AMBIVALENT IMPLICATIONS OF HEALTH CARE INFORMATION SYSTEMS: A STUDY IN THE BRAZILIAN PUBLIC HEALTH CARE SYSTEM

This article evaluates social implications of the ""SIGA"" Health Care Information System (HIS) in a public health care organization in the city of Sao Paulo. The evaluation was performed by means of an in-depth case study with patients and staff of a public health care organization, using qualitative and quantitative data. On the one hand, the system had consequences perceived as positive such as improved convenience and democratization of specialized treatment for patients and improvements in work organization. On the other hand, negative outcomes were reported, like difficulties faced by employees due to little familiarity with IT and an increase in the time needed to schedule appointments. Results show the ambiguity of the implications of HIS in developing countries, emphasizing the need for a more nuanced view of the evaluation of failures and successes and the importance of social contextual factors.

Ambivalent implications of health care information systems: a study in the Brazilian public health care system

This article evaluates social implications of the "SIGA" Health Care Information System (HIS) in a public health care organization in the city of São Paulo. The evaluation was performed by means of an in-depth case study with patients and staff of a public health care organization, using qualitative and quantitative data. On the one hand, the system had consequences perceived as positive such as improved convenience and democratization of specialized treatment for patients and improvements in work organization. On the other hand, negative outcomes were reported, like difficulties faced by employees due to little familiarity with IT and an increase in the time needed to schedule appointments. Results show the ambiguity of the implications of HIS in developing countries, emphasizing the need for a more nuanced view of the evaluation of failures and successes and the importance of social contextual factors.

Performance evaluation of hospitals that provide care in the public health system, Brazil

OBJECTIVE To analyze if size, administrative level, legal status, type of unit and educational activity influence the hospital network performance in providing services to the Brazilian Unified Health System.METHODS This cross-sectional study evaluated data from the Hospital Information System and the Cadastro Nacional de Estabelecimentos de Saúde (National Registry of Health Facilities), 2012, in Sao Paulo, Southeastern Brazil. We calculated performance indicators, such as: the ratio of hospital employees per bed; mean amount paid for admission; bed occupancy rate; average length of stay; bed turnover index and hospital mortality rate. Data were expressed as mean and standard deviation. The groups were compared using analysis of variance (ANOVA) and Bonferroni correction.RESULTS The hospital occupancy rate in small hospitals was lower than in medium, big and special-sized hospitals. Higher hospital occupancy rate and bed turnover index were observed in hospitals that include education in their activities. The hospital mortality rate was lower in specialized hospitals compared to general ones, despite their higher proportion of highly complex admissions. We found no differences between hospitals in the direct and indirect administration for most of the indicators analyzed.CONCLUSIONS The study indicated the importance of the scale effect on efficiency, and larger hospitals had a higher performance. Hospitals that include education in their activities had a higher operating performance, albeit with associated importance of using human resources and highly complex structures. Specialized hospitals had a significantly lower rate of mortality than general hospitals, indicating the positive effect of the volume of procedures and technology used on clinical outcomes. The analysis related to the administrative level and legal status did not show any significant performance differences between the categories of public hospitals.

Dynamic network data envelopment analysis for university hospitals evaluation

ABSTRACT OBJECTIVE To develop an assessment tool to evaluate the efficiency of federal university general hospitals. METHODS Data envelopment analysis, a linear programming technique, creates a best practice frontier by comparing observed production given the amount of resources used. The model is output-oriented and considers variable returns to scale. Network data envelopment analysis considers link variables belonging to more than one dimension (in the model, medical residents, adjusted admissions, and research projects). Dynamic network data envelopment analysis uses carry-over variables (in the model, financing budget) to analyze frontier shift in subsequent years. Data were gathered from the information system of the Brazilian Ministry of Education (MEC), 2010-2013. RESULTS The mean scores for health care, teaching and research over the period were 58.0%, 86.0%, and 61.0%, respectively. In 2012, the best performance year, for all units to reach the frontier it would be necessary to have a mean increase of 65.0% in outpatient visits; 34.0% in admissions; 12.0% in undergraduate students; 13.0% in multi-professional residents; 48.0% in graduate students; 7.0% in research projects; besides a decrease of 9.0% in medical residents. In the same year, an increase of 0.9% in financing budget would be necessary to improve the care output frontier. In the dynamic evaluation, there was progress in teaching efficiency, oscillation in medical care and no variation in research. CONCLUSIONS The proposed model generates public health planning and programming parameters by estimating efficiency scores and making projections to reach the best practice frontier.

Social network analysis applied to knowledge creation and transfer in the portuguese agricultural R&D field: an exploratory study

Paper presented at the 9th European Conference on Knowledge Management, Southampton Solent University, Southampton, UK, 4-5 Sep. 2008. URL: http://academic-conferences.org/eckm/eckm2008/eckm08-home.htm

Value added logistics in supply and demand chains. Smile. Part 1. eBusiness between global company and itslocal sme supplier network

VALOSADE (Value Added Logistics in Supply and Demand Chains) is the research project of Anita Lukka's VALORE (Value Added Logistics Research) research team inLappeenranta University of Technology. VALOSADE is included in ELO (Ebusiness logistics) technology program of Tekes (Finnish Technology Agency). SMILE (SME-sector, Internet applications and Logistical Efficiency) is one of four subprojects of VALOSADE. SMILE research focuses on case network that is composed of small and medium sized mechanical maintenance service providers and global wood processing customers. Basic principle of SMILE study is communication and ebusiness insupply and demand network. This first phase of research concentrates on creating backgrounds for SMILE study and for ebusiness solutions of maintenance case network. The focus is on general trends of ebusiness in supply chains and networksof different industries; total ebusiness system architecture of company networks; ebusiness strategy of company network; information value chain; different factors, which influence on ebusiness solution of company network; and the correlation between ebusiness and competitive advantage. Literature, interviews and benchmarking were used as research methods in this qualitative case study. Networks and end-to-end supply chains are the organizational structures, which can add value for end customer. Information is one of the key factors in these decentralized structures. Because of decentralization of business, information is produced and used in different companies and in different information systems. Information refinement services are needed to manage information flows in company networksbetween different systems. Furthermore, some new solutions like network information systems are utilised in optimising network performance and in standardizingnetwork common processes. Some cases have however indicated, that utilization of ebusiness in decentralized business model is not always a necessity, but value-add of ICT must be defined case-specifically. In the theory part of report, different ebusiness and architecture models are introduced. These models are compared to empirical case data in research results. The biggest difference between theory and empirical data is that models are mainly developed for large-scale companies - not for SMEs. This is due to that implemented network ebusiness solutions are mainly large company centered. Genuine SME network centred ebusiness models are quite rare, and the study in that area has been few in number. Business relationships between customer and their SME suppliers are nowadays concentrated more on collaborative tactical and strategic initiatives besides transaction based operational initiatives. However, ebusiness systems are further mainly based on exchange of operational transactional data. Collaborative ebusiness solutions are in planning or pilot phase in most case companies. Furthermore, many ebusiness solutions are nowadays between two participants, but network and end-to-end supply chain transparency and information systems are quite rare. Transaction volumes, data formats, the types of exchanged information, information criticality,type and duration of business relationship, internal information systems of partners, processes and operation models (e.g. different ordering models) differ among network companies, and furthermore companies are at different stages on networking and ebusiness readiness. Because of former factors, different customer-supplier combinations in network must utilise totally different ebusiness architectures, technologies, systems and standards.

Regional Data Transmission Network

The globalization and development of an information society promptly change shape of the modern world. Cities and especially megacities including Saint-Petersburg are in the center of occuring changes. As a result of these changes the economic activities connected to reception and processing of the information now play very important role in economy of megacities what allows to characterize them as "information". Despite of wide experience in decision of information questions Russia, and in particular Saint-Petersburg, lag behind in development of information systems from the advanced European countries. The given master's thesis is devoted to development of an information system (data transmission network) on the basis of wireless technology in territory of Saint-Petersburg region within the framework of FTOP "Electronic Russia" and RTOP "Electronic Saint-Petersburg" programs. Logically the master's thesis can be divided into 3 parts: 1. The problems, purposes, expected results, terms and implementation of the "Electronic Russia" program. 2. Discussion about wireless data transmission networks (description of technology, substantiation of choice, description of signal's transmission techniques and types of network topology). 3. Fulfillment of the network (organization of central network node, regional centers, access lines, description of used equipment, network's capabilities), financial provision of the project, possible network management models.

Maintenance process development for remote administration of network servers

Maintenance is a part of system development and it is possible to develop operation models for accomplishing maintenance tasks. These models can be applied to individual maintenance tasks, maintenance projects and version management. Beneficial operation models makes maintenance more effective and they assist in managing various changes. The purpose of this thesis was to develop a maintenance process which can be used to remote administer network servers. This consisted of defining those operation models and technical specifications which enable to set up, manage changes, maintain and monitor resources of information systems that are located in several different sites. At first in this thesis the needs of the process were determined and requirements were defined based on those needs. The meaning of processes in maintenance of information systems, maintenance workflows and challenges were studied. Then current practical problems and disadvantages of maintenance work were analyzed in order to focus the development to proper issues. Because available operation models did not cover all the recent needs, new maintenance process which fulfilled the requirements was developed.

Rainfall erosivity for the State of Rio de Janeiro estimated by artificial neural network

The Artificial Neural Networks (ANNs) are mathematical models method capable of estimating non-linear response plans. The advantage of these models is to present different responses of the statistical models. Thus, the objective of this study was to develop and to test ANNs for estimating rainfall erosivity index (EI30) as a function of the geographical location for the state of Rio de Janeiro, Brazil and generating a thematic visualization map. The characteristics of latitude, longitude e altitude using ANNs were acceptable to estimating EI30 and allowing visualization of the space variability of EI30. Thus, ANN is a potential option for the estimate of climatic variables in substitution to the traditional methods of interpolation.

Parasitic Order Machine. A Sociology and Ontology of Information Securing

This study examines information security as a process (information securing) in terms of what it does, especially beyond its obvious role of protector. It investigates concepts related to ‘ontology of becoming’, and examines what it is that information securing produces. The research is theory driven and draws upon three fields: sociology (especially actor-network theory), philosophy (especially Gilles Deleuze and Félix Guattari’s concept of ‘machine’, ‘territory’ and ‘becoming’, and Michel Serres’s concept of ‘parasite’), and information systems science (the subject of information security). Social engineering (used here in the sense of breaking into systems through non-technical means) and software cracker groups (groups which remove copy protection systems from software) are analysed as examples of breaches of information security. Firstly, the study finds that information securing is always interruptive: every entity (regardless of whether or not it is malicious) that becomes connected to information security is interrupted. Furthermore, every entity changes, becomes different, as it makes a connection with information security (ontology of becoming). Moreover, information security organizes entities into different territories. However, the territories – the insides and outsides of information systems – are ontologically similar; the only difference is in the order of the territories, not in the ontological status of entities that inhabit the territories. In other words, malicious software is ontologically similar to benign software; they both are users in terms of a system. The difference is based on the order of the system and users: who uses the system and what the system is used for. Secondly, the research shows that information security is always external (in the terms of this study it is a ‘parasite’) to the information system that it protects. Information securing creates and maintains order while simultaneously disrupting the existing order of the system that it protects. For example, in terms of software itself, the implementation of a copy protection system is an entirely external addition. In fact, this parasitic addition makes software different. Thus, information security disrupts that which it is supposed to defend from disruption. Finally, it is asserted that, in its interruption, information security is a connector that creates passages; it connects users to systems while also creating its own threats. For example, copy protection systems invite crackers and information security policies entice social engineers to use and exploit information security techniques in a novel manner.

Establishment of a Cross-European Field Site Network in the ALARM Project for Assessing Large-Scale Changes in Biodiversity

The field site network (FSN) plays a central role in conducting joint research within all Assessing Large-scale Risks for biodiversity with tested Methods (ALARM) modules and provides a mechanism for integrating research on different topics in ALARM on the same site for measuring multiple impacts on biodiversity. The network covers most European climates and biogeographic regions, from Mediterranean through central European and boreal to subarctic. The project links databases with the European-wide field site network FSN, including geographic information system (GIS)-based information to characterise the test location for ALARM researchers for joint on-site research. Maps are provided in a standardised way and merged with other site-specific information. The application of GIS for these field sites and the information management promotes the use of the FSN for research and to disseminate the results. We conclude that ALARM FSN sites together with other research sites in Europe jointly could be used as a future backbone for research proposals

Beneath a learning management system: understanding the human information interaction in information systems

Studies on learning management systems have largely been technical in nature with an emphasis on the evaluation of the human computer interaction (HCI) processes in using the LMS. This paper reports a study that evaluates the information interaction processes on an eLearning course used in teaching an applied Statistics course. The eLearning course is used as a synonym for information systems. The study explores issues of missing context in stored information in information systems. Using the semiotic framework as a guide, the researchers evaluated an existing eLearning course with the view to proposing a model for designing improved eLearning courses for future eLearning programmes. In this exploratory study, a survey questionnaire is used to collect data from 160 participants on an eLearning course in Statistics in Applied Climatology. The views of the participants are analysed with a focus on only the human information interaction issues. Using the semiotic framework as a guide, syntactic, semantic, pragmatic and social context gaps or problems were identified. The information interactions problems identified include ambiguous instructions, inadequate information, lack of sound, interface design problems among others. These problems affected the quality of new knowledge created by the participants. The researchers thus highlighted the challenges of missing information context when data is stored in an information system. The study concludes by proposing a human information interaction model for improving the information interaction quality issues in the design of eLearning course on learning management platforms and those other information systems.

Using GIS Network Analyst to Identify Suppliers for a Produce Co-op in Waterville, ME

The idea for organizing a cooperative market on Waterville Main Street was proposed by Aime Schwartz in the fall of 2008. The Co-op would entail an open market located on Main Street to provide fresh, local produce and crafts to town locals. Through shorter delivery distances and agreements with local farmers, the co-op theoretically will offer consumers lower prices on produce than can be found in conventional grocery stores, as well as an opportunity to support local agriculture. One of the tasks involved with organizing the Co-op is to source all of the produce from among the hundreds of farmers located in Maine. The purpose of this project is to show how Geographic Information System (GIS) tools can be used to help the Co-op and other businesses a) site nearby farms that carry desired produce and products, and b) determine which farms are closest to the business site. Using GIS for this purpose will make it easier and more efficient to source produce suppliers, and reduce the workload on business planners. GIS Network Analyst is a tool that provides network-based spatial analysis, and can be used in conjunction with traditional GIS technologies to determine not only the geometric distance between points, but also distance over existing networks (like roads). We used Network Analyst to find the closest produce suppliers to the Co-op for specific produce items, and compute how far they are over existing roads. This will enable business planners to source potential suppliers by distance before contacting individual farmers, allowing for more efficient use of their time and a faster planning process.

Development Of Water Pollution Early Warning System For Oyster Harvesting Areas

The objective of this study is to develop a Pollution Early Warning System (PEWS) for efficient management of water quality in oyster harvesting areas. To that end, this paper presents a web-enabled, user-friendly PEWS for managing water quality in oyster harvesting areas along Louisiana Gulf Coast, USA. The PEWS consists of (1) an Integrated Space-Ground Sensing System (ISGSS) gathering data for environmental factors influencing water quality, (2) an Artificial Neural Network (ANN) model for predicting the level of fecal coliform bacteria, and (3) a web-enabled, user-friendly Geographic Information System (GIS) platform for issuing water pollution advisories and managing oyster harvesting waters. The ISGSS (data acquisition system) collects near real-time environmental data from various sources, including NASA MODIS Terra and Aqua satellites and in-situ sensing stations managed by the USGS and the NOAA. The ANN model is developed using the ANN program in MATLAB Toolbox. The ANN model involves a total of 6 independent environmental variables, including rainfall, tide, wind, salinity, temperature, and weather type along with 8 different combinations of the independent variables. The ANN model is constructed and tested using environmental and bacteriological data collected monthly from 2001 – 2011 by Louisiana Molluscan Shellfish Program at seven oyster harvesting areas in Louisiana Coast, USA. The ANN model is capable of explaining about 76% of variation in fecal coliform levels for model training data and 44% for independent data. The web-based GIS platform is developed using ArcView GIS and ArcIMS. The web-based GIS system can be employed for mapping fecal coliform levels, predicted by the ANN model, and potential risks of norovirus outbreaks in oyster harvesting waters. The PEWS is able to inform decision-makers of potential risks of fecal pollution and virus outbreak on a daily basis, greatly reducing the risk of contaminated oysters to human health.

Interactive system for placement and coordination of overcurrent protective devices

In this paper, an expert and interactive system for developing protection system for overhead and radial distribution feeders is proposed. In this system the protective devices can be allocated through heuristic and an optimized way. In the latter one, the placement problem is modeled as a mixed integer non-linear programming, which is solved by genetic algorithm (GA). Using information stored in a database as well as a knowledge base, the computational system is able to obtain excellent conditions of selectivity and coordination for improving the feeder reliability indices. Tests for assessment of the algorithm efficiency were carried out using a real-life 660-nodes feeder. © 2006 IEEE.