Abstract: In order to prevent overburdened courts, rising costs of litigation, and lengthy trial resolutions, the Law on Mediation for Civil Disputes was enacted, which was aimed at defining the procedure and guiding principles for dispute resolutions under Civil Law, in 2012. This “Mediation Code” also applies for civil healthcare disputes in Turkey. Aside from mediation, reconciliation, governed by Articles 253-255 of Criminal Procedure Law, has emerged as an alternative way to resolve criminal medical disputes, but the difference between mediation and conciliation is mostly procedural. This article deals with mediation in Turkish health law and aspect of medical malpractice mediation in Turkey. In addition, this study examines the issue of mediation in health law from both a legal and normative point of view, including codes of mediation which regulate both the structural and professional practice of mediation providers. As a result, although there is not official record about success rate of medical malpractice litigations and malpractice mediation in Turkey, it is widely accepted that the success rate for medical malpractice cases is relatively low compared to other personal injury cases even if it is generally considered that medical malpractice case filings have gradually increased recently. According to the Justice Ministry’s Department of Mediation in Turkey, 719 civil disputes have referred to mediators since 2013 (when the first mediation law came into force) with a 98% success rate.
Abstract: Quantitative measurement of myocardium perfusion is possible with single photon emission computed tomography (SPECT) using a semiconductor detector. However, accumulation of 99mTc-tetrofosmin in the liver may make it difficult to assess that accurately in the inferior myocardium. Our idea is to reduce the high accumulation in the liver by using dynamic SPECT imaging and a technique called time subtraction. We evaluated the performance of a new SPECT system with a cadmium-zinc-telluride solid-state semi- conductor detector (Discovery NM 530c; GE Healthcare). Our system acquired list-mode raw data over 10 minutes for a typical patient. From the data, ten SPECT images were reconstructed, one for every minute of acquired data. Reconstruction with the semiconductor detector was based on an implementation of a 3-D iterative Bayesian reconstruction algorithm. We studied 20 patients with coronary artery disease (mean age 75.4 ± 12.1 years; range 42-86; 16 males and 4 females). In each subject, 259 MBq of 99mTc-tetrofosmin was injected intravenously. We performed both a phantom and a clinical study using dynamic SPECT. An approximation to a liver-only image is obtained by reconstructing an image from the early projections during which time the liver accumulation dominates (0.5~2.5 minutes SPECT image-5~10 minutes SPECT image). The extracted liver-only image is then subtracted from a later SPECT image that shows both the liver and the myocardial uptake (5~10 minutes SPECT image-liver-only image). The time subtraction of liver was possible in both a phantom and the clinical study. The visualization of the inferior myocardium was improved. In past reports, higher accumulation in the myocardium due to the overlap of the liver is un-diagnosable. Using our time subtraction method, the image quality of the 99mTc-tetorofosmin myocardial SPECT image is considerably improved.
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: Lean philosophy has evolved over time and has been implemented both in manufacturing and services, more recently lean has been integrated in the companies of the health sector. Currently it is important to understand the successful way to implement this philosophy and try to identify barriers and enablers to the sustainability of lean healthcare. The main purpose of this research is to identify the barriers and enablers in the implementation of Lean Healthcare based on case studies of Colombian healthcare centers. In order to do so, we conducted semi-structured interviews based on a maturity model. The main results indicate that the success of Lean implementation depends on its adaptation to contextual factors. In addition, in the Colombian context were identified new factors such as organizational culture, management models, integration of the care and administrative departments and triple helix relationship.
Abstract: With the aging of the world population and the
continuous growth in technology, service robots are more and more
explored nowadays as alternatives to healthcare givers or personal
assistants for the elderly or disabled people. Any service robot
should be capable of interacting with the human companion, receive
commands, navigate through the environment, either known or
unknown, and recognize objects. This paper proposes an approach
for object recognition based on the use of depth information and
color images for a service robot. We present a study on two of the
most used methods for object detection, where 3D data is used to
detect the position of objects to classify that are found on horizontal
surfaces. Since most of the objects of interest accessible for service
robots are on these surfaces, the proposed 3D segmentation reduces
the processing time and simplifies the scene for object recognition.
The first approach for object recognition is based on color histograms,
while the second is based on the use of the SIFT and SURF feature
descriptors. We present comparative experimental results obtained
with a real service robot.
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: Healthcare waste management continues to present an
array of challenges for developing countries, and Liberia is of no
exception. There is insufficient information available regarding the
generation, handling, and disposal of health care waste. This face
serves as an impediment to healthcare management schemes. The
specific objective of this study is to present an evaluation of the
current health care management practices in Liberia. It also presented
procedures, techniques used, methods of handling, transportation, and
disposal methods of wastes as well as the quantity and composition
of health care waste. This study was conducted as an investigative
case study, covering three different health care facilities; a hospital, a
health center, and a clinic in Monrovia, Montserrado County. The
average waste generation was found to be 0-7kg per day at the clinic
and health center and 8-15kg per/day at the hospital. The composition
of the waste includes hazardous and non-hazardous waste i.e. plastic,
papers, sharps, and pathological elements etc. Nevertheless, the
investigation showed that the healthcare waste generated by the
surveyed healthcare facilities were not properly handled because of
insufficient guidelines for separate collection, and classification, and
adequate methods for storage and proper disposal of generated
wastes. This therefore indicates that there is a need for improvement
within the healthcare waste management system to improve the
existing situation.
Abstract: Cloud computing can reduce the start-up expenses of implementing EHR (Electronic Health Records). However, many of the healthcare institutions are yet to implement cloud computing due to the associated privacy and security issues. In this paper, we analyze the challenges and opportunities of implementing cloud computing in healthcare. We also analyze data of over 5000 US hospitals that use Telemedicine applications. This analysis helps to understand the importance of smart phones over the desktop systems in different departments of the healthcare institutions. The wide usage of smartphones and cloud computing allows ubiquitous and affordable access to the health data by authorized persons, including patients and doctors. Cloud computing will prove to be beneficial to a majority of the departments in healthcare. Through this analysis, we attempt to understand the different healthcare departments that may benefit significantly from the implementation of cloud computing.
Abstract: Introduction: To update ourselves and understand the
concept of latest electronic formats available for Health care
providers and how it could be used and developed as per standards.
The idea is to correlate between the patients Manual Medical Records
keeping and maintaining patients Electronic Information in a Health
care setup in this world. Furthermore, this stands with adapting to the
right technology depending upon the organization and improve our
quality and quantity of Healthcare providing skills. Objective: The
concept and theory is to explain the terms of Electronic Medical
Record (EMR), Electronic Health Record (EHR) and Personal Health
Record (PHR) and selecting the best technical among the available
Electronic sources and software before implementing. It is to guide
and make sure the technology used by the end users without any
doubts and difficulties. The idea is to evaluate is to admire the uses
and barriers of EMR-EHR-PHR. Aim and Scope: The target is to
achieve the health care providers like Physicians, Nurses, Therapists,
Medical Bill reimbursements, Insurances and Government to assess
the patient’s information on easy and systematic manner without
diluting the confidentiality of patient’s information. Method: Health
Information Technology can be implemented with the help of
Organisations providing with legal guidelines and help to stand by
the health care provider. The main objective is to select the correct
embedded and affordable database management software and
generating large-scale data. The parallel need is to know how the
latest software available in the market. Conclusion: The question lies
here is implementing the Electronic information system with
healthcare providers and organization. The clinicians are the main
users of the technology and manage us to “go paperless”. The fact is
that day today changing technologically is very sound and up to date.
Basically, the idea is to tell how to store the data electronically safe
and secure. All three exemplifies the fact that an electronic format
has its own benefit as well as barriers.
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: The aim of this study is to examine the relationship
between organizational commitment which is defined as a strong
belief in and acceptance of the organization’s goals and values, and
burnout syndrome and organizational cynicism. Accordingly, a field
research based on survey method was conducted on the employees of
a health institution operating in the province of Konya. The findings
of the research show that there is a positive statistically significant
relationship between organizational cynicism and burnout while
there is a negative statistically significant relationship between
organizational commitment and burnout. Furthermore, it has been
also realized that there is a negative and statistically significant
relationship between organizational commitment and organizational
cynicism.
Abstract: A teeming set of doctors that graduated from various
universities within and outside Nigeria with the hope of practicing in
the country, has their hope shattered because of poor financing, lack
of medical equipments and a very weak healthcare systems. Such
hydra headed challenges, allows room for quackery which
increasingly contributes to the cause of mortality in Nigeria. With a
view of reversing the challenges of healthcare delivery and financing
in Nigeria, African Health Market for Equity (AHME), a project
funded by the Bill and Melinda Gates foundation [With contribution
from Department For International Development (DFID)] and
currently implemented in three African Countries (Nigeria, Kenya
and Ghana) over a Five (5) year period supports the healthcare sector
via Medical credit fund (MCF). The study examines the impact of
credit policy and medical credit funding on Nigerian health market.
Ordinary least square analysis, correlation and granger causality tests
were employed to measure the extent to which the Nigerian
healthcare market has been influenced. Medical credit fund
significantly and positively influenced average monthly turnover of
private healthcare providers and Commercial bank’s lending rate had
a weak relationship with access to credit/approved loans (13.46%).
The programme has so far made 13.91% progress, which is very
poor, considering the minimum targeted private health care providers
(437.6) and expected number of loan approvals (180.4) for the two
years. Medical credit policy in Nigeria should be revised to include
private healthcare providers in rural area for more positive impact
and increased returns. Good brand advert and sensitization of the
programme to stakeholders and health pressure group, and an
extension of the programme beyond five years is necessary to better
address the issues raised in the study.
Abstract: Healthcare safety has been perceived important. It is
essential to prevent troubles in healthcare processes for healthcare
safety. Trouble prevention is based on trouble prediction using
accumulated knowledge on processes, troubles, and countermeasures.
However, information on troubles has not been accumulated in
hospitals in the appropriate structure, and it has not been utilized
effectively to prevent troubles. In the previous study, however a
detailed knowledge acquisition process for trouble prediction was
proposed, the knowledgebase for countermeasures was not involved.
In this paper, we aim to propose the structure of the knowledgebase for
countermeasures, in the knowledge acquisition process for trouble
prediction in healthcare process. We first design the structure of
countermeasures and propose the knowledge representation form on
countermeasures. Then, we evaluate the validity of the proposal, by
applying it into an actual hospital.
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: Moving into a new era of healthcare, new tools and
devices are developed to extend and improve health services, such as
remote patient monitoring and risk prevention. In this concept,
Internet of Things (IoT) and Cloud Computing present great
advantages by providing remote and efficient services, as well as
cooperation between patients, clinicians, researchers and other health
professionals. This paper focuses on patients suffering from bipolar
disorder, a brain disorder that belongs to a group of conditions
called affective disorders, which is characterized by great mood
swings. We exploit the advantages of Semantic Web and Cloud
Technologies to develop a patient monitoring system to support
clinicians. Based on intelligently filtering of evidence-knowledge and
individual-specific information we aim to provide treatment
notifications and recommended function tests at appropriate times or
concluding into alerts for serious mood changes and patient’s nonresponse
to treatment. We propose an architecture as the back-end
part of a cloud platform for IoT, intertwining intelligence devices
with patients’ daily routine and clinicians’ support.
Abstract: It is likely that robots will cross the boundaries of
industry into households over the next decades. With demographic
challenges worldwide, the future ageing populations will require the
introduction of assistive technologies capable of providing, care,
human dignity and quality of life through the aging process. Robotics
technology has a high potential for being used in the areas of social
and healthcare by promoting a wide range of activities such as
entertainment, companionship, supervision or cognitive and physical
assistance. However such close Human Robotics Interaction (HRI)
encompass a rich set of ethical scenarios that need to be addressed
before Socially Assistive Robots (SARs) reach the global markets.
Such interactions with robots may seem a worthy goal for many
technical/financial reasons but inevitably require close attention to
the ethical dimensions of such interactions. This article investigates
the current HRI benchmark of social success. It revises it according
to the ethical principles of beneficence, non-maleficence and justice
aligned with social care ethos. An extension of such benchmark is
proposed based on an empirical study of HRIs conducted with elderly
groups.
Abstract: With increasingly more mobile health applications
appearing due to the popularity of smartphones, the possibility arises
that these data can be used to improve the medical diagnostic process,
as well as the overall quality of healthcare, while at the same time
lowering costs. However, as of yet there have been no reports of a
successful combination of patient-generated data from smartphones
with data from clinical routine. In this paper we describe how these
two types of data can be combined in a secure way without
modification to hospital information systems, and how they can
together be used in a medical expert system for automatic nutritional
classification and triage.
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: Early pre-code reinforced concrete structures present
undetermined resistance to earthquakes. This situation is particularly
unacceptable in the case of essential structures, such as healthcare
structures and pilgrims' houses. Amongst these, an existing old RC
building in Madinah city (KSA) is seismically evaluated with and
without infill wall and their dynamic characteristics are compared
with measured values in the field using ambient vibration
measurements (AVM). After updating the mathematical models for
this building with the experimental results, three dimensional
pushover analysis (Nonlinear static analysis) was carried out using
commercial structural analysis software incorporating inelastic
material properties for concrete, infill and steel. The purpose of this
analysis is to evaluate the expected performance of structural systems
by estimating, strength and deformation demands in design, and
comparing these demands to available capacities at the performance
levels of interest. The results summarized and discussed.
Abstract: The purpose of this study was to reduce patient
waiting times, improve system throughput and improve resources
utilization in radiology department. A discrete event simulation
model was developed using Arena simulation software to investigate
different alternatives to improve the overall system delivery based on
adding resource scenarios due to the linkage between patient waiting
times and resource availability. The study revealed that there is no
addition investment need to procure additional scanner but hospital
management deploy managerial tactics to enhance machine
utilization and reduce the long waiting time in the department.