Health Systems最新文献

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Cloud-based multi-media systems for patient education and adherence: a pilot study to explore patient compliance with colonoscopy procedure preparation. 用于患者教育和依从性的基于云的多媒体系统:一项探索患者对结肠镜检查程序准备依从性的试点研究。
IF 1.8
Health Systems Pub Date : 2019-09-12 DOI: 10.1080/20476965.2019.1663974
Benjamin Schooley, Tonia San Nicolas-Rocca, Richard Burkhard
{"title":"Cloud-based multi-media systems for patient education and adherence: a pilot study to explore patient compliance with colonoscopy procedure preparation.","authors":"Benjamin Schooley,&nbsp;Tonia San Nicolas-Rocca,&nbsp;Richard Burkhard","doi":"10.1080/20476965.2019.1663974","DOIUrl":"https://doi.org/10.1080/20476965.2019.1663974","url":null,"abstract":"<p><p>Technology based patient education and adherence approaches are increasingly utilized to instruct and remind patients to prepare correctly for medical procedures. This study examines the interaction between two primary factors: patterns of patient adherence to challenging medical preparation procedures; and the demonstrated, measurable potential for cloud-based multi-media information technology (IT) interventions to improve patient adherence. An IT artifact was developed through prior design science research to serve information, reminders, and online video instruction modules to patients. The application was tested with 297 patients who were assessed clinically by physicians. Results indicate modest potential (43.4% relative improvement) for the IT-based approach for improving patient adherence to endoscopy preparations. Purposively designed cloud-based applications hold promise for aiding patients with complex medical procedure preparation. Health care provider involvement in the design and evaluation of a patient application may be an effective strategy to produce medical evidence and encourage the adoption of adherence apps.</p>","PeriodicalId":44699,"journal":{"name":"Health Systems","volume":"10 2","pages":"89-103"},"PeriodicalIF":1.8,"publicationDate":"2019-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20476965.2019.1663974","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39076454","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Clinical pathway modelling: a literature review. 临床路径建模:文献综述。
IF 1.8
Health Systems Pub Date : 2019-09-11 DOI: 10.1080/20476965.2019.1652547
Emma Aspland, Daniel Gartner, Paul Harper
{"title":"Clinical pathway modelling: a literature review.","authors":"Emma Aspland, Daniel Gartner, Paul Harper","doi":"10.1080/20476965.2019.1652547","DOIUrl":"10.1080/20476965.2019.1652547","url":null,"abstract":"<p><p>Hospital information systems are increasingly used as part of decision support tools for planning at strategic, tactical and operational decision levels. Clinical pathways are an effective and efficient approach in standardising the progression of treatment, to support patient care and facilitate clinical decision making. This literature review proposes a taxonomy of problems related to clinical pathways and explores the intersection between Information Systems (IS), Operational Research (OR) and industrial engineering. A structured search identified 175 papers included in the taxonomy and analysed in this review. The findings suggest that future work should consider industrial engineering integrated with OR techniques, with an aim to improving the handling of multiple scopes within one model, while encouraging interaction between the disjoint care levels and with a more direct focus on patient outcomes. Achieving this would continue to bridge the gap between OR, IS and industrial engineering, for clinical pathways to aid decision support.</p>","PeriodicalId":44699,"journal":{"name":"Health Systems","volume":"10 1","pages":"1-23"},"PeriodicalIF":1.8,"publicationDate":"2019-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7946019/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25510462","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Using the theory of constraints' processes of ongoing improvement to address the provider appointment scheduling system execution problem. 利用约束过程的持续改进理论,解决了提供者预约调度系统的执行问题。
IF 1.8
Health Systems Pub Date : 2019-09-01 DOI: 10.1080/20476965.2019.1646105
James F Cox
{"title":"Using the theory of constraints' processes of ongoing improvement to address the provider appointment scheduling system execution problem.","authors":"James F Cox","doi":"10.1080/20476965.2019.1646105","DOIUrl":"https://doi.org/10.1080/20476965.2019.1646105","url":null,"abstract":"<p><p>Many primary care clinics suffer from chaos. In scheduling, providers are continually trying unsuccessfully to balance supply and demand, and in execution, to manage disruptions to provider focus and patient flow. In this research the theory of constraints' (TOC) three processes of ongoing improvement (POOGI) provide a direction for the solution to achieving more, cheaper, better, and faster healthcare. This research is the second of a two-part study examining the appointment scheduling literature, identifying the core problem (using a case study for validation) and providing a generic process for developing effective provider appointment scheduling systems (PASS). In the first part, PASS design was studied and in this second part PASS execution is studied. A strawman process is developed to apply across outpatient medical practices. With this generic process implemented across outpatient scheduling systems cost could be reduced significantly while the quality and timeliness could be increased significantly.</p>","PeriodicalId":44699,"journal":{"name":"Health Systems","volume":"10 1","pages":"41-72"},"PeriodicalIF":1.8,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20476965.2019.1646105","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25510463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 3
The potential role of dashboard use and navigation in reducing medical errors of an electronic health record system: a mixed-method simulation handoff study. 仪表板使用和导航在减少电子健康记录系统的医疗差错中的潜在作用:一项混合方法模拟切换研究。
IF 1.8
Health Systems Pub Date : 2019-05-28 eCollection Date: 2019-01-01 DOI: 10.1080/20476965.2019.1620637
Danny T Y Wu, Smruti Deoghare, Zhe Shan, Karthikeyan Meganathan, Katherine Blondon
{"title":"The potential role of dashboard use and navigation in reducing medical errors of an electronic health record system: a mixed-method simulation handoff study.","authors":"Danny T Y Wu,&nbsp;Smruti Deoghare,&nbsp;Zhe Shan,&nbsp;Karthikeyan Meganathan,&nbsp;Katherine Blondon","doi":"10.1080/20476965.2019.1620637","DOIUrl":"https://doi.org/10.1080/20476965.2019.1620637","url":null,"abstract":"<p><p>The dashboards of electronic health record (EHR) systems could potentially support the chart biopsy that occurs before or after physician handoffs. In this study, we conducted a simulation handoff study and recorded the participants' navigation patterns in an EHR system mock-up. We analyzed the navigation patterns of dashboard use in terms of duration, frequency, and sequence, and we examined the relationship between dashboard use in chart biopsy and the errors identified after handoffs. The results show that the participants frequently used the dashboard as an information hub and as an information resource to help them navigate the EHR system and answer the questions in a nursing call. Moreover, using the dashboard as an information hub can help reduce imprecision and factual errors in handoffs. Our findings suggest the need for a \"context-aware\" dashboard to accommodate dynamic navigation patterns and to support clinical work as well as to reduce medical errors.</p>","PeriodicalId":44699,"journal":{"name":"Health Systems","volume":"8 3","pages":"203-214"},"PeriodicalIF":1.8,"publicationDate":"2019-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20476965.2019.1620637","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37459953","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 7
Development of a computerized paediatric intensive care unit septic shock pathway: improving user experience. 计算机化儿科重症监护病房脓毒性休克路径的发展:改善用户体验。
IF 1.8
Health Systems Pub Date : 2019-05-28 eCollection Date: 2019-01-01 DOI: 10.1080/20476965.2019.1620638
Lauren Shivers, Sue S Feldman, Leslie W Hayes
{"title":"Development of a computerized paediatric intensive care unit septic shock pathway: improving user experience.","authors":"Lauren Shivers,&nbsp;Sue S Feldman,&nbsp;Leslie W Hayes","doi":"10.1080/20476965.2019.1620638","DOIUrl":"https://doi.org/10.1080/20476965.2019.1620638","url":null,"abstract":"<p><p>The purpose of this study was to understand the user experience with a computerized septic shock protocol relative to the workflow of Paediatric Intensive Care Unit clinicians. The need for data-driven, condition-specific, computerized protocols in the intensive care unit helps improve decision-making at the bedside. PICU clinicians were interviewed and given pre-and post-implementation surveys asking their opinions on the current PICU septic shock protocol, as well as the current electronic health record being used at [Paediatric Academic Medical Center]. User preferences guided adjustments toward improved usability of the septic shock protocol. Computerized Physician Order Entry, a critical component of the septic shock protocol, allows for more streamlined processes, more complete records, and more time to care for patients. This study revealed that although clinicians had an unfavorable view of the EHR in general, the computerized septic shock protocol was very well-received with an overall usability score of 82.</p>","PeriodicalId":44699,"journal":{"name":"Health Systems","volume":"8 3","pages":"155-161"},"PeriodicalIF":1.8,"publicationDate":"2019-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20476965.2019.1620638","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37460007","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 2
The impact of systemic innovations for transforming transplant systems. Lessons learned from the German lung transplantation system. A qualitative study. 系统创新对移植系统转型的影响。德国肺移植系统的经验教训。定性研究。
IF 1.8
Health Systems Pub Date : 2019-05-16 eCollection Date: 2020-01-01 DOI: 10.1080/20476965.2019.1604086
Antoniya Hauerwaas, Ursula Weisenfeld
{"title":"The impact of systemic innovations for transforming transplant systems. Lessons learned from the German lung transplantation system. A qualitative study.","authors":"Antoniya Hauerwaas,&nbsp;Ursula Weisenfeld","doi":"10.1080/20476965.2019.1604086","DOIUrl":"https://doi.org/10.1080/20476965.2019.1604086","url":null,"abstract":"<p><p>The aim of this paper is to demonstrate the potential of the systemic innovations approach for transforming transplantation systems. It explores potential leverage points for intervening in the LTx-system as well as possible paths of transformation. We present possible transition pathways giving the example of the German Lung transplantation system that teeters on the brink of collapse due to system failures and organ scarcity and illustrate systemic innovations as core mechanisms for systems change in health systems. Desk research and semi-structured experts interviews provided qualitative data for a deductive-inductive coding and a rigorous qualitative content analysis of the data. Depending on the systemic innovations chosen to achieve systems change, transplant systems follow different transformational paths: from a collapse to a leapfrogging towards a non-human transplantation system. Thus, global health areas like transplantation benefit from analysis on systemic innovations as these support researchers, public policy and regulators by developing transformative strategies in healthcare systems.</p>","PeriodicalId":44699,"journal":{"name":"Health Systems","volume":"9 1","pages":"76-93"},"PeriodicalIF":1.8,"publicationDate":"2019-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20476965.2019.1604086","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37829238","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Real-Time Automated Hazard Detection Framework for Health Information Technology Systems. 卫生信息技术系统实时自动危害检测框架。
IF 1.8
Health Systems Pub Date : 2019-05-07 eCollection Date: 2019-01-01 DOI: 10.1080/20476965.2019.1599701
Olufemi A Omitaomu, Ozgur Ozmen, Mohammed M Olama, Laura L Pullum, Teja Kuruganti, James Nutaro, Hilda B Klasky, Helia Zandi, Aneel Advani, Angela L Laurio, Merry Ward, Jeanie Scott, Jonathan R Nebeker
{"title":"Real-Time Automated Hazard Detection Framework for Health Information Technology Systems.","authors":"Olufemi A Omitaomu,&nbsp;Ozgur Ozmen,&nbsp;Mohammed M Olama,&nbsp;Laura L Pullum,&nbsp;Teja Kuruganti,&nbsp;James Nutaro,&nbsp;Hilda B Klasky,&nbsp;Helia Zandi,&nbsp;Aneel Advani,&nbsp;Angela L Laurio,&nbsp;Merry Ward,&nbsp;Jeanie Scott,&nbsp;Jonathan R Nebeker","doi":"10.1080/20476965.2019.1599701","DOIUrl":"https://doi.org/10.1080/20476965.2019.1599701","url":null,"abstract":"<p><p>An increase in the reliability of Health Information Technology (HIT) will facilitate institutional trust and credibility of the systems. In this paper, we present an end-to-end framework for improving the reliability and performance of HIT systems. Specifically, we describe the system model, present some of the methods that drive the model, and discuss an initial implementation of two of the proposed methods using data from the Veterans Affairs HIT and Corporate Data Warehouse systems. The contributions of this paper, thus, include (1) the design of a system model for monitoring and detecting hazards in HIT systems, (2) a data-driven approach for analysing the health care data warehouse, (3) analytical methods for characterising and analysing failures in HIT systems, and (4) a tool architecture for generating and reporting hazards in HIT systems. Our goal is to work towards an automated system that will help identify opportunities for improvements in HIT systems.</p>","PeriodicalId":44699,"journal":{"name":"Health Systems","volume":"8 3","pages":"190-202"},"PeriodicalIF":1.8,"publicationDate":"2019-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20476965.2019.1599701","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37460010","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 8
Combining regression trees and panel regression for exploring and testing the impact of complementary management practices on short-notice elective operation cancellation rates. 结合回归树和面板回归,探索和测试补充管理措施对临时通知的择期手术取消率的影响。
IF 1.2
Health Systems Pub Date : 2019-04-19 DOI: 10.1080/20476965.2019.1596338
Reza Salehnejad, Manhal Ali, Nathan Proudlove
{"title":"Combining regression trees and panel regression for exploring and testing the impact of complementary management practices on short-notice elective operation cancellation rates.","authors":"Reza Salehnejad, Manhal Ali, Nathan Proudlove","doi":"10.1080/20476965.2019.1596338","DOIUrl":"10.1080/20476965.2019.1596338","url":null,"abstract":"<p><p>Variation in the performance of providers across healthcare systems is pervasive. It is recognised as both a major concern and an opportunity for learning and improvement. Variation between providers is broadly considered to be due to management practices and contextual factors such as catchment-area demographics. However, there is little understanding of the ways in which these impact on performance and how they can be measured. We use recent developments in both regression trees and panel regression techniques to explore and then statistically test complementary alignments of management practices whilst taking into account contextual factors. We apply this to 5 years of NHS hospital trust data, examining performance on short-notice cancellation rates. We find that different alignments of management practices give rise to quite different short-notice cancellation rates between trusts, with some being substantially lower. Our research offers a data-driven approach for identifying optimal clusters of management practices.</p>","PeriodicalId":44699,"journal":{"name":"Health Systems","volume":"9 4","pages":"326-344"},"PeriodicalIF":1.2,"publicationDate":"2019-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7738292/pdf/THSS_9_1596338.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10292914","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Planning security architecture for health survey data storage and access. 规划健康调查数据存储和访问的安全架构。
IF 1.2
Health Systems Pub Date : 2019-04-15 eCollection Date: 2020-01-01 DOI: 10.1080/20476965.2019.1599702
M Rita Thissen, Katherine M Mason
{"title":"Planning security architecture for health survey data storage and access.","authors":"M Rita Thissen, Katherine M Mason","doi":"10.1080/20476965.2019.1599702","DOIUrl":"10.1080/20476965.2019.1599702","url":null,"abstract":"<p><p>Sensitive data from health research surveys need to be protected from loss, damage or unwanted release, especially when data include personally identifying information, protected health information or other private material. Researchers and practitioners must ensure privacy and confidentiality in the architecture of data systems and in access to the data. Internal and external risks may be deliberate or accidental, involving unintended loss, modification or exposure. To prevent risk while allowing access requires balancing concerns against providing an environment that does not impede work. The authors' purpose in this paper is to draw attention to basic data security needs for health survey data from the perspective of both the health researcher/practitioner and infrastructure/programming staff to ensure that data are securely and adequately protected. We describe risk classifications and how they affect system architecture, drawing on recent experience with systems for storage of and access to electronic health survey data.</p>","PeriodicalId":44699,"journal":{"name":"Health Systems","volume":"9 1","pages":"57-63"},"PeriodicalIF":1.2,"publicationDate":"2019-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7144259/pdf/THSS_9_1599702.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37829236","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Modelling competition in health care markets as a complex adaptive system: an agent-based framework. 作为复杂适应系统的医疗保健市场竞争建模:基于主体的框架。
IF 1.8
Health Systems Pub Date : 2019-01-24 DOI: 10.1080/20476965.2019.1569480
Abdullah Alibrahim, Shinyi Wu
{"title":"Modelling competition in health care markets as a complex adaptive system: an agent-based framework.","authors":"Abdullah Alibrahim,&nbsp;Shinyi Wu","doi":"10.1080/20476965.2019.1569480","DOIUrl":"https://doi.org/10.1080/20476965.2019.1569480","url":null,"abstract":"<p><p>Health market reforms necessitate continuous re-evaluation of initiatives, competitive regulations, and antitrust policies. Synergistic implications, evolution, and behaviour changes associated with the market competition are often overlooked due to methodological limitations. To rectify these limitations, parallels between defining features of health care markets (HCM) and complex adaptive systems (CAS) are drawn. The science of CAS develops complex system-level models of dynamic interactions to allow insights for heterogeneous agents and emergent behaviours. Agent-based modelling (ABM) is a computational tool of CAS science suitable for investigating competition in HCM. The proposed agent-based framework conceptualises agents, environment, and interactions, and formalises agent-specific attributes and modules that achieve agent roles to recreate HCM dynamics. The framework conceptualises competition in HCM into an implementable ABM for a CAS assessment, identifies data sources, and develops face-validity procedures. Developments in data, computational power, and decisions theory compel CAS approach to complement studies on pressing HCM issues.</p>","PeriodicalId":44699,"journal":{"name":"Health Systems","volume":"9 3","pages":"212-225"},"PeriodicalIF":1.8,"publicationDate":"2019-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20476965.2019.1569480","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38487182","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 2
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