International Journal of Electronic Healthcare (12 papers in press)
Electronic medical records: Taking young generations of patients and physicians through innovative technology and change management
by Jamil Razmak, Charles H. Bélanger, Ghaleb El Refae, Wejdan Farhan
Abstract: Billions of dollars have been invested in developing, implementing, and promoting an electronic medical records system that Canadian physicians (EMR) and patients (electronic personal records) would use to manage healthcare files. Barriers have been identified in the literature and there is a wide range of them. The main research objectives of the study aimed to assess EMR adoption by physicians based on their age and to determine the preferences of patients in using the EMR system. Secondary data were tapped from the National Physicians Survey respondents encompassing close to 10,000 physicians from across Canada, 4,000 from Ontario, and 316 from Northern Ontario as well as 325 patients who were directly surveyed to obtain primary data. Significant differences were found across geographical jurisdictions and age strata in terms of electronic adoption by physicians and patients. The general trend leads to younger physicians using more exclusively electronic records than their senior colleagues do.
Keywords: electronic medical records; EMR; change management; e-health adoption; young generations.
A smart-contract based blockchain for a healthcare IoT network
by Adwitiya Mukhopadhyay, Vinayaka R
Abstract: The demand for IoT systems in healthcare services is increasing widely and the data generated from these networks should be transferred and stored in a highly secure manner. Blockchain technology helps in maintaining the privacy and integrity of the electronic health records (EHR) data with the help of smart contracts that authenticate the users and maintain confidentiality in the network. Integrating blockchain into IoT systems improves the overall security of the network. In this paper, we propose an architecture based on Hyperledger Fabric which is a private blockchain platform that is used for storing the EHR data which are collected from various IoT sensors. The deployed smart-contract helps in performing some of the basic database functionalities onto the blockchain.
Keywords: blockchain; IoT; healthcare networks; Hyperledger Fabric; smart-contracts; electronic health records; EHR.
A Review of Mobile Health Applications and its Use Phases
by Rajesh Pai, Sreejith Alathur
Abstract: The use of mobile and wireless devices in healthcare plays a vital role in transforming health service delivery for patients and physicians across the globe. These devices are mainly driven because of rising healthcare costs and demand from the patients for diagnosing, treatment and care. Initiatives from the government and private companies have already started for developing mobile health interventions in the low resource setting areas. Yet, there has been less adequate reviews about mobile health applications across patients use-phases. This paper provides a comprehensive review of mobile health applications across patients use-phases. It reviews the most significant research articles and proposes variables that can be used for testing its significance among the people of low- and medium-income countries. It also emphasises the challenges involved in the successful deployment of mobile health applications which help in identifying the current state of research thereby establishing an agenda for future research direction.
Keywords: healthcare; health information technology; mobile health; mobile health challenges; patients use-phases.
Integration of Primary Health Care and Public Health
by Nabi Yessimov, Nailya Izmailova, Dauletkhan Yessimov
Abstract: The primary healthcare system (PHCS) is integrated into the public health service (PHS). The planned efficacy parameters and the formation of a sustainable public health model in the Republic of Kazakhstan (RK) are far from reality. The novelty of the study is that the authors propose to use a system of public opinion to achieve a synergistic effect and thereby integrate primary patient feedback in the organisation of the promotion of primary care and PHS. This integration will impose new requirements both for management decisions on the operation of medical institutions and for the organisation of training of doctors. The practical novelty of the study is due to the fact that, for the first time, the organisation of the synergic system of primary healthcare and public health is implemented on the basis of the public administration system and local systems of public health evaluation.
Keywords: public health; primary care; primary healthcare; medical service; public healthcare.
Multiple Share Creation Scheme with Optimal Key Generation for Secure Medical Image Transmission in Internet of Things Environment
by M. Duraisamy, S.P. Balamurugan
Abstract: This study introduces a new multiple share creation scheme (MSC) with optimal key generation (OKG) called MSC-OKG technique for secure medical transmission in the IoT environment. The proposed MSC-OKG technique involves different processes such as data acquisition, MSC process, share encryption, and optimal key generation. Primarily, the proposed method enables IoT devices to gather medical images. Next, the MSC process takes place for the generation of multiple shares for the input images and the shares are further encrypted with elliptic curve cryptography (ECC). Followed by, the optimal key generation process is carried out by the manta ray foraging optimization (MRFO) algorithm to encrypt and decrypt the shares. For evaluating the analysis of the results of the proposed MSC-OKG technique, extensive experimentation takes place on benchmark diabetic retinopathy (DR), dermoscopic and lung cancer computed tomography (CT) images. The experimental results indicated that the MSC-OKG technique has outperformed the compared methods in terms of mean square error (MSE), peak signal to noise ration (PSNR), bit rate and correlation coefficient (CC).
Keywords: Elliptic Curve Cryptography; Internet of Things; Optimization; Visual Cryptography.
A MULTI-STAGE PREDICTIVE MODEL FOR SMOKING CESSATION: SUCCESS AND CHOICES OF MEDICATION APPROACHES
by Sotarat Thammaboosadee, Karoon Yuttanawa
Abstract: The number of deaths from diseases related to smoking is 11.6% of all Thai populations. So helping smokers to quit smoking cigarettes is one of the essential tasks of the medical personnel. This research developed a hybrid prediction model to support decision-making in the medical treatment of smoking cessation, which consists of medication decisions, the likelihood of three-month and six-month quitting, and medication choices using the data mining process. This research collected the treatment data from Thai Physicians Alliance Against Tobacco between 2015 to 2017 and was processed by data selection, data cleansing, data transformation, data resampling, and comparative experiments. Overall results were over 70% accuracy based on gradient boosted trees and neural network based on evolutionary parameter optimisation and ten-fold cross-validation evaluation method. Finally, the findings from the study would be beneficial to health personnel in making clinical decision support for better coverage of treatment for smokers.
Keywords: smoking cessation; data mining; predictive modelling; gradient boosted trees.
A case study on the influence of fitness trackers on older adults health and fitness activities.
by Pranathy Enamela, Gayle Trofe Prybutok, Jerry Dake, Victor R. Prybutok
Abstract: This case study provides insight into older adults motivation to improve their physical activity through the use of a fitness tracker. The study is qualitative and identified some of the obstacles related to adopting a healthy lifestyle including the need to modify dietary habits, expand knowledge of health-oriented decision making, and establishing exercise routines that are sustainable among older adults. The case study examined three professors over the age of 65. The participants had strong yet different perspectives towards personal health and fitness trackers. The key finding from this study is that wearables, especially fitness trackers, can significantly facilitate increased physical activity.
Keywords: exercise; fitness trackers; IoT; Mobility; perceived health; physical fitness; technology adoption; wearables.
Implementation of eHealth Applications by Primary Care Physicians in the European Union Member States
by Eva Ardielli
Abstract: eHealth is referred to as the use of information and communication technologies in health care, covering products, services, processes and organisational changes in health care systems. It is practiced and dealt with in most developed countries and of course also in the European Union member states. By adopting and deploying of eHealth, European Union member states endeavour to reduce health care costs, to increase the efficiency of health care and to give more control to patients. Special importance is given to the primary care and the development of the implementation of eHealth by general practitioners. The article is focused on the evaluation of the implementation of eHealth by primary care physicians in the European Union member states by usage of multi-criteria decision-making methods. The analysis is performed by usage of TOPSIS method and supplemented by the cluster analysis. The results of the empirical research are evaluating the state of eHealth implementation by general practitioners in all European Union member states by selected criteria and enable the comparison of eHealth implementation in the international context and the assessment of eHealth development during the period 2013 to 2018.
Keywords: healthcare; health information technology; mobile health; mobile health challenges; patients use-phases.
VIRTUAL DOCTOR CONSULTATION, POTENTIAL TO REVOLUTIONIZE HEALTH CARE ACCESS IN RESOURCE POOR SETTINGS: OPPORTUNITIES AND CHALLENGES
by Murali Mohan Reddy Gopireddy, Srinivas Gunda, Prasad Kompalli, Priyanka Gollapalli, Anjana Sevagamoorthy
Abstract: Access to quality healthcare still remains a distant dream for significant proportion of global population. Direct virtual doctor consultation is emerging as potential solution to improve healthcare access. Current review was conducted to summarise the nature and impact of various virtual healthcare models reported in peer reviewed scientific journals. We have also reviewed user and provider perspectives and attempted to present a critical analytical input to relevant stakeholders. Current study was a qualitative review of published studies retrieved from PubMED, Embase, Cochrane, CINHAL plus. Virtual doctor consultation is not a new phenomenon and has been in practice for about last few decades. Massive increase in the scale of adaptation in recent times makes it more palpable and is responsible for spurious perception of it as a recent phenomenon. Current technological advancements and better quality of data transfer makes it more effective and safer than ever before.
Keywords: virtual doctor consultation; e-health; e-consultation; digital health; telemedicine; tele-health; m-health.
Implementing electronic health care record in a public health facility in Nigeria: awareness, acceptance and concerns among critical stakeholders
by Daprim Ogaji, Chinelo Ezinwanne Anyanwu
Abstract: This descriptive cross-sectional study investigated staff and patient awareness, preferences and concerns for EHR using a structured questionnaire. More of the staff were females (52.5%), nurses (48%) with less than or equal to 5 years of experience (71.4%). More staff (56.3%) than patient (38.9%) possesses at least average computer skills. Most patients were aware (87.2%), willing to accept (94.6%) and willing to have their personal health records (80.6%) in the EHR. Tendency to be anxious, less cautious, possibility of data security breaches as well as having poor understanding of the contents on their electronic records were prominent concerns of patients. Staff major concerns were related to data security and the technical aspects of the EHR implementation. The reported positive attitude of staff and patients underscore the facilitys readiness for deployment of EHR. Their preferences and concerns should however be considered in the implementation of the EHR in the hospital.
Keywords: Awareness; acceptance; uptake; stakeholders; patients; staff; e-health; electronic health records; EHR; UPTH; Nigeria.
Network Analysis of Infant Brain Functional Connectivity using Spectral EEG.
by Hemang Shrivastava, Hare Ram Sah, Manoj Ramaiya, Jayesh Gangrade
Abstract: Currently MRI is the primary method used to calculate brain connectivity in sleeping infants. In this study, we analysed functional connectivity in infants through event-related potentials (ERP) calculated using electroencephalogram (EEG). Time locked EEG is cheaper than MRI and provides temporally precise brain response. Each electrode of the EEG acquisition cap used for recording the EEG signals served as a node in the derived connectivity network. Finally, we have calculated connectivity network measures like characteristic path length (CPL), global efficiency (GE), and average clustering coefficient (ACC) for each infant. Both term and pre-term infants resting state connectivity was characterised by a dense cluster between central and centro-parietal locations. However, the tactile network in term infants displayed lateralisation to the centro-parietal locations overlaying the somatosensory cortex, while the pre-terms tactile network was dense between frontal and central locations. Overall, the tactile network CPL decreased, while GE and ACC increased with higher gestational age at birth, indicating increased efficiency. This is the first study demonstrating differences between tactile functional connectivity in term and pre-term infants using EEG. We suggest that network measures like CPL, GE and ACC may be used as biomarkers of tactile-dependent functional outcomes in early childhood.
Keywords: functional connectivity; electroencephalography; EEG; network analysis; infants brain; resting state connectivity; event-related potentials; ERP; brain-computer interface; BCI.
Balanced Scorecard Adoption in Healthcare
by Renato Lopes Da Costa, Leandro Ferreira Pereira, Álvaro Dias, Carlos Jeronimo, Rui Gonçalves
Abstract: The health sector is gaining more and more space in the market. The offer of health services, of different specialties, has been increasing exponentially in the last decades. However, professionals in the field have little knowledge of management and many do not know how to use this knowledge in favour of their establishment. The lack of adequate management in health services can lead to not only financial losses, but the delivery of low-quality services can have serious consequences for the health of the client/patient. The objective of the present study was to understand the potential of balanced scorecard adoption in health institutions. The research was based on secondary data of hundreds of articles about the adoption of this standard is health sector. The results showed that the balanced scorecard is an effective method to apply in public and private health sector.
Keywords: health service; balanced scorecard; BSC; health management; standard adoption.