Health Information Exchange in the wake of ‘big data’ paradigm – the theme is from ‘quality of information to quality of life’

Health Information Exchange (HIE) is an interesting phenomenon. It is a patient centric health and/or medical information management scenario enhanced by integration of Information and Communication Technologies (ICT). While health information systems are repositioning complex system directives, in the wake of the ‘big data’ paradigm, extracting quality information is challenging. It is anticipated that in this talk, ICT enabled healthcare scenarios with big data analytics will be shared. In addition, research and development regarding big data analytics, such as current trends of using these technologies for health care services and critical research challenges when extracting quality of information to improve quality of life will be discussed.

Complexity of collaborative work in residential aged care facilities: An analysis of information exchange for medication management

Information exchange (IE) is a critical component of the complex collaborative medication process in residential aged care facilities (RACFs). Designing information and communication technology (ICT) to support complex processes requires a profound understanding of the IE that underpins their execution. There is little existing research that investigates the complexity of IE in RACFs and its impact on ICT design. The aim of this study was thus to undertake an in-depth exploration of the IE process involved in medication management to identify its implications for the design of ICT. The study was undertaken at a large metropolitan facility in NSW, Australia. A total of three focus groups, eleven interviews and two observation sessions were conducted between July to August 2010. Process modelling was undertaken by translating the qualitative data via in-depth iterative inductive analysis. The findings highlight the complexity and collaborative nature of IE in RACF medication management. These models emphasize the need to: a) deal with temporal complexity; b) rely on an interdependent set of coordinative artefacts; and c) use synchronous communication channels for coordination. Taken together these are crucial aspects of the IE process in RACF medication management that need to be catered for when designing ICT in this critical area. This study provides important new evidence of the advantages of viewing process as a part of a system rather than as segregated tasks as a means of identifying the latent requirements for ICT design and that is able to support complex collaborative processes like medication management in RACFs. © 2012 IEEE.

Medication errors in residential aged care facilities: A distributed cognition analysis of the information exchange process

Background Medication safety is a pressing concern for residential aged care facilities (RACFs). Retrospective studies in RACF settings identify inadequate communication between RACFs, doctors, hospitals and community pharmacies as the major cause of medication errors. Existing literature offers limited insight about the gaps in the existing information exchange process that may lead to medication errors. The aim of this research was to explicate the cognitive distribution that underlies RACF medication ordering and delivery to identify gaps in medication-related information exchange which lead to medication errors in RACFs. Methods The study was undertaken in three RACFs in Sydney, Australia. Data were generated through ethnographic field work over a period of five months (May–September 2011). Triangulated analysis of data primarily focused on examining the transformation and exchange of information between different media across the process. Results The findings of this study highlight the extensive scope and intense nature of information exchange in RACF medication ordering and delivery. Rather than attributing error to individual care providers, the explication of distributed cognition processes enabled the identification of gaps in three information exchange dimensions which potentially contribute to the occurrence of medication errors namely: (1) design of medication charts which complicates order processing and record keeping (2) lack of coordination mechanisms between participants which results in misalignment of local practices (3) reliance on restricted communication bandwidth channels mainly telephone and fax which complicates the information processing requirements. The study demonstrates how the identification of these gaps enhances understanding of medication errors in RACFs. Conclusions Application of the theoretical lens of distributed cognition can assist in enhancing our understanding of medication errors in RACFs through identification of gaps in information exchange. Understanding the dynamics of the cognitive process can inform the design of interventions to manage errors and improve residents’ safety.

An investigation into the information exchange between a consultant and client company: a case study

This report deals with collaborations of engineering consultants and clients in the automobile industry.

In these relationships three main challenges have been identified which have to be addressed by the consultancies. Therefore, the research takes the viewpoint of the consulting side. The challenges are

(i) the appropriate project goal definition;

(ii) achieving client satisfaction; and

(iii) dealing with international clients.

An investigation of such a relationship carried out on a case study shows that improvements can be achieved through communication support. The ways to do that are proposed.

Information Exchange and Fusion in Dynamic and Heterogeneous Distributed Environments

Context awareness, dynamic reconfiguration at runtime and heterogeneity are key characteristics of future distributed systems, particularly in ubiquitous and mobile computing scenarios. The main contributions of this dissertation are theoretical as well as architectural concepts facilitating information exchange and fusion in heterogeneous and dynamic distributed environments. Our main focus is on bridging the heterogeneity issues and, at the same time, considering uncertain, imprecise and unreliable sensor information in information fusion and reasoning approaches. A domain ontology is used to establish a common vocabulary for the exchanged information. We thereby explicitly support different representations for the same kind of information and provide Inter-Representation Operations that convert between them. Special account is taken of the conversion of associated meta-data that express uncertainty and impreciseness. The Unscented Transformation, for example, is applied to propagate Gaussian normal distributions across highly non-linear Inter-Representation Operations. Uncertain sensor information is fused using the Dempster-Shafer Theory of Evidence as it allows explicit modelling of partial and complete ignorance. We also show how to incorporate the Dempster-Shafer Theory of Evidence into probabilistic reasoning schemes such as Hidden Markov Models in order to be able to consider the uncertainty of sensor information when deriving high-level information from low-level data. For all these concepts we provide architectural support as a guideline for developers of innovative information exchange and fusion infrastructures that are particularly targeted at heterogeneous dynamic environments. Two case studies serve as proof of concept. The first case study focuses on heterogeneous autonomous robots that have to spontaneously form a cooperative team in order to achieve a common goal. The second case study is concerned with an approach for user activity recognition which serves as baseline for a context-aware adaptive application. Both case studies demonstrate the viability and strengths of the proposed solution and emphasize that the Dempster-Shafer Theory of Evidence should be preferred to pure probability theory in applications involving non-linear Inter-Representation Operations.

Neighborhood information exchange and voter participation : an experimental study

We study the effect of social embeddedness on voter turnout by investigating the role of information about other voters’ decisions. We do so in a participation game, where some voters (‘receivers’) are told about some other voters’ (‘senders’) turnout decision at a first stage of the game. Cases are distinguished where the voters support the same or different candidates or where they are uncertain about each other’s preferences. Our experimental results show that such information matters. Participation is much higher when information is exchanged than when it is not. Senders strategically try to use their first mover position and some receivers respond to this.

Networks of Information Exchange Under Uncertainty: The Case of Unconventional Gas Development in the United Kingdom

Modern policy-making is increasingly influenced by different types of uncertainty. Political actors are supposed to behave differently under the context of uncertainty then in “usual” decision-making processes. Actors exchange information in order to convince other actors and decision-makers, to coordinate their lobbying activities and form coalitions, and to get information and learn on the substantive issue. The literature suggests that preference similarity, social trust, perceived power and functional interdependence are particularly important drivers of information exchange. We assume that social trust as well as being connected to scientific actors is more important under uncertainty than in a setting with less uncertainty. To investigate information exchange under uncertainty analyze the case of unconventional shale gas development in the UK from 2008 till 2014. Our study will rely on statistical analyses of survey data on a diverse set of actors dealing with shale gas development and regulation in the UK.

Mitigating the syndromes of desertification: The requirements for transdisciplinary research and information exchange

In developing meaningful mitigation strategies to combat desertification, it is important to address the complex constellation of desertification under different bio-physical, social, demographic, political and economic conditions. In particular, desertification can be described as a cluster of key processes of global change which together form a typical syndrome. A critical reflection on the potential of research to help mitigate desertification will be a useful first step, before addressing the requirements for research partnerships between institutions at local levels and beyond. A practical example from Eritrea, an ecoregion which has been plagued by desertification for many centuries, is given at the end of the paper. It illustrates options for generating the necessary data and developing useful information in order to enhance the impact of research on sustainable development.

Health information exchange: Using metrics to address quality of care and return on investment

Health Information Exchange (HIE) will play a key part in our nation’s effort to improve healthcare. The evidence of HIEs transformational role in healthcare delivery systems is quite limited. The lack of such evidence led us to explore what exists in the healthcare industry that may provide evidence of effectiveness and efficiency of HIEs. The objective of the study was to find out how many fully functional HIEs are using any measurements or metrics to gauge impact of HIE on quality improvement (QI) and on return on investment (ROI).^ A web-based survey was used to determine the number of operational HIEs using metrics for QI and ROI. Our study highlights the fact that only 50 percent of the HIEs who responded use or plan to use metrics. However, 95 percent of the respondents believed HIEs improve quality of care while only 56 percent believed HIE showed positive ROI. Although operational HIEs present numerous opportunities to demonstrate the business model for improving health care quality, evidence to document the impact of HIEs is lacking. ^