Healthcare Management System Research Articles

강직성 척추염 환자를 위한 운동 가이드라인

Exercise is an essential element of management for ankylosing spondylitis, of which symptoms and disease activity can be controlled by disease-modifying agents and monitored and followed up. However, due to a lack of support of the healthcare system, rehabilitation, and exercise management are not actively provided to patients with ankylosing spondylitis in clinical settings, and any qualified educational materials for exercise are not available. We aimed to develop the Korean exercise guideline to be used for patient with ankylosing spondylitis. The guideline has been developed through adapting existing evidence-based guidelines and making consensus by experts from the Korean Association of Sports Science and Exercise Medicine and the Korean College of Rheumatology. A draft recommendation was prepared through four expert meetings. The survey was conducted using the modified Delphi technique by expanding the experts for both academic societies. For questions that did not meet the consensus criteria, the survey was conducted again, and the recommendations that reached consensus were adopted. As a result, we suggested Korean exercise recommendations for ankylosing spondylitis including evaluation and monitoring of ankylosing spondylitis patients, safety management, disease management, ankylosing spondylitis specific exercises, considerations in advanced ankylosing spondylitis, dosage and adherence, and exercise setting. Based on the guideline, exercise education materials were produced. From this guideline, patients can receive professional guidance for self-management, and healthcare professionals can take advantage of prescribing specific exercise programs safely and effectively.

Enhancing Healthcare Management during COVID-19: A Patient-Centric Architectural Framework Enabled by Hyperledger Fabric Blockchain

The highly transmissible COVID-19 virus has wreaked havoc on the global economy, health, and lives. The abrupt burst and exponential spread of this pandemic has shown the inadequacies of existing healthcare institutions in handling a public health emergency. As governments around the world strive to re-establish their economies, open workplaces, ensure safe journeys, and return to regular life, they require solutions to reduce losses. The proposed framework provides virtual assistance from various medical practitioners and physicians. Furthermore, it promotes the accuracy of information gathered from COVID-19 patients, which can aid in the launch of a variety of government decisions and public guidelines aimed at combating health exigencies. The authors present a revolutionary blockchain-based solution that builds trust between the medical professionals and patients while preventing accidental coronavisrus transmission. This solution also keeps track of COVID-19 patients and improves EHR management, which can be a viable solution for common EHR challenges such as lowering the risk of patient data loss, maintaining privacy and security, and obtaining immutable consensus on the maintenance of health records, gaps in hospital communication, and inefficient clinical data retrieval methods. This research work describes a COVID-19 patient-centric blockchain-based EHR employing JavaScript-based smart contracts for a decentralized healthcare management system. The proposed Hyperledger fabric and a Composer-based working prototype ensure the model’s security and the authenticity of the health records. The authors used the Hyperledger Caliper benchmarking tool, which measures latency, throughput, resource utilization, etc., under different conditions and control parameters. The findings highlight the importance of the proposed blockchain-enabled architecture in revolutionizing healthcare administration during and after the COVID-19 pandemic, promoting enhanced clinical outcomes and supporting patient-centered care.

The Role of Blockchain in Medical Data Sharing

As medical technology advances, there is an increasing need for healthcare providers all over the world to securely share a growing volume of data. Blockchain is a powerful technology that allows multiple parties to securely access and share data. Given the enormous challenge that healthcare systems face in digitizing and sharing health records, it is not unexpected that many are attempting to improve healthcare processes by utilizing blockchain technology. By systematically examining articles published from 2017 to 2022, this review addresses the existing gap by methodically discussing the state, research trends, and challenges of blockchain in medical data exchange. The number of articles on this issue has increased, reflecting the growing importance and interest in blockchain research for medical data exchange. Recent blockchain-based medical data sharing advances include safe healthcare management systems, health data architectures, smart contract frameworks, and encryption approaches. The evaluation examines medical data encryption, blockchain networks, and how the Internet of Things (IoT) improves hospital workflows. The findings show that blockchain can improve patient care and healthcare services by securely sharing data.

Saudi Arabia’s “Vision 2030”: Structural Reforms and Their Challenges

This paper assesses the Saudi crown prince's visionary mega-project, "Vision 2030," superimposed as a new form of a social contract to diversify the country's economy and end dependency on oil revenue. The project sets to revive the long-staggering economy and propel the indicators of all sectors above the international averages. Concomitantly, the vision faces a colossal challenge as the kingdom is wheeled by authoritarian monarchical Islamic values that repudiate the concept of modernity, the final corollary of the prince's vision. This paper primarily assesses the education and healthcare system management based on the old social contract and seeks possible changes or restructuring according to "Vision 2030" objectives. The paper also looks into managing water shortages which are doomed to become more acute with the launch of mega infrastructural development projects. Further, this paper found that "Vision 2030" is steadily pushing boundaries, albeit there are impeding challenges ranging from the availability of skilled professionals to social, cultural and religious intransigence. Nevertheless, it can be convincible to argue that the cultural, social and political reformation is conceivable unless the citizenry has a strong will and vision regardless of how tumultuous the transition is, which would, in turn, help in streamlining the economic growth of the kingdom.

FORMATION OF CLUSTERS OF MEDICAL INSTITUTIONS AS AN ADMINISTRATIVE TOOL OF MANAGEMENT IN THE INDUSTRY OF HEALTH CARE IN THE CONDITIONS OF DECENTRALIZATION

The health care management system involves the application of administrative methods of managing medical facilities, which are a tool of state regulation in the field of health care. The transformation of the health care system through medical reform is aimed at providing citizens of Ukraine with equal access to quality medical services and reorienting the system so that the patient is at its center. The article examines the management of health care institutions in the process of reform, finds out the relevant issues of the infrastructural stage of the medical reform and the effective functioning of medical institutions in conditions of decentralization. Attention is focused on the transformation of the health care system in the form of the formation of clusters of medical institutions, which is proposed by the Ministry of Health of Ukraine and aims to improve the quality and availability of medical care through the creation of a new network of medical institutions in accordance with the principle of hospital districts. The structure of the cluster distribution of medical institutions within the framework of the medical reform and the characteristics of a capable network of medical institutions in the Odesa region are considered. The significance of the division of territories into hospital clusters in the process of balancing the advantages and disadvantages of decentralization and the maximum approximation to the modern European system of providing medical care is emphasized. A promising direction of further research on this issue is to solve the problem of «community hospitals», which are not included in the capable network of the hospital district (region) and, due to uncertainty, create a risk of reducing the availability and quality of medical care for residents of territorial communities.

Insights from leaders on effectively addressing overweight and obesity in the Thai community

Introduction: Effective management of health care system at the district level through an important health project can improve health and quality of life of people in the district. Key factors to drive a successful project are important. The purpose of this study was to explore perspectives of leaders managing the health care system at a district level on improving health problems of people in a community through a project according to preventing and solving overweight and obesity issues.
 Methods: The participants of this qualitative study consisted of nine district health board committees, ten members of the district health system startup team and twenty-four village health system managers. Data was collected by using focus group interviews, observation and documents analysis, also analyzing data by summarizing and categorizing the data of main points.
 Results: The study results indicated that managing successful health problems at the district level needed: 1) creating clear and equal understanding, 2) having precious community capital and 4) integrating effective incentives for people in the community.
 Conclusion: The findings of the study can be used as a guideline for managing the health care system in a district level through a project for the development of health issues and the quality of life among people in a community. This successful health system management might be able to help develop the sustainability of public health care at the district level.

Resolving the practical factors in the healthcare system management by considering a combine approach of AHP and ANP methods

Healthcare System Management (HSM) is a technique for integrating technology in public hospitals. Knowledge of strategies and decision-making issues is crucial for improving hospital services during the HSM implementation since it directly impacts the efficiency of the hospital and the level of the patient healthcare system. To address the research gap, this study presents a hybrid decision making model that combines the Analysis Hierarchical Process (AHP) method and the Analytic Network Process (ANP) to select Balanced Scorecard Policy (BSP) indicators for evaluating HSM application in a resource-limited background. The hybrid modeling approach not only assists in allocating resources for the execution of HSM but also in determining the significance of the relationship between each analyzed aspect. The hierarchical structure used in this study's quantitative and qualitative relations assessment can also assist various medical facilities in determining how the evaluation criteria and the resources needed to provide HSM services are related. In addition, the management decision policy is shown by the BSP in a healthcare center by combining the two methods mentioned satisfy the goal of strategy weights and limited resources. Finally, the article results indicate that the proposed method increases the efficiency of decisions and maximizes the can improve the reliability in HSM.

Automated Detection of Patients at High Risk of Polypharmacy including Anticholinergic and Sedative Medications.

Ensuring that medicines are prescribed safely is fundamental to the role of healthcare professionals who need to be vigilant about the risks associated with drugs and their interactions with other medicines (polypharmacy). One aspect of preventative healthcare is to use artificial intelligence to identify patients at risk using big data analytics. This will improve patient outcomes by enabling pre-emptive changes to medication on the identified cohort before symptoms present. This paper presents a mean-shift clustering technique used to identify groups of patients at the highest risk of polypharmacy. A weighted anticholinergic risk score and a weighted drug interaction risk score were calculated for each of 300,000 patient records registered with a major regional UK-based healthcare provider. The two measures were input into the mean-shift clustering algorithm and this grouped patients into clusters reflecting different levels of polypharmaceutical risk. Firstly, the results showed that, for most of the data, the average scores are not correlated and, secondly, the high risk outliers have high scores for one measure but not for both. These suggest that any systematic recognition of high-risk groups should consider both anticholinergic and drug-drug interaction risks to avoid missing high-risk patients. The technique was implemented in a healthcare management system and easily and automatically identifies groups at risk far faster than the manual inspection of patient records. This is much less labour-intensive for healthcare professionals who can focus their assessment only on patients within the high-risk group(s), enabling more timely clinical interventions where necessary.

Improving healthcare for children in rural China: commentary on WeChat-based self-assessment with tailored feedback

Improving healthcare for children in rural China: commentary on WeChat-based self-assessment with tailored feedback

Clinical characteristics and outcomes of hospitalized patients with COVID-19 in a city of South Brazil: Have they changed through the first year of the pandemic?

The Coronavirus Disease 2019 (COVID-19) pandemic posed various challenges to the healthcare system and disease management. This study aimed to describe changes in the clinical characteristics and outcomes of hospitalized patients during the first year of the COVID-19 pandemic in a city in southern Brazil. This prospective study was carried out in two tertiary care private hospitals in Curitiba. A total of 1151 patients hospitalized between March 2020 and March 2021 were included. We identified three epidemiological critical periods of the pandemic and compared patients' characteristics and the frequencies of oral intubation, intensive care unit (ICU) admission and mortality. Continuous variables were analyzed by variance analysis model (ANOVA) or the Kruskal-Wallis nonparametric test and categorical variables by the chi-square or Fisher's exact test. Models for univariate and multivariate logistic regression analysis were adjusted to identify the factors associated with mortality. All p-values were two-tailed and p<0.05 was considered statistically significant. The average age of the patients was 58 years and 60.9% (n = 701) were males. The most prevalent comorbidities were systemic arterial hypertension, diabetes and obesity. There were no significant variations in the demographic characteristics and previous comorbidities of the patients for the different periods of analysis. Mortality was positively associated with the age ≥65 years and the presence of one or more cardiometabolic comorbidities (p<0.001). March 2021 was the most important critical period of the pandemic since there were higher frequencies of patients admitted later in the course of the disease, with desaturation and more symptoms at hospital admission (p<0.001). There was also an increase in the duration of hospital stay (p<0.001) and the frequencies of all critical outcomes for this period: oral intubation (p<0.001), ICU admission (p = 0.606) and mortality (p = 0.001). Our key findings revealed that, although there were no statistically significant differences between the subgroups of hospitalized patients over time in terms of demographic characteristics and comorbidities, the course of COVID-19 was significantly more severe for patients admitted to the hospital at the end of the first year of the pandemic in Brazil.

Precision Medicine on the Effects of Microbiota on Head-Neck Diseases and Biomarkers Diagnosis.

A literature search of PubMed, Scopus, and Web of Science was performed analysing the various interactions between microorganisms, biomarkers, and oral cancer. After screening processes, 21 articles were selected for qualitative analysis. The correlation between oral diseases/cancers and changes in the microbiota explains the increasing utility of precision medicine in enhancing diagnosis and adapting treatment on the individual components of the microbiota. Diagnosing and treating oral diseases and cancers through precision medicine gives, as well as economic advantages to the health care system, predictable and rapid management of the patient.

Facilitators of Organizational Resilience Within South Carolina AIDS Service Organizations: Lessons Learned from the COVID-19 Pandemic.

HIV care services have been interrupted by the COVID-19 pandemic in many states in the U.S. including South Carolina (SC). However, many HIV care facilities demonstrated organizational resilience (i.e., the ability to maintain needed health services amid rapidly changing circumstances) by addressing challenges to maintaining care during the pandemic. This study, therefore, aims to identify key facilitators for organizational resilience among AIDS Services Organizations (ASOs) in SC. In-depth interviews were conducted among 11 leaders, from 8 ASOs, across SC during the summer of 2020. The interviews were recorded after receiving proper consent and thentranscribed. Utilizing a codebook based upon the interview guide, a thematic analysis approach was utilized to analyze the data. All data management and analysis were conducted in NVivo 11.0. Our findings demonstrate several facilitators of organizational resilience, including (1) accurate and timely crisis information dissemination; (2) clear and preemptive protocols; (3) effective healthcare system policies, management, and leadership; (4) prioritization of staff psychological wellbeing; (5) stable access to personal protective equipment (PPE); (6) adequate and flexible funding; and (7) infrastructure that supports telehealth. Given the facilitators of organizational resilience among ASOs in SC during the COVID-19 pandemic, it is recommended that organizations implement and maintain coordinated and informed responses based upon preemptive protocols and emerging needs. ASO funders are encouraged to allow a flexibility in spending. The lessons learned from the participating leaders enable ASOs to develop and strengthen their organizational resilience and experience fewer disruptions in the future.

Digital Healthcare Application

The population of the world is multiplying with each coming year and so are the diseases and health issues. There is a rise in the need for blood as the population grows. There are many potential blood donors thanks to the world's expanding population. Blood banks play an important role in the process of collecting blood and managing blood stocks, approving blood requests, updating donations, and updating available blood types. The use of digital healthcare software makes it easier for patients and healthcare professionals to communicate with one another. With the help of this function, medical professionals such as doctors and therapists can interact intimately with their patients and provide them with very individualized health information. The software system is an online healthcare management system that helps in managing various blood banks and healthcare operations effectively. The project comprises a central repository with a variety of blood deposits and related information. These particulars include blood type, storage location, and storage date. These specifics aid in preserving and keeping an eye on the blood deposits. The project is an online system that enables users to determine whether the blood bank has the required blood deposits for a specific group. Moreover, the system also has added features such as patient name and contacts, blood booking, and even use for certain blood groups provided in case of emergency. Also, the project has various other health care facilities like providing contact of hospitals with dialysis services, booking blood test schedules online scheduling of appointments, ambulance services, and ventilator services. Key Word: Flutter, SQL, Languages, Database

Challenges in Healthcare Management Models in The Country of Georgia and Proposed Solutions

The article "Problems in Georgia's Health Care Management System and the Proposed Solutions" examines the impact of ongoing health care reforms in Georgia on the overall health status of the population and its influence on changes in such indicators as the country's demography. The article eexplores both the primary health care system and the secondary care and highlights that despite much interventions and funding coming from donor organizations and the state budget, Georgia's health care system is still far from reaching the European Core Health Indicators (ECHI). Specifically: referral rates to a "family doctor" is low; the proportion of "out-of-pocket" payment is still high; there is a substantial shortage of nurses and a surplus of doctors; low hospital bed occupancy rates; funding for primary care on a "residual principle" remains a challenge and more. Concomitantly, all of the above reflected the demographic indicators of the country, and within the last three decades over the period from 1990 to 2021 the birth rates declined, mortality increased, and average life expectancy decreased. Based on the findings, the authors conclude that it is hard to close the existing gaps the country's health care system is facing by means of a single sectoral approach, and propose a strategy for inter-sectoral management model for health care within one cluster. The article examines a model on the example of the Samtskhe-Javakheti region of Georgia. Keywords: health care reforms; management of reforms; "Family Doctor"; Family Medicine; intersectoral management; cluster.

Metacare: A Cross-Platform Healthcare Management System Using Progressive UI Framework and MySQL

The study aimed to design an automated system for a healthcare centre to manage their records. It aimed to describe the process of designing and developing the system using the modified waterfall model. The International Organization for Standardization (ISO) 25010 software standards were utilized to assess the technical feature of the system and the quality of using the system. The developmental research design was used, and IT experts and healthcare workers/residents served as the respondents. The results were analysed using weighted mean and frequency distribution, revealing that the system was successfully designed and developed using the software development model. IT experts and end-users evaluated the system with highly acceptable ratings. This study concluded that the system met the software quality standards assessment and recommended its implementation to benefit more people in the locality with further improvements

Healthcare Waste and Sustainability: Implications for a Circular Economy

The field of healthcare waste systems is an emerging research field with new methodologies being developed to reinforce sustainability. Medical treatments are becoming more sophisticated and in demand due to increasing incidences of chronic disease. Healthcare is also becoming widely available worldwide. Healthcare waste disposal includes multiple disposal methods including incineration, landfilling, and chemical treatments. These rudimentary methods and their increased prevalence present their own problems that negatively impact both the environment and public health. As a result, there is a global call for healthcare waste systems to transition from a linear to a circular economy (CE). The CE philosophy is employed in other waste management industries. There are limited studies, however, that assess the challenges to CE implementation, particularly in the United States. This research presents the challenges to the implementation of a CE in healthcare waste management systems. The challenges were determined by an extensive literature review. Three experts from the industry verified and provided additional context to the challenges through meetings. The challenges were grouped into seven categories: supply chain management, regulations and policies, industry, organizations internal, technology and operational, economic, and funding, and social. A decision-making trial and evaluation (DEMATEL) was used to rank the challenges and illustrate interrelationships between the challenges. The most significant challenge was found to be a lack of governmental legislation on CE healthcare policies, followed by a lack of a realistic CE business model and lack of consumer interest in the environment. The research will provide context to further developments into adopting CE practices. The limitations and future scope of the research are presented.

Dashboard as a public transparency tool for management and planning data in Brazilian healthcare system

Dashboard as a public transparency tool for management and planning data in Brazilian healthcare system

A UML Activity Flow Graph-Based Regression Testing Approach

Regression testing is a crucial process that ensures that changes made to a system do not affect existing functionalities. However, there is currently no adequate technique for selecting test cases that consider changes in Unified Modeling Language (UML) activity flow graphs. This paper proposes a novel approach to regression testing of UML diagrams, focusing on healthcare management systems. We provide a formal definition of sequence and activity diagrams and their relationship and construct corresponding activity flow graphs, which are used to develop a regression testing algorithm. The proposed algorithm categorizes test cases into reusable, retestable, obsolete, and newly generated categories by comparing old and new versions of UML activity flow graphs. The methodology is evaluated using a custom-designed hospital management system website as the test case, and the results demonstrate a significant reduction in time and resources required for regression testing. Our study provides valuable insights into the application of UML diagrams and activity flow graphs in regression testing, making it an important contribution to software testing research.

Seasonal ARIMA model for Covid-19 pandemic Prediction in the United States

The COVID-19 pandemic has had a profound impact on global health and economies. The pandemic continues to spread and accurate forecasting of its spread is essential for the effective management of healthcare systems and the development of effective policies. The development of forecasting models for COVID-19 has become increasingly important as the pandemic continues to evolve. In this paper, we will summarize the Covid-19 pandemic in the United States state by state. And then, we utilize the temporal data of coronavirus spread from January 18, 2020 to January 29, 2023. Finally, we model the evolution of the COVID-19 outbreak and perform prediction using ARIMA and time series forecasting models on some selected states.

Asking informed consent may lead to significant participation bias and suboptimal cardiovascular risk management in learning healthcare systems

BackgroundThe Utrecht Cardiovascular Cohort – CardioVascular Risk Management (UCC-CVRM) was set up as a learning healthcare system (LHS), aiming at guideline based cardiovascular risk factor measurement in all patients in routine clinical care. However, not all patients provided informed consent, which may lead to participation bias. We aimed to study participation bias in a LHS by assessing differences in and completeness of cardiovascular risk management (CVRM) indicators in electronic health records (EHRs) of consenting, non-consenting, and non-responding patients, using the UCC-CVRM as an example.MethodsAll patients visiting the University Medical Center Utrecht for first time evaluation of a(n) (a)symptomatic vascular disease or condition were invited to participate. Routine care data was collected in the EHR and an informed consent was asked. Differences in patient characteristics were compared between consent groups. We performed multivariable logistic regression to identify determinants of non-consent. We used multinomial regression for an exploratory analysis for the determinants of non-response. Presence of CVRM indicators were compared between consent groups. A waiver (19/641) was obtained from our ethics committee.ResultsOut of 5730 patients invited, 2378 were consenting, 1907 non-consenting, and 1445 non-responding. Non-consent was related to young and old age, lower education level, lower BMI, physical activity and haemoglobin levels, higher heartrate, cardiovascular disease history and absence of proteinuria. Non-response increased with young and old age, higher education level, physical activity, HbA1c and decreased with lower levels of haemoglobin, BMI, and systolic blood pressure. Presence of CVRM indicators was 5–30% lower in non-consenting patients and even lower in non-responding patients, compared to consenting patients. Non-consent and non-response varied across specialisms.ConclusionsA traditional informed consent procedure in a LHS may lead to participation bias and potentially to suboptimal CVRM, which is detrimental for feedback on findings in a LHS. This underlines the importance of reassessing the informed consent procedure in a LHS.