Showing papers on "Health management system published in 2019"

Chatbot-based heathcare service with a knowledge base for cloud computing

Abstract: With the recent increase in the interest of individuals in health, lifecare, and disease, hospital medical services have been shifting from a treatment focus to prevention and health management. The medical industry is creating additional services for health- and life-promotion programs. This change represents a medical-service paradigm shift due to the prolonged life expectancy, aging, lifestyle changes, and income increases, and consequently, the concept of the smart health service has emerged as a major issue. Due to smart health, the existing health-promotion medical services that typically have been operated by large hospitals have been developing into remote medical-treatment services where personal health records are used in small hospitals; moreover, a further expansion has been occurring in the direction of u-Healthcare in which health conditions are continuously monitored in the everyday lives of the users. However, as the amount of data is increasing and the medical-data complexity is intensifying, the limitations of the previous approaches are increasingly problematic; furthermore, since even the same disease can show different symptoms depending on the personal health conditions, lifestyle, and genome information, universal healthcare is not effective for some patients, and it can even generate severe side effects. Thus, research on the AI-based healthcare that is in the form of mining-based smart health, which is a convergence technology of the 4IR, is actively being carried out. Particularly, the introduction of various smart medical equipment for which healthcare big data and a running machine have been combined and the expansion of the distribution of smartphone wearable devices have led to innovations such as personalized diagnostic and treatment services and chronic-disease management and prevention services. In addition, various already launched applications allow users to check their own health conditions and receive the corresponding feedback in real time. Based on these innovations, the preparation of a way to determine a user’s current health conditions, and to respond properly through contextual feedback in the case of unsound health conditions, is underway. However, since the previously made healthcare-related applications need to be linked to a wearable device, and they provide medical feedback to users based solely on specific biometric data, inaccurate information can be provided. In addition, the user interfaces of some healthcare applications are very complicated, causing user inconvenience regarding the attainment of desired information. Therefore, we propose a chatbot-based healthcare service with a knowledge base for cloud computing. The proposed method is a mobile health service in the form of a chatbot for the provision of fast treatment in response to accidents that may occur in everyday life, and also in response to changes of the conditions of patients with chronic diseases. A chatbot is an intelligent conversation platform that interacts with users via a chatting interface, and since its use can be facilitated by linkages with the major social network service messengers, general users can easily access and receive various health services. The proposed framework enables a smooth human–robot interaction that supports the efficient implementation of the chatbot healthcare service. The design of the framework comprises the following four levels: data level, information level, knowledge level, and service level.

Empowering Patients to Co-Create a Sustainable Healthcare Value

Abstract: Extensive literature suggests that a solution to the current problems of healthcare sustainability is the active involvement of patients in health management through the empowerment of their abilities. Latest marketing frameworks suggest that patients are important resources for co-creating health value together with operators. This research aims to analyze the effects of patient empowerment on patients’ value co-creation behaviors. An empirical survey was conducted on 250 patients with chronic diseases in Italy. The results, analyzed using the structural equation modeling, showed that their empowerment enhanced value co-creation behaviors. Patients apply their health competencies and resources in their co-creation of health service with operators. It is, therefore, important to empower patients in their transformation from passive to active stakeholders, working with providers for the most optimal health outcomes. This research provides practitioners with suggestions for patient involvement which utilizes their knowledge, capabilities and responsibility to improving healthcare services.

Health Information Counselors: A New Profession for the Age of Big Data.

Abstract: Health care is increasingly data-driven. Concurrently, there are growing concerns that health professionals lack the time and training to guide patients through the growing medical “data jungle.” In the age of big data, ever wider domains of people’s lives are “datafied,” which renders ever more information—at least in principle—usable for health care purposes. Turning data into meaningful information for clinical practice—and deciding what data or information should not be used for this purpose—requires a significant amount of time, resources, and skill. The authors argue that academic medicine should lead the way in navigating the use of complex, highly personal data in clinical practice. In order to make data actionable for both clinicians and patients, the authors propose that the best way to navigate the interface between patients and providers in the era of data-rich medicine would be the creation of a new profession entirely: health information counselors (HICs). HICs would have a broad knowledge of various kinds of health data and data quality evaluation techniques, as well as analytic skills in statistics and data interpretation. Trained also in interpersonal communication, health management, insurance systems, and medico-legal aspects of data privacy, HICs would know enough about clinical medicine to advise on the relevance of any kind of data for prevention, diagnosis, and treatment. The creation of this new specialty would help patients and health care professionals to make more informed choices about how increasing amounts of health data and information can or should inform health care. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.

District-level health management and health system performance.

Abstract: Strengthening district-level management may be an important lever for improving key public health outcomes in low-income settings; however, previous studies have not established the statistical associations between better management and primary healthcare system performance in such settings. To explore this gap, we conducted a cross-sectional study of 36 rural districts and 226 health centers in Ethiopia, a country which has made ambitious investment in expanding access to primary care over the last decade. We employed quantitative measure of management capacity at both the district health office and health center levels and used multiple regression models, accounting for clustering of health centers within districts, to estimate the statistical association between management capacity and a key performance indicator (KPI) summary score based on antenatal care coverage, contraception use, skilled birth attendance, infant immunization, and availability of essential medications. In districts with above median district management capacity, health center management capacity was strongly associated (p < 0.05) with KPI performance. In districts with below median management capacity, health center management capacity was not associated with KPI performance. Having more staff at the district health office was also associated with better KPI performance (p < 0.05) but only in districts with above median management capacity. The results suggest that district-level management may provide an opportunity for improving health system performance in low-income country settings.

Service Availability and Readiness Assessment (SARA) of Health Facilities in Moyamba District Southern Province of Sierra Leone

Abstract: Sierra Leone needs strong information systems to adequately track progress made and to inform decisions about the implementation of health care programmes as it implements its recovery and resilience plans. A challenge observed with the national health management information system (HMIS) is the quality of routine reports from health facilities and districts. The objective of this research is to assess the service availability and readiness of health facilities in Moyamba district. This research was facility based cross sectional survey. A representative sample of 87 health facilities was selected for the assessment, with an oversampling of hospitals. In this sampling procedure 86% of the health facilities considered for this research were Government/Public owned facilities and 1.1% mission/faith owned facilities. Stat graphic 18 was used to do the data analysis. The district has 55% General Service Index (GSI) for all categories of health facilities. Readiness scores in preventive curative, antenatal care service and malaria services were above 90% in the district. The least readiness score was high level diagnostic equipment with 1%. Blood transmission services had the least specific readiness score of 4.3%. Government of Sierra Leone to Strengthening capacity of District Health Management Teams to plan, supervise and monitor all health facility programs at district levels.

A Design Construct of Developing Approaches to Measure Mental Health Conditions

Abstract: Mental health is an important determinant of communities’ well-being, influenced not only by individual attributes, but also by social and organisational environments in which people work and live. Despite studies examining mental health status among specific populations, few attempts are evident that focus on solution designs for detecting and measuring impact of mental health conditions. In this study, we develop a construct utilising design science research principles for outlining common vocabulary around the problem, and solution design relevant to a mental health management system. For the case of IT professionals, the developed construct is informed through a social-media based dataset containing more than 65,000 cells and 100 attributes potentially identifying influencing factors. Machine learning techniques are applied to the dataset to discover new findings for this specific group. It is anticipated that the analysis reported in this study would contribute in developing other electronic health management systems both for communities and healthcare professionals.

Evaluating the Effectiveness of the Health Management Program for the Elderly on Health-Related Quality of Life among Elderly People in China: Findings from the China Health and Retirement Longitudinal Study

Abstract: The world's rapidly aging population brings serious challenges which could be addressed by changes in behaviour and policy that promote good health in older age. However, these cheap and simple interventions are not available in many countries. China is one of the fastest-ageing countries in the world. The health management programs for the elderly in basic public health services was introduced by the government to promote the health of the elderly in China and address the challenges related to ageing. However, the effectiveness of the program is uncertain. So, we use a propensity score matching difference-in-difference (PSM-DID) model to analyse the causal effect of the health management program for the elderly in basic public health services on the health-related quality of life (HRQoL) of the elderly in China. The result shows that the program has improved the physical health of the elderly but has had no significant impact on mental health. Expanding the program to cover mental health could further benefit the HRQoL of the elderly. The program is a cost-effective approach to tackle the challenges of ageing and is a good example for other developing countries facing the same ageing challenges.

Facilitators, best practices and barriers to integrating family planning data in Uganda’s health management information system

Abstract: Health management information systems (HMIS) are instrumental in addressing health delivery problems and strengthening health sectors by generating credible evidence about the health status of clients. There is paucity of studies which have explored possibilities for integrating family planning data from the public and private health sectors in Uganda’s national HMIS. This study sought to investigate the facilitators, best practices and barriers of integrating family planning data into the district and national HMIS in Uganda. We conducted a qualitative study in Kampala, Jinja, and Hoima Districts of Uganda, based on 16 key informant interviews and a multi-stakeholder dialogue workshop with 11 participants. Deductive and inductive thematic methods were used to analyze the data. The technical facilitators of integrating family planning data from public and private facilities in the national and district HMIS were user-friendly software; web-based and integrated reporting; and availability of resources, including computers. Organizational facilitators included prioritizing family planning data; training staff; supportive supervision; and quarterly performance review meetings. Key behavioral facilitators were motivation and competence of staff. Collaborative networks with implementing partners were also found to be essential for improving performance and sustainability. Significant technical barriers included limited supply of computers in lower level health facilities, complex forms, double and therefore tedious entry of data, and web-reporting challenges. Organizational barriers included limited human resources; high levels of staff attrition in private facilities; inadequate training in data collection and use; poor culture of information use; and frequent stock outs of paper-based forms. Behavioral barriers were low use of family planning data for planning purposes by district and health facility staff. Family planning data collection and reporting are integrated in Uganda’s district and national HMIS. Best practices included integrated reporting and performance review, among others. Limited priority and attention is given to family planning data collection at the facility and national levels. Data are not used by the health facilities that collect them. We recommend reviewing and tailoring data collection forms and ensuring their availability at health facilities. All staff involved in data reporting should be trained and regularly supervised.

Care Coordination and Population Health Management Strategies and Challenges in a Behavioral Health Home Model.

Abstract: Objectives Behavioral health home (BHH) models have been developed to integrate physical and mental health care and address medical comorbidities for individuals with serious mental illnesses. Previous studies identified population health management capacity and coordination with primary care providers as key barriers to BHH implementation. This study examines the BHH leaders' perceptions of and organizational capacity to conduct these functions within the community mental health programs implementing BHHs in Maryland. Methods Interviews and surveys were conducted with 72 implementation leaders and 627 front-line staff from 46 of 48 Maryland BHH programs. In-depth coding of the population health management and primary care coordination themes identified subthemes related to these topics. Results BHH staff described cultures supportive of evidence-based practices, but limited ability to effectively perform population health management or primary care coordination. Tension between population health management and direct, clinical care, lack of experience, and state regulations for service delivery were identified as key challenges for population health management. Engaging primary care providers was the primary barrier to care coordination. Health information technology and staffing were barriers to both functions. Conclusions BHHs face a number of barriers to effective implementation of core program elements. To improve programs' ability to conduct effective population health management and care coordination and meaningfully impact health outcomes for individuals with serious mental illness, multiple strategies are needed, including formalized protocols, training for staff, changes to financing mechanisms, and health information technology improvements.

Subnational health management and the advancement of health equity: a case study of Ethiopia

Abstract: Health equity is a cross-cutting theme in the United Nations 2030 Agenda for Sustainable Development, and a priority in health sector planning in countries including Ethiopia. Subnational health managers in Ethiopia are uniquely positioned to advance health equity, given the coordination, planning, budgetary, and administration tasks that they are assigned. Yet, the nature of efforts to advance health equity by subnational levels of the health sector is poorly understood and rarely researched. This study assesses how subnational health managers in Ethiopia understand health equity issues and their role in promoting health equity and offers insight into how these roles can be harnessed to advance health equity. A descriptive case study assessed perspectives and experiences of health equity among subnational health managers at regional, zonal, district and Primary Health Care Unit administrative levels. Twelve in-depth interviews were conducted with directors, vice-directors, coordinators and technical experts. Data were analyzed using thematic analysis. Subnational managers perceived geographical factors as a predominant concern in health service delivery inequities, especially when they intersected with poor infrastructure, patriarchal gender norms, unequal support from non-governmental organizations or challenging topography. Participants used ad hoc, context-specific strategies (such as resource-pooling with other sectors or groups and shaming-as-motivation) to improve health service delivery to remote populations and strengthen health system operations. Collaboration with other groups facilitated cost sharing and access to resources; however, the opportunities afforded by these collaborations, were not realized equally in all areas. Subnational health managers’ efforts in promoting health equity are affected by inadequate resource availability, which restricts their ability to enact long-term and sustainable solutions. Advancing health equity in Ethiopia requires: extra support to communities in hard-to-reach areas; addressing patriarchal norms; and strategic aligning of the subnational health system with non-health government sectors, community groups, and non-governmental organizations. The findings call attention to the unrealized potential of effectively coordinating governance actors and processes to better align national priorities and resources with subnational governance actions to achieve health equity, and offer potentially useful knowledge for subnational health system administrators working in conditions similar to those in our Ethiopian case study.

Global Advances in Value-Based Payment and Their Implications for Global Health Management Education, Development, and Practice.

Abstract: Global advances in health policy reform, health system improvement and health management education and practice need to be closely aligned to successfully change national health policies and improve the performance of health care delivery organizations. This paper describes the globally acknowledged need for incentive-based organizational performance and relevant implications for health care management education (HCME) and practice. It also outlines the major rationale underlying Value-Based Payment (VBP) or Pay for Performance (P4P) health policy initiatives and their basic elements. Clearly, the major global health policy shift that is underway will likely ultimately have major impacts on the strategic and operational management and performance of health care delivery organizations. Thus, practical specific suggestions are made regarding changes that need to be introduced and strengthened in contemporary health care management education and development programs to help organizational managers in the future.

Design of a consumer mobile health app for heart failure: findings from the nurse-led co-design of Care4myHeart

Abstract: Background : Consumer health care technology shows potential to improve outcomes for community-dwelling persons with chronic conditions, yet health app quality varies considerably. In partnership with patients and family caregivers, hospital clinicians developed Care4myHeart, a mobile health (mHealth) app for heart failure (HF) self-management. Objective : The aim of this paper was to report the outcomes of the nurse-led design process in the form of the features and functions of the developed app, Care4myHeart. Methods : Seven patients, four family caregivers, and seven multidisciplinary hospital clinicians collaborated in a design thinking process of innovation. The co-design process, involving interviews, design workshops, and prototype feedback sessions, incorporated the lived experience of stakeholders and evidence-based literature in a design that would be relevant and developed with rigor. Results : The home screen displays the priority HF self-management components with a reminder summary, general information on the condition, and a settings tab. The health management section allows patients to list health care team member’s contact details, schedule medical appointments, and store documents. The My Plan section contains nine important self-management components with a combination of information and advice pages, graphical representation of patient data, feedback, and more. The greatest strength of the co-design process to achieve the design outcomes was the involvement of local patients, family caregivers, and clinicians. Moreover, incorporating the literature, guidelines, and current practices into the design strengthened the relevance of the app to the health care context. However, the strength of context specificity is also a limitation to portability, and the final design is limited to the stakeholders involved in its development. Conclusions : We recommend health app development teams strategically incorporate relevant stakeholders and literature to design mHealth solutions that are rigorously designed from a solid evidence base and are relevant to those who will use or recommend their use.

Workplace Employees' Annual Physical Checkup and During Hire on the Job to Increase Health-care Awareness Perception to Prevent Disease Risk: A Work for Policy-Implementable Option Globally

Abstract: Background Increasing workplace health-care perception has become a major issue in the world. Most of the health-related problems are faced because of the lack of health management instruments. The level of health care can be improved through workplace health well-being regulations. The aim of the present study is to formulate a conceptual model of physical checkup. Methods This study applied conceptual theories and figures and used secondary data from articles and relevant websites for evaluating the validity of the study. Results Annual health checkup increases health-care awareness perception of states, organizations, employees, and their families and manages the annual health record of employees, organizations, and states. Conclusions Health care and awareness perception of states, organizations, employees, and families improves with annual health checkup, and annual health checkup also prevents unhealthy acts.

Public Health Entrepreneurship: A Novel Path for Training Future Public Health Professionals.

Abstract: Background: As schools of public health adapt to the new Council on Public Health (CEPH) competencies there is increased relevance in training public health professionals in public health entrepreneurship. Public health entrepreneurship provides an alternate process to traditional academic approaches focusing on translating public health knowledge into effective, sustainable, and scalable solutions. Objective: This study reports student perceptions of public health entrepreneurship and training needs for successfully equipping future public health professionals. Methods: Focus groups were conducted in April 2018 with graduate public health students in pilot entrepreneurship courses at two U.S.-based CEPH-accredited schools of public health. Results: Participating students (n = 29) were mainly pursing MPH degrees (62%) within Health Management and Policy (38%) or Health Promotion/Global Health (31%) departments. Most students (52%) were between 21 and 30 years old. For 71% of students this was their first academic course with a focus on entrepreneurial thinking. Four themes emerged regarding public health entrepreneurship and training needs for becoming a successful public health professional of the future. Students confirmed a place for public health entrepreneurship in the emerging educational paradigm because it is action-oriented, skills-driven, and fosters innovation through inter-professional collaboration and cross-pollination of knowledge and skills between professional disciplines. Conclusions: The competencies required for public health entrepreneurship are in alignment with CEPH competencies and are well-received by the next generation of public health professionals as an adjunct but nascent approach to stimulate public health innovation.

Health systems readiness to provide geriatric friendly care services in Uganda: a cross-sectional study

Abstract: As ageing emerges as the next public health threat in Africa, there is a paucity of information on how prepared its health systems are to provide geriatric friendly care services. In this study, we explored the readiness of Uganda’s public health system to offer geriatric friendly care services in Southern Central Uganda. Four districts with the highest proportion of old persons in Southern Central Uganda were purposively selected, and a cross-section of 18 randomly selected health facilities (HFs) were visited and assessed for availability of critical items deemed important for provision of geriatric friendly services; as derived from World Health Organization’s Age-friendly primary health care centres toolkit. Data was collected using an adapted health facility geriatric assessment tool, entered into Epi-data software and analysed using STATA version 14. Kruskal-Wallis and Dunn’s post hoc tests were conducted to determine any associations between readiness, health facility level, and district. The overall readiness index was 16.92 (SD ±4.19) (range 10.8–26.6). This differed across districts; Lwengo 17.91 (SD ±3.15), Rakai 17.63 (SD ±4.55), Bukomansimbi 16.51 (SD ±7.18), Kalungu 13.74 (SD ±2.56) and facility levels; Hospitals 26.62, Health centers four (HCIV) 20.05 and Health centers three (HCIII) 14.80. Low readiness was due to poor scores concerning; leadership (0%), financing (0%), human resources (1.7%) and health management information systems (HMIS) (11.8%) WHO building blocks. Higher-level HFs were statistically significantly friendlier than lower-level HFs (p = 0.015). The difference in readiness between HCIIIs and HCIVs was 2.39 (p = 0.025). There is a low readiness for public health facilities to provide geriatric friendly care services in Uganda. This is due to gaps in all of the health system building blocks. There is a need for health system reforms in Uganda to adequately cater for service provision for older adults if the 2020 global healthy ageing goal is to be met.

Towards improved health service quality in Tanzania: contribution of a supportive supervision approach to increased quality of primary healthcare

Abstract: Universal Health Coverage only leads to the desired health outcomes if quality of health services is ensured. In Tanzania, quality has been a major concern for many years, including the problem of ineffective and inadequate routine supportive supervision of healthcare providers by council health management teams. To address this, we developed and assessed an approach to improve quality of primary healthcare through enhanced routine supportive supervision. Mixed methods were used, combining trends of quantitative quality of care measurements with qualitative data mainly collected through in-depth interviews. The former allowed for identification of drivers of quality improvements and the latter investigated the perceived contribution of the new supportive supervision approach to these improvements. The results showed that the new approach managed to address quality issues that could be solved either solely by the healthcare provider, or in collaboration with the council. The new approach was able to improve and maintain crucial primary healthcare quality standards across different health facility level and owner categories in various contexts. Together with other findings reported in companion papers, we could show that the new supportive supervision approach not only served to assess quality of primary healthcare, but also to improve and maintain crucial primary healthcare quality standards. The new approach therefore presents a powerful tool to support, guide and drive quality improvement measures within council. It can thus be considered a suitable option to make routine supportive supervision more effective and adequate.

Constructing a general competency model for Chinese public health physicians: a qualitative and quantitative study

Abstract: BACKGROUND The purpose of the study was to construct a general model of the competencies required by Chinese public health physicians. This study is intended to lay the foundation for promoting reform of public health education in China, and may help perfect the testing and grading system of public health courses. METHODS The behavioral event interviews were used to collect data on knowledge, skills and performance characteristics of public health physicians for coping with public health events. A random stratified sampling survey was used to select public health professionals and workers from different public health institutions in 14 provinces (municipalities or autonomous regions) of China. We then purposively selected 150 senior public health professionals from various agencies and 85 senior public health educators at colleges and universities to take part in the checklist survey. Finally, three times expert consultations were performed to determine the dimensions and elements of the general competency model for Chinese public health physicians. RESULTS The age range of the 3245 participants was 18-65 years old. When comparing public health professionals and public health education specialists, we found significant differences in the perceived importance of the core competencies between these groups. The model was revised several times and finalized through the expert consultations, and comprised seven competency dimensions. CONCLUSION The final public health practitioner competency model comprised seven competency dimensions: basic knowledge of medicine, public health knowledge, health management and health promotion, specialized skills, research and development, comprehensive abilities and professionalism.

Designing a Health Management Process Model for Hospital Staff (Qualitative Research)

Abstract: Accepted: 28 Oct, 2019 Abstract Background and Objectives: Safety and health of employees is one of the top priorities of human resource managers in every organization. In the meantime, hospital staffs are exposed to various occupational hazards, including different types of infections, stressors, allergen materials, and so on. Therefore, the need for a health care and monitoring plan is one of the most important management programs. The present study was performed with the purpose of designing a staff health management process in hospitals.

IoHT and Edge Computing, Warrants of Optimal Responsiveness of Monitoring Applications for Seniors. A Case Study

Abstract: The global ageing population puts a burden on healthcare systems not only from the point of view of cost-related aspects, but also from the senior patients' point of view who tend to be predominately empowered regarding their own health management, digitally-skilled and demanding for personalized health protocols and solutions. Silver Digital Patients can be defined as seniors that master improved abilities of using digital technology in their daily activities, including in monitoring their health, who prove increased interest in having access to the best healthcare to preserve as much as possible their independence and health. An active, decent and safe life for seniors is at its best in their own homes; therefore, a remote health monitoring represents the most appropriate way to smooth the disruptive degenerative age-related factors, together with the important benefit of relieving the expenditures for senior institutionalizations. In this respect, emerging senior-centered technologies have the potential to provide a reliable support for building the most appropriate healthcare provision and environment. Internet of Health Things (IoHT) is a concept for a great variety of devices connected to the Internet that are able to gather a huge amount of diverse data - like health or environmental parameters - in order to keep a close remote watch on the patient, to improve the diagnose of his/her health status and to establish a better preventative healthcare. Edge computing brings the potential of improving the performance and responsiveness of IoHT by allowing the real-time collected data to be pre-processed closer to the source, which can be extremely important for time-sensitive health data in order to identify and trigger anticipatory or reactive health actions. This paper presents a case study -" Non-invasive monitoring and health assessment of the elderly in a smart environment (RO-SmartAgeing)" project - that evaluates the opportunities brought by IoHT and edge computing for a monitoring application. The general objective of this project is to demonstrate the potential of some emerging technology for the positive transformation of how healthcare services are provided to the seniors and to healthcare provider. According to its current development state, a proposed IoHT-based architecture of the monitoring application and a data analytics demo for a health parameter is presented.

Self-management of health by people with intellectual and developmental disabilities.

Abstract: Background Self-management of health includes people with intellectual and developmental disabilities (IDD) playing a key role in health management in collaborating with healthcare professionals. Methods This study analysed data from Personal Outcome Measures® surveys (n = 1,341) to explore self-management of health. We had the following research questions: Who is most likely to be supported to self-manage their health? How does being supported to self-manage impact different areas of health? and How does being supported to self-manage impact other health-related organizational supports? Results Findings revealed the impact of self-management of health can be wide-ranging, regardless of impairment severity. When supported to self-manage their health, healthcare professionals were more likely to address healthcare issues, and interventions were more likely to be effective. Conclusions Self-management represents a paradigm shift for people with IDD because it transforms people from passive recipients to active directors of their health.

Improving Self-Management and Care Coordination with Person-Generated Health Data and Mobile Health

Abstract: Triggered by the advent of mobile health (mHealth) technologies such as smartphones and wearable devices, person-generated health data (PGHD) provides a great opportunity for health management and care. These technological advancements have generated great interest among both researchers and individuals, whether healthy or ill, in maintaining wellness, remediating illness, and increasing performance of the health system. This chapter describes the rise of PGHD, development of mHealth applications, and evolution of self-monitoring tools for chronic illness. Beginning with early research, this chapter explores evidence documenting rapid growth in this field.

Realist evaluation of allied health management in Queensland: what works, in which contexts and why.

Abstract: Objective Allied health structures and leadership positions vary throughout Australia and New Zealand in their design and implementation It is not clear which organisational factors support allied health leaders and professionals to enhance clinical outcomes The aim of this project was to identify key organisational contexts and corresponding mechanisms that influenced effective outcomes for allied health professionals Methods A qualitative realist evaluation was chosen to describe key aspects of allied health organisational structures, identify positive outcomes and describe how context and processes are operationalised to influence outcomes for the allied health workforce and the populations they serve Results A purposive sample of nine allied health leaders, five executives and 49 allied health professionals were interviewed individually and in focus groups, representing nine Queensland Health services Marked differences exist in the title and focus of senior allied health leaders’ roles The use of a qualitative realist evaluation methodology enabled identification of the mechanisms that work to achieve effective and efficient outcomes, within specific contexts Conclusions The initial middle range theory of allied health organisational structures in Queensland was supported and extended to better understand which contexts were important and which key mechanisms were activated to achieve effective outcomes Executive allied health leadership roles enable allied health leaders to use their influence in organisational planning and decision-making to ensure allied health professionals deliver successful patient care services Professional governance systems embed the management and support of the clinical workforce most efficiently within professional disciplines With consistent data management systems, allied health professional staff can be integrated within clinical teams that provide high-quality care Interprofessional learning opportunities can enhance collaborative teamwork and, when allied health professionals are supported to understand and use research, they can deliver positive patient and business outcomes for the health service What is known about the topic? A collective allied health organisational structure encourages engagement of allied health professionals within healthcare organisations Organisational structures commonly include management and leadership strategies and service delivery models Allied health leaders in Queensland work across a range of senior management levels to ensure adequate resources for sufficient suitably skilled professional staff to meet patient needs What does this paper add? Literature to date has described how allied health professionals operate within organisational structures This paper examines key aspects of allied health management, governance and leadership, together with mechanisms that support allied health professionals to deliver effective clinical and business outcomes for their local community What are the implications for practitioners? Health service executives and allied health leaders should consider supporting executive allied health leadership roles to influence strategic planning and decision-making, as well as to deliver outcomes that are important to the health service When allied health leaders implement integrated professional and operational governance systems, executives described allied health professionals as influential in supporting team-based models of care that add value to the business and improve outcomes for patients When allied health leaders use consistent data management, executives reinforced the benefit of aligning activity data with financial costs to monitor, recognise and reimburse appropriate clinical interventions for patients When allied health leaders support allied health workforce capability through educational and research opportunities, clinicians can use research to inform their clinical practice

Design & Development of IoT Based Rehabilitation Outdoor Landscape for Gait Phase Recognition

Abstract: Over a few decades, there is a steady accretion of life expectancy in many countries. Significant advances in modern healthcare technologies, medicines and overall health care awareness gave many to lead a prolonged healthy life. Over the past few years, there has been a huge demand for unobtrusive health monitoring systems from both medical professionals and the general populace to use these technologies for understanding the general health well being in order to improve life longevity. However, most of the available technologies for health monitoring are difficult for the general populace to access and most of the developed health monitoring systems are either deployed in a controlled environment or in healthcare facilities, thus severely limiting the ease of access to many, especially the elderly people. For effective health management of elderly people, evidence-based decision making, continuously monitoring the health status of the elderly demographic is paramount. In order to address these issues, we developed an innovative smart IoT based outdoor health monitoring system. The proposed system collects information about the mobility, posture, and overall gait of the person in an easy to access public outdoor setting such as parks, supermarkets etc. It is quite evident from multiple studies, that analysing the gait can be a useful tool in early detection of the declining health of individuals, as mobility is a key factor in any individual's well being. Also, detecting gait disorders earlier will allow for functional relief to the health care system with the possibility of reducing the number and severity of gait disorders through early intervention.

Health literacy of commercial industry managers: an exploratory qualitative study in Germany.

Abstract: Managers have been neglected in health literacy research. There still is little known about the health-literacy status and needs of commercial industry managers. This article reduces the existing knowledge gap by presenting findings of an exploratory qualitative study. We conducted 23 separate semi-structured interviews of managers from all management levels (low, middle and top) and experts in the field of health management and/or personnel management. The qualitative interviews were analysed according to Mayring's content analytic approach using MAXQDA. The findings indicate that managers do have considerable information levels about existing health topics and relevant problems but have difficulties of discernment as to which sources of information can be activated or accessed in a timely fashion due to work and information overload. Even those who devise strategies often fail in implementing health-literate behavior. Experts and managers had fairly consistent views on the importance of health literacy among managers. Most agreed that mental health was neglected and that company conditions were important in influencing the ability to act in a way that promoted health literacy. The findings also show that strengthening of managerial self-perception, self-regulation and self-control, raising awareness and ability to take personal responsibility for one's own health, developing skills in handling large amounts of information and fostering open and trusting communication are all essential.

How effective is the integration of sport and exercise medicine in the English national health service for sport related injury treatment and health management

Abstract: Background: Regular participation in sport, exercise and physical activity is associated with positive health outcomes and form a mainstay of British public health policies However, regular participation in sport and exercise can result in sport related injury (SRI) which, in turn, is a key cause of exercise cessation The integration of Sport and Exercise Medicine (SEM) in the English National Health Service (NHS) aims to provide a specialist service for public populations and thus reduce the impact of SRI on exercise cessation and associated negative health outcomes More broadly it aims to both support physical activity health promotion policies and improve healthcare organisations efficiencies through providing the most condition-appropriate treatment Methods: This qualitative interview study examines patients’ (n=19) experiences of accessing and receiving SEM treatment within the English NHS Results: The research demonstrates that referral pathways into SEM were often prolonged, characterised by multiple General Practitioner (GP) visits and referrals into other musculoskeletal services, demonstrating an inefficient use of healthcare resources Prolonged pathways fostered only limited recovery back to previous physical activity levels and other negative health behaviours, yet on accessing the SEM clinic, patients experienced progressive rehabilitation back into sport and exercise participation Conclusion: This study highlights the importance of more fully integrating SEM services into public healthcare as a way of improving the organisational capacity of healthcare in treating SRI and ensuring that citizens comply with state interventions which orchestrate health management through raising physical activity levels across the population

Transforming the Health Sector in Kenya by Adopting Integrated Health Management Information System

Abstract: Achieving better health outcomes is every health organization’s dream.Several health management strategies have been developed;a key one being production of quality information for purposes of informed decision making.Most public health facilities in Kenya are by large extent using manual health information systems,which are cumbersome and fragmented leading to delayed or uninformed decision making. Five key drivers are viewed to influence Integration of Health Management Information System(IHMIS): i) organizational factor, ii) technical factor, iii) behavioral factor, iv) adopted leadership style and v) operationalization of the functions of management.The purpose of the study was to prescribe an ideal design of an IHMIS.A mixed method research design was adopted to determine the significance of the drivers identified in influencing the IHMIS.Both semi-structured questionnaire and a key informant guide were used to collect data that was analyzed and reported using mean scores,correlation and regression analysis.Integration of HMIS was found to positively and significantly correlate with organizational factor,technical factor,behavioral factor,leadership style adopted and operationalization of the functions of management.The study also showed that all variables accounted for total variation in the integration of HMIS.In a multiple regression analysis,the study found the model valid.However only 4 out of 5 of the predictor variables(operationalization of management functions,behavioral factor,technical factor,leadership style adopted) were good in explaining total variations in the integrated HMIS in Kenya. This implies that the more these variables are improved the better it gets in achieving integration of HMIS which is achievable if all the study variables are taken into account.The study suggests that the ideal design of an integrated HMIS would be in the form of an automated web based system in each health organization as opposed to the current manual system.IHMIS will be more successful,if integration within a single health organization is successful.The study recommends a central database for each level of care.