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Satellite communication has played an important part in many different industries because of its advantages of wide coverage, strong disaster tolerance and high flexibility. The security of satellite communication systems has always been the concern of many scholars. Without authentication, user should not obtain his/her required services. Beyond that, the anonymity also needs to be protected during communications. In this study, we design an efficient and provably secure key agreement scheme for satellite communication systems. In each session, we replace user's true identity by a temporary identity, which will be updated for each session, to guarantee the anonymity. Because the only use of lightweight algorithms, our proposed scheme has high performance. Furthermore, the security of the proposed scheme is proved in the real-or-random model and the performance analysis shows that the proposed scheme is more efficient than some other schemes for satellite communication systems., Competing Interests: The authors have declared that no competing interests exist.

The use of information systems in healthcare (HIS) has been recognised as having crucial importance in improving the efficiency, cost-effectiveness, quality, and safety of medical care delivery. HIS has the potential to improve individuals' health and providers' performance by producing better quality, cost savings, and greater patient involvement in their own health. There have been two major drivers for the HIS investments in healthcare: The ever-increasing burden from chronic disease with costs growing significantly faster and the recognition of the need for greatly improved quality and safety in health delivery. Maturity models (MM) are based on the premises that people, organizations, functional areas and processes evolve through a process of development or growth towards a more advanced maturity, going through a distinct number of levels. Through a state-of-the-art review of HIS, focused on their maturity state, we identify and characterize a set of critical factors recognized as determinants in the context of HIS maturity. The article identifies a broad spectrum of MM applied to the health sector and its characteristics and reinforces the belief that the maturity of HIS can contribute to the quality of information and knowledge management in the sector.

Along with the digital revolution, information and communication technology applications are currently transforming the delivery of health and social care services. This paper investigates prevailing opinions toward future technology-based healthcare solutions among Austrian healthcare professionals. During a biphasic online Delphi survey, panelists rated expected outcomes of two future scenarios describing pervasive health monitoring applications. Experts perceived that the scenarios were highly innovative, but only moderately desirable, and that their implementation could especially improve patients' knowledge, quality of healthcare, and living standard. Contrarily, monetary aspects, technical prerequisites, and data security were identified as key obstacles. We further compared the impact of professional affiliation. Clearly, opinions toward pervasive healthcare differed between the interest groups, medical professionals, patient advocates, and administrative personnel. These data suggest closer collaborations between stakeholder groups to harmonize differences in expectations regarding pervasive health monitoring.

Objectives: The incidence of pediatric acute pancreatitis (AP) increased over the past 2 decades and is estimated to be 3 to 13 per 100,000. The impact of rising AP incidence on health care costs is unknown. Our aim was to examine pediatric AP admissions and associated hospital costs in the United States between years 2004 and 2014., Methods: Acute pancreatitis admission and cost data were extracted from the Pediatric Health Information System. We determined AP admission and cost percentages each year, as well as the ratio of AP cost to admission percentages to estimate AP "burden." Length of stay, costs of hospitalization, and the effect of intensive care unit care on these estimates were examined., Results: Between 2004 and 2014, AP admission percentages increased (P = 0.002). Length of stay decreased over time (P < 0.0001) and was longer for those requiring intensive care unit care (P < 0.0001). Acute pancreatitis admissions cost per day significantly increased over time (P < 0.0001). Median AP cost percentage remained 1.2 to 1.7 times higher than AP admission percentage., Conclusions: Acute pancreatitis admissions constitute an expensive burden on the health care system relative to the percentage of all admissions. If AP admissions continue to increase, the cost of AP admissions may pose a substantial financial health care burden.

Background: The growth of "big data" and the emphasis on patient-centered health care have led to the increasing use of two key technologies: personalized medicine and digital medicine. For these technologies to move into mainstream health care and be reimbursed by insurers, it will be essential to have evidence that their benefits provide reasonable value relative to their costs. These technologies, however, have complex characteristics that present challenges to the assessment of their economic value. Previous studies have identified the challenges for personalized medicine and thus this work informs the more nascent topic of digital medicine., Objectives: To examine the methodological challenges and future opportunities for assessing the economic value of digital medicine, using personalized medicine as a comparison., Methods: We focused specifically on digital biomarker technologies and multigene tests. We identified similarities in these technologies that can present challenges to economic evaluation: multiple results, results with different types of utilities, secondary findings, downstream impact (including on family members), and interactive effects., Results: Using a structured review, we found that there are few economic evaluations of digital biomarker technologies, with limited results., Conclusions: We conclude that more evidence on the effectiveness of digital medicine will be needed but that the experiences with personalized medicine can inform what data will be needed and how such analyses can be conducted. Our study points out the critical need for typologies and terminology for digital medicine technologies that would enable them to be classified in ways that will facilitate research on their effectiveness and value., (Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.)

Information and Communications Technologies in healthcare has increased the need to consider quality criteria through standardised processes. The aim of this study was to analyse the software quality evaluation models applicable to healthcare from the perspective of ICT-purchasers. Through a systematic literature review with the keywords software, product, quality, evaluation and health, we selected and analysed 20 original research papers published from 2005-2016 in health science and technology databases. The results showed four main topics: non-ISO models, software quality evaluation models based on ISO/IEC standards, studies analysing software quality evaluation models, and studies analysing ISO standards for software quality evaluation. The models provide cost-efficiency criteria for specific software, and improve use outcomes. The ISO/IEC25000 standard is shown as the most suitable for evaluating the quality of ICTs for healthcare use from the perspective of institutional acquisition.

Background: To address the need for timely and comprehensive human resources for health (HRH) information, governments and organizations have been actively investing in electronic health information interventions, including in low-resource settings. The economics of human resources information systems (HRISs) in low-resource settings are not well understood, however, and warrant investigation and validation., Case Description: This case study describes Uganda's Human Resources for Health Information System (HRHIS), implemented with support from the US Agency for International Development, and documents perceptions of its impact on the health labour market against the backdrop of the costs of implementation. Through interviews with end users and implementers in six different settings, we document pre-implementation data challenges and consider how the HRHIS has been perceived to affect human resources decision-making and the healthcare employment environment., Discussion and Evaluation: This multisite case study documented a range of perceived benefits of Uganda's HRHIS through interviews with end users that sought to capture the baseline (or pre-implementation) state of affairs, the perceived impact of the HRHIS and the monetary value associated with each benefit. In general, the system appears to be strengthening both demand for health workers (through improved awareness of staffing patterns) and supply (by improving licensing, recruitment and competency of the health workforce). This heightened ability to identify high-value employees makes the health sector more competitive for high-quality workers, and this elevation of the health workforce also has broader implications for health system performance and population health., Conclusions: Overall, it is clear that HRHIS end users in Uganda perceived the system to have significantly improved day-to-day operations as well as longer term institutional mandates. A more efficient and responsive approach to HRH allows the health sector to recruit the best candidates, train employees in needed skills and deploy trained personnel to facilities where there is real demand. This cascade of benefits can extend the impact and rewards of working in the health sector, which elevates the health system as a whole.

Context: A recent systematic review found that use of an immunization information system (IIS) is an effective intervention to increase vaccination rates. The purpose of this review was to evaluate costs and benefits associated with implementing, operating, and participating with an IIS. The speed of technology change has had an effect on costs and benefits of IIS and is considered in this review., Evidence Acquisition: An economic evaluation for IIS was conducted using methods developed for Community Guide systematic reviews. The literature search covered the period from January 1994 to March 2012 and identified 12 published articles and 2 government reports., Evidence Synthesis: Most studies involving cost data evaluated (1) system costs of building an IIS and (2) cost of exchanging immunization data; most economic benefits focused on administrative efficiency., Conclusions: A major challenge to evaluating a technology-based intervention is the evolution that comes with technology improvements and advancements. Although the cost and benefit data may be less applicable today due to changes in system technology, data exchange methods, availability of vendor support, system functionalities, and scope of IIS, it is likely that more up-to-date estimates and comprehensive estimates of benefits would support the findings of cost savings in this review. More research is needed to update and address limitations in the available evidence and to enable assessment of economic costs and benefits of present-day IIS.

Small and midsize healthcare organizations may not have the IT capabilities to properly evaluate software offerings. Organizations can avoid choosing inappropriate software by asking questions, reading reviews, and vetting the software. If an IT installation fails to work properly, hospitals can respond by seeking a settlement or filing suit.

Recent studies demonstrate the potential of Mobile Health (mHealth) to improve quality of care and efficiency in low- and middle- income countries (LMIC). However, strong evidence of their impact, especially in large scale projects is still missing. The objective of this paper is to provide an overview about the current status of mHealth in LMIC, and to identify Requirements and possible Strategies to strength their health systems. A search in Pubmed was performed, which resulted in 427 articles. Restricting the search to review papers published during the last 5 years, 72 publications were identified and characterized, and the more relevant articles analyzing mHealth use, impact and/or adoption in LMIC from a more generic perspective were analyzed in detail. Finally, based on the literature, and complemented with the authors own reflections and experience, mHealth challenges and strategies were identified and presented according to the WHO Health Systems Framework which identifies six main lines of action to improve the performance of health systems: service delivery, health workforce, health information systems, essential medical products and technologies, health financing and governance.

In September 2014, the FDA will establish a unique device identification (UDI) system to aid hospitals in better tracking and managing medical devices and analyzing their effectiveness. When these identifiers become part of patient medical records, the UDI system will provide a much-needed link between supply cost and patient outcomes. Hospitals should invest in technology and processes that can enable them to trace supply usage patterns directly to patients and analyze how these usage patterns affect cost and quality.

This contribution to the Ken D. Eason special issue is an illustration of the value of socio-technical analysis applied at an organizational level. We provide a brief historical overview of socio-technical IS research and review studies investigating the impact of IT on organizational structures in the last five decades, identifying a dominating (new) research theme in each decade. A key overall impact of IT in all decades has been a dramatic decrease in transaction costs making it increasingly easier for organizations to source from external providers. A five level taxonomy of sourcing arrangement is developed together with a framework of organizational activities, and a number of significant cases are offered of how organizations are sourcing practically all types of business processes, including innovation. We argue that future IT will further accelerate the movement towards more sourcing, eventually leading to a new type of organization that we call the Ambient organization., (Copyright © 2013 Elsevier Ltd and The Ergonomics Society. All rights reserved.)

The power management of ICT systems, that is, data processing (Dp) and telecommunication (Tlc) systems, is becoming a relevant problem in economical terms. Dp systems totalize millions of servers and associated subsystems (processors, monitors, storage devices, etc.) all over the world that need to be electrically powered. Dp systems are also used in the government of Tlc systems, which, besides requiring Dp electrical power, also require Tlc-specific power, both for mobile networks (with their cell-phone towers and associated subsystems: base stations, subscriber stations, switching nodes, etc.) and for wired networks (with their routers, gateways, switches, etc.). ICT research is thus expected to investigate into methods to reduce Dp- and Tlc-specific power consumption. However, saving power may turn into waste of performance, in other words, into waste of ICT quality of service (QoS). This paper investigates the Dp and Tlc power management policies that look at compromises between power saving and QoS.

Urban safety-net clinics are considered prime targets for the adoption of health information technology innovations; however, little is known about their utilization in such safety-net settings. Current scholarship provides limited guidance on the implementation of health information technology into safety-net settings as it typically assumes that adopting institutions have sufficient basic resources. This study addresses this gap by exploring the unique challenges urban resource-poor safety-net clinics must consider when adopting and utilizing health information technology. In-depth interviews (N = 15) were used with key stakeholders (clinic chief executive officers, medical directors, nursing directors, chief financial officers, and information technology directors) from staff at four clinics to explore (a) nonhealth information technology-related clinic needs, (b) how health information technology may provide solutions, and (c) perceptions of and experiences with health information technology. Participants identified several challenges, some of which appear amenable to health information technology solutions. Also identified were requirements for effective utilization of health information technology including physical infrastructural improvements, funding for equipment/training, creation of user groups to share health information technology knowledge/experiences, and specially tailored electronic billing guidelines. We found that despite the potential benefit that can be derived from health information technologies, the unplanned and uninformed introduction of these tools into these settings might actually create more problems than are solved. From these data, we were able to identify a set of factors that should be considered when integrating health information technology into the existing workflows of low-resourced urban safety-net clinics in order to maximize their utilization and enhance the quality of health care in such settings.

This study assessed the effectiveness of a fully automated surveillance system for the detection of healthcare-associated infections (HCAIs) in intensive care units. Manual ward surveillance (MS) and electronic surveillance (ES) were performed for two intensive care units of the Vienna General Hospital. All patients admitted for a period longer than 48 h between 13 November 2006 and 7 February 2007 were evaluated according to HELICS-defined rules for HCAI. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and personnel time spent per surveillance type were calculated. Ninety-three patient admissions were observed, whereby 30 HCAI episodes were taken as a reference standard. Results with MS versus ES were: sensitivity 40% versus 87%, specificity 94% versus 99%, PPV 71% versus 96%, NPV 80% versus 95%, and time spent per surveillance type 82.5 h versus 12.5 h. In conclusion, ES was found to be more effective than MS while consuming fewer personnel resources.

The performance of a classification system depends on the context in which it will be used, including the prevalence of the classes and the relative costs of different types of errors. Metrics such as accuracy are limited to the context in which the experiment was originally carried out, and metrics such as sensitivity, specificity, and receiver operating characteristic area--while independent of prevalence--do not provide a clear picture of the performance characteristics of the system over different contexts. Graphing a prevalence-specific metric such as F-measure or the relative cost of errors over a wide range of prevalence allows a visualization of the performance of the system and a comparison of systems in different contexts.

We sought to better understand the perceived costs and benefits of joining a nascent health information exchange (HIE) from the perspective of potential provider organization participants. We therefore conducted semi-structured interviews with organizational representatives. Interview transcriptions were thematically coded, and coded text was subsequently aggregated to summarize the breadth and depth of responses. Although no respondents expected HIE to result in net financial benefit to their organization, all respondents recognized some potential benefits, and some respondents expected HIE to result in overall organizational benefit. Disproportionate benefit was expected for the poorest, sickest patients. Many respondents had concerns about HIE increasing the risk of data security breaches, and these concerns were most pronounced at larger organizations. We found little evidence of organizational concern regarding loss of patients to other organizations or publication of unfavorable quality data. If HIE's greatest benefactors are indeed the poorest, sickest patients, our current health care financing environment will make it difficult to align HIE costs with benefits. To sustain HIE, state and federal governments may need to consider ongoing subsidies. Furthermore, these governments will need to ensure that policies regulating data exchange have sufficient nationwide coordination and liability limitations that the perceived organizational risks of joining HIEs do not outweigh perceived benefits. HIE founders can address organizational concerns by attempting to coordinate HIE policies with those of their largest founding organizations, particularly for data security policies. Early HIE development and promotional efforts should not only focus on potential benefits, but should also address organizational concerns.

The Health Information Technology for Economic and Clinical Health Act is intended to enhance reimbursement of health care providers for meaningful use of electronic health records systems. This presents both opportunities and challenges for public health departments. To earn incentive payments, clinical providers must exchange specified types of data with the public health system, such as immunization and syndromic surveillance data and notifiable disease reporting. However, a crisis looms because public health's information technology systems largely lack the capabilities to accept the types of data proposed for exchange. Cloud computing may be a solution for public health information systems. Through shared computing resources, public health departments could reap the benefits of electronic reporting within federal funding constraints.

Background: During the pandemic (H1N1) 2009 influenza vaccination campaign, health regions in Canada collected client-level immunization data using fully electronic or hybrid systems, with the latter comprising both electronic and paper-based elements. The objective of our evaluation was to compare projected five-year costs associated with implementing these systems in Ontario public health units (PHUs) during pandemic and seasonal influenza vaccination campaigns., Methods: Six PHUs provided equipment and staffing costs during the pandemic (H1N1) 2009 influenza vaccination campaign and staffing algorithms for seasonal campaigns. We standardized resources to population sizes 100,000, 500,000 and 1,000,000, assuming equipment lifetime of five years and public health vaccine administration rates of 18% and 2.5% for H1N1 and seasonal campaigns, respectively. Two scenarios were considered: Year 1 pandemic and Year 1 seasonal campaigns, each followed by four regular influenza seasons. Costs were discounted at 5%., Results: Assuming a Year 1 pandemic, the five-year costs per capita for the electronic system decrease as PHU population size increases, becoming increasingly less costly than hybrid systems ($4.33 vs. $4.34 [100,000], $4.17 vs. $4.34 [500,000], $4.12 vs. $4.34 [1,000, 000]). The same trend is observed for the scenario reflecting five seasonal campaigns, with the electronic system being less expensive per capita than the hybrid system for all population sizes ($1.93 vs. $1.95 [100,000], $1.91 vs. $1.94 [500,000], $1.87 vs. $1.94 [1,000, 000]). Sensitivity analyses identified factors related to nurse hours as affecting the direction and magnitude of the results., Conclusions: Five-year cost projections for electronic systems were comparable or less expensive than for hybrid systems, at all PHU population sizes. An intangible benefit of the electronic system is having data rapidly available for reporting.

The number of institutions implementing AIMS is increasing. Shortcomings in the design and implementation of EMRs have been associated with unanticipated consequences, including changes in workflow. These have often resulted from the carryover of paper-based documentation practices into an electronic environment. The new generation of mobile devices allows providers to have situational awareness of multiple care sites simultaneously, possibly allowing for improved proactive decision making. Although potentially facilitating safer anesthetic supervision, technologic and cultural barriers remain. Security, quality of information delivery, regulatory issues, and return on investment will continue as challenges in implementing and maintaining this new technology., (Copyright © 2011 Elsevier Inc. All rights reserved.)

This article addresses the brief history of anesthesia information management systems (AIMS) and discusses the vendors that currently market AIMS. The current market penetration based on the information provided by these vendors is presented and the rationale for the purchase of AIMS is discussed. The considerations to be evaluated when making a vendor selection are also discussed., (Copyright © 2011 Elsevier Inc. All rights reserved.)

In 2010, the Centers for Medicare and Medicaid Services (CMS) published its final rule describing plans for incentivizing eligible professionals (EPs) and eligible hospitals to become meaningful users of electronic health record (EHR) technology using funds provided by the Health Information Technology for Economic and Clinical Health (HITECH) Act. Beginning in 2011, non-hospital-based EPs can earn monetary benefits for meeting meaningful use criteria through implementation of certified EHR technology. Most anesthesiologists qualify as non-hospital-based EPs under CMS' new hospital-based definition. The authors distill CMS' final rule into its most basic facts and requirements and explain the implications for US anesthesiologists., (Copyright © 2011. Published by Elsevier Inc.)

The meaningful use attestation period opened in April. Will hospitals be ready to apply?

Recognition of the improvements in patient safety, quality of patient care, and efficiency that health care information systems have the potential to bring has led to significant investment. Globally the sale of health care information systems now represents a multibillion dollar industry. As policy makers, health care professionals, and patients, we have a responsibility to maximize the return on this investment. To this end we analyze alternative licensing and software development models, as well as the role of standards. We describe how licensing affects development. We argue for the superiority of open source licensing to promote safer, more effective health care information systems. We claim that open source licensing in health care information systems is essential to rational procurement strategy.

Monitoring, evaluation, and surveillance measure how well public health programs operate over time and achieve their goals. As countries approach malaria elimination, these activities will need to shift from measuring reductions in morbidity and mortality, to detecting infections (with or without symptoms) and measuring transmission. Thus, the monitoring and evaluation and surveillance research and development agenda needs to develop the tools and strategies that will replace passive surveillance of morbidity with active and prompt detection of infection, including confirmation of interruption of transmission by detecting present and past infections, particularly in mobile populations. The capacity to assess trends and respond without delay will need to be developed, so that surveillance itself becomes an intervention. Research is also needed to develop sensitive field tests that can detect low levels of parasitaemia, together with strategies for their implementation. Other areas to explore include the rigorous evaluation of the utility of more detailed maps of disease and infection incidence and prevalence, the development of new maps to inform programmatic responses and the use of surveillance technologies based on cell phone or real-time internet Web-based reporting. Because any new strategies for monitoring and evaluation and surveillance for eradication have major implications for program implementation, research is also needed to test systems of delivery for acceptability, feasibility, efficiency, cost-effectiveness, and community engagement. Finally, there is a clear need to systematically review the information from past elimination efforts for malaria and other infectious diseases.

Objective: To evaluate and analyze health information systems (his) in the Mesoamerican Region., Material and Methods: The conceptual framework and tools of the Health Metrics Network (nhm) was used. It measures six components of the his assessment: resources, indicators, data sources, information management, products and use., Results: In this study we found that the average score of the HIS in the Mesoamerican region was 57%, being the maximum value for Mexico (75%) and the minimum for El Salvador (41%). The item that had lowest scores was that referring to the Management and Administration, where the average assessment was 37%, placing it as present but not adequate. The component with the highest score was Information Products with more than 69%, adequate. In any case, no items were very adequate., Conclusion: The performance of his is heterogeneous between countries. It is necessary to strengthen and standardize the criteria of the his in the region, so that these are integrated and used in the decision making process based on real information.

As healthcare financial executives plan their health IT investments, they should evaluate not only the technology, but also the governance model. Hospitals need health-centric collaboration of stakeholders and a sustainable business model to ensure the success of their IT investment. The whole enterprise of health IT should be about improving the health delivery system and reducing its cost.