My Thesis posits a novel method of utilizing emerging web semantics, through HTML5 markup; to improve experience of Health Information seekers through a framework for creating functional, tailored Health Information Resource Collections potentially hosted by their own Health Information Support Networks; and based upon long-standing principles of online Information Retrieval. Most such organizations have websites, with links to useful Resources. This research exemplifies how to design and to present the Resource Collections as pathfinders to existing online Health Information, adding context to each link, to directly address the needs of each community served. The research appeals to a Needs Analysis process rooted in Everyday Life Information Seeking research methodologies, especially Participatory Action Research. As a pilot project, the Needs Analysis focuses necessarily on the Spina Bifida & Hydrocephalus community – with which the author of the Thesis is intimately familiar as a person living with Hydrocephalus, making the choice of a Participatory Action Research framework ideal – and enlisted just one National (Canada) and one Regional (British Columbia) Association for the same rationale. Results of the Needs Analysis were used to identify necessary Resources, but also to select familiar web tools and technologies for design of the Resource Collection and Resource Cards. At completion, there is a functional Collection of Spina Bifida & Hydrocephalus Resources for researchers, caregivers, or patients with Spina Bifida and/or Hydrocephalus – not limited to members of any organization, but best suited by design to the two through which analysis was done. / Graduate

近來，隨著電子病歷的日漸普及，大眾對病人隱私的關注也隨之增加。在現行的醫療資訊系統 (Healthcare Information System, HIS) 中，透過適當的權限控管機制以保障電子病歷隱私是相當普遍的作法。然而，此機制並沒有考慮到病人對於隱私資訊用途的偏好不同。因此，擴充現行醫療資訊系統的權限控管機制，以處理病人隱私偏好的需求相當迫切。 針對此議題，我們認為剖面導向程式設計 (Aspect-Oriented Programming) 技術可以成為其解決方案的重要一環。本研究試著實作一個剖面導向的管理框架，在無需大幅度改寫系統的前提之下，能夠和現有的醫療資訊系統整合，達到讓病人自訂及管理隱私偏好。該框架和現行系統的關係是鬆散耦合 (loosely coupled) 的，因此，能夠輕易地用來擴充現行的系統，以便達到支援病人自定隱私偏好的目的。 / Electronic health records are getting more and more popular these days, however, concerns for patients' privacy also increase greatly. Currently, it's not unusual for Healthcare Information System (HIS) to adopt a proper access control mechanism to protect patients' electronic health records. Nonetheless, this design did not consider the requirements of supporting patients’ preferences regarding the use of their privacy information. Hence, it is desirable to extend the original access control system to handle patients' privacy preferences. For this issue, we argue that Aspect-Oriented Programming (AOP) can be an important part of the solutions. This thesis presents an aspect-based preference management framework that collects and manages patients' preferences. It can be integrated with the existing HIS to support patients' privacy preferences without rewriting from scratch. The proposed mechanisms are loosely coupled with the underlying system. It is therefore easier to use it to improve existing systems to support patients’ privacy preferences.

<p>How can we develop usable and work process-oriented ICT systems for shared homecare?</p><p>Shared homecare involves different professionals, consists of mobile work and requires immediate and ubiquitous access to patient-oriented information, supporting an integrated view on the care process.</p><p>This thesis presents a new collaborative design method for user needs analysis and requirements specification in the context of health information systems development; the Multi-disciplinary Thematic Seminar (MdTS) method. The thesis also describes the MdTS method’s application and two different usability evaluations of the developed system.</p><p>The MdTS addresses a significant problem with health information technologies; they tend to support collaborative work of healthcare professionals poorly, sometimes leading to a fragmentation of workflow and disruption of healthcare processes. Based on human-computer interaction methods, MdTS implies a multiple-user needs analysis by thorough investigation of the entire interdisciplinary cooperative work and its transformation into technical specifications in order to develop appropriate information and communication technology (ICT) for the users’ differing work situations.</p><p>Application of the MdTS resulted in a prototype, the OLD@HOME Virtual Health Record (VHR), adapted to the specific demands in shared homecare. Through mobile devices each care professional accessed patient information in profession-specific views from an integrated platform.</p><p>This thesis provides an interesting case, illustrating how mobile ICT can support shared homecare, thereby bridging health and social care activities and improving knowledge about joint work processes.</p><p>Results from the usability evaluations were overall positive. Information needed at point of care was available on mobile devices and presented in an understandable manner. However, the evaluations also indicated that it is difficult to transfer results from one homecare setting to another due to differences in operational routines.</p><p>In conclusion, application of the MdTS method, in this study, succeeded in elicitation of correct user needs and in transferring correct requirements specifications to system developers for implementation.</p>

How can we develop usable and work process-oriented ICT systems for shared homecare? Shared homecare involves different professionals, consists of mobile work and requires immediate and ubiquitous access to patient-oriented information, supporting an integrated view on the care process. This thesis presents a new collaborative design method for user needs analysis and requirements specification in the context of health information systems development; the Multi-disciplinary Thematic Seminar (MdTS) method. The thesis also describes the MdTS method’s application and two different usability evaluations of the developed system. The MdTS addresses a significant problem with health information technologies; they tend to support collaborative work of healthcare professionals poorly, sometimes leading to a fragmentation of workflow and disruption of healthcare processes. Based on human-computer interaction methods, MdTS implies a multiple-user needs analysis by thorough investigation of the entire interdisciplinary cooperative work and its transformation into technical specifications in order to develop appropriate information and communication technology (ICT) for the users’ differing work situations. Application of the MdTS resulted in a prototype, the OLD@HOME Virtual Health Record (VHR), adapted to the specific demands in shared homecare. Through mobile devices each care professional accessed patient information in profession-specific views from an integrated platform. This thesis provides an interesting case, illustrating how mobile ICT can support shared homecare, thereby bridging health and social care activities and improving knowledge about joint work processes. Results from the usability evaluations were overall positive. Information needed at point of care was available on mobile devices and presented in an understandable manner. However, the evaluations also indicated that it is difficult to transfer results from one homecare setting to another due to differences in operational routines. In conclusion, application of the MdTS method, in this study, succeeded in elicitation of correct user needs and in transferring correct requirements specifications to system developers for implementation.

Prologue is a health information system developed for underserved communities in Bihar, India. It is aimed at helping people living in poverty and with low literacy to take the right steps to manage their and their family’s health. Bihar suffers from one of the worst healthcare records in the country. This is as much due to the lack of access to the right information as it is due to the economic condition of the region. The inaccessibility of information is aggravated by the complex social set up in these communities, for e.g. women aren’t allowed to leave their homes and community has the strongest influence on an individual’s decision making. To make sure that right information permeates even to the most inaccessible user groups, especially women and to uplift community’s awareness as a whole, two different communication channels were designed-an interactive radio show and a public installation.

The purpose of this project was to evaluate the effectiveness of a practice-based dermoscopy training program for dermatology healthcare providers in order to improve their technique of performing clinical skin exams for the early detection of melanomas. The overall incidence of melanoma continues to rise. More than 75% of all skin cancer deaths are from melanoma. Advanced melanoma spreads to lymph nodes and internal organs and can result in death. One American dies from melanoma almost every hour (American Cancer Society [ACS], 2009). Early diagnosis and excision are essential to reduce morbidity and to improve patient survival. This one-group before-and-after study design utilized a convenience sample of three dermatology healthcare providers (DHPs). The primary investigator conducted a retrospective review of the pathology logs for each provider. The time frame for the review was a three-month period in 2010, which represented the same time frame that the study was conducted in 2011. The DHPs participated in a four-hour training workshop that included pattern analysis recognition using dermoscopy. Following the workshop, each DHP was given a DermLite 3Gen DL100 to use in practice when performing clinical skin examinations. All DHPs completed a data collection sheet to document their pattern of decision making with and without a DermLite. The outcome of interest was the use of dermoscopy by DHPs to demonstrate an increased detection of melanoma when compared to naked-eye examination. The outcome was evaluated 12 weeks postworkshop training. There were 120 evaluations made with the DermLite as compared to the naked eye. The overall agreement was 0.52, AC1 coefficient (95% CI) was 0.36 (0.30, 0.42), p < .001, and kappa coefficient (95% CI) was 0.27 (0.20, 0.43), p < .001. Overall, the risk of lesion under exam being suspicion for skin cancer was higher on 27.5% (33 out of 120) of the evaluations and lower on 20.8% (25 out of 120) evaluations. The risk of lesion was evaluated the same on 51.7% (62 out of 120) of the evaluations. This is an indication of “Poor” agreement between the two methods. The diagnosis and disposition made using DermLite compared to naked-eye results for both coefficients provided an “Intermediate to Good” agreement between the two methods in assigning diagnosis and disposition. This indicates that there is no difference between DermLite and naked-eye evaluations. More studies are needed in order to provide better evidence on the value of dermoscopy in clinical practice at the Dermatology and Laser Center. Future projects should be more explicit regarding the methods used and lesion selection in order to better understand the benefits of dermoscopy.

No description available.

One of the main tasks for journalism is to provide people with the information they need to be able to make independent decisions that can help them improve their lives. In order to know that the media fullfils this task it is important to study how the information is received by the audience. This thesis aims to investigate if, and if so how, a selected group of people in Dar es Salaam use news media to inform themselves on problems regarding healthcare, and how they value the information on these topics.A minor field study was carried out in Dar es Salaam in April 2014. The study was limited to Dar es Salaam, the economic capital of Tanzania, because it holds the majority of the media. Three different residential areas were chosen for the study, these were Mwananyamala, which is a low-income area, Sinza, middle–income and Mikocheni, high–income. A survey questionnaire was distributed in each area, 30 in Mwananyamala, 31 in Sinza and 30 in Mikocheni, and in every area four interviews was preformed.According to the selection group there is plenty of healthcare information in the media that is useful to the audience but it is not seen to be very varied. Most information is about malaria and HIV/AIDS, which are two of the most common diseases in Tanzania, but many call for a broader reporting on health issues. Media is however a useful source of information, according to most of the respondents, and especially radio and television has a big impact since it reaches out to a large part of the population. This is a good thing as long as the information is factual and accurate, but several of the respondents believe that this is not always the case.

No abstract available.

Health Information Systems (HIS) make extensive use of Information and Communication Technologies (ICT). The use of ICT aids in improving the quality and efficiency of healthcare services by making healthcare information available at the point of care (Goldstein, Groen, Ponkshe, and Wine, 2007). The increasing availability of healthcare data presents security and privacy issues which have not yet been fully addressed (Liu, Caelli, May, and Croll, 2008a). Healthcare organisations have to comply with the security and privacy requirements stated in laws, regulations and ethical standards, while managing healthcare information. Protecting the security and privacy of healthcare information is a very complex task (Liu, May, Caelli and Croll, 2008b). In order to simplify the complexity of providing security and privacy in HIS, appropriate information security services and mechanisms have to be implemented. Solutions at the application layer have already been implemented in HIS such as those existing in healthcare web services (Weaver et al., 2003). In addition, Discretionary Access Control (DAC) is the most commonly implemented access control model to restrict access to resources at the OS layer (Liu, Caelli, May, Croll and Henricksen, 2007a). Nevertheless, the combination of application security mechanisms and DAC at the OS layer has been stated to be insufficient in satisfying security requirements in computer systems (Loscocco et al., 1998). This thesis investigates the feasibility of implementing Security Enhanced Linux (SELinux) to enforce a Role-Based Access Control (RBAC) policy to help protect resources at the Operating System (OS) layer. SELinux provides Mandatory Access Control (MAC) mechanisms at the OS layer. These mechanisms can contain the damage from compromised applications and restrict access to resources according to the security policy implemented. The main contribution of this research is to provide a modern framework to implement and manage SELinux in HIS. The proposed framework introduces SELinux Profiles to restrict access permissions over the system resources to authorised users. The feasibility of using SELinux profiles in HIS was demonstrated through the creation of a prototype, which was submitted to various attack scenarios. The prototype was also subjected to testing during emergency scenarios, where changes to the security policies had to be made on the spot. Attack scenarios were based on vulnerabilities common at the application layer. SELinux demonstrated that it could effectively contain attacks at the application layer and provide adequate flexibility during emergency situations. However, even with the use of current tools, the development of SELinux policies can be very complex. Further research has to be made in order to simplify the management of SELinux policies and access permissions. In addition, SELinux related technologies, such as the Policy Management Server by Tresys Technologies, need to be researched in order to provide solutions at different layers of protection.