Chronicling the patient journey: Co-creating value with digital health ecosystems

With the introduction of the PCEHR (Personally Controlled Electronic Health Record), the Australian public is being asked to accept greater responsibility for the management of their health information. However, the implementation of the PCEHR has occasioned poor adoption rates underscored by criticism from stakeholders with concerns about transparency, accountability, privacy, confidentiality, governance, and limited capabilities. This study adopts an ethnographic lens to observe how information is created and used during the patient journey and the social factors impacting on the adoption of the PCEHR at the micro-level in order to develop a conceptual model that will encourage the sharing of patient information within the cycle of care. Objective: This study aims to firstly, establish a basic understanding of healthcare professional attitudes toward a national platform for sharing patient summary information in the form of a PCEHR. Secondly, the studies aims to map the flow of patient related information as it traverses a patient’s personal cycle of care. Thus, an ethnographic approach was used to bring a “real world” lens to information flow in a series of case studies in the Australian healthcare system to discover themes and issues that are important from the patient’s perspective. Design: Qualitative study utilising ethnographic case studies. Setting: Case studies were conducted at primary and allied healthcare professionals located in Brisbane Queensland between October 2013 and July 2014. Results: In the first dimension, it was identified that healthcare professionals’ concerns about trust and medico-legal issues related to patient control and information quality, and the lack of clinical value available with the PCEHR emerged as significant barriers to use. The second dimension of the study which attempted to map patient information flow identified information quality issues, clinical workflow inefficiencies and interoperability misconceptions resulting in duplication of effort, unnecessary manual processes, data quality and integrity issues and an over reliance on the understanding and communication skills of the patient. Conclusion: Opportunities for process efficiencies, improved data quality and increased patient safety emerge with the adoption of an appropriate information sharing platform. More importantly, large scale eHealth initiatives must be aligned with the value proposition of individual stakeholders in order to achieve widespread adoption. Leveraging an Australian national eHealth infrastructure and the PCEHR we offer a practical example of a service driven digital ecosystem suitable for co-creating value in healthcare.

Interpretation of Services Marketing Concepts

Scholarly research has produced conceptual knowledge that is based on real-life marketing phenomena. An initial aim of past research has been to produce marketing knowledge as a base for efficient business operation and for the improvement of productivity. Thus, an assumption has been that the knowledge would be applied by organisations. This study focuses on understanding the use of marketing knowledge within the field of service marketing. Hence, even if marketing knowledge about service-oriented principles and marketing of services is based on empirical research, there is a lack of knowledge on how this marketing knowledge is in fact applied by businesses. The study focuses on four essential concepts of services marketing knowledge, namely service quality, servicescape, internal marketing, and augmented service offering. The research involves four case companies. Data is based on in depth interviews and questionnaire-based surveys conducted with managers, employees, and customers of these companies. All organisations were currently developing in a service-oriented and customer-oriented direction. However, we found limitations, gaps, and barriers for the implementation of service-oriented and customer-oriented principles. Hence, we argue that the organisations involved in the study exploited conceptual knowledge symbolically and conceptually, but the instrumental use of knowledge was limited. Due to the shortcomings found, we also argue that the implementation of the various practices and processes that are related to becoming service-oriented and customer-oriented has not been fully successful. Further, we have come to the conclusion that the shortcomings detected were at least in some respect related to the fact that the understanding and utilisation of conceptual knowledge of service-oriented principles and marketing of services were somewhat limited.

Plano de implantação de uma arquitetura orientada a serviços - SOA - na Câmara dos Deputados

Apresenta um plano para implantação de uma Arquitetura Orientada a Serviços "SOA", na Câmara dos Deputados - Brasil. O plano de implantação SOA foi estruturado em dois projetos: "Entender SOA" e "Implantar SOA", descritos em suas macro atividades e foi embasado em um arcabouço teórico fundamentado em significativa literatura pesquisada que incluiu os modelos de referência e de arquitetura SOA disponíveis. Foram abordados, além dos aspectos tecnológicos, as questões de governança de TI e questões de cultura organizacional que precisam ser consideradas em projetos dessa natureza, considerando que SOA não é simplesmente uma questão de tecnologia, mas fundamentalmente uma questão de negócio e governança empresarial. Os aspectos de TI também foram explorados de forma suficiente para que as equipes técnicas tenham condições de implementar os princípios de desenho da arquitetura SOA.

Exploring the financial consequences of the servitization of manufacturing

Commentators suggest that to survive in developed economies manufacturing firms have to move up the value chain, innovating and creating ever more sophisticated products and services, so they do not have to compete on the basis of cost. While this strategy is proving increasingly popular with policy makers and academics there is limited empirical evidence to explore the extent to which it is being adopted in practice. And if so, what the impact of this servitization of manufacturing might be. This paper seeks to fill a gap in the literature by presenting empirical evidence on the range and extent of servitization. Data are drawn from the OSIRIS database on 10,028 firms incorporated in 25 different countries. The paper presents an analysis of these data which suggests that: [i] manufacturing firms in developed economies are adopting a range of servitization strategies-12 separate approaches to servitization are identified; [ii] these 12 categories can be used to extend the traditional three options for servitization-product oriented Product-Service Systems, use oriented Product-Service Systems and result oriented Product-Service Systems, by adding two new categories "integration oriented Product-Service Systems" and "service oriented Product-Service Systems"; [iii] while the manufacturing firms that have servitized are larger than traditional manufacturing firms in terms of sales revenues, at the aggregate level they also generate lower profits as a % of sales; [iv] these findings are moderated by firm size (measured in terms of numbers of employees). In smaller firms servitization appears to pay off while in larger firms it proves more problematic; and [v] there are some hidden risks associated with servitization-the sample contains a greater proportion of bankrupt servitized firms than would be expected. © Springer Science + Business Media, LLC 2009.

Strategies for designing and developing services for manufacturing firms

Product/service-systems (PSS) are in effect an approach to designing integrated products and services with a focus on both customer and product life cycle activities. A range of service-oriented design strategies can be found in current literature, from product-oriented DfX approaches to more customer-oriented approaches, such as integrated solutions. In this article, design strategies related to different types of services are mapped. Case studies from two industrial companies are used to confront the existing literature in order to improve the understanding of how manufacturing companies may align their product and service development activities with their business strategies. © 2010.

Performance assessment of XACML authorizations for supply chain traceability web services

Service-Oriented Architecture (SOA) and Web Services (WS) offer advanced flexibility and interoperability capabilities. However they imply significant performance overheads that need to be carefully considered. Supply Chain Management (SCM) and Traceability systems are an interesting domain for the use of WS technologies that are usually deemed to be too complex and unnecessary in practical applications, especially regarding security. This paper presents an externalized security architecture that uses the eXtensible Access Control Markup Language (XACML) authorization standard to enforce visibility restrictions on trace-ability data in a supply chain where multiple companies collaborate; the performance overheads are assessed by comparing 'raw' authorization implementations - Access Control Lists, Tokens, and RDF Assertions - with their XACML-equivalents. © 2012 IEEE.

基于OSGi的Web容器重构

The OSGi component architecture for software development can better meet the requirements of current Internet environment in scalability, readability and reusability. This paper presents an approach to refactor legacy softwares towards service-oriented systems using the OSGi as the foundation framework. A case study on reconstructing our Web container system is also involved to validate the approach.

基于SOA的银联智能商业平台的研究与实现

智能商业平台是大型企业商务应用的一个新兴领域，智能商业平台通过数据仓库、数据挖掘技术对企业的大量数据进行分析从而发现企业发展的内部规律，为企业的科学决策提供有效支持。目前的智能商业平台在体系结构上采用传统的集中式的IT架构，尚存在如下问题：1）不能与其它的信息系统间进行交互；2）采用重建系统的方式开发，不能有效利用现有信息系统资源；3）不能适应快速变化的业务需求进行灵活的系统扩充；4）由于系统的所有功能集中在同一服务器中，严重影响了系统的访问性能。 面对上述具有挑战的问题，本文将Web服务同智能商业平台相结合，从体系结构角度出发，提出一种基于SOA(Service-Oriented Architecture)的智能商业平台，并在银联需求基础上开发基于SOA的银联智能商业平台，解决传统智能商业平台无法与其它系统交互、资源浪费、不能灵活扩展及访问性能等方面的问题。 本文首先分析了国内外智能商业平台的研究现状，指出了其中尚未解决的问题，然后结合SOA的设计思想和传统的OOAD方法进行银联智能商业平台的业务流程建模，提出了面向服务的业务流程模型，并根据对用户需求的分析和理解设计了基于SOA的分层体系结构。然后文章着重阐述了服务管理层、核心服务层和应用服务层的设计思想与实现方法：1）服务管理层负责系统中所有服务的统一维护和管理，其中重点分析、讨论了基于UDDI的服务注册中心等核心技术；2）核心服务层是我们为了支撑上层应用服务所开发的大量底层服务，包括报表统计服务、多维分析服务、数据挖掘服务、用户管理、日志管理服务等，文中详细介绍了这些核心服务的设计和工作流程描述；3）应用层主要是各种系统功能的应用集成，提供了统一的门户交互系统，在这部分将着重给出统一门户集成的实现。 通过构建面向服务的业务流程和体系结构，基于SOA的银联智能商业平台在解决了传统智能商业平台问题的基础上还具有多项优势：标准化，构件化，可重用性，可扩展性，可互操作性等。

DIP: Density Inference Protocol for wireless sensor networks and its application to density-unbiased statistics

Wireless sensor networks have recently emerged as enablers of important applications such as environmental, chemical and nuclear sensing systems. Such applications have sophisticated spatial-temporal semantics that set them aside from traditional wireless networks. For example, the computation of temperature averaged over the sensor field must take into account local densities. This is crucial since otherwise the estimated average temperature can be biased by over-sampling areas where a lot more sensors exist. Thus, we envision that a fundamental service that a wireless sensor network should provide is that of estimating local densities. In this paper, we propose a lightweight probabilistic density inference protocol, we call DIP, which allows each sensor node to implicitly estimate its neighborhood size without the explicit exchange of node identifiers as in existing density discovery schemes. The theoretical basis of DIP is a probabilistic analysis which gives the relationship between the number of sensor nodes contending in the neighborhood of a node and the level of contention measured by that node. Extensive simulations confirm the premise of DIP: it can provide statistically reliable and accurate estimates of local density at a very low energy cost and constant running time. We demonstrate how applications could be built on top of our DIP-based service by computing density-unbiased statistics from estimated local densities.

The cloud personal assistant for providing services to mobile clients

This paper introduces the original concept of a cloud personal assistant, a cloud service that manages the access of mobile clients to cloud services. The cloud personal assistant works in the cloud on behalf of its owner: it discovers services, invokes them, stores the results and history, and delivers the results to the mobile user immediately or when the user requests them. Preliminary experimental results that demonstrate the concept are included.

A design pattern for integration of business process management systems

A cross-domain workflow application may be constructed using a standard reference model such as the one by the Workflow Management Coalition (WfMC) [7] but the requirements for this type of application are inherently different from one organization to another. The existing models and systems built around them meet some but not all the requirements from all the organizations involved in a collaborative process. Furthermore the requirements change over time. This makes the applications difficult to develop and distribute. Service Oriented Architecture (SOA) based approaches such as the BPET (Business Process Execution Language) intend to provide a solution but fail to address the problems sufficiently, especially in the situations where the expectations and level of skills of the users (e.g. the participants of the processes) in different organisations are likely to be different. In this paper, we discuss a design pattern that provides a novel approach towards a solution. In the solution, business users can design the applications at a high level of abstraction: the use cases and user interactions; the designs are documented and used, together with the data and events captured later that represents the user interactions with the systems, to feed an intermediate component local to the users -the IFM (InterFace Mapper) -which bridges the gaps between the users and the systems. We discuss the main issues faced in the design and prototyping. The approach alleviates the need for re-programming with the APIs to any back-end service thus easing the development and distribution of the applications

The good our field can hope to do, the harm it should avoid

This paper tries to achieve a balanced view of the ethical issues raised by emotion-oriented technology as it is, rather than as it might be imagined. A high proportion of applications seem ethically neutral. Uses in entertainment and allied areas do no great harm or good. Empowering professions may do either, but regulatory systems already exist. Ethically positive aspirations involve mitigating problems that already exist by supporting humans in emotion-related judgments, by replacing technology that treats people in dehumanized and/or demeaning ways, and by improving access for groups who struggle with existing interfaces. Emotion-oriented computing may also contribute to revaluing human faculties other than pure intellect. Many potential negatives apply to technology as a whole. Concerns specifically related to emotion involve creating a lie, by simulate emotions that the systems do not have, or promoting mechanistic conceptions of emotion. Intermediate issues arise where more general problems could be exacerbated-helping systems to sway human choices or encouraging humans to choose virtual worlds rather than reality. "SIIF" systems (semi-intelligent information filters) are particularly problematic. These use simplified rules to make judgments about people that are complex, and have potentially serious consequences. The picture is one of balances to recognize and negotiate, not uniform good or evil. © 2010-2012 IEEE.

Establishment of stackable community networks

Uma das áreas de investigação em Telecomunicações de interesse crescente prende-se com os futuros sistemas de comunicações móveis de 4a geração e além destes. Nos últimos anos tem sido desenvolvido o conceito de redes comunitárias, no qual os utilizadores se agregam de acordo com interesses comuns. Estes conceitos têm sido explorados de uma forma horizontal em diferentes camadas da comunicação, desde as redes comunitárias de comunicação (Seattle Wireless ou Personal Telco, p.ex.) até às redes de interesses peer-to-peer. No entanto, estas redes são usualmente vistas como redes de overlay, ou simplesmente redes de associação livre. Na prática, a noção de uma rede auto-organizada, completamente orientada ao serviço/comunidade, integralmente suportada em termos de arquitetura, não existe. Assim este trabalho apresenta uma realização original nesta área de criação de redes comunitárias, com uma arquitetura subjacente orientada a serviço, e que suporta integralmente múltiplas redes comunitárias no mesmo dispositivo, com todas as características de segurança, confiança e disponibilização de serviço necessárias neste tipo de cenários (um nó pode pertencer simultaneamente a mais do que uma rede comunitária). Devido à sua importância para os sistemas de redes comunitárias, foi dado particular atenção a aspetos de gestão de recursos e controlo de acessos. Ambos realizados de uma forma descentralizada e considerando mecanismos dotados de grande escalabilidade. Para isso, é apresentada uma linguagem de políticas que suporta a criação de comunidades virtuais. Esta linguagem não é apenas utilizada para o mapeamento da estrutura social dos membros da comunidade, como para, gerir dispositivos, recursos e serviços detidos pelos membros, de uma forma controlada e distribuída.

Electronic health records for mobile citizens: a secure and collaborative architecture

Durante as ultimas décadas, os registos de saúde eletrónicos (EHR) têm evoluído para se adaptar a novos requisitos. O cidadão tem-se envolvido cada vez mais na prestação dos cuidados médicos, sendo mais pró ativo e desejando potenciar a utilização do seu registo. A mobilidade do cidadão trouxe mais desafios, a existência de dados dispersos, heterogeneidade de sistemas e formatos e grande dificuldade de partilha e comunicação entre os prestadores de serviços. Para responder a estes requisitos, diversas soluções apareceram, maioritariamente baseadas em acordos entre instituições, regiões e países. Estas abordagens são usualmente assentes em cenários federativos muito complexos e fora do controlo do paciente. Abordagens mais recentes, como os registos pessoais de saúde (PHR), permitem o controlo do paciente, mas levantam duvidas da integridade clinica da informação aos profissionais clínicos. Neste cenário os dados saem de redes e sistemas controlados, aumentando o risco de segurança da informação. Assim sendo, são necessárias novas soluções que permitam uma colaboração confiável entre os diversos atores e sistemas. Esta tese apresenta uma solução que permite a colaboração aberta e segura entre todos os atores envolvidos nos cuidados de saúde. Baseia-se numa arquitetura orientada ao serviço, que lida com a informação clínica usando o conceito de envelope fechado. Foi modelada recorrendo aos princípios de funcionalidade e privilégios mínimos, com o propósito de fornecer proteção dos dados durante a transmissão, processamento e armazenamento. O controlo de acesso _e estabelecido por políticas definidas pelo paciente. Cartões de identificação eletrónicos, ou certificados similares são utilizados para a autenticação, permitindo uma inscrição automática. Todos os componentes requerem autenticação mútua e fazem uso de algoritmos de cifragem para garantir a privacidade dos dados. Apresenta-se também um modelo de ameaça para a arquitetura, por forma a analisar se as ameaças possíveis foram mitigadas ou se são necessários mais refinamentos. A solução proposta resolve o problema da mobilidade do paciente e a dispersão de dados, capacitando o cidadão a gerir e a colaborar na criação e manutenção da sua informação de saúde. A arquitetura permite uma colaboração aberta e segura, possibilitando que o paciente tenha registos mais ricos, atualizados e permitindo o surgimento de novas formas de criar e usar informação clínica ou complementar.