Description:
Continuous monitoring of patient's physiological signs has the potential to augment traditional medical practice, particularly in developing countries that have a shortage of healthcare professionals. However, continuously streamed data presents additional security, storage and retrieval challenges and further inhibits initiatives to integrate data to form electronic health record systems. Blockchain technologies enable data to be stored securely and inexpensively without recourse to a trusted authority. Blockchain technologies also promise to provide architectures for electronic health records that do not require huge government expenditure that challenge developing nations. However, Blockchain deployment, particularly with streamed data challenges existing Blockchain algorithms that take too long to place data in a block, and have no mechanism to determine whether every data point in every stream should be stored in such a secure way. This article presents an architecture that involves a Patient Agent, coordinating the insertion of continuous data streams into Blockchains to form an electronic health record.
Description:
Studies in Health Technology and Informatics
Description:
This research paper looks at the social implications of biometrics pertaining to the ethics of privacy and the ownership of individual biometric data, including how these issues can be resolved through the establishment of a Biometric Commission by introducing global standardised biometric uniformity and the guidelines that will ensure their technological foundations. Much of the distrust that engulfs society is due to the past performances and policy implementations that governments have initiated surrounding biometric technology and its miss use beyond the realms of individual identification for security purposes. There needs to be total transparency from governments and organisations that use biometric technology for security identification in how every individuals biometric data will be used, stored and the ethical standards provided in eliminating many of the implications that every society has towards on how their biometric data will be used.
Description:
Background: This regional pilot site ‘end-user attitudes’ study explored nurses’ experiences and impressions of using the Nurses’ Behavioural Assistant (NBA) (a knowledge-based, interactive ehealth system) to assist them to better respond to behavioural and psychological symptoms of dementia (BPSD) and will be reported here. Methods: Focus groups were conducted, followed by a four-week pilot site ‘end-user attitudes’ trial of the NBA at a regional aged care residential facility (ACRF). Brief interviews were conducted with consenting nursing staff. Results: Focus group feedback (N = 10) required only minor cosmetic changes to the NBA prototype. Post pilot site end-user interview data (N = 10) indicated that the regional ACRF nurses were positive and enthusiastic about the NBA, however several issues were also identified. Conclusions: Overall the results supported the utility of the NBA to promote a person centred care approach to managing BPSD. Slight modifications may be required to maximise its uptake across all ACRF nursing staff.
Barriers and enablers to the delivery of psychological care in the management of patients with type 2 diabetes mellitus in China : a qualitative study using the theoretical domains framework
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This paper presents a model of knowledge acquisition from definitions of data, information and knowledge. The model asserts that knowledge cannot exist outside of the human brain, and that any expression of the knowledge requires it to be transformed into information to be communicated outside of the brain. The model asserts that information is acquired through the sensors to the brain where it is processed with prior knowledge and that new knowledge can be created from the processing of information within the brain only. From a discussion of this model in the context of alternative viewpoints, it is concluded that the future focus for knowledge management should be toward human resource strategies that leverage human-intellectual capital within firms and for the dissemination and sharing of important information that promotes creativity and innovation within and between employees.
Description:
International studies indicate that the recognition and management of deteriorating patients in hospitals are poor and that patient assessment is often inadequate. Face-to-face simulation programs have been shown to have an impact on educational and clinical outcomes; however, little is known about performance in contemporary healthcare e-simulation approaches. Using data from an open-access Web-based patient deterioration program (FIRSTACTWeb), the performance of 367 Australian nursing students in identification of treatment priorities and clinical actions was analyzed using a military model of Course of Action Simulation Analysis. Participants' performance in the whole program demonstrated a significant improvement in knowledge and skills (P ≤ .001) with high levels of participant satisfaction. Course of Action Simulation Analysis modeling identified three key participant groupings within which only 18% took the "best course of action" (the right actions and timing), with most (70%) completing the right actions but in the wrong order. The remaining 12% produced incomplete assessments and actions in an incorrect sequence. Contemporary approaches such as e-simulation do enhance educational outcomes. Measurement of performance when combined with Course of Action Simulation Analysis becomes a useful tool in the description of outcomes, an understanding of decision making, and the prediction of future events.
Description:
This study explores preregistration nursing students’ views of a Web-based simulation program: FIRST2 ACTWeb (Feedback Incorporating Review and Simulation Techniques to Act on Clinical Trends-Web). The multimedia program incorporating three videoed scenarios portrayed by a standardized patient (human actor) aims to improve students’ recognition and management of hospital patient deterioration. Participants were 367 final-year nursing students from three universities who completed an online evaluation survey and 19 students from two universities who attended one of five focus groups. Two researchers conducted a thematic analysis of the transcribed narratives. Three core themes identified were as follows: “ease of program use,” “experience of e-Simulation,” and “satisfaction with the learning experience.” The Web-based clinical learning environment was endorsed as functional, feasible, and easy to use and was reported to have high fidelity and realism. Feedback in both focus groups and surveys showed high satisfaction with the learning experience. Overall, evaluation suggested that the Web-based simulation program successfully integrated elements essential for blended learning. Although Web-based educational applications are resource intensive to develop, positive appraisal of program quality, plus program accessibility and repeatability, appears to provide important educational benefits. Further research is needed to determine the transferability of these learning experiences into real-world practice.