자연주의적 탐구조사(Naturalistic Inquiry)

by J. Biggs and C. Tang, Maidenhead, England,
Open University Press, 2007, 360 pp., £29.99, ISBN-13: 978-0-335-22126-4

Teaching for quality learning at university

我的台灣, 看見心靈的故鄉 =2009林磐聳藝術與設計展

The aging population, prevalence of chronic diseases, and outbreaks of infectious diseases are some of the major challenges of our present-day society. To address these unmet healthcare needs, especially for the early prediction and treatment of major diseases, health informatics, which deals with the acquisition, transmission, processing, storage, retrieval, and use of health information, has emerged as an active area of interdisciplinary research. In particular, acquisition of health-related information by unobtrusive sensing and wearable technologies is considered as a cornerstone in health informatics. Sensors can be weaved or integrated into clothing, accessories, and the living environment, such that health information can be acquired seamlessly and pervasively in daily living. Sensors can even be designed as stick-on electronic tattoos or directly printed onto human skin to enable long-term health monitoring. This paper aims to provide an overview of four emerging unobtrusive and wearable technologies, which are essential to the realization of pervasive health information acquisition, including: 1) unobtrusive sensing methods, 2) smart textile technology, 3) flexible-stretchable-printable electronics, and 4) sensor fusion, and then to identify some future directions of research.

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Unobtrusive Sensing and Wearable Devices for Health Informatics

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Secrets and Lies: Digital Security in a Networked World

The increased connectivity to existing computer networks has exposed medical devices to cybersecurity vulnerabilities from which they were previously shielded. For the prevention of cybersecurity incidents, it is important to recognize the complexity of the operational environment as well as to catalog the technical vulnerabilities. Cybersecurity protection is not just a technical issue; it is a richer and more intricate problem to solve. A review of the factors that contribute to such a potentially insecure environment, together with the identification of the vulnerabilities, is important for understanding why these vulnerabilities persist and what the solution space should look like. This multifaceted problem must be viewed from a systemic perspective if adequate protection is to be put in place and patient safety concerns addressed. This requires technical controls, governance, resilience measures, consolidated reporting, context expertise, regulation, and standards. It is evident that a coordinated, proactive approach to address this complex challenge is essential. In the interim, patient safety is under threat.

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Cybersecurity vulnerabilities in medical devices: A complex environment and multifaceted problem

In a 'trusting' environment, everyone is responsible for information security

In an environment that is only now addressing the security issues of medical devices as a constituent part of IT networks, a new wave of technological development is threatening to swamp healthcare. The Healthcare Internet of Things (HIoT) encompasses the new embedded sensing capabilities of devices together with the availability of always being connected, to improve patient care whilst reducing costs. This development highlights existing security threats as well as creating new vulnerabilities, making the once comprehensive endpoint data transfer frameworks less identifiable and challenging current techniques for information security. This paper reviews the new environment using HIoT, to identify the challenges for security and the impact of this on interoperability in the healthcare setting. Each device and sensor is a potential point of vulnerability for entire networks. The low power design, limited processing and storage capabilities, together with a lack of standard interfaces will also add to the complexity of effective security solutions. Understanding these challenges is vital for anyone engaged in healthcare, as the impact of HIoT will be far-reaching for patients, clinicians, healthcare providers, and healthcare delivery. Making security the enabler of safe and protected data transfer, exchange, and use, is fundamental to using this technology.

Always connected: The security challenges of the healthcare Internet of Things

Issue addressed Digital health technologies can potentially reduce health disparities in cancer care. However, the benefits of digital health technology depend partly on users' digital health literacy, that is, "capabilities and resources required for individuals to use and benefit from digital health resources," which combines health and digital literacy. We examined issues for digital health technology implementation in cancer care regarding digital health literacy, via stakeholder consultation. Methods Consumers, health care professionals, researchers, developers, nongovernment and government/policy stakeholders (N = 51) participated in focus groups/interviews discussing barriers, enablers, needs and opportunities for digital health implementation in cancer care. Researchers applied framework analysis to identify themes of digital health literacy in the context of disparity and inclusion. Results Limited digital and traditional health literacy were identified as barriers to digital technology engagement, with a range of difficulties identified for older, younger and socio-economically or geographically disadvantaged groups. Digital health technology was a potential enabler of health care access and literacy, affording opportunities to increase reach and engagement. Education combined with targeted design and implementation were identified means of addressing health and digital literacy to effectively implement digital health in cancer care. Conclusions Implementing digital health in cancer care must address the variability of digital health literacy in recipients, including groups living with disadvantage and older and younger people, in order to be effective. SO WHAT?: If cancer outcome disparity is to be reduced via digital health technologies, they must be implemented strategically to address digital health literacy needs. Health policy should reflect this approach.

Health literacy, digital health literacy and the implementation of digital health technologies in cancer care: the need for a strategic approach

Big data analytics is a growth area with the potential to provide useful insight in healthcare. Whilst many dimensions of big data still present issues in its use and adoption, such as managing the volume, variety, velocity, veracity, and value, the accuracy, integrity, and semantic interpretation are of greater concern in clinical application. However, such challenges have not deterred the use and exploration of big data as an evidence source in healthcare. This drives the need to investigate healthcare information to control and reduce the burgeoning cost of healthcare, as well as to seek evidence to improve patient outcomes. Whilst there are a number of well-publicised examples of the use of big data in health, such as Google Flu and HealthMap, there is no general classification of its uses to date. This study used a systemic review methodology to create a categorisation of big data use in healthcare. The results indicate that the natural classification is not clinical application based, rather it falls into four broad categories: administration and delivery, clinical decision support (with a sub category of clinical information), consumer behaviour, and support services. Further, the results demonstrate that the use of big data in all examples in the literature is not singular in its approach and each study covers multiple use and application areas. This study provides a baseline to assess the proliferation of the use of big data in healthcare and can assist in the understanding the breadth of big data applications.

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Patricia A. H. Williams

Papers

Cybersecurity vulnerabilities in medical devices: A complex environment and multifaceted problem

In a 'trusting' environment, everyone is responsible for information security

Always connected: The security challenges of the healthcare Internet of Things

Health literacy, digital health literacy and the implementation of digital health technologies in cancer care: the need for a strategic approach

Big data in healthcare: What is it used for?