Rui Rijo

A web-based information system for a regional public mental healthcare service network in Brazil

BackgroundRegional networking between services that provide mental health care in Brazil’s decentralized public health system is challenging, partly due to the simultaneous existence of services managed by municipal and state authorities and a lack of efficient and transparent mechanisms for continuous and updated communication between them. Since 2011, the Ribeirao Preto Medical School and the XIII Regional Health Department of the Sao Paulo state, Brazil, have been developing and implementing a web-based information system to facilitate an integrated care throughout a public regional mental health care network.Case presentationAfter a profound on-site analysis, the structure of the network was identified and a web-based information system for psychiatric admissions and discharges was developed and implemented using a socio-technical approach. An information technology team liaised with mental health professionals, health-service managers, municipal and state health secretariats and judicial authorities. Primary care, specialized community services, general emergency and psychiatric wards services, that comprise the regional mental healthcare network, were identified and the system flow was delineated. The web-based system overcame the fragmentation of the healthcare system and addressed service specific needs, enabling: detailed patient information sharing; active coordination of the processes of psychiatric admissions and discharges; real-time monitoring; the patients’ status reports; the evaluation of the performance of each service and the whole network. During a 2-year period of operation, it registered 137 services, 480 health care professionals and 4271 patients, with a mean number of 2835 accesses per month. To date the system is successfully operating and further expanding.ConclusionWe have successfully developed and implemented an acceptable, useful and transparent web-based information system for a regional mental healthcare service network in a medium-income country with a decentralized public health system. Systematic collaboration between an information technology team and a wide range of stakeholders is essential for the system development and implementation.

Contact center: information systems design

The economic sector of contact centers is growing by more than 8% a year. It is a multidisciplinary area in which information systems are decisive to organizations’ success. Contact Centers’ Information Systems deal with real time requisites and critical business information. A theory-building research shows a framework with 12 key design factors to consider, which managers might use to develop projects and researchers may adopt for further investigation in the area of Contact Center design. This work intends to provide a valuable link between the research community and practitioners in industry.

Towards a Business Process Management Governance Approach Using Process Model Templates and Flexibility

Organizations that include several organizational units with similar business processes often suffer, with time, from the proliferation of processes variant models that significantly deviate from the original (to be followed) one. Take, for instance, student enrolment processes on distinct faculties of the same university, or healthcare processes of a National Health Service across distinct health centers. This can lead to poor global (process) management, since measuring and improving processes can be difficult with too many variants of the same business process. Related works analyse the generalisation and flexibility aspects of process models and related variants, but do not deal with the overall process model lifecycle, especially for this kind of organizations. This paper introduces a novel approach for the Governance and continuous improvement of process models for this kind of organizations. The approach is based on the general Business Process Management (BPM) cycle for process models, proposing concrete techniques for the phases of evaluation, classification and analysis between real and concrete variant models from each organizational unit. It includes the use of similarity metrics and flexibility in business processes, and the main output is a continuously improved template process model. This template foresees a common process part (best practice-based) including process elements collected from the process model variants verified in organizational units, and a flexible part, referring to possible (controlled) deviations that can be tolerated by the organizations headquarters. This approach enhances overall business process management and associated resources by enforcing uniform (good) behavior across similar organizational units. We present the results of our approach applied to a real-world case study of home-healthcare related business process models.

Text Mining Applied to Electronic Medical Records: A Literature Review

The analysis of medical records is a major challenge, considering they are generally presented in plain text, have a very specific technical vocabulary and are nearly always unstructured. It is an interdisciplinary work that requires knowledge from several fields. The analysis may have several goals, such as assistance on clinical decision, classification of medical procedures, and to support hospital management decisions. This work presents the concepts involved, the relevant existent related work, and the main open issues for future research within the analysis of electronic medical records, using data and text mining techniques. It provides a comprehensive contextualization to all those who wish to perform an analytical work of medical records, enabling the identification of fruitful research fields. With the digitalization of medical records and the large amount of medical data available, this is an area of wide research potential.

Impact assessment on patients’ satisfaction and healthcare professionals’ commitment of software supporting Directly Observed Treatment, Short-course: A protocol proposal

Doctors, nurses, and other healthcare professionals use software that affects the patients. Directly Observed Treatment, Short-course is the name given to the tuberculosis control strategy recommended by the World Health Organization. The main goal of this work is to propose a protocol for evaluating the impact of healthcare software supporting Directly Observed Treatment, Short-course on patients, healthcare professionals, and services. The proposed protocol consists of a set of instruments and steps. The instruments are reliable and validated existing questionnaires to be applied before and after using the software tool. The literature points out the need for standards on the software assessment. This is particularly critical when software affects patients directly. The present protocol is a universal tool to assess the impact of software used to support the fight against the tragedy of tuberculosis where a rigorous evaluation of IT in healthcare is highly recommended and of great importance.

Multiple Approaches to the Diagnosis of Attention Deficit Hyperactivity Disorder

Studies indicate that about 3-7% of school-age children have attention deficit hyperactivity disorder ADHD. If these disorders are not diagnosed and treated early, its consequences can harshly impair the adult life of the individual. In this context, early diagnosis is critical. Clinical reasoning is a key contributor to the quality of health care. Clinical decisions at the policy level are made within a stochastic domain; decisions for individuals are usually more qualitative. In both cases, poor reasoning can result in an undesirable outcome. Clinical decisions are most typically communicated in a document through free text. Text has significant limitations particularly ambiguity and poor structuring whether used for analysis, or to explain the decision-making process. In safety engineering, similar problems are faced in conveying safety arguments to support certification. As a result, approaches have been developed to conveying arguments in ways which improve communication and which are more amenable to analysis. The Goal Structuring Notation GSN-a graphical argumentation notation for safety-was developed for those reasons. It has evolved to be one of the most widely used techniques for representing safety arguments. The use of text-mining techniques is another approach in the process of achieving or suggesting a diagnosis to the physician. This paper investigates the relative feasibility of these two approaches and discuss their complementation. Based on a case example, the benefits and problems of adopting GSN and ontology approach in clinical decision-making for ADHD are discussed and illustrated.

Information Management, Proposal for an Integration Platform Using Metadata

The world population is aging and human resources are beginning to become too scarce to maintain adequate care for an increasingly elderly population. The elderly population requires continued care, and their relatives cannot answer that need. To ensure that elderly populations have continuous care, various systems for assistance and monitoring are being researched and deployed. However there isn’t a platform that can integrate all the existing systems. This article intends to present an initial study performed and the resulting architecture of a complete system integration platform for applications that cover various areas of biopsychosocial well-being. It has as its aim to store collected data from different systems using metadata, making a patient medical history that can be consulted by qualified personnel.

Towards a Clinical Trial Protocol to Evaluate Health Information Systems: Evaluation of a Computerized System for Monitoring Tuberculosis from a Patient Perspective in Brazil

Assessment of health information systems consider different aspects of the system itself. They focus or on the professional who will use the software or on its usability or on the software engineering metrics or on financial and managerial issues. The existent approaches are very resources consuming, disconnected, and not standardized. As the software becomes more critical in the health organizations and in patients, becoming used as a medical device or a medicine, there is an urgency to identify tools and methods that can be applied in the development process. The present work is one of the steps of a broader study to identify standardized protocols to evaluate the health information systems as medicines and medical devices are evaluated by clinical trials. The goal of the present work was to evaluate the effect of the introduction of an information system for monitoring tuberculosis treatment (SISTB) in a Brazilian municipality from the patients’ perspective. The Patient Satisfaction Questionnaire and the Hospital Consumer Assessment of Healthcare Providers and Systems were answered by the patients before and after the SISTB introduction, for comparison. Patients from an outpatient clinic, formed the control group, that is, at this site was not implanted the SISTB. Descriptive statistics and mixed effects model were used for data analysis. Eighty-eight interviews were conducted in the study. The questionnaire’s results presented better averages after the system introduction but were not considered statistically significant. Therefore, it was not possible to associate system implantation with improved patient satisfaction. The HIS evaluation need be complete, the technical and managerial evaluation, the safety, the impact on the professionals and direct and/or indirect impact on patients are important. Developing the right tools and methods that can evaluate the software in its entirety, from the beginning of the development cycle with a normalized scale, are needed.

A New Approach for Schematics for Public Transport Spider Maps

This research aims to create a new approach for spider maps production that results in a fast and automatic method having as input only network location data. Schematization task is commonly done by hand or by purely graphics software. This is a difficult and time consuming task that also needs a skilled map designer, which results in an expensive outcome. A configurable force-directed algorithm allows fast creation of eye-pleasing schematic maps, avoiding labor-intensive manual arrangement. In the other hand, different sets of design rules and constraints may be used to quickly generate alternatives, and allow the configuration of a distinctive graphic style. This document presents some of the rules and constraints that may be used to output a map that meets certain criteria in order to be used as a spider map in transportation systems. We present results with real public transport network datasets, and discuss possible evaluation criteria. The present work introduces a new set of experimental validations that confirm the previous research but also leading to new open issues for future work.

Management Model for Mobile Applications Assisted by Events

Information and Communication Technologies are used in almost every activity sector. With the adoption and proliferation of such technologies in mobile devices, a complex and major growth of mobile applications is observed.