The diffusion of information and communication technology (ICT) into healthcare has been generally low. This varies with application and setting, but at the point of care clinical level it has been particularly slow. The ICT niche in clinics has been recognised in numerous publications, where it potential benefits are proclaimed. A reoccurring factor identified with criticism of design i information systems research (ISR) is the difficulty in integrating the different human and technical elements. Activity Theory (AT) has been proposed as a means of overcoming this by providing single theoretical framework able to represent relevant factors across all levels of operational abstraction. In this work the (practical) operational functionality of AT is employed (tested) as a basis for design and evaluation of ICT, applied to integration at the clinical level of the National Health Service (NHS) healthcare organisation. Chronic wound healing is a complex activity, with a long history and strong dependence on data, as observed and recorded by clinicians, to treat and heal patients. Wound clinics that are part of the NHS, which is currently actively pursuing a strategy for information technology (IT) integration in healthcare, afford the opportunity to develop specific ICT for wound data and consider issues of diffusion at different levels of the organisation. An Action Research paradigm, using methods borrowed from soft systems methodology (SSM), is applied to the problem of producing ICT to manage wound data in participating NHS clinics. Data are collected via naturalistic (participant) observation, 'in-depth' interviews and focus groups, and are recorded using ethnographic field notes, a research logbook and diary, and digital and analogue voice recordings. Activity models are generated, to interpret the research process and represent the activity at the action level of the clinic, situating the analysis, both within the network of supporting activities, and the influence and constraints of the administrative and the organisational levels. Practical findings highlight the potential of ICT in participating clinics, showing how this can be expanded to the chronic wound healing activity in general, and reporting the implications that this has for the NHS IT strategy at the level of the clinics involved with regards to integration of ICT. Theoretical findings support the suitability of the Action Research strategy and the relevance of AT both as a descriptive framework for information systems development (!SD), and as an evaluative framework for ISR.

Includes bibliography. / The Institute for Medical Literature (IML) provides an online bibliographic service to the biomedical community in South Africa. The requirements of the users of the services of IML were evaluated in respect of needs and satisfaction of these needs. A non-user population was also identified and evaluated. The research study was undertaken by (a) conducting a review of the literature; and (b) conducting an empirical study of users and non-users of IML to construct both a "personal" and "information behaviour" profile of both the user and non-user groups. The literature was studied to provide (i) a conceptual framework for the field of research, (ii) a compilation of findings in studies related to this study and (iii) a basis for the selection of the methodology employed in the study. The "personal" profile comprised details of age, rank and work activity type and the "information behaviour" profile comprised details of use of information channels. The needs of the users, as measured by various criteria for satisfaction of these needs, were also measured. The reasons for the non-use of the service were also investigated. The principal conclusions reached were: (a) The expressed information need of the users of IML were satisfied; (b) the majority of non-users had not heard of IML; (c) there was a difference between the information seeking behaviour of users and non-users of IML; and (d) age, rank and work activity type influenced the use or non-use of IML.

Indiana University-Purdue University Indianapolis (IUPUI) / Translational research has proven to be a powerful process that bridges the gap between basic science and medical practice. The complexity of translational research is two-fold: integration of vast amount of information in disparate silos, and dissemination of discoveries to stakeholders with different interests. We designed and implemented a hybrid knowledge discovery framework. We developed strategies to leverage both traditional biomedical databases and Health Social Network Communities content in the discovery process. Heuristic and quantitative evaluations were carried out in Colorectal Cancer and Amyotrophic Lateral Sclerosis disease areas. The results demonstrate the potential of our approach to bridge silos and to identify hidden links among clinical observations, drugs, genes and diseases, which may eventually lead to the discovery of novel disease targets, biomarkers and therapies.

Typescript (photocopy). / Digitized by Kansas Correctional Industries

This thesis will examine the manual hospital document retrieval system and electronic document scanning system. From this examination, requirements will be listed for the Administrative Reporting for the Hospital Document Scanning System which will provide better service and reliability than the previous systems. To assure that the requirements can be met, this will be developed into a working system which is named as the Administrative Reporting for the Hospital Document Scanning System(ARHDSS). / Department of Computer Science

Thesis (MTech (Information Technology))--Cape Peninsula University of Technology, 2011. / The research was conducted as part of a socio-tech initiative undertaken at the Cape Peninsula University of Technology. The socio-tech initiative overall focus was on addressing issues faced by rural and under-resourced communities in South Africa, specifically looking at Home-Based Healthcare (HBHC) primarily in the Western Cape. As research into the HBHC context in rural and under-resourced communities continued numerous issues around data and data-elements came to light. These data issues were especially prevalent in relation to the various paper forms being used by the HBHC initiatives that attempt to deliver care in these communities. The communities have the tendency to suffer from poor access to formal healthcare services and healthcare facilities. The data issues were primarily in terms of how data was defines and used within the HBHC initiatives. Within the HBHC initiatives that cater for rural and under-resourced communities there was a clear prevalence of paper-based systems, and a very low penetration of IT-based solution. Because similar and related data-elements are used throughout the paper forms and within different context these data-elements are inconsistently used and presented. The paper forms further obfuscate these inconsistencies as the paper forms regularly change due to internal and external factors. When these paper forms are changed date elements are added or removed without the changes to the underlying ontologies being considered.

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.

The current study is a user-centred enquiry into how wellness-related personal informatics (PI) systems can be more effectively designed to better promote lasting behaviour change and sustained wellbeing in the context of the changing health paradigm. Until recently, the Western biomedical model with its disease focus has been effective in delivering health care; however, this paradigm does not efficiently support a system in crises - the contemporary health care system which is confronted with complex challenges of modern lifestyle diseases and behavioural disorders. Enabled by the technological revolution, a Systems Medicine model - a preventative, personalised, predictive and participatory (P4) approach - is emerging and PI systems play a significant role in realising this pre-clinical, patient-centric, behaviour-focussed shift in health care. This viewpoint paper argues that design strategies applied in PI systems to promote behaviour change play a vital role in supporting health outcomes, specifically, persuasive and mindful user experience (UX) strategies. By applying a phenomenographic research methodology, a user-centred approach is taken to understand qualitatively different ways in which PI systems (and their inherent design strategies) are experienced by users, to inform more intuitive design of PI systems that balance behaviour change strategies to support more lasting shifts and sustainable states of wellbeing. Drawing together ideas from systems medicine, complexity theory, persuasive and mindful design approaches in conjunction with phenomenography, this study aims to understand experiential nuances to offer implications for the future design of health care through PI systems. The theory built through the research process is applied in a prototype design, which is presented as an example of a PI system design that balances persuasive and mindful strategies and aims to promote lasting behaviour change and enduring states of wellbeing more effectively.

A medical expert system for predicting qualitative pharmacodynamic interactions of the cardiovascular system is described. TLCM traces causal paths of drug action through up to three levels of drug action. The three levels which are molecular/receptor level, physiological level and clinical level provide both deep and shallow reasoning in order to overcome the problem of unknowns in medical expert systems. Sparsity of information in pharmacology results from necessity of using non-invasive techniques for monitoring drug effects in the human subject and difficulty in isolating effect from feedback. The qualitative nature of TLCM is another attempt to deal with incomplete information in pharmacology. / Master of Science

Thesis (M.App.Sc.) - Carleton University, 2002. / Includes bibliographical references (p. 180-187). Also available in electronic format on the Internet.