Optimization of and the Use of IT for Healthcare Processes
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ItemThe Digital Transformation of Physician–Patient Consultations: Identifying Problems and Approaches to Improve Adherence( 2019-01-08)There is evidence for a correlation between effective physician–patient communication in consultations and improved adherence to treatment. Lack of time, limited communication training, growing administrative duties, and low recall of physicians’ information and recommendations by patients are antagonists to effective physician–patient communication. In interviews with physicians, therapists, and patients, we first identify problems of current consultation practices and condense them in a problem scenario. We then use interview results to explore potential solutions, applying modern information technology such as digital medical assistants. Lastly, those potential solutions are condensed in an activity scenario that can be used for further design science research activities.
ItemThe Role of Mediators in Transforming and Translating Information Quality: A Case of Quality Assurance in a Norwegian Hospital Trust( 2019-01-08)The existing literature on information quality (IQ) provides limited understanding of how roles influence IQ in healthcare. The traditional way of understanding roles such as collectors, custodians, and consumers assumes that data are simply transformed into information and subsequently used by consumers. However, this does not explain how interpersonal communication influences IQ. In reality, the actors involved can actively change the quality of healthcare information through transformation, translation, or distortion. Latour’s idea of intermediaries and mediators can be an appropriate lens for understanding these roles. Latour defined intermediaries as socio-technical actors who simply transport information, whereas mediators can transform, translate, distort, and change the meaning of information. Following Latour’s idea, we conducted a qualitative case study of quality assurance in a Norwegian healthcare organization. In doing so, we illustrated how IQ mediators can distort or create shared understanding of quality assurance information, which further influences enactment.
ItemAn Integrated Decision Making Framework for Medical Audit Sampling( 2019-01-08)The loss of three to ten percent of annual health care expenditures to fraudulent transactions makes medical audits paramount. In order to handle the size and complexity of medical claims, the use of analytical methods and information technology tools to aid in medical audits is necessary. In general, sampling frameworks are utilized to choose representative claims. However, these are not integrated within audit decision-making procedures. As a novelty, this paper presents an integrated decision-making framework for medical audit sampling. We propose a simple but effective optimization method that uses sampling output and enables auditors address the trade-offs between audit costs and expected overpayment recovery. We use U.S. Medicare Part B claims payment data to demonstrate the framework.
ItemCentralising the Admission Process in a German Hospital( 2019-01-08)The admission process is the first part of a hospital stay for all in- and outpatients. For the hospital, it is a critical part as all the necessary data must be stored in the hospital information system and all legal documents have to be signed in order to guarantee the best possible treatment and efficient logistics. In this paper, we focus on the admission process in a German hospital. As the admission of a patient, especially informing and advising him, is very time consuming, the hospital aims at installing a digital admission process. The first important step towards this goal is pooling the current decentralised patient admission in one new building. Using a simulation, we determine efficient staffing levels and rosters for the centralised admission and analyse the expected waiting times for the patients. In addition, we outline potential steps towards a digital patient admission process.
ItemOptimal Dispatch of Volunteers to Out-of-hospital Cardiac Arrest Patients( 2019-01-08)Initiatives with mobile phone dispatched volunteers to out-of-hospital cardiac arrest (OHCA) cases, can be found today in some countries, e.g. Sweden, the Netherlands, Switzerland and Italy. When an OHCA case is reported, an alarm is sent to the registered volunteers’ phones. However, the allocation of which volunteers to send to the automatic external defibrillator (AED) and who to send directly to the patient, is today based on simple rules of thumb. In this paper, we propose a model to optimally select how many and which volunteers to send directly to the patient, and who should pick up and deliver an AED. The results show that the model can help increase the survivability of the patients, compared to simple decision rules.