Vivian Vimarlund

Patient-centered applications: use of information technology to promote disease management and wellness. A white paper by the AMIA knowledge in motion working group

Advances in information technology (IT) enable a fundamental redesign of health care processes based on the use and integration of electronic communication at all levels. New communication technologies can support a transition from institution centric to patient-centric applications. This white paper defines key principles and challenges for designers, policy makers, and evaluators of patient-centered technologies for disease management and prevention. It reviews current and emerging trends; highlights challenges related to design, evaluation, reimbursement and usability; and reaches conclusions for next steps that will advance the domain.

Methods to Evaluate Health information Systems in Healthcare Settings: A Literature Review

Although information technology (IT)-based applications in healthcare have existed for more than three decades, methods to evaluate outputs and outcomes of the use of IT-based systems in medical informatics is still a challenge for decision makers, as well as to those who want to measure the effects of ICT in healthcare settings. The aim of this paper is to review published articles in the area evaluations of IT-based systems in order to gain knowledge about methodologies used and findings obtained from the evaluation of IT-based systems applied in healthcare settings. The literature review includes studies of IT-based systems between 2003 and 2005. The findings show that economic and organizational aspects dominate evaluation studies in this area. However, the results focus mostly on positive outputs such as user satisfaction, financial benefits and improved organizational work. This review shows that there is no standard framework for evaluation effects and outputs of implementation and use of IT in the healthcare setting and that until today no studies explore the impact of IT on the healthcare system’ productivity and effectiveness.

Understanding business intelligence in the context of healthcare

In today’s fast changing healthcare sector, decision makers are facing a growing demand for both clinical and administrative information in order to comply with legal and customer-specific requirements. The use of business intelligence (BI) is seen as a possible solution to this actual challenge. As the existing research about BI is primarily focused on the industrial sector, it is the aim of this contribution to translate and adapt the current findings for the healthcare context. For this purpose, different definitions of BI are examined and condensed in a framework. Furthermore, the sector-specific preconditions for the effective use and future role of BI are discussed.

Health Information System Implementation: A Qualitative Meta-analysis

Healthcare information systems (HISs) are often implemented to enhance the quality of care and the degree to which it is patient-centered, as well as to improve the efficiency and safety of services. However, the outcomes of HIS implementations have not met expectations. We set out to organize the knowledge gained in qualitative studies performed in association with HIS implementations and to use this knowledge to outline an updated structure for implementation planning. A multi-disciplinary team performed the analyses in order to cover as many aspects of the primary studies as possible. We found that merely implementing an HIS will not automatically increase organizational efficiency. Strategic, tactical, and operational actions have to be taken into consideration, including management involvement, integration in healthcare workflow, establishing compatibility between software and hardware and, most importantly, user involvement, education and training. The results should be interpreted as a high-order scheme, and not a predictive theory.

Economic analyses for ICT in elderly healthcare: questions and challenges

Elderly healthcare is a likely arena for extensive change in years to come, and information and communication technology (ICT) will be an important enabler of such change. Before investing in new systems and practices, there will be a call for evaluations. To date, economic evaluations of ICT applications in healthcare have been rare, and a literature review did not turn up any examples of such evaluations of elderly care. The options for elderly care will often have to transcend organization boundaries, as the point of many ICT initiatives now being discussed is to make healthcare institutions, home care, and self-administered care interact in new ways. Analysts performing evaluations of such complex changes will have to be very specific about such classic issues in economic analysis as defining alternatives, the basis for comparison, and combining different indicators into an overall evaluation.

Applications of Terrestrial Laser Scanning for Tunnels: a Review

In recent years, the use of terrestrial laser scanning (TLS) technique in engineering surveys is gaining an increasing interest due to the advantages of non-contact, rapidity, high accuracy, and large scale. Millions of accurate 3D points (mm level accuracy) can be delivered by this technique with a high point density in a short time (up to 1 million points per second), which makes it a potential technique for large scale applications in engineering environments such as tunnels, bridges, and heritage buildings. Tunnels, in particular those with long lengths, create great challenges for surveyors to obtain the satisfactory scanned data. This paper presents a short history of TLS techniques used for tunnels. A general overview of TLS techniques is given, followed by a review of several applications of TLS for tunnels. These applications are classified as: detecting geological features of drilling tunnels, monitoring the geometry of tunnels during excavation, making deformation measurements, and extracting features. The review emphasizes how TLS techniques can be used to measure various aspects of tunnels. It is clear that TLS techniques are not yet a common tool for tunnel investigations, but there is still a huge potential to excavate.

Big Data, Smart Homes and Ambient Assisted Living

OBJECTIVES To discuss how current research in the area of smart homes and ambient assisted living will be influenced by the use of big data. METHODS A scoping review of literature published in scientific journals and conference proceedings was performed, focusing on smart homes, ambient assisted living and big data over the years 2011-2014. RESULTS The health and social care market has lagged behind other markets when it comes to the introduction of innovative IT solutions and the market faces a number of challenges as the use of big data will increase. First, there is a need for a sustainable and trustful information chain where the needed information can be transferred from all producers to all consumers in a structured way. Second, there is a need for big data strategies and policies to manage the new situation where information is handled and transferred independently of the place of the expertise. Finally, there is a possibility to develop new and innovative business models for a market that supports cloud computing, social media, crowdsourcing etc. CONCLUSIONS The interdisciplinary area of big data, smart homes and ambient assisted living is no longer only of interest for IT developers, it is also of interest for decision makers as customers make more informed choices among todays services. In the future it will be of importance to make information usable for managers and improve decision making, tailor smart home services based on big data, develop new business models, increase competition and identify policies to ensure privacy, security and liability.

Nordic eHealth Indicators: Organisation of research, first results and plan for the future.

eHealth indicator and benchmarking activities are rapidly increasing nationally and internationally. The work is rarely based on a transparent methodology for indicator definition. This article describes first results of testing an indicator methodology for defining eHealth indicators, which was reported at the Medical Informatics Europe conference in 2012. The core elements of the methodology are illustrated, demonstrating validation of each of them in the context of Nordic eHealth Indicator work. Validation proved the importance of conducting each of the steps of the methodology, with several scientific as well as practical outcomes. The article is based on a report to be published by the Nordic Council of Ministers [4].

Healthcare professional’s demand for knowledge in informatics

OBJECTIVE To develop an economic model of health care professional demand for knowledge capital in health informatics. DESIGN Case study with application of the contingent valuation method to develop a small-scale model. SETTING Specialized clinic at a university Hospital in Sweden. RESULTS The model displays the economic rationale behind an individual choice to spend leisure time for obtaining knowledge in health informatics. This decision reduces the total leisure time, but does not increase salary. Instead, it may increase the personal well-being by higher satisfaction gained from using information systems and by being recognized as a computer expert. CONCLUSIONS Individuals have preferences over all uses of time and for activities they can choose to engage in. Support of health care staffs investment in health informatics knowledge capital may benefit both the individuals and indirectly the health care organization.

Experiences of professionals participating in inter-organisational cooperation aimed at promoting clients' return to work

In Sweden, the activities initiated to promote return to work (RTW) are performed in parallel by four different public organisations: the health services, the social services, the employment and the social insurance authorities. The aim was to gain deeper understanding on the experiences of professionals involved in cooperative projects aimed at promoting RTW among unemployed sickness benefit recipients. Qualitative analyses were performed of transcribed data from interviews of professionals participating in cooperative projects. First, the analysis identified that the daily collaboration on the same cases enabled development of good relationships and cooperative competence, which improved the contact with clients. Second, the cooperative projects made it possible to include only clients perceived motivated for RTW measures. Third, the closer and more frequent interaction with clients proved to be constructive in that it facilitated recognition and mobilisation of strengths and abilities. Fourth, the differences in rules and regulations between the social insurance and the unemployment insurance standards were often perceived to induce problems, for example, on how to assess the work capacity of clients. The assessments of work capacity represent important and complex tasks that professionals must perform without having access to either scientific knowledge or consensus agreement on which to base their decisions.