Information security and privacy in health care is a critical issue, it is crucial to protect the patients’ privacy and ensure the systems availability all the time. Managing information security systems is a major part of managing information systems in health care organizations. The purpose of this study is to discover the security metrics that can be used in health care organizations and to provide the security managers with a security metrics scorecard that enable them to measure the performance of the security system in a monthly basis. To accomplish this a prototype with a suggested set of metrics was designed and examined in a usability study and semi-structured interviews. The study participants were security experts who work in health care organizations. In the study security management in health care organizations was discussed, the preferable security metrics were identified and the usable security metrics scorecard specifications were collected. Applying the study results on the scorecard prototype resulted in a security metrics scorecard that matches the security experts’ recommendations. / Graduate / 0723 / 0769 / 0454 / hebae@uvic.ca

Similar to a product supply chain, an information supply chain is a dynamic environment where networks of information-sharing agents gather data from many sources and utilize the same data for different tasks. Unfortunately, raw data arriving from a variety of sources are often plagued by errors (Ballou et al. 1998), which can lead to poor decision making. Supporting decision making in this challenging environment demands a proactive approach to data quality management, since the decision maker has no control over these data sources (Shankaranarayan et al. 2003). This is true in health care, and in particular in health planning, where health care resource allocation is often based on summarized data from a myriad of sources such as hospital admissions, vital statistic records, and specific disease registries. This work investigates issues of data quality in the information supply chain. It proposes three result-driven data quality metrics that inform and aid decision makers with incomplete and inconsistent data and help mitigate insensitivity to sample size, a well known decision bias. To design and evaluate the result-driven data quality metrics this thesis utilizes the design science paradigm (Simon 1996; Hevner, March et al. 2004). The metrics are implemented within a simple OLAP interface, utilizing data aggregated from several healthcare data sources, and presented to decision makers in four focus groups. This research is one of the first to propose and outline the use of focus groups as a technique to demonstrate utility and efficacy of design science artifacts. Results from the focus groups demonstrate that the proposed metrics are useful, and that the metrics are efficient in altering a decision maker's data analytic strategies. Additionally, results indicate that comparative techniques, such as benchmarking or scenario based approaches, are promising approaches in data quality. Finally, results from this research reveal that decision making literature needs to be considered in the design of BI tools. Participants of the focus groups confirmed that people are insensitive to sample size, but when attention was drawn to small sample sizes, this bias was mitigated.

While information systems researchers have argued well from socio-technical and organizational culture perspectives that information technology (IT) and organizational structures are interdependent and continually reshape each other, few studies have sought fine-grained, micro-level explanations for the heterogeneity in IT use often observed across seemingly similar end users and seemingly similar work contexts. Using a nested comparative case study design, I explore electronic medical record (EMR) use by physicians in an integrated multi-specialty health care organization. I use multiple methods to observe and develop micro-level understandings of factors associated with EMR use. The study was conducted in eight practices operating within the same organization. Data collection methods included semi-structured interviews, non-participant observations, and questionnaires. A constant comparative approach guided data analysis. Differences in physician values were noted, as were differences in physician perspectives of uncertainty. I categorized physicians as high, medium and low EMR users depending on a variety of factors including degree to which the EMR was integrated into work practices, degree of feature use, and degree of EMR-enabled communication. Drawing on theories of professionalism, I explain between-physician heterogeneity in EMR use as partly a function of differences in dimensionality of professional values. Three dimensions of professional values were identified 1) profession-oriented, 2) patient-oriented and 3) organization-oriented. Drawing on complexity theory, I argue that differences in physician perspectives of uncertainty influence their EMR use. I found that physicians who viewed uncertainty primarily as reducible through information tended to be higher users of the EMR. Physicians who viewed uncertainty as fundamental, or inherent, in care delivery processes tended to be lower users of the EMR. This study contributes to information systems research by extending current understandings of IT use. The professional values held by physicians and their perspectives of uncertainty may be more important in shaping EMR use than previously thought. These findings indicate the need to more aggressively pursue EMR designs, implementation strategies and policies that accommodate these two additional factors. Additionally, findings from this research indicate a need for IT managers in professional settings to consider end-user professional values and perspectives of uncertainty in decisions involving IT assets. / text

Darbo tikslas - Ištirti ir įvertinti visuomenės vaistinės pacientų gaunamą farmacinę ir sveikatinimo informaciją. Tiksli, teisinga ir savalaikė informacija apie vaistus ir sveikatos stiprinimą yra svarbus sveikatos priežiūros ir saugaus vaistų vartojimo komponentas. Šiandien pacientams yra prieinama daug rašytinių, vaizdinių ir interaktyvių informacijos šaltinių. Dalis pacientus pasiekiančios informacijos gali būti dviprasmiška ar netgi klaidinanti. Itin svarbu, kad prieš priimdami svarbus gydymosi sprendimus pacientai pasikonsultuotų su atitinkamą išsilavinimą turinčiu sveikatos priežiūros specialistu. Vaistininkai – lengviausiai pasiekiami sveikatos priežiūros specialistai. Ši pozicija įpareigoja suteikti pacientams reikalingas žinias apie vaistus ir sveikatą. Mūsų tyrimo metu buvo taikyti skirtingos prigimties mokslinės informacijos rinkimo kiekybiniai metodai – apklausa, stebėjimas ir slapto pirkėjo tyrimas. Tyrimų rezultatai atskleidė, kad visuomenės vaistinėms pacientams vaistinėje suteikiamos konsultacijos apimtis ir trukmė priklauso nuo įsigyjamo vaisto tipo, vaistų kiekio, paciento amžiaus, lyties, jų aktyvumo (užduodamų klausimų). Informacija dažniausiai suteikiama vaistininko iniciatyva taikant diversifikuotus informacijos pateikimo būdus. Pacientams ne tik suteikiama informacija apie įsigyjamus vaistus, bet taip pat ir atsakoma į jų klausimus apie ligas bei gydymosi alternatyvas. / The aim of the study is to evaluate the medicine and health information received by the community pharmacy patients. Objectives: To evaluate the patients’ attitude towards the pharmacist as the source of information about the health care and medications; to compare the patients’ attitude towards their doctors and pharmacists as the sources of the information about medicines; to determine the importance of the drug usage problem among the pharmacy clients and the correlation between the proper use of the medications and the information given by the pharmacists; to analyze the aspects and the ways of the information about drugs given at the pharmacies; to determine factors which influence the amount of received information by community pharmacy patients; to detect what part of the pharmacy patients give questions to the pharmacist; to analyze what factors influence community pharmacy patient satisfaction; to reveal whether the pharmacists, while delivering extra health care services, also use the possibility to spread the health promotion information. Evaluation of the medicine and health information was performed with a complex of various sociological methods such us questionnaire, participant observation and secret standardized patient.

Diss. (sammanfattning) Linköping : Univ., 2003. / Härtill 5 uppsatser.

Consolidating patient and clinical data to support better-informed clinical decisions remains a primary function of electronic health records (EHRs). In the United States, nearly 6 million patients receive care from an accountable care organization (ACO). Knowledge of clinical decision support (CDS) tool design for use by physicians participating in ACOs remains limited. The purpose of this quantitative study was to examine whether a significant correlation exists between characteristics of alert content and alert timing (the independent variables) and physician perceptions of improved ACO quality measure adherence during electronic ordering (the dependent variable). Sociotechnical theory supported the theoretical framework for this research. Sixty-nine physician executives using either a Cerner Incorporated or Epic Systems EHR in a hospital or health system affiliated ACO participated in the online survey. The results of the regression analysis were statistically significant, R2 = .108, F(2,66) = 3.99, p = .023, indicating that characteristics of alert content and timing affect physician perceptions for improving their adherence to ACO quality measures. However, analysis of each independent variable showed alert content highly correlated with the dependent variable (p = .007) with no significant correlation found between workflow timing and the dependent variable (p = .724). Understanding the factors that support physician acceptance of alerts is essential to third-party software developers and health care organizations designing CDS tools. Providing physicians with improved EHR-integrated CDS tools supports the population health goal of ACOs in delivering better patient care.

Most leaders of healthcare delivery organizations have increased their rate of technological innovation, but some still struggle to keep pace with other industries. The problem addressed in this study was that senior leaders in some rural ambulatory healthcare facilities failed to innovate, even with recent healthcare technological innovations, which could lead to increased medical errors and a loss of efficiency. The purpose of the study was to examine if a relationship exists between the avoidance of technology threats by senior leaders in ambulatory healthcare organizations and the innovation propensity of the organization. Technology threat avoidance theory served as the theoretical basis for this correlational study. The research questions were used to investigate the relationship between technology threat avoidance by senior leaders and the ways avoidance affects an organization's level of technological innovation. Data were collected from 90 respondents via an anonymous online survey, developed from the innovation culture measurement and the COPE measurement, and analyzed using multiple regression and Spearman's correlation. Organizations with senior leaders who actively avoided technology threats had significantly higher innovation propensity (β = .51, p = .001). The analysis also showed that rural healthcare delivery organizations tended to have lower innovation propensity (β = -.18, p = .05). The study social change implications enable the leaders of more health care delivery organizations to actively mitigate technology threats, rather than passively avoiding them. Properly handling these threats could allow management to make more informed decisions about technology implementations and thus increase their ability to provide meaningful, innovative care and to avoid one of the leading causes of death-medical errors.

Medical records are being adjusted to match the practical way of understanding an illness as a disorder in the balanced state of the organism. This approach has also modified opinions regarding the form of medical documentation, the determination of necessary examinations and treatment. The progress in medicine along with the growing need for specific medical information made it necessary to look for new ways of making medical information available. One of these ways is to make the system of health care documentation electronic. The main tool of this system is an electronic health card. The objective of my work was to find out the following: the extent of utilization of electronic health cards; doctors´ opinions regarding the use of electronic medical documentation; the attitude of patients to medical documentation and the willingness of doctors to join the IZIP project of electronic health cards. Two hypotheses were checked for the purpose of the graduation work. Hypothesis no. 1 {--} Medical personnel expect that the project of electronic health cards will speed up the process of providing information about patients´ state of health. Hypothesis no. 2 {--} Health care facilities are willing to keep electronic documentation only if they receive compensation for increased administrative activities. To check the hypotheses, the author used the method of quantitative research. Data was collected by means of a questionnaire. The research was carried out between January and March 2009. The research was performed in health care facilities in South Bohemia represented by private doctors. 200 questionnaires were printed out. 152 of these could be fully used for the research. Hypothesis no. 1 was confirmed since 58% of the people who filled out the questionnaire agreed with the statement that the project of electronic health cards would accelerate the process of sharing information about patients´ state of health. Hypothesis no. 2 was not confirmed. There are two main problems preventing the use of IZIP; one of them is that patients are not interested and the other that doctors do not trust the system. That is why the necessary information is not always found in the IZIP since some health care facilities do not work with the system. Doctors would have to be forced or sufficiently motivated to transfer to the use of electronic medical documentation and they would have to change their negative attitude to modern technologies. This work could extend the information about medical documentation and electronic health cards among health care providers and the broader public and give feedback to people working in health care facilities.

Made available in DSpace on 2014-06-11T19:26:44Z (GMT). No. of bitstreams: 0 Previous issue date: 2010-09-14Bitstream added on 2014-06-13T19:55:00Z : No. of bitstreams: 1 silva_jc_me_mar.pdf: 478207 bytes, checksum: e4df2a83f1e50aac162e977815658db0 (MD5) / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / Universidade Estadual Paulista (UNESP) / A Ciência da Informação desenvolve metodologias para tratamento, acesso e transferência da informação e do conhecimento, tendo em vista as necessidades e demandas dos usuários e estabelece relações com a Terminologia, pois ao considerar a função de organização da informação e do conhecimento, ambas cumprem os papéis de recuperar e disseminar a informação e atender os usuários em suas necessidades informacionais. Ressalta-se ainda, que dentre as inúmeras possibilidades de estudos interdisciplinares no campo da Ciência da Informação, a informação em saúde é de grande importância. Pois embora a informação tenha um valor essencial na sociedade contemporânea, na área da saúde, a informação técnica-científica é vital. Neste trabalho a informação em saúde referese ao estudo da terminologia da área da saúde, destacando-se que os termos técnico-científicos desse campo do saber são utilizados principalmente para a comunicação de informações e transferência de conhecimentos entre os profissionais. Todavia, a variação na terminologia utilizada na área da saúde requer a harmonização dos termos técnico-científicos, visto que estes apresentam imprecisão e ambiguidade e podem dificultar a recuperação da informação pelos profissionais. Considerando-se ser necessário o emprego de uma terminologia mais harmoniosa para uma melhor comunicação entre os profissionais de saúde surgiu a proposta de se destacar a importância da Teoria Comunicativa da Terminologia através de uma análise da representação da informação em prontuários de pacientes de hospitais universitários, especificamente na especialidade Neurologia. Observou-se, na comparação feita entre os Hospitais Universitários, a saber, o Hospital das Clínicas da Faculdade de Medicina de Marília e o Hospital das Clínicas da Faculdade de... / Information Science develops methodologies for processing, accessing and transferring information and knowledge, in view of the needs and demands of users and establish relations with the Terminology, because when considering the function of organizing information and knowledge, both fulfill the role of retrieving and disseminating information and serve users in their informational needs. It is also noteworthy that, among the many possibilities of interdisciplinary studies in the field of Information Science, information in health care is of great importance. Although information has a core value in contemporary society, in health, scientific-technical information is vital. In this work, information in health care refers to the study of health care terminology, pointing out that the technical and scientific terms in this field are mainly used for reporting information and transferring of knowledge among professionals. However, the variation in the terminology of health care requires technical and scientific terms harmonized, since they show a lot of imprecision and ambiguity and can hinder the retrieval of information by health care professionals. Taking into consideration the need to use a more harmonious terminology, for better communication among health care professionals, emerged the proposal to highlight the importance of the Communicative Theory of Terminology through an analysis of the representation of information in medical records of patients from university hospitals, specifically in the Neurology field. It was observed in the comparison made among University Hospitals, namely, the Clinical Hospital at the Faculty of Medicine of Marília and the Clinical Hospital at the Faculty of Medicine of Ribeirao Preto, University of Sao Paulo that there are more similarities than differences at filling out patient records. As to the... (Complete abstract click electronic access below)

Orientador: João Batista Ernesto de Moraes / Banca: Mariângela Spotti Lopes Fujita / Banca: Maria de Fátima Gonçalves Moreira Tálamo / Resumo: A Ciência da Informação desenvolve metodologias para tratamento, acesso e transferência da informação e do conhecimento, tendo em vista as necessidades e demandas dos usuários e estabelece relações com a Terminologia, pois ao considerar a função de organização da informação e do conhecimento, ambas cumprem os papéis de recuperar e disseminar a informação e atender os usuários em suas necessidades informacionais. Ressalta-se ainda, que dentre as inúmeras possibilidades de estudos interdisciplinares no campo da Ciência da Informação, a informação em saúde é de grande importância. Pois embora a informação tenha um valor essencial na sociedade contemporânea, na área da saúde, a informação técnica-científica é vital. Neste trabalho a informação em saúde referese ao estudo da terminologia da área da saúde, destacando-se que os termos técnico-científicos desse campo do saber são utilizados principalmente para a comunicação de informações e transferência de conhecimentos entre os profissionais. Todavia, a variação na terminologia utilizada na área da saúde requer a harmonização dos termos técnico-científicos, visto que estes apresentam imprecisão e ambiguidade e podem dificultar a recuperação da informação pelos profissionais. Considerando-se ser necessário o emprego de uma terminologia mais harmoniosa para uma melhor comunicação entre os profissionais de saúde surgiu a proposta de se destacar a importância da Teoria Comunicativa da Terminologia através de uma análise da representação da informação em prontuários de pacientes de hospitais universitários, especificamente na especialidade Neurologia. Observou-se, na comparação feita entre os Hospitais Universitários, a saber, o Hospital das Clínicas da Faculdade de Medicina de Marília e o Hospital das Clínicas da Faculdade de... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Information Science develops methodologies for processing, accessing and transferring information and knowledge, in view of the needs and demands of users and establish relations with the Terminology, because when considering the function of organizing information and knowledge, both fulfill the role of retrieving and disseminating information and serve users in their informational needs. It is also noteworthy that, among the many possibilities of interdisciplinary studies in the field of Information Science, information in health care is of great importance. Although information has a core value in contemporary society, in health, scientific-technical information is vital. In this work, information in health care refers to the study of health care terminology, pointing out that the technical and scientific terms in this field are mainly used for reporting information and transferring of knowledge among professionals. However, the variation in the terminology of health care requires technical and scientific terms harmonized, since they show a lot of imprecision and ambiguity and can hinder the retrieval of information by health care professionals. Taking into consideration the need to use a more harmonious terminology, for better communication among health care professionals, emerged the proposal to highlight the importance of the Communicative Theory of Terminology through an analysis of the representation of information in medical records of patients from university hospitals, specifically in the Neurology field. It was observed in the comparison made among University Hospitals, namely, the Clinical Hospital at the Faculty of Medicine of Marília and the Clinical Hospital at the Faculty of Medicine of Ribeirao Preto, University of Sao Paulo that there are more similarities than differences at filling out patient records. As to the... (Complete abstract click electronic access below) / Mestre