Privacy and trust management for electronic health records

Establishing a nationwide Electronic Health Record system has become a primary objective for many countries around the world, including Australia, in order to improve the quality of healthcare while at the same time decreasing its cost. Doing so will require federating the large number of patient data repositories currently in use throughout the country. However, implementation of EHR systems is being hindered by several obstacles, among them concerns about data privacy and trustworthiness. Current IT solutions fail to satisfy patients’ privacy desires and do not provide a trustworthiness measure for medical data. This thesis starts with the observation that existing EHR system proposals suer from six serious shortcomings that aect patients’ privacy and safety, and medical practitioners’ trust in EHR data: accuracy and privacy concerns over linking patients’ existing medical records; the inability of patients to have control over who accesses their private data; the inability to protect against inferences about patients’ sensitive data; the lack of a mechanism for evaluating the trustworthiness of medical data; and the failure of current healthcare workflow processes to capture and enforce patient’s privacy desires. Following an action research method, this thesis addresses the above shortcomings by firstly proposing an architecture for linking electronic medical records in an accurate and private way where patients are given control over what information can be revealed about them. This is accomplished by extending the structure and protocols introduced in federated identity management to link a patient’s EHR to his existing medical records by using pseudonym identifiers. Secondly, a privacy-aware access control model is developed to satisfy patients’ privacy requirements. The model is developed by integrating three standard access control models in a way that gives patients access control over their private data and ensures that legitimate uses of EHRs are not hindered. Thirdly, a probabilistic approach for detecting and restricting inference channels resulting from publicly-available medical data is developed to guard against indirect accesses to a patient’s private data. This approach is based upon a Bayesian network and the causal probabilistic relations that exist between medical data fields. The resulting definitions and algorithms show how an inference channel can be detected and restricted to satisfy patients’ expressed privacy goals. Fourthly, a medical data trustworthiness assessment model is developed to evaluate the quality of medical data by assessing the trustworthiness of its sources (e.g. a healthcare provider or medical practitioner). In this model, Beta and Dirichlet reputation systems are used to collect reputation scores about medical data sources and these are used to compute the trustworthiness of medical data via subjective logic. Finally, an extension is made to healthcare workflow management processes to capture and enforce patients’ privacy policies. This is accomplished by developing a conceptual model that introduces new workflow notions to make the workflow management system aware of a patient’s privacy requirements. These extensions are then implemented in the YAWL workflow management system.

An investigation of rail condition monitoring by Fibre Bragg Grating sensors

Condition monitoring on rails and train wheels is vitally important to the railway asset management and the rail-wheel interactions provide the crucial information of the health state of both rails and wheels. Continuous and remote monitoring is always a preference for operators. With a new generation of strain sensing devices in Fibre Bragg Grating (FBG) sensors, this study explores the possibility of continuous monitoring of the health state of the rails; and investigates the required signal processing techniques and their limitations.

Research and application of Building Information Modelling (BIM) in the Architecture, Engineering and Construction (AEC) industry : a review and direction for future research

With an increasing level of collaboration amongst researchers, software developers and industry practitioners in the past three decades, building information modelling (BIM) is now recognized as an emerging technological and procedural shift within the architect, engineering and construction (AEC) industry. BIM is not only considered as a way to make a profound impact on the professions of AEC, but is also regarded as an approach to assist the industry to develop new ways of thinking and practice. Despite the widespread development and recognition of BIM, a succinct and systematic review of the existing BIM research and achievement is scarce. It is also necessary to take stock on existing applications and have a fresh look at where BIM should be heading and how it can benefit from the advances being made. This paper first presents a review of BIM research and achievement in AEC industry. A number of suggestions are then made for future research in BIM. This paper maintains that the value of BIM during design and construction phases is well documented over the last decade, and new research needs to expand the level of development and analysis from design/build stage to postconstruction and facility asset management. New research in BIM could also move beyond the traditional building type to managing the broader range of facilities and built assets and providing preventative maintenance schedules for sustainable and intelligent buildings

Knowledge infrastructure : managing the assets of creative urban regions

Urban infrastructure along the hard forms such as roads, electricity, water and sewers also includes the soft forms such as research, training, innovation and technology. Knowledge and creativity are keys to soft infrastructure and socioeconomic development. Many city administrations around the world adjust their endogenous development strategies increasingly by investing in soft infrastructure and aiming for a knowledge-based development. At this point, the mapping and management of knowledge asset of cities has become a critical issue for promoting creative urban regions. The chapter scrutinizes the relations between knowledge assets and urban infrastructures and examines the management model to improve soft infrastructure provision.

Case management educational intervention with public health nurses : cluster randomized controlled trial

Aim: This paper is a report of a study conducted to determine the effectiveness of a community case management collaborative education intervention in terms of satisfaction, learning and performance among public health nurses. Background: Previous evaluation studies of case management continuing professional education often failed to demonstrate effectiveness across a range of outcomes and had methodological weaknesses such as small convenience samples and lack of control groups. Method: A cluster randomised controlled trial was conducted between September 2005 and February 2006. Ten health centre clusters (5 control, 5 intervention) recruited 163 public health nurses in Taiwan to the trial. After pre-tests for baseline measurements, public health nurses in intervention centres received an educational intervention of four half-day workshops. Post-tests for both groups were conducted after the intervention. Two-way repeated measures analysis of variance was performed to evaluate the effect of the intervention on target outcomes. Results: A total of 161 participants completed the pre- and post-intervention measurements. This was almost a 99% response rate. Results revealed that 97% of those in the experimental group were satisfied with the programme. There were statistically significant differences between the two groups in knowledge (p = 0.001), confidence in case management skills (p = 0.001), preparedness for case manager role activities (p = 0.001), self-reported frequency in using skills (p = 0.001), and role activities (p = 0.004). Conclusion: Collaboration between academic and clinical nurses is an effective strategy to prepare nurses for rapidly-changing roles.

Infrastructure asset management: The challenges and approaches

Infrastructure organisations such as airport, seaport, rail and road are operating in an increasingly challenging business environment as a result of globalisation, privatisation and deregulation. These organisations must ensure that their main resource i.e. their infrastructure assets are well managed in order to support their business operations. Brisbane Airport is used as a case study to understand the challenges faced in the management of infrastructure assets as well as the approaches used to overcome them. The findings can be useful in helping asset managers to identify the resources they should seek to manipulate in order to make improvement to their activities and contribute to the overall performance of their organisation.

Geographical information systems : an effective planning and decision-making platform for community health coalitions in Australia

The development of locally-based healthcare initiatives, such as community health coalitions that focus on capacity building programs and multi-faceted responses to long-term health problems, have become an increasingly important part of the public health landscape. As a result of their complexity and the level of investment, it has become necessary to develop innovative ways to help manage these new healthcare approaches. Geographical Information Systems (GIS) have been suggested as one of the innovative approaches that will allow community health coalitions to better manage and plan their activities. The focus of this paper is to provide a commentary on the use of GIS as a tool for community coalitions and discuss some of the potential benefits and issues surrounding the development of these tools.

Structural health monitoring of bridges : source localisation in acoustic emission technique

Managing the sustainability of urban infrastructure requires regular health monitoring of key infrastructure such as bridges. The process of structural health monitoring involves monitoring a structure over a period of time using appropriate sensors, extracting damage sensitive features from the measurements made by the sensors, and analysing these features to determine the current state of the structure. Various techniques are available for structural health monitoring of structures, and acoustic emission is one technique that is finding an increasing use in the monitoring of civil infrastructures such as bridges. Acoustic emission technique is based on the recording of stress waves generated by rapid release of energy inside a material, followed by analysis of recorded signals to locate and identify the source of emission and assess its severity. This chapter first provides a brief background of the acoustic emission technique and the process of source localization. Results from laboratory experiments conducted to explore several aspects of the source localization process are also presented. The findings from the study can be expected to enhance knowledge of the acoustic emission process, and to aid the development of effective bridge structure diagnostics systems.

Damage localisation in beams and plates using vibration characteristics

Dynamic computer simulation techniques are used to develop and apply a multi-criteria procedure, incorporating changes in natural frequencies, modal flexibility and the modal strain energy, for damage localisation in beams and plates. Numerically simulated modal data obtained through finite element analyses are used to develop algorithms based on changes of modal flexibility and modal strain energy before and after damage and used as the indices for assessment of the state of structural health. The proposed procedure is illustrated through its application to flexural members under different damage scenarios and the results confirm its feasibility for damage assessment.

Chronic disease, geographic location and socioeconomic disadvantage as obstacles to equitable access to e-health

Despite recent public attention to e-health as a solution to rising healthcare costs and an ageingpopulation, there have been relatively few studies examining the geographical pattern of e-health usage. This paper argues for an equitable approach to e-health and attention to the way in which e-health initiatives can produce locational health inequalities, particularly in socioeconomically disadvantaged areas. In this paper, we use a case study to demonstrate geographical variation in Internet accessibility, Internet status and prevalence of chronic diseases within a small district. There are signifi cant disparities in access to health information within socioeconomically disadvantaged areas. The most vulnerable people in these areas are likely to have limited availability of, or access to Internet healthcare resources. They are also more likely to have complex chronic diseases and, therefore, be in greatest need of these resources. This case study demonstrates the importance of an equitable approach to e-health information technologies and telecommunications infrastructure.

The key to successful implementation : project management of sustainable infrastructure provision

Delivering infrastructure projects involves many stakeholders. Their responsibilities and authorities vary over the course of the project lifecycle - from establishing the project parameters and performance requirements, to operating and maintaining the completed infrastructure. To ensure the successful delivery of infrastructure projects, it is important for the project management team to identify and manage the stakeholders and their requirements. This chapter discusses the management of stakeholders in delivering infrastructure projects, from their conception to completion. It includes managing the stakeholders for project selection and involving them to improve project constructability, operability and maintainability.

Preface : rethinking sustainable development : urban management, engineering, and design

In an atmosphere where civilization is progressing and becoming more aware of the consequences of careless development decisions, rethinking sustainable development - particularly sustainable urban and infrastructure development - has become an inevitable necessity. ------ ----- Rethinking Sustainable Development: Urban Management, Engineering, and Design considers the role of urban, regional and infrastructure planning in achieving sustainable urban and infrastructure development, providing insights into overcoming the consequences of unsustainable development. This companion volume to Sustainable Urban and Regional Infrastructure: Technology, Planning and Management, overviews all aspects of sustainable urban and infrastructure development.

Engineering curricula in the 21st century : the global scenario and challenges for India

In the 21st century's global economy, the new challenges facing the engineering profession have arrived, confirming the need to restructure engineering curricula, teaching and learning practices, and processes, including assessment. Possessing merely technical knowledge no longer guarantees an engineering graduate a successful career. And while all countries are facing this dilemma, India is struggling the most. It has been argued that most Indian engineering educational institutions struggle with the systemic problem of centralisation coupled with an archaic examination system that is detrimental to student learning. This article examines some internationally renowned educational institutions that are embracing the growing importance of non-technical subjects and soft skills in 21st century engineering curricula. It will then examine the problems that India faces in doing the same.

An analysis of the variability in Queensland WiM data

The Queensland Department of Main Roads uses Weigh-in-Motion (WiM) devices to covertly monitor (at highway speed) axle mass, axle configurations and speed of heavy vehicles on the road network. Such data is critical for the planning and design of the road network. Some of the data appears excessively variable. The current work considers the nature, magnitude and possible causes of WiM data variability. Over fifty possible causes of variation in WiM data have been identified in the literature. Data exploration has highlighted five basic types of variability specifically: ----- • cycling, both diurnal and annual;----- • consistent but unreasonable data;----- • data jumps;----- • variations between data from opposite sides of the one road; and ----- • non-systematic variations.----- This work is part of wider research into procedures to eliminate or mitigate the influence of WiM data variability.

Strategic management practices in the construction industry : a study of Indonesian enterprises

Since the establishment of the first national strategic development plan in the early 1970s, the construction industry has played an important role in terms of the economic, social and cultural development of Indonesia. The industry’s contribution to Indonesia’s gross domestic product (GDP) increased from 3.9% in 1973 to 7.7% in 2007. Business Monitoring International (2009) forecasts that Indonesia is home to one of the fastest-growing construction industries in Asia despite the average construction growth rate being expected to remain under 10% over the period 2006 – 2010. Similarly, Howlett and Powell (2006) place Indonesia as one of the 20 largest construction markets in 2010. Although the prospects for the Indonesian construction industry are now very promising, many local construction firms still face serious difficulties, such as poor performance and low competitiveness. There are two main reasons behind this problem: the environment that they face is not favourable; the other is the lack of strategic direction to improve competitiveness and performance. Furthermore, although strategic management has now become more widely used by many large construction firms in developed countries, practical examples and empirical studies related to the Indonesian construction industry remain scarce. In addition, research endeavours related to these topics in developing countries appear to be limited. This has potentially become one of the factors hampering efforts to guide Indonesian construction enterprises. This research aims to construct a conceptual model to enable Indonesian construction enterprises to develop a sound long-term corporate strategy that generates competitive advantage and superior performance. The conceptual model seeks to address the main prescription of a dynamic capabilities framework (Teece, Pisano & Shuen, 1997; Teece, 2007) within the context of the Indonesian construction industry. It is hypothesised that in a rapidly changing and varied environment, competitive success arises from the continuous development and reconfiguration of firm’s specific assets achieving competitive advantage is not only dependent on the exploitation of specific assets/capabilities, but on the exploitation of all of the assets and capabilities combinations in the dynamic capabilities framework. Thus, the model is refined through sequential statistical regression analyses of survey results with a sample size of 120 valid responses. The results of this study provide empirical evidence in support of the notion that a competitive advantage is achieved via the implementation of a dynamic capability framework as an important way for a construction enterprise to improve its organisational performance. The characteristics of asset-capability combinations were found to be significant determinants of the competitive advantage of the Indonesian construction enterprises, and that such advantage sequentially contributes to organisational performance. If a dynamic capabilities framework can work in the context of Indonesia, it suggests that the framework has potential applicability in other emerging and developing countries. This study also demonstrates the importance of the multi-stage nature of the model which provides a rich understanding of the dynamic process by which asset-capability should be exploited in combination by the construction firms operating in varying levels of hostility. Such findings are believed to be useful to both academics and practitioners, however, as this research represents a dynamic capabilities framework at the enterprise level, future studies should continue to explore and examine the framework in other levels of strategic management in construction as well as in other countries where different cultures or similar conditions prevails.