SciCombinator

Discover the most talked about and latest scientific content & concepts.

Journal: Journal of medical systems

28

The study aims to provide an ease-of-use approach for senior patients to utilize remote healthcare systems. An ease-of-use remote healthcare system (RHS) architecture using RFID (Radio Frequency Identification) and networking technologies is developed. Specifically, the codes in RFID tags are used for authenticating the patients' ID to secure and ease the login process. The patient needs only to take one action, i.e. placing a RFID tag onto the reader, to automatically login and start the RHS and then acquire automatic medical services. An ease-of-use emergency monitoring and reporting mechanism is developed as well to monitor and protect the safety of the senior patients who have to be left alone at home. By just pressing a single button, the RHS can automatically report the patient’s emergency information to the clinic side so that the responsible medical personnel can take proper urgent actions for the patient. Besides, Web services technology is used to build the Internet communication scheme of the RHS so that the interoperability and data transmission security between the home server and the clinical server can be enhanced. A prototype RHS is constructed to validate the effectiveness of our designs. Testing results show that the proposed RHS architecture possesses the characteristics of ease to use, simplicity to operate, promptness in login, and no need to preserve identity information. The proposed RHS architecture can effectively increase the willingness of senior patients who act slowly or are unfamiliar with computer operations to use the RHS. The research results can be used as an add-on for developing future remote healthcare systems.

Concepts: Health care provider, Medicine, Patient, Illness, RFID, Wireless, Radio-frequency identification, Electronic Product Code

28

Currently, patients not only want access to various medical records their health care providers keep about them, but they also are willing to become active participants in managing their own health information and the health information of the ones they care for. Personal health records were developed to help fulfill this need. Health care professionals are instrumental in the successful adoption of PHRs. Nevertheless, a full understanding of different health care practitioners' views of PHRs, including how PHRs could fit into the existing health care system, is lacking. The purpose of this exploratory study is to investigate PHRs from the perspective of health care professionals. Twenty-one practitioners with 10 different specialties were interviewed. The results suggest that although PHRs were still a novel concept to the study participants, a majority of them did value information provided by patients and would recommend that patients keep such records. Participants with different specialties tended to look for different types of information to be included in PHRs, and wished the information to be presented in ways that supported their work, as well as supported knowledge discovery. The participants also expressed a need to share patient information, but had various concerns about sharing. The implications of the results of the study in regard to the design of future PHR systems are discussed.

Concepts: Health care, Health care provider, Health economics, Medicine, Healthcare, Patient, Illness, Personal health record

28

With the advancement of pharmaceutical development, drug interactions have become increasingly complex. As a result, a computer-based drug interaction search system is required to organize the whole of drug interaction data. To overcome problems faced with the existing systems, we developed a drug interaction search system using a hash table, which offers higher processing speeds and easier maintenance operations compared with relational databases (RDB). In order to compare the performance of our system and MySQL RDB in terms of search speed, drug interaction searches were repeated for all 45 possible combinations of two out of a group of 10 drugs for two cases: 5,604 and 56,040 drug interaction data. As the principal result, our system was able to process the search approximately 19 times faster than the system using the MySQL RDB. Our system also has several other merits such as that drug interaction data can be created in comma-separated value (CSV) format, thereby facilitating data maintenance. Although our system uses the well-known method of a hash table, it is expected to resolve problems common to existing systems and to be an effective system that enables the safe management of drugs.

Concepts: Pharmacology, Drugs, Pharmaceutical drug, Relational database, Searching, SQL, Relational model, Relation

28

Recently, Chen et al. have proposed a novel tamper resistant prescription RFID access control system, published in the Journal of Medical Systems. In this paper we consider the security of the proposed protocol and identify some existing weaknesses. The main attack is a reader impersonation attack which allows an active adversary to impersonate a legitimate doctor, e.g. the patient’s doctor, to access the patient’s tag and change the patient prescription. The presented attack is quite efficient. To impersonate a doctor, the adversary should eavesdrop one session between the doctor and the patient’s tag and then she can impersonate the doctor with the success probability of ‘1’. In addition, we present efficient reader-tag to back-end database impersonation, de-synchronization and traceability attacks against the protocol. Finally, we propose an improved version of protocol which is more efficient compared to the original protocol while provides the desired security against the presented attacks.

Concepts: English-language films, Security, Authentication, Access control, Physical security, Smart card, Authorization, Burglar alarm

27

Višekriterijumsko kompromisno rangiranje (VIKOR) method is one of the commonly used multi criteria decision making (MCDM) methods for improving the quality of decision making. VIKOR has an advantage in providing a ranking procedure for positive attributes and negative attributes when it is used and examined in decision support. However, we noticed that this method may failed to support an objective result inmedical field because most medical data have normal reference ranges (e.g., for normally distributed data: [Formula: see text]), this limitation shows a negative effect on the acceptance of it as an effective decision supporting method in medical decision making. This paper proposes an improved VIKOR method with enhanced accuracy (ea-VIKOR) to make it suitable for such data in medical field by introducing a new data normalization method taking the original distance to the normal reference range (ODNRR) into account. In addition, an experimental example was presented to demonstrate efficiency and feasibility of the ea-VIKOR method, the results demonstrate the abilityof ea-VIKOR to deal with moderate data and support the decision making in healthcare care management. Forthis reason, the ea-VIKOR should be considered for use as a decision support tool for future study.

Concepts: Decision making, Risk, Cognition, Decision theory, Decision making software, Normal distribution, Decision engineering, Multi-criteria decision analysis

27

This study aims to determine what the initial disposition of physicians towards the use of Clinical Decision Support Systems (CDSS) based on Computerised Clinical Guidelines and Protocols (CCGP) is; and whether their prolonged utilisation has a positive effect on their intention to adopt them in the future. For a period of 3 months, 8 volunteer paediatricians monitored each up to 10 asthmatic patients using two CCGPs deployed in thee-GuidesMed CDSS. A Technology Acceptance Model (TAM) questionnaire was supplied to them before and after using the system. Results from both questionnaires are analysed searching for significant improvements in opinion between them. An additional survey was performed to analyse the usability of the system. It was found that initial disposition of physicians towards e-Guidesmed is good. Improvement between the pre and post iterationsof the TAM questionnaire has been found to be statistically significant. Nonetheless, slightly lower values in the Compatibility and Habit variables show that participants perceive possible difficulties to integrate e-GuidesMed into their daily routine. The variable Facilitators shows the highest correlation with the Intention to Use. Usabilityof the system has also been rated very high and, in this regard, no fundamental flaw has been detected. Initial views towards e-GuidesMed are positive, and become reinforced after continued utilisation of the system. In order to achieve an effective implementation, it becomes essential to facilitate conditions to integrate the system intothe physician’s daily routine.

Concepts: Decision theory, Decision support system, Clinical decision support system, Decision engineering, Information systems, Data warehouse, Knowledge engineering, Self service software

27

Previous studies show that the healthcare industry lags behind many other economic sectors in the adoption of information technology. The purpose of this study is to understand differences in structural characteristics between providers that do and that do not adopt Health Information Technology (HIT) applications. Publicly available secondary data were used from three sources: American Hospital Association (AHA) annual survey, Healthcare Information and Management Systems Society (HIMSS) analytics annual survey, and Healthcare Cost and Utilization Project (HCUP) Nationwide Inpatient Sample (NIS) databases. Fifty-two information technologies were grouped into three clusters: clinical, administrative, and strategic decision making ITs. Negative binomial regression was applied with adoption of technology as the dependent variables and eight organizational and contextual factors as the independent variables. Hospitals adopt a relatively larger proportion of administrative information technology as compared to clinical and strategic IT. Large size, urban location and HMO penetration were found to be the most influential hospital characteristics that positively affect information technology adoption. There are still considerable variations in the adoption of information technology across hospitals and in the type of technology adopted. Organizational factors appear to be more influential than market factors when it comes to information technology adoption. The future research may examine whether the Electronic Health Record (EHR) Incentive Program in 2011 would increase the information technology uses in hospitals as it provides financial incentives for HER adoptions and uses among providers.

Concepts: Health care, Health insurance, Adoption, Electronic health record, Health informatics, Incentive, Medical informatics, Information technology

27

With the development of Internet, patients could enjoy health-care delivery services through telecare medicine information systems (TMIS) in their home. To control the access to remote medical servers' resources, many authentication schemes using smart cards have been proposed. However, the performance of these schemes is not satisfactory since modular exponential operations are used in these schemes. In the paper, we propose a chaotic map-based authentication scheme for telecare medicine information systems. The security and performance analysis shows our scheme is more suitable for TMIS.

Concepts: Medicine, Health, Physician, Illness, Health science, Access control, Physical security, Computer security

27

According to Taiwan’s legislation pertaining to the protection of electronic data, the creators of electronic medical records (EMR) are solely responsible for the security of EMR. However, actual implementations that fulfill the security standards and requirements for electronic medical record systems are still lacking. Most EMR created from picture archive and communication system are not considered secure, as security protection mechanisms have not yet been granted legal status. This paper describes the details of establishing a digital signature system using Taiwan health professional cards. A digital signature system has been included to ensure quality assurance (QA) operations are controlled by technicians, and reporting capabilities have been provided for radiologist. Six imaging modalities and eight types of radiology reports have also been included in the system. Results indicate that the process of creating QA signatures does not have an adverse effect on the workflow of the facility, requiring less time for the signing and verification of radiology reports. This system has already been used routinely online in a real clinical setting for more than 2 years.

Concepts: X-ray, Medical imaging, Radiology, Electronic medical record, Medical record, Signature, Digital signature, Electronic signature

27

Ultrasound guided aspiration of ovarian endometrioma had been tried as an alternative therapeutic modality in patients whose desire to avoid surgery or surgical approach is contraindicated since 1991. Cyst puncture can reduce tumor volume and destruct the cyst wall, alleviate sticking circumstances and enhance the chance of recovery. But simple aspiration without other treatments results in high recurrence rate (28.5 % to 100 %). In order to reduce recurrence after aspiration, ultrasound-guided aspiration with instillation of tetracycline, methotrexate, and recombinant interleukin-2 has been combined and proven to be effective with the recurrence rates of 46.9 %, 18.1 %, and 40 % respectively. Noma et al. (2001) reported that conduct of ethanol instillation for more than 10 min particularly for a case with a single endometrial cyst is considered most effective from the standpoint of recurrence (14.9 %). Our goal is to analyze patients with recurrent pelvic cyst who underwent surgical intervention. The research data are based on clinical diagnosis, symptoms and medical intervention classification, and the cyst numbers are defined as forecast project target. The decision tree, methodology of data mining technology, is used to find the meaningful characteristic as well as each other mutually connection. The experimental result can help the clinical faculty doctors to better diagnose and provide treatment reference for future patients.

Concepts: Medicine, Surgery, Physician, Ovarian cyst, Case study, Decision tree, Recurrence relation, Endometriosis