Abstract: Telehealth is an advanced technology using digital information and telecommunication facilities that provide access to health services from a distance. It slows the transmission factor of COVID-19, especially for elderly patients and patients with chronic diseases during the pandemic. Therefore, understanding patient perspectives on telehealth services and the factors impacting their option of telehealth service will shed light on the measures that healthcare providers can take to improve the quality of telehealth services. This study aimed to evaluate perceptions of telehealth services among different patient groups and explore various aspects of telehealth utilization in the United States during the COVID-19 pandemic. An online survey distributed via social media platforms was used to collect research data. In addition to the descriptive statistics, both correlation and regression analyses were conducted to test research hypotheses. The empirical results highlighted that the factors such as accessibility to telehealth services and the type of specialty clinics that the patients required play important roles in the effectiveness of telehealth services they received. However, the results found that patients’ waiting time to receive telehealth services and their annual income did not significantly influence their desire to select receiving healthcare services via telehealth. The limitations of the study and future research directions are discussed.
Abstract: Technological innovation plays a crucial role in virtual healthcare services. A growing number of telehealth platforms are concentrating on using digital tools to improve the quality and availability of care. As a result, telehealth represents an opportunity to redesign the way health services are delivered. The research objective is to discover a new business model for digital health services and related industries to participate with telehealth solutions. The business opportunity is valuable for healthcare investors as a startup company to further investigations or implement the telehealth platform. The paper presents a digital healthcare business model and business opportunities to related industries. These include digital healthcare services extending from a traditional business model and use cases of business opportunities to related industries. Although there are enormous business opportunities, telehealth is still challenging due to the patient adaption and digital transformation process within a healthcare organization.
Abstract: This work presents the various perspectives, dimensions, components and definitions given to quality in the operations management (OM) and healthcare services (HCS) literature in time, highlighting gaps and learning opportunities between the two disciplines through a thorough search into their rich and distinct body of knowledge. Greater and new insights about the general nature of quality are obtained with findings such as in OM, quality has been approached in six fairly distinct paradigms (excellence, value, conformity to specifications, attributes, satisfaction and meeting or exceeding customer expectations), whereas in HCS, two approaches are prominent (Donabedian’s structure, process and outcomes model and Lohr and Schroeder’s circumscribed definition). The two disciplines views on quality seem to have progressed much in parallel with little cross-learning from each other. This work then proposes an encompassing definition of quality as a lever and suggests further research and development avenues for a better use of the concept of quality by academics and practitioners alike toward the goals of greater organizational performance and improved management in healthcare and possibly other service domains.
Abstract: Being a patient with a chronic disease is both a physical and emotional experience. The ability to recognize a patient’s emotional health is an important part of a health care provider’s skills. For the purposes of this paper, emotional health is viewed as the way that we feel, and the way that our feelings affect us. Understanding the patient’s emotional health leads to improved provider-patient relationships and health outcomes. For example, when a patient first hears his or her diagnosis from a provider, they might find it difficult to cope with their emotions. Struggling to cope with emotions interferes with the patient’s ability to read, understand, and act on health information and services. As a result, the patient becomes more frustrated and confused, creating barriers to accessing healthcare services. These barriers are challenging for both the patient and their healthcare providers. There are five basic emotions that are part of who we are and are always with us: fear, anger, sadness, joy, and compassion. Living with a chronic disease however can cause a patient to experience and express these emotions in new and unique ways. Within the provider-patient relationship, there needs to be an understanding that each patient experiences these five emotions and, experiences them at different times. In response to this need, the paper highlights a health promotion framework for patients with chronic disease. This framework emphasizes the emotional health of patients.
Abstract: This study investigates the impact of public healthcare facilities and socio-economic circumstances on the status of child health in Pakistan. The complete analysis is carried out in correspondence with fourth and sixth millennium development goals. Further, the health variables chosen are also inherited from targeted indicators of the mentioned goals (MDGs). Trends in the Human Opportunity Index (HOI) for both health inequalities and coverage are analyzed using the Pakistan Social and Living Standards Measurement (PLSM) data set for 2001-02 to 2012-13 at the national and provincial level. To reveal the relative importance of each circumstance in achieving the targeted values for child health, Shorrocks decomposition is applied on HOI. The annual point average growth rate of HOI is used to simulate the time period for the achievement of target set by MDGs and universal access also. The results indicate an improvement in HOI for a reduction in child mortality rates from 52.1% in 2001-02 to 67.3% in 2012-13, which confirms the availability of healthcare opportunities to a larger segment of society. Similarly, immunization against measles and other diseases such as Diphtheria, Polio, Bacillus Calmette-Guerin (BCG), and Hepatitis has also registered an improvement from 51.6% to 69.9% during the period of study at the national level. On a positive note, no gender disparity has been found for child health indicators and that health outcome is mostly affected by the parental and geographical features and availability of health infrastructure. However, the study finds that this achievement has been uneven across provinces. Pakistan is not only lagging behind in achieving its health goals, disappointingly with the current rate of health care provision, but it will take many additional years to achieve its targets.
Abstract: The management of pharmacotherapy and the process of dispensing medicines is becoming critical in clinical pharmacy due to the increase of incidence and prevalence of chronic diseases, the complexity and customization of therapeutic regimens, the introduction of innovative and more expensive medicines, the unbalanced relation between expenditure and revenue as well as due to the lack of rationalization associated with medication use. For these reasons, co-payments emerged in Europe in the 70s and have been applied over the past few years in healthcare. Co-payments lead to a rationing and rationalization of user’s access under healthcare services and products, and simultaneously, to a qualification and improvement of the services and products for the end-user. This analysis, under hospital practices particularly and co-payment strategies in general, was carried out on all the European regions and identified four reference countries, that apply repeatedly this tool and with different approaches. The structure, content and adaptation of European co-payments were analyzed through 7 qualitative attributes and 19 performance indicators, and the results expressed in a scorecard, allowing to conclude that the German models (total score of 68,2% and 63,6% in both elected co-payments) can collect more compliance and effectiveness, the English models (total score of 50%) can be more accessible, and the French models (total score of 50%) can be more adequate to the socio-economic and legal framework. Other European models did not show the same quality and/or performance, so were not taken as a standard in the future design of co-payments strategies. In this sense, we can see in the co-payments a strategy not only to moderate the consumption of healthcare products and services, but especially to improve them, as well as a strategy to increment the value that the end-user assigns to these services and products, such as medicines.
Abstract: This qualitative study aimed to describe the opinions in relation to humanized care emerging from the volunteer activities of nursing students at Boromarajonani College of Nursing, Chonburi, Thailand. One hundred and twenty-seven second-year nursing students participated in this study. The volunteer activity model was composed of preparation, implementation, and evaluation through a learning log, in which students were encouraged to write their daily activities after completing practical training at the healthcare center. The preparation content included three main categories: service minded, analytical thinking, and client participation. The preparation process took over three days that accumulates up to 20 hours only. The implementation process was held over 10 days, but with a total of 70 hours only, with participants taking part in volunteer work activities at a healthcare center. A learning log was used for evaluation and data were analyzed using content analysis. The findings were as follows. With service minded, there were two subcategories that emerged from volunteer activities, which were service minded towards patients and within themselves. There were three categories under service minded towards patients, which were rapport, compassion, and empathy service behaviors, and there were four categories under service minded within themselves, which were self-esteem, self-value, management potential, and preparedness in providing good healthcare services. In line with analytical thinking, there were two components of analytical thinking, which were analytical skill for their works and analytical thinking for themselves. There were four subcategories under analytical thinking for their works, which were evidence based thinking, real situational thinking, cause analysis thinking, and systematic thinking, respectively. There were four subcategories under analytical thinking for themselves, which were comparative between themselves, towards their clients that leads to the changing of their service behaviors, open-minded thinking, modernized thinking, and verifying both verbal and non-verbal cues. Lastly, there were three categories under participation, which were mutual rapport relationship; reconsidering client’s needs services and providing useful health care information.
Abstract: In Rwanda, many healthcare organizations are still using a paper based patients’ data record system although it still present weaknesses to share health patients’ information across different services when necessary. In developed countries, the EHR has been put in place to revolutionize the paper based record system but still the EHR has some challenges related to privacy, security, or interoperability. The purpose of this research was to assess the existing patients’ data record system in healthcare sector in Rwanda, see what an EHR can improve to the system in place and assess the acceptance of EHR as system which is interoperable, very secure and interoperable and see whether stakeholders are ready to adopt the system. The case based methodology was used and TAM theoretical framework to design the questionnaire for the survey. A judgmental sample across two cases, CHUB and Hopital de Nemba, has been selected and SPSS has been used for descriptive statistics. After a qualitative analysis, the findings showed that the paper based record is useful, gives complete information about the patient, protects the privacy of patients but it is still less secure and less interoperable. The respondents shown that they are ready to use the proposed EHR System and want it secure, capable of enforcing the privacy but still they are not all ready for the interoperability. A conclusion has been formulated; recommendations and further research have been proposed.
Abstract: Background: To improve the delivery of paediatric
healthcare in low resource settings, Community Health Workers
(CHW) have been provided with a paper-based set of protocols
known as Community Case Management (CCM). Yet research has
shown that CHW adherence to CCM guidelines is poor, ultimately
impacting health service delivery. Digitising the CCM guidelines via
mobile technology is argued in extant literature to improve CHW
adherence. However, little research exist which outlines how (a) this
process can be digitised and (b) adherence could be improved as a
result. Aim: To explore how an electronic mobile version of CCM
(eCCM) can overcome issues associated with the paper-based CCM
protocol (inadequate adherence to guidelines) vis-à-vis service
blueprinting. This service blueprint will outline how (a) the CCM
process can be digitised using mobile Clinical Decision Support
Systems software to support clinical decision-making and (b)
adherence can be improved as a result. Method: Development of a
single service blueprint for a standalone application which visually
depicts the service processes (eCCM) when supporting the CHWs,
using an application known as Supporting LIFE (SL eCCM app) as
an exemplar. Results: A service blueprint is developed which
illustrates how the SL eCCM app can be utilised by CHWs to assist
with the delivery of healthcare services to children. Leveraging
smartphone technologies can (a) provide CHWs with just-in-time
data to assist with their decision making at the point-of-care and (b)
improve CHW adherence to CCM guidelines. Conclusions: The
development of the eCCM opens up opportunities for the CHWs to
leverage the inherent benefit of mobile devices to assist them with
health service delivery in rural settings. To ensure that benefits are
achieved, it is imperative to comprehend the functionality and form
of the eCCM service process. By creating such a service blueprint for
an eCCM approach, CHWs are provided with a clear picture
regarding the role of the eCCM solution, often resulting in buy-in
from the end-users.
Abstract: During the post-Civil War era, the city of Nashville,
Tennessee, had the highest mortality rate in the United States. The
elevated death and disease rates among former slaves were
attributable to lack of quality healthcare. To address the paucity of
healthcare services, Meharry Medical College, an institution with the
mission of educating minority professionals and serving the
underserved population, was established in 1876.
Purpose: The social ecological framework and partial least squares
(PLS) path modeling were used to quantify the impact of
socioeconomic status and adverse health outcome on primary care
professionals serving the disadvantaged community. Thus, the study
results could demonstrate the accomplishment of the College’s
mission of training primary care professionals to serve in underserved
areas.
Methods: Various statistical methods were used to analyze alumni
data from 1975 – 2013. K-means cluster analysis was utilized to
identify individual medical and dental graduates in the cluster groups
of the practice communities (Disadvantaged or Non-disadvantaged
Communities). Discriminant analysis was implemented to verify the
classification accuracy of cluster analysis. The independent t-test was
performed to detect the significant mean differences of respective
clustering and criterion variables. Chi-square test was used to test if
the proportions of primary care and non-primary care specialists are
consistent with those of medical and dental graduates practicing in
the designated community clusters. Finally, the PLS path model was
constructed to explore the construct validity of analytic model by
providing the magnitude effects of socioeconomic status and adverse
health outcome on primary care professionals serving the
disadvantaged community.
Results: Approximately 83% (3,192/3,864) of Meharry Medical
College’s medical and dental graduates from 1975 to 2013 were
practicing in disadvantaged communities. Independent t-test confirmed the content validity of the cluster analysis model. Also, the
PLS path modeling demonstrated that alumni served as primary care
professionals in communities with significantly lower socioeconomic
status and higher adverse health outcome (p < .001). The PLS path
modeling exhibited the meaningful interrelation between primary
care professionals practicing communities and surrounding
environments (socioeconomic statues and adverse health outcome),
which yielded model reliability, validity, and applicability.
Conclusion: This study applied social ecological theory and
analytic modeling approaches to assess the attainment of Meharry
Medical College’s mission of training primary care professionals to
serve in underserved areas, particularly in communities with low
socioeconomic status and high rates of adverse health outcomes. In
summary, the majority of medical and dental graduates from Meharry
Medical College provided primary care services to disadvantaged
communities with low socioeconomic status and high adverse health
outcome, which demonstrated that Meharry Medical College has
fulfilled its mission. The high reliability, validity, and applicability of
this model imply that it could be replicated for comparable
universities and colleges elsewhere.
Abstract: The study of organisations’ information security
cultures has attracted scholars as well as healthcare services industry
to research the topic and find appropriate tools and approaches to
develop a positive culture. The vast majority of studies in Saudi
national health services are on the use of technology to protect and
secure health services information. On the other hand, there is a lack
of research on the role and impact of an organisation’s cultural
dimensions on information security. This research investigated and
analysed the role and impact of cultural dimensions on information
security in Saudi Arabia health service. Hypotheses were tested and
two surveys were carried out in order to collect data and information
from three major hospitals in Saudi Arabia (SA). The first survey
identified the main cultural-dimension problems in SA health
services and developed an initial information security culture
framework model. The second survey evaluated and tested the
developed framework model to test its usefulness, reliability and
applicability. The model is based on human behaviour theory, where
the individual’s attitude is the key element of the individual’s
intention to behave as well as of his or her actual behaviour. The
research identified a set of cultural and sub-cultural dimensions in SA
health information security and services.
Abstract: Lean technique is very important in the service and industrial fields. It is defined as an effective tool to eliminate the wastes. In lean the wastes are defined as anything which does not add value to the end product. There are wastes that can be avoided, but some are unavoidable for many reasons.
The present study aims to apply the principles of lean in two different sectors, healthcare and industry. Two case studies have been selected to apply the experimental work. The first case was Al-Jalaa Hospital, while the second case study was the Technical Company of Aluminum Sections in Benghazi, LIBYA. In both case studies the Value Stream Map (VSM) of the current state has been constructed. The proposed plans have been implemented by merging or eliminating procedures or processes.
The results obtained from both case studies showed improvement in Capacity, Idle time and Utilized time.
Abstract: Automated intelligent, clinical decision support systems generally promote to help or to assist physicians and patients regarding to prevention of diseases or treatment of illnesses using computer represented knowledge and information. In this paper, assessment factors affecting the proper design of clinical decision support system were investigated. The required procedure steps for gathering the data from clinical trial and extracting the information from large volume of healthcare repositories were listed, which are necessary for validation and verification of evidence-based implementation of clinical decision support system. The goal of this paper is to extract useful evaluation factors affecting the quality of the clinical decision support system in the design, development, and implementation of a computer-based decision support system.
Abstract: Knowledge is increasingly recognised in this, the
knowledge era, as a strategic resource, by public sector organisations,
in view of the public sector reform initiatives. People and knowledge
play a vital role in attaining improved organisational performance
and high service quality. Many government departments in the public
sector have started to realise the importance of knowledge
management in streamlining their operations and processes. This
study focused on knowledge management in the public healthcare
service organisations, where the concept of service provider
competitiveness pales to insignificance, considering the huge
challenges emanating from the healthcare and public sector reforms.
Many government departments are faced with challenges of
improving organisational performance and service delivery,
improving accountability, making informed decisions, capturing the
knowledge of the aging workforce, and enhancing partnerships with
stakeholders.
The purpose of this paper is to examine the knowledge
management practices of the Gauteng Department of Health in South
Africa, in order to understand how knowledge management practices
influence improvement in organisational performance and healthcare
service delivery. This issue is explored through a review of literature
on dominant views on knowledge management and healthcare service
delivery, as well as results of interviews with, and questionnaire
responses from, the general staff of the Gauteng Department of
Health. Web-based questionnaires, face-to-face interviews and
organisational documents were used to collect data. The data were
analysed using both the quantitative and qualitative methods. The
central question investigated was: To what extent can the conditions
required for successful knowledge management be observed, in order
to improve organisational performance and healthcare service
delivery in the Gauteng Department of Health.
The findings showed that the elements of knowledge management
capabilities investigated in this study, namely knowledge creation,
knowledge sharing and knowledge application, have a positive,
significant relationship with all measures of organisational
performance and healthcare service delivery. These findings thus
indicate that by employing knowledge management principles, the
Gauteng Department of Health could improve its ability to achieve its
operational goals and objectives, and solve organisational and
healthcare challenges, thereby improving organisational performance
and enhancing healthcare service delivery in Gauteng.
Abstract: Due to the rise of aging population, effective utilization
of healthcare resources has become an important issue. With the
advance of ICT technology, the application of tele-healthcare service
has received more attention than ever. The main purpose of this
research is to investigate how to conduct innovative design for
tele-healthcare service based on user-s perspectives. First, the
healthcare service blueprint was used to describe the processes
of tele-healthcare service delivery, and then construct PZB service
quality gap model based on the literature and practitioners-
interviews. Next, TRIZ theory is applied to implement service
innovation. We found the proposed service innovation procedures can
effectively improve the quality of service design.
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: Biological, psychological and social experiences and
perceptions of healthcare services in patients medically diagnosed of
coronary heart disease were investigated using a sample of 10
participants whose responses to the in-depth interview questions
were analyzed based on inter-and-intra-case analyses. The results
obtained revealed that advancing age, single status, divorce and/or
death of spouse and the issue of single parenting negatively impacted
patients- biopsychosocial experiences. The patients- experiences of
physical signs and symptoms, anxiety and depression, past serious
medical conditions, use of self-prescribed medications, family
history of poor mental/medical or physical health, nutritional
problems and insufficient physical activities heightened their risk of
coronary attack. Collectivist culture served as a big source of relieve
to the patients. Patients- temperament, experience of different
chronic life stresses/challenges, mood alteration, regular drinking,
smoking/gambling, and family/social impairments compounded their
health situation. Patients were satisfied with the biomedical services
rendered by the healthcare personnel, whereas their psychological
and social needs were not attended to. Effective procedural treatment
model, a holistic and multidimensional approach to the treatment of
heart disease patients was proposed.
Abstract: Recent advancements in sensor technologies and
Wireless Body Area Networks (WBANs) have led to the
development of cost-effective healthcare devices which can be used
to monitor and analyse a person-s physiological parameters from
remote locations. These advancements provides a unique opportunity
to overcome current healthcare challenges of low quality service
provisioning, lack of easy accessibility to service varieties, high costs
of services and increasing population of the elderly experienced
globally. This paper reports on a prototype implementation of an
architecture that seamlessly integrates Wireless Body Area Network
(WBAN) with Web services (WS) to proactively collect
physiological data of remote patients to recommend diagnostic
services. Technologies based upon WBAN and WS can provide
ubiquitous accessibility to a variety of services by allowing
distributed healthcare resources to be massively reused to provide
cost-effective services without individuals physically moving to the
locations of those resources. In addition, these technologies can
reduce costs of healthcare services by allowing individuals to access
services to support their healthcare. The prototype uses WBAN body
sensors implemented on arduino fio platforms to be worn by the
patient and an android smart phone as a personal server. The
physiological data are collected and uploaded through GPRS/internet
to the Medical Health Server (MHS) to be analysed. The prototype
monitors the activities, location and physiological parameters such as
SpO2 and Heart Rate of the elderly and patients in rehabilitation.
Medical practitioners would have real time access to the uploaded
information through a web application.