Trends on integrating framework of applications or data

International audienceA lot of telemedicine applications are nowadays tested in medical situation, but the challenges underlined through the best papers selection deals on the ability of proposing integrative framework for application or data in order to handle efficiency of health and clinical management

Case Management Program for the Frail Elderly, June 2005

The Case Management Program for the Frail Elderly (CMPFE) is a coordinated comprehensive system that strives to provide Iowa’s frail elderly clients with the opportunity to make their own choices regarding long-term care and to receive services in the home and community setting

A quality-of-data aware mobile decision support system for patients with chronic illnesses

We present a mobile decision support system (mDSS) which runs on a patient Body Area Network consisting of a smartphone and a set of biosensors. Quality-of-Data (QoD) awareness in decision making is achieved by means of a component known as the Quality-of-Data Broker, which also runs on the smartphone. The QoD-aware mDSS collaborates with a more sophisticated decision support system running on a fixed back-end server in order to provide distributed decision support. This distributed decision support system has been implemented as part of a larger system developed during the European project MobiGuide. The MobiGuide system is a guideline-based Patient Guidance System designed to assist patients in the management of chronic illnesses. The system, including the QOD-aware mDSS, has been validated by clinicians and is being evaluated in patient pilots against two clinical guidelines

Organizational, technical, physical and clinical quality standards for radiotherapy

AbstractBackgroundIndisputably, radiotherapy has become an entirely interdisciplinary specialty. This situation requires efficient planning, verification, monitoring, quality control and constant improvement of all aspects of service delivery, referring both to patients’ (including diagnosis, prescription and method of treatment, its justification, realization and follow up) and organizational, technical and physics matters.AimThe aim of this work was to develop technical, physics and clinical quality standards for radiotherapy. This paper presents chosen standards for each of the aforementioned category.Materials and methodsFor the development of quality standards the comparison analysis of EU and Polish acts of law passed between 1980 and 2010 was conducted, the universal industrial ISO norm 9001:2008 referring to quality management system was reviewed. Recommendations of this norm were completed with detailed quality standards based on the author's 11 year work experience and the review of articles on quality assurance and quality control standards for radiotherapy published between 1984 and 2009 and the review of current recommendations and guidelines of American, International, European and National bodies (associations, societies, agencies such as AAPM, ESTRO, IAEA, and OECI) for quality assurance and quality management in radiotherapy.ResultsAs a result 352 quality standards for radiotherapy were developed and categorized into the following three groups: (1) organizational standards, (2) physics and technical standards and (3) clinical standards.ConclusionsProposed quality standards for radiotherapy, can be used by any institution using ionizing radiation for medical procedures. Nevertheless standards are only of value if they are implemented, reviewed, audited and improved and if there is a clear mechanism in place to monitor and address failure to meet agreed standards

Breaking New Ground in Hungary: Summary of Selected Provisions of the Hungarian Labour Legislation

[Excerpt] Hungarian labour law has gone through significant changes in the last decade and become one of the most developing areas of Hungarian law. Since the end of the communist regime, the labour law legislation has had to cope with the challenges of the new social and economic system. As a result of Hungary’s accession to the EU in 2004, Hungarian labour law has been almost fully harmonized with the applicable EU laws. Employee protection rules, the general principle of anti-discrimination work force lending, and provisions concerning working from home have also become part of the Labour Code

HOLMeS: eHealth in the Big Data and Deep Learning Era

Now, data collection and analysis are becoming more and more important in a variety of application domains, as long as novel technologies advance. At the same time, we are experiencing a growing need for human–machine interaction with expert systems, pushing research toward new knowledge representation models and interaction paradigms. In particular, in the last few years, eHealth—which usually indicates all the healthcare practices supported by electronic elaboration and remote communications—calls for the availability of a smart environment and big computational resources able to offer more and more advanced analytics and new human–computer interaction paradigms. The aim of this paper is to introduce the HOLMeS (health online medical suggestions) system: A particular big data platform aiming at supporting several eHealth applications. As its main novelty/functionality, HOLMeS exploits a machine learning algorithm, deployed on a cluster-computing environment, in order to provide medical suggestions via both chat-bot and web-app modules, especially for prevention aims. The chat-bot, opportunely trained by leveraging a deep learning approach, helps to overcome the limitations of a cold interaction between users and software, exhibiting a more human-like behavior. The obtained results demonstrate the effectiveness of the machine learning algorithms, showing an area under ROC (receiver operating characteristic) curve (AUC) of 74.65% when some first-level features are used to assess the occurrence of different chronic diseases within specific prevention pathways. When disease-specific features are added, HOLMeS shows an AUC of 86.78%, achieving a greater effectiveness in supporting clinical decisions

Software development and risk management in the safety critical medical device domain

The healthcare sector is one of the fastest growing economic sectors of today. The medical device domain is one part of that sector. An increasing part of functionality in medical devices and systems is implemented in software and many features should not be possible to implement without software. The use of medical software is an inherent risk to the patient and the outcome of a failure can vary from death to almost no effect at all. Risks and risk management is closely connected to medical device domain and it is crucial to all medical device companies to have a good risk management process. It is also stated in law that the companies developing medical devices must have a risk management process. One part of the research in this thesis focuses on the current state of practice in the medical device domain. As a result of this research, the need for high quality software in this domain has been identified and also the needs for new techniques, methods and processes to further improve software quality in the medical device domain. The results have been used to derive a set of requirements on new processes, methods and techniques in the area, to be used by researchers as a guide in the development of more adapted processes, methods and techniques for software development in the medical devices domain. The other part of the research in this thesis focuses on risk and is based on two experiments. A number of decisions regarding risks are taken during software project risk management and it is the people involved that make the decisions. Different people’s opinions about the importance of identified risks are investigated in an experiment and it is concluded that different participants have different opinions about how serious risks are concerning faults remaining after testing are. Probably it is possible to generalise this and conclude that in the software engineering process different people are more or less risk seeking. From the second experiment it could be concluded that multiple roles and thereby different experiences will affect the risk identification process. Involving multiple roles will result in a more complete set of identified risks than if only one role is included

International Profiles of Health Care Systems, 2011

This publication presents overviews of the health care systems of Australia, Canada, Denmark, England, France, Germany, Japan, Italy, the Netherlands, New Zealand, Norway, Sweden, Switzerland, and the United States. Each overview covers health insurance, public and private financing, health system organization, quality of care, health disparities, efficiency and integration, use of health information technology, use of evidence-based practice, cost containment, and recent reforms and innovations. In addition, summary tables provide data on a number of key health system characteristics and performance indicators, including overall health care spending, hospital spending and utilization, health care access, patient safety, care coordination, chronic care management, disease prevention, capacity for quality improvement, and public views