Artificial intelligence (AI) is being rapidly integrated into healthcare with a naïve belief in the objectivity of AI and a complacent trust in the omniscience of computational knowledge. While AI has the potential to transform healthcare, there are significant ethical and safety concerns. The pace of AI development and the race for AI supremacy is leading to a rapid, and largely unregulated, proliferation of AI applications. It is important to understand that AI technologies bring new and accelerated risks and need meaningful human control and oversight. However, standards and regulation in the field are at a very nascent stage and need urgent attention. This paper explores the issues related to reliability, transparency, bias, and ethics to illustrate the ground realities and makes a case for developing standards and regulatory frameworks for the safe, effective, and ethical use of AI in healthcare.
{"title":"Artificial Intelligence and the Myth of Objectivity","authors":"R. Pathni","doi":"10.4018/jhms.329234","DOIUrl":"https://doi.org/10.4018/jhms.329234","url":null,"abstract":"Artificial intelligence (AI) is being rapidly integrated into healthcare with a naïve belief in the objectivity of AI and a complacent trust in the omniscience of computational knowledge. While AI has the potential to transform healthcare, there are significant ethical and safety concerns. The pace of AI development and the race for AI supremacy is leading to a rapid, and largely unregulated, proliferation of AI applications. It is important to understand that AI technologies bring new and accelerated risks and need meaningful human control and oversight. However, standards and regulation in the field are at a very nascent stage and need urgent attention. This paper explores the issues related to reliability, transparency, bias, and ethics to illustrate the ground realities and makes a case for developing standards and regulatory frameworks for the safe, effective, and ethical use of AI in healthcare.","PeriodicalId":256559,"journal":{"name":"Journal of Healthcare Management Standards","volume":"23 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117154926","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The authors return to the points made in their article published in the inaugural edition of this journal to expand upon recommendations to healthcare industry leadership regarding electrical power security. If best practice is to be data driven, then healthcare executives can take action by funding front-line experts to participate in the United States standards system as a user-interest to assure best practice has been discovered by a balance of interests. As of yet, there is no standard approach for developing resilience metrics for hospitals in Italy, in the European Union, or the United States. When that condition is present, then leaders and managers will default to federal agencies or the market itself – an imperfect taskmaster. Engineers learn from failures, but they do not like to learn the hard way. Perhaps artificial intelligence will assist this journey in reconciling the competing requirements of safety and economy in healthcare facilities. In any case, best practice discovery should rest upon the foundation of data recommended by Lord Kelvin.
{"title":"Position","authors":"Michael Anthony","doi":"10.4018/jhms.329216","DOIUrl":"https://doi.org/10.4018/jhms.329216","url":null,"abstract":"The authors return to the points made in their article published in the inaugural edition of this journal to expand upon recommendations to healthcare industry leadership regarding electrical power security. If best practice is to be data driven, then healthcare executives can take action by funding front-line experts to participate in the United States standards system as a user-interest to assure best practice has been discovered by a balance of interests. As of yet, there is no standard approach for developing resilience metrics for hospitals in Italy, in the European Union, or the United States. When that condition is present, then leaders and managers will default to federal agencies or the market itself – an imperfect taskmaster. Engineers learn from failures, but they do not like to learn the hard way. Perhaps artificial intelligence will assist this journey in reconciling the competing requirements of safety and economy in healthcare facilities. In any case, best practice discovery should rest upon the foundation of data recommended by Lord Kelvin.","PeriodicalId":256559,"journal":{"name":"Journal of Healthcare Management Standards","volume":"10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"120953423","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Patients are harmed too often by the care they receive today. The authors discuss a recent large study of harm, its results in terms of harm incidence, and distribution, and compare these with prior studies of harm in hospitals. The authors suggest what these results imply in terms of improving the safety of care, and how to accelerate it. They go over the roles of boards, and leadership including the c-suite. They discuss metrics and achieving sustainable results. They also evaluate the role of culture, and the future potential of artificial intelligence to improve safety. Overall, there is great room for improvement, but achieving it will require addressing all these areas.
{"title":"What Will It Take to Make Healthcare Safer?","authors":"David W. Bates, Patricia Folcarellli, E. Mort","doi":"10.4018/jhms.329200","DOIUrl":"https://doi.org/10.4018/jhms.329200","url":null,"abstract":"Patients are harmed too often by the care they receive today. The authors discuss a recent large study of harm, its results in terms of harm incidence, and distribution, and compare these with prior studies of harm in hospitals. The authors suggest what these results imply in terms of improving the safety of care, and how to accelerate it. They go over the roles of boards, and leadership including the c-suite. They discuss metrics and achieving sustainable results. They also evaluate the role of culture, and the future potential of artificial intelligence to improve safety. Overall, there is great room for improvement, but achieving it will require addressing all these areas.","PeriodicalId":256559,"journal":{"name":"Journal of Healthcare Management Standards","volume":"89 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123677714","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Brian W. Jack, Kirsten Austad, D. Renfro, S. Mitchell
The hospital discharge is non-standardized and frequently marked with poor quality and is an important driver of healthcare costs. There is now ample evidence that improving communication at hospital discharge can prevent problems after hospital discharge including rehospitalization. The ReEngineered Discharge (RED) successfully delivers high quality transitions in care, improves patient satisfaction, achieves patient-centered outcomes, and reduces rehospitalization by over 20% while lowering healthcare costs. However, implementing these evidence-based processes into US hospitals requires smooth integration into customary hospital workflows, while not increasing health professional time needed to carry out these duties. Now, rapidly evolving health-information technology systems using conversational agents such as the MayaRED have great potential to deliver the benefits of RED, with the added benefits of saving nurses' and other health professionals' time, delivering post-discharge reinforcement of the care plan and connecting chronic care patients to remote patient monitoring platforms.
{"title":"Re-Engineering the Hospital Discharge to Improve the Transition From Hospital to Home","authors":"Brian W. Jack, Kirsten Austad, D. Renfro, S. Mitchell","doi":"10.4018/jhms.328775","DOIUrl":"https://doi.org/10.4018/jhms.328775","url":null,"abstract":"The hospital discharge is non-standardized and frequently marked with poor quality and is an important driver of healthcare costs. There is now ample evidence that improving communication at hospital discharge can prevent problems after hospital discharge including rehospitalization. The ReEngineered Discharge (RED) successfully delivers high quality transitions in care, improves patient satisfaction, achieves patient-centered outcomes, and reduces rehospitalization by over 20% while lowering healthcare costs. However, implementing these evidence-based processes into US hospitals requires smooth integration into customary hospital workflows, while not increasing health professional time needed to carry out these duties. Now, rapidly evolving health-information technology systems using conversational agents such as the MayaRED have great potential to deliver the benefits of RED, with the added benefits of saving nurses' and other health professionals' time, delivering post-discharge reinforcement of the care plan and connecting chronic care patients to remote patient monitoring platforms.","PeriodicalId":256559,"journal":{"name":"Journal of Healthcare Management Standards","volume":"97 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125248309","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Heather Whiteman, Solange Charas, Hieu Bui, Lee S. Webster, James Gaskin
Despite long histories, the disciplines of healthcare performance analytics and human capital analytics followed parallel but separate tracks during the 19th and 20th centuries. Little has been done to integrate these two analytic disciplines to improve the delivery of medical care and the sustainability of healthcare organizations. Today, there is an increased demand for healthcare to meet the aging world population, spiraling healthcare costs, and a shortage of human resources to meet patient needs. It is imperative that healthcare professionals apply innovations to explore and optimize value from a combined discipline of healthcare human capital measurement and reporting.
{"title":"The Critical Need for Human Capital Measurement Standards and Transparency in Healthcare","authors":"Heather Whiteman, Solange Charas, Hieu Bui, Lee S. Webster, James Gaskin","doi":"10.4018/jhms.328520","DOIUrl":"https://doi.org/10.4018/jhms.328520","url":null,"abstract":"Despite long histories, the disciplines of healthcare performance analytics and human capital analytics followed parallel but separate tracks during the 19th and 20th centuries. Little has been done to integrate these two analytic disciplines to improve the delivery of medical care and the sustainability of healthcare organizations. Today, there is an increased demand for healthcare to meet the aging world population, spiraling healthcare costs, and a shortage of human resources to meet patient needs. It is imperative that healthcare professionals apply innovations to explore and optimize value from a combined discipline of healthcare human capital measurement and reporting.","PeriodicalId":256559,"journal":{"name":"Journal of Healthcare Management Standards","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114303368","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Florence Nightingale is the modern founder of nursing and professionalized nursing by creating training programs for aspiring nurses. Nursing standards for education started in the early days of nursing education, beginning in the late 1800s. National accreditation standards shape nursing educational programs and clinical practices; however, state-level boards of nursing establish and monitor practice standards. Nursing education accreditation agencies recently shifted their focus to competency-based education, including core abilities required to function as a nurse, provide comprehensive care, and meet patients' complex and diverse needs in every setting. This manuscript reviews the state of current competencies that educational institutions are adopting. A relationship between competencies, standards of practice, and emerging opportunities is needed to develop further education programs that address current clinical practice needs in today's technical and post-pandemic work and clinical environments.
{"title":"Nursing Competencies in the Nursing Curriculum","authors":"A. Talsma","doi":"10.4018/jhms.327947","DOIUrl":"https://doi.org/10.4018/jhms.327947","url":null,"abstract":"Florence Nightingale is the modern founder of nursing and professionalized nursing by creating training programs for aspiring nurses. Nursing standards for education started in the early days of nursing education, beginning in the late 1800s. National accreditation standards shape nursing educational programs and clinical practices; however, state-level boards of nursing establish and monitor practice standards. Nursing education accreditation agencies recently shifted their focus to competency-based education, including core abilities required to function as a nurse, provide comprehensive care, and meet patients' complex and diverse needs in every setting. This manuscript reviews the state of current competencies that educational institutions are adopting. A relationship between competencies, standards of practice, and emerging opportunities is needed to develop further education programs that address current clinical practice needs in today's technical and post-pandemic work and clinical environments.","PeriodicalId":256559,"journal":{"name":"Journal of Healthcare Management Standards","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125362481","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The COVID-19 pandemic put indoor air quality and ventilation in the spotlight. Health system leaders are often responsible for identifying and leading the implementation of building facility upgrades such as indoor air quality, HVAC, and ventilation improvements based on the current occupancy level for each zone to mitigate the spread of airborne infection including SARS-CoV2, particulate matter, smoke, allergens, and more inside their facilities. Harvard's T.H. Chan School of Public Health highlights the critical role of healthy buildings. Simultaneously, the healthcare industry is facing a harsher and uncertain economic environment post COVID-19 with cost-cutting taking the top spot on the list business priorities. Managing Scope 1, 2, and 3 emissions is also a priority along with meeting environmental, social, governance (ESG) goals. Of the three types of emissions, Scope 2 emissions are the easiest to reduce and help organizations reduce their reliance on purchased utilities.
{"title":"Indoor Air Quality's Tie to Environmental Social Governance (ESG) and Better Business Outcomes","authors":"Kimberlee Archer, John Bohlmann","doi":"10.4018/jhms.317106","DOIUrl":"https://doi.org/10.4018/jhms.317106","url":null,"abstract":"The COVID-19 pandemic put indoor air quality and ventilation in the spotlight. Health system leaders are often responsible for identifying and leading the implementation of building facility upgrades such as indoor air quality, HVAC, and ventilation improvements based on the current occupancy level for each zone to mitigate the spread of airborne infection including SARS-CoV2, particulate matter, smoke, allergens, and more inside their facilities. Harvard's T.H. Chan School of Public Health highlights the critical role of healthy buildings. Simultaneously, the healthcare industry is facing a harsher and uncertain economic environment post COVID-19 with cost-cutting taking the top spot on the list business priorities. Managing Scope 1, 2, and 3 emissions is also a priority along with meeting environmental, social, governance (ESG) goals. Of the three types of emissions, Scope 2 emissions are the easiest to reduce and help organizations reduce their reliance on purchased utilities.","PeriodicalId":256559,"journal":{"name":"Journal of Healthcare Management Standards","volume":"66 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114792106","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Accreditation is a common method to assess quality and plan for improvements in the delivery of health and human services. CARF accreditation was established to create standards of quality for specialty programs in rehabilitation and for community-based services. Since its inception, the person-served has uniquely been the focus of standards design, with specificity to program-based standards that address “person-centered” service needs. As a quality improvement model, CARF's standards are referenced as typical to another respected quality assessment and improvement model, ISO standards. The importance of ensuring a person's served focus in the health and human service industry is discussed with benefits of a peer review accreditation system and experience of accreditation based on CARF customer feedback and those served. It is posited that long-term growth for accreditation and CARF's mission, to “enhance the lives of persons served through a consultative accreditation process,” will sustain CARF's global acceptance and contribute to improving lives in our communities.
{"title":"Extending the Reach of Quality With CARF Accreditation","authors":"B. J. Boon","doi":"10.4018/jhms.315607","DOIUrl":"https://doi.org/10.4018/jhms.315607","url":null,"abstract":"Accreditation is a common method to assess quality and plan for improvements in the delivery of health and human services. CARF accreditation was established to create standards of quality for specialty programs in rehabilitation and for community-based services. Since its inception, the person-served has uniquely been the focus of standards design, with specificity to program-based standards that address “person-centered” service needs. As a quality improvement model, CARF's standards are referenced as typical to another respected quality assessment and improvement model, ISO standards. The importance of ensuring a person's served focus in the health and human service industry is discussed with benefits of a peer review accreditation system and experience of accreditation based on CARF customer feedback and those served. It is posited that long-term growth for accreditation and CARF's mission, to “enhance the lives of persons served through a consultative accreditation process,” will sustain CARF's global acceptance and contribute to improving lives in our communities.","PeriodicalId":256559,"journal":{"name":"Journal of Healthcare Management Standards","volume":"57 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121786500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Fast Healthcare Interoperability Resources (FHIR), created by HL7 more than a decade ago, has become a global standard for exchanging data. Communities of interest have organized under the HL7 FHIR Accelerator Program to develop implementation guides and applications for patient care, health payment systems, public health, patient engagement, clinical and basic research, and social determinants of health. Despite efforts to coordinate the creation of applications in an ever-increasing diversity of use cases, there have been challenges to ensure semantic interoperability, security, privacy, consistent interpretation of the specifications, and the workforce capacity across the industry. In response to these challenges, HL7 created the Standards Implementation Division with the aims of developing a unique ecosystem for continuous testing and discovery, building a global education and certification program, and facilitating advancement across the diverse FHIR implementation communi
{"title":"Implementing HL7 FHIR","authors":"C. Jaffe, D. Vreeman, Diego Kaminker, V. Nguyen","doi":"10.4018/jhms.316144","DOIUrl":"https://doi.org/10.4018/jhms.316144","url":null,"abstract":"Fast Healthcare Interoperability Resources (FHIR), created by HL7 more than a decade ago, has become a global standard for exchanging data. Communities of interest have organized under the HL7 FHIR Accelerator Program to develop implementation guides and applications for patient care, health payment systems, public health, patient engagement, clinical and basic research, and social determinants of health. Despite efforts to coordinate the creation of applications in an ever-increasing diversity of use cases, there have been challenges to ensure semantic interoperability, security, privacy, consistent interpretation of the specifications, and the workforce capacity across the industry. In response to these challenges, HL7 created the Standards Implementation Division with the aims of developing a unique ecosystem for continuous testing and discovery, building a global education and certification program, and facilitating advancement across the diverse FHIR implementation communi","PeriodicalId":256559,"journal":{"name":"Journal of Healthcare Management Standards","volume":"25 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126167156","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Healthcare organisations are continually forced to rethink and redesign their processes and procedures due to internal and external requirements and occurrences. The best way to test new procedures would be through real-life experiments and/or simulations based on real-time data. However, experiments are only rarely possible in a service provision environment which is highly complex and safety and security driven, and so data are sometimes not available in the required quantity (yet). The application of models provides an alternative. However, to serve as a solid foundation, such models need to fulfil certain criteria: they need to be consistent, complete, accurate, and without redundancies, and they also have to provide the basis for a common understanding for stakeholders from different backgrounds, thereby making it possible to choose from multiple perspectives.
{"title":"Position Paper on Developing Standardized Modelling Approaches for the Management of Healthcare Organizations","authors":"Nicole Gerber","doi":"10.4018/jhms.315772","DOIUrl":"https://doi.org/10.4018/jhms.315772","url":null,"abstract":"Healthcare organisations are continually forced to rethink and redesign their processes and procedures due to internal and external requirements and occurrences. The best way to test new procedures would be through real-life experiments and/or simulations based on real-time data. However, experiments are only rarely possible in a service provision environment which is highly complex and safety and security driven, and so data are sometimes not available in the required quantity (yet). The application of models provides an alternative. However, to serve as a solid foundation, such models need to fulfil certain criteria: they need to be consistent, complete, accurate, and without redundancies, and they also have to provide the basis for a common understanding for stakeholders from different backgrounds, thereby making it possible to choose from multiple perspectives.","PeriodicalId":256559,"journal":{"name":"Journal of Healthcare Management Standards","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130814821","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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