Healthcare interfaces

In summary, currerrt trairring and education create another barrier to improving safety culture because they do not support the development of shared norms and behaviours across different professional groups. Rather they create professional silos. The net effect of the current training approach is that doctors and nurses carmot walk in each other s shoes. Handovers, where multi-disciplinary team input is needed to commimicate safety information across healthcare interfaces, illustrate this issue very well. All too often, nurses seek nursing information and doctors want to hand over a clinical management plan in which key information required by the nurses is not included. 

Service delivery is the interface between the healthcare system and its patients where the ultimate goal is effective treatment of health problems. This decision point encompasses inpatient and outpatient care, drug administration or dispensing and counseling, ADE monitoring, and patient compliance. 

Electrospray ionization (ESI), a very powerful MS ionization mode, has been coupled with liquid chromatography becoming a popular tool in biomolecular analysis and drug analysis applications [1], Use of HPLC or ultra performance liquid chromatography (UPLC) combined with a mass spectrometry through the interface—ESI has become a powerful and routinely used analytical tool for many fields in scientific research, pharma industry, healthcare, and clinical diagnostic applications. 

Most analytical devices used in clinical laboratories are directly linked or connected via an electronic interface to a laboratory information system (LIS). In this progression, many different informatic functions (see Chapter 18) are used, including the electronic transfer of data from the analyzers to the LIS and ultimately into a patient s electronic medical record. This provides healthcare professionals with quick, accurate, and appropriate access to the patient s medical history and information. 

With the most comprehensive food knowledge base and set of program features, Nutritionist Pro provides thorough analysis of diets, recipes, and menus. The intuitive user interface design and powerful functionality of Nutritionist Pro can help ease the workload and boost the productivity of nutrition professionals in virtually any healthcare delivery, food service, or educational setting. 

Healthcare providers (physicians, hospitals, clinics, etc.) operate and are sustained by the reimbursement or payment for care they provide to patients. In the United States, revenue for healthcare services comes from a variety of sources including the patient, insurance companies (i.e., Blue-Cross/BlueShield, Cigna, Aetna), and the Centers for Medicare and Medicaid Services (CMS), formerly the Health Care Financing Administration (HCFA). The CMS provides healthcare insurance for Medicare and Medicaid beneficiaries. When interfacing with an insurance company or the CMS, there are three fundamental reimbursement concepts that must be considered to assure appropriate revenue for services provided. These include the concepts of coverage, coding, and payment. 

Hardware and software - constitutes the physical infrastructure, computer code, user interfaces, operating system and other software dependencies which make up the technical system. These components will typically be assembled according to a strategic architecture drawn np by the manufacturer or healthcare organisation and designed to balance cost, performance, functionality and resilience. 

Similarly the specification of client workstations can also impact the perceived performance at the user interface. In the trend to move to cloud-based architectures the amount of processing undertaken by the client machine is often quite small. However this cannot be assumed and it important that healthcare organisations ensure that local technology meets the minimum specification provided by the manufacturer. Organisations should take into account the fact that client machines could be simultaneously running other software which could compete for processing power. 

Documenting a clinical risk assessment takes time and effort. But, where a healthcare organisation wishes a fix to be prioritised on the basis of its impact on clinical safety, it seems reasonable for that request to be backed up by an objective analysis. Manufacturers are often more than willing to prioritise serious concerns but support staff who are often non-clinical need the right information to justify escalation. Where the issue is in relation to a user interface component, anonymised screenshots are vital on the basis that a picture paints a thousand words and that safety issues are often very subtle. 

FIGURE 42.4 Otto Bock SiOCX socket system (Otto Bock Healthcare, GmbH, Duderstadt, Germany). The socket consists of an inner made of HTV silicone that connects to the outer composite socket using a mechanical screw interface. 

Continued acknowledgment and improvement in device human factors—especially as they apply to the device-user interface. As devices become increasingly human-friendly and their operation more intuitively obvious, the consequence of use errors is minimized, and patient injuries and deaths are also reduced. One of the best ways of assessing the human factors associated with device design is still done through prepurchase evaluations performed within the user s actual clinical environment. Here, the Agency for Healthcare Research and Quality also recommends ... 

At the moment it seems safe to say that there is excessive reliance in healthcare on human memory and other fallible processes computers, memory and decision aids of all kinds are grossly underused. The boundaries of the human machine interface will change over time, as we develop more powerful and sophisticated systems and accept that clinical expertise, essential though it is, does not necessarily bring reliability and consistency to routine operations. In some areas however, there have already been considerable advances a notable example is the use of computerized systems in the process of medication administration. 

At the forefront of engineering innovation in healthcare are ways of interfacing devices such as prosthetic limbs to the peripheral nervous systems and brain [10], These can, for example, aim to allow movement of a prosthetic limb with subconscious control of a type similar to that of natural limbs. Such developments raise issues regarding the nature and status of the delegated action, which is partly controlled by a microprocessor. Provision of non-invasive brain-computer interfaces to aid patients with degenerative conditions such as amyotrophic lateral syndrome (Tocked-in syndrome ) may require very detailed knowledge of how the brain processes information and how this is affected by the condition. 

Consider the textiles within a healthcare environment in terms of the total surface area, not in terms of different product types and there is an immediate realisation of the potential for textiles in this eontext if the interface of the surface and the user is fully exploited, especially when combined with smart technologies. 

Educate and involve patients and their families in the change processes under way. Healthcare facilities undergoing change and transition to a true safety culture should consider the three overlapping organizational levels impacted by change (1) enviromnental, (2) organizational, and (3) the clinical interface between clinicians and patients. 

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