Health care industry, Drugs -- Product/Service Evaluations, Cancer -- Diagnosis, Rapid prototyping, and Yuan (China)

Health care industry, Health care reform -- Analysis, Health care reform -- Health aspects, Target marketing -- Analysis, Target marketing -- Health aspects, Signage -- Usage, Signage -- Analysis, Signage -- Health aspects, Health care industry -- Analysis, and Health care industry -- Health aspects

Author(s): Lauren Clack[sup.1] , Manuel Stuhlinger[sup.2] , Marie-Theres Meier[sup.1] , Aline Wolfensberger[sup.1] and Hugo Sax[sup.1] Introduction Healthcare-associated infections (HAI) are a major threat to patient safety on a global level, [...]
Background Isolation precautions are intended to prevent transmission of infectious agents, yet healthcare provider (HCP) adherence remains suboptimal. This may be due to ambiguity regarding the required precautions or to cognitive overload of HCPs. In response to the challenge of changing HCP behaviour, increasing attention should be paid to the role of engineering controls and facility design that incorporate human factors elements. In the current study, we aimed to develop an isolation precaution signage system that provides visual cues, serves as a cognitive aid at the point of care, and removes ambiguity regarding which precautions are necessary (e.g. masks, gowns, gloves, single rooms) when caring for isolated patients. Methods We employed a user-centred, participatory design approach in which HCPs were actively involved in generating an isolation precaution signage system based on human factors design principles. HCPs were purposefully sampled for each design phase to include a representative sample of potential system users. We conducted front-end analysis through interviews and observations to identify challenges related to the existing signage and to establish design requirements for new signage. This was followed by the creation of user personas, design thinking workshops, and prototyping, which then underwent iterative cycles of evaluation. Graphical symbols were developed and tested for comprehensibility. Results Front-end analysis revealed several barriers to use of the current signage system such as unclear target audience, low signal-to-noise ratio, and ambiguity regarding the applicable precautions. A comprehensive list of design requirements was generated. The project ultimately resulted in a collection of validated, comprehensible symbols and signs for contact, droplet, and airborne isolation, as well as the identification of several systems-level solutions for work re-organisation to improve compliance with isolation precautions. Conclusions The introduction of visual cues in the form of signage offers a promising opportunity to make guidelines available directly at the frontline. Anecdotal evidence based on observations and interviews with HCP have shown that the current solution is superior to previous isolation signage. User-centred participatory design was a useful approach that holds potential for further improving design in healthcare settings. Keywords: Infection control, Isolation precautions, Personal protective equipment, Human factors, User-centred design, Participatory design, Co-design, Visual cues, Signage

Health care industry, Medical imaging equipment -- Physiological aspects, Image processing -- Physiological aspects, Health care industry -- Physiological aspects, Cardiac patients -- Physiological aspects, and CT imaging -- Physiological aspects

Author(s): Louis Mullie[sup.1,2] and Jonathan Afilalo[sup.1,2,3] Background Syndromes characterized by pathological alterations of body composition, such as sarcopenia, cachexia and obesity, are increasingly prevalent and portend an increased risk of [...]
Background Analytic morphomics, or more simply, 'morphomics,' refers to the measurement of specific biomarkers of body composition from medical imaging, most commonly computed tomography (CT) images. An emerging body of literature supports the use of morphomic markers measured on single-slice CT images for risk prediction in a range of clinical populations. However, uptake by healthcare providers been limited due to the lack of clinician-friendly software to facilitate measurements. The objectives of this study were to describe the interface and functionality of CoreSlicer- a free and open-source web-based interface aiming to facilitate measurement of analytic morphomics by clinicians - and to validate muscle and fat measurements performed in CoreSlicer against reference software. Results Measurements of muscle and fat obtained in CoreSlicer show high agreement with established reference software. CoreSlicer features a full set of DICOM viewing tools and extensible plugin interface to facilitate rapid prototyping and validation of new morphomic markers by researchers. We present published studies illustrating the use of CoreSlicer by clinicians with no prior knowledge of medical image segmentation techniques and no formal training in radiology, where CoreSlicer was successfully used to predict operative risk in three distinct populations of cardiovascular patients. Conclusions CoreSlicer enables extraction of morphomic markers from CT images by non-technically skilled clinicians. Measurements were reproducible and accurate in relation to reference software. Keywords: Analytic morphomics, Morphometric analysis, Body composition analysis, Planimetric measurements, Medical image segmentation, Computed tomography, Obesity, Sarcopenia

Health care industry, Company business management, Technology application, Company systems management, Medical informatics -- Management, Health care industry -- Technology application, Health care industry -- Information management, and E-health -- Methods

Introduction Strategic use of information technologies (ITs) is a research field that strategically and optimally obtains the organizational needs from the several possibilities supplied by the latest feasible hardware and [...]
This article illustrates a Web-based health information system that is comprised of specific information exchange standards related to health information for healthcare services in National Taiwan University Health System. Through multidisciplinary teamwork, medical and informatics experts collaborated and studied on system scope definition, standard selection challenges, system implementation barriers, system management outcomes, and further expandability of other systems. After user requirement analysis and prototyping, from 2005 to 2008, an online clinical decision support system with multiple functions of reminding and information push was implemented. It was to replace its original legacy systems and serve among the main hospital and three branches of 180-200 clinics and 7,500-8,000 patient visits per day. To evaluate the effectiveness of this system, user surveys were performed, which revealed that the average score of user satisfaction increased from 2.80 to 3.18 on a 4-point scale. Among the items, especially e-learning for training service, courtesy communications for system requests, and courtesy communications for system operations showed statistically significant improvement. From this study, the authors concluded that standardized information exchange technologies can be used to create a brand new enterprise value and steadily obtain more competitive advantages for a prestige healthcare system. Key words: information management, e-health, policy, medical records, business administration/economics