Papers by Nilmini Wickramasinghe
Financial model for investment recovery period in electronic health records implementations
International Journal of Economics and Business Research, 2015
Technology usage for better healthcare delivery is being emphasised in the USA and other advanced... more Technology usage for better healthcare delivery is being emphasised in the USA and other advanced nations. Electronic health records (EHR) are being widely seen as improving operational efficiency and reducing medication errors in clinic practices and hospitals. Further, hospitals and clinics stand to gain incentives from the federal government if they implement EHRs and demonstrate meaningful use of EHRs. While numerous other aspects of HER implementations is found in literature, financial models have not been well studied. Before implementing EHR, one must take into consideration investment recovery period considering the costs, savings and possible tax incentives. In this paper, we develop financial model for computing investment recovery period in EHR implementations assuming constant patient visits. We further develop required growth rate formula if investments need to be recovered in fixed number of years. The model is illustrated with numerical example.
Innovation in Aging
Heart failure (HF) affects approximately 26 million people globally resulting in morbidity, morta... more Heart failure (HF) affects approximately 26 million people globally resulting in morbidity, mortality, and rehospitalization. With 30-day rehospitalization rates ranging from 19% to 25%, HF is burdensome for patients and challenging for clinicians to manage. HF costs in the U.S. exceeded $30 billion in 2012, projected to exceed $70 billion by 2030, and produce estimated social care costs of 12 billion in 2020. Therefore, reducing HF readmissions should be a global priority. A technology-based platform may assist in the goal of reducing readmissions. This platform may accomplish this goal by providing several digital tools that can assist the clinician in the care process, while simultaneously enabling patients with self-care through more effective communication in all care settings. Digital twins (DT) and the nursing Avatar (NA) are two such tools. The DT is a virtual, real-time digital representation of a physical object/process. It originated from NASA to improve physical model si...
Healthcare Delivery in the Information Age, 2016
Facilitating Mobile Initiatives in Healthcare and Wellness Management
Advances in Healthcare Information Systems and Administration, 2020
Arguably, the most prevailing chronic disease today is diabetes. The World Health Organization (W... more Arguably, the most prevailing chronic disease today is diabetes. The World Health Organization (WHO) notes that diabetes is a silent epidemic, and by 2020, there will be a 54% rise in the total number of individuals diagnosed with this disease. These are distressing figures. Many are turning to technology solutions to assist. What becomes important is the ability to rapidly design and develop appropriate digital health and wellness solutions.
Advances in Medical Technologies and Clinical Practice, 2021
The novel coronavirus (SARS-CoV-2) first identified in Wuhan, China in late December 2019 was ide... more The novel coronavirus (SARS-CoV-2) first identified in Wuhan, China in late December 2019 was identified as a pandemic by the World Health Organization (WHO) in March 2020 and has caused tremendous disruption to economies around the world and significant loss of life and serious illness. The current outbreak which has been thought to have originated in an animal wet market in late 2019, being transferred from the horse shoe bat to the pangolin, is well adapted to human cell receptors. This enables it to easily infect people with an R0 of approximately 2.2 causing a respiratory illness (COVID-19) which can develop into pneumonia in moderate to severe cases. Older adults and people with underlying medical conditions are at higher risk. The following outlines a responsible digital health solution.
Cancer Medicine, 2019
BackgroundSmartphone technology represents an opportunity to deliver practical solutions for peop... more BackgroundSmartphone technology represents an opportunity to deliver practical solutions for people affected by cancer at a scale that was previously unimaginable, such as information, appointment monitoring, and improved access to cancer support services. This study aimed to determine whether a smartphone application (app) reduced the unmet needs among people newly diagnosed with cancer.MethodsA single blind, multisite randomized controlled trial to determine the impact of an app‐based, 4‐month intervention. Newly diagnosed cancer patients were approached at three health service treatment clinics.ResultsEighty‐two people were randomized (intervention; n = 43 and control; n = 39), average age was 59.5 years (SD: 12.9); 71% female; 67% married or in a de facto relationship. At baseline, there were no differences in participants’ characteristics between the groups. No significant effects, in reducing unmet needs, were demonstrated at the end of intervention (4‐month) or 12‐month follo...
Integrative Diabetes and Cardiovascular Diseases, 2019
As noted by the World Health Organization (WHO) diabetes is a silent epidemic, and by 2020 there ... more As noted by the World Health Organization (WHO) diabetes is a silent epidemic, and by 2020 there will be a 54% rise in the total number of individuals diagnosed with this disease. Moreover, diabetes is the most prevalent chronic disease globally today. What these figures underscore is that the current approaches to prevention and management of diabetes appear to be flawed and thus not delivering the desired results. While it is well recognized that early detection and proactive management of diabetes is essential, this paper suggests a technology solution to assist a key patient frustration around diet and meal planning; namely a solution that can frequently provide reliable information, decision support and guidance to empower people with type 2 diabetes.
Handbook of Research on Healthcare Administration and Management
In today's cost challenged healthcare environment accountable care and evidence-based decisio... more In today's cost challenged healthcare environment accountable care and evidence-based decision making have become important considerations. Contemporaneous to this is the fact that the superior management of diabetes has become a global priority especially given the exponential increase in the number of diabetes patients as well as the financial implications of treating this silent epidemic. Thus, this research focuses on trying to address these respective yet critical issues by examining the possibility of using a mobile web-based reporting system that taps into existing widely available resources to monitor and manage gestational diabetes. To test this solution, we adopted a randomized control trial with two-arm cross over applied to a not-for profit hospital in Victoria, Australia. From the perspective of practice, we have uncovered far reaching implications for hospital management's cost vs. quality care to patients. In particular, it appears that the adoption of smartph...
Handbook of Research on Healthcare Administration and Management
It is widely known that nurses are pivotal in coordinating and communicating patient care informa... more It is widely known that nurses are pivotal in coordinating and communicating patient care information in the complex network of healthcare professionals and service delivery. Yet, despite their pivotal role, information communication technologies have historically rarely been designed around nurses' operational needs. This could explain the poor integration of technologies into nursing work processes and consequent rejection by nursing professionals. The complex nature of acute care delivery in hospitals and the frequently interrupted patterns of nursing work suggest that nurses require flexible intelligent systems that can support and adapt to their variable workflow patterns. This study is designed to explore nurses' initial reactions to a new integrated point of care solution for acute healthcare contexts. We report on the first stage of a longitudinal project to use an innovative approach involving nurses in the development and refinement of this solution. Unified Theory of Acceptance and Use of Technology was used to evaluate acceptability of the proposed system by nurses.
Managing Gestational Diabetes Mellitus (GDM) with Mobile Web-Based Reporting of Glucose Readings
Healthcare Delivery in the Information Age, 2016
A pilot study is conducted to identify the potential benefits of utilising mobile Web-based repor... more A pilot study is conducted to identify the potential benefits of utilising mobile Web-based reporting of glucose readings in the management of gestational diabetes mellitus (GDM). Given the recent significant increases in GMD as well as the extraordinary increase in the penetration of mobile phones, it would appear prudent to investigate the possible benefits of using mobile technology to support patient self-management of their GDM, especially how this approach can improve with regard to information and knowledge access for the patient. The pilot study described serves to establish proof of concept of this approach.
Applying Predictive Analytics to Develop an Intelligent Risk Detection Application for Healthcare Contexts
Studies in health technology and informatics
Healthcare is an information rich industry where successful outcomes require the processing of mu... more Healthcare is an information rich industry where successful outcomes require the processing of multi-spectral data and sound decision making. The exponential growth of data and big data issues coupled with a rapid increase of service demands in healthcare contexts today, requires a robust framework enabled by IT (information technology) solutions as well as real-time service handling in order to ensure superior decision making and successful healthcare outcomes. Such a context is appropriate for the application of real time intelligent risk detection decision support systems using predictive analytic techniques such as data mining. To illustrate the power and potential of data science technologies in healthcare decision making scenarios, the use of an intelligent risk detection (IRD) model is proffered for the context of Congenital Heart Disease (CHD) in children, an area which requires complex high risk decisions that need to be made expeditiously and accurately in order to ensure successful healthcare outcomes.
Maximizing Healthcare Delivery and Management through Technology Integration
Rapid increase of service demands in healthcare contexts today requires a robust framework enable... more Rapid increase of service demands in healthcare contexts today requires a robust framework enabled by IT (information technology) solutions as well as real-time service handling in order to ensure superior decision making and successful healthcare outcomes. Contemporaneous with the challenges facing healthcare, we are witnessing the development of very sophisticated intelligent tools and technologies such as Business Analytics techniques. Therefore, it would appear to be prudent to investigate the possibility of applying such tools and technologies into various healthcare contexts to facilitate better risk detection and support superior decision making. The following serves to do this in the context of Total Hip and Knee Arthroplasty and Congenital Heart Disease.
Leading healthcare organizations are recognizing the need to incorporate the power of a decision ... more Leading healthcare organizations are recognizing the need to incorporate the power of a decision efficiency approach driven by intelligent solutions. The primary drivers for this include the time pressures faced by healthcare professionals coupled with the need to process voluminous and growing amounts of disparate data and information in shorter and shorter time frames and yet make accurate and suitable treatment decisions which have a critical impact on successful healthcare outcomes. This research contends that such a context is appropriate for the application of real time intelligent risk detection decision support systems using Business Intelligence (BI) technologies. The following thus proposes such a model in the context of the case of Congenital Heart Disease (CHD), an area which requires complex high risk decisions which need to be made expeditiously and accurately in order to ensure successful healthcare outcomes.
International Journal of Networking and Virtual Organisations, 2010
Diabetes is a chronic disease that increases exponentially. Its consequences are long-term and pr... more Diabetes is a chronic disease that increases exponentially. Its consequences are long-term and problematic. To date, there is no cure and patients must rely on appropriate and constant monitoring to maintain a state of health that is as good as possible. This paper proposes a superior method that is grounded in wireless technology and social networks to enable the effective and efficient monitoring of patients suffering from diabetes.
Technological Advancements and the Impact of Actor-Network Theory
The WHO has labelled diabetes the silent epidemic. This is because the instances of diabetes worl... more The WHO has labelled diabetes the silent epidemic. This is because the instances of diabetes worldwide continue to grow exponentially. In fact, by 2030 it is expected that there will be a 54% global increase. Thus, it behooves all to focus on solutions that can result in superior management of this disease. Hence, this chapter presents findings from a longitudinal exploratory case study that examined the application of a pervasive technology solution, a mobile phone to provide superior diabetes self-care. Notably, the benefits of a pervasive technology solution for supporting superior self-care in the context of chronic disease are made especially apparent when viewed through the rich lens of Actor-Network Theory (ANT), and thus, the chapter underscores the importance of using ANT in such contexts to facilitate a deeper understanding of all potential advantages.
2011 44th Hawaii International Conference on System Sciences, 2011
Healthcare professionals, especially surgeons must make complex decisions with far reaching conse... more Healthcare professionals, especially surgeons must make complex decisions with far reaching consequences and associated risks. As has been shown in other industries, the ability to drill down into pertinent data to explore knowledge behind the data greatly facilitates superior, informed decisions to ensue. This proposal proffers an Intelligent Risk Detection (IRD) Model using data mining techniques followed by Knowledge Discovery in order to detect the dominant risk factors across a complex surgical decision making process and thereby to predict the surgery results and hence support superior decision making. To illustrate the benefits of this model, the case of the Congenital Heart Disease (CHD) is presented 1 .
The Role for a Healthcare System of Systems Approach Coupled with Collaborative Technologies to Provide Superior Healthcare Delivery
Lean Thinking for Healthcare, 2013
Healthcare delivery in the United States exists at varying levels. The Cleveland Clinic, Johns Ho... more Healthcare delivery in the United States exists at varying levels. The Cleveland Clinic, Johns Hopkins, Kaiser, and the Mayo Clinic are noted for typically providing world class care. However, there also exist several instances of inferior delivery of care, mostly as a result of inefficient and ineffective processes which in turn result in poor access and low quality. One segment of the community that continues to suffer from issues pertaining to poor access and low quality is the American Indians and Alaska Natives (AI/AN) population. Such a situation is clearly untenable, especially given the plethora of tools, techniques, technologies, and tactics afforded by today’s knowledge economy. In this chapter, we proffer a model incorporating a system of systems approach in order to streamline process flows and thereby provide better healthcare delivery to Native American patients. We note that while this chapter specifically focuses on the case study of Native American patients we strongly urge for the incorporation of a system of systems perspective in all areas of healthcare delivery.
The Role of Healthcare System of Systems and Collaborative Technologies in Providing Superior Healthcare Delivery to Native American Patients
2012 45th Hawaii International Conference on System Sciences, 2012
Healthcare delivery throughout the United States occurs at varying standards of quality. One segm... more Healthcare delivery throughout the United States occurs at varying standards of quality. One segment of the community that continues to suffer from issues pertaining to poor access and low quality is the American Indians and Alaska Natives (AI/AN) population. Such a situation is clearly untenable, especially given the plethora of tools, techniques, technologies and tactics afforded by today's knowledge economy.
A Pervasive Wireless Knowledge Management Solution to Address Urban Health Inequalities with Indigenous Australians
Perspectives of Knowledge Management in Urban Health, 2010
A recent study by Adelaide Aboriginal and Torres Straight Islander Health (Gallaher et al., In Ou... more A recent study by Adelaide Aboriginal and Torres Straight Islander Health (Gallaher et al., In Our Own Backyard: Urban Health Inequalities and Aboriginal Experiences of Neighbourhood Life, Social Capital and Racism, 2009) revealed some alarming findings ...
A regulatory framework for pervasive e-health: A case study
Health Policy and Technology, 2012
ABSTRACT To facilitate superior healthcare delivery and address current challenges faced by healt... more ABSTRACT To facilitate superior healthcare delivery and address current challenges faced by healthcare today, a plethora of pervasive e-health solutions are emerging. However, existing regulatory regimes are ill-equipped for dealing with them. This not only causes frustration to various stakeholders including patients, providers, healthcare organizations and payers, not to mention vendors but also means that the most appropriate solution cannot be accessed and used. Hence this exploratory study serves to investigate institutional regulatory factors that can impact the adoption of such pervasive e-health solutions. These factors are important as they can shape both the nature of these solutions and their diffusion trajectory. We argue that co-regulation, a mixture of direct monitoring and intervention of regulators through legislation and complete industry self-regulation, can be an effective approach especially in view of the complex and dynamic nature of this industry, co-regulation can minimize monitoring costs and enhance compliance. We illustrate with a case vignette.
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Papers by Nilmini Wickramasinghe