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  Subjects -> HEALTH AND SAFETY (Total: 1283 journals)
    - CIVIL DEFENSE (18 journals)
    - DRUG ABUSE AND ALCOHOLISM (87 journals)
    - HEALTH AND SAFETY (514 journals)
    - HEALTH FACILITIES AND ADMINISTRATION (379 journals)
    - OCCUPATIONAL HEALTH AND SAFETY (106 journals)
    - PHYSICAL FITNESS AND HYGIENE (99 journals)
    - WOMEN'S HEALTH (80 journals)

HEALTH AND SAFETY (514 journals)                  1 2 3 | Last

Showing 1 - 200 of 203 Journals sorted alphabetically
16 de Abril     Open Access  
A Life in the Day     Hybrid Journal   (Followers: 9)
Acta Informatica Medica     Open Access   (Followers: 1)
Acta Scientiarum. Health Sciences     Open Access  
Adultspan Journal     Hybrid Journal  
Advances in Child Development and Behavior     Full-text available via subscription   (Followers: 10)
Advances in Public Health     Open Access   (Followers: 20)
African Health Sciences     Open Access   (Followers: 2)
African Journal for Physical, Health Education, Recreation and Dance     Full-text available via subscription   (Followers: 6)
African Journal of Health Professions Education     Open Access   (Followers: 4)
Afrimedic Journal     Open Access   (Followers: 2)
Air Quality, Atmosphere & Health     Hybrid Journal   (Followers: 3)
AJOB Primary Research     Partially Free   (Followers: 2)
American Journal of Family Therapy     Hybrid Journal   (Followers: 10)
American Journal of Health Economics     Full-text available via subscription   (Followers: 13)
American Journal of Health Education     Hybrid Journal   (Followers: 25)
American Journal of Health Promotion     Hybrid Journal   (Followers: 22)
American Journal of Health Studies     Full-text available via subscription   (Followers: 8)
American Journal of Preventive Medicine     Hybrid Journal   (Followers: 21)
American Journal of Public Health     Full-text available via subscription   (Followers: 179)
American Journal of Public Health Research     Open Access   (Followers: 27)
American Medical Writers Association Journal     Full-text available via subscription   (Followers: 2)
Analytic Methods in Accident Research     Hybrid Journal   (Followers: 2)
Annali dell'Istituto Superiore di Sanità     Open Access  
Annals of Global Health     Open Access   (Followers: 8)
Annals of Health Law     Open Access   (Followers: 3)
Annals of Tropical Medicine and Public Health     Open Access   (Followers: 15)
Applied Biosafety     Hybrid Journal  
Applied Research In Health And Social Sciences : Interface And Interaction     Open Access  
Archives of Medicine and Health Sciences     Open Access   (Followers: 2)
Asia Pacific Journal of Counselling and Psychotherapy     Hybrid Journal   (Followers: 8)
Asia Pacific Journal of Health Management     Full-text available via subscription   (Followers: 2)
Asia-Pacific Journal of Public Health     Hybrid Journal   (Followers: 8)
Asian Journal of Gambling Issues and Public Health     Open Access   (Followers: 3)
Association of Schools of Allied Health Professions     Full-text available via subscription   (Followers: 5)
Atención Primaria     Open Access   (Followers: 1)
Australasian Journal of Paramedicine     Open Access   (Followers: 2)
Australian Advanced Aesthetics     Full-text available via subscription   (Followers: 4)
Australian Family Physician     Full-text available via subscription   (Followers: 2)
Australian Indigenous HealthBulletin     Free   (Followers: 6)
Autism & Developmental Language Impairments     Open Access   (Followers: 1)
Behavioral Healthcare     Full-text available via subscription   (Followers: 4)
Best Practices in Mental Health     Full-text available via subscription   (Followers: 6)
Bijzijn     Hybrid Journal   (Followers: 2)
Bijzijn XL     Hybrid Journal   (Followers: 1)
Biomedical Safety & Standards     Full-text available via subscription   (Followers: 9)
BLDE University Journal of Health Sciences     Open Access  
BMC Oral Health     Open Access   (Followers: 5)
BMC Pregnancy and Childbirth     Open Access   (Followers: 18)
BMJ Simulation & Technology Enhanced Learning     Full-text available via subscription   (Followers: 7)
Brazilian Journal of Medicine and Human Health     Open Access  
Buletin Penelitian Kesehatan     Open Access   (Followers: 2)
Buletin Penelitian Sistem Kesehatan     Open Access  
Bulletin of the World Health Organization     Open Access   (Followers: 15)
Cadernos de Educação, Saúde e Fisioterapia     Open Access   (Followers: 1)
Cadernos Saúde Coletiva     Open Access   (Followers: 1)
Canadian Family Physician     Partially Free   (Followers: 11)
Canadian Journal of Community Mental Health     Full-text available via subscription   (Followers: 10)
Canadian Journal of Human Sexuality     Hybrid Journal   (Followers: 1)
Canadian Journal of Public Health     Full-text available via subscription   (Followers: 18)
Case Reports in Women's Health     Open Access   (Followers: 2)
Case Studies in Fire Safety     Open Access   (Followers: 11)
Central Asian Journal of Global Health     Open Access   (Followers: 2)
Central European Journal of Public Health     Full-text available via subscription   (Followers: 4)
CES Medicina     Open Access  
Child Abuse Research in South Africa     Full-text available via subscription   (Followers: 1)
Child's Nervous System     Hybrid Journal  
Childhood Obesity and Nutrition     Open Access   (Followers: 10)
Children     Open Access   (Followers: 2)
CHRISMED Journal of Health and Research     Open Access  
Christian Journal for Global Health     Open Access  
Ciência & Saúde Coletiva     Open Access   (Followers: 2)
Ciencia y Cuidado     Open Access  
Ciencia, Tecnología y Salud     Open Access  
ClinicoEconomics and Outcomes Research     Open Access   (Followers: 1)
CME     Hybrid Journal   (Followers: 1)
CoDAS     Open Access  
Community Health     Open Access   (Followers: 1)
Conflict and Health     Open Access   (Followers: 8)
Curare     Open Access  
Current Opinion in Behavioral Sciences     Hybrid Journal   (Followers: 1)
Day Surgery Australia     Full-text available via subscription   (Followers: 2)
Digital Health     Open Access  
Dramatherapy     Hybrid Journal   (Followers: 2)
Drogues, santé et société     Full-text available via subscription  
Duazary     Open Access   (Followers: 1)
Early Childhood Research Quarterly     Hybrid Journal   (Followers: 13)
East African Journal of Public Health     Full-text available via subscription   (Followers: 3)
Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity     Hybrid Journal   (Followers: 16)
EcoHealth     Hybrid Journal   (Followers: 3)
Education for Health     Open Access   (Followers: 4)
electronic Journal of Health Informatics     Open Access   (Followers: 4)
ElectronicHealthcare     Full-text available via subscription   (Followers: 3)
Elsevier Ergonomics Book Series     Full-text available via subscription   (Followers: 5)
Emergency Services SA     Full-text available via subscription   (Followers: 2)
Ensaios e Ciência: Ciências Biológicas, Agrárias e da Saúde     Open Access  
Environmental Disease     Open Access  
Environmental Sciences Europe     Open Access   (Followers: 1)
Epidemics     Open Access   (Followers: 3)
Epidemiology, Biostatistics and Public Health     Open Access   (Followers: 18)
Ethics, Medicine and Public Health     Full-text available via subscription  
Ethiopian Journal of Health Development     Open Access   (Followers: 8)
Ethiopian Journal of Health Sciences     Open Access   (Followers: 7)
Ethnicity & Health     Hybrid Journal   (Followers: 13)
European Journal of Investigation in Health, Psychology and Education     Open Access   (Followers: 1)
European Medical, Health and Pharmaceutical Journal     Open Access  
Evaluation & the Health Professions     Hybrid Journal   (Followers: 8)
Evidence-based Medicine & Public Health     Open Access   (Followers: 4)
Evidência - Ciência e Biotecnologia - Interdisciplinar     Open Access  
Face à face     Open Access   (Followers: 1)
Families, Systems, & Health     Full-text available via subscription   (Followers: 8)
Family & Community Health     Partially Free   (Followers: 12)
Family Medicine and Community Health     Open Access   (Followers: 3)
Family Relations     Partially Free   (Followers: 11)
Fatigue : Biomedicine, Health & Behavior     Hybrid Journal   (Followers: 1)
Food and Public Health     Open Access   (Followers: 10)
Frontiers in Public Health     Open Access   (Followers: 8)
Gaceta Sanitaria     Open Access   (Followers: 3)
Galen Medical Journal     Open Access  
Geospatial Health     Open Access  
Gesundheitsökonomie & Qualitätsmanagement     Hybrid Journal   (Followers: 11)
Giornale Italiano di Health Technology Assessment     Full-text available via subscription  
Global Health : Science and Practice     Open Access   (Followers: 4)
Global Health Promotion     Hybrid Journal   (Followers: 15)
Global Journal of Health Science     Open Access   (Followers: 6)
Global Journal of Public Health     Open Access   (Followers: 9)
Global Medical & Health Communication     Open Access  
Globalization and Health     Open Access   (Followers: 5)
Hacia la Promoción de la Salud     Open Access  
Hastings Center Report     Hybrid Journal   (Followers: 7)
HEADline     Hybrid Journal  
Health & Place     Hybrid Journal   (Followers: 14)
Health & Justice     Open Access   (Followers: 5)
Health : An Interdisciplinary Journal for the Social Study of Health, Illness and Medicine     Hybrid Journal   (Followers: 7)
Health and Human Rights     Free   (Followers: 8)
Health and Social Care Chaplaincy     Hybrid Journal   (Followers: 9)
Health and Social Work     Hybrid Journal   (Followers: 45)
Health Behavior and Policy Review     Full-text available via subscription   (Followers: 1)
Health Care Analysis     Hybrid Journal   (Followers: 11)
Health Inform     Full-text available via subscription  
Health Information Management Journal     Hybrid Journal   (Followers: 10)
Health Issues     Full-text available via subscription   (Followers: 1)
Health Policy     Hybrid Journal   (Followers: 32)
Health Policy and Technology     Hybrid Journal  
Health Professional Student Journal     Open Access   (Followers: 1)
Health Promotion International     Hybrid Journal   (Followers: 20)
Health Promotion Journal of Australia : Official Journal of Australian Association of Health Promotion Professionals     Full-text available via subscription   (Followers: 10)
Health Promotion Practice     Hybrid Journal   (Followers: 15)
Health Prospect     Open Access   (Followers: 1)
Health Psychology     Full-text available via subscription   (Followers: 47)
Health Psychology Research     Open Access   (Followers: 18)
Health Psychology Review     Hybrid Journal   (Followers: 39)
Health Renaissance     Open Access  
Health Research Policy and Systems     Open Access   (Followers: 9)
Health SA Gesondheid     Open Access   (Followers: 2)
Health Science Reports     Open Access  
Health Sciences and Disease     Open Access   (Followers: 2)
Health Services Insights     Open Access   (Followers: 1)
Health Systems     Hybrid Journal   (Followers: 2)
Health Voices     Full-text available via subscription  
Health, Culture and Society     Open Access   (Followers: 10)
Health, Risk & Society     Hybrid Journal   (Followers: 9)
Healthcare     Open Access   (Followers: 1)
Healthcare in Low-resource Settings     Open Access   (Followers: 1)
Healthcare Quarterly     Full-text available via subscription   (Followers: 8)
HERD : Health Environments Research & Design Journal     Full-text available via subscription  
Highland Medical Research Journal     Full-text available via subscription  
Hispanic Health Care International     Full-text available via subscription  
HIV & AIDS Review     Full-text available via subscription   (Followers: 10)
Home Health Care Services Quarterly     Hybrid Journal   (Followers: 5)
Hong Kong Journal of Social Work, The     Hybrid Journal   (Followers: 2)
Hospitals & Health Networks     Free   (Followers: 2)
IEEE Journal of Translational Engineering in Health and Medicine     Open Access   (Followers: 3)
IMTU Medical Journal     Full-text available via subscription  
Indian Journal of Health Sciences     Open Access   (Followers: 1)
Inmanencia. Revista del Hospital Interzonal General de Agudos (HIGA) Eva Perón     Open Access  
Innovative Journal of Medical and Health Sciences     Open Access  
Institute for Security Studies Papers     Full-text available via subscription   (Followers: 6)
interactive Journal of Medical Research     Open Access  
International Health     Hybrid Journal   (Followers: 4)
International Journal for Equity in Health     Open Access   (Followers: 7)
International Journal for Quality in Health Care     Hybrid Journal   (Followers: 32)
International Journal of Applied Behavioral Sciences     Open Access   (Followers: 1)
International Journal of Behavioural and Healthcare Research     Hybrid Journal   (Followers: 7)
International Journal of Circumpolar Health     Open Access   (Followers: 1)
International Journal of Community Medicine and Public Health     Open Access   (Followers: 5)
International Journal of E-Health and Medical Communications     Full-text available via subscription   (Followers: 2)
International Journal of Environmental Research and Public Health     Open Access   (Followers: 19)
International Journal of Evidence-Based Healthcare     Hybrid Journal   (Followers: 8)
International Journal of Food Safety, Nutrition and Public Health     Hybrid Journal   (Followers: 13)
International Journal of Health & Allied Sciences     Open Access   (Followers: 1)
International Journal of Health Care Quality Assurance     Hybrid Journal   (Followers: 7)
International Journal of Health Geographics     Open Access   (Followers: 6)
International Journal of Health Policy and Management     Open Access   (Followers: 2)
International Journal of Health Professions     Open Access   (Followers: 2)
International Journal of Health Promotion and Education     Hybrid Journal   (Followers: 12)
International Journal of Health Sciences Education     Open Access   (Followers: 2)
International Journal of Health Services     Full-text available via subscription   (Followers: 9)
International Journal of Health Studies     Open Access   (Followers: 3)
International Journal of Health System and Disaster Management     Open Access   (Followers: 2)

        1 2 3 | Last

Journal Cover Health Policy and Technology
  [SJR: 0.271]   [H-I: 6]   [0 followers]  Follow
    
   Hybrid Journal Hybrid journal (It can contain Open Access articles)
   ISSN (Print) 2211-8837
   Published by Elsevier Homepage  [3031 journals]
  • Making Health Technology Assessment More Dynamic - Temporal Trend Analysis
           to Capture Performance Trajectories
    • Authors: Patrik Hidefjäll; Magnus Backheden
      Abstract: Publication date: Available online 23 April 2017
      Source:Health Policy and Technology
      Author(s): Patrik Hidefjäll, Magnus Backheden
      Objectives Health technology assessment (HTA) has an increasing role in evaluating not only drugs, but also medical devices. Assessing medical devices is more challenging as outcomes tend to improve substantially over time. This paper analyzes clinical outcomes over time of insulin pump therapy in adult type 1 diabetes. Meta-regression was used to capture outcome trends while considering innovation theory. Methods A systematic review of 4.297 studies was conducted covering a 35 year time period. To meet the need for a more dynamic evaluation method, temporal trend analysis was applied based on meta-regression of three extracted outcome parameters: HbA1c, incidence of severe hypoglycemia and ketoacidosis. Results The systematic review included 150 studies. Performance improvement in HbA1c and ketoacidosis was rapid during the 1980 and 90s.Thereafter the improvement trajectory of insulin pumps measured by HbA1c, ketoacidosis or severe hypoglycemia was essentially flat. Meta-regression of several covariates was performed showing publication year to be statistically significant. Retrospective recruitment and the percentage of female patients were also statistically significant. A technology cycle model analysis revealed convergence to a dominant design by the end 1990s, followed by slower progress in outcomes. Conclusions Insulin pump technology currently does not offer an improving performance trajectory according to key indicators HbA1c, incidence of severe hypoglycemia and ketoacidosis, but compares well to manual insulin injections in terms of quality of life. Applying temporal trend analysis is especially valuable in an early technology cycle stage when uncertainty is high, and when predicted improvements in future performance can influence the choice of technology.

      PubDate: 2017-04-27T10:54:40Z
      DOI: 10.1016/j.hlpt.2017.04.005
       
  • Evaluation of the unique device identification system and an approach for
           medical device tracking
    • Authors: Tuncay Bayrak; Funda Özdiler Çopur
      Abstract: Publication date: Available online 20 April 2017
      Source:Health Policy and Technology
      Author(s): Tuncay Bayrak, Funda Özdiler Çopur
      Background Most countries have different registration and tracking system, but unique device identification based approach was recently introduced in the USA. In 2013, FDA and EU released regulations about unique device identification system. In literature, there is not any study that compares the UDI legislations on the basis of the requirements. In addition to the legal requirements, establishing a UDI system in digital environment is very challenging. Methods This is a theory based study that includes information from healthcare industries and key points from UDI related legislations which are discussed. To visualize the design of the proposed system, the Dia program that contains the Unified Modeling Language (UML) components was used. Results Implementation of the UDI based tracking system is very difficult due to two reasons. First, the relevant legislations do not give detailed information on how UDI system will be implemented. Second, each type of medical device has difficulties due to UDI labeling. We have observed that the stakeholders in the medical devices sector in Turkey, especially the manufacturers, are not yet ready for UDI-based tracking. The current registry system is not effective to track medical devices and share data. Conclusions To overcome compliance problems, UDI requirements should be perfectly determined and subsequently related legislation should be established. Regarding these requirements, every country should introduce an action plan and include all sector stakeholders in that action plan. We suggest a model for medical device tracking to be able to use instead of the current registry system in Turkey.

      PubDate: 2017-04-27T10:54:40Z
      DOI: 10.1016/j.hlpt.2017.04.003
       
  • Development of Nationwide Electronic Health Record (ΝEHR): An
           international survey
    • Authors: Leonidas L. Fragidis; Prodromos D. Chatzoglou
      Abstract: Publication date: Available online 14 April 2017
      Source:Health Policy and Technology
      Author(s): Leonidas L. Fragidis, Prodromos D. Chatzoglou
      The primary aim of this research is to capture the existing experience from countries where nationwide EHR systems have already been implemented or the development is in a mature phase. To capture the necessary information, an international survey has been conducted with expert participants from 13 countries. The results of this research show that private vendors’ involvement in most of the system development lifecycle phases is inevitable. However, the phase where most private vendors are involved in during the development of an EHR system is System Design. Interestingly, their involvement does not depend on who has the responsibility of the EHR system development (either a national organization or a private vendor). Finally, examining the supported standards by EHR systems and their interoperability with other information systems, in respect to both technical and semantic interoperability, it is found that more efforts should be made for the integration of the most widely supported standards, and the enhancement of interoperability among health information systems, which will lead to the successful integration of a NEHR system.

      PubDate: 2017-04-19T10:02:38Z
      DOI: 10.1016/j.hlpt.2017.04.004
       
  • Assessing eHealth skills across Europeans
    • Authors: María Rosalía Vicente; Gary Madden
      Abstract: Publication date: Available online 13 April 2017
      Source:Health Policy and Technology
      Author(s): María Rosalía Vicente, Gary Madden
      The Internet has made health information more assessable to the general public. However, some serious concerns remain about the quality and reliability of that information, and the ability of the population to accurately interpret these data. An important aspect interpreting healthcare information are eHealth skills. To date, the available evidence is usually based on national analyses of composite measures of eHealth skills. To contribute to the debate our paper analyses particular eHealth skills based on data from a pan-European Union data set. In particular, with microdata from a representative sample, five skills are analysed, viz. searching, locating, understanding, evaluating and using online health information. We use a discrete choice model to identify statistical associations between respondent socio-demographic characteristics and skills. Our analysis reveals a complex pattern of eHealth skills is present across socio-demographic groups, with only self-reported health status and Internet experience influential for all skills. This finding suggests that targeted training actions are necessary to improve eHealth kills, with the seniors and the less educated the groups most in need of training.

      PubDate: 2017-04-19T10:02:38Z
      DOI: 10.1016/j.hlpt.2017.04.001
       
  • Supporting the Critical role of Family Carers in Wellness Management
    • Authors: Audrey Grace; Robert Gleasure
      Abstract: Publication date: Available online 13 April 2017
      Source:Health Policy and Technology
      Author(s): Audrey Grace, Robert Gleasure
      Aging populations, the increased prevalence of chronic disease, and spiraling healthcare costs have led to calls for policy and technology that focuses on wellness management, preventative interventions, and decentralized healthcare. This has prompted several initiatives aimed at empowering individuals to proactively manage their wellness, including employee wellness programmes, step-tracking mobile apps, etc. However, a critical actor in this proposed new healthcare model is the family carer. These individuals are charged with managing outpatients’ wellness, tracking deteriorations, providing support, and even administering routine care in order to minimize and/or delay the need for further clinical intervention. Yet for most people, ‘wellness’ is a poorly understood and ambiguously measured concept. Hence, family carers are often asked to rely upon personal discretion to perform their duties. This paper uses a qualitative case study based on a series of semi-structured interviews to explore how family carers manage this responsibility, the support available to them (technologically and socially), and the challenges they face. It is informed by a research model which combines activity theory and attribute substitution theory in order to make sense of how the diverse actors involved in wellness management (e.g. the family carers, the patients, other family members, clinical/non-clinical healthcare workers) communicate and coordinate. Findings suggest family carers’ role in managing outpatient wellness is hindered by their inability to gather/share key wellness-related information with others involved. The study concludes by calling for better technological infrastructure linking carers with clinical professionals and more standardized information channels between various stakeholders in the caring activity.

      PubDate: 2017-04-19T10:02:38Z
      DOI: 10.1016/j.hlpt.2017.04.002
       
  • Patient Accessible Electronic Health Records: Connecting policy and
           provider action in the Netherlands
    • Authors: Anna Essen; Reinie Gerrits; Ellen Kuhlmann
      Abstract: Publication date: Available online 16 March 2017
      Source:Health Policy and Technology
      Author(s): Anna Essen, Reinie Gerrits, Ellen Kuhlmann
      Objectives The study provides a conceptual model for analyzing the connections and gaps between national policy and care provider processes aimed at patient accessible electronic health records. We illustrate the model using empirical data from the Netherlands as an explorative case study. Methods The conceptual model integrates governance and organizational theory of routines. Empirical material was gathered in 2015 in the Netherlands comprising documents and interviews with policymakers and healthcare providers (N=14). The integrated conceptual model guided the data analysis. Results The findings reveal a common aim of patient participation and improving patents' self- management at both policy and care provider level, while both sides lack comprehensive strategies to translate this shared goal into regulatory frameworks, guidelines, technological solutions and daily performances. Furthermore, initiatives on the levels of policymaking and service providers are poorly connected, thereby constraining the vision of improved patient participation and innovation more generally. Conclusions The research highlights the need for developing standards at various levels for the implementation of patient accessible electronic health records in order to improve equal access and interoperable technological solutions. The conceptual model illustrates the benefits of linking governance and organization theories to bring existing gaps between policy and healthcare provider perspectives into view, which may block more efficient implementation of e-Health policies.

      PubDate: 2017-03-22T07:01:15Z
      DOI: 10.1016/j.hlpt.2017.03.001
       
  • Editorial Board/Aims and Scope
    • Abstract: Publication date: March 2017
      Source:Health Policy and Technology, Volume 6, Issue 1


      PubDate: 2017-03-22T07:01:15Z
       
  • Stakeholder Consensus on the Purpose of Clinical Evaluation of Electronic
           Health Records is Required
    • Authors: Lisa Ericson; Tora Hammar; Nils Schönström; Göran Petersson
      Abstract: Publication date: Available online 1 March 2017
      Source:Health Policy and Technology
      Author(s): Lisa Ericson, Tora Hammar, Nils Schönström, Göran Petersson
      Objective To explore the purpose and performance of clinical evaluation of electronic health records (EHRs) among stakeholders in order to identify any need for regulatory actions or guidelines. Methods This was a qualitative study of information collected in semi-structured interviews (n=28) of representatives of the five largest EHR vendors in Sweden, healthcare provider IT managers, users, and representatives of national authorities. Results We found a difference between the stated purpose of clinical evaluation of EHRs by the authorities and the perception of the purpose by the vendors, IT managers, and the users. The respondents gave divergent answers about the medical purpose of the application: e.g. availability of data, overview and documentation, patient safety, process efficiency, decision support, a working tool, and an aid to communication and follow-up. Several vendors found it difficult to put the term clinical evaluation in its specific context, instead referring to literature reviews, risk analyses, risk-management processes, acceptance tests, test facilities, pilot tests, and proven experience. Conclusions Stakeholders need to agree on a mutually acceptable, consistent method to guide regulatory decisions. The lack of consensus regarding the purpose and performance of clinical evaluation of EHRs could impact negatively on a safe and efficient documentation in healthcare. Thus, there is a need for more consistent use of terms and concepts in, and a more systematic approach to, clinical evaluation of EHRs. To ensure that the implementation of IT in healthcare meets expectations, delivers the desired outcome, and does not create new problems, it should be evaluated.

      PubDate: 2017-03-03T03:12:22Z
      DOI: 10.1016/j.hlpt.2017.02.005
       
  • Dynamic capabilities in e-health innovation: Implications for policies
    • Authors: Niels Frederik Garmann-Johnsen; Tom Roar Eikebrokk
      Abstract: Publication date: Available online 24 February 2017
      Source:Health Policy and Technology
      Author(s): Niels Frederik Garmann-Johnsen, Tom Roar Eikebrokk
      Objective To mitigate the effect of caregiver shortage, collaborative networks in Norwegian municipalities are exploring the possibilities provided by e-health and welfare technologies. However, extracting benefits from such technologies depends on many factors. Methods In this study, an extensive literature review is performed to compare e-health and other sectors in terms of the critical success factors in collaborative business process management. Using the dynamic capabilities view as a general theoretical lens, and a process orientation framework for operationalization, these factors are then conceptualized and validated in a cross-sectional study of cases in the Norwegian municipal e-health sector. Results The study contributes to e-health research by identifying the key factors that influence performance. These factors are significantly driven by government policies and regulations. Our findings challenge the assumption that welfare technology networks can be built from the bottom up without government intervention. Regulatory interventions are needed, to obtain process performance metrics and foster viable, long-term business models for the participating institutions. Conclusion The findings have an impact on research and practice, especially in local public management, for predicting and prescribing future development in this context. There are indications of significant gaps in government policies and regulations. Further research should examine whether and how these findings transcend the chosen context.
      Graphical abstract image

      PubDate: 2017-03-03T03:12:22Z
      DOI: 10.1016/j.hlpt.2017.02.003
       
  • Convergent analytics and informed decision-making: A retrospective
           multimethod case study project in Kenya
    • Authors: Irene Podolak; Anteneh Ayanso; Maureen Connolly; Madelyn Law; Jarold Cosby
      Abstract: Publication date: Available online 24 February 2017
      Source:Health Policy and Technology
      Author(s): Irene Podolak, Anteneh Ayanso, Maureen Connolly, Madelyn Law, Jarold Cosby
      Objective The objective of this qualitative, retrospective case study was to explain how and why the Chaguo Letu project was able to successfully make informed strategic decisions on how to implement a Cervical Self Sampling Program (CSSP) in Kenya. Methods This qualitative, inductive, study applied the case study method; a retrospective, explanatory, single bounded case study involving critical reflection on four embedded units of analysis: 1) Participatory Action Research (PAR) methodology, 2) Scenario Based Planning (SBP) method, 3) Existential Phenomenology (EP) method, and 4) Convergent Analytics (CA) model. Theory-related analytic generalization provided the foundation for the data analysis approach. Results The PAR methodology was critical to grounding this complex study and provided a new way of interacting and learning. The SBP data collection and analysis tools performed well in conducting perception analysis and trend/uncertainty analysis exercises. Incorporating EP enabled a deeper investigation of the phenomenon of cervical self-sampling and determined which units of significance (i.e., situational or emotional) had a greater influence on CSSP social acceptability. The CA model provided an approach to make sense of data, turn it into meaningful information and facilitate the convergence of tacit, explicit and cultural knowledge, which ultimately enabled informed decision-making for an uncertain future. Conclusions Applying an integrated approach encompassing the PAR methodology, SBP method, EP method and CA model enabled the Chaguo Letu project to make informed strategic choices on how to implement a CSSP in Kenya. Each element of the study design, by itself, could not have achieved this outcome.

      PubDate: 2017-03-03T03:12:22Z
      DOI: 10.1016/j.hlpt.2017.02.004
       
  • The politics of participatory epidemiology Technologies, social media and
           influenza surveillance in the US
    • Authors: Gabriel Blouin-Genest; Allison Miller
      Abstract: Publication date: Available online 20 February 2017
      Source:Health Policy and Technology
      Author(s): Gabriel Blouin-Genest, Allison Miller
      Background Health surveillance is now being augmented and transformed by the use of “unofficial” knowledge or sources of information. This unofficial data largely comes from Internet-based systems which gather information from non-state actors through intelligence networks, Internet and media scrawling, metadata analysis (online drug sale reports, Google searches, online forums, etc.) and social media analysis. Objectives The main objective of this article is to explore the policy implications of such a revolution, an issue that has been surprisingly largely ignored by the literature in public policy. The research question underpinning this analysis is: What are the policy implications of the growing use of knowledge/data from Internet-based technologies for health surveillance in the US? The theoretical importance and challenges of these technologies for public policies conclude this paper. Methods Using influenza as a case study, this article conducts a review of the documented impacts, for public health policy, of the use of communication and Internet-based technologies for surveillance. To do so, we inventory different social media-based initiatives currently used for influenza and public health surveillance while evaluating their consequences/impacts for public health policy. Conclusions The main conclusion is that the way we access, produce and distribute data/information about influenza (through the use of communication and Internet-based technologies for surveillance) has a direct impact on the risk perception and, ultimately, on public health policies through an “overload” of data.

      PubDate: 2017-02-24T00:42:10Z
      DOI: 10.1016/j.hlpt.2017.02.001
       
  • Predicting Obesity Rate and Obesity-Related Healthcare Costs using Data
           Analytics
    • Authors: Stephanie Revels; Sathish A.P Kumar; Ofir Ben-Assuli
      Abstract: Publication date: Available online 17 February 2017
      Source:Health Policy and Technology
      Author(s): Stephanie Revels, Sathish A.P Kumar, Ofir Ben-Assuli
      Objective Obesity is a worldwide problem that has been linked to serious medical issues. Obesity-related conditions drain healthcare expenditures globally, and in particular in the U.S. This article suggests methods to forecast future costs associated with obesity-related healthcare in the next two decades. Methods An Auto Regressive Integrated Moving Average (ARIMA) time series analysis was implemented to model the data published by the Center for Disease Control and Prevention. Results The findings suggest that the proportion of individuals in the population defined as overweight will decline slowly in the next 20 years. However, the proportion of the population considered obese will increase substantially and could represent as much as 45% of the entire population by 2035. The proportion of morbidly obese will also increase considerably. These trends are likely to impact the actual costs of healthcare considerably. Conclusions Policy makers in the healthcare sector should be aware of this trend and prepare to deal with increasing numbers of medical problems related to obesity. Concrete recommendations for policy makers are put forward in the discussion as well as avenues for future research.

      PubDate: 2017-02-24T00:42:10Z
      DOI: 10.1016/j.hlpt.2017.02.002
       
  • Spatial clusters of AIDS in Indonesia
    • Authors: Hui-Peng Liew; Talbot Brooks
      Abstract: Publication date: Available online 28 January 2017
      Source:Health Policy and Technology
      Author(s): Hui-Peng Liew, Talbot Brooks
      Objective This study seeks to determine whether distinctive clusters of case rates, number of new cases, treatment types, and other socio-demographic characteristics exist among provinces in Indonesia. Hierarchical Agglomerative and k-means clustering techniques are used to empirically derive the patterns of AIDS among Indonesian provinces by forming clusters of provinces with similar characteristics. Methods Cluster analysis is used to segment the Indonesian provinces in terms of how their rates of medical care and number of new cases of AIDS vary with respect to the socio-economic characteristics and sustainable health system of the province. Data from the 2011 Statistik Indonesia (2014–2015) and the 2006 Governance and Decentralization Survey were used. Results Cluster analysis yielded three distinct clusters: the high incidence rates and moderately high case rates cluster, the low case and incidence rates cluster, and the high case and incidence rates cluster. Conclusion Addressing the socioeconomic, demographic, and health inequalities that exist among the provinces should be a priority. Preventive interventions should consider provincial poverty and illiteracy rates, the population and its density, the type of self-treatment sought, the unmet need for healthcare services, the density of medical professionals, as well as the number of opportunistic infections.

      PubDate: 2017-01-29T18:00:03Z
      DOI: 10.1016/j.hlpt.2017.01.005
       
  • Factors Influencing Health Data Sharing Preferences of Consumers: A
           Critical Review
    • Authors: Lisa A. Moon
      Abstract: Publication date: Available online 25 January 2017
      Source:Health Policy and Technology
      Author(s): Lisa A. Moon
      The purpose of this critical review is to synthesize available literature and identify factors influencing consumer data sharing preferences, while presenting a logic model for legal / public policy development that aligns with consumer expectations for management of ePHI. Eighteen articles were included for the critical review; including 16 studies from three countries. The fourteen cross-sectional studies were evaluated using Olsen and St. George's (2004) Cross-sectional Study Design and Data Analysis framework and two qualitative studies were assessed using Kuper, Lingard, & Levinson (2008) Critically Appraising Qualitative Research strategies. An emerging classification schema of statistically significant factors identified in this critical review shows that, 1) Trust relationship, 2) Harm Threshold, 3) Balance Risk and Benefits, 4) Transparency of Data Exchange and 5) Access and Control of Data are important when considering how to best include the consumer voice in the development of legal / public policies related to the privacy, security and consent management of ePHI.

      PubDate: 2017-01-29T18:00:03Z
      DOI: 10.1016/j.hlpt.2017.01.001
       
  • The impact of pharmaceutical innovation on health outcomes and utilization
           in Turkey: a re-examination
    • Authors: Frank Lichtenberg; Mehtap Tatar; Zafer Çalışkan
      Abstract: Publication date: Available online 25 January 2017
      Source:Health Policy and Technology
      Author(s): Frank Lichtenberg, Mehtap Tatar, Zafer Çalışkan
      Previous research investigating the impact of pharmaceutical innovation in Turkey has shown that the use of newer drugs increased mean age at death by approximately 3 years during the period 1999–2008 and reduced the number of hospital days by approximately 1% per year during the period 2007–2010. The present study assesses the contribution of pharmaceutical innovation to longevity and hospital use in Turkey during a more recent period (2009–2013), using different longevity measures, and with a different data set. The IMS Health Turkey Medical Prescription Index, which provides detailed diagnosis and treatment profiles of patients treated in outpatient clinics, is used. This enables us to use annual data during the period 2009–2013 on the drugs prescribed by doctors for the treatment of 19 medical conditions to measure pharmaceutical innovation. Our findings indicate that new technology continued to have a favorable impact on potential years of life lost before age 70, the age-standardized mortality rate, and hospitalization during the period 2009–2013. Pharmaceutical innovation (i.e., the use of newer molecules) decreased premature deaths by 2.2%, the age-adjusted mortality rate by 3.6%, and hospitalization by 7.3%. Turkish healthcare policy-makers should consider the broader outcomes of restrictions on access to new medicines.

      PubDate: 2017-01-29T18:00:03Z
      DOI: 10.1016/j.hlpt.2017.01.003
       
  • Privacy and Security Issues in Mobile Health: Current Research and Future
           Directions
    • Authors: Soumitra Bhuyan; Hyunmin Kim; Oluwaseyi O. Isehunwa; Naveen Kumar; Jay Bhatt; David K. Wyant; Satish Kedia; Cyril F. Chang; Dipankar Dasgupta
      Abstract: Publication date: Available online 25 January 2017
      Source:Health Policy and Technology
      Author(s): Soumitra Bhuyan, Hyunmin Kim, Oluwaseyi O. Isehunwa, Naveen Kumar, Jay Bhatt, David K. Wyant, Satish Kedia, Cyril F. Chang, Dipankar Dasgupta
      Mobile health (mHealth) is being recognized as an innovative approach to deliver health care in an accessible, portable and cost effective manner. Despite the numerous benefits associated with the use of mobile devices, there are major concerns with mhealth in the area of privacy and security. These aspects need to be considered at every stages of design and development of mHealth devices and applications and need to be developed by security-trained, trusted manufacturers who need to take responsibilities to minimize damages in healthcare industry. It is also crucial for users and/or organizations to be more cautious and responsible to use mobile devices. Major stakeholders, including those in the users community (patients and providers), vendors and developers, and policy makers, to come together to survey the landscape, identify the issues, and develop policies, regulations, safeguards and industry standards.

      PubDate: 2017-01-29T18:00:03Z
      DOI: 10.1016/j.hlpt.2017.01.004
       
  • Constructing a nationwide interoperable health information system in
           China: The case study of Sichuan Province
    • Authors: Huiping Zhang; Bernard T. Han; Zhiwei Tang
      Abstract: Publication date: Available online 23 January 2017
      Source:Health Policy and Technology
      Author(s): Huiping Zhang, Bernard T. Han, Zhiwei Tang
      Objectives China has set up an ambitious goal to complete the construction of a nationwide interoperable health information system (HIS) by the end of 2020. This paper provides a policy analysis, from the perspective of a province, on how China achieves nationwide interoperability through integrating Population Health Information Platforms (PHIP), developed by healthcare authorities at different levels, with HIS implemented by healthcare institutions. Methods An analytical framework, with a focus on interoperability between PHIPs and healthcare institutions’ HIS, is proposed and used to analyze Sichuan Province's interoperable HIS to shed light on China's approach. To assure the validity of our research, this study analyzed data collected from multiple sources including literature review, web-based search, and interviews with staff from healthcare institutions. Results China's approach to constructing a nationwide HIS offers great potential and flexibility through delegating PHIP construction to healthcare authorities at different levels. Our findings reveal that developed PHIPs have strong capacities for health information exchange. China's approach provides clear guidelines and standards such that healthcare authorities able to complete the construction of PHIPs on time. However, remedial policies are needed to improve the effective use and sustainability of completed systems. Conclusions To maximize use of developed systems, China government should: a) define a monitoring policy to ensure full observation of construction guidelines; b) promote a new payment mechanism to motivate information sharing; c) clarify the role of PHIPs, at different levels, to assure their effective use; d) provide incentives for non-public institutions to participate in EMR adoption.

      PubDate: 2017-01-29T18:00:03Z
      DOI: 10.1016/j.hlpt.2017.01.002
       
  • Is the Health App Challenge approach of patient-led application
           conception, development, and review worthwhile?
    • Authors: Emily J Ashurst; Ray B Jones
      Abstract: Publication date: Available online 28 December 2016
      Source:Health Policy and Technology
      Author(s): Emily J Ashurst, Ray B Jones
      Objectives A Health App Challenge, supporting young people with diabetes to develop and review their own Internet applications (apps) had previously been shown feasible. We aimed to clarify whether such patient-developed apps fill ‘app gaps’ and can be sustained, and if the approach can be generalized to other conditions. We asked, ‘Is it worth trying to run further Health App Challenges or elements of Health App Challenges?’ Methods Two Health App Challenges, one for diabetes and one for weight loss surgery, were run simultaneously. Each Challenge (i) invited patient review of existing apps, (ii) supported patient-led teams to design and/or develop their own apps for better health self-management and (iii) invited patient review of the patient-designed or developed apps. Results In the diabetes Challenge, 130 patient reviews were written for existing apps, five designs for new apps submitted and reviewed 17 times. Participants took account of the reviews and designs appeared to fill ‘app gaps’ in the market, but the designs were not developed as apps. In the bariatric Challenge, only 13 reviews were given for existing apps and no designs or developed apps were submitted. Conclusions Supporting patients to develop apps using this approach is not sustainable. However, a website where health apps and websites can be reviewed and prototype designs submitted would be worthwhile, at least for conditions with high prevalence such as diabetes. It remains unclear whether condition specific health charities could take the role of sustaining such review websites.

      PubDate: 2017-01-04T20:12:06Z
      DOI: 10.1016/j.hlpt.2016.12.001
       
  • Stakeholder preferences about policy objectives and measures of
           pharmaceutical pricing and reimbursement
    • Authors: Sabine Vogler; Nina Zimmermann; Katharina Habimana
      Pages: 213 - 225
      Abstract: Publication date: September 2016
      Source:Health Policy and Technology, Volume 5, Issue 3
      Author(s): Sabine Vogler, Nina Zimmermann, Katharina Habimana
      Objective Policy objectives, such as cost-containment and reward for innovation, can be conflicting, and different stakeholders are likely to prioritise policy measures with regard to their objectives differently. The study elicits preferences of different stakeholders in European countries about policy objectives and pharmaceutical pricing and reimbursement measures in accordance with their preferred objectives. Methods Representatives of eight stakeholder groups (patients, consumers, competent authorities for pharmaceutical pricing and reimbursement, public payers, research-oriented industry, generic medicines industry, pharmacists, doctors) from the 28 EU Member States were invited to express their preferences about seven policy objectives and 16 measures in a web-based questionnaire. The replies were analysed through a Multi-Criteria Decision Analysis (MCDA), using an outranking method based on the ELECTRE III algorithm. Results Based on 81 valid responses showed that nearly all stakeholders attributed highest priority to equitable access to medicines. Overall, stakeholders considered pharmaco-economic evaluation as the most appropriate policy measure to achieve policy objectives in accordance with their preferences. Value-based pricing and a transparent reimbursement process were ranked second and third. Across all groups, low preference was given to external price referencing (EPR) and co-payments, whereas stakeholders had differences in assessment on tendering, generic substitution and differential pricing. Conclusions The overall negative assessment of the commonly used EPR policy suggests a possible need for change in current pricing practice. However, positions about alternative pricing options differ considerably across stakeholders. It is recommended to further explore the motivation of the stakeholders for their assessments in a qualitative research project.

      PubDate: 2016-09-15T12:19:00Z
      DOI: 10.1016/j.hlpt.2016.03.009
       
  • Organizing standardized electronic healthcare records data for mining
    • Authors: Shivani Batra; Shelly Sachdeva
      Pages: 226 - 242
      Abstract: Publication date: September 2016
      Source:Health Policy and Technology, Volume 5, Issue 3
      Author(s): Shivani Batra, Shelly Sachdeva
      Digitized and standard health data is highly desirable in healthcare domain. Current research started with the aim of mining standardized electronic health records (EHRs) data. It is observed that the available column-modeled database lacks in volatility and ability to deal with sparseness. Due to highly sparse nature of EHRs, there is need of organized standard based EHRs data to ascertain the benefit of mining and also to improve storage capacity. This paper proposes an architecture for preprocessing of data that deals with the issues of volatility and sparseness, and then transforming the data in a form which is desirable for data mining. The architecture proposed in this paper can be used by the data administrator to organize standardized EHRs for the application of any type of mining which can reveal knowledge to benefit various healthcare users, such as, doctors, patient and insurance company users. Simulation of proposed architecture is done on a sample set of 6700 instances of EHRs. Results demonstrate benefits of our approach in terms of storage required and time consumed (reduced by a factor of 2.5 approximately) to retrieve the desired piece of information. Consequently, data mining techniques capable of automatically extracting useful knowledge to provide clinical decision support may be applied. The decision support thus developed can be used by stakeholders, policy makers and other persons involved directly or indirectly with EHRs to take accurate and calculative decisions.

      PubDate: 2016-09-15T12:19:00Z
      DOI: 10.1016/j.hlpt.2016.03.006
       
  • Medical Technologies Evaluation Programme: A review of NICE progression
           decisions, 2010–2013
    • Authors: Kim Keltie; Derek R Bousfield; Helen Cole; Andrew J Sims
      Pages: 243 - 250
      Abstract: Publication date: September 2016
      Source:Health Policy and Technology, Volume 5, Issue 3
      Author(s): Kim Keltie, Derek R Bousfield, Helen Cole, Andrew J Sims
      Objectives To review the progression decisions for notifications considered at National Institute of Health and Care Excellence (NICE) Medical Technology Advisory Committee (MTAC) meetings during its first three years (2010–2013) to identify trends. Methods The list of medical devices discussed at committee, briefing notes, committee decisions, and non-progression letters, where applicable, were obtained from NICE. Each medical device presented to committee was classified using five different medical device categorisation systems. Trends in progression decision, scores against programme selection criteria over time, and reasons provided by committee to support the non-progression decision, were analysed. Results Between January 2010 and March 2013 31 MTAC meetings were held. Of the 110 medical technologies considered, 45 were given a progression decision (23 selected for Medical Technologies Guidance development, 22 routed for guidance development in other NICE programmes), 64 did not progress to guidance development and 1 was excluded from analysis whilst awaiting final committee decision. The six programme categories and total scores were not sensitive or specific predictors of progression to guidance decision. No significant change in the proportion selected for progression over time was observed (P>0.05). No compelling evidence of an association between the type of medical device and progression decision was found. Fifteen distinct reasons for non-progression were identified; ‘lack of evidence’ being provided in the majority, 93.8%, of cases. Conclusions During its first three years, MTAC׳s progression decisions for guidance development on medical technologies were not associated with device type and there is no evidence of changes over time.

      PubDate: 2016-09-15T12:19:00Z
      DOI: 10.1016/j.hlpt.2016.03.003
       
  • Editorial
    • Authors: Wendy L. Currie
      Pages: 97 - 98
      Abstract: Publication date: December 2016
      Source:Health Policy and Technology, Volume 5, Issue 4
      Author(s): Wendy L. Currie


      PubDate: 2016-11-17T03:27:20Z
      DOI: 10.1016/j.hlpt.2016.03.002
       
  • Editorial
    • Authors: Wendy L. Currie
      Pages: 97 - 98
      Abstract: Publication date: September 2016
      Source:Health Policy and Technology, Volume 5, Issue 3
      Author(s): Wendy L. Currie


      PubDate: 2016-09-15T12:19:00Z
      DOI: 10.1016/j.hlpt.2016.03.002
       
  • Identifying Priorities for Data Quality Improvement within Haiti's iSanté
           EMR System: Comparing Two Methods
    • Authors: Nancy Puttkammer; Kenny Pettersen; Nathaelf Hyppolite; Garilus France; Jean Solon Valles; Jean Guy Honoré; Scott Barnhart
      Abstract: Publication date: Available online 8 December 2016
      Source:Health Policy and Technology
      Author(s): Nancy Puttkammer, Kenny Pettersen, Nathaelf Hyppolite, Garilus France, Jean Solon Valles, Jean Guy Honoré, Scott Barnhart
      Objectives The aim of this case study was to compare two alternative strategies for prioritizing data elements for data quality assessment (DQA) in a routine health management information system. The study used data from iSanté, a multi-site electronic medical record implemented by the Haitian Ministry of Health. We described and compared two prioritization strategies: 1) a Delphi process drawing iterative feedback from clinicians and stakeholders responsible for monitoring and evaluation (M&E) of health programs to identify consensus priorities for data on HIV patients; and 2) a process using burden of disease estimates from Haiti to establish priorities for data on primary care patients. Methods The Delphi process included 26 individuals across 6 institutions, including clinicians and M&E specialists. Through three rounds of questionnaires, the stakeholders provided input for prioritization of 13 indicators for completeness, accuracy and timeliness of HIV data. The burden of disease prioritization process revealed that cardiovascular disease contributed to the greatest number of disability-adjusted life-years (DALYs). This resulted in the selection of 16 data quality indicators for primary care data. Results Both methods informed the definition of a set of automated data quality queries to assess internal validity, completeness, and timeliness using logic and clinical plausibility. The Delphi process benefited from stakeholder input, but was lengthy in process. The burden of disease prioritization process was objective and easier to implement, but lacked stakeholder buy-in. Conclusions A hybrid approach guided by both disease burden and stakeholder input may be most beneficial for prioritizing data elements for DQA. Key Messages • Strong data quality is necessary before data can be used to monitor and evaluate the performance of health systems. • In resource limited settings, data quality assessment within routine health information systems (HIS) can be resource-intensive, and automated queries within electronic HMIS can be useful in exposing strengths and gaps in data quality. • A Delphi process of stakeholder input and an objective process using burden of disease ranking were each used to priorities areas for data quality improvement within a large-scale HMIS in Haiti, and each process offered both strengths and limitations. • A hybrid approach to prioritization, using both disease burden and stakeholder input, would be beneficial in guiding automated queries for data quality improvement in electronic HMIS.

      PubDate: 2016-12-08T14:47:05Z
      DOI: 10.1016/j.hlpt.2016.11.006
       
  • A conjoint analysis of inpatient satisfaction ratings in Indonesia
    • Authors: Hui-Peng Liew; Talbot Brooks
      Abstract: Publication date: Available online 5 December 2016
      Source:Health Policy and Technology
      Author(s): Hui-Peng Liew, Talbot Brooks
      Objective The purpose of this study is to examine Indonesian men and women׳s satisfaction rating of the different attributes associated with the location, convenience, accessibility, and affordability of inpatient care and how the ratings differ across clusters of individuals. Methods The empirical work of this study is based on using the 2007 Indonesian Family and Life Survey. A conjoint analysis is used to examine Indonesian men and women׳s satisfaction rating of the above-mentioned attributes. Results Indonesians who utilizes the inpatient care are responsive to the type, cost, quality, and location of the inpatient care even though individuals in different clusters attach different importance to the different attributes associated inpatient care. Conclusion There is a pressing need for sound policies that seek to reduce the cost of treatment and consultation, to improve the quality of care facility, to build more care facilities, and to improve public transport infrastructure. Priority should be given to patients who visited facilities located outside their province of residence. Efforts to enhance the quality of inpatient care should focus on public facilities and facilities located in Sumatra.

      PubDate: 2016-12-08T14:47:05Z
      DOI: 10.1016/j.hlpt.2016.11.007
       
  • Access policy and the digital divide in patient access to medical records
    • Authors: Jessica S. Ancker; Sarah Nosal; Diane Hauser; Christopher Way; Neil Calman
      Abstract: Publication date: Available online 24 November 2016
      Source:Health Policy and Technology
      Author(s): Jessica S. Ancker, Sarah Nosal, Diane Hauser, Christopher Way, Neil Calman
      Background Patient access to medical records may help them manage their healthcare. After socioeconomic disparities were found in early adoption of a patient portal, a safety net medical organization implemented universal access policies, a mobile portal app, and a Spanish version. The objective of this study was to estimate the effect of the changes on socioeconomic disparities in use of the patient portal. Methods Retrospective cohort study of 129,738 adult patients visiting the Institute for Family Health between 2011 and 2014. Logistic regression was used to model the odds of receiving portal access and using the portal. Results In 2011, members of socioeconomically disadvantaged groups were less likely to receive offers to use the portal and subsequently to use it. In 2014, black patients became just as likely as other racial groups to use the portal, but publicly insured and uninsured patients were still less likely to become users. Uptake of the mobile app was slow. Conclusions Replacing an opt-in policy with a universal access policy was associated with a large reduction in socioeconomic disparities between those who did and did not access their medical records. However, a small digital divide remained evident in use of the technology, probably due to structural factors beyond the control of the healthcare system such as lack of computer access by less affluent patients.

      PubDate: 2016-12-01T13:08:16Z
      DOI: 10.1016/j.hlpt.2016.11.004
       
  • An examination of EHR implementation impacts on patient-flow
    • Authors: Jennifer Bushelle-Edghill; J. Lee Brown; Su Dong
      Abstract: Publication date: Available online 17 November 2016
      Source:Health Policy and Technology
      Author(s): Jennifer Bushelle-Edghill, J. Lee Brown, Su Dong
      Introduction This study builds upon prior knowledge to integrate data from an EHR system to investigate EHR implementation on patient -flow for operations within a pediatric practice. We compare pre-implementation administrative data from a practice management system with paper-based documents, and post-implementation data from a cloud-based EHR system. Methods This study reports on visits from a clinic within a network of eleven pediatric clinics during the period of April 16, 2012 to April 15, 2014. Results 2448 independent patient visits were used in the study. 838 pre-implementation visit records were collected for the period April 16, 2012 to May 15, 2012 period, 789 visit records for the period April 16, 2013 to May 15, 2013, and 821 visit records for April 16, 2014 to May 15, 2014. Overall mean process time increased to 81.43min immediately after implementation of the new EHR system. This was followed by a decrease (16.83min) in time from check in to check out post-implementation. Discussion There were significant improvements observed in patient-flow relative to initial EHR adoption; such improvements resulted in gains in operational efficiency in several steps within the process. Conclusion Findings suggests the effective use of knowledge-sharing among employees in complement with EHR training cannot be overlooked. While expected gains in operational efficiency may initially be achieved within some steps of the process, sustained overall gains can only be accomplished by overcoming the barriers and challenges to organizational learning.

      PubDate: 2016-11-24T05:05:51Z
      DOI: 10.1016/j.hlpt.2016.11.005
       
  • Editorial Board/Aims and Scope
    • Abstract: Publication date: December 2016
      Source:Health Policy and Technology, Volume 5, Issue 4


      PubDate: 2016-11-17T03:27:20Z
       
  • Patient Empowerment and Engagement with a Health Infomediary
    • Authors: Jiban Khuntia; Dobin Yim; Mohan Tanniru; Sanghee Lim
      Abstract: Publication date: Available online 13 November 2016
      Source:Health Policy and Technology
      Author(s): Jiban Khuntia, Dobin Yim, Mohan Tanniru, Sanghee Lim
      Objectives This study explores the role of three types of empowerment, psychological, discretionary, and leadership, on sustained engagement with a health infomediary. Discretionary empowerment refers to authority, psychological empowerment is the manifestation of inherent motivation and response, and leadership empowerment is the trait of knowledge-based control and governance for a group in an infomediary. Sustained engagement is critical for patients to derive long-term benefits from an infomediary. Relationships between the three types of patient empowerments on sustained patient engagement is conceptualized and operationalized with testable hypotheses. Methods Data from a health infomediary providing a knowledge exchange platform for patients interested in cosmetic surgery was obtained through the website. Probit regression models were used to test hypotheses using daily activity observations of 21,715 patients during the first 30 and 60 days of their engagement with the infomediary platform. Results All three empowerment types have positive association with sustained engagement. In addition, leadership empowerment is shown to play a higher role than discretionary or psychological empowerments in sustaining patient engagement. Conclusions Identifying empowered patients is likely to benefit health infomediaries. Leadership empowerment has a greater role than discretionary or psychological empowerments in sustaining patient engagement with infomediaries. Incentive structures around promoting patients towards leadership empowerment are likely to generate positive returns for health infomediaries.

      PubDate: 2016-11-17T03:27:20Z
      DOI: 10.1016/j.hlpt.2016.11.003
       
  • Barriers and Facilitators of a Real-Time Feedback Approach for Measuring
           Patient Experiences of Hospital Care
    • Authors: Susanne Käsbauer; Robyn Cooper; Laura Kelly; Jenny King
      Abstract: Publication date: Available online 9 November 2016
      Source:Health Policy and Technology
      Author(s): Susanne Käsbauer, Robyn Cooper, Laura Kelly, Jenny King
      Objectives To contribute towards the current policy directive and recommendations outlined in the Francis Report (1) to strengthen relational aspects of hospital care and increase the use of a near real-time feedback (RTF) approach. This article offers insight into the challenges and enablers faced when collecting near real-time feedback of patient experiences with trained volunteers; and using the data to facilitate improvements. Methods Feedback was collected from staff and volunteers before, during and after a patient experience data collection. This took the form of both formal mixed methods data collections via interviews, surveys and a diary; and informal anecdotal evidence, collected from meetings, workshops, support calls and a networking event. Results Various challenges and enablers associated with the RTF approach were identified. These related to technology, the setting, volunteer engagement and staff engagement. This article presents the key barriers experienced followed by methods suggested and utilised by staff and volunteers in order to counteract the difficulties faced. Conclusions The results from this evaluation suggest that a near real-time feedback approach, when used in a hospital setting with trained volunteers, benefits from various support structures or systems to minimise the complications or burden placed on both staff and volunteers.

      PubDate: 2016-11-10T02:25:49Z
      DOI: 10.1016/j.hlpt.2016.09.003
       
  • eHealth strategies and platforms - the issue of health equity in Sweden
    • Authors: Sofie Hellberg; Peter Johansson
      Abstract: Publication date: Available online 9 November 2016
      Source:Health Policy and Technology
      Author(s): Sofie Hellberg, Peter Johansson
      Objective This paper critically reviews the national strategies on e-health development in Sweden during the last decade. The aim is to identify the discourses that drive the development and implementation of eHealth in Sweden, with a particular focus on the rationales behind the government initiated PHR platform HälsaFörMig (HealthForMe), and discuss them in relation to health equity. Methods The empirical base for this study is government policy documents and interviews made with policy makers in the e-health sector in Sweden. The research design builds on qualitative text analysis method drawing on epistemological and ontological assumptions from discourse analysis. Results Our framework for analysis focuses on governing aspects of the eHealth sector drawing on the works of governmentality theorists. We have identified how the eHealth sector is increasingly governed through market mechanisms, healthism and responsibilisation and is forming individuals into self-managing health-conscious consumers in a way that may undermine reaching other core values in society such as health equity. It also shows that the design and administration of HälsaFörMig aim to stimulate innovation in the eHealth sector thereby illustrating the interrelationship between the governing techniques of market mechanism and healthism. Conclusion In order to close health gaps in a population the core governing rationalities driving the development in the eHealth sector have to be identified, monitored and evaluated to foresee if they help or hinder health equity.

      PubDate: 2016-11-10T02:25:49Z
      DOI: 10.1016/j.hlpt.2016.09.002
       
  • Engaging Stakeholders into an Electronic Patient-Reported Outcome
           Development Study: on Making an HIV-Specific e-PRO Patient-Centered
    • Authors: Kim Engler; David Lessard; Isabelle Toupin; Andràs Lènàrt; Bertrand Lebouché
      Abstract: Publication date: Available online 9 November 2016
      Source:Health Policy and Technology
      Author(s): Kim Engler, David Lessard, Isabelle Toupin, Andràs Lènàrt, Bertrand Lebouché
      Background The use of patient-reported outcome (PRO) measures in care and research is proposed to foster patient-centered care but this outcome may depend on stakeholder engagement in their development and implementation. Hence, we subsequently engaged HIV patients and clinicians into a study aimed at creating a new electronic PRO (e-PRO) for monitoring barriers to antiretroviral therapy adherence in HIV care. As detailed examples of such engagement are lacking, we describe our rationale, methods and first results of these engagement initiatives. Methods We established a 10-member patient committee. Periodic focus groups engaged HIV clinicians. Focus groups were conducted with both groups to assess needs for the e-PRO: 3 mainly with patient committee members (n=12) and 5 with clinicians (n=31). Content on the e-PRO's targeted concept (adherence barriers) was analysed with Grounded Theory (patients) and with typological analysis (clinicians). Results Patients’ discussions reflected three temporal categories (imprinting, domino effects, future-shadowing) and one overarching theme (weathering) in the experience of adherence and its many barriers. Latent within HIV clinicians’ discussions was a typology of patients organized by distinct barriers to adherence, life conditions, and attitudes to care. Discussion Results emphasize the lived experience of managing barriers and its complexity. They suggest the new e-PRO should accommodate patient diversity, contextualize scores longitudinally, and address the personal significance of individual barriers (e.g., distressfulness) beyond their mere presence. These initial results and the opportunities presented by our long-term engagement initiatives should ensure the production of a useful and used patient-centered e-PRO.

      PubDate: 2016-11-10T02:25:49Z
      DOI: 10.1016/j.hlpt.2016.11.002
       
  • Editorial: Patient-Centered Health Information Technology: Preparing for a
           New Era
    • Authors: Reeva Lederman; Ofir Ben-Assuli
      Abstract: Publication date: Available online 4 November 2016
      Source:Health Policy and Technology
      Author(s): Reeva Lederman, Ofir Ben-Assuli


      PubDate: 2016-11-10T02:25:49Z
      DOI: 10.1016/j.hlpt.2016.11.001
       
  • Improving EU policies for ICT for development: Results from a survey of
           ICT experts
    • Authors: GianLuca Quaglio; Theodoros Karapiperis; Giovanni Putoto; Laura Delponte; Giorgio Micheletti; Helmut Brand; Luigi Bertinato; Göran Tomson; Laurent Bonnardot; Paolo Zanaboni
      Abstract: Publication date: Available online 23 September 2016
      Source:Health Policy and Technology
      Author(s): GianLuca Quaglio, Theodoros Karapiperis, Giovanni Putoto, Laura Delponte, Giorgio Micheletti, Helmut Brand, Luigi Bertinato, Göran Tomson, Laurent Bonnardot, Paolo Zanaboni
      Background There is scarce and fragmented evidence of the European Union's policies and strategies being used in ICT for development in LMICs. Methods An online survey was conducted to collect feedback from experts evaluating past EU initiatives in ICT for development, and the type of approach EU institutions should pursue in ICT in LMICs in the future. Structured interviews were also carried out with ten of the respondents. Results One hundred and twenty-one experts responded to the survey. About 30% believe that the EU institutions’ support to ICT for development has improved in the last decade. However, a similar percentage indicated that the EU's support has not improved or even has worsened. The evaluation of the EU's cooperation with international organizations was considered good or sufficient by nearly 31% of respondents. Regarding priorities to be pursued by EU policies towards the use of ICT for development, the EU should focus on reducing health inequalities and the digital divide. Concerning the approaches to promote ICT within EU development cooperation, the EU should carry out a mix of top-down and bottom-up approaches. Almost 70% believe that it is better to support an approach that integrates ICT into different areas of action, rather than having ICT as a specific priority area. Health and education were indicated as priority sectors where the EU should increase the use of ICT. Conclusions The results of this survey can support decision-makers and ICT managers to better plan and implement ICT in LMICs.

      PubDate: 2016-09-27T14:33:06Z
      DOI: 10.1016/j.hlpt.2016.09.001
       
  • Editorial Board/Aims and Scope
    • Abstract: Publication date: September 2016
      Source:Health Policy and Technology, Volume 5, Issue 3


      PubDate: 2016-09-15T12:19:00Z
       
  • The disconnect between healthcare provider tasks and privacy requirements
    • Authors: Michael Lapke; Christopher Garcia; David Henderson
      Abstract: Publication date: Available online 20 August 2016
      Source:Health Policy and Technology
      Author(s): Michael Lapke, Christopher Garcia, David Henderson
      Objectives Healthcare organizations have been digitizing their Electronic Medical Records (EMRs) for several years now and one of the primary concerns of their widespread implementation is the assurance of privacy for the sensitive information [22,23]. The objective of this study is to shed light into healthcare providers׳ attitudes towards privacy with regards to EMRs. We argue that healthcare providers place a priority on privacy issues given regulatory, fiscal, and reputation repercussions. Methods Using Information Boundary Theory [41] as a theoretical framework, we established four research questions. These questions formed the basis for the hypotheses that healthcare providers would agree with withholding information (to prevent loss and increase gains) as well as disagree with sharing information. We constructed a survey from this framework and administered it to 327 subjects (with a 45% response rate). Survey validation was conducted as well as hypothesis testing. Results The analysis of the data yielded a result that indicated that the survey responses did not support the hypotheses. Healthcare providers strongly disagreed that they would withhold information to solidify gains or mitigate losses. The subjects also agreed that they would share information in order to solidify gains or mitigate losses. Conclusions This led to the surprising conclusion that healthcare providers do not place privacy as a high-priority within the context of their duties. Healthcare professionals prioritize personal and organizational gain as well as mitigating personal and organizational loss over privacy of EMRs.

      PubDate: 2016-09-15T12:19:00Z
      DOI: 10.1016/j.hlpt.2016.08.004
       
  • Enabling Clinical Teams to Deliver Patient-centered Cancer Care: The
           Critical Role of Health Information Technology
    • Authors: Gurvaneet Randhawa; David Ahern; Bradford Hesse
      Abstract: Publication date: Available online 20 August 2016
      Source:Health Policy and Technology
      Author(s): Gurvaneet Randhawa, David Ahern, Bradford Hesse
      The existing healthcare delivery system does not provide high-quality care to all Americans. There is a need for a multi-level system redesign that takes advantage of the recent advances in computational power; real-time connectivity; human and organizational capabilities and management science; and patient empowerment and communication with clinical teams. A key goal of the redesigned system is to deliver high-quality, patient-centered care. This narrative review highlights promising new developments in health information technology (IT) that can help clinical team functioning. We view team functioning to include team interactions, communications across multiple levels of care, and inclusion of patients and family members as the anchor for patient-centered communications. Failures in teamwork and communication have contributed to medical errors. A sociotechnical perspective and an understanding that health systems are complex adaptive systems is important for the effective design and use of health IT. The use of automation to help quit smoking, secure messaging to reduce “no shows”, and using telehealth to help care delivery and patient self-management are examples of how health IT has helped teams deliver high-quality, patient-centered care. We found several knowledge gaps that limit our ability to realize the full potential of health IT. The gaps are in diverse domains: patient engagement; care coordination; team interactions with each other and with health IT; tools to improve cognition, situation awareness and decision-making; patient portal customization; quality and flow of data; and generalizable principles of user-centered design that apply to patient engagement with cancer care delivery teams.

      PubDate: 2016-09-15T12:19:00Z
      DOI: 10.1016/j.hlpt.2016.08.001
       
  • Primary prevention for employees in the Information Age Organization
    • Authors: Stefan Schellhammer; Stefan Klein; Esther Ebner
      Abstract: Publication date: Available online 20 August 2016
      Source:Health Policy and Technology
      Author(s): Stefan Schellhammer, Stefan Klein, Esther Ebner
      The nature of work and the way it is organized continues to change profoundly. The continuing debate on flexible work arrangements reveals the perceived need of policy makers to react to these changes in a balanced manner. Despite the demand of organizations and employees alike, the negative implications of flexible work arrangements threaten to counteract the equally valid arguments for their benefits. The new autonomy of the individual employee is mirrored by a management style that emphasizes results rather than specifying the way to achieve them. Despite the cherished liberties of the new workplace, studies indicate that stress due to unhealthy work practices has become a major concern for preventive care in these environments. Based on a study with IT professionals we set out to dispute the effectiveness of mainstream measures of preventive care that aim at (re-)regulating work. Instead, we propose an employee-centred approach to preventive care that aims at sensitizing employees to structural defects of new ways of working (through biofeedback and reflection on work patterns) and helping employees in crafting their work practices. Initial results of our empirical study, which combines biometric as well as qualitative data, indicate both the need and the potential for employee-centred preventive care. We demonstrate how bio feedback can inform the coaching of individuals in their quest for sustainable work practices.

      PubDate: 2016-09-15T12:19:00Z
      DOI: 10.1016/j.hlpt.2016.08.005
       
  • Public use of electronic personal health information: Measuring progress
           of the Healthy People 2020 objectives
    • Authors: Alexandra J. Greenberg; Katrina J. Serrano; Chan L. Thai; Kelly D. Blake; Richard P. Moser; Bradford W. Hesse; David K. Ahern
      Abstract: Publication date: Available online 20 August 2016
      Source:Health Policy and Technology
      Author(s): Alexandra J. Greenberg, Katrina J. Serrano, Chan L. Thai, Kelly D. Blake, Richard P. Moser, Bradford W. Hesse, David K. Ahern
      Use of the internet for seeking and managing health information in the U.S., Europe, and emerging and developing nations is growing. Recent global trends indicate more interactive uses of the internet including online communication with providers. In the U.S., The Healthy People 2020 (HP2020) initiative was created by the Department of Health and Human Services to provide 10-year goals for improving the health of American citizens. Two goals of HP2020 were to increase the proportion of individuals who use the Internet to keep track of their personal health information (PHI) online and to increase the proportion of individuals who use the internet to communicate with their healthcare provider. In the present study, we use data from the seven administrations of the Health Information National Trends Survey (HINTS) to assess progress towards these goals. These data were analyzed using descriptive, bivariate, and logistic regression analytic techniques. Results of this study suggested that the HP2020 target of having 15.7% of individuals manage their PHI online by 2020 has already been exceeded (28.1%); similarly, the goal for proportion of individuals communicating with their provider using the internet (15.0%) was exceeded by 2014 (29.7%). While progress towards these goals was positive in all sociodemographic groups for both goals, differences in the rate of progress were seen by gender, race/ethnicity, income, and education, but not by age group. The rapidly increasing proportion of individuals globally who use the internet to manage their health information provides unique opportunities for patient-centered health information technology interventions.

      PubDate: 2016-09-15T12:19:00Z
      DOI: 10.1016/j.hlpt.2016.08.003
       
  • A review of PHR, EMR and EHR integration: A more personalized healthcare
           and public health policy
    • Authors: Tsipi Heart; Ofir Ben-Assuli; Itamar Shabtai
      Abstract: Publication date: Available online 20 August 2016
      Source:Health Policy and Technology
      Author(s): Tsipi Heart, Ofir Ben-Assuli, Itamar Shabtai
      Objective To review and present the relationship and need for integrating EMR, EHR and PHR data, by highlighting its use and value challenges and threats. Method Critical overview of the literature. Results Electronic Medical Records (EMR) and Electronic Health Records (EHR) are used by physicians to improve quality of care and contain costs. Whereas EMR is usually considered an internal organizational system, the EHR is defined as an inter-organizational system. Recently, a computerized platform for patient-centered medical care known as Personal health records (PHR) was introduced, as an enabler for self-management of medical records. PHRs are online systems used by patients. Their transparency of information should lead to better informed and engaged patients. PHR, EMR and EHR can reside on different platforms under various technologies and standards. Although EMR contains local information and provides fast and accurate delivery, the major advantage of EHR in medical practice is the availability of cross-provider medical information. Patient-centered health initiatives such as PHR enable the integration of the prime information components in the EMR and the EHR systems. Conclusion This integration of medical information combines demographic, lifestyle and behavioral data with health records, thus providing a comprehensive view that coincides with the definition of patient-centered medical care. It can lead to a dramatic amelioration in personalized care as well as public health decision-making, resulting in improved health and wellness, but also poses serious challenges and threats to security and privacy.

      PubDate: 2016-09-15T12:19:00Z
      DOI: 10.1016/j.hlpt.2016.08.002
       
  • Pharmaceutical price comparisons across the European Union and relative
           affordability in Cyprus
    • Authors: Panagiotis Petrou; Sotiris Vandoros
      Abstract: Publication date: Available online 8 August 2016
      Source:Health Policy and Technology
      Author(s): Panagiotis Petrou, Sotiris Vandoros
      This paper performs price comparisons of branded pharmaceutical products in markets of eleven European Union countries. We follow a Laspeyres index approach, using Cyprus as the base country and analyse prices in the private and public markets and also consider biotechnology products separately. We find that Germany, Denmark and Austria demonstrate the highest pharmaceutical prices in the EU, followed by Cyprus. When adjusting for per capita income, Cyprus demonstrates the highest prices. Given that there is no universal health insurance in Cyprus, and that the country is facing a financial crisis, our findings underline possible affordability problems for patients. In order to remove barriers to access to medicines, pharmaceutical pricing regulation could be adjusted and price revisions should take place more frequently, and, most importantly, Cyprus must move in the direction of adopting universal health insurance.

      PubDate: 2016-09-15T12:19:00Z
      DOI: 10.1016/j.hlpt.2016.07.009
       
  • E-Health in Europe: Current situation and challenges ahead
    • Authors: Gianluca Quaglio; Claudio Dario; Panos Stafylas; Madis Tiik; Sarah McCormack; Pēteris Zilgalvis; Marco d’Angelantonio; Theodoros Karapiperis; Claudio Saccavini; Eva Kaili; Luigi Bertinato; John Bowis; Wendy L. Currie; Alexander Hoerbst
      Abstract: Publication date: Available online 6 August 2016
      Source:Health Policy and Technology
      Author(s): Gianluca Quaglio, Claudio Dario, Panos Stafylas, Madis Tiik, Sarah McCormack, Pēteris Zilgalvis, Marco d’Angelantonio, Theodoros Karapiperis, Claudio Saccavini, Eva Kaili, Luigi Bertinato, John Bowis, Wendy L. Currie, Alexander Hoerbst


      PubDate: 2016-09-15T12:19:00Z
      DOI: 10.1016/j.hlpt.2016.07.010
       
  • Integrating smartphone communication strategy and technology into clinical
           practice: A mixed methods research study
    • Authors: Carly Webb; Sean P. Spina; Shirley Young
      Abstract: Publication date: Available online 2 August 2016
      Source:Health Policy and Technology
      Author(s): Carly Webb, Sean P. Spina, Shirley Young
      Background Paging systems continue to be used by the majority of hospitals despite the nearly ubiquitous use of personal and/or corporate smartphones by hospital clinicians. Integrated multi-platform smartphone apps, such as the Vocera® Collaboration Suite (VCS), have the potential to be a reliable, efficient, and secure methods of communication in hospitals. Objective To examine the effect of VCS, on communication and the efficiency of communication between hospital clinicians. Methods A Three-month prospective observational study was completed at two tertiary care hospitals, and one community hospital, at Island Health (Vancouver Island, British Columbia, Canada). Hospitalists, obstetricians, intensivists, and pharmacists piloted the VCS smartphone app in the replacement of pagers. Switchboard operators, ICU nurses, and ICU unit clerks had access to the app via a desktop computer based web console. Our primary outcome was the difference in page turnaround time before and after the implementation of VCS. We also conducted baseline and post-study surveys and measured the volume of the app׳s usage. Results Physicians responded to pages faster (5.5 vs 3min; p<0.05) when using VCS compared to traditional pagers. Physicians found the app was more efficient, reduced interruptions to patient care, and 81% of physicians wanted to continue using the system. The highest reported drawback of the app was the reduction in phone battery life. Conclusions Smartphone based communication systems, such as Vocera® Collaboration Suite, improve the speed of, and satisfaction with hospital communication when compared to pagers. Reduced phone battery life should be considered when implementing VCS.

      PubDate: 2016-09-15T12:19:00Z
      DOI: 10.1016/j.hlpt.2016.07.004
       
  • Raising concern about the information provided on medical travel agency
           websites: A place for policy
    • Authors: Áine Maguire; Sarah Bussmann; Celine Meier zu Köcker; Sanne E. Verra; Lavinia Alexandra Giurgi; Kai Ruggeri
      Abstract: Publication date: Available online 20 July 2016
      Source:Health Policy and Technology
      Author(s): Áine Maguire, Sarah Bussmann, Celine Meier zu Köcker, Sanne E. Verra, Lavinia Alexandra Giurgi, Kai Ruggeri
      Patients are increasingly choosing to travel abroad for essential but non-urgent medical treatments, such as hip and heart valve replacements. Websites are frequently the first contact point with potential international service providers, such as medical travel agencies (MTAs). Yet only a few studies have previously assessed the standard of information provided on the websites of MTAs. This study examined the information provided by European MTA websites using a modified version of the Health on the Net (HON) code. A content analysis of the information collected assessed how the MTA websites promoted their services and communicated the risks, benefits and other issues related to medical travel. Twenty-seven websites based in thirteen different European countries were identified and coded using a modified version of the HON tool. Considerable inconsistencies across websites were noted on all domains assessed and no single item of the tool was addressed by all websites. The most frequently included item on websites was a contact form (74%), but no website provided information on risk rates, or used scientific references to support their claims. The promotion of benefits of medical travel coupled with the absence of risk communication was concerning. It is evident that there is a need for a policy which considers the regulation of MTAs and the information and services that they provide.

      PubDate: 2016-09-15T12:19:00Z
      DOI: 10.1016/j.hlpt.2016.07.001
       
  • Information and communications technologies in low and middle-income
           countries: Survey results on economic development and health
    • Authors: GianLuca Quaglio; Claudio Dario; Theodoros Karapiperis; Laura Delponte; Sarah Mccormack; Göran Tomson; Giorgio Micheletti; Laurent Bonnardot; Giovanni Putoto; Paolo Zanaboni
      Abstract: Publication date: Available online 20 July 2016
      Source:Health Policy and Technology
      Author(s): GianLuca Quaglio, Claudio Dario, Theodoros Karapiperis, Laura Delponte, Sarah Mccormack, Göran Tomson, Giorgio Micheletti, Laurent Bonnardot, Giovanni Putoto, Paolo Zanaboni
      Background Despite the wide gap between the developed and developing world in terms of ICT access, ICT investment in low and middle-income countries (LMICs) has increased due to the rapid development of mobile services. However, the effects of ICTs in LMICs remain debatable. Methods An online survey was conducted to collect feedback from experts. The questionnaire explored the role of ICTs in the economic development of LMICs, investigated the benefits and limits of e-health, and collected evaluations of past EU initiatives on future development policies. Structured interviews were also carried out with ten of the respondents. Results One hundred and forty-five experts responded to the survey. Health and education were considered to be the two main areas where ICTs can support economic development. Poor infrastructure, lack of political support and human capital, and poor affordability were found to be the main obstacles. The shortcomings of donors in fostering the role of ICTs in LMICs development were identified as sustainability of interventions and lack of a coherent approach. The main benefits of e-health technologies in LMICs are their ability to facilitate health information and increase access to health care. Remote data collection, training for healthcare workers and education are the most effective m-health applications. Poor infrastructure and lack of equipment are considered the main barriers to the use of e-health in LMICs. Limited financial resources and lack of policy and regulatory frameworks might prevent the scaling up of e-health. Conclusions The results of this survey can support decision makers and healthcare managers to better plan and implement ICTs in LMICs and make improved use of European resources for development.

      PubDate: 2016-09-15T12:19:00Z
      DOI: 10.1016/j.hlpt.2016.07.003
       
  • An automatic key medical information generating model
    • Authors: Shih-Ting Yang
      Abstract: Publication date: Available online 19 July 2016
      Source:Health Policy and Technology
      Author(s): Shih-Ting Yang
      Present-day society shows keen interest in the field of medical treatment, and the diagnostic mode is now developing toward doctor–patient shared decision-making. Therefore, a patient׳s source of medical information is quite important, with that source needing to be reliable, accurate, and easily accessible. Ensuring that informational sources meet these requirements becomes a challenge with the development of the informational network, which causes the amount of material available online to steadily increase and the general public to become more aware of health- and medical-treatment-related information. Therefore, focusing on the medical information seeker, this paper will discuss two user identities: patients and healthcare professionals. For patients, online medical articles are a major source of medical information; patients with concerns about diseases often search for their symptoms on the Internet and look for related medical information. However, online medical articles are usually long, so patients sometimes self-diagnose their disease or determine the severity of their condition based on only part of an article or on limited, incomplete, or even inaccurate information in several articles related to the symptoms searched out. Consequently, patients may misdiagnose their condition or underestimate the severity or seriousness of the condition and delay treatment. In addition, present medical technology advances rapidly, so physicians and other healthcare professionals must obtain the latest medical information from the Internet. However, searching for and reading professional in-depth medical articles to find required, critical information online is time-consuming, creating a time-management challenge. To address these aforementioned problems, this paper develops an Automatic Key Medical Information Generating model, uses medical articles as the basis of analysis, and develops and designs a medical article key-information-generating methodology applicable to medical article retrieval and reading. The word segmentation is implemented for the articles according to the Chinese Knowledge and Information Processing (CKIP) of Academia Sinica, and the medical articles are then distributed to various clusters by the clustering technology of this model, so that the medical information seeker can conduct a rapid search for the required medical article information. When the medical information seeker finds the target medical article, the article׳s key statements are screened out by the keywords rule base created in this paper, and the key statement scores are calculated. The medical article key information is sequenced according to the key statements so as to generate the medical article key information table. In addition, a web-based key-medical-information-generating system will be built based on the proposed model, and the effectiveness and feasibility of the model and technology will be evaluated using a real-world case. In summary, this paper presents a model to analyze the keywords and key statements of medical articles to generate a medical article key information table. This model can help the medical information seeker look for the required health information rapidly and accurately on the Internet, shortening the time for screening medical information and increasing the probability of obtaining the required information.

      PubDate: 2016-09-15T12:19:00Z
      DOI: 10.1016/j.hlpt.2016.07.006
       
  • A preliminary analysis on CPOE functioning in Mississippi and implications
           for future research
    • Authors: Hui-Peng Liew
      Abstract: Publication date: Available online 18 July 2016
      Source:Health Policy and Technology
      Author(s): Hui-Peng Liew
      Objective This study seeks to describe the state of the hospitals in Mississippi in terms of the computerized physician order entry (CPOE) scores in relation to their overall performance rankings, safety standards, mortality rates from treatable serious complications, as well as the racial composition and the median household income of the city or the town whether the hospital is located. A secondary goal of this study is to determine whether clusters exist among these hospitals in terms of these characteristics. Methods Data is obtained from the 2015 Leapfrog Survey, HealthInsights, and the 2010 U.S. census. Descriptive statistics are used to describe the state of the hospitals in Mississippi in terms of CPOE scores, as well as performance rankings and safety standards in relation to the demographic and socioeconomic characteristics of the city or the town whether the hospital is located. Two-step clustering within SPSS is used to segment hospitals based on the above mentioned characteristics. Results There is a great variation in terms of CPOE scores among hospitals in Mississippi. Most hospitals in Mississippi have a relatively well functioning CPOE system (the scores range from 65 to 100%). Hospitals with low CPOE functioning scores tend to have low safety grades and tend to be located in low income areas. Conclusion Strategies to promote usage of the CPOE systems should be continued. Priority should be given to hospitals characterized by low performance rankings and low safety standards that are located in located in areas that are either predominantly black or in areas with low median incomes.

      PubDate: 2016-09-15T12:19:00Z
      DOI: 10.1016/j.hlpt.2016.07.005
       
  • Sustainability strategies for regional health information organization
           startups
    • Authors: Till J. Winkler; Pinar Ozturk; Carol V. Brown
      Abstract: Publication date: Available online 18 July 2016
      Source:Health Policy and Technology
      Author(s): Till J. Winkler, Pinar Ozturk, Carol V. Brown
      Objectives Similar to other Western healthcare systems, the U.S. has sought to build a national infrastructure to enable widespread electronic health information exchange (HIE). The 2009 U.S. HITECH Act׳s State HIE Cooperative Agreement Program (SHIECAP) was a short-term catalyst for bottom-up HIE initiatives by states and regional health information organizations (HIOs). Given the high failure rates of regional U.S. HIOs in the past, our primary objective is to identify the key characteristics of HIO startups that became operational and demonstrated sustainability with non-renewable SHIECAP funding in a state environment with very minimal prior HIE activities. Methods Based on interview data we collected from 22 stakeholders in New Jersey (NJ) at the state, HIO, and hospital levels, we apply grounded theory techniques to identify cross-case similarities and differences. Results Although the three NJ HIOs that became operational during the SHIECAP grant period faced similar startup challenges, the two HIOs that demonstrated sustainability pursued distinct technology and sustainability strategies to develop HIE capabilities to fit their very different regional needs: an HIE capability to improve the population health of an underserved urban population, and an HIE capability to enable the transition to a healthcare landscape that rewards care coordination across suburban hospitals and physician practices. Conclusions We propose two models of technology and sustainability strategies for developing bottom-up HIE capabilities for different regional populations. Future research within and beyond U.S. contexts needs to take into account these key characteristics to improve our understanding of effective policy levers and government funding mechanisms.

      PubDate: 2016-09-15T12:19:00Z
      DOI: 10.1016/j.hlpt.2016.07.002
       
  • Design framework for sensors and RFID tags with healthcare applications
    • Authors: Mark Gaynor; Jason Waterman
      Abstract: Publication date: Available online 18 July 2016
      Source:Health Policy and Technology
      Author(s): Mark Gaynor, Jason Waterman
      Objectives This paper presents a framework to aid in the integration of sensor and radio frequency device (e.g., RFID tags) data into IT applications. This framework is applied to the area of healthcare applications because data quality is important to improving patient care while reducing overall costs. Real-time, high quality data are critical for emergency medical applications, telemedicine, and preventive care, which sensor based applications can provide. Methods This is a theory-based approach, illustrated with examples from the healthcare industry. Results While the benefits of sensor-enabled applications are clear, the many design decisions faced by designers are complex. A sensor design framework is presented that links the requirements of the application with the capabilities of the many types of sensors available for healthcare. Conclusion This framework highlights the design decisions between technology, architecture, and algorithmic solutions. This provides the tools needed to design and implement effective and efficient sensor-based IT solutions in healthcare applications.

      PubDate: 2016-09-15T12:19:00Z
      DOI: 10.1016/j.hlpt.2016.07.007
       
  • Information and/or medical technology staff experience with regulations
           for medical information systems and medical devices
    • Authors: Bodil Ivarsson; Stig Wiinberg; Martin Svensson
      Abstract: Publication date: Available online 18 July 2016
      Source:Health Policy and Technology
      Author(s): Bodil Ivarsson, Stig Wiinberg, Martin Svensson
      Objectives Regulations heavily control medical technology (MT), which often includes information technology (IT), but staff experiences related to these regulations are unknown. The study aim was to assess Swedish IT/MT staff experiences regarding regulations for medical devices and medical information systems. Methods An anonymous, ten-item, self-report questionnaire was administered to IT and MT staff (N=228) who attended a 3-h training course on IT and information security and MT regulations in 2014. Results Most of the 228 (86%) IT and MT staff who completed the survey strongly agreed that IT security and MT security are relevant to patient safety. One third of the IT staff reported feeling that their knowledge about regulations within MT was sufficient. Less than half of the respondents experienced that healthcare professionals generally had sufficient knowledge of IT or MT regulations (41% versus 46%, IT and MT regulations, respectively). Conclusions Although IT/MT staff felt that they had knowledge of regulations for medical devices and medical information systems, they reported that maintaining and increasing this knowledge is important and that there is a need for recurring training programs in IT and MT regulations. Improved knowledge in IT and MT regulation, and a better understanding of clinical healthcare, could lead to an increased quality in the daily operations and support to the healthcare professionals. Healthcare professionals may need education to develop their knowledge of IT or MT regulations, which in turn will ensure higher patient safety.

      PubDate: 2016-09-15T12:19:00Z
      DOI: 10.1016/j.hlpt.2016.07.008
       
 
 
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