Saptarshi Purkayastha

Big Data Analytics for developing countries – Using the Cloud for Operational BI in Health

The multi‐layered view of digital divide suggests there is inequality of access to ICT, inequality of capability to exploit ICT and inequality of outcomes after exploiting ICT. This is evidently clear in the health systems of developing countries. In this paper, we look at cloud computing being able to provide computing as a utility service that might bridge this digital divide for Health Information Systems in developing countries. We highlight the role of Operational Business Intelligence (BI) tools to be able to make better decisions in health service provisioning. Through the case of DHIS2 software and its Analytics‐as‐a‐Service (AaaS) model, we look at how tools can exploit Cloud computing capabilities to perform analytics on Big Data that is resulting from integration of health data from multiple sources. Beyond looking at purely warehousing techniques, we suggest understanding Big Data from Organizational Capabilities and expanding organizational capabilities by offloading computing as a utility to vendors through cloud computing.

Dyscover — An Orton-Gillingham approach inspired multi-sensory learning application for dyslexic children

The Orton-Gillingham (OG) instructional approach has been widely used in different pedagogical settings. This multi-sensory approach has been especially helpful in teaching children with dyslexia and other learning disabilities. In this paper, we show how due to modern-day innovation in ICT like touch-screens, accelerometers, gyroscopes, voice recognition, sound reproduction, powerful processing and wide availability of mobile devices, this approach can help more learners than ever. The paper presents personalization of OG using Gardners theory of multiple intelligence and demonstrates a software application suited for language learning by dyslexies and pre-school children. We propose that since OG is a one-to-one teacher-student approach, it has special characteristics that can allow ICT devices to become more than teaching aids, but to be used as tutors.

Know thy eHealth user: Development of biopsychosocial personas from a study of older adults with heart failure.

BACKGROUND Personas are a canonical user-centered design method increasingly used in health informatics research. Personas-empirically-derived user archetypes-can be used by eHealth designers to gain a robust understanding of their target end users such as patients. OBJECTIVE To develop biopsychosocial personas of older patients with heart failure using quantitative analysis of survey data. METHOD Data were collected using standardized surveys and medical record abstraction from 32 older adults with heart failure recently hospitalized for acute heart failure exacerbation. Hierarchical cluster analysis was performed on a final dataset of n=30. Nonparametric analyses were used to identify differences between clusters on 30 clustering variables and seven outcome variables. RESULTS Six clusters were produced, ranging in size from two to eight patients per cluster. Clusters differed significantly on these biopsychosocial domains and subdomains: demographics (age, sex); medical status (comorbid diabetes); functional status (exhaustion, household work ability, hygiene care ability, physical ability); psychological status (depression, health literacy, numeracy); technology (Internet availability); healthcare system (visit by home healthcare, trust in providers); social context (informal caregiver support, cohabitation, marital status); and economic context (employment status). Tabular and narrative persona descriptions provide an easy reference guide for informatics designers. DISCUSSION Personas development using approaches such as clustering of structured survey data is an important tool for health informatics professionals. We describe insights from our study of patients with heart failure, then recommend a generic ten-step personas development process. Methods strengths and limitations of the study and of personas development generally are discussed.

A Post-development Perspective on mHealth -- An Implementation Initiative in Malawi

While the sheer number of mHealth implementations around the world have been increasing dramatically, authoritative voices on global health have tried to put the focus on quantifiable evaluations and comparisons of these projects (e.g. health outcomes, cost savings, efficiency) in order to channel donor funds and investments into proven and scalable solutions. Drawing on empirical data from an mHealth implementation in Malawi we argue that quantitative evaluation of health interventions often assumes a top-down and limited view on the developmental impact of mHealth. Through our action-research involvement with facility-based reporting of routine health data through mobile phones, we conclude that developmental impacts of mHealth are local and each locale experience a different developmental impact depending on the context of use and available resources. The paper contrasts global concerns for quantifiable development with local priorities with respect to mHealth projects and information system (IS) interventions in health more broadly.

A Platform for Innovation and Standards Evaluation: a Case Study from the OpenMRS Open-Source Radiology Information System

Open-source development can provide a platform for innovation by seeking feedback from community members as well as providing tools and infrastructure to test new standards. Vendors of proprietary systems may delay adoption of new standards until there are sufficient incentives such as legal mandates or financial incentives to encourage/mandate adoption. Moreover, open-source systems in healthcare have been widely adopted in low- and middle-income countries and can be used to bridge gaps that exist in global health radiology. Since 2011, the authors, along with a community of open-source contributors, have worked on developing an open-source radiology information system (RIS) across two communities—OpenMRS and LibreHealth. The main purpose of the RIS is to implement core radiology workflows, on which others can build and test new radiology standards. This work has resulted in three major releases of the system, with current architectural changes driven by changing technology, development of new standards in health and imaging informatics, and changing user needs. At their core, both these communities are focused on building general-purpose EHR systems, but based on user contributions from the fringes, we have been able to create an innovative system that has been used by hospitals and clinics in four different countries. We provide an overview of the history of the LibreHealth RIS, the architecture of the system, overview of standards integration, describe challenges of developing an open-source product, and future directions. Our goal is to attract more participation and involvement to further develop the LibreHealth RIS into an Enterprise Imaging System that can be used in other clinical imaging including pathology and dermatology.

Mobile-Application Based Cognitive Behavior Therapy (CBT) for Identifying and Managing Depression and Anxiety

Mobile technology is a cost effective and scalable platform for developing a therapeutic intervention. This paper discusses the development of a mobile application for people suffering with depression and anxiety. The application which we have developed is similar to a Cognitive Behavior Therapy (CBT) website, which is freely available on the internet. Past research has shown that CBT delivered over the internet is effective in alleviating the depressive symptoms in users. But, this delivery method is associated with some innate drawbacks, which caused user dropout and reduced adherence to the therapy. To overcome these shortfalls, from web based CBT delivery, a mobile application called MoodTrainer was developed. The application is equipped with mobile specific interventions and CBT modules which aim at delivering a dynamic supportive psychotherapy to the user. The mobile specific interventions using this application ensures that the user is constantly engaged with the application and focused to change the negative thought process. We present MoodTrainer as a self-efficacy tool and virtual CBT that is not meant to replace a clinical caregiver. Rather, it is a supportive tool that can be used to self-monitor, as well as a monitoring aid for clinicians.

Conversion of JPG Image into DICOM Image Format with One Click Tagging

DICOM images are the centerpiece of radiological imaging. They contain a lot of metadata information about the patient, procedure, sequence of images, device and location. To modify, annotate or simply anonymize images for distribution, we often need to convert DICOM images to another format like jpeg since there are a number of image manipulation tools available for jpeg images compared to DICOM. As part of a research at our institution to customize radiology images to assess cognitive ability of multiple user groups, we created an open-source tool called Jpg2DicomTags, which is able to extract DICOM metadata tags, convert images to lossless jpg that can be manipulated and subsequently reconvert jpg images to DICOM by adding back the metadata tags. This tool provides a simple, easy to use user-interface for a tedious manual task that providers, researchers and patients might often need to do.

HIXEn: An integration engine for multi-vocabulary health information using REST & semantic metadata mapping

Integration of Health Information Systems (HIS) has been a challenge because of the different semantics that are used by health-care practices and different levels of health-care systems need different kinds of information. Looking through the case of two widely used open-source HIS (one patient-level and one aggregate country-level system), the paper analyses multiple approaches for integration. The paper develops a novel integration engine (HIXEn) that uses concepts of distributed hypermedia systems from RESTful architecture and Resource Descriptors from semantic web that can allow health information exchanges to flexibly connect different HIS.