scholarly journals An approach to modular and testable security models of real-world health-care applications

2011 ◽  
Author(s):  
Achim D. Brucker ◽  
Lukas Brügger ◽  
Paul Kearney ◽  
Burkhart Wolff
Keyword(s):  
Health Care ◽  
Real World ◽  
World Health ◽  
Security Models ◽  
Health Care Applications

scholarly journals The Health Care Sector’s Experience of Blockchain: A Cross-disciplinary Investigation of Its Real Transformative Potential

10.2196/24109 ◽  
2021 ◽  
Vol 23 (12) ◽  
pp. e24109
Author(s):  
Karen Yeung
Keyword(s):  
Health Care ◽  
Data Sharing ◽  
Real World ◽  
Social Trust ◽  
World Health ◽  
Successful Development ◽  
Computational Trust ◽  
Fine Grained ◽  
Blockchain Technology ◽  
Health Care Applications

Background Academic literature highlights blockchain’s potential to transform health care, particularly by seamlessly and securely integrating existing data silos while enabling patients to exercise automated, fine-grained control over access to their electronic health records. However, no serious scholarly attempt has been made to assess how these technologies have in fact been applied to real-world health care contexts. Objective The primary aim of this paper is to assess whether blockchain’s theoretical potential to deliver transformative benefits to health care is likely to become a reality by undertaking a critical investigation of the health care sector’s actual experience of blockchain technologies to date. Methods This mixed methods study entailed a series of iterative, in-depth, theoretically oriented, desk-based investigations and 2 focus group investigations. It builds on the findings of a companion research study documenting real-world engagement with blockchain technologies in health care. Data were sourced from academic and gray literature from multiple disciplinary perspectives concerned with the configuration, design, and functionality of blockchain technologies. The analysis proceeded in 3 stages. First, it undertook a qualitative investigation of observed patterns of blockchain for health care engagement to identify the application domains, data-sharing problems, and the challenges encountered to date. Second, it critically compared these experiences with claims about blockchain’s potential benefits in health care. Third, it developed a theoretical account of challenges that arise in implementing blockchain in health care contexts, thus providing a firmer foundation for appraising its future prospects in health care. Results Health care organizations have actively experimented with blockchain technologies since 2016 and have demonstrated proof of concept for several applications (use cases) primarily concerned with administrative data and to facilitate medical research by enabling algorithmic models to be trained on multiple disparately located sets of patient data in a secure, privacy-preserving manner. However, blockchain technology is yet to be implemented at scale in health care, remaining largely in its infancy. These early experiences have demonstrated blockchain’s potential to generate meaningful value to health care by facilitating data sharing between organizations in circumstances where computational trust can overcome a lack of social trust that might otherwise prevent valuable cooperation. Although there are genuine prospects of using blockchain to bring about positive transformations in health care, the successful development of blockchain for health care applications faces a number of very significant, multidimensional, and highly complex challenges. Early experience suggests that blockchain is unlikely to rapidly and radically revolutionize health care. Conclusions The successful development of blockchain for health care applications faces numerous significant, multidimensional, and complex challenges that will not be easily overcome, suggesting that blockchain technologies are unlikely to revolutionize health care in the near future.

Diagnosis of deep-vein thrombosis: Adherence to guidelines and outcomes in real-world health care

2009 ◽  
Vol 102 (12) ◽  
pp. 1234-1240 ◽  
Author(s):  
Horst Gerlach ◽  
Viola Hach-Wunderle ◽  
Eberhard Rabe ◽  
Hanno Riess ◽  
Heike Carnarius ◽  
...  
Keyword(s):  
Health Care ◽  
Deep Vein Thrombosis ◽  
Ambulatory Care ◽  
Real World ◽  
Diagnostic Methods ◽  
World Health ◽  
Vein Thrombosis ◽  
Deep Vein ◽  
Work Up ◽  
Current Guidelines

SummaryCurrent guidelines recommend optimised algorithms for diagnosis of suspected deep-vein thrombosis (DVT). There is little data to determine to what extent real-world health care adheres to guidelines, and which outcome in terms of diagnostic efficiency and safety is achieved. This registry involved patients with clinically suspected DVT of the leg recruited in German ambulatory care between October and December 2005. Registry items were: diagnostic methods applied; diagnostic categories at day 1; and venous thromboembolic events up to 90 days in patients without firmly established DVT. A total of 4,976 patients were recruited in 326 centres. Venous ultrasonography was performed in 4,770 patients (96%), D-dimer assay in 1,773 patients (36%) and venography in 288 patients (6%). At day 1, DVT was confirmed in 1,388 patients (28%), and ruled out in 3,389 patients (68%), and work-up was inconclusive in 199 patients (4%).The rate of venous thromboembolism at 90 days was 0.34% (95% confidence interval [CI]: 0.09 to 0.88) in patients in whom the diagnosis of DVT had been ruled out, and 2.50% (95% CI: 0.69 to 6.28) in patients with inconclusive diagnostic workup. This nationwide evaluation in German ambulatory care revealed that the diagnostic work-up for suspected DVT did not adhere to current guidelines. However, the overall diagnostic safety was excellent, although there is potential for improvement in a well defined minority of patients.The TULIPA registry was funded by GlaxoSmithKline GmbH und Co KG, Munich.

scholarly journals Real-world utilization and outcomes of the Veterans Health Administration’s smoking cessation text message program

2020 ◽  
Author(s):  
Dana E Christofferson ◽  
Paul A Dennis ◽  
Jeffrey S Hertzberg ◽  
Jean C Beckham ◽  
Jennifer Knoeppel ◽  
...  
Keyword(s):  
Health Care ◽  
Smoking Cessation ◽  
Real World ◽  
Primary Outcome ◽  
Text Message ◽  
Safety Net ◽  
World Health ◽  
Veterans Health ◽  
Female Population ◽  
Health Care Settings

Abstract Introduction Smoking cessation mobile health (mHealth) programs are effective and have been recommended for integration into health care services but have not been evaluated in real-world health care settings. The Veterans Health Administration (VHA), a safety net health care provider, provides health care for 9 million U.S. military veterans. VHA implemented the SmokefreeVET text message program in 2013. Methods A retrospective evaluation of 6,153 SmokefreeVET subscribers was conducted. The primary outcome was 30-day self-reported abstinence at 6 months. Secondary outcomes included percentage of opt outs, program completers, and 30-day self-reported abstinence at 3 months. Results SmokefreeVET subscribers were on average 47.5 years old and 71.4% male. Smoking cessation medication use was reported by 11.5% of subscribers at the start of their quit attempt and subscribers enrolled in the program for an average of 29 days. Subscribers who were younger, female, and heavier smokers were more likely to opt out of the six-week program early. The abstinence rate for the primary outcome, self-reported 30-day abstinence at 6 months among all subscribers was 3.7%. Conclusions SmokefreeVET enrolled a younger and more female population of subscribers than other studies of veterans interested in tobacco treatment. The mHealth program was generally acceptable to veterans, yet strategies to increase retention may improve completion rates and outcomes. In this real-world setting, nearly half of the mHealth program subscribers combined use of the text program with smoking cessation medication. Further study of the optimal combination of mHealth with smoking cessation treatments is needed. Implications mHealth smoking cessation programs can be effectively implemented within real-world health care settings, even in those serving disadvantaged populations. Further research to improve mHealth program efficacy and integration into clinical settings will increase the population-level impact of these effective smoking cessation programs.

scholarly journals Real-World Health Care Resource Utilisation Among Patients With Chronic Heart Failure: A Canadian Assessment

2014 ◽  
Vol 17 (3) ◽  
pp. A119
Author(s):  
R.J. Petrella ◽  
P. Liu ◽  
S. Chiva-Razavi ◽  
C. Deschaseaux ◽  
A. Sagkriotis
Keyword(s):  
Heart Failure ◽  
Health Care ◽  
Chronic Heart Failure ◽  
Real World ◽  
Health Care Resource ◽  
World Health ◽  
Resource Utilisation

scholarly journals Co-creating and Evaluating a Web-app Mapping Real-World Health Care Services for Students: The servi-Share Protocol

2017 ◽  
Vol 6 (2) ◽  
pp. e24 ◽  
Author(s):  
Ilaria Montagni ◽  
Emmanuel Langlois ◽  
Jérôme Wittwer ◽  
Christophe Tzourio
Keyword(s):  
Health Care ◽  
Real World ◽  
Health Care Services ◽  
World Health ◽  
Care Services ◽  
Web App

scholarly journals Analysis of real-world health care costs among immunocompetent patients aged 50 years or older with herpes zoster in the United States

2017 ◽  
Vol 13 (8) ◽  
pp. 1861-1872 ◽  
Author(s):  
Juliana L. Meyers ◽  
Shweta Madhwani ◽  
Debora Rausch ◽  
Sean D. Candrilli ◽  
Girishanthy Krishnarajah ◽  
...  
Keyword(s):  
United States ◽  
Health Care ◽  
Herpes Zoster ◽  
Health Care Costs ◽  
Real World ◽  
The United States ◽  
World Health ◽  
Care Costs ◽  
Immunocompetent Patients
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