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1	The Design and Evaluation of Ambient Displays in a Hospital Environment Koelemeijer, Dorien January 2016 (has links) Hospital environments are ranked as one of the most stressful contemporary work environments for their employees, and this especially concerns nurses (Nejati et al. 2016). One of the core problems comprises the notion that the current technology adopted in hospitals does not support the mobile nature of medical work and the complex work environment, in which people and information are distributed (Bardram 2003). The employment of inadequate technology and the strenuous access to information results in a decrease in efficiency regarding the fulfilment of medical tasks, and puts a strain on the attention of the medical personnel. This thesis proposes a solution to the aforementioned problems through the design of ambient displays, that inform the medical personnel with the health statuses of patients whilst requiring minimal allocation of attention. The ambient displays concede a hierarchy of information, where the most essential information encompasses an overview of patients’ vital signs. Data regarding the vital signs are measured by biometric sensors and are embodied by shape-changing interfaces, of which the ambient displays consist. User-authentication permits the medical personnel to access a deeper layer within the hierarchy of information, entailing clinical data such as patient EMRs, after gesture-based interaction with the ambient display. The additional clinical information is retrieved on the user’s PDA, and can subsequently be viewed in more detail, or modified at any place within the hospital.In this thesis, prototypes of shape-changing interfaces were designed and evaluated in a hospital environment. The evaluation was focused on the interaction design and user-experience of the shape-changing interface, the capabilities of the ambient displays to inform users through peripheral awareness, as well as the remote communication between patient and healthcare professional through biometric data. The evaluations indicated that the required attention allocated for the acquisition of information from the shape-changing interface was minimal. The interaction with the ambient display, as well as with the PDA when accessing additional clinical data, was deemed intuitive, yet comprised a short learning curve. Furthermore, the evaluations in situ pointed out that for optimised communication through the ambient displays, an overview of the health statuses of approximately eight patients should be displayed, and placed in the corridors of the hospital ward. ambient displays AmI hospital healthcare ambient intelligence ubiqtuitous computing calm technology ubicomp weiser health care technology shape-changing interface shape changing interface shape-changing display shape changing display biometrics remote communication social awareness system peripheral awareness hospital technology nurses medical personnel body area networks dual-task experiment common information space arduino electronic medical record vital signs data visualisation prototypes Engineering and Technology Teknik och teknologier
2	Disruptive Transformations in Health Care: Technological Innovation and the Acute Care General Hospital Lucas, D. Pulane 24 April 2013 (has links) Advances in medical technology have altered the need for certain types of surgery to be performed in traditional inpatient hospital settings. Less invasive surgical procedures allow a growing number of medical treatments to take place on an outpatient basis. Hospitals face growing competition from ambulatory surgery centers (ASCs). The competitive threats posed by ASCs are important, given that inpatient surgery has been the cornerstone of hospital services for over a century. Additional research is needed to understand how surgical volume shifts between and within acute care general hospitals (ACGHs) and ASCs. This study investigates how medical technology within the hospital industry is changing medical services delivery. The main purposes of this study are to (1) test Clayton M. Christensen’s theory of disruptive innovation in health care, and (2) examine the effects of disruptive innovation on appendectomy, cholecystectomy, and bariatric surgery (ACBS) utilization. Disruptive innovation theory contends that advanced technology combined with innovative business models—located outside of traditional product markets or delivery systems—will produce simplified, quality products and services at lower costs with broader accessibility. Consequently, new markets will emerge, and conventional industry leaders will experience a loss of market share to “non-traditional” new entrants into the marketplace. The underlying assumption of this work is that ASCs (innovative business models) have adopted laparoscopy (innovative technology) and their unification has initiated disruptive innovation within the hospital industry. The disruptive effects have spawned shifts in surgical volumes from open to laparoscopic procedures, from inpatient to ambulatory settings, and from hospitals to ASCs. The research hypothesizes that: (1) there will be larger increases in the percentage of laparoscopic ACBS performed than open ACBS procedures; (2) ambulatory ACBS will experience larger percent increases than inpatient ACBS procedures; and (3) ASCs will experience larger percent increases than ACGHs. The study tracks the utilization of open, laparoscopic, inpatient and ambulatory ACBS. The research questions that guide the inquiry are: 1. How has ACBS utilization changed over this time? 2. Do ACGHs and ASCs differ in the utilization of ACBS? 3. How do states differ in the utilization of ACBS? 4. Do study findings support disruptive innovation theory in the hospital industry? The quantitative study employs a panel design using hospital discharge data from 2004 and 2009. The unit of analysis is the facility. The sampling frame is comprised of ACGHs and ASCs in Florida and Wisconsin. The study employs exploratory and confirmatory data analysis. This work finds that disruptive innovation theory is an effective model for assessing the hospital industry. The model provides a useful framework for analyzing the interplay between ACGHs and ASCs. While study findings did not support the stated hypotheses, the impact of government interventions into the competitive marketplace supports the claims of disruptive innovation theory. Regulations that intervened in the hospital industry facilitated interactions between ASCs and ACGHs, reducing the number of ASCs performing ACBS and altering the trajectory of ACBS volume by shifting surgeries from ASCs to ACGHs. Disruptive Disruptive Innovation Theory Disruptive Transformations Disruptive Innovation Innovation Technology Technological Innovation Medical Innovation Medical Technology Medical Advancement Laparoscopy Laparoscopic Surgery open surgery appendectomy cholecystectomy bariatric surgery weight loss surgery appendectomies cholecystectomies inpatient outpatient ambulatory ambulatory surgery ambulatory surgery center acute care general hospital hospital acute care hospital general hospital health care healthcare hospital industry health care industry Clayton Christensen Clayton M Christensen Michael Porter Harvard Business School Virginia Commonwealth University CMS Health policy public policy public administration organizational theory organization theory Population Ecology Theory Competitive Strategy policy analysis John Kimberly Organization Size Structural Inertia liability of smallness health spending health care cost specialty medical facility open system niche width dynamic outpatient department technology shift surgical setting surgical setting shift medical facility shift substitution threat health system system level analysis Ecological Approach hospital trends ambulatory surgery trends reimbursement rate Medicare CMS coverage decision P J DiMaggio DiMaggio and Powell w w Powell Hannan and Freeman M T Hannan Organizational change minimally invasive surgery less invasive surgery Prospective Payment System Outpatient Prospective Payment System entreprenuerial physician health care organization health care management Roice Luke Carl Ameringer new technology surgical utilization elective surgery Medicare Payment Advisory Commission MedPAC coverage decision trends in surgery abdominal surgery surgical variation physician-owned physician ownership physician autonomy outpatient clinic utilization trends unnecessary surgery Pfeffer Salancik technology diffusion redefining health care interdisciplinary research health care delivery panel design diffusion of hospital technology state variation regional variation local health care market government intervention medical facility health care capacity focused factory advances in health care physician organization relationship hospital competition medical specialization hospital expansion medical arms race integrated care integrated health system J E Wennberg health care transformation reimbursement scheme surgical volume Florida Wisconsin policy making health policy analysis competitive dynamics center of excellence intervening factor service line competition service-line competition surgical reimbursement innovative business model innovative technology environmental influence established firm new market entrant patient safety sophisticated technology Harvard Divinity School Social and Behavioral Sciences

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The Design and Evaluation of Ambient Displays in a Hospital Environment

Disruptive Transformations in Health Care: Technological Innovation and the Acute Care General Hospital