gaining attention, yet no appropriate instrument is available
in Taiwan. Measurement tools that were developed and used in
western countries may not be appropriate for use in Taiwan due to a
different language system. Purpose of this research was to develop a
Health Literacy measurement instrument specific for Taiwan adults.
Methods, several experts of clinic physicians; healthcare
administrators and scholars identified 125 common used health related
Chinese phrases from major medical knowledge sources that easy
accessible to the public. A five-point Likert scale is used to measure
the understanding level of the target population. Such measurement is
then used to compare with the correctness of their answers to a health
knowledge test for validation. Samples, samples under study were
purposefully taken from four groups of people in the northern
Pingtung, OPD patients, university students, community residents,
and casual visitors to the central park. A set of health knowledge index
with 10 questions is used to screen those false responses. A sample
size of 686 valid cases out of 776 was then included to construct this
scale. An independent t-test was used to examine each individual
phrase. The phrases with the highest significance are then identified
and retained to compose this scale. Result, a Taiwan Health Literacy
Scale (THLS) was finalized with 66 health-related phrases under nine
divisions. Cronbach-s alpha of each division is at a satisfactory level
of 89% and above. Conclusions, factors significantly differentiate the
levels of health literacy are education, female gender, age, family
members of stroke victims, experience with patient care, and
healthcare professionals in the initial application in this study..
Abstract: Nowadays pharmaceutical care departments located in
hospitals are amongst the important pillars of the healthcare system.
The aim of this study was to evaluate quality of hospital drugstores
affiliated with Kermanshah University of Medical Sciences.
In this cross-sectional study a validated questionnaire was used.
The questionnaire was filled in by the one of the researchers in all
seventeen hospital drugstores located in the teaching and nonteaching
hospitals affiliated with Kermanshah University of Medical
Sciences. The results shows that in observed hospitals,24% of
pharmacy environments, 25% of pharmacy store and storage
conditions, 49% of storage procedure, 25% of ordering drugs and
supplies, 73% of receiving supplies (proper procedure are fallowed
for receiving supplies), 35% of receiving supplies (prompt action
taken if deterioration of drugs received is suspected), 23.35% of
drugs delivery to patients and finally 0% of stock cards are used for
proper inventory control have full compliance with standards.
Abstract: In this paper the authors present the framework of a
system for assisting users through counseling on personal health, the
Personal Health Assistance Service Expert System (PHASES).
Personal health assistance systems need Personal Health Records
(PHR), which support wellness activities, improve the understanding
of personal health issues, enable access to data from providers of
health services, strengthen health promotion, and in the end improve
the health of the population. This is especially important in societies
where the health costs increase at a higher rate than the overall
economy. The most important elements of a healthy lifestyle are
related to food (such as balanced nutrition and diets), activities for
body fitness (such as walking, sports, fitness programs), and other
medical treatments (such as massage, prescriptions of drugs). The
PHASES framework uses an ontology of food, which includes
nutritional facts, an expert system keeping track of personal health
data that are matched with medical treatments, and a comprehensive
data transfer between patients and the system.
Abstract: This study investigates the relationship between the reliability of critical medical equipment (CME) and the effectiveness of CME maintenance management strategies in relation to patient outcomes in 84 public hospitals of a top 20 OECD country. The work has examined the effectiveness of CME maintenance management strategies used by the public hospital system of a large state run health organization. The conceptual framework was designed to examine the significance of the relationship between six variables: (1) types of maintenance management strategies, (2) maintenance services, (3) maintenance practice, (4) medical equipment reliability, (5) maintenance costs and (6) patient outcomes. The results provide interesting insights into the effectiveness of the maintenance strategies used. For example, there appears to be about a 1 in 10 000 probability of failure of anesthesia equipment, but these seem to be confined to specific maintenance situations. There are also some findings in relation to outsourcing of maintenance. For each of the variables listed, results are reported in relation to the various types of maintenance strategies and services. Decision-makers may use these results to evaluate more effective maintenance strategies for their CME and generate more effective patient outcomes.
Abstract: Psychoacoustics has become a potential area of research due to the growing interest of both laypersons and medical and mental health professionals. Non invasive brain computer interface like Electroencephalography (EEG) is widely being used in this field. An attempt has been made in this paper to examine the response of EEG signals to acoustic stimuli further analyzing the brain electrical activity. The real time EEG is acquired for 6 participants using a cost effective and portable EMOTIV EEG neuro headset. EEG data analysis is further done using EMOTIV test bench, EDF browser and EEGLAB (MATLAB Tool) application software platforms. Spectral analysis of acquired neural signals (AF3 channel) using these software platforms are clearly indicative of increased brain activity in various bands. The inferences drawn from such an analysis have significant correlation with subject’s subjective reporting of the experiences. The results suggest that the methodology adopted can further be used to assist patients with sleeping and depressive disorders.
Abstract: Problem based learning is one of the highly acclaimed learning methods in medical education since its first introduction at Mc-Master University in Canada in the 1960s. It has now been adopted as a teaching learning method in many medical colleges of Nepal. B.P. Koirala Institute of Health Sciences (BPKIHS), a health science deemed university is the second institute in Nepal to establish problem-based learning academic program and need-based teaching approach hence minimizing teaching through lectures since its inception. During the first two years of MBBS course, the curriculum is divided into various organ-systems incorporated with problem-based learning exercise each of one week duration.
Abstract: Medical care is vital for our life, health and well-being. But the waste generated from medical activities can be hazardous, toxic and even lethal because of their high potential for diseases transmission. The hazardous and toxic parts of waste from healthcare establishments comprising infectious, medical and radioactive material as well as sharps constitute a grave risks to mankind and the environment, if these are not properly treated / disposed or are allowed to be mixed with other municipal waste. In Nigeria, practical information on this aspect is inadequate and research on the public health implications of poor management of medical wastes is few and limited in scope. Findings drawn from Literature particularly in the third world countries highlights financial problems, lack of awareness of risks involved in MWM, lack of appropriate legislation and lack of specialized MWM staff. The paper recommends how MWM practices can be improved in medical facilities.
Abstract: Brain tumor is inherently serious and life-threatening disease. Brain tumor builds the intracranial pressure in the brain, by shifting the brain or pushing against the skull, and also damaging nerves and healthy brain tissues. This intracranial pressure affects and interferes with normal brain functionality, which results in generation of abnormal electrical activities from brain. With recent development in the medical engineering and instruments, EEG instruments are able to record the brain electric activities with high accuracy, which establishes EEG as a primary tool for diagnosing the brain abnormalities. Research scholars and general physicians, often face difficulty in understanding EEG patterns. This paper presents the EEG patterns associated with brain tumor by combing medicine theory and neurologist experience. Paper also explains the pros-cons of the EEG based brain tumor identification.
Abstract: Medical image is an integral part of e-health care and e-diagnosis system. Medical image watermarking is widely used to protect patients’ information from malicious alteration and manipulation. The watermarked medical images are transmitted over the internet among patients, primary and referred physicians. The images are highly prone to corruption in the wireless transmission medium due to various noises, deflection, and refractions. Distortion in the received images leads to faulty watermark detection and inappropriate disease diagnosis. To address the issue, this paper utilizes error correction code (ECC) with (8, 4) Hamming code in an existing watermarking system. In addition, we implement the high complex ECC on a graphics processing units (GPU) to accelerate and support real-time requirement. Experimental results show that GPU achieves considerable speedup over the sequential CPU implementation, while maintaining 100% ECC efficiency.
Abstract: Supplier evaluation and selection is one of the most important components of an effective supply chain management system. Due to the expanding competition in healthcare, selecting the right medical device suppliers offers great potential for increasing quality while decreasing costs. This paper proposes a fuzzy decision making approach for medical supplier selection. A real-world medical device supplier selection problem is presented to illustrate the application of the proposed decision methodology.
Abstract: Ageing population is a global trend; therefore the need of care service has been increasing dramatically. There are three basic forms of service delivered to the elderly: institution, community, and home. Particularly, the institutional service can be seen as an extension of medical service. The nursing home or so-called care home which is equipped with professional staff and facilities can provide a variety of service including rehabilitation service, short-term care, and long term care. Similar to hospital and other health care service, care home service do need to provide quality and cost-effective service to satisfy the dwellers. The main purpose of this paper is to show how lean thinking and service innovation can be applied to care home operation. The issues and key factors of implementing lean practice are discussed.
Abstract: The proliferation of health data standards today is somewhat overlapping and conflicting, resulting in market confusion and leading to increasing proprietary interests. The government role and support in standardization for health data are thought to be crucial in order to establish credible standards for the next decade, to maximize interoperability across the health sector, and to decrease the risks associated with the implementation of non-standard systems. The normative literature missed out the exploration of the different steps required to be undertaken by the government towards the development of national health data standards. Based on the lessons learned from a qualitative study investigating the different issues to the adoption of health data standards in the major tertiary hospitals in Saudi Arabia and the opinions and feedback from different experts in the areas of data exchange and standards and medical informatics in Saudi Arabia and UK, a list of steps required towards the development of national health data standards was constructed. Main steps are the existence of: a national formal reference for health data standards, an agreed national strategic direction for medical data exchange, a national medical information management plan and a national accreditation body, and more important is the change management at the national and organizational level. The outcome of this study can be used by academics and practitioners to develop the planning of health data standards, and in particular those in developing countries.
Abstract: One of the main biomedical problem lies in detecting dependencies in semi structured data. Solution includes biomedical portal and algorithms (integral rating health criteria, multidimensional data visualization methods). Biomedical portal allows to process diagnostic and research data in parallel mode using Microsoft System Center 2012, Windows HPC Server cloud technologies. Service does not allow user to see internal calculations instead it provides practical interface. When data is sent for processing user may track status of task and will achieve results as soon as computation is completed. Service includes own algorithms and allows diagnosing and predicating medical cases. Approved methods are based on complex system entropy methods, algorithms for determining the energy patterns of development and trajectory models of biological systems and logical–probabilistic approach with the blurring of images.
Abstract: In this paper, we propose a multi-agent intelligent
system that is used for monitoring the health conditions of elderly
people. Monitoring the health condition of elderly people is a
complex problem that involves different medical units and requires
continuous monitoring. Such expert system is highly needed in rural
areas because of inadequate number of available specialized
physicians or nurses. Such monitoring must have autonomous
interactions between these medical units in order to be effective. A
multi-agent system is formed by a community of agents that
exchange information and proactively help one another to achieve the
goal of elderly monitoring. The agents in the developed system are
equipped with intelligent decision maker that arms them with the
rule-based reasoning capability that can assist the physicians in
making decisions regarding the medical condition of elderly people.
Abstract: Health analytics (HA) is used in healthcare systems
for effective decision making, management and planning of
healthcare and related activities. However, user resistances, unique
position of medical data content and structure (including
heterogeneous and unstructured data) and impromptu HA projects
have held up the progress in HA applications. Notably, the accuracy
of outcomes depends on the skills and the domain knowledge of the
data analyst working on the healthcare data. Success of HA depends
on having a sound process model, effective project management and
availability of supporting tools. Thus, to overcome these challenges
through an effective process model, we propose a HA process model
with features from rational unified process (RUP) model and agile
methodology.
Abstract: Medical imaging technology has experienced a
dramatic change in the last few years. Medical imaging refers to the
techniques and processes used to create images of the human body
(or parts thereof) for various clinical purposes such as medical
procedures and diagnosis or medical science including the study of
normal anatomy and function. With the growth of computers and
image technology, medical imaging has greatly influenced the
medical field. The diagnosis of a health problem is now highly
dependent on the quality and the credibility of the image analysis.
This paper deals with the various aspects and types of medical
imaging.