Primary indicators of healthcare success

As been mentioned peripherally that appearance act as a reference for many who used to put judgement even in work issues depending only on appearance and external image. Whereas their pretext says that animals in nature are doing the same and they only make a judgment also on appearance and external feature. Actually; the animals are hundred percent right to do their judgment depending only on external features and apparently characters, why they are right?!. Because they have not any other measure to calibrate with other creatures so, they visually talk to themselves related to present moment and now appearance, nothing else. Human kind could not do the same due to our facilities to know and judge differently that make human on wide spectrum of analytical thinking. A lot of animal envy us for these abilities that enable humankind to put things on will and right ways, surprisingly some societies push indirectly their citizens to do the same exactly like animals- means present and now. Why they do so?!, because they would like to suppress their mindsets of creation and building strength they have, to be easy controlled and easy directed J. Our blog will not discuss politics, just was a introduction to know from that does not matter the appearance of the healthcare system seemed Wow than how far performance they achieve and what capacity they do daily with patients.

Patients are our priceless asset, if we succeed to do our tasks properly and give them best service ever, that will reflect on their health and care system wholly. In order not to go far from the post title and the purpose embedded, there are main indicators when the care system achieves them in appropriate way, then they represent good seeds for success and future performance flourish:

-Accessibility and availability of data

-Configurable presentation of data

-Active communication with other professionals and with patients

-Data aggregation

-Access to knowledge bases

-Decision making support systems

-Care quality improvement

We almost covered most of them in past and all needed just put them in front of you when any one faces healthcare system in life. There are no complications and sophistications about, any ordinary person can apply these parameters to judge and calibre performance with positive points inside the system they contact with. For specialists of care systems; they also apply the same by a bit deeply with little more branched purposes that service academic research and statistics. Frankly; the nice of these parameters that they are not depending only on the system appearance than the real actual performance it does which serves the country patients and future generations. Moreover, that give a hint about the working system to find faults and fast management corrections as fast as needed. Happy who can understand the game of success and happier who have ability to see people around him happy because of him/her. In care systems the results reflect your effort, time and thinking way with patients and children faces at once which put their welfare become main target and society health is endless pursues. Full health J

Managing services request

After patient got defined and identified by system then next step to order for getting the demanded services. Why I do not say needed services because demanded services forced by purchase power and ability to get it depending on private income or insurance funds. Managing modules of service orders widely common used as a term of service management policy of patient service request. Apparently; state healthcare system regularly own module of patient management orders that enable hospitals teams to manage and distribute care orders among physicians and specialists from different medical departments over the country care system to produce synergism in between and maximize the gained benefits from system itself. Frankly; distributing tasks among medical workers and pushing system resources including human related ones- to do and perform more. Then create and build sustainable revenues to the operation unites of system (hospitals) and also annual yield from whole other unites. Point of benefits maximization is confused issue for many readers, so in order to get better understanding to the point as mine, let me explain it by example. Actually; those who own very fast cars and paid a lot of money to buy them and later on to manage that maintenance and everything to keep them safe far from any scratch. But at the same time they rarely travel long distance by car because it exhausted for body, to sit long hours and for mind, to focus only on the frontal road. The same measure you can use here exactly; very solid infrastructure and well built healthcare system and easy defined delivery channels with near access platforms to everyone. After all, operation capacity of system does not reach to planned targets and patients numbers to serve correctly. Academically, It called poor managed operation lead to inferior to modest performance results with clear level of patient dissatisfaction.

Fortunately; there are resources to cover everyone needs on this earth but the choice is ours to maximize the gains or waste it for nothing. Every system must own some setbacks behind the scenes and that does not mean the work was done wrong but alternatively we figure some sources of development and future improvements for what is better. Believe me or may not managing the patients operations and issues which going on daily basis is much bigger than doing the best to make the system appear modern or in hi-tech mode. I know decades growing generations have learned and brought up to judge depending only on external appearance. May be that work with some matters but never with all of them particularly technical and performance grades of medical care. Performance is actually the key of any success within the medical system and care components whatever level of modernisation is. For sure if everything accepted in a good grade and decently works well, that is good.

Some protocols of patient services belong to WHO discussed some routes and processes to distribute and organise patient and service requests. On the same level; some staff is more creative than us to create and build private and adaptable circle of service distribution that service the system capacity and help them to be more and achieve better. Creation of human being is the endless process that would never die by years or ages, free to do, free to perform and also free to achieve. Life is open and our planet has a lot still to offer only with builders and reconstruct mindsets we can get more and be actually more, all the best and enjoy good time with next posts, full health J

After hospital operation system unite

Hospitals in healthcare system considered the building brick of the system and also operational and functional unites to serve and provide people and patient with different kind of services. So, after the matter of planning the hospital from inside and care about their securities in order to keep that system safe as long as possible and properly work in future. It is the time to define and draw baseline of introduced services that enable patient to be satisfied with their effort and time they are going to spend with medical care and system data gate. The term "services" refers to all actions that can be performed in relation to a patient, such as diagnostic tests, therapeutic procedures, visits with doctors, nurses or other groups, surgical interventions, interdepartmental consultation,…..etc.

Briefly; there are some measurable factor determines shape and frame of introduced service compiled together to form service package for certain category of patients or aimed treatable diseases. Service on demand needs to be scheduled by booking appointment in advance that help the provider to give proper and sufficient time to each patient that in need to such care or services. It does not mean that there is other kind of services do not need appointment making process. For instance; emergencies and urgent cases including accidents and sudden surgical operations, that kind of services ever needed to be planed because the time of occurrence is unknown. So, on the same measure there is a big difference between each service and belong category by through subsequently need some different regulations and procedures matches with patient needs and end value results. Nothing is constant regarding name or nature of services that can differ from country to another and also from area to other in the same state.   

Validation period of results; this informs the person request the appointment that there was already a valid result for the same action, and it is therefore not necessary to request it again. This avoids unnecessary expense, further inconvenience for the patient. The service category of specialist visits on demands and those also in need to get appointment making process. 

Service resources; it means all resources associated nurses, doctors and tools or medical equipments that related to service process of patient service provision. Actually many of resources will not be available just because not all needed resources not existed usually at the same time. Matter of operation resources is seriously due to critical significance toward daily routine work, might everything is well done and operated perfectly in the system but regular situation of daily work does not find always resources to do sustainably and to offer the same quality of service. Moreover; in some situations due to lack of resources-also including human resources and physicians, the whole services stop depending on the availability of such resources for every service. Some services need medical surgical operations and associated devices and trained surgeons while others need in site medications and solutions might not there at all. All of these problems are not something new, medical workers and nurses aware well with this point of service resources deprivation and regular shortage that give them availabilities to provide the service properly. Privately opinion of mine, operation of enterprise is much more than anything else, many people own businesses and more wanted to create one but few who in real know how to operate and lead to success. If we consider the hospital or medical provider as a business enterprise it means rules of management and operation of resources maximisation almost the same with little difference to fit with medical care and nature of work tasks. Full health J

Master patient index

How hospital runs patients data and case information is differ from provider to another according to work policy and available tools. For many years in past hospital used to document patient data and medication manually by hand written papers. After digital era invaded everything so, matter of big amount of papers and documents got easier to handle and be processed. Moreover; software developers created and built a lot of helpful system and applied protocols to organize everything related to data mining, storage and even retrieving them. Nowadays; every patient granted clinical record number by provider, through hospitals and care providers can indentify the patient case history and tracking the process in service and result at time in mutual pathways. HIS of hospital have sub-systems within in form of integration informative layers make the patient service index easy to monitor and easier to be judged. Mastering patient index take time and effort with synergism to reach feasible standards and get appropriate results. May you found in life many hospitals have good appearance of PC and digital infrastructure but still they are on the favourable threshold to get good score in master patient index. That mean appearance does not mean always strength or improvement as many thought. Psychiatry textbooks mention that appearance form only ten percent from the actual reality and what really people insist eagerly to broadcast deny the truth in vast of situations.

From other side; in order to do exchange patient data over regional and national levels through those sub-systems of hospitals also need to master patient index and reach reasonable standards of service make out patients and their information stay in safe and security side of work. Some countries like Spain make TIS of patient identifier but there is wide orbit of possibilities to open new routes for identification. I hearing some voices still ask about meaning of master patient index literally; index is indicator for something may be improved in future or not while master patient is being mange and form data productive frames could help in quality standards and end result service levels to the intended patient.

Here, honestly I would like to get your attention more that implementation of hospital information system properly with good security standards can translated directly to reflect the quality of healthcare operation that represented in prestigious qualified medical care providers. Then, building brick of care system already done and issue of where medical providers are located would be discussed internally with authorized country institutions for each of them. Private providers should not be different, all get the same level of digital care portfolios and services lists with accepted significance face if they want to integrate with national care system. No difference or discrimination. It means level of the same standards applied to all without any biass or hidden agenda and authorized operation licence strictly applied such obligations to direct entire society toward health welfare to get the optimum point and keep the care market far from unkown inferior products managed by poor developed providers. Full health J

 

Security configuration of HIS

Security configuration has carried out in order to do some sort of hospital information system adaptation with the same system users and their level of access. System availability and accessibility differ according to shape of medical care unites and running processes. Also there are variables among level of services in compliance with funding current which nourish the primary providers to properly give the services in a good degree of acceptance. Meanwhile; those who refuse to join the state network of medical care would not get that advantage to have the same service standards. Though, medical institutions embraced what is called ‘security document’ which draw up the shape of security features regarding dealing of files processing, documents, equipments, and system programs. The primary and also primitive way to protect HIS from future misuse that briefly summarized in two steps; Identification and Authentication…

The person identifies himself/herself to confirm the person identity through certain system steps prepared and constructed to easily understandable with minimum steps of processing to get into hospital access gates. The second step is authentication; a) System might apply this step depending on some well known by users ex: password and user name. b) System might apply this step in form of user ID card or personal care provided by care providers or even state. c) Last one through biometric methods based on finger print analysis and iris. Most of these methods of authentications already applied and run presently in considerable number of country and critical service sites for some security reasons. A point here that level of system access of ordinary users like patients is completely differ in functionality from the access level of medical workers which applied on system inside tracks. That for sure, drawn in form of grape like network data construction. It means the apex of grape is the end user unites or value receiver persons who deal with the system on beneficiary base where every upgrade level related mainly to system management itself and security obligations. It is not necessary to regular service receivers to know about hidden security system figures should not be ever announced publicly.

Moreover; the process of identifications and authentications should undergo to be in compliance with data protection laws. Users directed only to the demanded functionality with total control of next level of authentication step to allow and give the necessary permission far from solid core of the hospital system which might be affected from big user numbers. The last point about HIS here is the matter of tracking the users and defined any existence of errors probably been happened or awaited due to misuse of the system. Also continuous in mind that the permission was granted to some users and guests who entitled to do and receive some work or technical issues touch the core of system. Soundness and intactness of the hospital information security is on the highest level of significance and first object to keep it far from any threatens that affect directly or even indirectly with time. Tracking users by whom authorized to check, delete and modify the entered data make the system safe for long decades and virgin land for next progress and development. Full health J

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Hospital information system prototype

You will never be criticized by someone do better than you, so when you found such category of people just smile and be silent. During healthcare prototypes a lot of people are going to criticise you not because they are smarter than you. Ever; the truth is that their minds are much bigger than their own bodies with noticed tough of emptiness made them forget own achievements and spend their time looking at other people work setbacks. Most of people used to spend a lot of life time to judge and mock others at the same time it is hard for them to join to produce and create something useful. But in medical systems prototypes people do the opposite; we do the work and necessary tasks that make them fit to produce and build collaborative state of mind toward the eventual goals. As I promised you to start symbolic medical system prototypes to build visionary imagination about how the process of medical system was designed and repeated as the same in future. No one was born master and every master was once beginner, this is main life rule and everyone should know by heart.  Hospital information system is the first step to plan and design main service integrators and value unites to be ready later to join them together. Exactly; prepare the bricks before integrate all together to build our house (healthcare system), but the question is how hospital would be designed according to modern standards of ICT ( information and communication technology)?!.

HIS (Hospital information system) is a design tool to manage and organize Clinical, administrative and financial aspects of aimed hospital to work with. Meanwhile; available data could useful in academic researches and epidemiological measures and state statistics. Blog post is much short to describe all in details by words, there is one picture here enclosed and summarized most of talk.....

E-health system project management

As known; management as science academically is different than management in practice. On the same measure each field own little difference in management and applied procedure. Some fields need more technical skills than personal or communication skills while other fields in to more personal and communication skills more than technical or academic knowledge. Though; try to digest that concept which says that management is not a constant hypothesis for every field. Decades many of people thought that management that someone authorized give orders to do or give orders not to do. But actually the opposite is the true where everyone knows how to work and how to perform then the involved manager later checks over subordinates occasionally to find any work errors or mis-conception. For instance; in some careers management restricted in that forms just to check group of charts then the managers take the proper decision according to rather than put their hands in every details they are not aware of them all technically.  Second example; in some careers the manager entitled to manage and organize the physical effort and work pathways like in factories and industrial firms. That leading us to know and be sure from one fact here, there are sorts of management such as operation management, logistics management, project management and so on.

Project management is unique kind of management and how it done and implement is much interesting than even could imagine.  It is science of project building and management to set up which without, project preparation and implementation going to be different but the question seen now in many minds that why is not famous and known. Simply, because that is branched and specific kind of management dealing with projects preparation and building stages assessments from scratch, yes it needs big numbers of papers and long time to prepare them but eventually, It would be as a indicator to find decision or adjustment to next move or step. Healthcare and related projects not far from the same meaning and purpose, we always in need to finish and complete the care project according to planned schedule. Every execution step need to be planned well and managed in comply with entire whole project with start and end times.

Medical healthcare system base as formerly discussed started with good and proper infrastructure, through we put our implementation plans for execution and during each steps the project management teams stop for assessments and do their best in order to avoid any deformities whether within the constructed small steps or even during stage of big unite articulations. Project management make the whole project look like exactly big screen to see and watch what is coming and what is going to full such ability to adjust and redirect or modify certain procedures to reach end desired results. Last point here would like to talk about that there are four main part of healthcare system project management; planning stage, execution stage, assessment stage to each step and eventually the project entirely assessment to evaluate every step that was built the procedures had been applied in related to the total end results. Now you got almost the main points and components regarding healthcare system project management. Full health J

E-health systems project implementation

In order to implement healthcare system as a whole project which needs long time of planning and design each part of that system separately. Afterward; when details of each unite and other indirect associated infrastructure issues be completed perfectly then you have main bricks of healthcare system building. As a symbolic meaning; bricks need cement or holding substance which facilitate binding them together and protect what inside that building. The same thing going to carry out here, healthcare needs holding substance in form of information systems, you think I mean by so one system, absolutely not, there are many of them indulged in each operating medical unite. For instance; lab unite and analysis (LIS) platform own three system gates; one to organize work with patients and their data. Second; to work with physician and specialists whereas the last one connect stat lab centres together that permit to join country healthcare system wholly in one platform easily. Moreover; to be entered by medical workers in order to get whatever data needed from any lab centre over the same country. Although those systems constructed as three working system but they appear as one working system with multiple and different working gates!.

Then, we can generalize that example above with any operating unite of healthcare system; information system organizes the work within while two other systems mange matter of linkage with different other unites and last one manage the communication among other unites but from the same level of work tasks.  After this simplified notes about system construction and constituent parts, it is imaginary now how the draw of healthcare system of most countries highly convoluted and hard to be fully understandable without explanation. In next post we are going to draw and design symbolic prospect of healthcare and associated informative systems but in small scale just to reveal how medical care prototypes could be.

Some of readers may ask that most of healthcare system similar to each other particularly in Europe, what does it means?!. It means simply that the implementation firms are actually the same or group of cooperative firms make the medical system projects in many countries through. Just remember design and implementation of healthcare systems in one country is not easy work; it needs teams and national big budget and moreover long time schedules to implement that for sure after ready infrastructure and trials and then operate. I would like to be much clear here about it; nothing is fixed and ever would be in process and procedures of design. System prototypes have drawn according to national purposes and demands of each country toward their citizens with complete freedom to modify and adjust its bricks to serve society nation and patients hopes.

Good news that we would narrative some prototypes but on small scale that enable the reader to imagine and get better understanding of system design and how it does work. If you are really excited to know more and get better about something new, It is a surprise to find out after next few posts be able to know much about healthcare system not only as a user but also deep thinker and analytical participant. We are going to discuss hospital information system, electronic health records, electronic management of medical orders in electronic health, clinical laboratory information system,….etc. all of them are big unite names form building bricks mentioned under main category types of previous post. Follow the next posts to enjoy more, full health J

Operational linkage among e-health unites

Operating unites linkage is the main part of integration whilst most unites of medical system work together; many theories determined the role and significance of nature of confrontation between two working unites. Put in mind that not all of medical system integrated unites that work on the same line or on the same hierarchical pathway. Moreover; there are endless possibilities to modify and adapt certain group of unites to match and suits to particular service or value. Undoubtedly; there are many books talked and drew proper imagination and how linkage should and would be. But eventually you will find that in every healthcare system owns different work nature and more roles adaptable to serve different planned purposes by state that could fulfil health and care welfare to the citizens. So, taking certain model of integration and linkage among unites is not completely right decision and would not be fit enough to give proper and desirable end results. In coming rows you are going to figure out several forms of unite linkage and briefly described to be simple and understandable:

Linear Linkage: one sort of unites linkage defined simple readable communication between two operating unites and what is really significant here that this form serve linear and series of medical care unites. It means hard to use it with multiple layer integration or multiple services unite functions.

Central unit Linkage:  is the more common form of unite linkage of healthcare systems, why so?. Because it serves many other unites at the same time through the same unite. Moreover, it could control and distribute needs and demands of patients according to their numbers. Central unite is wide existed among almost all modern healthcare systems because their ability to perform multiple tasks among and in between similar group of unites. Therefore; Healthcare system designers use this unite and frontal platform to open next pathways to patients and also use it as a booster unite to exaggerate and magnify other tasks to and from other unites.

Corner unite linkage: from its name it is not in the central of integration so, the work significanceof this unite is represented to make corner coherence or reflect serves to go into opposite direction. Literally it is aside unite to serve and do aside tasks and it always hidden among system unites folds far from light of direct tasks.

Parallel unite linkage: this kind of unites linkage are always located on the pathways of whole healthcare system and rarely to find them take more than two direct conjunctions. That means one before and another after to deliver service tasks to reach next medical unite.  None of that kind of unite suitable and fit to do multiple tasks or receive many tasks from many unites. They serve and perform over their path nothing more could be done by them. Subsequently, they have less employees because there is not much to do even in case of work burdens and big patients numbers.

There are many other sorts of integration linkage among healthcare operating unites but these which have mentioned formerly most common and easiest ones would be describe only by words. It is clear that every system should own working unites shapes according to state plans and system fulfilment purposes to reach country future objectives of medical care to their patients. Full health J

  

E-health unites systems integrations

People will never understand something until it happens to them; some people watching someone silent most of his time. They think this is coldness or calmness within personality while open talkative ones judged as a weak emotional person. It hard to understand someone else at present time many of people failed actually to understand even themselves. Most of societies individuals brought up to be apparently judge and evaluate life matters only on appearance. But in order to be fully understand and precisely judgmental, individuals need to learn how to be analytical, deeply analytical even if all of apparently signs said something else. So, that needed to be aware with all of life book pages related to someone then if you did it and still have time, you are be able to put proper judgment suits previous experiences and past backgrounds before, it absolutely waste of time to judge someone you know nothing about his/her history. Analytical mindset; It means see behind the wall or in other word through the wall itself in some critical situations. This example has mentioned here to just explain how many existed systems, it is completely hard be evaluated apparently as we do evaluate people in parties and festivals depending on their dresses. Patients who dealing with healthcare systems they see the end platforms of delivery channels of the same system. But the whole processes of integration among different medical unites are completely hidden not because lack of interest from patients but because also security and safety of them. From all above we got simple result that if we are willing to put judgment over one of a medical system, it should be studied all in all from different faces of working unites and constructed articulation borders in-between. May be some of readers think that integration is simple as the word but unfortunately the most and tough work of any medical system lies in that articulation of many operating unites together while the biggest errors produced and correction always done from the convergence point of system articulation. Because inside the operation unites everything is under control from working nurses and medical staffs. There are many of successful articulation models carried out in many countries with good to excellent end results.

But it is not meaningful here to indulge readers in useless details regarding model and articulation methodologies and procedures but as a hint and overview to imagine the process would be as follow.

-Electronic health records

-Computerized physician order entry (CPOE) module

-Picture archiving and communication system (PACS) and also RIS (Radiology information system)

-Anatomic pathology information system (APIS)

These core components of system articulation and most of medical modern systems own them. Each one could be stretched to be sub-unites branched and prevailed to serve work purposes depending on received planned end values by patients. Therefore; there are sub-articulation procedures aggregate and grasp the whole integration of such components. For instance; there are many sorts of electronic records, the articulation process would happen to reach a point of unite integration and after many successful productive sub-integration then upgrade the integration itself to include the main components of medical system on different pathways of state system. Pathways of integration among main and sub- operating unites depending mainly on two factor; first size of state medical system according country population and secondly how far and branched this system going to be inside country organization and to draw them all over the meant umbrella of society care. Full health J

  

E-health system design fundamentals

Articulation of design prototypes is the essence of success for any medical care system designing. Not only articulation but nature and tightness integration between different operation unites in the same system. The degree of articulation among many or numerous prototypes measured basically first by integration of structure and synchronization of the same unites at times of work and perform.  Before exceeding this point, may some of you ask what do you mean?, synchronization means how cooperative the same system unites together to fulfil one task at the same time. In over population countries each hospital is considered separate healthcare system so, you can imagine when the patient needs some papers or documents issued in the past, he/she needs to bring them by themselves and there is no informative linkage between hospitals and other healthcare providers. I guess now imaginable how important and much significant matter of integrated to the whole system in the same infrastructure and synchronize all working unites to do and perform at the same time of work day. Then, patient will never exhausted to deal with healthcare system on any service level, much more, the patients got ready to be adaptable to the next and innovative medical applications without any personal discomfort and resistance.

Fundamentals of design carries the same meaning of perform and execution but still some other considerations taken usually as design fundamentals to be minded fully during the process of prototype creation such as:

Infrastructure: somewhere previously we discussed the matter of infrastructure and how it is very strong parameter leading medical system toward the success later in every stage of implementation and trials.  Easily talk and simple meaning of expression without infrastructure you simply plant seeds over rock land nothing will not going to work if there is no solid valid and modern infrastructure. Infrastructure preparation matter comes before even any prototype of medical system, just as to prepare the land for the next and proper seeds of system construction for future plans.

Goals and purposes: the goals of medical must serve certain type of medical purposes that existed in the orbit of whole system. Why we make that goal if we have not target the purpose that serve the patients and or even medical staffs with. Medical people need to understand that there is not a goal devoid of purpose otherwise all of design work is just waste of time and only make some national expenditures. In order to find a purpose for any goal simply you should look for the main and direct benefits from that purpose. These benefits are not private directed within, it is some sort of system, patients and society benefits which serve national rewards and state strategies for sure if they have one).

Medical welfare exaggeration: the main state goals and benefits before and after e-medical system. That also including the financial and money currents benefits along stages of implementation. The shape of society after system start to work, how many disadvantages of conventional system going to disappear with modern e-health systems. Moreover, the quality of values and services that help in society overall health. Modern healthcare systems should serve the general strategies of future aims and serve country improvement to be better. Full health J

E-health systems design concept

All of our posts have written about e-health system separately, just different episodes about healthcare systems and medical care delivery channels. In the coming posts we are going to upgrade our posts to make cohesion regarding information mentioned. We are going to discuss simplified medical systems design and prototypes as a whole project and different methods of implementation. Just put in mind that design medical care system and other associated unites are not individual work and sometimes is bigger than regular teams; it is national task and all of state effort should enlist to do so. It is really unbelievable when you found someone and/or small teams claim that they can do it alone in form of consultations and supervisions. Term design is one of most common term known among people, and many of us thoughts that design restricted only around dresses and fashions while those who exceed that reach to get design as engineering process. This thinking effort is good and accepted for regular ordinary projects which implemented by professional consultation offices and agencies. Whereas medical care and healthcare system design is completely something more complicated and much more convoluted than that. Design of healthcare systems including several components related to prototypes of state governmental services incorporated with private medical providers and also financial prototypes with insurers. So, imagine how big the work tasks and effort awaited teams who going to work over all of them.

The good news in next posts would be simplified hints about them and do my best to make it easy understandable and imaginable. Back to the main concept of medical design and mind integrated visions about future of services and people health. In most circumstances; we make design because we need some goals serve certain purposes, so in order to make proper and beneficial design there are goals must be existed before and purposes could be achieved by them. Design itself is not championship if we have clear purposes and work goals serve and complementary each other to get best end results and massive optimum points. Design processes can take years to draw every step which could be taken to achieve and reach smaller goal and purposed target. Design touch everything works with medical system even building and management hierarchy and nature of workers and level of their training, vision of work strategies with patients and where they want to go after couple of years with the same pattern of work.

System Design here would not exclude anything particularly with financial issues and insurance firms. Design insurance level and roof suits to health welfare of population of certain of certain areas. For instance, people who live in tropical countries suffer more from seasonal infections than who those live in cold country in which coldness of weather make them suffer more with muscles and bones problems. The same measure should apply for every issue of design prototypes; the insurers get ready to work with people in much of tropical countries to fund vaccines and protective bacterial antibiotics and be able to supply enough surgical operation with enough expenditures in case of cold weather patients. Every issue, vision, consideration must be in mind without any personal bias. In other word, design prototypes could be excellent if design over multiple dimensions than only one or two work (linear) dimensions. Sometimes medical system design prototypes of some countries take more ten (multiple) dimensions that serve end goals and final aimed results. Full health J

Apps innovation and development

Apps innovation is really interesting branch of creative mindset to initiate and apply their talents. Without innovation there is no talent and opportunity to be creative even if creation is build from nothing and innovation sometime carried out by just modifying. People spend their lives do the same thing and take the same lifestyle just because they do not know how to be innovative for change and creative toward something new in life. Moreover; the question here is why innovation closer to development because simply most of innovative solutions are closer to be applied or just a step before the process. Development without innovation is like desire to change but there is no starting point. In medical career and delivery system know new and innovative methods to do and perform the job act as mindfulness toward each change. And starting point toward every opportunity to get and fulfil better achievements for future. E-health and systems continuously need innovation and development the most in order to get step forward and do proper acclimatization. We are going to discuss most important phases of any innovation process just pay attention and enjoy reading:

Planting the idea: planting the idea is baby step when desire to change and develop showed of, an idea is forming the primitive and first move point toward innovation and that is the real fact about whole process of innovation. Planting ideas is not easy process because people and their subconscious mind used life routines as standards and resist any noticeable effort required changes. 

Believe the idea: believe your idea is the solid infrastructure to build roadmap of implementation. Many people own very interesting ideas and also very useful for individuals and society but they never moved because they never believe themselves can do and also the process of believing takes time, commitment and dedication.

Plan the idea; roadmap toward implementation with schedule timelines arrive at sub-divided goals of the same idea serve entire process. 

Try the idea: it is the process of putting the small successful reachable goals in different level of implantation in order to test quality and durability and correct the mistakes later on. Therefore; trying every step or plan and adjust steps according to end givers form definite productive direction to success and minimum errors. 

Final change: many few reachable goals lead undoubtedly to big success of innovation to new ideas. Final changes represent main and whole effort had been pain to carry this innovation idea to the light. Innovation and development in healthcare is not stoppable process, as long as going on the medical care to do better and become better in front of life challenges and growing patients demands and requests.  

Being able to get and go through those innovation phases make you unique in your way of thinking and also the way you look at things generally. By differences and variation among ideas serve the process of innovation, it means some ideas more complicated than other so, each phase slightly differs according to nature of system and purposes of results. Full health J

Apps business and profitability

Profitability from apps most people do not know it clearly and even how knows some information-if supposed to be right. They try to keep them unknown and unclear enough to be understandable to public. As known that perfect profit which not known or understandable; there are many of traders all over the world they earn millions but no one could understand the process or the procedure of business cycle of their own yet. That make them far enough from any attacks of haters and away from success enemies. It is difficult to enumerate all of profit forms related to mobile apps in one article but guess better to pass over some of them. There are many tools enable apps to be cash cow and produce cash current and therefore profits. Put in mind that there are differences between free in store and authorized country apps which accredited to be used as official platform for healthcare and medical services.  Advertisements are the first profitable business by apps. It is easy to understand that most of downloaded apps show sometimes some sort of advertisements according your country and location in which easily identified by Google timeline. Second is the in-app purchases through the same app the service provider introduce and show other or associated goods and services, and if the user wanted also to upgrade into paid edition in order to get more and other additional services and choices while the basic edition downloaded for free.

Email marketing is considered most famous tool used in marketing and business; I agree many of them are not in goal of your need but some still in need sometimes. Sponsorship and subscription is separate profitable actions in mobile apps but mostly subscription to get digital products followed by sponsorship for something subsequently. Fremium upsell refers to basic and premium services of certain category of apps while keep certain level of services in basic business model for users, Video and Audio apps are the common type of such apps and when the users would like to get more then should purchase premium package of services. Affiliate income and referral marketing (from CPA to CPI); term affiliate programs for selling and redirect traffic toward certain category apps. In these software programs the user pay effort to sell and act as online sales hand over amount of products that given percents after selling process and many affiliate programs available online.

Collecting and selling data is significant importance for commercial, medical and even in research uses. Users tracking data play effective role when used for good reasons and constructive purposes, unfortunately many of apps and sites use personal data for selling and exchange in commercial uses without taking a clear permission up from users. But still data collection itself as a purpose is considered good and useful for analytical decisions, success and future change. Last common one in app video advertising; many of us found short video advertising only few second and then stop fixed banner after. This is video advertising introduced through mobile app in very short time to serve the activities found on app itself-in case of country apps, or to service and introduce products and services for commercial uses. Paid banners, incentives and display ads is the substitute tools of the same video advertising in-app but that in different form and shapes whether fixed banner or fixed incentive signs where the same service the same purposes almost. These are the most and common forms of profitable money cycle from free and paid apps. Full health J