Thesis (MTech (Information Technology))--Cape Peninsula University of Technology, 2016. / In the Western Cape, South Africa, despite the prospective benefits that e-Health information systems (e-Health IS) offer to support the healthcare sector; there are limitations in terms of usability, functionality and peculiar socio-technical factors. Thus, healthcare professionals do not make the most use of the implemented e-Health IS. Unfortunately, explanations remain tentative and unclear, yet non-usage of the e-Health IS defeats the objectives of its adoption, in the sense that the plan to improve and deliver quality healthcare service in the public sector may not be achieved as envisaged. The aim of the study was to acquire explanations to the causes of the limitations regarding the adoption and, particularly, the use (or non-use) of e-Health IS by clinical staff in the public healthcare institutions in South Africa. The choice of research approach was informed by the research problem, objectives, and the main research question. By the reasons of the subjective and socio-technical nature of the phenomenon, a deductive approach was adopted for this investigation. The nominalist ontology and interpretivist epistemology positions were taken by the researcher as a lens to conduct this research; which informed a qualitative methodology for this investigation. The purposive sampling technique was used to identify the appropriate participants from different hospital levels consisting of Hospital Administrative staff, and Clinical staff (Clinicians and Nurses) of relative experiences in their clinical units. Subsequently, the Unified Theory of Acceptance and Use of Technology (UTAUT) and content analysis technique were used to contextualize, simplify, and analysis the text data transcripts. The findings indicate that healthcare professionals have a high level of awareness and acceptance to use implemented e-Health IS. There are positive perceptions on the expected outcomes, that e-Health IS would improve processes and enhance healthcare services delivery in the public healthcare sector. Also, findings indicate that social influence plays a vital role especially on the willingness of individuals (or groups); as the clinical staff are influenced by their colleagues despite the facilitating conditions provided by the hospital management. Further, findings indicate that it is somewhat problematic to maintain balance in running a parallel paper-electronic system in the hospital environment. Hence, the core factors that influence successful adoption and use of e-Health IS include; willingness of an individual (or group) to accept and use a technology, the performance expectancy, social influence among professionals in the healthcare scenery and adequate facilitating conditions. In summary, it is recommended that there should be an extensive engagement inclusive of all respective stakeholders involved in the adoption processes. This would ensure that e-Health IS are designed to meet both practical organizational and clinical needs (and expectations) with respect to the hospital contexts.

O objetivo deste trabalho foi desenvolver um software de computador que gerencie um banco de dados contendo informações sobre avaliação da voz e o exame de fonetografia e que confeccione o fonetograma (gráfico). Através da utilização de software de desenvolvimento de sistemas (Delphi), foi criado um programa com a finalidade de gerenciar um banco de dados (Paradox), com informações referentes ao exame de fonetografia e, baseado nestes dados, gerar o gráfico do fonetograma. Para a avaliação deste software foram introduzidos no sistema os dados de 30 fichas, contendo as informações de exames de fonetografia já realizados, no intuito de verificar da sua capacidade de gerenciar estas informações e traçar seus gráficos. O programa mostrou-se capaz de realizar o armazenamento dos dados, a consulta de informações e a geração do fonetograma. Sua utilização poderá ser muito útil para melhorar a organização dos dados dos exames, agilizar a interpretação dos resultados e facilitar a interação entre clínico e paciente, tornando-se assim um valioso instrumento na aplicação da fonetografia / The aim of this study was to develop a computer software in order to manage a data base with information collected during phonetography, which allows the program to produce a phonetogram graph. The computer software was obtained through Delphi Developer and the data base used was Paradox. The data of 30 forms of phonetography test were introduced in the system in order to evaluate, to store the data, to make the data available for consulting and to produce the phonetogram successfully. The developed software will be very useful to improve the organization of the test data, to speed up the comprehension of the results and to facilitate the interaction between the clinician and patient

In this thesis, a very flexible framework for simulating RIS is designed to beused for Infobroker testing. Infobroker is an application developed by MawellSvenska AB that connects RIS and PACS to achieve interoperability by enablingimage and journal data transmission between radiology sites. To put the project in context, the field of medical informatics, RIS and PACS systems and common protocols and standards are explored. A proof-of-concept implementation of the proposed design shows its potential and verifies that it works. The thesis concludes that a more specialized approach is preferred.

Appropriate e-services as well as revenue generation capabilities are key to the deployment and the sustainability for ICT installations in poor areas, particularly common in developing country. The area of e-Health is a promising area for e-services that are both important to the population in those areas and potentially of direct interest to National Health Organizations, which already spend money for Health campaigns there. This thesis focuses on the design, implementation, and full functional testing of HealthAware, an application that allows health organization to set up targeted awareness campaigns for poor areas. Requirements for such application are very specific, starting from the fact that the preparation of the campaign and its execution/consumption happen in two different environments from a technological and social point of view. Part of the research work done for this thesis was to make the above requirements explicit and then use them in the design. This phase of the research was facilitated by the fact that the thesis' work was executed within the context of the Siyakhula Living Lab (SLL; www.siyakhulaLL.org), which has accumulated multi-year experience of ICT deployment in such areas. As a result of the found requirements, HealthAware comprises two components, which are web-based, Java applications that run in a peer-to-peer fashion. The first component, the Dashboard, is used to create, manage, and publish information for conducting awareness campaigns or surveys. The second component, HealthMessenger, facilitates users' access to the campaigns or surveys that were created using the Dashboard. The HealthMessenger was designed to be hosted on TeleWeaver while the Dashboard is hosted independently of TeleWeaver and simply communicates with the HealthMessenger through webservices. TeleWeaver is an application integration platform developed within the SLL to host software applications for poor areas. Using a core service of TeleWeaver, the profile service, where all the users' defining elements are contained, campaigns and surveys can be easily and effectively targeted, for example to match specific demographics or geographic locations. Revenue generation is attained via the logging of the interactions of the target users in the communities with the applications in TeleWeaver, from which billing data is generated according to the specific contractual agreements with the National Health Organization. From a general point of view, HealthAware contributes to the concrete realizations of a bidirectional access channel between Health Organizations and users in poor communities, which not only allows the communication of appropriate content in both directions, but get 'monetized' and in so doing becomes a revenue generator.

Since the early 20th century, the view has developed that high quality health care can be delivered only when all the pertinent data about the health of a patient is available to the clinician. Various types of health records have emerged to serve the needs of healthcare providers and more recently, patients or consumers. These health records include, but are not limited to, Personal Health Records, Electronic Heath Records, Electronic Medical Records and Payer-Based Health Records. Payer-Based Health Records emerged to serve the needs of medical aids or health care plans. Electronic Medical Records and Electronic Health Records were targeted at the healthcare provider market, whereas a gap developed in the patient market. Personal Health Records were developed to address the patient market, but adoption was slow at first. The success of online social networking reignited the flame that Personal Health Records needed and online consumer-based Personal Health Records were developed. Despite all the various types of health records, there still seems to be a lack of meaningful use of personal health records in modern society. The purpose of this dissertation is to propose a framework for Personal Health Records in online social networking, to address the issue of a lack of a central, accessible repository for health records. In order for a Personal Health Record to serve this need it has to be of meaningful use. The capability of a PHR to be of meaningful use is core to this research. In order to determine whether a Personal Health Record is of meaningful use, a tool is developed to evaluate Personal Health Records. This evaluation tool takes into account all the attributes that a Personal Health Record which is of meaningful use should comprise of. Suitable ratings are allocated to enable measuring of each attribute. A model is compiled to facilitate the selection of six Personal Health Records to be evaluated. One of these six Personal Health Records acts as a pilot site to test the evaluation tool in order to determine the tool’s utility and effect improvements. The other five Personal Health Records are then evaluated to measure their adherence to the attributes of meaningful use. These findings, together with a literature study on the various types of health records and the evaluation tool, inform the building blocks used to present the framework. It is hoped that the framework for Personal Health Records in online social networking proposed in this research, may be of benefit to provide clear guidance for the achievement of a central or integrated, accessible repository for health records through the meaningful use of Personal Health Records.

It is widely acknowledged that patients' emotional expressions and doctors' empathic responses play a key role in providing satisfactory healthcare services and improving doctor-patient relationships. While such affective aspect of medical consultation discourse has been studied in different fields of research with the focus of examining medical consultations that occur in face-to-face settings, this area is extremely under-researched in the field of linguistics, particularly in the non-western context and the online space. While online medical consultation (OMC) has ushered in the new era of e-communication around the beginning of this century, discourse-related research on OMC is still in its infancy and studies on the affective dimension of the OMC discourse in non-western sites are, to my best knowledge, apparently absent in the literature. As China has seen a significant increase in the use of OMC platforms, studying OMC discourse in the China context is not only important but vital. With the support of the Chinese government's "Internet Plus Healthcare" policy issued in 2018, the reliance on the online mode of medical consultation will be further strengthened and the future of OMC service in China will remain promising. In order to have a better understanding of the affective aspect of OMC discourse, this thesis explores the online interaction between doctors and e-patients (including patients' caregivers) from a poststructuralist discourse analysis perspective. The data for this study consists of 300 text-based one-to-one instant messaging OMC cases collected from three popular OMC websites used in China. Each OMC case contains e-patients' emotional expression and doctors' empathic response. The data are analysed by the approach of computer-mediated discourse analysis in terms of two dimensions: the textual dimension and the social practice dimension. At the textual level, the study identifies indirect negative emotional acts by e-patients and empathic acts by doctors (which constitute the affective practice); it also examines the interactional discursive features involved in the affective practice. At the social practice level, it explores the discursive positions of e-patients and doctors within the affective practice context and the power relations that are reflected in the identity positionings. This study finds that the text-based OMC affective practice is rich in various types of emotional expressions and different ways of manifesting empathy, some of which are not mentioned in studies on medial consultation discourse. The study also identifies positions that disrupt the traditional or stereotypical roles of doctor and patient. Besides, it presents dynamic power relations, which problematizes the idea that doctors are always the more powerful party and patients are always powerless in medical encounters. This study sheds light on the importance of examining the affective facet of medical consultation from a discourse analytic perspective, when it comes to identifying non-traditional positions and power relations in clinical communication. The study also provides the implication that e-healthcare platforms, especially those with an e-commercialised model for healthcare services, have potential to produce a type of neo-liberal discourse - the e-commercialised medical consultation discourse - in which patients and caregivers, who are acknowledged as the less powerful group in the traditional healthcare activities, are empowered and privileged

It is widely acknowledged that patients' emotional expressions and doctors' empathic responses play a key role in providing satisfactory healthcare services and improving doctor-patient relationships. While such affective aspect of medical consultation discourse has been studied in different fields of research with the focus of examining medical consultations that occur in face-to-face settings, this area is extremely under-researched in the field of linguistics, particularly in the non-western context and the online space. While online medical consultation (OMC) has ushered in the new era of e-communication around the beginning of this century, discourse-related research on OMC is still in its infancy and studies on the affective dimension of the OMC discourse in non-western sites are, to my best knowledge, apparently absent in the literature. As China has seen a significant increase in the use of OMC platforms, studying OMC discourse in the China context is not only important but vital. With the support of the Chinese government's "Internet Plus Healthcare" policy issued in 2018, the reliance on the online mode of medical consultation will be further strengthened and the future of OMC service in China will remain promising. In order to have a better understanding of the affective aspect of OMC discourse, this thesis explores the online interaction between doctors and e-patients (including patients' caregivers) from a poststructuralist discourse analysis perspective. The data for this study consists of 300 text-based one-to-one instant messaging OMC cases collected from three popular OMC websites used in China. Each OMC case contains e-patients' emotional expression and doctors' empathic response. The data are analysed by the approach of computer-mediated discourse analysis in terms of two dimensions: the textual dimension and the social practice dimension. At the textual level, the study identifies indirect negative emotional acts by e-patients and empathic acts by doctors (which constitute the affective practice); it also examines the interactional discursive features involved in the affective practice. At the social practice level, it explores the discursive positions of e-patients and doctors within the affective practice context and the power relations that are reflected in the identity positionings. This study finds that the text-based OMC affective practice is rich in various types of emotional expressions and different ways of manifesting empathy, some of which are not mentioned in studies on medial consultation discourse. The study also identifies positions that disrupt the traditional or stereotypical roles of doctor and patient. Besides, it presents dynamic power relations, which problematizes the idea that doctors are always the more powerful party and patients are always powerless in medical encounters. This study sheds light on the importance of examining the affective facet of medical consultation from a discourse analytic perspective, when it comes to identifying non-traditional positions and power relations in clinical communication. The study also provides the implication that e-healthcare platforms, especially those with an e-commercialised model for healthcare services, have potential to produce a type of neo-liberal discourse - the e-commercialised medical consultation discourse - in which patients and caregivers, who are acknowledged as the less powerful group in the traditional healthcare activities, are empowered and privileged

No description available.

Indiana University-Purdue University Indianapolis (IUPUI) / Biomedical research has produced vast amounts of new information in the last decade but has been slow to find its use in clinical applications. Data from disparate sources such as genetic studies and summary data from published literature have been amassed, but there is a significant gap, primarily due to a lack of normative methods, in combining such information for inference and knowledge discovery. In this research using Bayesian Networks (BN), a probabilistic framework is built to address this gap. BN are a relatively new method of representing uncertain relationships among variables using probabilities and graph theory. Despite their computational complexity of inference, BN represent domain knowledge concisely. In this work, strategies using BN have been developed to incorporate a range of available information from both raw data sources and statistical and summary measures in a coherent framework. As an example of this framework, a prototype model (In-silico Bayesian Integration of GWAS or IsBIG) has been developed. IsBIG integrates summary and statistical measures from the NIH catalog of genome wide association studies (GWAS) and the database of human genome variations from the international HapMap project. IsBIG produces a map of disease to disease associations as inferred by genetic linkages in the population. Quantitative evaluation of the IsBIG model shows correlation with empiric results from our Electronic Medical Record (EMR) – The Regenstrief Medical Record System (RMRS). Only a small fraction of disease to disease associations in the population can be explained by the linking of a genetic variation to a disease association as studied in the GWAS. None the less, the model appears to have found novel associations among some diseases that are not described in the literature but are confirmed in our EMR. Thus, in conclusion, our results demonstrate the potential use of a probabilistic modeling approach for combining data from disparate sources for inference and knowledge discovery purposes in biomedical research.

Indiana University-Purdue University Indianapolis (IUPUI) / Acceptance of PHR by physicians is fundamental as they play important role towards the promotion of PHR adoption by providing the access to the data to be maintained in PHR and also, using the information within the PHR for decision making. Therefore it is important to measure physicians' perspective on usefulness of PHR, and also the value and trust they have in PHR usage. Review of previous researches identifies the lack of availability of a valid survey instrument that can be used to measure physicians' perception on all different aspects of PHR use and acceptance. Using the integrated literature review methodology and Unified Theory of Acceptance and Use of Technology (UTAUT) as a guiding framework, this study was aimed to identify the factors that can be used in the development of comprehensive evaluation instrument to understand physicians' acceptance of PHR. Total 15 articles were selected for literature review and using the content analysis method, 189 undifferentiated data units were extracted from those articles. These data units were then categorized into the four core constructs of UTAUT. ―Other categorization system was also created for the data units that could not be classified into one of the UTAUT core constructs. Among four core UTAUT constructs, Performance Expectancy is found to be the most influential factor in physicians' acceptance of PHR, followed by ―Other factors, Facilitating Condition and Social Influence. Effort expectancy was found to be the least influential. The identified specific factors within each domain can be used to develop a valid survey instrument to measure physicians' perception on PHR.