Displaying publications 21 - 28 of 28 in total

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  1. Pahl C, Zare M, Nilashi M, de Faria Borges MA, Weingaertner D, Detschew V, et al.
    J Biomed Inform, 2015 Jun;55:174-87.
    PMID: 25900270 DOI: 10.1016/j.jbi.2015.04.004
    This work investigates, whether openEHR with its reference model, archetypes and templates is suitable for the digital representation of demographic as well as clinical data. Moreover, it elaborates openEHR as a tool for modelling Hospital Information Systems on a regional level based on a national logical infrastructure. OpenEHR is a dual model approach developed for the modelling of Hospital Information Systems enabling semantic interoperability. A holistic solution to this represents the use of dual model based Electronic Healthcare Record systems. Modelling data in the field of obstetrics is a challenge, since different regions demand locally specific information for the process of treatment. Smaller health units in developing countries like Brazil or Malaysia, which until recently handled automatable processes like the storage of sensitive patient data in paper form, start organizational reconstruction processes. This archetype proof-of-concept investigation has tried out some elements of the openEHR methodology in cooperation with a health unit in Colombo, Brazil. Two legal forms provided by the Brazilian Ministry of Health have been analyzed and classified into demographic and clinical data. LinkEHR-Ed editor was used to read, edit and create archetypes. Results show that 33 clinical and demographic concepts, which are necessary to cover data demanded by the Unified National Health System, were identified. Out of the concepts 61% were reused and 39% modified to cover domain requirements. The detailed process of reuse, modification and creation of archetypes is shown. We conclude that, although a major part of demographic and clinical patient data were already represented by existing archetypes, a significant part required major modifications. In this study openEHR proved to be a highly suitable tool in the modelling of complex health data. In combination with LinkEHR-Ed software it offers user-friendly and highly applicable tools, although the complexity built by the vast specifications requires expert networks to define generally excepted clinical models. Finally, this project has pointed out main benefits enclosing high coverage of obstetrics data on the Clinical Knowledge Manager, simple modelling, and wide network and support using openEHR. Moreover, barriers described are enclosing the allocation of clinical content to respective archetypes, as well as stagnant adaption of changes on the Clinical Knowledge Manager leading to redundant efforts in data contribution that need to be addressed in future works.
    Matched MeSH terms: Models, Organizational
  2. Zinn JS, Kashlak RJ, Balotsky ER
    Hosp Health Serv Adm, 1994;39(1):17-30.
    PMID: 10132097
    As growth potential in the U.S. market declines and regulatory constraints increase, providers of health-related services may look increasingly to international opportunities as a way to supplement the lost domestic market. In this article, critical factors bearing on the decision to compete in international markets are identified. Existing theories of multinational competition are expanded to provide a framework for analyzing international competition. Applied in the context of the proprietary hospital industry, the critical factors governing both the selection of foreign markets and mode of entry are proposed to be host country receptivity and market growth potential.
    Matched MeSH terms: Models, Organizational
  3. Razali SM
    Trop Doct, 2000 Apr;30(2):105-6.
    PMID: 10842562 DOI: 10.1177/004947550003000218
    Matched MeSH terms: Models, Organizational
  4. Yusof M, Sahroni MN
    Int J Health Care Qual Assur, 2018 Oct 08;31(8):1014-1029.
    PMID: 30415623 DOI: 10.1108/IJHCQA-07-2017-0125
    PURPOSE: The purpose of this paper is to present a review of health information system (HIS)-induced errors and its management. This paper concludes that the occurrence of errors is inevitable but it can be minimised with preventive measures. The review of classifications can be used to evaluate medical errors related to HISs using a socio-technical approach. The evaluation could provide an understanding of errors as a learning process in managing medical errors.

    DESIGN/METHODOLOGY/APPROACH: A literature review was performed on issues, sources, management and approaches to HISs-induced errors. A critical review of selected models was performed in order to identify medical error dimensions and elements based on human, process, technology and organisation factors.

    FINDINGS: Various error classifications have resulted in the difficulty to understand the overall error incidents. Most classifications are based on clinical processes and settings. Medical errors are attributed to human, process, technology and organisation factors that influenced and need to be aligned with each other. Although most medical errors are caused by humans, they also originate from other latent factors such as poor system design and training. Existing evaluation models emphasise different aspects of medical errors and could be combined into a comprehensive evaluation model.

    RESEARCH LIMITATIONS/IMPLICATIONS: Overview of the issues and discourses in HIS-induced errors could divulge its complexity and enable its causal analysis.

    PRACTICAL IMPLICATIONS: This paper helps in understanding various types of HIS-induced errors and promising prevention and management approaches that call for further studies and improvement leading to good practices that help prevent medical errors.

    ORIGINALITY/VALUE: Classification of HIS-induced errors and its management, which incorporates a socio-technical and multi-disciplinary approach, could guide researchers and practitioners to conduct a holistic and systematic evaluation.

    Matched MeSH terms: Models, Organizational
  5. Lim RBL
    J Pain Palliat Care Pharmacother, 2003;17(3-4):77-85; discussion 87-9.
    PMID: 15022953 DOI: 10.1080/j354v17n03_11
    Palliative care first began in Malaysia in 1991, and since then there has been a growing interest in the field and its development both from the government and nongovernmental organizations. It is important to recognize the potential advantages and disadvantages of palliative care provided by both government and private programs to maximize development for the greater benefit of patients. A close relationship between these two bodies must be created so that there is smooth continuity of service and no overlapping of roles. This article highlights some thoughts on how palliative care has developed over the years from the perspective of a clinician who is currently working in the government sector and cooperating with nongovernmental organizations to develop a palliative care network in the region.
    Matched MeSH terms: Models, Organizational
  6. Schröeder SE, Pedrana A, Scott N, Wilson D, Kuschel C, Aufegger L, et al.
    Liver Int, 2019 Oct;39(10):1818-1836.
    PMID: 31433902 DOI: 10.1111/liv.14222
    Viral hepatitis is a leading cause of morbidity and mortality worldwide, but has long been neglected by national and international policymakers. Recent modelling studies suggest that investing in the global elimination of viral hepatitis is feasible and cost-effective. In 2016, all 194 member states of the World Health Organization endorsed the goal to eliminate viral hepatitis as a public health threat by 2030, but complex systemic and social realities hamper implementation efforts. This paper presents eight case studies from a diverse range of countries that have invested in responses to viral hepatitis and adopted innovative approaches to tackle their respective epidemics. Based on an investment framework developed to build a global investment case for the elimination of viral hepatitis by 2030, national activities and key enablers are highlighted that showcase the feasibility and impact of concerted hepatitis responses across a range of settings, with different levels of available resources and infrastructural development. These case studies demonstrate the utility of taking a multipronged, public health approach to: (a) evidence-gathering and planning; (b) implementation; and (c) integration of viral hepatitis services into the Agenda for Sustainable Development. They provide models for planning, investment and implementation strategies for other countries facing similar challenges and resource constraints.
    Matched MeSH terms: Models, Organizational
  7. Kananatu K
    Asia Pac J Public Health, 2002;14(1):23-8.
    PMID: 12597514
    This paper presents an overview of the Malaysian healthcare system and its method of financing. The development of the healthcare delivery system in Malaysia is commendable. However, the strength and weaknesses of the public healthcare system and the financing problems encountered are also discussed. Cost of healthcare and funding of both the public and private sectors were also revealed. One must optimise the advantages of operating a health financing scheme which is affordable and controllable which contribute towards cost-containment and quality assurance. Thus, there is a need for the establishment of a National Healthcare Financing, a mechanism to sustain the healthcare delivery network and operate it as a viable option. A model of the National Health Financing Scheme (NHFS) was proposed.
    Matched MeSH terms: Models, Organizational
  8. Biswas R, Maniam J, Lee EW, Gopal P, Umakanth S, Dahiya S, et al.
    J Eval Clin Pract, 2008 Oct;14(5):750-60.
    PMID: 19018906 DOI: 10.1111/j.1365-2753.2008.00997.x
    The hypothesis in the conceptual model was that a user-driven innovation in presently available information and communication technology infrastructure would be able to meet patient and health professional users information needs and help them attain better health outcomes. An operational model was created to plan a trial on a sample diabetic population utilizing a randomized control trial design, assigning one randomly selected group of diabetics to receive electronic information intervention and analyse if it would improve their health outcomes in comparison with a matched diabetic population who would only receive regular medical intervention. Diabetes was chosen for this particular trial, as it is a major chronic illness in Malaysia as elsewhere in the world. It is in essence a position paper for how the study concept should be organized to stimulate wider discussion prior to beginning the study.
    Matched MeSH terms: Models, Organizational
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