Hitec

About: Hitec is a based out in . It is known for research contribution in the topics: Health care & Casing. The organization has 272 authors who have published 300 publications receiving 4573 citations.

Eviction of Misbehaving and Faulty Nodes in Vehicular Networks

Abstract: Vehicular networks (VNs) are emerging, among civilian applications, as a convincing instantiation of the mobile networking technology. However, security is a critical factor and a significant challenge to be met. Misbehaving or faulty network nodes have to be detected and prevented from disrupting network operation, a problem particularly hard to address in the life-critical VN environment. Existing networks rely mainly on node certificate revocation for attacker eviction, but the lack of an omnipresent infrastructure in VNs may unacceptably delay the retrieval of the most recent and relevant revocation information; this will especially be the case in the early deployment stages of such a highly volatile and large-scale system. In this paper, we address this specific problem. We propose protocols, as components of a framework, for the identification and local containment of misbehaving or faulty nodes, and then for their eviction from the system. We tailor our design to the VN characteristics and analyze our system. Our results show that the distributed approach to contain nodes and contribute to their eviction is efficiently feasible and achieves a sufficient level of robustness.

Effects of workload, work complexity, and repeated alerts on alert fatigue in a clinical decision support system.

Abstract: Although alert fatigue is blamed for high override rates in contemporary clinical decision support systems, the concept of alert fatigue is poorly defined. We tested hypotheses arising from two possible alert fatigue mechanisms: (A) cognitive overload associated with amount of work, complexity of work, and effort distinguishing informative from uninformative alerts, and (B) desensitization from repeated exposure to the same alert over time. Retrospective cohort study using electronic health record data (both drug alerts and clinical practice reminders) from January 2010 through June 2013 from 112 ambulatory primary care clinicians. The cognitive overload hypotheses were that alert acceptance would be lower with higher workload (number of encounters, number of patients), higher work complexity (patient comorbidity, alerts per encounter), and more alerts low in informational value (repeated alerts for the same patient in the same year). The desensitization hypothesis was that, for newly deployed alerts, acceptance rates would decline after an initial peak. On average, one-quarter of drug alerts received by a primary care clinician, and one-third of clinical reminders, were repeats for the same patient within the same year. Alert acceptance was associated with work complexity and repeated alerts, but not with the amount of work. Likelihood of reminder acceptance dropped by 30% for each additional reminder received per encounter, and by 10% for each five percentage point increase in proportion of repeated reminders. The newly deployed reminders did not show a pattern of declining response rates over time, which would have been consistent with desensitization. Interestingly, nurse practitioners were 4 times as likely to accept drug alerts as physicians. Clinicians became less likely to accept alerts as they received more of them, particularly more repeated alerts. There was no evidence of an effect of workload per se, or of desensitization over time for a newly deployed alert. Reducing within-patient repeats may be a promising target for reducing alert overrides and alert fatigue.

Electronic Prescribing Improves Medication Safety in Community-Based Office Practices

Abstract: BACKGROUND Although electronic prescribing (e-prescribing) holds promise for preventing prescription errors in the ambulatory setting, research on its effectiveness is inconclusive.