Ian M. Marshall

Electronic health records approaches and challenges: a comparison between Malaysia and four East Asian countries

An integrated Lifetime Health Record (LHR) is fundamental for achieving seamless and continuous access to patient medical information and for the continuum of care. However, the aim has not yet been fully realised. The efforts are actively progressing around the globe. Every stage of the development of the LHR initiatives had presented peculiar challenges. The best lessons in life are those of someone elses experiences. This paper presents an overview of the development approaches undertaken by four East Asian countries in implementing a national Electronic Health Record (EHR) in the public health system. The major challenges elicited from the review including integration efforts, process reengineering, funding, people, and law and regulation will be presented, compared, discussed and used as lessons learned for the further development of the Malaysian integrated LHR.

Critical analysis of the usage of patient demographic and clinical records during doctor-patient consultations: a Malaysian perspective

The Lifetime Health Record (LHR) is the central key delivery component of Malaysias integrated telehealth application. The LHR consists of the summarised health records of every individual compiled from their Electronic Medical Record (EMR). The most important consideration however is that the patient health record should not only be available and accessible seamlessly, but also has the ability to be continuously captured by healthcare professionals. This research aims to analyse and identify the most crucial patient demographic and clinical records that are referred to and recorded by the doctors during the consultation encounter.

An analysis of the healthcare informatics and systems in Southeast Asia: a current perspective from seven countries

This paper presents an overview of the healthcare systems in Southeast Asia, with a focus on the healthcare informatics development and deployment in seven countries, namely, Singapore, Cambodia, Malaysia, Thailand, Laos, the Philippines and Vietnam. Brief geographic and demographic information is provided for each country, followed by a historical review of the national strategies for healthcare informatics development. An analysis of the state-of-the-art healthcare infrastructure is also given, along with a critical appraisal of national healthcare provisions.

The design of flexible front end framework for accessing patient health records through short message service

Seamless access to a patientpsilas lifetime health records is crucial for helping doctors in making decision for providing accurate treatment and continuous care. It is equally crucial in the situation where patients freely visit any healthcare facility for the same medical problem, and can be referred to the appropriate hospital anywhere in the country. Without seamless and continuous capability, the patient health records cannot be accessed timely, accurately and completely. Patients may have to perform repetitive tests and exams even though they may have historically suffered from the same disease. This paper proposes flexible front-end framework to upkeep a patientpsilas health records continuously and seamlessly using portable devices such as laptops and mobile phones and the Global System for Mobile and Short Message Service.

Industrial and academic collaboration: hybrid models for research and innovation diffusion

This paper explores how, in the light of global economic downturn and rising student populations, new academic–industrial models for research collaboration based upon specific technological expertise and knowledge can be developed as potential mechanisms for preserving and extending central university research infrastructure. The paper explores two case studies that focus upon the new serious games sector: the UK-based Coventry University’s Serious Games Institute – a hybrid model of applied research and business, and the Netherlands-based TU-Delft University’s Serious Game Center – a networked model of semi-commercial funding and public–private co-operation between industry, public sector and research partners. To facilitate these kinds of academic–industrial collaborations, the paper introduces the Innovation Diffusion Model (IDM) which promotes innovation diffusion by bringing academic and industrial experts into close proximity. Overall, the benefits include: sustained intellectual property development and publication opportunities for academics, employment creation, accelerated development and real commercial benefits for industrial partners.

Knowledge-Based Issues for Aid Agencies in Crisis Scenarios: Evolving from Impediments to Trust

As part of its expanding role, particularly as an agent of peace building, the United Nations (UN) actively participates in the implementation of measures to prevent and manage crisis/disaster situations. The purpose of such an approach is to empower the victims, protect the environment, rebuild communities, and create employment. However, real world crisis management situations are complex given the multiple interrelated interests, actors, relations, and objectives. Recent studies in healthcare contexts, which also have dynamic and complex operations, have shown the merit and benefits of employing various tools and techniques from the domain of knowledge management (KM).

The Analysis and Design of a Pervasive Health Record: Perspectives From Malaysia

This chapter will outline the design of an innovative and pervasive Lifetime Health Record (LHR) dataset for the Ministry of Health Malaysia (MOHM). The dataset was developed after an analysis of clinical consultation workflows and the usage of patient demographic and clinical records in a typical outpatient clinic. Common LHR components, structures, and messages are proposed. The proposed dataset and associated framework are crucial for achieving prompt access to a patient’s LHR and for the provision of seamless and continuous care. Implications for management of health information and knowledge and pervasive access are provided.

The Development of a Framework to Evaluate the Management of HIV/AIDS Programmes in Rural and Urban South Africa

Nearly 40 million people worldwide are living with Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (HIV/AIDS), with just 12% of those who urgently need treatment receiving it. South Africa has one of the highest cases of HIV infections in the world. Intervention efforts have not kept pace with the spread of HIV/AIDS, and a knowledge divide has been identified as a major factor in this. An initial empirical investigation suggests that HIV/AIDS organisations are working individually to address the problems, but there is no overall coordination between them, no system to share knowledge, and the organisations compete for the same funds. The result of this could be wasted resources and a systematic and systemic approach may assist in achieving better results. As mentioned above, a knowledge divide has been identified, and knowledge sharing between HIV/AIDS organisations is at best unplanned and at worse simply does not happen. Given these things, knowledge management would appear to be able to offer some ways forward. Combining systems thinking with knowledge management offers a powerful approach to addressing these issues. By using a hierarchy of systems complexity it may be possible to identify where approaches and possible solutions to problems have been incorrectly specified because they are addressing the wrong level. In this context, the right level refers to approaches of information technology, information systems and knowledge management. This chapter explains the background to HIV/AIDS in South Africa and the issues involved in addressing the management of HIV/AIDS programmes. The chapter outlines how these may be approached by using the concepts of knowledge management, systems thinking and the seven wastes of lean.

Air pollution in Bangalore, India: an eight-year trend analysis.

Bangalore is one of Indias fastest growing metropolises and, although benefiting economically due to its fast development, has a rapidly deteriorating environment. This paper provides a critical analysis of the air pollution trend in the city over the period 2006-2013 at six specific locations where measurements have been consistently recorded. It also discusses the potential health implications pertaining to exceeding levels of pollutants where these are applicable. In order to attain informed decisions on the protection of the health of populations from elevated levels of air pollution, an understanding of spatial-temporal variance of air pollutant patterns is necessary. The study highlights the fact that Bangalore and other similar developing cities do not have an adequate number of fixed monitoring stations that could provide a complete coverage of the air pollution levels for the entire city. It is suggested that this can be overcome by using geospatial interpolation techniques that provide a complete coverage of the levels of pollutants, as well as assist in mapping health characteristics of the population, in order to reach evidence-based decisions and target effective interventions.

Data quality issues in the GIS modelling of air pollution and cardiovascular mortality in Bangalore

Cardiovascular disease (CVD) is the worlds number one cause of mortality. Research in recent years has begun to illustrate a significant association between CVD and air pollution. As most of these studies employed traditional statistics, cross-sectional or meta-analysis methods, a study undertaken by the authors was designed to investigate how a geographical information system (GIS) could be used to develop a more efficient spatio-temporal method of analysis than the currently existing methods mainly based on statistical inference. Using Bangalore, India, as a case study, demographic, environmental and CVD mortality data was sought from the city. However, critical deficiencies in the quality of the environmental data and mortality records were identified and quantified. This paper discusses the shortcomings in the quality of mortality data, together with the development of a framework based on WHO guidelines to improve the defects, henceforth considerably improving data quality.