CAMMD: Context Aware Mobile Medical Devices

Telemedicine applications on a medical practitioners mobile device should be context-aware. This can vastly improve the effectiveness of mobile applications and is a step towards realising the vision of a ubiquitous telemedicine environment. The nomadic nature of a medical practitioner emphasises location, activity and time as key context-aware elements. An intelligent middleware is needed to effectively interpret and exploit these contextual elements. This paper proposes an agent-based architectural solution called Context-Aware Mobile Medical Devices (CAMMD). This framework can proactively communicate patient records to a portable device based upon the active context of its medical practitioner. An expert system is utilised to cross-reference the context-aware data of location and time against a practitioners work schedule. This proactive distribution of medical data enhances the usability and portability of mobile medical devices. The proposed methodology alleviates constraints on memory storage and enhances user interaction with the handheld device. The framework also improves utilisation of network bandwidth resources. An experimental prototype is presented highlighting the potential of this approach

On the Use of XML in Medical Imaging Web-Based Applications

The rapid growth of digital technology in medical fields over recent years has increased the need for applications able to manage patient medical records, imaging data, and chart information. Web-based applications are implemented with the purpose to link digital databases, storage and transmission protocols, management of large volumes of data and security concepts, allowing the possibility to read, analyze, and even diagnose remotely from the medical center where the information was acquired. The objective of this paper is to analyze the use of the Extensible Markup Language (XML) language in web-based applications that aid in diagnosis or treatment of patients, considering how this protocol allows indexing and exchanging the huge amount of information associated with each medical case. The purpose of this paper is to point out the main advantages and drawbacks of the XML technology in order to provide key ideas for future web-based applicationsPeer ReviewedPostprint (author's final draft

A feasibility study for the provision of electronic healthcare tools and services in areas of Greece, Cyprus and Italy

Background: Through this paper, we present the initial steps for the creation of an integrated platform for the provision of a series of eHealth tools and services to both citizens and travelers in isolated areas of thesoutheast Mediterranean, and on board ships travelling across it. The platform was created through an INTERREG IIIB ARCHIMED project called INTERMED. Methods: The support of primary healthcare, home care and the continuous education of physicians are the three major issues that the proposed platform is trying to facilitate. The proposed system is based on state-of-the-art telemedicine systems and is able to provide the following healthcare services: i) Telecollaboration and teleconsultation services between remotely located healthcare providers, ii) telemedicine services in emergencies, iii) home telecare services for "at risk" citizens such as the elderly and patients with chronic diseases, and iv) eLearning services for the continuous training through seminars of both healthcare personnel (physicians, nurses etc) and persons supporting "at risk" citizens. These systems support data transmission over simple phone lines, internet connections, integrated services digital network/digital subscriber lines, satellite links, mobile networks (GPRS/3G), and wireless local area networks. The data corresponds, among others, to voice, vital biosignals, still medical images, video, and data used by eLearning applications. The proposed platform comprises several systems, each supporting different services. These were integrated using a common data storage and exchange scheme in order to achieve system interoperability in terms of software, language and national characteristics. Results: The platform has been installed and evaluated in different rural and urban sites in Greece, Cyprus and Italy. The evaluation was mainly related to technical issues and user satisfaction. The selected sites are, among others, rural health centers, ambulances, homes of "at-risk" citizens, and a ferry. Conclusions: The results proved the functionality and utilization of the platform in various rural places in Greece, Cyprus and Italy. However, further actions are needed to enable the local healthcare systems and the different population groups to be familiarized with, and use in their everyday lives, mature technological solutions for the provision of healthcare services

Towards an interoperable healthcare information infrastructure - working from the bottom up

Historically, the healthcare system has not made effective use of information technology. On the face of things, it would seem to provide a natural and richly varied domain in which to target benefit from IT solutions. But history shows that it is one of the most difficult domains in which to bring them to fruition. This paper provides an overview of the changing context and information requirements of healthcare that help to explain these characteristics.First and foremost, the disciplines and professions that healthcare encompasses have immense complexity and diversity to deal with, in structuring knowledge about what medicine and healthcare are, how they function, and what differentiates good practice and good performance. The need to maintain macro-economic stability of the health service, faced with this and many other uncertainties, means that management bottom lines predominate over choices and decisions that have to be made within everyday individual patient services. Individual practice and care, the bedrock of healthcare, is, for this and other reasons, more and more subject to professional and managerial control and regulation.One characteristic of organisations shown to be good at making effective use of IT is their capacity to devolve decisions within the organisation to where they can be best made, for the purpose of meeting their customers' needs. IT should, in this context, contribute as an enabler and not as an enforcer of good information services. The information infrastructure must work effectively, both top down and bottom up, to accommodate these countervailing pressures. This issue is explored in the context of infrastructure to support electronic health records.Because of the diverse and changing requirements of the huge healthcare sector, and the need to sustain health records over many decades, standardised systems must concentrate on doing the easier things well and as simply as possible, while accommodating immense diversity of requirements and practice. The manner in which the healthcare information infrastructure can be formulated and implemented to meet useful practical goals is explored, in the context of two case studies of research in CHIME at UCL and their user communities.Healthcare has severe problems both as a provider of information and as a purchaser of information systems. This has an impact on both its customer and its supplier relationships. Healthcare needs to become a better purchaser, more aware and realistic about what technology can and cannot do and where research is needed. Industry needs a greater awareness of the complexity of the healthcare domain, and the subtle ways in which information is part of the basic contract between healthcare professionals and patients, and the trust and understanding that must exist between them. It is an ideal domain for deeper collaboration between academic institutions and industry

Description and Experience of the Clinical Testbeds

This deliverable describes the up-to-date technical environment at three clinical testbed demonstrator sites of the 6WINIT Project, including the adapted clinical applications, project components and network transition technologies in use at these sites after 18 months of the Project. It also provides an interim description of early experiences with deployment and usage of these applications, components and technologies, and their clinical service impact

Addendum to Informatics for Health 2017: Advancing both science and practice

This article presents presentation and poster abstracts that were mistakenly omitted from the original publication

Advancing Artificial Intelligence in Sensors, Signals, and Imaging Informatics.

ObjectiveTo identify research works that exemplify recent developments in the field of sensors, signals, and imaging informatics.MethodA broad literature search was conducted using PubMed and Web of Science, supplemented with individual papers that were nominated by section editors. A predefined query made from a combination of Medical Subject Heading (MeSH) terms and keywords were used to search both sources. Section editors then filtered the entire set of retrieved papers with each paper having been reviewed by two section editors. Papers were assessed on a three-point Likert scale by two section editors, rated from 0 (do not include) to 2 (should be included). Only papers with a combined score of 2 or above were considered.ResultsA search for papers was executed at the start of January 2019, resulting in a combined set of 1,459 records published in 2018 in 119 unique journals. Section editors jointly filtered the list of candidates down to 14 nominations. The 14 candidate best papers were then ranked by a group of eight external reviewers. Four papers, representing different international groups and journals, were selected as the best papers by consensus of the International Medical Informatics Association (IMIA) Yearbook editorial board.ConclusionsThe fields of sensors, signals, and imaging informatics have rapidly evolved with the application of novel artificial intelligence/machine learning techniques. Studies have been able to discover hidden patterns and integrate different types of data towards improving diagnostic accuracy and patient outcomes. However, the quality of papers varied widely without clear reporting standards for these types of models. Nevertheless, a number of papers have demonstrated useful techniques to improve the generalizability, interpretability, and reproducibility of increasingly sophisticated models

ELECTRONIC MEDICAL RECORD - SUCCESS OR FAILURE IN THE MEDICAL DECISION FROM THE ROMANIAN HEALTH SYSTEM ?

The investments in informational and communicational technologies in the health field represent a for of investing in human capital because health and medical services will exceed the physician – patient relationship and the improvement of the physical and emotional condition of the individuals of a society will become a prioritary problem of the community. In Romania is noticed a high degree of data fragmenting, with a negligible communication, often inexistent, within and outside the system, and the decision makers of the health system hold exclusivity on their own data, fact that makes them unavailable to the other participants to the system. The software-s, the formats and supports used differ both inside the system and outside it. And because a patient is given a diagnosis without complete and safe medical data, the medical error is one of the causes for the incorrect diagnosis of the patient. The decision makers from the health system must take on responsibilities for the efficient and safe management of these data, to represent a desired issue for all medical institutions. Only the interconnected and standardized electronic medical files will be able to improve the medical decision and the care given to patients. The care will be safer, more efficient, the medical information will be also useful to other clinic physicians in time and space by using the informational and communicational technologies. The complete electronic medical record must include all types of information connected to the patient`s health (medical, family history, health file, hereditary-collateral antecedents, treatments, prescriptions, allergies) and they must be protected, shared by physicians, patients and those interested in a safe and extended environment. It is necessary to computerize the medical information specific to patient and the clinical processes, and performance in the health system will depend on the transformation of the medical services system by bringing the benefits of the medical science and technology to all individuals.critical; inefficient medical service; electronic medical record; medical information computerization, interconnected electronic medical files, medical error, health electronic file, clinical decision, protected and shared medical information, interoperability, standard.

Medical data processing and analysis for remote health and activities monitoring

Recent developments in sensor technology, wearable computing, Internet of Things (IoT), and wireless communication have given rise to research in ubiquitous healthcare and remote monitoring of human\u2019s health and activities. Health monitoring systems involve processing and analysis of data retrieved from smartphones, smart watches, smart bracelets, as well as various sensors and wearable devices. Such systems enable continuous monitoring of patients psychological and health conditions by sensing and transmitting measurements such as heart rate, electrocardiogram, body temperature, respiratory rate, chest sounds, or blood pressure. Pervasive healthcare, as a relevant application domain in this context, aims at revolutionizing the delivery of medical services through a medical assistive environment and facilitates the independent living of patients. In this chapter, we discuss (1) data collection, fusion, ownership and privacy issues; (2) models, technologies and solutions for medical data processing and analysis; (3) big medical data analytics for remote health monitoring; (4) research challenges and opportunities in medical data analytics; (5) examples of case studies and practical solutions