Investigación original / Original research. Maria Carolina Jimenez-Marroquin, 1 Raisa Deber, 2 and Alejandro R. Jadad 2

Size: px
Start display at page:

Download "Investigación original / Original research. Maria Carolina Jimenez-Marroquin, 1 Raisa Deber, 2 and Alejandro R. Jadad 2"

Transcription

1 Investigción originl / Originl reserch Pn Americn Journl of Public Helth Informtion nd communiction technology (ICT) nd ehelth policy in Ltin Americ nd the Cribben: review of ntionl policies nd ssessment of socioeconomic context Mri Crolin Jimenez-Mrroquin, 1 Ris Deber, 2 nd Alejndro R. Jdd 2 Suggested cittion Jimenez-Mrroquin MC, Deber R, Jdd AR. Informtion nd communiction technology (ICT) nd ehelth policy in Ltin Americ nd the Cribben: review of ntionl policies nd ssessment of socioeconomic context. Rev Pnm Slud Public. 2014;35(5/6): bstrct Key words Objective. To exmine the vilbility of ntionl informtion nd communiction technology (ICT) or ehelth policies produced by countries in Ltin Americ nd the Cribben (LAC), nd to determine the influence of country s socioeconomic context on the existence of these policies. Methods. Documents describing ntionl ICT or ehelth policy in ny of the 33 countries belonging to the LAC region s listed by the United Ntions were identified from three dt sources: cdemic dtbses; the Google serch engine; nd government gencies nd representtives. The reltionship between the existence of policy nd ntionl socioeconomic indictors ws lso investigted. Results. There hs been some progress in the estblishment of ICT nd ehelth policies in the LAC region. The most useful methods for identifying the policies were 1) use of the Google serch engine nd 2) contct with Pn Americn Helth Orgniztion (PAHO) country representtives. The countries tht hve developed ntionl ICT policy seem to be more likely to hve ntionl ehelth policy in plce. There ws no sttisticl significnt ssocition between the existence of policy nd country s socioeconomic context. Conclusions. Governments need to mke stronger efforts to rise wreness bout existing nd plnned ICT nd ehelth policies, not only to fcilitte ese of use nd communiction with their stkeholders, but lso to promote collbortive interntionl efforts. In ddition, better understnding of the effect of economic vribles on the role tht ICTs ply in helth sector reform efforts will help shpe the vision of wht cn be chieved. Helth policy; informtion technology; Ltin Americ; Cribben region. In n incresingly digitl world, there is growing recognition tht the helth sector must integrte informtion nd communiction technologies (ICTs) t ll 1 Centre for Globl ehelth Innovtion, Toronto, Cnd. 2 Institute of Helth Policy, Mngement nd Evlution, University of Toronto, Toronto, Cnd. Send correspondence to: Alejndro R. Jdd, levels, especilly t time when helth systems fce stringent economic chllenges nd growing demnds to provide more nd better helth cre services, especilly to those most in need (1). ICTs might help improve helth conditions in low- nd middle-income countries (LMICs) by strengthening disese prevention nd mngement efforts, or through effects on the broder determinnts of helth (2). The experience from high-income countries tht hve implemented lrgescle ICT inititives hs shown tht success is lrgely dependent on solid plns to hrness the power of ehelth 3 3 The use of ICT for the helth sector. Rev Pnm Slud Public 35(5/6),

2 Originl reserch Jimenez-Mrroquin et l. Informtion nd communiction technology nd ehelth policy in LAC systems nd services (3, 4). It is therefore vluble for countries to develop policies tht could fcilitte the doption of ehelth nd guide the use of ICTs towrd the chievement of the desired gols (5). It is not cler the extent to which systemtic efforts hve been undertken to identify ntionl ICT nd ehelth policies developed or dopted by countries in Ltin Americ nd the Cribben (LAC), nd whether there is n ssocition with the socioeconomic conditions of these countries. This study exmines the extent to which ntionl ICT or ehelth policies hve been creted by countries in the LAC region, nd explores the influence of country s socioeconomic context on the existence of these policies. LAC is region with diverse demogrphic, socil, economic, nd technologicl chrcteristics (6) nd thus provides good setting in which to exmine whether such chrcteristics re relted to the implementtion of such policies. MATERIALS AND METHODS Study design A scoping review ws crried out between Mrch nd October 2010 to identify documents describing ntionl ICT or ehelth policy in countries listed s belonging to the LAC region ccording to the United Ntions (UN) clssifiction. The study protocol ws pproved by the reserch ethics bord of the University of Toronto. For the purposes of this study, policy ws defined s set of interrelted decisions tken by politicl ctor or group of ctors concerning the selection of gols nd the mens of chieving them within specified sitution where these decisions should, in principle, be within the power of these ctors to chieve (7). To define ICT policy nd ehelth policy, previously estblished definitions from the literture were used. An ICT policy ws defined s generl pln on how to bring society nd its economy forwrd through the use of ICT tht focused on specific sectors, such s helth, eduction, or dministrtion (8). An ehelth policy ws defined s set of sttements, directives, regultions, lws, nd judicil interprettions tht direct nd mnge the life cycle of ehelth (9, 10), nd frmework nd pproch for developing ehelth in country, estblished by government with the intent of chieving helth gols (3). Eligibility criteri To be considered eligible, documents hd to meet both of the following criteri: were issued by the ntionl government of ny of the 33 countries listed in the LAC region by the UN; nd estblished cler set of gols, objectives nd strtegies to guide the use of ICTs t the ntionl level (ICT policy) or in the helth sector exclusively (ehelth policy). Documents were excluded if they 1) were issued by nongovernmentl orgniztion or country not listed in the UN clssifiction; 2) were pplicble to ny sector or in combintion with other sectors (for ICT policies); 3) were pplicble to sector other thn helth (for ehelth policies); or 4) did not clerly stte gols objectives nd strtegies for the use of ICTs t the ntionl level (for ICT policies) or in the helth sector exclusively (for ehelth policies). Serch strtegy The serch strtegy included three sources of dt: cdemic dtbses; the Google serch engine; nd government gencies nd representtives. The serch of cdemic dtbses ws crried out between 18 Mrch nd 21 June 2010 nd included list of 173 terms relted to the nmes of the countries, helth policy, nd ICTs. The titles nd bstrcts were screened for potentil eligibility first, followed by review of the full text of potentilly eligible documents. Avilble policies were identified directly through the Google serch engine by using the following terms: [Country nme] AND Policy AND ehelth OR informtion technologies. The Web serch ws crried out primrily in English nd Spnish. When no relevnt link resulted, the serch ws lso conducted using the sme serch terms trnslted into Dutch, French, nd Portuguese. After the min Google serch ws completed, the officil websites of the ntionl governments nd the ministries of helth nd of telecommunictions for ech country were locted online nd serched for dditionl eligible documents. LAC government representtives were contcted online, by phone, nd fce-to-fce to verify the ccurcy of the documents identified nd retrieved online nd to inquire bout ny other vilble documents. Online contct included messges sent through posted forms nd chts nd to emil ddresses provided in the identified government websites. A rndom smple ws used for telephone clls, which ultimtely included the governments of Argentin, Bhms, Brbdos, Brzil, El Slvdor, Colombi, Guteml, Mexico, Prguy, nd Venezuel. Government representtives were lso contcted directly during the Pn Americn Helth Orgniztion (PAHO) 50th Annul Directing Council Meeting, n nnul event tht brings together ministers of helth nd selected government representtives from ll PAHO member sttes to discuss the helth gend for the region. Finlly, PAHO country representtives were contcted by emil to complete the verifiction of results. Contextul vribles The selected socioeconomic indictors included those tht 1) provided n overview of the economic, helth, nd technologicl context t the ntionl level; 2) were vilble for the countries in the study; nd 3) were published in relible sources. Dt were obtined from the Humn Development Report 2011 (11), the World Helth Sttistics Report 2012 (12), nd the Interntionl Telecommunictions Union (ITU) Mesuring the Informtion Society report for 2011 (13). The vribles included: totl popultion (ll usul residents of the country or ll persons present in the country t the time of the census) (11); gross ntionl income (GNI) per cpit (n indictor of inequlity), clculted in US$ bsed on constnt 2005 purchsing power prity (PPP) (11); totl helth expenditure (the sum of public nd privte helth expenditure clculted s the percentge of country s gross domestic product (GDP) nd comprising ll finncil resources spent on the provision of helth services, fmily plnning ctivities, nutrition ctivities, nd emergency id designted for helth, excluding wter nd snittion) (14); nd the ICT development index (IDI), composite index mde up of three sub-indices, including 11 indictors, which mesures the extent 330 Rev Pnm Slud Public 35(5/6), 2014

3 Jimenez-Mrroquin et l. Informtion nd communiction technology nd ehelth policy in LAC Originl reserch to which countries cn use ICTs to enhnce growth nd development, bsed on vilble cpbilities nd skills required to mke effective use of ICTs nd enhnce their impct (13). Sttisticl nlysis Sttisticl nlysis ws crried out in SPSS 21.0 for Mc (IBM Corp, Armonk, New York, USA). Descriptive sttistics were used to chrcterize the countries. To explore the influence of demogrphic nd socioeconomic indictors on the existence of ntionl ICT or ehelth policy in LAC, binomil nd multinomil logistic regressions were crried out. Dt from the 33 countries in the study were included in the nlysis. The dependent vrible ws the outcome of whether country hd policy or not. Bseline covrite vlues were totl popultion, GNI per cpit, totl helth expenditure, nd government expenditure on helth. The ppropriteness of the regression models ws tested by performing likelihood rtio test to determine model fit nd the pseudo-coefficient of determintion (R 2 ) to mesure the model s predictive power. The Hosmer Lemeshow test ws lso conducted to ssess model relibility. Logistic regression ws crried out becuse it is well suited for describing nd testing hypotheses bout reltionships between ctegoricl dependent vrible nd one or more ctegoricl or continuous explntory vribles (15). A P vlue < 0.05 ws considered significnt for ll group comprisons. While the IDI rnk reported dt for more countries in the LAC region compred to the Network Rediness Index (NRI), dt were still missing for eight countries. Given the smll smple size, the IDI rnk ws excluded from the logistic regression models. Results Existing ICT nd ehelth policies The findings of the serch effort suggest tht 19 (57.6%) countries hve ntionl ICT policies nd seven (21%) hve ntionl ehelth policies. Acdemic dtbses yielded 41 potentilly eligible documents, which were reviewed in detil, but only four documents met the inclusion criteri. Of these, one mde reference to n existing ntionl ICT policy in Argentin, one ech to n ehelth policy in Brzil nd Chile, nd the fourth mentioned the existence of ntionl progrm for the estblishment of n informtion system in the helth sector nd the existence of ntionl strtegy for n informtion society in Cub, but did not directly provide informtion bout policy. The Google serch identified 19 eligible documents. Of these, 17 referred to ntionl ICT policy nd two corresponded to ntionl ehelth policy (from Belize nd Peru). Contcting government representtives through government websites ws not very helpful. The 31 countries tht hd n officil government website were contcted vi online forms, emil, or cht, depending on the vilble feture. However, none of the submitted online forms resulted in response, messges to 19 emil ddresses led to prtil response in most cses, nd only the contct for the Peruvin government responded with potentilly eligible policy document. Telephone contct lso did not produce vluble results. In most cses, there ws some difficulty in obtining response or identifying person or deprtment who ws fmilir with the topic nd who could provide useful informtion. Only representtives from Brzil nd Colombi were ble to provide informtion leding to potentilly eligible document or bout plns to develop new policies. During PAHO s 50th Directive Council meeting, the Colombin representtive ffirmed the country hd n ICT policy but did not corroborte the current development of n ehelth policy. The representtives from both Trinidd nd Tobgo nd Venezuel sid they were wre of ongoing work in the re of ICTs nd policy in their country, but only the Trinidd nd Tobgo representtive mde ny reference to specific document. Both promised to send informtion upon their return, but none hd been received by the end of In contrst, of the 27 PAHO country representtives contcted, 19 (70.3%) responded. Although most of the responses did not vry from other forms of contct with governments, three dditionl ntionl ehelth policies were identified (Cub, Ecudor, nd Mexico). Upon review of the ehelth policy of Ecudor, ntionl ICT policy ws identified for tht country s well. Tble 1 describes the finl group of ICT nd ehelth policies retrieved, nd the sources where they were found. Overview of country context Tble 2 summrizes the diversity in the LAC region with respect to demogrphic, socil, economic, nd technology context. The verge popultion ws 17.9 million, with the smllest being the popultion of the islnds in the Cribben nd the lrgest the popultion of Brzil. Hiti hd the lowest GNI per cpit nd Trinidd nd Tobgo hd the highest. The verge helth expenditure ws 7% of GDP, with St. Vincent nd the Grendines hving the lowest vlue nd Cub the highest. Cub lso hd the highest government expenditure on helth, in contrst to Hiti, where only 21.8% of helth expenses were pid by the government. In terms of ICT development, the best-rnked country ws Uruguy t number 41 nd the lowest ws Nicrgu t 114 (out of 152 countries). Logistic regression For the logistic regression nlysis, the hypothesis ws tht the likelihood tht country hs n ICT or ehelth policy is relted to its popultion, GNI per cpit, totl helth expenditure, nd/or government expenditure on helth. The null hypothesis would imply no difference between the covrites nd the existence of n ICT or ehelth policy. The multinomil logistic regression model ws creted with four ctegories in the dependent vrible: 1) no policy, 2) only n ICT policy, 3) only n ehelth policy, nd 4) both policies. The binomil model only hd two ctegories ( hs policy versus does not hve policy ) in the dependent vrible nd ws conducted seprtely for ICT nd ehelth policies. Absence of both n ICT nd n ehelth policy ws set s the reference group. Tble 3 shows the results from the multinomil logistic regression. The pseudo- R 2 (Cox Snell = 0.580; Ngelkerke = ; McFdden = 0.390) nd goodness of fit (Person χ 2 = , P = 1.000; devince χ 2 = , P = 1.000) suggest tht the fit of the model ws good. While the model fitting rejected the hypothesis (χ 2 = , P = 0.004), none of the vri- Rev Pnm Slud Public 35(5/6),

4 Originl reserch Jimenez-Mrroquin et l. Informtion nd communiction technology nd ehelth policy in LAC TABLE 1. Informtion nd communiction technology (ICT) nd ehelth policies in Ltin Americ nd the Cribben, 2010 Country ICT policy ehelth policy Antigu nd Brbud Informtion nd Communiction Technologies (ICTs) Drft Policy Source: Argentin Pln Ncionl de Gobierno Electrónico Decreto Nº 378/2005 Source: or Bhms Brbdos Brbdos Ntionl ICT Strtegic Pln Mobile Brbdos: Building the Networked Ntion Drft Report Source: Belize Belize Helth Informtion System (BHIS) Pln Source: publictions/ntionl-helth-informtion-systemstrtegic-pln Bolivi Estrtegi Ncionl de Tecnologís de Informción y Comunicción pr el Desrrollo (ETIC) Source: Proceso.pdf Brzil Estrtégi Gerl de Tecnologi d Informção EGTI 2010 Source: Chile Estrtegi Digitl Chile Source: Colombi Cost Ric Pln Ncionl de Tecnologís de l Informción y ls Comunicciones (PLAN TIC) Source: Cost Ric: Verde e Inteligente Estrtegi Ncionl de Tecnologís de Informción y Comunicción. Source: Polític Ncionl de Informção e Informátic em Súde Propost Versão 2.0 Source: www2.dtsus.gov.br/ DATASUS/APRESENTACAO/ PoliticInformcoSude29_03_2004.pdf El Libro Azul Agend Digitl del Ministerio Slud Source: CHILE_libro_zul.pdf Cub Progrm de Informtizción del Sector de l Slud Source: de%20informtizcion.pdf Dominic Government of Dominici [sic] Informtion Technology Strtegic Pln April 18, Source: unstts.un.org/unsd/dnss/docviewer.spx?docid=2241 Dominicn Republic Ecudor Pln Estrtégico E-Dominicn Source: Agend Ncionl de Conectividd Source: ut=blog&id=38&itemid=158 El Slvdor Grend ICT Strtegy nd Action Pln for Grend ICT Strtegy nd Action Pln - Grend ( ) Source: / nd Guteml Guyn ICT4D Ntionl Strtegy Guyn Finl Drft 2006 Source: Hiti Hondurs Jmic Drft Mster Implementtion Pln for E-Powering Jmic 2012 Ntionl ICT Strtegy Source: ntionl-ict-strtegy Mexico Vision Mexico Sistem Ncionl e-mexico Source: Descrgbles/Doc_PP_vision_ Mexico_2020_resumen.pdf / nd Nicrgu Polític Ncionl de Telemedicin/Teleslud Propuest Source: Document not public t the time obtined through Ecudor s PAHO representtive Progrm de Acción de Teleslud Source: comite_e-slud/telesludcomiteinterisntitucionl. pdf (Continues) 332 Rev Pnm Slud Public 35(5/6), 2014

5 Jimenez-Mrroquin et l. Informtion nd communiction technology nd ehelth policy in LAC Originl reserch TABLE 1. Continued Country ICT policy ehelth policy Pnm Prguy Peru St. Kitts nd Nevis St. Luci St. Vincent nd the Grendines Surinme Trinidd nd Tobgo Pln de Desrrollo de l Sociedd de l Informción en el Perú L Agend Digitl Perun Source: Government of St. Kitts nd Nevis Ntionl Informtion nd Communictions Technology (ICT) Strtegic Pln Source: unstts.un.org/unsd/dnss/docviewer.spx?docid=2297 Fst forwrd: Trinidd nd Tobgo s Ntionl Informtion nd Communiction Technology Strtegy Source: Uruguy Estrtegi y gend digitl Uruguy Source: uruguy_2008_-_2010.html?menuderecho=3 Venezuel Pln Ncionl de Teleslud Source: ftp://ftp2.mins.gob.pe/ otrspublicciones/22/teleslud.pdf The use of ICT for helth. TABLE 2. Descriptive sttistics, Ltin Americ nd the Cribben, 2010 Vrible Minimum Mximum Men Stndrd devition Popultion GNI b per cpit Helth expenditure c Government expenditure d IDI e rnk In millions (11). b Gross ntionl income (in US$ bsed on constnt 2005 purchsing power prity) (11). c Totl expenditure on helth s percentge of 2009 gross domestic product (12). d Generl government expenditure on helth s percentge of 2009 totl expenditure on helth (12). e ICT Development Index (8). TABLE 3. Multinomil logistic regression model for probbility of informtion nd communiction technology (ICT) nd ehelth policies, Ltin Americ nd the Cribben, 2010 Policy OR b P 95% CI c ICT nd ehelth Intercept d Popultion GNI e per cpit Helth expenditure Government expenditure ICT only Intercept d Popultion GNI per cpit Helth expenditure Government expenditure ehelth only Intercept d Popultion f 1.000E 013 NA g 1.000E E-013 GNI per cpit f Helth expenditure f Government expenditure f The use of ICT for helth. b OR: odds rtio. c CI: confidence intervl. d Reference: no ICT or ehelth policy. e GNI: gross ntionl income. f Floting point overflow occurred while computing this sttistic; therefore its vlue ws set to system missing. g NA: not pplicble. bles in the model showed sttisticl significnce, lthough popultion showed trend towrd significnce (P = 0.069). Tbles 4 nd 5 summrize the results of the binry logistic regression for ehelth nd ICT policies. The Hosmer Lemeshow test evlutes whether logistic regression model is well clibrted to help determine if the probbility predictions generted by it reflect the occurrence of events in the dt (16). The test does not estimte the extent of the fit. The results of the test for this study s models for ehelth policy nd ICT policy (χ 2 = 9.598, degrees of freedom = 8, p = 0.294, nd χ 2 = , degrees of freedom = 8, p = 0.146, respectively) suggest tht both models fit the dt well. However, despite the good fit of the dt, none of the independent vribles showed sttisticl significnce. Discussion This study showed tht governments in LAC countries hve begun to develop ntionl ICT nd ehelth policies. The results reveled tht five countries hd both policies, 14 hd only n ICT policy, two countries hd only n ehelth policy, nd 12 countries did not pper to hve ny. The most useful methods for identifying the policies were 1) conducting Google serch nd 2) consulting the PAHO country representtives. Serching trditionl cdemic dtbses nd Rev Pnm Slud Public 35(5/6),

6 Originl reserch Jimenez-Mrroquin et l. Informtion nd communiction technology nd ehelth policy in LAC TABLE 4. Binry logistic regression model for ehelth policy, Ltin Americ nd the Cribben, 2010 Step 1 OR b P 95% CI c Vribles nlyzed: Popultion GNI d per cpit Helth expenditure Government expenditure Constnt NA e The use of informtion nd communiction technology (ICT) for helth. b OR: odds rtio. c CI: confidence intervl. d GNI: gross ntionl income. e NA: not pplicble. TABLE 5. Binry logistic regression for informtion nd communiction technology (ICT) policy, Ltin Americ nd the Cribben, 2010 Step 1 OR P 95% CI b Vribles nlyzed: Popultion GNI c per cpit Helth expenditure Government expenditure Constnt NA d OR: odds rtio. b CI: confidence intervl. c GNI: gross ntionl income. d NA: not pplicble. contcting government representtives did not yield high number of eligible documents. Across countries wide vribility ws found in 1) popultion, 2) GNI per cpit, 3) expenditure on helth, nd 4) ICT development. The logistic regression models did not show significnt sttisticl difference, lthough there seemed to be trend for popultion. Two orgniztions hve strted to keep trck of ICT policies nd ehelth policies in LAC. The Observtory for the Informtion Society in Ltin Americ nd the Cribben (OSILAC) is joint effort between the United Ntions Economic Commission for Ltin Americ (ECLAC) nd the Institute for Connectivity in the Americs (ICA) t the Interntionl Development Reserch Centre (IDRC) to monitor nd support the progress of regionl countries towrd the development of informtion societies (17). The Globl Observtory for ehelth (GOe) is n inititive from the World Helth Orgniztion (WHO) tht seeks to improve helth by providing member sttes with strtegic informtion nd guidnce on effective prctices nd stndrds in ehelth (18). More recently, the ITU strted reporting on the estblishment of ntionl ICT policies cross UN member sttes (8). Contrsting the serch yields with dt from OSILAC nd GOe suggested tht the current study s effort led to n incomplete picture. OSILAC, for instnce, reported tht 26 LAC countries (79%) hd ICT policies (19 21). Similrly, GOe reported in 2006 tht 12 out of 14 LAC countries for which they obtined dt hd n ICT policy, dding eight dditionl countries in 2010 (out of 10 countries) (3, 22). While GOe mde no reference to specific ICT policies tht could be trcked, OSILAC s informtion suggested tht documents from the Bhms nd Sint Luci did not meet the inclusion criteri for this study. In ddition, lthough there were some news or presenttions on the Internet mentioning potentilly eligible documents, this study ws unble to find the reported policy for El Slvdor, Nicrgu, nd Pnm mentioned by OSILAC. The study serch did not find the ICT policy for Cub, Guteml, Prguy, or Venezuel reported by OSILAC. On the other hnd, Internet reference to n ICT policy ws found for Dominic nd St. Kitts nd Nevis, neither of which ws listed by OSILAC t the time of the study. The GOe published n updted report in 2012 (23), nd this study s list of ehelth policies mtched it, with the exception of Argentin, which did not meet this study s inclusion criteri. The results of this study suggest tht there my be lck of wreness mong government representtives with respect to the development nd implementtion of ehelth policies s well s, sometimes, ICT policies. Therefore, governments need to explore vrious wys to rise wreness bout existing nd plnned ehelth policies, not only to fcilitte ese of use nd communiction with their stkeholders, but lso to promote collbortive interntionl efforts. According to Guerr & Jordn, the ntionl policy environment relies hevily on the individul country s socioeconomic nd politicl sitution, which sets the priorities for government ctivities. Their study showed correltion between levels of economic nd digitl development but noted tht even where GNI levels were identicl, some countries were mking fster progress in the use of ICTs, which they sid could be becuse those countries re more committed to nd wre of the issue, giving it plce in the policy gend nd promoting ctions gered towrd digitl development (19). An explortory model ws developed to ssess some of the fctors tht could ffect the development of n ICT or ehelth policy but it filed to identify ny independent vribles tht showed significnt ssocition. Further reserch is needed to better understnd the influence of country s context in the development nd implementtion of ntionl ICT nd ehelth policies. As governments incresingly recognize tht incorporting ICT is priority for helth systems development, collbortion between different sectors, both public nd privte, is centrl to chieving strtegic nd integrted ction (1). The chllenges posed by chrcteristics of the helth system nd fctors ssocited with ptients nd their fmilies will likely shpe the trnsformtive potentil of ICTs in the region (24). A better understnding of the effect of economic vribles on the role tht ICTs ply in helth sector reform efforts (23, 25) will help shpe the vision of wht cn be chieved, nd the scope of ctivities nd mgnitude of investment required. 334 Rev Pnm Slud Public 35(5/6), 2014

7 Jimenez-Mrroquin et l. Informtion nd communiction technology nd ehelth policy in LAC Originl reserch Limittions The current results should be interpreted in light of vrious study limittions. First, given the strict inclusion criteri for ICT nd ehelth policies, it is possible tht documents for some countries did not meet the study criteri or exist in sources not used in the study nd were thus excluded from the nlysis. Second, the study did not differentite between developed nd dopted policies or consider policies being developed/tested (but not yet officil). As result, the uthors my hve 1) overestimted the extent/ use of ICT/eHelth policy in countries with n eligible document tht hd not been dopted yet nd/or 2) excluded countries tht did not yet hve n officil policy but hd mde progress in the re of ICT/eHelth within their helth systems. Finlly, lthough the use of logistic regression is common in helth reserch, the use of multinomil logistic regression is rre (15), which limits the comprisons tht cn be drwn from similr studies. Moreover, it is cler tht mny fctors ffect country context nd thus it is likely tht the vribles in this study s models were not sufficiently comprehensive. Conclusions The countries in LAC hve been mking progress in envisioning the incorportion of ICT nd ehelth policy within their helth systems. However, prtnerships t the ntionl nd regionl level should be strongly encourged to level the plying field for ll countries in the region to ssist them in dvncing the equitble delivery of helth services for their citizens. Further studies re needed to investigte the ssocition between the endogenous nd exogenous fctors tht ffect the bility of country to generte, implement, nd monitor ICT or ehelth policies. Acknowledgments. The uthors thnk Lur O Grdy from the Centre for Globl ehelth Innovtion, for supporting the design of the review of the literture; Mrin Engleskis from the University Helth Network (UHN), for supporting the review of cdemic dtbses; An Luci Ruggiero from the Pn Americn Helth Orgniztion (PAHO), for fcilitting the contct with PAHO/WHO country representtives; nd Adm Dimnt from the University of Toronto, for supporting the sttisticl nlysis. Conflicts of interest. None. REFERENCES 1. Interntionl Telecommuniction Union; World Helth Orgniztion. Ntionl ehelth Strtegy Toolkit. Genev: World Helth Orgniztion nd ITU; Avilble from: www. itu.int/pub/d-str-e_health Accessed on 7 My Chndrsekhr CP, Ghosh J. Informtion nd communiction technologies nd helth in low income countries: the potentil nd the constrints. Bull World Helth Orgn. 2001;79(9): World Helth Orgniztion Globl Observtory for ehelth. Building foundtions for ehelth progress of Member Sttes. Genev: WHO; Avilble from: goe/publictions/bf_final.pdf Accessed on 7 My Cndin Interntionl Development Agency. CIDA s Strtegy on Knowledge for Development through Informtion nd Communiction Technologies. Gtineu, Cnd: CIDA; Avilble from: gc.c/inet/images.nsf/vluimges/ pdf/$file/ict.pdf Accessed on 7 My Khoj S, Durrni H, Prvez N, Fhim A. Scope of policy issues in ehelth: results from structured literture review. J Med Internet Res. 2012;14(1):e United Ntions Development Progrmme. Regionl humn development report for Ltin Americ nd the Cribben Acting on the future: breking the intergenertionl trnsmission of inequlity. Sn Jose, Cost Ric: UNDP; Avilble from: ltinmeric.undp.org/content/rblc/en/ home/librry/humn_development/humndevelopment-report/ Accessed on 8 My Jenkins, W. Policy Anlysis: politicl nd orgniztionl perspective. New York: St. Mrtin s Press; Interntionl Telecommunictions Union; United Ntions Regionl Commissions. Ntionl e-strtegies for development: globl sttus nd perspectives Genev: ITU; Avilble from: D/ cyb/estrt/estrt2010.html Accessed on 7 My Mrs M, Scott RE. Globl e-helth policy: work in progress. Helth Aff (Millwood). 2010;29(2): Scott RE, Chowdhury MF, Vrghese S. Telehelth policy: looking for globl complementrity. J Telemed Telecre. 2002;8 Suppl 3: United Ntions Development Progrmme. Humn development report Sustinbility nd equity: better future for ll. New York: United Ntions; Avilble from: Accessed on 8 My World Helth Orgniztion. World helth sttistics report. Prt III: globl helth indictors. Genev: WHO; Avilble from: Prt3.pdf?u=1 Accessed on 8 My Interntionl Telecommunictions Union. Mesuring the informtion society. Genev: ITU; Avilble from: itu.int/itu-d/ict/publictions/idi/mteril/2011/mis_2011_without_nnex_5.pdf Accessed on 8 My World Bnk. Helth expenditure, totl (% of GDP) [dtbse on the Internet]. Wshington: World Bnk; c2011. Avilble from: dt.worldbnk.org/indictor/sh.xpd. TOTL.ZS Accessed on 7 My Jonne Peng CY, Nichols RN. Using multinomil logistic models to predict dolescent behviorl risk. J Mod App Stt Meth. 2003;2(1): LVlley MP. Sttisticl primer for crdiovsculr reserch. Circultion. 2008;117: United Ntions Economic Commission for Ltin Americ. About ECLAC [Internet]. Sntigo: UN; c2013. Avilble from: noticis/pgins/4/43024/p xml&xsl=/tpl-i/p18f-st.xsl&bse=/tpl-i/topbottom.xsl Accessed on 7 My World Helth Orgniztion. Globl Observtory for ehelth (GOe) [homepge on the Internet]. Genev: WHO; c2014. Avilble from: Accessed on 7 My Guerr M, Jordn V. Public policies for the informtion society: shred vision? Project document. Sntigo: United Ntions; Avilble from: Accessed on 8 My Peres W, Hilbert M. L sociedd de l informción en Améric Ltin y el Cribe: desrrollo de ls tecnologís y tecnologís pr el desrrollo. Sntigo: United Ntions; Avilble from: cgi-bin/getprod.sp?xml=/publicciones/ xml/2/36002/p36002.xml&xsl=/ddpe/tpl/ p9f.xsl&bse=/dmh/tpl/top-bottom.xslt Accessed on 8 My Observtory for the Informtion Society in Ltin Americ nd the Cribben. Monitoring elac2007: progress nd current stte of development of Ltin Americn nd Cribben informtion societies. Sntigo: United Ntions; Avilble from: stdev0125_en.pdf Accessed on 8 My Globl Observtory for ehelth. Atls ehelth country profiles bsed on the findings of the second globl survey on ehelth. Genev: World Helth Orgniztion; Avilble from: publictions/ehelth_series_vol1/en/index. html Accessed on 7 My Rev Pnm Slud Public 35(5/6),

8 Originl reserch Jimenez-Mrroquin et l. Informtion nd communiction technology nd ehelth policy in LAC 23. World Helth Orgniztion. The bigger picture for e-helth. Bull World Helth Orgn. 2012;90(5): Fernndez A, Oviedo E. Slud electrónic en Améric Ltin y el Cribe: vnces y desfíos. Sntigo: United Ntions nd Europen Union; Avilble from: www. eclc.org/publicciones/xml/5/41825/dislud-electrinic-lac.pdf Accessed on 7 My Ktz J, Hilbert M. Rod mps towrds n informtion society in Ltin Americ nd the Cribben. Sntigo: United Ntions; Avilble from: publicciones/xml/0/12900/rodmps.pdf Accessed on 8 My Mnuscript received on 15 July Revised version ccepted for publiction on 12 My resumen Polític en mteri de eslud y tecnologís de l informción y l comunicción en Améric Ltin y el Cribe: nálisis de ls polítics ncionles y evlución del contexto socioeconómico Plbrs clve Objetivo. Anlizr l disponibilidd de polítics ncionles en mteri de tecnologís de l informción y l comunicción (TIC) o eslud formulds por los píses de Améric Ltin y el Cribe, y determinr l influenci del contexto socioeconómico del pís sobre l existenci de este tipo de polítics. Métodos. Se seleccionron documentos que describiern un polític ncionl de TIC o eslud en culquier de los 33 píses de Améric Ltin y el Cribe según l clsificción de ls Nciones Unids, prtir de tres fuentes de dtos: bses de dtos cdémics; el motor de búsqued Google; y orgnismos y representciones gubernmentles. Tmbién se investigó l relción entre l existenci de un polític de este tipo y los indicdores socioeconómicos ncionles. Resultdos. Se h producido lgún progreso en el estblecimiento de polítics de TIC y eslud en Améric Ltin y el Cribe. Los métodos más útiles pr determinr ls polítics fueron: 1) el uso del motor de búsqued Google, y 2) el contcto con ls representciones de l Orgnizción Pnmericn de l Slud (OPS) en los píses. Prece más probble que los píses que hn elbordo un polític ncionl de TIC hyn implntdo tmbién un polític ncionl de eslud. No se observó ningun socición estdísticmente significtiv entre l existenci de un polític y el contexto socioeconómico de un pís. Conclusiones. Es preciso que los gobiernos intensifiquen ls inicitivs pr concientizr cerc de ls polítics existentes y plnificds en mteri de TIC y eslud, no solo pr fcilitr su utilizción y l comunicción con los interesdos directos, sino tmbién pr promover inicitivs colbortivs escl interncionl. Por otr prte, un mejor comprensión del efecto de ls vribles económics sobre l función que ls TIC desempeñn en ls inicitivs de reform del sector de l slud yudrá estblecer l perspectiv de lo se puede llegr logrr. Polític de slud; tecnologí de l informción; Améric Ltin; región del Cribe. 336 Rev Pnm Slud Public 35(5/6), 2014

Enterprise Risk Management Software Buyer s Guide

Enterprise Risk Management Software Buyer s Guide Enterprise Risk Mngement Softwre Buyer s Guide 1. Wht is Enterprise Risk Mngement? 2. Gols of n ERM Progrm 3. Why Implement ERM 4. Steps to Implementing Successful ERM Progrm 5. Key Performnce Indictors

More information

JaERM Software-as-a-Solution Package

JaERM Software-as-a-Solution Package JERM Softwre-s--Solution Pckge Enterprise Risk Mngement ( ERM ) Public listed compnies nd orgnistions providing finncil services re required by Monetry Authority of Singpore ( MAS ) nd/or Singpore Stock

More information

An Undergraduate Curriculum Evaluation with the Analytic Hierarchy Process

An Undergraduate Curriculum Evaluation with the Analytic Hierarchy Process An Undergrdute Curriculum Evlution with the Anlytic Hierrchy Process Les Frir Jessic O. Mtson Jck E. Mtson Deprtment of Industril Engineering P.O. Box 870288 University of Albm Tuscloos, AL. 35487 Abstrct

More information

ClearPeaks Customer Care Guide. Business as Usual (BaU) Services Peace of mind for your BI Investment

ClearPeaks Customer Care Guide. Business as Usual (BaU) Services Peace of mind for your BI Investment ClerPeks Customer Cre Guide Business s Usul (BU) Services Pece of mind for your BI Investment ClerPeks Customer Cre Business s Usul Services Tble of Contents 1. Overview...3 Benefits of Choosing ClerPeks

More information

San Mateo County ACCEL Adult-Education College and Career Educational Leadership AB 86 Adult Education Consortium Project Management Plan 24, 2014 -

San Mateo County ACCEL Adult-Education College and Career Educational Leadership AB 86 Adult Education Consortium Project Management Plan 24, 2014 - A Sn Mteo County ACCEL Adult-Eduction College nd Creer Eductionl Ledership AB 86 Adult Eduction Consortium Project Mngement Pln - Februry 24, 2014 - This project mngement pln presents ACCEL s process frmework

More information

Corporate Compliance vs. Enterprise-Wide Risk Management

Corporate Compliance vs. Enterprise-Wide Risk Management Corporte Complince vs. Enterprise-Wide Risk Mngement Brent Sunders, Prtner (973) 236-4682 November 2002 Agend Corporte Complince Progrms? Wht is Enterprise-Wide Risk Mngement? Key Differences Why Will

More information

Test Management using Telelogic DOORS. Francisco López Telelogic DOORS Specialist

Test Management using Telelogic DOORS. Francisco López Telelogic DOORS Specialist Test Mngement using Telelogic DOORS Frncisco López Telelogic DOORS Specilist Introduction Telelogic solution for Requirements Mngement DOORS Requirements mngement nd trcebility pltform for complex systems

More information

Small Businesses Decisions to Offer Health Insurance to Employees

Small Businesses Decisions to Offer Health Insurance to Employees Smll Businesses Decisions to Offer Helth Insurnce to Employees Ctherine McLughlin nd Adm Swinurn, June 2014 Employer-sponsored helth insurnce (ESI) is the dominnt source of coverge for nonelderly dults

More information

DlNBVRGH + Sickness Absence Monitoring Report. Executive of the Council. Purpose of report

DlNBVRGH + Sickness Absence Monitoring Report. Executive of the Council. Purpose of report DlNBVRGH + + THE CITY OF EDINBURGH COUNCIL Sickness Absence Monitoring Report Executive of the Council 8fh My 4 I.I...3 Purpose of report This report quntifies the mount of working time lost s result of

More information

Treatment Spring Late Summer Fall 0.10 5.56 3.85 0.61 6.97 3.01 1.91 3.01 2.13 2.99 5.33 2.50 1.06 3.53 6.10 Mean = 1.33 Mean = 4.88 Mean = 3.

Treatment Spring Late Summer Fall 0.10 5.56 3.85 0.61 6.97 3.01 1.91 3.01 2.13 2.99 5.33 2.50 1.06 3.53 6.10 Mean = 1.33 Mean = 4.88 Mean = 3. The nlysis of vrince (ANOVA) Although the t-test is one of the most commonly used sttisticl hypothesis tests, it hs limittions. The mjor limittion is tht the t-test cn be used to compre the mens of only

More information

Lump-Sum Distributions at Job Change, p. 2

Lump-Sum Distributions at Job Change, p. 2 Jnury 2009 Vol. 30, No. 1 Lump-Sum Distributions t Job Chnge, p. 2 E X E C U T I V E S U M M A R Y Lump-Sum Distributions t Job Chnge GROWING NUMBER OF WORKERS FACED WITH ASSET DECISIONS AT JOB CHANGE:

More information

Health insurance marketplace What to expect in 2014

Health insurance marketplace What to expect in 2014 Helth insurnce mrketplce Wht to expect in 2014 33096VAEENBVA 06/13 The bsics of the mrketplce As prt of the Affordble Cre Act (ACA or helth cre reform lw), strting in 2014 ALL Americns must hve minimum

More information

Psychological health and safety in the workplace Prevention, CAN/CSA-Z1003-13/BNQ 9700-803/2013

Psychological health and safety in the workplace Prevention, CAN/CSA-Z1003-13/BNQ 9700-803/2013 Psychologicl helth nd sfety in the workplce Prevention, CAN/CSA-Z1003-13/BNQ 9700-803/2013 promotion, nd guidnce to stged implementtion This smple udit tool is n nnex of the Ntionl Stndrd of Cnd on Psychologicl

More information

Health insurance exchanges What to expect in 2014

Health insurance exchanges What to expect in 2014 Helth insurnce exchnges Wht to expect in 2014 33096CAEENABC 02/13 The bsics of exchnges As prt of the Affordble Cre Act (ACA or helth cre reform lw), strting in 2014 ALL Americns must hve minimum mount

More information

Functional low vision in adults from Latin America: findings from population-based surveys in 15 countries

Functional low vision in adults from Latin America: findings from population-based surveys in 15 countries Investigción originl / Originl reserch Pn Americn Journl of Public Helth Functionl low vision in dults from Ltin Americ: findings from popultion-bsed surveys in 15 countries Hns Limburg, 1 Rosrio Espinoz,

More information

VoIP for the Small Business

VoIP for the Small Business VoIP for the Smll Business Reducing your telecommunictions costs Reserch firm IDC 1 hs estimted tht VoIP system cn reduce telephony-relted expenses by 30%. Voice over Internet Protocol (VoIP) hs become

More information

VoIP for the Small Business

VoIP for the Small Business Reducing your telecommunictions costs Reserch firm IDC 1 hs estimted tht VoIP system cn reduce telephony-relted expenses by 30%. Voice over Internet Protocol (VoIP) hs become vible solution for even the

More information

VoIP for the Small Business

VoIP for the Small Business Reducing your telecommunictions costs Reserch firm IDC 1 hs estimted tht VoIP system cn reduce telephony-relted expenses by 30%. Voice over Internet Protocol (VoIP) hs become vible solution for even the

More information

a GAO-03-568 GAO COLLEGE COMPLETION Additional Efforts Could Help Education with Its Completion Goals Report to Congressional Requesters

a GAO-03-568 GAO COLLEGE COMPLETION Additional Efforts Could Help Education with Its Completion Goals Report to Congressional Requesters GAO United Sttes Generl Accounting Office Report to Congressionl Requesters My 2003 COLLEGE COMPLETION Additionl Efforts Could Help Eduction with Its Completion Gols GAO-03-568 My 2003 COLLEGE COMPLETION

More information

VoIP for the Small Business

VoIP for the Small Business Reducing your telecommunictions costs TechAdvisory.org SME Reports sponsored by Cybernut Solutions provides outsourced IT support from welth of knowledgeble technicins nd system dministrtors certified

More information

Vendor Rating for Service Desk Selection

Vendor Rating for Service Desk Selection Vendor Presented By DATE Using the scores of 0, 1, 2, or 3, plese rte the vendor's presenttion on how well they demonstrted the functionl requirements in the res below. Also consider how efficient nd functionl

More information

VoIP for the Small Business

VoIP for the Small Business Reducing your telecommunictions costs Reserch firm IDC 1 hs estimted tht VoIP system cn reduce telephony-relted expenses by 30%. Voice over Internet Protocol (VoIP) hs become vible solution for even the

More information

A National Look at the High School Counseling Office

A National Look at the High School Counseling Office A Ntionl Look t the High School Counseling Office Wht Is It Doing nd Wht Role Cn It Ply in Fcilitting Students Pths to College? by Alexndri Wlton Rdford, Nicole Ifill, nd Terry Lew Introduction Between

More information

VoIP for the Small Business

VoIP for the Small Business VoIP for the Smll Business Reducing your telecommunictions costs Reserch firm IDC 1 hs estimted tht VoIP system cn reduce telephony-relted expenses by 30%. Voice over Internet Protocol (VoIP) hs become

More information

VoIP for the Small Business

VoIP for the Small Business Reducing your telecommunictions costs Reserch firm IDC 1 hs estimted tht VoIP system cn reduce telephony-relted expenses by 30%. Voice over Internet Protocol (VoIP) hs become vible solution for even the

More information

VoIP for the Small Business

VoIP for the Small Business Reducing your telecommunictions costs Reserch firm IDC 1 hs estimted tht VoIP system cn reduce telephony-relted expenses by 30%. Voice over Internet Protocol (VoIP) hs become vible solution for even the

More information

VoIP for the Small Business

VoIP for the Small Business Reducing your telecommunictions costs Reserch firm IDC 1 hs estimted tht VoIP system cn reduce telephony-relted expenses by 30%. Voice over Internet Protocol (VoIP) hs become vible solution for even the

More information

2015 EDITION. AVMA Report on Veterinary Compensation

2015 EDITION. AVMA Report on Veterinary Compensation 2015 EDITION AVMA Report on Veterinry Compenstion AVMA Report on Veterinry Compenstion 2015 EDITION Copyright 2015 by the All rights reserved. ISBN-13: 978-1-882691-31-9 AVMA Report on Veterinry Compenstion

More information

FDIC Study of Bank Overdraft Programs

FDIC Study of Bank Overdraft Programs FDIC Study of Bnk Overdrft Progrms Federl Deposit Insurnce Corportion November 2008 Executive Summry In 2006, the Federl Deposit Insurnce Corportion (FDIC) initited two-prt study to gther empiricl dt on

More information

Quality Evaluation of Entrepreneur Education on Graduate Students Based on AHP-fuzzy Comprehensive Evaluation Approach ZhongXiaojun 1, WangYunfeng 2

Quality Evaluation of Entrepreneur Education on Graduate Students Based on AHP-fuzzy Comprehensive Evaluation Approach ZhongXiaojun 1, WangYunfeng 2 Interntionl Journl of Engineering Reserch & Science (IJOER) ISSN [2395-6992] [Vol-2, Issue-1, Jnury- 2016] Qulity Evlution of Entrepreneur Eduction on Grdute Students Bsed on AHP-fuzzy Comprehensive Evlution

More information

July 22, 2009. The Honorable Henry A. Waxman Chairman Committee on Energy and Commerce House of Representatives

July 22, 2009. The Honorable Henry A. Waxman Chairman Committee on Energy and Commerce House of Representatives United Sttes Government Accountbility Office Wshington, DC 20548 July 22, 2009 The Honorble Henry A. Wxmn Chirmn Committee on Energy nd Commerce House of Representtives The Honorble John D. Dingell Chirmn

More information

GAO IRS AUDIT RATES. Rate for Individual Taxpayers Has Declined But Effect on Compliance Is Unknown

GAO IRS AUDIT RATES. Rate for Individual Taxpayers Has Declined But Effect on Compliance Is Unknown GAO United Sttes Generl Accounting Office Report to the Chirmn, Subcommittee on Oversight, Committee on Wys nd Mens, House of Representtives April 2001 IRS AUDIT RATES Rte for Individul Txpyers Hs Declined

More information

Assessing authentically in the Graduate Diploma of Education

Assessing authentically in the Graduate Diploma of Education Assessing uthenticlly in the Grdute Diplom of Eduction Dr Mree DinnThompson Dr Ruth Hickey Dr Michelle Lsen WIL Seminr JCU Nov 12 2009 Key ides plnning process tht embeds uthentic ssessment, workintegrted

More information

Preliminary Overview of the Economies. of Latin America and the Caribbean

Preliminary Overview of the Economies. of Latin America and the Caribbean 2007 Preliminry Overview of the Economies of Ltin Americ nd the Cribben The Preliminry Overview of the Economies of Ltin Americ nd the Cribben is n nnul publiction prepred by the Economic Development Division

More information

VoIP for the Small Business

VoIP for the Small Business VoIP for the Smll Business Reducing your telecommunictions costs Reserch firm IDC 1 hs estimted tht VoIP system cn reduce telephony-relted expenses by 30%. Voice over Internet Protocol (VoIP) hs become

More information

Long Term Financial Planning

Long Term Financial Planning Long Term Finncil Plnning Overview of New Pltform City of Knss City, Missouri 2013 2018 Long term finncil plnning combines finncil forecsting with finncil strtegizing to identify future chllenges nd opportunities

More information

VoIP for the Small Business

VoIP for the Small Business Reducing your telecommunictions costs Reserch firm IDC 1 hs estimted tht VoIP system cn reduce telephony-relted expenses by 30%. Voice over Internet Protocol (VoIP) hs become vible solution for even the

More information

Contextualizing NSSE Effect Sizes: Empirical Analysis and Interpretation of Benchmark Comparisons

Contextualizing NSSE Effect Sizes: Empirical Analysis and Interpretation of Benchmark Comparisons Contextulizing NSSE Effect Sizes: Empiricl Anlysis nd Interprettion of Benchmrk Comprisons NSSE stff re frequently sked to help interpret effect sizes. Is.3 smll effect size? Is.5 relly lrge effect size?

More information

VoIP for the Small Business

VoIP for the Small Business Reducing your telecommunictions costs Reserch firm IDC 1 hs estimted tht VoIP system cn reduce telephony-relted expenses by 30%. Voice over Internet Protocol (VoIP) hs become vible solution for even the

More information

Economics Letters 65 (1999) 9 15. macroeconomists. a b, Ruth A. Judson, Ann L. Owen. Received 11 December 1998; accepted 12 May 1999

Economics Letters 65 (1999) 9 15. macroeconomists. a b, Ruth A. Judson, Ann L. Owen. Received 11 December 1998; accepted 12 May 1999 Economics Letters 65 (1999) 9 15 Estimting dynmic pnel dt models: guide for q mcroeconomists b, * Ruth A. Judson, Ann L. Owen Federl Reserve Bord of Governors, 0th & C Sts., N.W. Wshington, D.C. 0551,

More information

Introducing Kashef for Application Monitoring

Introducing Kashef for Application Monitoring WextWise 2010 Introducing Kshef for Appliction The Cse for Rel-time monitoring of dtcenter helth is criticl IT process serving vriety of needs. Avilbility requirements of 6 nd 7 nines of tody SOA oriented

More information

VoIP for the Small Business

VoIP for the Small Business VoIP for the Smll Business Reducing your telecommunictions costs Reserch firm IDC 1 hs estimted tht VoIP system cn reduce telephony-relted expenses by 30%. Voice over Internet Protocol (VoIP) hs become

More information

Utilization of Smoking Cessation Benefits in Medicaid Managed Care, 2009-2013

Utilization of Smoking Cessation Benefits in Medicaid Managed Care, 2009-2013 Utiliztion of Smoking Cesstion Benefits in Medicid Mnged Cre, 2009-2013 Office of Qulity nd Ptient Sfety New York Stte Deprtment of Helth Jnury 2015 Introduction According to the New York Stte Tocco Control

More information

VoIP for the Small Business

VoIP for the Small Business VoIP for the Smll Business Reducing your telecommunictions costs Reserch firm IDC 1 hs estimted tht VoIP system cn reduce telephony-relted expenses by 30%. Voice over Internet Protocol (VoIP) hs become

More information

VoIP for the Small Business

VoIP for the Small Business Reducing your telecommunictions costs Reserch firm IDC 1 hs estimted tht VoIP system cn reduce telephony-relted expenses by 30%. Voice over Internet Protocol (VoIP) hs become vible solution for even the

More information

Portfolio approach to information technology security resource allocation decisions

Portfolio approach to information technology security resource allocation decisions Portfolio pproch to informtion technology security resource lloction decisions Shivrj Knungo Deprtment of Decision Sciences The George Wshington University Wshington DC 20052 knungo@gwu.edu Abstrct This

More information

VoIP for the Small Business

VoIP for the Small Business VoIP for the Smll Business Reducing your telecommunictions costs Reserch firm IDC 1 hs estimted tht VoIP system cn reduce telephony-relted expenses by 30%. Voice over Internet Protocol (VoIP) hs become

More information

Factors Affecting Electronic Medical Record System Adoption in Small Korean Hospitals

Factors Affecting Electronic Medical Record System Adoption in Small Korean Hospitals Originl Article Helthc Inform Res. 2014 July;20(3):183-190. pissn 2093-3681 eissn 2093-369X Fctors Affecting Electronic Medicl Record System Adoption in Smll Koren Hospitls Young-Tek Prk, PhD 1, Jinhyung

More information

Hillsborough Township Public Schools Mathematics Department Computer Programming 1

Hillsborough Township Public Schools Mathematics Department Computer Programming 1 Essentil Unit 1 Introduction to Progrmming Pcing: 15 dys Common Unit Test Wht re the ethicl implictions for ming in tody s world? There re ethicl responsibilities to consider when writing computer s. Citizenship,

More information

Helicopter Theme and Variations

Helicopter Theme and Variations Helicopter Theme nd Vritions Or, Some Experimentl Designs Employing Pper Helicopters Some possible explntory vribles re: Who drops the helicopter The length of the rotor bldes The height from which the

More information

Current Topics. Implications for Compliance Organizations. Presentation to the IIB. October, 2015

Current Topics. Implications for Compliance Organizations. Presentation to the IIB. October, 2015 Current Topics Implictions for Complince Orgniztions Presenttion to the IIB October, 2015 This presenttion contins generl informtion only nd Deloitte is not, by mens of this presenttion, rendering ccounting,

More information

GAO HIGHER EDUCATION. Federal Science, Technology, Engineering, and Mathematics Programs and Related Trends

GAO HIGHER EDUCATION. Federal Science, Technology, Engineering, and Mathematics Programs and Related Trends GAO United Sttes Government Accountbility Office Report to the Chirmn, Committee on Rules, House of Representtives October 2005 HIGHER EDUCATION Federl Science, Technology, Engineering, nd Mthemtics Progrms

More information

Small Business Networking

Small Business Networking Why network is n essentil productivity tool for ny smll business Effective technology is essentil for smll businesses looking to increse the productivity of their people nd processes. Introducing technology

More information

ENHANCING CUSTOMER EXPERIENCE THROUGH BUSINESS PROCESS IMPROVEMENT: AN APPLICATION OF THE ENHANCED CUSTOMER EXPERIENCE FRAMEWORK (ECEF)

ENHANCING CUSTOMER EXPERIENCE THROUGH BUSINESS PROCESS IMPROVEMENT: AN APPLICATION OF THE ENHANCED CUSTOMER EXPERIENCE FRAMEWORK (ECEF) ENHNCING CUSTOMER EXPERIENCE THROUGH BUSINESS PROCESS IMPROVEMENT: N PPLICTION OF THE ENHNCED CUSTOMER EXPERIENCE FRMEWORK (ECEF) G.J. Both 1, P.S. Kruger 2 & M. de Vries 3 Deprtment of Industril nd Systems

More information

VoIP for the Small Business

VoIP for the Small Business Reducing your telecommunictions costs Reserch firm IDC 1 hs estimted tht VoIP system cn reduce telephony-relted expenses by 30%. Voice over Internet Protocol (VoIP) hs become vible solution for even the

More information

Health Information Systems: evaluation and performance of a Help Desk

Health Information Systems: evaluation and performance of a Help Desk 536 Digitl Helthcre Empowering Europens R. Cornet et l. (Eds.) 2015 Europen Federtion for Medicl Informtics (EFMI). This rticle is published online with Open Access by IOS Press nd distributed under the

More information

Performance Evaluation of Academic Libraries Implementation Model

Performance Evaluation of Academic Libraries Implementation Model Performnce Evlution of Acdemic Librries Implementtion Model Luiz Bptist Melo CIDEHUS UE nd Librries of the Fculty of Science, University of Porto (Applied Mthemtics nd Botnicl Deprtments) Ru do Cmpo Alegre,

More information

VoIP for the Small Business

VoIP for the Small Business VoIP for the Smll Business Reducing your telecommunictions costs Reserch firm IDC 1 hs estimted tht VoIP system cn reduce telephony-relted expenses by 30%. Voice over Internet Protocol (VoIP) hs become

More information

Unit 29: Inference for Two-Way Tables

Unit 29: Inference for Two-Way Tables Unit 29: Inference for Two-Wy Tbles Prerequisites Unit 13, Two-Wy Tbles is prerequisite for this unit. In ddition, students need some bckground in significnce tests, which ws introduced in Unit 25. Additionl

More information

elearning platforms and consultation service at CU Presented by Judy Lo 31 August 2007

elearning platforms and consultation service at CU Presented by Judy Lo 31 August 2007 elerning pltforms nd consulttion service t CU Presented by Judy Lo 31 August 2007 Agend The elerning guidelines How elerning cn lower your work burden nd enhnce lerning? The elerning pltforms The elerning

More information

Note: Principal version Modification Amendment Equivalence list Consolidated version from October 1 2014

Note: Principal version Modification Amendment Equivalence list Consolidated version from October 1 2014 Note: The following curriculum is consolidted version. It is leglly non-inding nd for informtionl purposes only. The leglly inding versions re found in the University of Innsruck Bulletins (in Germn).

More information

C-crcs Cognitive - Counselling Research & Conference Services (eissn: 2301-2358)

C-crcs Cognitive - Counselling Research & Conference Services (eissn: 2301-2358) C-crcs Cognitive - Counselling Reserch & Conference Services (eissn: 2301-2358) Volume I Effects of Music Composition Intervention on Elementry School Children b M. Hogenes, B. Vn Oers, R. F. W. Diekstr,

More information

Innovative and applied research on big data platforms of smart heritage

Innovative and applied research on big data platforms of smart heritage Innovtive nd pplied reserch on big dt pltforms of smrt heritge J. Qiu, J. Li, H. Sun * qiujie@thid.cn lijijun@thid.cn sunhuijio@thid.cn KEY WORDS: Smrt heritge, Big dt, Explntion ABSTRACT: Big dt hs huge

More information

Recognition Scheme Forensic Science Content Within Educational Programmes

Recognition Scheme Forensic Science Content Within Educational Programmes Recognition Scheme Forensic Science Content Within Eductionl Progrmmes one Introduction The Chrtered Society of Forensic Sciences (CSoFS) hs been ccrediting the forensic content of full degree courses

More information

Numeracy across the Curriculum in Key Stages 3 and 4. Helpful advice and suggested resources from the Leicestershire Secondary Mathematics Team

Numeracy across the Curriculum in Key Stages 3 and 4. Helpful advice and suggested resources from the Leicestershire Secondary Mathematics Team Numercy cross the Curriculum in Key Stges 3 nd 4 Helpful dvice nd suggested resources from the Leicestershire Secondry Mthemtics Tem 1 Contents pge The development of whole school policy 3 A definition

More information

AN ANALYTICAL HIERARCHY PROCESS METHODOLOGY TO EVALUATE IT SOLUTIONS FOR ORGANIZATIONS

AN ANALYTICAL HIERARCHY PROCESS METHODOLOGY TO EVALUATE IT SOLUTIONS FOR ORGANIZATIONS AN ANALYTICAL HIERARCHY PROCESS METHODOLOGY TO EVALUATE IT SOLUTIONS FOR ORGANIZATIONS Spiros Vsilkos (), Chrysostomos D. Stylios (),(b), John Groflkis (c) () Dept. of Telemtics Center, Computer Technology

More information

ACCOUNTING FACULTY RESEARCH COLLABORATION: A STUDY OF RELATIONSHIP BENEFITS AND GENDER DIFFERENCES

ACCOUNTING FACULTY RESEARCH COLLABORATION: A STUDY OF RELATIONSHIP BENEFITS AND GENDER DIFFERENCES Globl Perspectives on Accounting Eduction Volume 2, 2005, 19-36 ACCOUNTING FACULTY RESEARCH COLLABORATION: A STUDY OF RELATIONSHIP BENEFITS AND GENDER DIFFERENCES Mry Jenne Welsh L Slle University Phildelphi,

More information

Health insurance exchanges What to expect in 2014

Health insurance exchanges What to expect in 2014 Helth insurnce exchnges Wht to expect in 2014 33096CAEENABC 11/12 The bsics of exchnges As prt of the Affordble Cre Act (ACA or helth cre reform lw), strting in 2014 ALL Americns must hve minimum mount

More information

STATUS OF LAND-BASED WIND ENERGY DEVELOPMENT IN GERMANY

STATUS OF LAND-BASED WIND ENERGY DEVELOPMENT IN GERMANY Yer STATUS OF LAND-BASED WIND ENERGY Deutsche WindGurd GmbH - Oldenburger Strße 65-26316 Vrel - Germny +49 (4451)/9515 - info@windgurd.de - www.windgurd.com Annul Added Cpcity [MW] Cumultive Cpcity [MW]

More information

Gippsland Regional Palliative Care Plan 2005-2009

Gippsland Regional Palliative Care Plan 2005-2009 Gippslnd Regionl Pllitive Cre Pln 2005-2009 The Gippslnd Region: The City of Ltrobe nd the Shires of Bss Cost, Bw Bw, Est Gippslnd, South Gippslnd nd Wellington Gippslnd Regionl Pllitive Cre Consortium

More information

VoIP for the Small Business

VoIP for the Small Business Reducing your telecommunictions costs VoIP (Voice over Internet Protocol) offers low cost lterntive to expensive trditionl phone services nd is rpidly becoming the communictions system of choice for smll

More information

GAO HIGHER EDUCATION. Improved Tax Information Could Help Families Pay for College. Report to the Committee on Finance, U.S.

GAO HIGHER EDUCATION. Improved Tax Information Could Help Families Pay for College. Report to the Committee on Finance, U.S. GAO United Sttes Government Accountbility Office Report to the Committee on Finnce, U.S. Sente My 2012 HIGHER EDUCATION Improved Tx Informtion Could Help Fmilies Py for College GAO-12-560 My 2012 HIGHER

More information

SPONSOR A CHILD Please sponsor a child like Reuben or Byiringiro

SPONSOR A CHILD Please sponsor a child like Reuben or Byiringiro AFRICA SPONSOR A CHILD Plese sponsor child like Reuben or Byiringiro REGIONAL How it works... Strt your sponsorship tody Receive your specific child s photo, fmily info, nd country Introduce yourself nd

More information

Small Business Networking

Small Business Networking Why network is n essentil productivity tool for ny smll business Effective technology is essentil for smll businesses looking to increse the productivity of their people nd processes. Introducing technology

More information

E-Mentoring and Information Systems Effectiveness Models: a useful nexus for evaluation in the small business context.

E-Mentoring and Information Systems Effectiveness Models: a useful nexus for evaluation in the small business context. School of Informtion Systems Fculty of Business nd Lw Victori University E-Mentoring nd Informtion Systems Effectiveness Models: useful nexus for evlution in the smll business context. Submitted by : Kim

More information

SyGEMe: Integrated Municipal Facilities Management of Water Ressources Swiss Geoscience Meeting, Neuchâtel, 21 novembre 2009 k

SyGEMe: Integrated Municipal Facilities Management of Water Ressources Swiss Geoscience Meeting, Neuchâtel, 21 novembre 2009 k SyGEMe: Integrted Municipl Fcilities Mngement of Wter Ressources Tool presenttion, choice of technology, mn-mchine mchine interfce, business opportunities nd prospects 1. Introduction 2. Mn-mchine interfce

More information

PROFILES. Physical Education Profiles. Physical Education and Physical Activity Practices and Policies Among Secondary Schools at Select US Sites

PROFILES. Physical Education Profiles. Physical Education and Physical Activity Practices and Policies Among Secondary Schools at Select US Sites PROFILES 2012 Physicl Eduction Profiles Physicl Eduction nd Physicl Activity Prctices nd Policies Among Secondry Schools t Select US s Ntionl Center for Chronic Disese Prevention nd Helth Promotion Division

More information

Implementation Evaluation Modeling of Selecting ERP Software Based on Fuzzy Theory

Implementation Evaluation Modeling of Selecting ERP Software Based on Fuzzy Theory Implementtion Evlution Modeling of Selecting ERP Softwre Bsed on Fuzzy Theory Xukn Xu 1, Ydong Jing 1 nd Zheng Shi 2 1 Informtion Mngement Deprtment, Chngzhou Cmpus, Hohi University, Chngzhou 213022, Jingsu,

More information

Kent School of Social Work Strategic Plan 2009

Kent School of Social Work Strategic Plan 2009 -2013 Gols 2007-2008 Bseline 2008-09 2009-11 Gol 1: Eduction Achieve Accredittion for MSSW, BSW nd MFT Objective 2: Add 25 students to the BSW progrm until rech t lest 60 per MSSW nd MFT lredy ccredited

More information

GAO HOME MORTGAGE INTEREST DEDUCTION. Despite Challenges Presented by Complex Tax Rules, IRS Could Enhance Enforcement and Guidance

GAO HOME MORTGAGE INTEREST DEDUCTION. Despite Challenges Presented by Complex Tax Rules, IRS Could Enhance Enforcement and Guidance GAO United Sttes Government Accountbility Office Report to the Joint Committee on Txtion July 2009 HOME MORTGAGE INTEREST DEDUCTION Despite Chllenges Presented by Complex Tx Rules, IRS Could Enhnce Enforcement

More information

Small Business Networking

Small Business Networking Why Network is n Essentil Productivity Tool for Any Smll Business TechAdvisory.org SME Reports sponsored by Effective technology is essentil for smll businesses looking to increse their productivity. Computer

More information

Influence of Playing Experience and Coaching Education on Coaching Efficacy among Malaysian Youth Coaches

Influence of Playing Experience and Coaching Education on Coaching Efficacy among Malaysian Youth Coaches World Applied Sciences Journl 30 (Innovtion Chllenges in Multidiciplinry Reserch & Prctice): 414-419, 2014 ISSN 1818-4952 IDOSI Publictions, 2014 DOI: 10.5829/idosi.wsj.2014.30.icmrp.198 Influence of Plying

More information

Reasoning to Solve Equations and Inequalities

Reasoning to Solve Equations and Inequalities Lesson4 Resoning to Solve Equtions nd Inequlities In erlier work in this unit, you modeled situtions with severl vriles nd equtions. For exmple, suppose you were given usiness plns for concert showing

More information

Gestational syphilis and stillbirth in the Americas: a systematic review and meta-analysis

Gestational syphilis and stillbirth in the Americas: a systematic review and meta-analysis Artículo de revisión / Review Pn Americn Journl of Pulic Helth nd stillirth in the Americs: systemtic review nd met-nlysis Luren Arnesen, 1 Suznne Serruy, 1 nd Plo Durán 1 Suggested cittion Arnesen L,

More information

Data quality issues for accounting information systems implementation: Systems, stakeholders, and organizational factors

Data quality issues for accounting information systems implementation: Systems, stakeholders, and organizational factors Journl of Technology Reserch Dt qulity issues for ccounting informtion systems implementtion: Systems, stkeholders, nd orgniztionl fctors ABSTRACT Hongjing Xu Butler University Qulity informtion is one

More information

UNIVERSITY OF NOTTINGHAM. Discussion Papers in Economics STRATEGIC SECOND SOURCING IN A VERTICAL STRUCTURE

UNIVERSITY OF NOTTINGHAM. Discussion Papers in Economics STRATEGIC SECOND SOURCING IN A VERTICAL STRUCTURE UNVERSTY OF NOTTNGHAM Discussion Ppers in Economics Discussion Pper No. 04/15 STRATEGC SECOND SOURCNG N A VERTCAL STRUCTURE By Arijit Mukherjee September 004 DP 04/15 SSN 10-438 UNVERSTY OF NOTTNGHAM Discussion

More information

DEVELOPING A NEW GRADUATE PROGRAM IN HEALTHCARE MANAGEMENT: EMBRACING THE TRANSFORMATION OF HEALTHCARE MANAGEMENT EDUCATION ON A PATHWAY TO SUCCESS

DEVELOPING A NEW GRADUATE PROGRAM IN HEALTHCARE MANAGEMENT: EMBRACING THE TRANSFORMATION OF HEALTHCARE MANAGEMENT EDUCATION ON A PATHWAY TO SUCCESS DEVELOPING A NEW GRADUATE PROGRAM IN HEALTHCARE MANAGEMENT: EMBRACING THE TRANSFORMATION OF HEALTHCARE MANAGEMENT EDUCATION ON A PATHWAY TO SUCCESS Dniel G. Dominguez, MHA, Ph.D. Chris Grci, MBA, Ph.D.,

More information

Software Cost Estimation Model Based on Integration of Multi-agent and Case-Based Reasoning

Software Cost Estimation Model Based on Integration of Multi-agent and Case-Based Reasoning Journl of Computer Science 2 (3): 276-282, 2006 ISSN 1549-3636 2006 Science Publictions Softwre Cost Estimtion Model Bsed on Integrtion of Multi-gent nd Cse-Bsed Resoning Hsn Al-Skrn Informtion Technology

More information

According to Webster s, the

According to Webster s, the dt modeling Universl Dt Models nd P tterns By Len Silversn According Webster s, term universl cn be defined s generlly pplicble s well s pplying whole. There re some very common ptterns tht cn be generlly

More information

Small Business Networking

Small Business Networking Why network is n essentil productivity tool for ny smll business Effective technology is essentil for smll businesses looking to increse the productivity of their people nd processes. Introducing technology

More information

Preliminary Overview of the Economies of Latin America and the Caribbean

Preliminary Overview of the Economies of Latin America and the Caribbean 2014 Preliminry Overview of the Economies of Ltin Americ nd the Cribben Alici Bárcen Executive Secretry Antonio Prdo Deputy Executive Secretry Dniel Titelmn Chief, Economic Development Division Ricrdo

More information

Lecture 3 Gaussian Probability Distribution

Lecture 3 Gaussian Probability Distribution Lecture 3 Gussin Probbility Distribution Introduction l Gussin probbility distribution is perhps the most used distribution in ll of science. u lso clled bell shped curve or norml distribution l Unlike

More information

Improving Library Users' Perceived Quality, Satisfaction and Loyalty: An Integrated Measurement and Management System

Improving Library Users' Perceived Quality, Satisfaction and Loyalty: An Integrated Measurement and Management System Improving Librry Users' Perceived Qulity, Stisfction nd Loylty: An Integrted Mesurement nd Mngement System by Anne Mrtensen nd Lrs Gr0nholdt This rticle describes the development nd ppliction of structurl

More information

2006 IPCC Software for National Greenhouse Gas Inventories: Application and use for India

2006 IPCC Software for National Greenhouse Gas Inventories: Application and use for India 2006 IPCC Softwre for Ntionl Greenhouse Gs Inventories: Appliction nd use for Indi Presenttion for NGGIP Side Event Bonn, June 8, 2013 Prof. Amit Grg (mitgrg@iimhd.ernet.in), INDIA GHG Inventory Softwre

More information

Small Business Networking

Small Business Networking Why network is n essentil productivity tool for ny smll business Effective technology is essentil for smll businesses looking to increse the productivity of their people nd business. Introducing technology

More information

Performance analysis model for big data applications in cloud computing

Performance analysis model for big data applications in cloud computing Butist Villlpndo et l. Journl of Cloud Computing: Advnces, Systems nd Applictions 2014, 3:19 RESEARCH Performnce nlysis model for big dt pplictions in cloud computing Luis Edurdo Butist Villlpndo 1,2,

More information