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Healthcare systems engineering

Aline Kunz, Sabrina Pohlmann, Oliver Heinze, Antje Brandner, Christina Reiß, Martina Kamradt, Joachim Szecsenyi, Dominik Ose
BACKGROUND: The importance of information and communication technology for healthcare is steadily growing. Newly developed tools are addressing different user groups: physicians, other health care professionals, social workers, patients, and family members. Since often many different actors with different expertise and perspectives are involved in the development process it can be a challenge to integrate the user-reported requirements of those heterogeneous user groups. Nevertheless, the understanding and consideration of user requirements is the prerequisite of building a feasible technical solution...
October 18, 2016: JMIR Human Factors
Kyoung Ok Kim
Patient safety has become an important policy agenda in healthcare systems since publication of the 1999 report entitled "To Err Is Human." The paradigm has changed from blaming the individual for the error to identifying the weakness in the system that led to the adverse events. Anesthesia is one of the first healthcare specialties to adopt techniques and lessons from the aviation industry. The widespread use of simulation programs and the application of human factors engineering to clinical practice are the influences of the aviation industry...
October 2016: Korean Journal of Anesthesiology
Ana A Aldana, Gustavo A Abraham
The development of biomimetic highly-porous scaffolds is essential for successful tissue engineering. Electrospun nanofibers are highly versatile platforms for a broad range of applications in different research areas. In the biomedical field, micro/nanoscale fibrous structures have gained great interest for wound dressings, drug delivery systems, soft and hard-tissue engineering scaffolds, enzyme immobilization, among other healthcare applications. In this mini-review, electrospun gelatin-based scaffolds for a variety of tissue engineering applications, such as bone, cartilage, skin, nerve, and ocular and vascular tissue engineering, are reviewed and discussed...
September 15, 2016: International Journal of Pharmaceutics
Amir A Zadpoor, Jos Malda
The introduction of additive manufacturing (AM), often referred to as three-dimensional (3D) printing, has initiated what some believe to be a manufacturing revolution, and has expedited the development of the field of biofabrication. Moreover, recent advances in AM have facilitated further development of patient-specific healthcare solutions. Customization of many healthcare products and services, such as implants, drug delivery devices, medical instruments, prosthetics, and in vitro models, would have been extremely challenging-if not impossible-without AM technologies...
September 8, 2016: Annals of Biomedical Engineering
G Hirsch, M Trusheim, E Cobbs, M Bala, S Garner, D Hartman, K Isaacs, M Lumpkin, R Lim, K Oye, E Pezalla, P Saltonstall, H Selker
The current system of biomedical innovation is unable to keep pace with scientific advancements. We propose to address this gap by re-engineering innovation processes to accelerate reliable delivery of products that address unmet medical needs. Adaptive Biomedical Innovation (ABI) provides an integrative, strategic approach for process innovation. While the term ABI is new, it encompasses fragmented "tools" that have been developed across the global pharmaceutical industry, and that could accelerate the evolution of the system through more coordinated application...
September 14, 2016: Clinical Pharmacology and Therapeutics
David Font, Joan Escarrabill, Mónica Gómez, Rafael Ruiz, Belén Enfedaque, Xavier Altimiras
The Integrated Health Area "Barcelona Esquerra" (Área Integral de Salud de Barcelona Esquerra - AIS-BE), which covers a population of 524,000 residents in Barcelona city, is running a project to improve healthcare quality and efficiency based on co-ordination between the different suppliers in its area through the participation of their professionals. Endowed with an Organisational Model that seeks decision-taking that starts out from clinical knowledge and from Information Systems tools that facilitate this co-ordination (an interoperability platform and a website) it presents important results in its structured programmes that have been implemented such as the Reorganisation of Emergency Care, Screening for Colorectal Cancer, the Onset of type 2 Diabetes Mellitus, Teledermatology and the Development of Cross-sectional Healthcare Policies for Care in Chronicity...
2016: International Journal of Integrated Care
Laura Rammazzo, Dimitris Kikidis, Amal Anwer, Nora Macdonald, Efthymios Kyrodimos, Christoph Maurer, Floris Wuyts, Linda Luxon, Athanasios Bibas, Doris-Eva Bamiou
BACKGROUND: Balance problems are caused by multiple factors and often lead to falls and related fractures, bringing large socio-economic costs. The complexity of balance control mechanisms, the lack of medical expertise, and the absence of specialised equipment contribute to the delayed or incorrect diagnosis and management ofthese patients. Advances in computer science have allowed the development of computer systems that support clinical diagnosis and treatment decisions based on individualised patient data...
2016: Trials
Eduardo Pinho, Tiago Godinho, Frederico Valente, Carlos Costa
The use of digital medical imaging systems in healthcare institutions has increased significantly, and the large amounts of data in these systems have led to the conception of powerful support tools: recent studies on content-based image retrieval (CBIR) and multimodal information retrieval in the field hold great potential in decision support, as well as for addressing multiple challenges in healthcare systems, such as computer-aided diagnosis (CAD). However, the subject is still under heavy research, and very few solutions have become part of Picture Archiving and Communication Systems (PACS) in hospitals and clinics...
August 25, 2016: Journal of Digital Imaging: the Official Journal of the Society for Computer Applications in Radiology
Davood Bayat, Seyed Reza Vakilinia, Majid Asghari
BACKGROUND: According to WHO estimation, the number of diabetic patients would reach about 591.9 million people in 2035. The tendency towards other kinds of treatment is increasing because of the high therapeutic expenditures and current medical complications. Positive results of massage in recent articles and the prominent role of dalk in Iranian traditional medicine led us to the present study review. METHODS: Studying Iranian traditional medicine textbooks, such as Canon of Ibn Sina, Kholasat Al Hekma of Aghili, Zakhireh-ye Khwarazm shahi of Jorjani, Alhavi of Razes and Kamel-al-sanaat of Ibn Abas were done on the topic of dalk discussion...
May 2016: Iranian Journal of Medical Sciences
José S Moya, Arturo Martínez, Roberto López-Píriz, Francisco Guitián, Luis A Díaz, Leticia Esteban-Tejeda, Belén Cabal, Federico Sket, Elisa Fernández-García, Antoni P Tomsia, Ramón Torrecillas
Bacterial and fungal infections remain a major clinical challenge. Implant infections very often require complicated revision procedures that are troublesome to patients and costly to the healthcare system. Innovative approaches to tackle infections are urgently needed. We investigated the histological response of novel free P2O5 glass-ceramic rods implanted in the jaws of beagle dogs. Due to the particular percolated morphology of this glass-ceramic, the dissolution of the rods in the animal body environment and the immature bone formation during the fourth months of implantation maintained the integrity of the glass-ceramic rod...
2016: Scientific Reports
Dursun Aras, Sinan Aydoğdu, Engin Bozkurt, Yüksel Çavuşoğlu, Mehmet Eren, Çetin Erol, Sadi Güleç, Pınar Kızılırmak, Zeki Öngen, Oktay Özdemir, Mete Saylan, Lale Tokgözoğlu, Ekrem Yeter, Mehmet Birhan Yılmaz
OBJECTIVE: To analyze health-related cost of heart failure (HF) and to evaluate health-related source utilization aiming to provide data on the economic burden of HF in actual clinical practice in Turkey. METHODS: The study used the Delphi process of seeking expert consensus of opinion including 11 cardiologists who are experienced in HF. The standardized questionnaire comprised items to reflect the opinion of the expert panelists on the distribution of the HF patients in terms of demographic and clinical characteristics and background disease states...
August 2016: Anatolian Journal of Cardiology
Anne-Marie Turcotte-Tremblay, Jessica Spagnolo, Manuela De Allegri, Valéry Ridde
Governments of low- and middle-income countries (LMICs) are widely implementing performance-based financing (PBF) to improve healthcare services. However, it is unclear whether PBF provides good value for money compared to status quo or other interventions aimed at strengthening the healthcare system in LMICs. The objective of this systematic review is to identify and synthesize the existing literature that examines whether PBF represents an efficient manner of investing resources. We considered PBF to be efficient when improved care quality or quantity was achieved with equal or lower costs, or alternatively, when the same quality of care was achieved using less financial resources...
December 2016: Health Economics Review
Nasia Safdar, Jackson S Musuuza, Anping Xie, Ann Schoofs Hundt, Matthew Hall, Kenneth Wood, Pascale Carayon
BACKGROUND: Guidelines from the Infectious Diseases Society of America/The American Thoracic Society (IDSA/ATS) provide recommendations for diagnosis and treatment of ventilator-associated pneumonia (VAP). However, the mere presence of guidelines is rarely sufficient to promote widespread adoption and uptake. Using the Systems Engineering Initiative for Patient Safety (SEIPS) model framework, we undertook a study to understand barriers and facilitators to the adoption of the IDSA/ATS guidelines...
2016: BMC Infectious Diseases
B Klaassen, B J F van Beijnum, H J Hermens
INTRODUCTION: The rapid development of sensors and communication technologies enable the growth of new innovative services in healthcare, such as Telemedicine. An essential ingredient in the development of a telemedicine system and its final acceptance by end users are usability studies. The principles of usability engineering, evaluations and telemedicine are well established, and it may contribute to the adoption and eventually deployment of such systems and services. An in-depth usability analysis, including performance and attitude measures, requires knowledge about available usability techniques, and is depending on the amount of resources...
September 2016: International Journal of Medical Informatics
Joseph M DeSimone
Nanoparticle properties such as size, shape, deformability, and surface chemistry all play a role in nanomedicine drug delivery. While many studies address the behavior of particle systems in a biological setting, revealing how these properties work together presents unique challenges on the nanoscale. Particle replication in non-wetting templates (PRINT®) is one molding technique that allows for fabrication of "calibration quality" micro and nanoparticles with independent control over their physical parameters...
July 13, 2016: Journal of Controlled Release: Official Journal of the Controlled Release Society
Amnon Shabo, Mor Peleg, Enea Parimbelli, Silvana Quaglini, Carlo Napolitano
BACKGROUND: Implementing a decision-support system within a healthcare organization requires integration of clinical domain knowledge with resource constraints. Computer-interpretable guidelines (CIG) are excellent instruments for addressing clinical aspects while business process management (BPM) languages and Workflow (Wf) engines manage the logistic organizational constraints. OBJECTIVES: Our objective is the orchestration of all the relevant factors needed for a successful execution of patient's care pathways, especially when spanning the continuum of care, from acute to community or home care...
July 13, 2016: Methods of Information in Medicine
Kirstine Zinck Pedersen
This article explores an apparent paradox of stability and change in patient safety thinking and practice. The dominant approach to patient safety has largely been focused on closing 'safety gaps' through standardisation in seemingly stable healthcare systems. However, the presupposition of system stability and predictability is presently being challenged by critics who insist that healthcare systems are complex and changing entities, thereby shifting focus towards the healthcare organisation's resilient and adaptive capacities...
September 2016: Sociology of Health & Illness
Tanya Doherty, Max Kroon, Natasha Rhoda, David Sanders
South Africa (SA) has emerged from the Millennium Development Goal era with a mixture of success and failure. The successful national scale-up of prevention of mother-to-child transmission of HIV services with increasingly efficacious antiretroviral regimens has reduced the mother-to-child transmission rate dramatically; however, over the same period there appears to have been no progress in coverage of high-impact interventions for pneumonia and diarrhoea, which are now leading causes of under-5 mortality...
July 2016: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
Stephan Hirschi, Mirko Stauffer, Daniel Harder, Daniel J Müller, Wolfgang Meier, Dimitrios Fotiadis
Synthetic biology approaches range from the introduction of unique features into organisms to the assembly of isolated biomacromolecules or synthetic building blocks into artificial biological systems with biomimetic or completely novel functionalities. Simple molecular systems can be based on containers on the nanoscale that are equipped with tailored functional modules for various applications in healthcare, industry or biological and medical research. The concept, or vision, of assembling native or engineered proteins and/or synthetic components as functional modules into molecular systems is discussed...
2016: Chimia
Andre W Kushniruk, Elizabeth M Borycki, Terje Solvoll, Carola Hullin
The tutorial goal is to familiarize participants with human aspects of health informatics and human-centered approaches to the design, evaluation and deployment of both usable and safe healthcare information systems. The focus will be on demonstrating and teaching practical and low-cost methods for evaluating mobile applications in nursing. Basic background to testing methods will be provided, followed by live demonstration of the methods. Then the audience will break into small groups to explore the application of the methods to applications of interest (there will be a number of possible applications that will be available for applications in areas such as electronic health records and decision support, however, if the groups have applications of specific interest to them that will be possible)...
2016: Studies in Health Technology and Informatics
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