M. Tech. Business Information Systems / Field-based healthcare is the provisioning of healthcare outside a traditional healthcare facility whose location is fixed. Although healthcare is not location and time dependent, the delivery of the service is often constrained to particular location and time. That is, although data accuracy and timely access to medical information is vital, healthcare service providers are not mobile enough to provide the on-demand healthcare service to patients. With restricted mobility, mistakes, unavailability and inaccuracy of information can have life-threatening consequences. To this point, this mini-dissertation argues that Mobile Information Technology (IT) Innovation could leverage field-based healthcare. Thus Mobile IT is considered essential to reducing medical errors, enhancing patient safety and improving quality of healthcare service delivery. Mobile IT can also be leveraged to meet ICT infrastructural challenges of field-based healthcare. That is, to enhance this service delivery, Mobile IT innovation will include the use of mobile devices such as mobile phones, smart phones, pocket computers, wireless networks and other technologies such as Radio Frequency Identification, smart cards, as well as information systems accessed through these technologies. In recent years, cases of Mobile IT application in healthcare service, particularly in South Africa, suggest the use of Mobile IT for disease management, monitoring as well as evaluation of patient care activities. There is a need for an empirical study to highlight the determinant factors that influence Mobile IT innovation for field-based healthcare. In response to this need, this study captured and unraveled the complexity of Mobile IT innovation for field-based healthcare through a case study conducted at a healthcare service provider.

The research explored the new health care service vehicle of South African with special reference to health service providers in Western Cape Department of health for the period 1995-2001. A study was made of the District Health System and the shift of emphasis from tertiary and secondary level of health care to the more cost effective Primary Health Care Service rendered at District level.

The aim of this thesis was to conduct a situational assessment of human resources planning at one local health authority, in order to determine how decentralisation has impacted the effectiveness of human resources planning.

Master of Philosophy / As Australia’s leading agency for funding health research (expending over $400 million in 2006), the National Health and Medical Research Council (NHMRC) has a major responsibility to improve the evidence base for health policy and practice. There is an urgent need for better evidence to guide policy and programs that improve the health of Indigenous peoples. In 2002, NHMRC endorsed a series of landmark policy changes to acknowledge its ongoing role and responsibilities in Indigenous health research—adopting a strategic Road Map for research, improving Indigenous representation across NHMRC Council and Principal Committees, and committing 5% of its annual budget to Indigenous health research. This thesis examines how these policies evolved, the extent to which they have been implemented, and their impact on agency expenditure in relation to People Support. Additionally, this thesis describes the impact of NHMRC policies in reshaping research practices among Indigenous populations.

Thesis (MPhil)--Stellenbosch University, 2002. / ENGLISH ABSTRACT: One of the main objectives of the new South African government who came into power in 1994 was to improve the daily living conditions of its citizens. To what extent did the government succeed in this objective? This is the basic research question informing the present study. In order to keep it within manageable proportions, the study investigated a very specific area of service delivery, namely the delivery of public health services. This was further narrowed down to the Western Cape and more specifically, to the role of public hospitals in the area. The Western Cape promised to be an interesting case, because although the government of national unity was dominated by the ANC, the Western Cape was ruled by a NNP dominated coalition. On the national level, the Province had to follow national policy guidelines, while on the provincial level it had more freedom to formulate and implement its own policies. The study itself consists of two parts. The first concerns policy formulation, the second policy implementation. As far as policy formulation is concerned, a study was made of basic documents articulating the fundamental values, national priorities and main objectives informing government policy. These included the Freedom Charter, the Constitution, and the Reconstruction and Development Program. It was found that these values and priorities were in general well translated into policy options on both the national and provincial level, especially in the various documents aimed at transforming the national health system. The second part of the study investigates the implementation of the broad policy guidelines in the area of public heath in selected public hospitals in the Western Cape. The main method of investigation was the use of structured interviews with representative employees from all different levels. The findings were therefore of a qualitative rather than a quantitative nature. The focal areas selected were personnel management issues, human resource planning, labour relation issues and human resource development issues. The main findings were that the formulation of policy both from basic values to the level of health care policies and from the national to provincial level in general was quite successful. On the other hand, there were serious shortcomings in the implementation of these policies on various levels. The investigation revealed a mixed and often contradictory picture. Although some hospitals made good progress in some respects, there is still a long way before quality health care will be delivered to all patients. A commitment to equity in the health services of the country implies a commitment to correcting the historical gender, class and racial imbalances in the development of human recourses for health care. Of necessity, a compassionate and caring health service will address the issue of corrective action. There is a real need to provide proper planning of those most disadvantaged by apartheid in managerial skills to fill managerial positions in the health sector. It is therefore is necessary to introduce as a matter of urgency new health management programmes, which will promote efficient and effectiveness management at all levels of health care service delivery. Current health managers need to be reoriented from the predominantly bureaucratic, rule-based approach towards a participative approach. The development of managerial capacity in areas such as participative and change management, leadership development, strategic planning, programme management and evaluation, and policy development and implementation is of crucial importance. The study concludes with a series of specific recommendations with regard to affirmative action, managerial and institutional capacity, human resource planning, and training needs for various sectors. / AFRIKAANSE OPSOMMING: Een van die hoofdoelstellings van die nuwe Suid-Afrikaanse regering wat in 1994 aan bewind gekom het, was om die leefomstandinghede van al die land se inwoners te verbeter. Tot watter mate het die regering geslaag in hierdie doelwit? Dit is die basiese navorsingsvraag onderliggend aan hierdie studie. Ten einde die ondersoek binne hanteerbare grense te hou, is op slegs een aspek van dienslewering gekonsenteer, naamlik die lewering van gesondheidsdienste. Hierdie terrein is verder vernou tot die Wes-Kaap en meer spesifiek tot die rol van openbare hospitale. Die Wes-Kaap was interessant omdat hoewel die regering op nasionale vlak deur die ANC beheer is, die Wes-Kaap basies deur die NNP in die periode van ondersoek geregeer is. Die provinsie was verplig om nasionale beleidsriglyne te volg, maar op provinsiale vlak het dit 'n sekere speelruimte geniet om eie beleid te formuleer en te implementeer. Die studie bestaan uit twee dele. Die eerste het te doen met beleidsformulering, die tweede met beleidsimplementering. Wat beleidsformulering betref, is 'n studie gemaak van die basisdokumente wat die kernwaardes, nasionale prioriteite en hoof doelstellings van die regering bevat. Dit het ingesluit die Vryheidmanifes, die Konstitusie en die Heropbou- en Ontwikkelingsprogram. Daar is bevind dat hierdie waardes en prioriteite in die algemeen suksesvol vertaal is in beleidsopsies op beide die nasionale en provinsiale vlak, veral in die dokumente wat gerig was op die transformasie van die nasionale gesondheidsektor. Die tweede deel van die studie het die implementering van die breë beleidsriglyne in die area van openbare gesondheid in geselekteerde publike hospitale in die Wes-Kaap ondersoek. Die hoof-ondersoekmetode was gestruktureerde onderhoude met verteenwoordigende werknemers van alle vlakke. Die bevindinge was gevolglik meer van 'n kwalitatiewe as kwantitatiewe aard. Die fokusareas waarop geskonsentreer is, was personeelbestuur, menslike hulpbronbeplanning, arbeidsverhoudinge en die ontwikkeling van menslike potensiaal. Die hoofbevindinge was dat die formulering van beleid beide van basiese waardes na gesondheidsbeleid en van die nasionale na provinsiale vlak in die algemeen suksesvol was. Aan die ander kant het ernstige gebreke aan die lig gekom sover dit die implementering van beleid op verskillende vlakke betref. Die resultaat was 'n gemengde en dikwels kontrasterende prentjie. Hoewel sommige hospitale goeie vordering gemaak het in sekere opsigte, laat die lewering van gehalte-diens aan alle pasiënte nog veel te wense oor. Die verbintenis to gelykheid in gesondheidsdienste veronderstel 'n verbintenis tot die regstelling van geslags-, klas- en rasse-ongelykhede in die ontwikkeling van menslike hulpbronne in die gesondheidsektor. Dienslewering gebaseer op sorg en empatie is van deurslaggewende belang in hierdie opsig. Daar is 'n groot behoefte aan behoorlike beplanning vir die verbetering van bestuur- en ander vaardighede van agtergestelde groepe. Die implementering van behoorlike bestuursopleidingsprogramme is van die uiterste belang, wat kan bydra tot effektiewe en goeie dienslewering. Die huidige oorwegend burokratiese en reëlsgebonde bestuurstyl behoort in 'n deelnemende benadering omgeskakel te word. Die ontwikkeling van bestuurskapasiteit in gebiede soos deelnemende veranderingsbestuur, leierskapsontwikkeling, strategiese beplanning, programbestuur en -evaluering en beleidsformulering is van die grootse belang. Die ondersoek sluit af met 'n reeks konkrete aanbevelings met betrekking tot regstellende aksie, verbetering van bestuurskapasiteit, menslike hulpbronontwikkeling en die opleidingsbehoeftes van die verskillende afdelings.

Thesis (MTech (Information Technology))--Cape Peninsula University of Technology, 2016. / Health information policies are constantly becoming a key feature in directing information usage in healthcare. After the passing of the Health Information Technology for Economic and Clinical Health (HITECH) Act in 2009 and the Affordable Care Act (ACA) passed in 2010, in the United States, there has been an increase in health systems innovations. Coupling this health systems hype is the current buzz concept in Information Technology, „Big data‟. The prospects of big data are full of potential, even more so in the healthcare field where the accuracy of data is life critical. How big health data can be used to achieve improved health is now the goal of the current health informatics practitioner. Even more exciting is the amount of health data being generated by patients via personal handheld devices and other forms of technology that exclude the healthcare practitioner. This patient-generated data is also known as Personal Health Records, PHR. To achieve meaningful use of PHRs and healthcare data in general through big data, a couple of hurdles have to be overcome. First and foremost is the issue of privacy and confidentiality of the patients whose data is in concern. Secondly is the perceived trustworthiness of PHRs by healthcare practitioners. Other issues to take into context are data rights and ownership, data suppression, IP protection, data anonymisation and reidentification, information flow and regulations as well as consent biases. This study sought to understand the role of data policies in the process of data utilisation in the healthcare sector with added interest on PHRs utilisation as part of big health data.

Este trabalho tem o propósito de examinar as implicações da estrutura federativa brasileira no processo de regionalização das ações e serviços de saúde do Sistema Único de Saúde (SUS). A ideia nuclear é que, por sua natureza federativa, a regionalização da saúde no Brasil deve realizar-se no contexto das relações intergovernamentais fundadas na configuração institucional do federalismo cooperativo do país e em sua expressão na área da saúde. O método empregado inclui a utilização de material bibliográfico e a incorporação de componentes de investigação empírica. A análise desenvolvida baseia-se numa abordagem diacrônica do federalismo, tomando-o como princípio organizador do Estado que se manifesta em suas diversas dimensões. Desse modo, o fenômeno do federalismo é estudado em função de sua evolução no tempo e, de forma concatenada, partindo de seus aspectos gerais em direção aos específicos que se exprimem no Estado brasileiro e particularmente no âmbito da saúde. O federalismo sanitário brasileiro é abordado a partir de seu ingresso no ordenamento constitucional, identificando dois períodos bem delimitados de formação: a descentralização e a regionalização. Agregam-se elementos empíricos de pesquisa em que a regionalização da saúde é caracterizada a partir de concepções expressas por atores políticos que representam as perspectivas das três esferas de governo. Os condicionantes do processo de regionalização do SUS são então explorados à luz do referencial teórico do federalismo em três dimensões de análise: base normativa, estrutura de financiamento e dinâmica política. Assim, identificam-se pontos facilitadores e entraves para a regionalização e apontam-se possibilidades para a efetivação dessa diretriz organizativa no SUS. Conclui-se que a regionalização da saúde no Brasil está apoiada em arcabouço normativo bem definido, proveniente da assimilação dos princípios do federalismo cooperativo no direito sanitário brasileiro, e que encontra obstáculos derivados do modelo federativo de financiamento e relacionados ao funcionamento das relações intergovernamentais instituídas no SUS. / This study aims to examine the implications of Brazilian federal structure in the regionalization process of healthcare services of the national health system (Sistema Único de Saúde SUS). The core idea is that, by its federal nature, the regional health planning in Brazil must take place in context of intergovernmental relations founded on the institutional configuration of cooperative federalism in the country and on its expression in health. The method includes the use of bibliographic material and incorporation of empirical research components. The analysis is based on a diachronic approach, taking federalism as an organizing principle of State which is manifested in its various dimensions. Therefore, the phenomenon of federalism is studied in terms of its evolution in time and, so concatenated, starting with its general aspects towards specific ones which are expressed in the Brazilian State and particularly in health. The Brazilian health federalism is approached from its entry into the constitutional order, with two clearly defined development periods: decentralization and regionalization. Empirical elements are added from a study in which health regionalization is characterized from ideas expressed by political actors representing the perspectives of three levels of government. The conditioning factors of SUS regional health planning are then explored in light of the federalism theoretical framework taking three dimensions of analysis: normative basis, funding structure and political dynamics. Thus, facilitators and barriers to regional health planning are identified and opportunities for actualizing this organizational guideline in SUS are indicated. It is concluded that health regionalization in Brazil is supported by well-defined regulatory framework, proceeding from assimilation of cooperative federalism principles in Brazilian health law, and that it has obstacles derived from the federal model of financing and related to the operation of intergovernmental relations established in SUS

INTRODUÇÃO: A atuação de uma equipe de reabilitação junto à Estratégia Saúde da Família (PSF), iniciada na cidade de São Paulo no ano de 2001, inaugura um serviço singular de atenção a pessoas com deficiência na atenção básica. Tal projeto tem como objetivo estabelecer uma cultura de defesa dos direitos da pessoa com deficiência na busca do desmonte dos processos de exclusão social, construindo intervenções que articulem a prevenção de deficiências, reabilitação e educação por meio de ações intersetoriais (Fichino et al, 2008). Essa pesquisa visa conhecer e analisar aspectos da organização do trabalho desse serviço, à luz de aspectos do referencial teórico da gestão da operação de serviços. MÉTODO: Pesquisa qualitativa do tipo estudo de caso baseada nos princípios de Yin (2003) que combinou diferentes procedimentos de coleta de dados (pesquisa documental, entrevistas semi-estruturadas e aplicação de questionários). Foram realizadas sete entrevistas com trabalhadores de uma equipe de reabilitação no ano de 2007. Cada fonte de evidência recebeu tratamento diferenciado tendo em vista a finalidade de sua utilização e posteriormente foi realizado um diálogo dos resultados obtidos para construção de uma cadeia de evidências sobre a qual se construiu o estudo do caso. RESULTADOS: Foi verificado nesse estudo que o conceito do serviço pesquisado não se consolidou devido às mudanças nas políticas públicas de saúde que ancoravam essa experiência e a falhas no projeto do serviço, como por exemplo, o não detalhamento da organização do trabalho. Isso teve impacto para os trabalhadores que diante da fluidificação do conceito do serviço passam a organizar suas ações a partir de estratégias individuais ou de demandas pontuais se remetendo pouco aos pressupostos que fundamentam o serviço. Para os gestores tal quadro resulta na dificuldade de alinhar suas expectativas com o serviço realizado de fato. CONCLUSÃO: O hiato que existe entre a operação e o conceito precisa ser preenchido em duas vias: uma aproximando as proposições teóricas presentes no conceito do serviço da realidade cotidiana de quem desempenha o trabalho; e, na direção oposta, reforçando as premissas do projeto pelo refinamento e incorporação dessas pelos profissionais de linha de frente e gestores / The performance of a rehabilitation team together with the Family Health Program (FHP), begun in the city of São Paulo in 2001, launches a unique service to attend people with deficiencies in primary care. Such service aims to establish a consciousness of protection of the rights of disabled people in order to dismantle the process of social exclusion by creating actions to promote the prevention of disabilities as well as education and rehabilitation through intersectorial interventions. This research seeks to understand and analyze aspects of the work organization of this rehabilitation team based on the theoretical framework of the service operation management. METHODS: Qualitative research conducted by means of case study following Yins principles (2003) which combined different procedures for data collection (desk research, semistructured interviews and questionnaires). Seven interviews were conducted with employees of a team of rehabilitation in 2007. Each source of evidence received a differentiated treatment according to the purpose of its use. And, later, the results obtained were compared for the construction of a chain of evidences on which a case study was built. RESULTS: It has been verified in this study that the concept of the service was not consolidated due to: 1. changes in public health policies that anchored this experience; 2. flaws in the project of the service, such as, the lack of detailing the work organization. These results had an impact on the workers who, before the weakening of the concept of the service, began to base their actions on individual strategies or specific demands, referring very little to the directives that ground the service. For the managers such situation is result of a difficulty to align their expectation with the actual service. CONCLUSION: The gap that exists between the operation and the concept needs to be completed in a two-way street. One way, approaching the theoretical propositions in the concept of the service from the daily reality of who performs the work. And, on the other way, reinforcing the premises of the project by the refinement and incorporation of the front-line professionals and managers

Job satisfaction studies are an essential element for ensuring improvement in service delivery. The researcher was committed to assist top management with important information that can make them aware of the causes and consequences of job satisfaction (Nel, Van Dyk, Haasbroek, Schultz, Sono and Werner, 2006:52). Job satisfaction is not only concerned with feeling good at work, it also encompasses job content, the work environment and interaction with all people. The study was conducted at the Department of Health in the Province of the Eastern Cape. This study aimed to describe the level of job satisfaction amongst middle managers of the Department of Health (DoH) at the Head Office, in terms of remuneration, interpersonal relationships, development, support, recognition, extent of supervision, their attitude to the work itself and working conditions.

Federally qualified health centers (FQHCs) that harness the reinforcing nature of collaborative efforts with aging services can better prepare for the future of older adult populations. The purpose of this research was to identify collaborative efforts between FQHCs and aging services and distinguish perceptions and knowledge regarding older adult populations. Executive directors, medical directors and social service directors (N=44) at 31 FQHCs across the state of Texas completed surveys measuring structural, procedural and environmental components of the health center setting. The 2007 Uniform Data System and 2000 US Census provided additional data on health centers use and services. Descriptive statistics analyzed independent variables of health center characteristics. Bivariate analysis determined significance of association between independent variables and levels of collaboration with aging services. Results found that all health centers collaborated with at least one aging service, with more informal than formal partnerships. Respondents indicated major barriers to providing services to older adults, including inadequate transportation, inadequate insurance, and limited funding. Respondents also indicated overloaded staff as a major barrier to collaborating with aging services. Aging topics for staff development and perceptions about older adults were also identified. Health center tenure (p=0.005, lambda=1.000), professional tenure (p=0.011, lambda=1.000), leadership in aging services (p=0.002, lambda=1.000), recent gerontological training (p=0.002, lambda=0.500), formal gerontological training p=0.002, lambda=1.000), strategic planning (p=0.002, lambda=1.000), and having older adults on governing boards (p=0.002, lambda= 1.000) were significantly associated with informal collaboration with aging services. Health center tenure (p=0.006, lambda=0.500), leadership in aging services (p=0.004, lambda=0.500), recent training (p=0.010, lambda=0.500), formal training (p=0.005, lambda=0.500), the designation of health center staff older adult services (p=0.025, lambda=0.250), strategic planning (p=0.011, Iambda=0.500), and older adults on governing board (p=0.009, lambda=0.500) were significantly associated with formal collaboration with aging services. In conclusion, FQHCs' efforts at partnering with aging services should include an investment in key staff and board development, the designation of staff to older adult programs, and strategic planning.