European Union (EU) healthcare systems are under financial and pandemic related pressure and will face further challenges not only due to a lack of medical workers and an ageing population. Technical innovation is seen as one of the ways to diffuse this ticking time bomb. Where innovation initiatives on corporate and governmental levels have in part failed, startups have the chance to be a grass-roots source for healthcare innovation in the future. This thesis explores the landscape of EU-based high performing healthcare startups. I try to answer the question: What types of EU-based healthcare startups are successful?In this thesis academic literature is examined for appropriate information on EU healthcare and healthcare innovation. Additionally, Crunchbase was utilized to identify one hundred high performing healthcare startups. Based on available academic literature I propose a new categorisation framework for healthcare innovation and use this framework to analyse the sample of one hundred high performing EU-based healthcare startups. The Crunchbase rank and funding amount were additionally used to quantitively analyse the sample.The results indicate that successful innovators in healthcare software mainly target consumers potentially due to lower entry barriers. Additionally, I find data supporting previous notions that pharmaceuticals use startups to outsource R&D activities. This coincides with relatively vast amounts of funding for some of these startups. Software innovations targeting medical care providers also see relatively high funding amounts potentially due to higher entry barriers. This research provides a better understanding of the landscape of high performing healthcare startups in the EU. Researchers and practitioners may use the new healthcare innovation categorization framework when analysing healthcare startups. Additionally, this work provides helpful insights on the stakeholders in healthcare, the state of healthcare innovation in the EU, and the landscape of innovative healthcare startups especially regarding funding.

Purpose: The purpose of this inquiry was to explore how nurses envision and benefit from restorative built environments in acute care hospitals. Background: The Covid-19 pandemic has resulted in alarming rates of occupational stress and attrition in front-line clinicians, which has made inquiry into how to promote well-being in nurses particularly timely, and salient. Much of the existing design literature is functionalist in tenor, foregrounding how to improve the efficiency and productivity of staff. Provided this, little is known about how nurses experience hospital environments and what restorative features they imagine within these spaces to attenuate stress. This insight is necessary for an improved articulation of supportive and restorative architectural affordances. Methods: Informed by interpretive description, a qualitative study using photo-elicitation was employed to solicit the experiences of 4 frontline registered nurses working in acute care hospitals in Canada. Data was triangulated from three sources; (1) Photographs; (2) Narrative notes; (3) Semi-structured interviews. Results: Iterative and thematic analysis revealed that nurses recognize the power of good design to promote staff retention and promote well-being, although participants largely regard their present work environments as pathogenic and perpetuating harm. Nurses visually and narratively envisioned enriched environments through the use of adaptable space, visual and associative references to nature, a creative atmosphere, inclusive spaces, a civic presence, and the provision of spaces to enable rituals of (self)care. Conclusions: Nurses have considerable tacit and embodied knowledge which can improve the hospital built environment, but further research is needed to capture and solicit these holistic experiences.

Access control is a key feature of healthcare information systems. Access control is about enforcing rules to ensure that only authorized users get access to resources in a system. In healthcare systems this means protecting patient privacy. However, the top priority is always to provide the best possible care for a patient. This depends on the clinicians having access to the information they need to make the best, most informed, care decisions. Care processes are often unpredictable and hard to map to strict access control rules. As a result, in emergency or otherwise unexpected situations, clinicians need to be able to bypass access control. In a crisis, availability of information takes precedence over privacy concerns. This duality of concerns is what makes access control in healthcare systems so challenging and interesting as a research subject. To create access control models for healthcare we need to understand how healthcare works. Before creating a model we need to understand the requirements the model should fulfill. Though many access control models have been proposed and argued to be suitable for healthcare, little work has been published on access control requirements for healthcare. This PhD project has focused on bridging the gap between formalized models and real world requirements for access control in healthcare by targeting the following research goals:RG1 To collect knowledge that forms a foundation for access control requirements in healthcare systems.RG2 To create improved access control models for healthcare systems based on real requirements.This PhD project has consisted of a number of smaller, distinct, but relatedprojects to reach the research goals. The main contributions can be summarized as:C1 Requirements for access control in healthcare: Studies performed onaudit data, in workshops, by observation and interviews have helped discoverrequirements. Results from this work include methods for access controlrequirements elicitation in addition to the actual requirements discovered.C2 Process-based access control: The main conclusion from the requirementswork is that access control should be tailored to care processes. Care processesare highly dynamic and often unpredictable, and access control needs to adaptto this. This thesis suggests how existing sources of process information, bothexplicit and implicit, may be used for this purpose.C3 Personally controlled health records (PCHR): This thesis explores theconsequences of making the patient the administrator of access control andproposes a model based on these initial requirements. From a performedusability study it is clear that the main challenge is how to keep the patientinformed about the consequences of sharing.

Smartphones are used by incredibly many people, and in 2011 there where a total of 491.4 million units soled worldwide. This makes it a relevant technique for performing dietary studies when the test patients are on the move. This thesis shows how to create a back end environment for an Android application with existing techniques linked together, using MSSQL database, Visual Studio Web Service, web pages and C# classes and ASP.NET security. The back end development is used in a dietary study on Gothenburg University, butcould be applied on many similar back end projects using databases and server development.Techniques used in this thesis are: REST (Representational State Transfer) -client implementation and development inside the Android application, using HTTP methods to set and get information from the server and database, and JSON-format to read and transferinformation in an easy and understandable way, both from the Android application and from the database. FileMaker is also used in this project as a third part programme tovisualise the information in the database.

Advantages of applying information and communication technologies to support complex team practices in healthcare domain have often been supported in the extant literature. The primary assumption is that before putting any technologies in place to support team functions, the team-based environment should be completely modeled. To date, many frameworks have been proposed for modeling healthcare teams; however, most of the frameworks only focus on single or a few aspects of teamwork and the outcomes usually present overlaps, limitations and inconsistencies. As a result, there is an increasing demand for offering an overarching framework that integrates the multiple dimensions of healthcare teamwork into a synthetic whole and clearly conceptualizes the potentially important relationships and dependencies that exist over those dimensions. In order to properly address the aforementioned challenge, this thesis applies ontological engineering to develop an overarching framework for integrating the multiple dimensions of teamwork concept in healthcare domain. For this purpose, we first illustrate a set of four stage methodological approach to provide explicit details on how to incorporate a theatrical foundation into the ontology. Then, the proposed approach is used to develop a derived ontological framework. Finally, accuracy and completeness of the proposed ontology based framework is validated to show that it is able to accurately represent the domain is it being employed for. The values and capabilities of ontology have already been studied and approved, and this technology is known as the best sources to represent a knowledge domain by means of concepts and accurately define the relationships among them. Our aim in this thesis is to further research how to develop and evaluate a standard ontology based framework to facilitate the healthcare team modeling.

This thesis focuses on provincial reactions to the Supreme Court decision on 5 June 2005, Chaoulli v. Quebec (Attorney General). In this decision, the Court struck down the government of Québec’s ban on private insurance for publicly-insured services, on the grounds it violated the Québec Charter of Human Rights and Freedoms, while the decision on the Canadian Charter ended in a 3:3 tie with one abstention. It is the purpose of this research to examine the reactions of each provincial government to the decision in an attempt to understand why each province responded in its chosen manner. In order to make this determination, four hypotheses were constructed in order to test four separate variables: court interference, current law, ideology, and political calculation. These hypotheses were tested against provincial reactions in the media, legislatures, court documents, and E-mail administered questionnaires. This research finds that each hypothesis had some success in predicting provincial reactions to the decision, with a government’s current law and ideology proving to be the most accurate predictors. Based on the evidence gathered, three conclusions were arrived at: first, a government’s law and its ideology will often predict how a government will behave; second, that governments are open to Supreme Court decisions in the area of health care, and, finally, that if provincial governments were to make the decision to increase the role of the private sector in health care, political leaders would require public opinion be in support of such a decision rather than act solely on an ideological predisposition to greater private sector involvement.

With the continued increases in the global population, a serious problem will occur in relation to an ageing population. The reason for this is that a significant number of elderly people may suffer from serial chronic diseases making it difficult for them to live independently and thus they pose a significant economic burden for both themselves and for their government. In order to solve this problem, more and more E-healthcare applications are being designed. In addition, a wide range of medical sensors exist, which can monitor almost all the important physiological parameters of the human body. However, different sensors may use different communication protocols, data units and formats. Additionally, the elderly may use more than one E-healthcare application at the same time and this can lead to problems if there is more than one data source. The project “A Middleware of Wireless sensor networks for Home healthcare monitoring application” is designed to solve these problems.  The focus of this report is on the design and implementation based on multiple modules of data acquisition. There are four data acquisition modules which include the ZigBee module, 6LowPAN module, Wi-Fi module and a Bluetooth module. Thus, multiple data acquisition module middleware supports the sensor by means of ZigBee, 6LowPAN, Wi-Fi and Bluetooth. The tasks of the middleware are to collect packets from sensors, perform data processing and mapping and then displaying as real-time data and finally transmitting the data to the remote server.

This thesis focuses on provincial reactions to the Supreme Court decision on 5 June 2005, Chaoulli v. Quebec (Attorney General). In this decision, the Court struck down the government of Québec’s ban on private insurance for publicly-insured services, on the grounds it violated the Québec Charter of Human Rights and Freedoms, while the decision on the Canadian Charter ended in a 3:3 tie with one abstention. It is the purpose of this research to examine the reactions of each provincial government to the decision in an attempt to understand why each province responded in its chosen manner. In order to make this determination, four hypotheses were constructed in order to test four separate variables: court interference, current law, ideology, and political calculation. These hypotheses were tested against provincial reactions in the media, legislatures, court documents, and E-mail administered questionnaires. This research finds that each hypothesis had some success in predicting provincial reactions to the decision, with a government’s current law and ideology proving to be the most accurate predictors. Based on the evidence gathered, three conclusions were arrived at: first, a government’s law and its ideology will often predict how a government will behave; second, that governments are open to Supreme Court decisions in the area of health care, and, finally, that if provincial governments were to make the decision to increase the role of the private sector in health care, political leaders would require public opinion be in support of such a decision rather than act solely on an ideological predisposition to greater private sector involvement.

There is not sufficient information in the market of medical service. Whether the public has adequate information is the key to the choice of healthcare seeking. Due to the shift of medical environment, rise of consumer¡¦s awareness and respect to patient¡¦s right, the public is concerned about their health and right. Becoming customer-oriented, the industries of medical service start to emphasize the management of customer¡¦s needs and provide appropriate products and service in order to achieve hospital¡¦s sustainable operation and development. This research aims to explore people¡¦s needs of medical seeking from the health news offered by medical institutes and to probe into the influence of health news on choice of medical seeking. Furthermore, the difference of people¡¦s medical seeking behavior of different demographic characteristics and health condition would also be discussed. This research adopts the quantitative survey method of questionnaire to collect data of outpatients in the over 15 age group on a regional hospital in Kaohsiung City. We received 381 valid questionnaires totally and 352 surveys are usable. The valid sample returns-ratio is 92.3%. The results for statistical analysis show that the rank order of demands on issues of news for people¡¦s seeking medical care are listed as follows according to the assisting extent of healthcare provider: ¡§The new trend of health and diseases¡¨, ¡§novel treatments or technique,¡¨ ¡§information of healthcare and hygienic education,¡¨ ¡§introduction of new equipment and facility,¡¨ ¡§medical discovery,¡¨ and ¡§doctor introduction or profession¡¨. The average mean of the required level marks above 4¡§satisfaction¡¨. (The score 5 is the highest.) By excluding other factors, it achieves levels of significance in aspects of health news path and health news issues on explanation of each dimension of people¡¦s medical seeking behavior. Health news shows significant effect on people¡¦s medical seeking behavior. The standardized coefficient is analyzed for further check that health news path and health news issues are positive predictable variables in each dimensions of people¡¦s medical seeking behavior. It implies that for people¡¦s medical seeking behavior, the higher the health news path uses and the higher the demand of health news requires, the stronger the influence on people¡¦s medical seeking behavior. In the discussion of the difference of people¡¦s medical seeking behavior of different demographic characteristics and health condition, it shows that gender, age, level of education, occupation, medical seeking under discomfort, commercial medical insurance, health condition and frequency of medical seeking in recent month would intervene how health news influence people¡¦s medical seeking behavior. By logistic regression analysis, it is found that level of education, coverage on newspapers, hospital handouts, introduction of new equipment and facility and medical discovery are possible predictors of the purpose of medical seeking. On the other hand, easy to choose of healthcare seeking , critical illness, frequency of medical seeking in recent month, coverage on newspapers and medical discovery are possible predictors of the site of medical seeking. In addition, age, level of education, medical seeking under discomfort, health condition, hospital website, community healthcare service and public relationship activity are possible predictors of the frequency of medical seeking. The conclusion of this research could be adopted by the hospital manager and the public relations practitioner for reference as they intend to release health news.

U.S. healthcare costs have experienced unsustainable growth, with expenditures of $2.5 trillion in 2009, and are rising at a rate faster than that of the U.S. economy. A major factor in the cost of the U.S. healthcare system is related to the strategic behavior of system participants based on their incentives. This dissertation addresses the challenge of designing incentives to solve problems in healthcare systems. Principal agent theory and Markov decision processes are the primary methods used to construct incentives. The first problem considered is how to design contracts in order to align consumer and provider incentives with respect to preventive efforts. The model consists of an insurer contracting with two agents, a consumer and a provider, and focuses on the trade off between ex ante moral hazard and insurance. Two classes of efforts on behalf of the provider are studied: those which complement consumer efforts, and those which substitute with consumer efforts. The results show that the provider must be given incentives when the consumer is healthy to induce effort, and that inducing provider effort allows an insurer to save on incentives given to the consumer. The insurer can save on the cost of incentives by using a multilateral contract compared to the bilateral benchmark. These savings are illustrated by an example showing which model features affect the savings achieved. The second problem addresses the decision to provide knowledge to consumers regarding the consequences of health behaviors. The model developed to address this second problem extends the literature on incentives in healthcare systems to consider dynamic environments and includes a behavioral model of healthcare consumers. By using a learning model of consumer behavior, a policy maker's knowledge provision problem is transformed into a Markov decision process. This framework is used to solve for optimal knowledge provision policies regarding behaviors affecting coronary health. Sensitivity analysis shows robust threshold features of optimal policies. The results show that knowledge about smoking should be provided at most health and behavior states. As the cost of providing knowledge increases or aptitude for behavioral change decreases, fewer states are in the optimal knowledge provision policy, with healthy consumers dropping out first. Knowledge about diet and physical activity is provided more selectively due to the to uncertainty in the health benefits, and the time delay in accrued rewards.