or country that will decide to use this instrument to trigger SMES'digitization and contribute to their business development
a business website and using it profitably, learning to use e-commerce tools to buy or sell,
4. 9 RFID and Bar-coding...15 4. 10 Business intelligence...15 5. Examples of Best Practice...
16 5. 1 Trinity Health...16 5. 2 York Hospitals...17 5. 3 Sundhed. dk...
Under the auspices of HISI (Health Informatics Society of Ireland), Prorec Ireland and The irish Computer Society, an ICT Industry group was established in mid-2009 to report
on the role that Healthcare ICT can play in delivering a world class health system to the
We would also like to thank the Health Informatics Society of Ireland, Prorec Ireland and The irish Computer Society for their role in the initiative,
and Enterprise Ireland, BT and Microsoft for the provision of physical and electronic facilities to support the activities of
the group The essential tenet of the document is that lives can be saved, patient care outcomes improved
as electronic transfer of medical data between professionals, e-prescriptions and lab tests electronically communicated to patients.
2 ehealth is Worth it, the economic benefits of implemented ehealth solutions at ten European sites, Karl A
the long term outlook is indeed bleak Looking at some of the problems in more detail, we note that some 60%of the public
Anecdotal and real data demonstrate excessive costs for overtime, medical card payments and drugs compared with European averages.
the internet, and will come to expect effective and safe medical care as a matter of course.
patient data delivery to the point of care. Collectively, this is often referred to as the 5 Rights of Medication:
by moving patient data instantly to where it is needed, and using electronic systems to order & view lab, radiology and other tests at high speed
not share) medical data, and also by moving the doctor-patient relationship towards a model of †shared care†through the use of disease management systems.
educate, inform and collaborate via the internet also promotes patient engagement independent living and better self management,
A number of key technologies were identified as proven catalysts to significant healthcare improvement, efficiently and effectively meeting the increasing demands of
Electronic Health Records aggregate patient-centric health data from the patient record systems of multiple independent healthcare organisations.
Many EHRS include detailed clinical data such as individual lab results and prescription refill information EHRS are used commonly to transfer a patient†s healthcare information between
less time and effort spent capturing patient data when crossing organisational boundaries. Additionally, ensuring the interoperability of these systems,
Communications, is defined as the computer system that allows direct entry of medical orders by the person with the licensure and privileges to do so.
into a computer, at the point of care, has the benefit of reducing errors by minimising the
data to be transmitted electronically between the prescribing health professional and the pharmacy, making prescribing and dispensing safer and more convenient for patients
It allows patients to book appointments on site at the surgery, over the phone or over the internet in the way that is most convenient for
them. Electronic appointment booking systems can exist as standalone applications but in highly integrated environment can often be found embedded in systems such as
The Personal Health Record (PHR) is based an Internet patient owned and patient controlled set of tools that allow people to access
dependents) through education and monitoring as well as enable the exchange of data with others regarding their health.
4. 9 RFID and Bar-coding Radio frequency identification (RFID) is a technology that allows traceable chips, called
RFID tags, carrying a set of predetermined information to be embedded in objects. RFID readers can pick up radio signals
which provide particular information related to the carrier such as identification number, name, and medication requirements These technologies can be used in a number of ways in a medical setting.
For example Patients can be provided with identification wristbands carrying an RFID tag or a barcode that will be used throughout the patient†s stay in hospital.
The tag or barcode would allow caregivers to positively identify and match patients to their care †for
example to ensure that the right medicines are going to the right patient. This technology also allows patients to be tracked within the hospital,
Bar-coding/RFID can also be used for inventory management and equipment tracking which allows for improved utilisation of
4. 10 Business intelligence (BI) for Real time Detection of Hospital Infection Patterns Through the collection, storage, analysis and interpretation of data, Business intelligence
systems can generate valuable actionable knowledge for tactical and strategic decision support, trend recognition, forecast, predictive modelling and strategic analysis
Business intelligence and in particular Data mining are useful tools in the detection of outbreaks when used for the real time detection of infection trends within hospitals
used to analyse vast amount of data in real time and to help distinguish patterns that could indicate abnormal situations that would require further attention or action from
Informatics technologies which have an EHR at their core, the Trinity Health Group have been able automate
administration, provision of access to evidence-based clinical data for clinicians and identification of opportunities for clinical, operational, financial and regulatory
York Hospitals NHS Foundation Trust have converged a voice and data network with almost 4000 phones and over 2000 PCS.
A system has been developed to make use of the wireless network, using wireless phones which integrate with the hospital†s patient
record There are two main routes for emergency admissions into the Hospital. A GP may phone the hospital to arrange an emergency admission, at which point the Bed Manager
system, and send a message to the wireless phone on the on-call doctor (s) while the
From either a wireless phone or a computer screen on the ward, the medical staff will be able to see some basic details of the patient
further message is sent to the wireless phone, informing the doctor that the patient is present.
The doctor, using the phone, can acknowledge and accept the admission which lets others know they have accepted the responsibility of attending the patient.
list of â€oemy patients†is always accessible on the wireless phone. The staff on the ward
The public health portal, Sundhed. dk now integrates health-related data from disparate healthcare systems throughout Denmark.
health records, view data from the National Patient Register and communicate with other healthcare providers.
For patients, the portal offers access to health-related data e-consultations and the ability to communicate with healthcare providers
As of 2006, more than 170,000 users were accessing the portal every month. More than 86,000 citizens and 4, 000 healthcare professionals are able to access the portal with
to the phone Patients can renew their prescriptions online, view test results and receive electronic
and the utilisation of this real-time electronic data to reduce claims unpaid. A solution was developed which addressed all of the issues detailed above which also seamlessly
Enterprise-wide collaboration software Overview The Secretaria Municipal de Saã de de Belo Horizonte (SMSA-BH), reorganised its
Doctors use the software's instant messaging capability to consult with each other for quick questions or opinions in a secure real-time environment.
complex cases, healthcare professional can schedule a Web conference, which enables multiple doctors to collaborate in real time
bespoke hospital information systems and clinical research databases. â€oepaper kills†is how Newt Gingrich (Former US House Speaker) described the problem of paper health
The purpose of this section is to position Information technology in the context of the benefits across the entire continuum of individual and patient care.
implementation of information technology. Specific examples of benefits realised are listed under the following headings and colour coded to position their benefit in
Specific examples of benefits realised through information technology, as outlined in the Gartner study of 6 EU member states on behalf of the Swedish Ministry of Health and
Reducing Hospital Acquired Infections (HAI) through Business intelligence and Data -Mining for Real time Detection of Infections
member states through the use of Business intelligence and Data mining for real time detection of in-hospital infections.
Reducing inpatient Mistaken Identity Medication Errors through RFID and Barcoding for Medication Administration Over 200 inpatient mistaken identity errors could be avoided in the UK and another 200
in The netherlands every year through the use of RFID and Barcoding for medication administration in hospitals.
Increasing availability by Reducing Hospitalisation Bed-days through Computer-based Patient Record with Computerised Physician/Provider Order Entry
Record/Computer-based Patient Record Over 800,000 unnecessary laboratory tests on patients could be avoided in England
healthcare data warehouse, both government and the HSE will be positioned better to measure, monitor and forecast future healthcare demand
sites, Karl A. Stroetmann, Tom jones, Alexander Dobrev, Veli N. Stroetmann, Sept 2006 European commission Health IT, Explaining International IT Application Leadership, Daniel Castro, Sept 2009, The
Information technology & Innovation Foundation (ITIF ehealth Strategy 2008 to 2011, The Scottish government/NHS Scotland ehealth, Priorities and Strategies in European countries, March 2007, European commission
Enabling Healthcare Reform Using Information technology, Recommendations for the Obama Administration and 111th Congress, Dec 2008, Healthcare Information and Management
Evidence on the Costs and Benefits of Health Information technology, May 2008, Congress of The United states Congressional Budget Office
Cisco systems dabl Disease Management Systems DMF Systems ecom Ireland Garivo Technologies GE Healthcare IBM IMS MAXIMS
Intel Microsoft Oracle PA Consulting Pricewaterhousecoopers Total Training Xyea ICT€ s Role in Healthcare Transformation
Report of the Health ICT Industry Group Page 32 Appendix B Companies who have reviewed the report
and wish to be associated with the content -Bearingpoint eircom Helix Health Hewlett packard Financial services IBEC IMEC Technologies
Irish Software Assocation isoft Lincor Solutions MANITEX Silicon & Software systems (S3 Slã¡inte Technologies System Dynamics
WP/14/79 European Productivity, Innovation and Competitiveness: The Case of Italy Andrew Tiffin  2013 International monetary fund WP/14/79
The Conference Board, Total Economy Database 6 0 %20 %40 %60 %80 %100 %1995 2007 2011
competing with other countries in the supply of iphones, but rather in the supply of final
and quality upgrades have featured prominently in this regard (Codogno 2009). ) Export quality cannot be observed directly, but the clearest evidence of this trend
4wto/UNCTAD relative unit-value data is available at: http://www. intracen. org/country/italy
Micro data on Italian firms confirms that this indeed has been a large part of the Italian story†where the manufacturing
available at http://www. imf. org/external/pubs/ft/scr/2013/cr13298. pdf and http://www. imf. org/external/pubs/ft/scr/2012/cr12167. pdf
16 Table 1. Changes in World Market Share and Shift-share Decomposition Large Exporters, 1995†2011
IMF Staff calculations using BACI database, developed by Gaulier & Zingano 2010 19 Appendix Shift-Share Analysis and Competitiveness (from ECB, 2012
analysis (ANOVA) of bilateral export data, disaggregated by product. The methodology is based on Cheptea and others (2005),
The computation of the method consists of four main steps Step 1: Compute midpoint growth rates
each year in the data. Hence, if Î is the intercept, Ï is the regression coefficient for exporter
Computation of the indices from the estimated coefficients From the estimated coefficients, growth is decomposed for each exporter (i e.,
Data The analysis draws from the BACI product-level database developed from COMTRADE data by Gaulier & Zingano (2010),
which provides reconciled USD flow figures on more than 200 countries over roughly 5000 products of the Harmonized System (HS
classification. Following Cheptea and others (2012), flows below USD10, 000 and those involving micro states are excluded,
the regressions, 6-digit product data are aggregated down to the 2-digit level Caveats Given the structure of the HS classification,
data 21 References Aghion, P, . and P. Howitt, 2009, â€oethe Economics of Growth, †(MIT Press
Evidence from a New Database of Competitiveness Indicatorsâ€, mimeo Ginsborg, P.,2003, â€oeitaly and Its Discontents:
taking into account user needs and addressing societal and ethical concerns. In this paper, we focus on ICT innovations related to home healthcare domain, in
integrity of the data chain and techniques that help service providers to assess the reliability of information and data contributed by patients.
This paper sketches various lines of research for the development of trusted healthcare ser -vices namely, patient compliance, reliability of information in healthcare, and
user friendly access control 1 Introduction The high bandwidth connectivity provided by the Internet enables new services to
support citizens in their daily lives. An important category of these services is healthcare services.
new propositions are based on the Internet. One of the important impediments for the use of the Internet is the lack of trust.
Trust is a requirement for the widespread adop -tion of healthcare services by clients (patients), by caregivers and by the parties that
reliability, integrity of the data chain, as well as techniques that help physicians to assess the reliability of information
and data contributed by patients. There is a need for an integrated and easy to understand approach to trust in terms of security, priva
-cy, and transparency, where users can make informed decisions whether to trust a service and can control the usage of their personal information
service provider in terms of privacy of the data chain and physicians†trust in the reli -ability of information and data contributed by patients.
In particular, a number of questions should be addressed ï How can compliance with a treatment be measured reliably
ï Can a physician trust data measured by a patient at home ï How can patients use home healthcare services
patient compliance, reliability of information in healthcare, and user friendly access control. The paper discusses the existing proposals in these areas
It also means that they should be driven by user needs (not by technology), tak -ing into consideration economic, societal and environmental sustainability.
mobile devices to next generation gene sequencing. The creation of national/regional EHR infrastructures such as RHIO€ s in the US, the NHS Spine project in the United
commercial Web-based personal health record (PHR) systems such as Microsoft Healthvault. These applications process, store
-mation and allow for harnessing big data to improve healthcare Clinical decision systems assist healthcare providers with decision making task
anytime anywhere on their mobile devices New technologies for genome sequencing will make possible that everyone†s ge
combine consumer electronics and the Internet to connect patients and their care pro -viders, thus enabling new care models.
-tient†s physiological and other contextual data can be collected and transmitted to remote care providers for review or intervention.
-cose meter) a medical hub device that collects the data from measurement devices and sends them to a backend service.
also considered as part of this eco system (the measurement data is sent from the med -ical hub to a PHR system,
health data, thereby endangering people's privacy 3 Trusted Healthcare Services Electronic healthcare services offer important economic and social benefits for our
Indeed, trust is a prerequisite for the acceptance of these services by end users Trust establishment is crucial for physicians
healthcare providers need to trust the patient data they obtain remotely from the measurement devices deployed in patient†s home.
vital sign of a registered user is measured (not of his friends/children), that the meas
Home healthcare services monitor patients and gather data that is interpreted by medical professionals. Health and well
-ness services support people in need in many ways on the basis of personal and health
-viders in terms of privacy, reliability, integrity of the data. Standard Internet security techniques provide authentication and encryption of the communication with a service
However, they do not provide the user with means to control or even know how a service provider will actually use their personal information.
have mechanisms in place that allow users to make an informed decision to trust a service provider on the basis of facts, such as reputation and security attributes
These techniques allow users and service providers to trust each other and to benefit from these new services
ï A technical protocol to reliably assess the quality of medical data (e g.,, blood pres
ï A cryptographic technology for privacy preserving data mining of patient health data to support clinical research and knowledge creation for clinical decision sup
-port systems In the remainder of this paper, we will focus on trust management for home
ï Can a physician trust data measured by a patient at home? Home healthcare pa -tients measure physiological parameters at home,
and a physician uses this data to make treatment and diagnosis decisions. It is very important that the measurements
other users of measured home healthcare information to easily determine the trustwor -thiness of the information and patient compliance.
user friendly technologies which will allow patients to control the processing and sharing of their information.
methods and text mining techniques 15 In summary, several efforts have been devoted to the definition of methods for
Next to ensuring proper patient/device authentication, data authenticity and integrity, it is important to capture the correctness of the authentication process too
as auction websites and peer-to-peer sharing networks 19. Lately, reputation sys -tems have been proposed for healthcare.
-viders via a web portal or a health oriented network 20,21. Conversely, very few studies address patients†trustworthiness from the perspective of healthcare providers
18,22 mainly focus on the reliability of the data maintained in the form of electronic and personal health records
Additional problems appeared with the growing use of web portals rating healthcare services. Patients often subscribe to expert websites and search information
regarding their illness on the Internet. Although this practice may have advantages the major drawback concerns the trustworthiness of information.
For instance, in Revolution Health3 and other similar online community reputation systems, the trust -worthiness of information is assessed only by considering the information source.
trustworthiness of information originating from the Internet should be integrated An interesting research challenge is thus the design of solutions for measuring in
to data coming from the Internet. We believe that a reputation-based solution can ensure the reliability of home healthcare data needed by physicians.
To this end, it is necessary to investigate the issue of data trustworthiness from both healthcare provid
-ers and patients†perspectives and elicit the requirements for reputation systems to be 3 http://www. revolutionhealth. com
on data reliability should be easily accessible and understandable. Therefore, methods for assessing data reliability should be coupled with methods
and tools that visualize indicators for data reliability in a way that is understandable by end-users 4. 3 User friendly advanced access control
Healthcare services deal with very personal and sensitive information. The protection of sensitive information is enforced usually using access control.
Several access con -trol models have been proposed in the literature (see 25 for a survey. In particular
Furthermore, medical data can also be formed as arbitrary text such as a patient report made by healthcare practitioners, leading to the need for poli
The last years have seen an increasing interest in the development of user friendly privacy management and access control systems.
designed platforms which allow users to set their privacy and access control policies One example is Google dashboard privacy tool,
which through a web interface dis -plays to users what information about them is stored and who can access it.
Similarly social networks such as Facebook let users restrict or grant access to other users or groups on their data (e g.,
, wall posts, photos. Although these proposals provide a simple and straightforward solution, they neither allow users to understand the effect
of the specified policies nor ensure secure access control Therefore, a need for more flexible yet friendly privacy management exists.
Efforts such as privacy dashboard4, Privacyos project5, Primelife project6) and privacy room 34 provide tools (e g.,
, browser add-ons, mobile applications) for regulating the ex -posure of user data to the network.
Pearson et al. 35 propose a client privacy man -agement scheme based on data obfuscation (not necessarily using encryption) and
user â€oepersonasâ€. Although these proposals increase usability and flexibility, they do not provide users with the overview of the effect of the specified policy
In conclusion, although several studies on access control have been carried out, no comprehensive studies on user friendly access control for healthcare exist.
The chal -lenge is to define a novel access control model which guarantees an appropriate level
of security and allows users to specify the policies regulating the exposure of their 4 http://code. w3. org/privacy-dashboard/wiki
5 https://www. privacyos. eu /6 http://www. primelife. eu information to others. In addition, the model should be easy to use by end-users.
Ide -ally, the access control system should not only allow users to define access rules to their data but also support them in â€oevisualizing†the effect of the defined access con
-trol policy and therefore in ensuring that the created policy reflects user†s intentions The lack of such an overview might result in a loss of sensitive information.
For in -stance, a patient might set strict access rules regarding his health condition and his
The design of a user friendly access control model demands to conceptually divide the access control model in two layers:
-ping of high-level policies (specified by users) into enforceable policies can be achieved, for instance by enabling semantic interoperability between high level de
and the data objects in which such infor -mation is stored. The aim of this semantic alignment is to support the automatic gen
-eration of enforceable policies from the high-level policies specified by users. As a result, enforceable policies can be dynamically customizable with respect to user
preferences 5 Conclusions The growth of the Internet and ICT technologies had a large impact on modern
healthcare. A fundamental need is to design novel electronic healthcare services that improve people†s health
-bility of information in healthcare, and user friendly access control Acknowledgements. This work has been done in the context of the THECS project
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Copyright  UNU-WIDER 2010 1 Indian Institute of Science, email: bala@mgmt. iisc. ernet. in, 2 Anna University, Tiruchirapalli, 3 Indian
Institute of Science This study has been prepared within the UNU-WIDER project on Entrepreneurship and Development
balance, internal factors are likely to be more important core determinants of whether innovation plays a key role in success
Moreover, these studies focused on a particular year for data collection and are therefore, cross-sectional in nature.
sales, and data on economic variables such as employment, investment, sales turnover etc. The validity and reliability of the questionnaire was ensured and based on the
In the absence of an official database, we relied on the databases of SME associations
approached about 150 to 200 SMES in each of the sectors and gathered primary data from
data were gathered for a period of five years from 2001/2 to 2005/6. Data collection was
done during January†December 2007. While the first objective was analysed descriptively making use of frequency tables for innovative SMES, the second objective
We have gathered data on sales at current prices as well as on employment and the current value of investment (in plant and machinery) from the SMES of auto, electronics
years†data on sales comparable by converting the values of current prices into values at
the latest series of data on SSI production, which are given at current prices as well as at
The core objective of this paper is to ascertain the relationship between innovation and firm growth in the identified SME sectors.
The Role of User Firms in Japan and Korea. Amsterdam: Harwood Academic Publishers 15 Lehtimaki, A. 1991.
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