Innovations for Healthcare and Wellbeing

Digitalization of medicine is an important factor for improving the efficiency of medical organizations and the quality of medical services. The most important digitalization tool is the optimal use and analysis of large amounts of information coming from various sources. This chapter is devoted to the use of analytics based on the analysis of big data and artificial intelligence (AI) in medicine, in particular for the analysis of genomic and other omics data. Existing problems, development prospects, necessary measures to develop the infrastructure and the personnel potential of medical organizations, including the introduction of such health models as personalized medicine, are considered. The areas of successful use of the considered digital technologies in medicine in the near future are also identified, for example, for disease prevention, public health management and medical care, and creation of new drugs. As a separate aspect, the issue of introducing data-driven management (DDM) in a medical organization is considered. Further research will be related to the development of new branches of knowledge and competencies (bioinformatics, sensory informatics, computational medicine, health informatics). New services and applications based on this should ensure an increase in the transparency, stability, quality, and safety of medical care.

The problem of the coexistence of a malignancy with pregnancy is extremely relevant nowadays due to the increase in cancer incidence among young women and the increase in age at first birth. This chapter discusses and summarizes recommendations for the management of patients with this problem, based on international and self experiences, in accordance with a personalized approach to treatment.

The main components of heart failure (HF) and heart transplantation (HTx) management programs in the Russian Federation in real clinical practice are represented. This chapter provides an experience of the HF Competence Center of the Almazov National Medical Research Center as well as opportunities and prospects for improving approaches to monitoring HF and HTx decompensation.

Robot-assisted surgery has significantly accelerated the development of surgery and medicine in general over its more than 20-year history, and it will undoubtedly play an important role in the development of surgery in future. Due to the minimal invasiveness and high technological effectiveness of the operations performed nowadays, this area of surgery allows achieving excellent treatment results in many areas of medicine. Worldwide, this technology is mainly used in urology, gynecology, and general surgery while the range of applications in robotic surgery is constantly expanding. In addition to da Vinci, which is currently the most common and versatile system, new robotic surgical complexes appear in many countries of the world. Robotic surgery has proven to be an effective and safe method of treatment, particularly in patients with severe comorbidities, including cardiovascular, pulmonary pathology, diabetes mellitus, obesity, etc., which is confirmed by numerous studies. The use of robotic surgery in multidisciplinary centers is an extremely important aspect of the successful functioning of the clinic, in the treatment of patients with comorbidities, in which a personalized and patient-oriented approach to treatment is of special importance.

Precapillary pulmonary hypertension (PH) is a difficult problem in the perioperative period of cardiac surgery. In these situations, there is a high risk of PH decompensation with the development of right ventricular failure and cardiogenic shock. In the intensive care of precapillary PH, pulmonary vasodilators are of great importance. Inhaled nitric oxide (NO) is known as the “gold standard” of intensive therapy for decompensation of precapillary PH, including in the postoperative period of cardiac surgery. In modern medical practice, NO is produced in chemical factories and delivered to hospitals in cylinders. The high cost of NO, feeding and dosing devices, and possible difficulties in the purchase and delivery of cylinders are important limitations of the widespread use of this therapy. The world’s first NO inhalation therapy device, which synthesizes NO by the method of nitrogen oxidation in a nonequilibrium plasma of a pulsed, periodic, diffuse electric discharge in air, was invented in Russia. The aim of this study was to evaluate the clinical efficacy and safety of the method of synthesis of NO from atmospheric air in the postoperative period of cardiac surgery. A total of 110 patients were enrolled in the single-center cohort study with retrospective controls. The results of the application of the method of synthesis of NO from atmospheric air using the AIT-NO-01 device (the main group) were compared with those obtained from the retrospective control group when using a device (NOxBOX Mobile, Bedfont, UK) for dosing NO from cylinders. A total of 55 patients were included in the main group and 55 in the retrospective control group. Inclusion criteria were having undergone cardiac surgery, mean pulmonary artery pressure (PAPm) ≥25 mmHg, and pulmonary artery wedge pressure (PAWP) ≤15 mmHg. All patients underwent surgical interventions of the heart. In order to control the effectiveness of NO inhalation therapy, a complex of hemodynamic parameters as well as indicators of the clinical course of the postoperative period were evaluated. There were no significant differences between the comparison groups in terms of the baseline characteristics of the patients, pulmonary circulation parameters, and the structure of the surgical procedures. After 1 h of NO inhalation in the main group, there was a 35% decrease in pulmonary vascular resistance (PVR) and a 16% decrease in PAPm. In the control group, there was a decrease in PVR by 40% and a decrease in PAPm by 19%. Inhalation of NO did not affect the systemic circulation hemodynamics both in the main and in the control groups. The median duration of mechanical ventilation (MV) was 7.3 (4.5; 13.8) h, and the median length of stay in the ICU was 23.2 (21.3; 46) h in the main group. In the retrospective control group, the median duration of MV was 8.2 (5; 14.1) h, and the length of ICU stay was 24 (22, 45.3) h; no differences were found between the two groups. NO synthesized from room air significantly reduced PVR and PAPm in patients with precapillary pulmonary hypertension after cardiac surgery. There were no significant differences in the effect on pulmonary circulation, clinical data, and side effects between the methods of synthesis of NO from room air and dosing from balloons.

Public health is considered to be one of the most promising branches in the development of economy, as it represents the fundamental element of national security and healthcare. Besides its basic functions, it forms new workplaces in other branches and provides room for functioning and development of many market sectors: medical equipment manufacturers, pharmaceutical enterprises, distribution centers, transport, trade, sports and recreation, etc.

Processes associated with globalization intensify qualitative changes in the structure of business entities and require development of alternative forms of business organization. Business structures, which are dynamically and consistently implementing innovative transformations in different spheres of their activity, get an opportunity to develop successfully and compete.

At present, one of the directions of such development is creation of different network structures aimed at achieving common goals and obtaining competitive advantage due to the synergetic effect. Under these conditions, participation in a medical hub allows coordinating intentions and establishing communication between all stakeholders: suppliers and state institutions. In modern economic conditions, a medical hub is a unique structure because it brings together the entire chain of professionals and specialists is a specific area, enabling them to coordinate better.

This research suggests a cluster approach to the development of health care. In this case, a medical hub is considered an innovative environment for business development. This chapter also formulates objectives, principles, functions, and structural elements of a medical hub. In addition, the structure of business processes of a medical hub is considered, together with the interface of interaction with suppliers, partners, and consumers of medical services.

The medical industry is characterized by the fact that its digital transformation and the subsequent changes run much slower than in other industries. The introduction of innovative solutions related to patient-centric, value-oriented digital technologies is extremely important for the global health-care system (as announced by the World Health Organization) as well as for the health-care system of the Russian Federation (as announced by the Ministry of Health of the Russian Federation) Digital transformation in health-care requires significant efforts to unify the researchers and specialists of various industries: scientific and medical organizations, pharmaceutical companies, manufacturers of medical equipment, innovative and information technology (IT) companies. Collaboration within the ecosystem of healthcare (medical) hubs, according to theorists and practitioners, can significantly accelerate the widespread introduction of innovations in medicine. The experience of combining cross-functional efforts through the formation of innovation medical hubs already exists in Japan, Germany, Switzerland and other countries. Theier experience demonstrates certain results in accelerating the innovative development of the health-care industry. The medical direction of activity of the European multi-industrial hub EIT Digital shows acceleration of the development and implementation of digital products by 25%, as well as an increase in the profits of companies involved in the hub associated with the development and implementation of digital products by an average of 20%. All these cases confirm the successful experience of implementing healthcare innovation hubs abroad. At the same time, in the Russian Federation, the practice of organizing innovation hubs is already being carried out in other industries (Kaspersky hub, Rosatom innovation hub), but, so far, there is no cross-functional medical innovation hubs, despite several attempts to organize cross-functional activities in the form of medical incubators and clusters. The purpose of this chapter is to present architectural models of a healthcare innovation hub (multi-industrial community) aimed at the development of research, educational and industrial project activities based on cross-industry and cross-disciplinary interaction of leading organizations and specialists in the field of medicine, high-tech medical companies, supported by information and digital technologies by analyzing the leading health-care hubs worldwide. As a result the healthcare hub architecture model consists of four layers and includes business processes of the hub, requirements for the digital platform of the hub, and a hardware system for working with medical, personal, and management data as well as physical infrastructure characteristic for innovation processes in medicine.

With the development of digital technologies, large amounts of personal data are recorded and stored by third parties, which is an invaluable gift to both public and private organizations. However, there is currently growing interest in whether such data can also create a public good. Can they be used to train artificial intelligence and machine learning? Is it possible to create an innovation industry hub? How can technology be useful in medicine, and can it help doctors predict diagnoses? Before we can answer such questions, we must first understand what motives will underpin people’s sharing of personal data and what kinds of data can be used. It is also necessary to determine which data can be used and which cannot. This chapter addresses the phenomenon of data donation in health care: it analyzes different methods and technologies of data collection, the types of data that can be collected, and the way of organizing industry-wide data collection. As a result, the authors provide evidence of positive experiences with the data donation technology.

Nowadays, every organization is inevitably faced with the need to make management decisions as part of its activities. Therefore, the question of the concept to guide decision-making is quite relevant. The digitalization of all areas of our lives is currently taking place, so ways of managing and making data-driven decisions are the most advanced concepts in organizational management. This chapter identifies the technical requirements of an organization to implement the data-driven concept and provides examples of successful implementation of the same in different companies and medical organizations. This chapter also presents two business models that are made with the help of Business Model Canvas, a public medical facility and a for-profit medical facility working on the data-driven concept, and makes a comparative analysis of them. As a main result, authors provide recommendations for healthcare facilities that want to become data-driven organizations in the future.

The COVID-19 pandemic has faced up health systems around the world with the challenge of organizing supplies and effectively distributing vaccines to citizens. Clear planning of need and constant tracking of actual values are necessary to achieve sustainable collective immunity and high rates of healthcare innovation. This chapter describes these processes using medical and demographic forecasting methods. The aim of the study is to develop a model for vaccine planning and distribution, the use of which will reduce the imbalance in vaccine doses supplied to the regions. The paper analyzes the current state of approaches to vaccine supply management in the world and IT solutions used to support this process; it develops a hierarchical model of vaccine distribution management for supply to the regions and describes the way to increase the accuracy of medical and demographic forecasting. The paper presents the results of a study conducted in open cooperation with healthcare organizations and regional healthcare authorities of Saint Petersburg, Russia. The results are published to openly disseminate new knowledge and enable its transformation and subsequent practical application to improve innovation penetration in such a socially and economically crucial segment as vaccination. The proposed approach is intended to serve to improve the reliability of national and regional systems for managing the distribution of vaccines through a planning system based on the needs of the population, taking into account the vulnerability factor.

The global processes of digital transformation today affect not only certain sectors of the economy, production, and business but also the state apparatus and society as a whole, which contributes to the active formation and development of business models to ensure sustainable growth and reaching a fundamentally new level of digitalization of economies in an ever-developing digital world. In healthcare, digitalization plays a significant role due to the aggravation of such problems as longer waiting times, increased workload for doctors, long waiting times and processing of examination and test results, difficulty in monitoring vital signs, and untimely assistance. The emergence of current trends in digitalization of medical services and the integration of digital devices into the organization’s ecosystem, together with an architectural approach to building an IT model, will help approach the solution of these problems and in the future will enable the transition to the highest level of digital maturity of medical organizations. Global digital transformation processes today affect not only individual sectors of economy, production, and business but also the state apparatus and society in general, which promotes the active formation of a digital health system. Digitalization plays a significant role in the field of healthcare due to the aggravation of such problems as longer waiting times, increased workload on doctors, long waiting times and processing of examination and test results, difficulty in monitoring vital system indicators and untimely assistance. The emergence of modern trends in digitalization of medical services support and integration of digital devices into the organization’s ecosystem, together with an architectural approach to building an IT model, will help to come closer to solving these problems and in the future will enable the transition to the highest level of digital maturity of the medical organization.

The chapter considers a case study on the implementation of data-driven management at the Almazov National Medical Research Center of the Russian Ministry of Health. Data-Driven Management (DDM) is an important digitalization trend, including healthcare digitalization. For a medical organization, the introduction of Data Driven Management is designed to improve the quality of decisions made and the overall efficiency of operations. The step-by-step implementation of Data-Driven Management in the national medical center is given, the problems identified during the implementation process are indicated, and ways to solve them are proposed. The implementation of the approach began with an increase in the level of process maturity. The next step was to build a quality control system and internal benchmarking as tools for implementing DDM. In the process of developing and implementing analytical dashboards in the activities of the Almazov Center, the need to ensure the validation and quality of data entered into information systems became obvious. This, in turn, required the construction of a user training system. The work carried out made it possible to speed up the decision-making process and objectify them, including by improving the quality, accessibility, and speed of data transfer required for decision-making.

In modern world, digital devices have long been used not only to facilitate routine and household tasks but also in such industries as healthcare as well. Telemedicine and the Internet of Things in healthcare are being actively developed. Many electronic devices allow you to monitor the dynamics of physical health indicators, as well as to perform self-monitoring of key biomarkers. However, “smart” devices also have a significant disadvantage – weak security and data encryption, which makes them vulnerable to virus attacks. This chapter makes a review of trends in the development of the Medical Internet of Things, analyzes the market for medical “smart” devices, proves the relevance of using these gadgets, and examines the issues in transferring of personal data via Bluetooth technology.

The chapter outlines the issues of improving the management system of a high-tech medical organization, taking into account the digitalization trends in all areas of the economy and a patient-centered approach in healthcare. The purpose of the study is to form a management system for a high-tech medical organization (HMO) based on a data-driven approach that provides the implementation of technologies for collecting, processing and analyzing data to monitor the KPI values of the organization and evaluate the effectiveness of the hospital. As a monitoring tool, it is proposed to use an intelligent data analysis platform. As a result, an approach to the management system of a digital organization is proposed through the evaluation of the key performance indicators (KPI) values and the evaluation of the implementation of an intelligent data analysis platform. The study also paid attention to the issue of modeling the IT architecture of a high-tech medical organization based on an intelligent data analysis platform.

Medical organizations need to manage the reliability of assets used in healthcare, especially high-tech organizations where technical unavailability can impact the treatment process. The management of assets is not usually included in the architecture of medical information systems (MISs), and the EAM (Enterprise Asset Management) or IAM (Intelligent Asset Management) component is not considered important or included in high priority tasks. Although there is at least one solution, SAP^® i.s.h.med^® hospital information system, that contains a component to support the management of assets, this solution is not specifically adapted to the needs of a medical organization. In most medical organizations, the clinical process is primary, assets are serviced outside of the treatment process, and the process of managing assets is not described in the reliability management. Thus, the task of managing the reliability of assets is not clear and needs to be elaborated for the case of a medical organization. This article concentrates on asset reliability management strategies and discusses variant of EAM systems implementation in a medical organization.

Various technological solutions are becoming increasingly common in healthcare, developing in the form of “smart” healthcare solutions, robots and various support systems. An extremely important aspect in the work of healthcare facilities is to address the problem of medicine supply. The challenge lies in fully managing (planning, recording, monitoring and controlling) medicines from the point of order to the point of delivery through all organisational and hierarchical levels of hospital management to the patient.

For healthcare organisations, sustainability-focused management implies the application of approaches to the organisation and management of activities that will ensure the medical and economic efficiency of health systems. In particular, this requires the development of approaches to the organisation and management of the key processes of a healthcare organisation: patient flow management, data management, resource management (staff, bed stock, equipment, medicines), etc.

The study examined various issues in the provision of medicines: regulatory framework, development of smart hospitals, IT company offerings and examination of other research materials. Aspects of medicines management such as personalised recording, planning and procurement of medicines, and IT support requirements were examined. The aim of the study was to produce a medicines management process model, covering all levels of hospital supply. To achieve this, an architectural approach and modelling were applied.

As a result, a business process model linked to information systems has been created, on the basis of which the complete medicines management cycle can be created. Of no small importance is the ability to use machine learning to create dashboards, with which the model is able to demonstrate in practice the state of the hospital in terms of medication provision.

Without employees, there are no organizations. In healthcare organizations, it is employees who define the services and the impact these will have on the health status of the people who consume them. These employees organizationally are translated as Human Resources. Thus, the search for a model for the Management of Human Resources in healthcare will be the main target of this work.

In order to develop a human resource management model applicable to health organizations, we studied human resource management practices in four health organizations: two public organizations, a private and non-profit organization (NPO). The case study method was used for this purpose, specifically multiple case study (Yin, Case study research: design and methods. Sage, Thousand Oaks, 2009).

Based on the literature review and data collected through studying health organizations, we propose an integrative model for human resource practices and strategies. The model in question falls within human resource management, from the operational and strategic levels of human resources in organizations to the relationship with the overall strategy of the organization and contextual (political and economic) factors framing health institutions.

Public institutions’ leadership and intellectual capital (IC) are vast areas of study. The study of these themes is frequent but very dispersed due to the complexity and diversity of public institutions. The studies focused on specific themes of this large area without any general and systematic approach to the subject. In this study, we intend to aggregate this vast theme, identify the research domains in this topic of knowledge, and, not least, understand to what extent the different leadership styles contribute to the development of the IC.

In this systematic literature review (SLR), we carried out a bibliographic search exclusively in the Scopus database, selected 576 articles, and analyzed bibliometrically through bibliographic coupling, resulting in a final base of 107 articles grouped into four thematic clusters.

This SLR is pertinent because it made it possible to find the lines of research used by the authors, some more general, such as leadership styles, knowledge management, the relationship between leaders and followers, innovation, motivation and performance, trust, and organizational citizenship. It also allowed for the perception that leadership assumes a central role in developing IC in public institutions. The ethical, transformational, and servant leadership styles are the most referred to as enhancers of IC development. Knowledge management plays a central role in developing IC and promoting service quality.

For researchers, it points out future research guidelines, and for managers, it provides knowledge and systematizes experiences, methods, and models applicable and replicable in various practice contexts.

To be successful, institutions need motivated employees to achieve their goals, especially in contexts of economic crisis. As such, an effective leader is fundamental to mobilize and influence people. Executive leadership is an essential component of social institutions (SIs)’ success. This study is based on a systematic literature review, with the main objective of analyzing how leadership styles affect intellectual capital (IC) in SIs. To this end, 80 articles from the Web of Science (WoS) were analyzed using the VOSviewer software. The main results allow the identification of four clusters, namely: effect of IC dimensions on productivity, better leadership policies through social and intellectual capital, factors that contribute to leadership in Sis, and the role of social and intellectual capital in the recognition of opportunities. The results also show how leadership styles and intellectual capital affect SIs and characteristics and factors inherent in this theme. Additionally, suggestions for future research have been identified.

This research aims to provide an overview of thematic events and their impacts on organizational performance. The mapping of the theme under analysis was prepared based on a systematic literature review of 171 scientific articles published in several reference journals. Regarding methodology, two analyses were used. The first is a co-citation analysis, which allows the identification of the most cited authors, journals, and references within the theme. The second is the bibliographic coupling analysis, which allows the identification of clusters (1) leadership styles and organizational performance, (2) intellectual capital and organizational performance, and (3) organizational sustainability. This study contributes to the state of the art through a transversal vision of the timeline, providing an identification of the essential elements that influence the beginning of the exploration of the theme, a static vision of the present, and the definition of gaps that enable the structuring of future lines of research.

The leaders of family businesses have a great impact on the decision-making that the company decides to make, so the leadership presented by these managers impacts the company’s processes, one of which is the internationalization of companies. The aim of this research is to discover how leadership influences the process of internationalization of family businesses, and in order to achieve this objective, we conducted a systematic review of the literature, using the Web of Science database. The 96 articles selected in the database were analyzed with the VOSviewer software, which shows the dispersion of the theme of leadership and internationalization of family businesses. This research contributes to the construction of an agenda on the process of internationalization of family businesses, and how this is influenced by leadership.

In recognizing that cognitive prototypes are vital for entrepreneurs to recognize entrepreneurial opportunities, the present chapter aims to shed light on the relationship between technology entrepreneurs’ human capital and their entrepreneurial opportunity prototypes. A Mann–Whitney U test is conducted to assess the differences in technology entrepreneurs’ opportunity prototypes due to prior start-up experience, formal education, and prior work experience in a sample of 27 technology entrepreneurs. Our findings show that experienced and novice entrepreneurs have diverse opportunity prototypes, with the former more focused on the potential economic and financial results which may be achieved by exploiting a particular opportunity. The work enhances our understanding of the role of prototypes and technology entrepreneurs’ stock of experience, background, and capability to identify entrepreneuriatl opportunities.

The current economic crisis and the COVID-19 have had severe consequences on individuals that lost their job and got anxious on career. The uncertainty on the future and career anxiety may have a negative impact on the future career decisions-making and entrepreneurial intentions.

Entrepreneurship, social entrepreneurship in particular, can not only contribute to the creation of healthier societies by enhancing quality of life (Zahra & Wright, 2016) and human well-being but also increase career anxiety.

We addressed the possibility that the students’ aptitudes such as innovation and leadership may have a positive impact on entrepreneurial intentions, whereas students’ future career anxiety is negatively related with entrepreneurial intentions.

A total of 709 Italian university students completed an online questionnaire composed by the constructs considered in this study. Results in the multivariate linear regression analyses partially supported our hypotheses: both leadership and innovation aptitudes positively affect students’ entrepreneurial intentions. However, we did not find a negative association between future career anxiety and entrepreneurial intentions. Further, the results show that entrepreneurial competences acquired during university studies positively affect students’ entrepreneurial intentions.

As implications, teachers and educators should stimulate students’ entrepreneurial aptitudes to promote entrepreneurship and specifically innovation and leadership aptitudes. In addition, more competences related to entrepreneurship should be delivered to students. This may also contribute to stimulate their entrepreneurial aptitudes.

In the field of management and psychology, recent years have seen increased interest in the topic of leadership profiles. This research contains a bibliometric analysis followed by a literature review with a narrative approach on servant and positive leadership, using rstudio software with the bibliometrix function package, aiming to respond better to the volume of data. The bibliometrics resulted in identifying forms of grouping, the first by thematic mapping and the second by bibliographic coupling joined by keywords. The result provides an interpretative view of the data and recognises that the two leadership profiles are at different stages, highlighting the development of the servant leadership profile, which has a broad list of scale items and measuring factors, while positive leadership does not yet have well-delimited and developed constructs. As an initial contribution, gaps in the literature are indicated regarding the most appropriate behaviour for leaders at times of crisis, the possibility of studying the transversal nature of the dimensions of servant and positive leadership, and finally, the need to extend the scope of knowledge of the positive leader profile.