Rajani S. Sadasivam Copyright (c) 2012 All rights reserved. http://works.bepress.com/rajani_sadasivam Recent documents in Rajani S. Sadasivam en-us Mon, 26 Nov 2012 10:51:43 PST 3600 Dental Practice Implementation of a Point of Care Electronic Referral System for Patients Who Smoke: A Dental PBRN Study http://works.bepress.com/rajani_sadasivam/19 http://works.bepress.com/rajani_sadasivam/19 Tue, 20 Nov 2012 12:56:44 PST Background: Tobacco use is the leading preventable cause of death in the U.S. and has been called the number one behavioral health problem. Although 1 in every 5 Americans smoke cigarettes, approximately 70% report that they want to quit smoking. There are many public health self-management interventions for smoking cessation that have been found to be effective; however, they are substantially underutilized. As more than half of smokers see a dentist at least once per year, patient referrals at point of care to a self-managed smoking cessation intervention could greatly increase their use.

Methods: We conducted a randomized controlled trial with community-based dental practices testing point-of care referrals of smokers to an interactive, tailored patient education website. Intervention practices referred patients via an electronic referral system (ReferASmoker) and control practices referred patients via a paper-based information prescription. Both control and intervention practices had access to the ReferASmoker website that has resources to assist with tobacco cessation services. The intervention practices, but not the control practices, received feedback about their number of patient referrals and the referral numbers of their peers.

Results: One hundred and one community-based dental practices from 8 states referred close to 1,900 patients to a patient education website for the self-management of smoking cessation. Based on estimates by the dental practices, the majority of patients were between the ages of 19 and 64 years, 23% of patients seen in participating practices were African American and 61% of practices saw patients with private insurance. Control and intervention practices were similar at baseline on all characteristics assessed except control practices had a higher self-reported proportion of African American patients. Based on the project coordinator comments, the ReferASmoker website was easy to use and offered useful resources to assist with tobacco control services.

Conclusions: Providers actively engaged in the program and were willing to refer patients to an online, tailored patient education website. Dental practices found the ReferASmoker tool useful and easy to implement into practice.

]]> Judith Huff-Shack et al. Smoking Smoking Cessation Web-based smoking cessation intervention that transitions from inpatient to outpatient: study protocol for a randomized controlled trial http://works.bepress.com/rajani_sadasivam/18 http://works.bepress.com/rajani_sadasivam/18 Tue, 18 Sep 2012 07:55:20 PDT BACKGROUND: E-health tools are a new mechanism to expand patient care, allowing supplemental resources to usual care, including enhanced patient-provider communication. These applications to smoking cessation have not yet been tested in a hospitalized patient sample. This project aims to evaluate the effectiveness and cost-effectiveness of a tailored web-based and e-message smoking cessation program for current smokers that, upon hospital discharge, transitions the patient to continue a quit attempt when home (Decide2Quit).

DESIGN: A randomized two-arm follow-up design will test the effectiveness of an evidence- and theoretically-based smoking cessation program designed for post-hospitalization.

METHODS: 1488 patients aged 19 or older, who smoked cigarettes in the previous 30 days, are being recruited from 27 patient care areas of a large urban university hospital. Study eligible hospitalized patients receiving tobacco cessation usual care are offered study referral. Trained hospital staff assist the 744 patients who are being randomized to the intervention arm with registration and orientation to the intervention website. This e-mail and web-based program offers tailored messages as well as education, self-assessment and planning aids, and social support to promote tobacco use cessation. Condition-blind study staff assess participants for tobacco use history and behaviors, tobacco use costs-related information, co-morbidities and psychosocial factors at 0, 3, 6, and 12 months. The primary outcome is self-reported 30-day tobacco abstinence at 6 months follow-up. Secondary outcomes include 7-day point prevalence quit rates at 3, 6, and 12 months follow-up, 30-day point prevalence quit rates at 3 and 12 months, biologically confirmed tobacco abstinence at 6-months follow-up, and multiple point-prevalence quit rates based on self-reported tobacco abstinence rates at each follow-up time period. Health care utilization and quality of life are assessed at baseline, and 6 and 12 months follow-up to measure program cost-effectiveness from the hospital, health care payer, patient, and societal perspectives.

DISCUSSION: Given the impact of tobacco use on medical resources, establishing feasible, cost-effective methods for reducing tobacco use is imperative. Given the minimal hospital staff burden and the automated transition to a post-hospitalization tailored intervention, this program could be an easily disseminated approach.

Trial Registration: Current Intervention Trial NCT01277250.

]]> Kathleen F. Harrington et al. Smoking Cessation Internet Hospitalization Development of an interactive, Web-delivered system to increase provider-patient engagement in smoking cessation http://works.bepress.com/rajani_sadasivam/17 http://works.bepress.com/rajani_sadasivam/17 Tue, 24 Apr 2012 05:55:12 PDT BACKGROUND: Patient self-management interventions for smoking cessation are effective but underused. Health care providers do not routinely refer smokers to these interventions.

OBJECTIVE: The objective of our study was to uncover barriers and facilitators to the use of an e-referral system that will be evaluated in a community-based randomized trial. The e-referral system will allow providers to refer smokers to an online smoking intervention during routine clinical care.

METHODS: We devised a four-step development and pilot testing process: (1) system conceptualization using Delphi to identify key functionalities that would overcome barriers in provider referrals for smoking cessation, (2) Web system programming using agile software development and best programming practices with usability refinement using think-aloud testing, (3) implementation planning using the nominal group technique for the effective integration of the system into the workflow of practices, and (4) pilot testing to identify practice recruitment and system-use barriers in real-world settings.

RESULTS: Our Delphi process (step 1) conceptualized three key e-referral functions: (1) Refer Your Smokers, allowing providers to e-refer patients at the point of care by entering their emails directly into the system, (2) practice reports, providing feedback regarding referrals and impact of smoking-cessation counseling, and (3) secure messaging, facilitating provider-patient communication. Usability testing (step 2) suggested the system was easy to use, but implementation planning (step 3) suggested several important approaches to encourage use (eg, proactive email cues to encourage practices to participate). Pilot testing (step 4) in 5 practices had limited success, with only 2 patients referred; we uncovered important recruitment and system-use barriers (eg, lack of study champion, training, and motivation, registration difficulties, and forgetting to refer).

CONCLUSIONS: Implementing a system to be used in a clinical setting is complex, as several issues can affect system use. In our ongoing large randomized trial, preliminary analysis with the first 50 practices using the system for 3 months demonstrated that our rigorous preimplementation evaluation helped us successfully identify and overcome these barriers before the main trial.

TRIAL: Clinicaltrials.gov NCT00797628; http://clinicaltrials.gov/ct2/show/NCT00797628 (Archived by WebCite at http://www.webcitation.org/61feCfjCy).

]]> Rajani S. Sadasivam et al. Smoking Cessation Internet Impact of content-specific email reminders on provider participation in an online intervention: a dental PBRN study http://works.bepress.com/rajani_sadasivam/16 http://works.bepress.com/rajani_sadasivam/16 Wed, 01 Dec 2010 12:50:24 PST Engaging busy healthcare providers in online continuing education interventions is challenging. In an Internet-delivered intervention for dental providers, we tested a series of email-delivered reminders - cues to action. The intervention included case-based education and downloadable practice tools designed to encourage providers to increase delivery of smoking cessation advice to patients. We compared the impact of email reminders focused on 1) general project announcements, 2) intervention related content (smoking cessation), and 3) unrelated content (oral cancer prevention focused content). We found that email reminders dramatically increased participation. The content of the message had little impact on the participation, but day of the week was important - messages sent at the end of the week had less impact, likely due to absence from clinic on the weekend. Email contact, such as day of week an email is sent and notice of new content post-ing, is critical to longitudinal engagement. Further research is needed to understand which messages and how frequently, will maximize participation.

]]> Thomas K. Houston et al. Smoking Smoking Cessation Patient Education as Topic Health Education, Dental Internet Electronic Mail Medical Informatics Applications Reminder Systems The QUIT-PRIMO provider-patient Internet-delivered smoking cessation referral intervention: a cluster-randomized comparative effectiveness trial: study protocol http://works.bepress.com/rajani_sadasivam/15 http://works.bepress.com/rajani_sadasivam/15 Wed, 01 Dec 2010 12:50:22 PST BACKGROUND: Although screening for tobacco use is increasing with electronic health records and standard protocols, other tobacco-control activities, such as referral of patients to cessation resources, is quite low. In the QUIT-PRIMO study, an online referral portal will allow providers to enter smokers' email addresses into the system. Upon returning home, the smokers will receive automated emails providing education about tobacco cessation and encouragement to use the patient smoking cessation website (with interactive tools, educational resources, motivational email messages, secure messaging with a tobacco treatment specialist, and online support group).

METHODS: The informatics system will be evaluated in a comparative effectiveness trial of 160 community-based primary care practices, cluster-randomized at the practice level. In the QUIT-PRIMO intervention, patients will be provided a paper information-prescription referral and then "e-referred" to the system. In the comparison group, patients will receive only the paper-based information-prescription referral with the website address. Once patients go to the website, they are subsequently randomized within practices to either a standard patient smoking cessation website or an augmented version with access to a tobacco treatment specialist online, motivational emails, and an online support group. We will compare intervention and control practice participation (referral rates) and patient participation (proportion referred who go to the website). We will then compare the effectiveness of the standard and augmented patient websites.

DISCUSSION: Our goal is to evaluate an integrated informatics solution to increase access to web-delivered smoking cessation support. We will analyze the impact of this integrated system in terms of process (provider e-referral and patient login) and patient outcomes (six-month smoking cessation). Trial Registration Web-delivered Provider Intervention for Tobacco Control (QUIT-PRIMO) - a randomized controlled trial: NCT00797628.

]]> Thomas K. Houston et al. Smoking Smoking Cessation Patient Education as Topic Internet Electronic Mail Medical Records Systems, Computerized Systems Integration Medical Informatics Applications Randomized Controlled Trial Development of a Point-of-Care HIV/Aids Medication Dosing Support System Using the Android Mobile Platform http://works.bepress.com/rajani_sadasivam/14 http://works.bepress.com/rajani_sadasivam/14 Wed, 01 Dec 2010 12:50:21 PST Medication dosing errors can greatly reduce HIV treatment effectiveness as incorrect dosing leads to drug resistance and non-adherence. In order to dose correctly, HIV therapy providers must balance several patient characteristics such as renal functions and weight. In developing countries and other resource-limited settings, dosing errors are more likely because treatment is provided by mid-level providers with only basic training in HIV therapy. These providers also typically lack electronic tools informing medical decisions. Widespread adoption of mobile phones in developing nations offers an opportunity to implement a point-of-care system to help providers reduce dosing errors. We discuss the development of the mHIV-Dr system prototype using the new Android mobile platform. mHIV-Dr is being designed to provide dosing recommendations for front-line providers in developing countries. We also discuss the additional challenges in the implementation of the mHIV-Dr system in a resource limited setting.

]]> Rajani S. Sadasivam et al. Medication Errors Point-of-Care Systems Telemedicine Cellular Phone HIV Infections Antiretroviral Therapy, Highly Active Medication Systems Medical Informatics Applications Decision Support Systems, Clinical A conceptual framework for personalized mobile health care http://works.bepress.com/rajani_sadasivam/12 http://works.bepress.com/rajani_sadasivam/12 Fri, 13 Aug 2010 10:00:30 PDT The widespread adoption of cell phones and other mobile platforms represent an opportunity to extend the benefits of personalized point-of-care healthcare applications to providers and patients in the developing world. However, the challenges facing the effective deployment of mobile health care applications are complex; thus, requiring a scalable, flexible, and configurable approach. A conceptual framework based on service-oriented-architecture is proposed to address the challenges of developing and deploying mobile health care applications. A particular emphasis of the framework is a service-agent-modeling-based personalized process support that is needed to support the diverse needs of the users.

]]> Rajani S. Sadasivam et al. Telemedicine Cellular Phone Point-of-Care Systems Drag-and-Drop Communication of Data Via a Computer Network http://works.bepress.com/rajani_sadasivam/13 http://works.bepress.com/rajani_sadasivam/13 Fri, 13 Aug 2010 10:00:30 PDT Patent Pub. No.: WO/2007/008687, from World Intellectual Property Organization:

The present invention provides a system, method, and computer program product for consuming Web Services, and is composed of two parts. The first component of the present invention is a Web Services agent known as HERMES (Heterogeneous Resources Management Enterprise System), which provides a uniform application interface for accessing a plurality of heterogeneous Web Services. The second component of the present invention, known as the 1-Drag Icon or system, provides a uniform user interface for accessing Web Services, and in one embodiment provides a uniform graphical user interface (GUI) component for the consumption of Web Services. HERMES and the 1-Drag Icon may be used separately or combined to provide a complete system for the consumption of Web Services.

]]> Murat M. Tanik et al. Computer Communication Networks Patents An architecture framework for composite services with process-personalization http://works.bepress.com/rajani_sadasivam/11 http://works.bepress.com/rajani_sadasivam/11 Fri, 13 Aug 2010 10:00:29 PDT The integration of large systems remains problematic in spite of advances in composite services approaches. Current composite services approaches can effectively address only the integration of mechanistic processes. Processes with human interaction, abundant in large systems, are integrated in an ad hoc manner. As a result, a process gap occurs between user needs and implemented systems. The lack of support for human interaction with processes in large systems is referred to as the composite process-personalization (CPP) challenge.

The CPP problems can occur at two stages. First, they occur at the modeling stage because of the difficulties in capturing the semantics of user needs. The lack of understanding of the problem domain and scope of integration of user needs results in a loss of semantics at this stage. Second, the CPP problems occur at the composition stage because of the lack of technology support for configuring and managing the semantics of user needs captured during the modeling stage.

The composite P2 FRAMEWORK , a composition, integration, and personalization framework, addresses the CPP problems in two ways. First, systematic guidance is provided to alleviate the problems of loss of semantics at the modeling stage. The systematic guidance is based on the dimensions of CPP, which identify the semantic and syntactic needs of large systems integration. The semantic aspects of the dimension provide guidance for the capturing of user needs. The syntactic aspects specify the need for flexible integration and automation of large systems processes. Second, the framework uses the service-agent model, a modeling approach for configuring and managing the semantics of user needs and developing composite services with CPP. The service-agent model supports both the semantic and syntactic dimensions of CPP.

The guidance of the composite P2 FRAMEWORK for large systems integration with CPP is demonstrated and validated by using two case studies. The first case study is a weather composite service process with a human interaction task. The second case study is the gene linkage identification part of the composite epidemiology research process for identifying candidate genes for obesity research.

Citation: Sadasivam, R.. An architecture framework for composite services with process-personalization. Ph.D. dissertation, The University of Alabama at Birmingham, United States -- Alabama. 2007.

]]> Rajani S. Sadasivam Computer Communication Networks Computer Systems A test-bed for the Correlation Center of Digital Services http://works.bepress.com/rajani_sadasivam/10 http://works.bepress.com/rajani_sadasivam/10 Fri, 13 Aug 2010 10:00:29 PDT For an e-business to be successful, companies need to formulate a business strategy, have informative strategic alliances, develop an international system, build a proactive infrastructure, internationalize their model, capture the residual value, exploit the international telecommunications liberalization, homogenize the data structure and globalize human resources. To achieve their objective, businesses need a more integrated automation system to speed up the process of establishing and conducting Internet-based services. In this paper, a component-based prototyping approach is used in developing a generic model and framework for a correlation center that provides entrepreneurs with a tool to quickly build and automate e-commerce linkages, thus enabling companies to establish their businesses over the Internet using a proven methodology.

]]> Rajani S. Sadasivam et al. Commerce Computer Systems Software Internet Transforming Continuing Healthcare Education with E-Learning 2.0 http://works.bepress.com/rajani_sadasivam/9 http://works.bepress.com/rajani_sadasivam/9 Fri, 13 Aug 2010 10:00:28 PDT Citation: R.S. Sadasivam, K. Crenshaw, V. Datla, and M. Scheon, “Transforming Continuing Healthcare Education with E-Learning 2.0” in: Handbook of Research on Practices and Outcomes in E-Learning: Issues and Trends, H. Yang and S. Yuen, Eds. IGI Global 2009. ISBN 1605667889, 9781605667881.

]]> Rajani S. Sadasivam et al. Education Health Education Education, Distance Internet Blogging A Component-Based Approach for Scientific Services for Education and Research (Scientific SEARCH) http://works.bepress.com/rajani_sadasivam/8 http://works.bepress.com/rajani_sadasivam/8 Fri, 13 Aug 2010 10:00:28 PDT Today’s challenge for retrieving digital information by users such as “students,” "educators,” or “researchers” is coping, more than ever before, with the excessive data and information available. The problem is further compounded because of the way scientific knowledge is structured, in terms of expert interviews, articles, conference coverage, journal scans etc. Great progress has been made in digital library research. The NSF/NSDL through their initiatives has assembled a great set of tools and techniques that hold significant potential. Many projects are now underway applying these tools and techniques to meet the information needs of different user communities. The primary focus of Scientific SEARCH project is enhancing access to high quality learning materials and resources, modules, and other digital objects targeted towards scientific consumer and scientific producer. The project will use a multi-phased approach to achieve the objective. The paper describes the first-phase work submitted to NSF 04-542 solicitation.

]]> Rajani S. Sadasivam et al. Information Storage and Retrieval Computer Systems Libraries, Digital Science Research Education Design and Process Development for Smart Phone Medication Dosing Support System and Educational Platform in HIV/Aids-TB Programs in Zambia http://works.bepress.com/rajani_sadasivam/6 http://works.bepress.com/rajani_sadasivam/6 Fri, 13 Aug 2010 10:00:27 PDT The widespread adoption of cell phones and other mobile platforms represents an opportunity to extend the benefits of personalized, point-of-care, healthcare applications to providers and patients in the developing world. However, the challenges facing the effective deployment of mobile health care applications are complex, and thus require a scalable, flexible, and configurable approach. A service-oriented-architecture-based conceptual framework is proposed to address the challenges of developing and deploying mobile health care applications. A particular emphasis of the framework is a service-agent-modeling-based composite process-personalization support that is needed to support the diverse and adaptable needs of the users.

]]> M. Willig et al. Telemedicine Cellular Phone Medication Systems Patient Compliance Medication Adherence HIV Infections Antiretroviral Therapy, Highly Active Composite Process-Personalization with Service-Oriented Architecture http://works.bepress.com/rajani_sadasivam/7 http://works.bepress.com/rajani_sadasivam/7 Fri, 13 Aug 2010 10:00:27 PDT Citation: R.S. Sadasivam and M.M. Tanik, “Composite process-personalization with service-oriented architecture” in Handbook of Research In Mobile Business: Technical, Methodological And Social Perspectives, B. Unhelkar, Ed. 2nd ed. IGI Global 2009. ISBN 1605661562, 9781605661568.

]]> Rajani S. Sadasivam et al. Cellular Phone Commerce Computer Systems Internet Software A Service-Based Entropic Model for Sensors Orchestration http://works.bepress.com/rajani_sadasivam/4 http://works.bepress.com/rajani_sadasivam/4 Fri, 13 Aug 2010 10:00:26 PDT Naval research programs are focusing on a distributed architecture approach for successful migration of data from one region to another. This presents a challenging area of modeling and managing the distributed approaches. This article describes a service-based model, which comprises of two steps that are decomposition and orchestration, for effectively managing distributed cluster networks. The contribution of this paper is two-fold. First, the article describes in detail the information transfer and entropy based decomposition approach. Second, it demonstrates the effectiveness of the orchestration approach to address challenges in distributed clusters using a simulation. We have implemented the decomposition approach in both Java and Matlab for verification.

]]> Rajani S. Sadasivam et al. Computer Communication Networks Computer Systems A Web-based interactive Student Advising system using Java frameworks http://works.bepress.com/rajani_sadasivam/5 http://works.bepress.com/rajani_sadasivam/5 Fri, 13 Aug 2010 10:00:26 PDT The use of open source frameworks and tools has become popular in Java development. These frameworks and tools have core strengths and weaknesses and are selected accordingly for development. Consequently, one of the key issues that developers face is to integrate and configure these tools together. This paper demonstrates the use of popular Java frameworks and tools to develop a Web-based interactive Student Registration and Advising system.

]]> V. R. Naini et al. Software Computer Systems Internet An Architecture Framework for Process-Personalized Composite Services: Service-Oriented Architecture, Web Services, Business-Process Engineering, and Human Interaction Management http://works.bepress.com/rajani_sadasivam/3 http://works.bepress.com/rajani_sadasivam/3 Fri, 13 Aug 2010 10:00:25 PDT The integration of large systems remains problematic in spite of advances in composite services approaches. Current composite services approaches can effectively address only the integration of mechanistic processes. Processes with human interaction, abundant in large systems, are integrated in an ad hoc manner. As a result, a process gap occurs between user needs and implemented systems. The lack of support for human interaction with processes in large systems is referred to as the composite process-personalization (CPP) challenge. An architecture framework is presented that can systematically address the lack of CPP in current composite services approach. The framework is validated with two case studies, one in the biomedical informatics domain.

Citation: R.S. Sadasivam, Architecture Framework for Process-Personalized Composite Services: Service-oriented Architecture, Web Services, Business-Process Engineering, and Human Interaction Management. VDM Verlag, 2008. ISBN 3639087240, 9783639087246.

]]> Rajani S. Sadasivam Information Storage and Retrieval Computer Systems User-Computer Interface Process Personalization Framework for Service-Driven Enterprises http://works.bepress.com/rajani_sadasivam/2 http://works.bepress.com/rajani_sadasivam/2 Fri, 13 Aug 2010 10:00:25 PDT Service functions and service activities are integral part of enterprises. Although technologies have improved for developing service functions, errors persist in service activities. Noted computer scientist Ramamoorthy describes personalization, customization, and humanization of service functions as an effective approach for reducing error in service activities. This paper argues that current personalization approaches does not effectively address the entire spectrum of service functions. The proposed personalization framework can advance current state of personalization through enabling tools as services and services as tools. We discuss the framework utilizing biological research as a service-driven enterprise example. The proposed framework is based on our enterprise process personalization patent.

]]> Rajani S. Sadasivam et al. Software Computer Systems Genetic region characterization (Gene RECQuest) - software to assist in identification and selection of candidate genes from genomic regions http://works.bepress.com/rajani_sadasivam/1 http://works.bepress.com/rajani_sadasivam/1 Fri, 13 Aug 2010 10:00:24 PDT BACKGROUND: The availability of research platforms like the web tools of the National Center for Biotechnology Information (NCBI) has transformed the time-consuming task of identifying candidate genes from genetic studies to an interactive process where data from a variety of sources are obtained to select likely genes for follow-up. This process presents its own set of challenges, as the genetic researcher has to interact with several tools in a time-intensive, manual, and cumbersome manner. We developed a method and implemented an effective software system to address these challenges by multidisciplinary efforts of professional software developers with domain experts. The method presented in this paper, Gene RECQuest, simplifies the interaction with existing research platforms through the use of advanced integration technologies.

FINDINGS: Gene RECQuest is a web-based application that assists in the identification of candidate genes from linkage and association studies using information from Online Mendelian Inheritance in Man (OMIM) and PubMed. To illustrate the utility of Gene RECQuest we used it to identify genes physically located within a linkage region as potential candidate genes for a quantitative trait locus (QTL) for very low density lipoprotein (VLDL) response on chromosome 18.

CONCLUSION: Gene RECQuest provides a tool which enables researchers to easily identify and organize literature supporting their own expertise and make informed decisions. It is important to note that Gene RECQuest is a data acquisition and organization software, and not a data analysis method.

]]> Rajani S. Sadasivam et al. Genetic Association Studies Software Internet Databases, Genetic