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

MedLAN: Compact mobile computing system for wireless information access in emergency hospital wards

This thesis was submitted for the degree of Doctor of Philosophy and awarded by Brunel University.As the need for faster, safer and more efficient healthcare delivery increases, medical consultants seek new ways of implementing a high quality telemedical system, using innovative technology. Until today, teleconsultation (the most common application of Telemedicine) was performed by transferring the patient from the Accidents and Emergency ward, to a specially equipped room, or by moving large and heavy machinery to the place where the patient resided. Both these solutions were unpractical, uneconomical and potentially dangerous. At the same time wireless networks became increasingly useful in point-of-care areas such as hospitals, because of their ease of use, low cost of installation and increased flexibility. This thesis presents an integrated system called MedLAN dedicated for use inside the A&E hospital wards. Its purpose is to wirelessly support high-quality live video, audio, high-resolution still images and networks support from anywhere there is WLAN coverage. It is capable of transmitting all of the above to a consultant residing either inside or outside the hospital, or even to an external place, thorough the use of the Internet. To implement that, it makes use of the existing IEEE 802.11b wireless technology. Initially, this thesis demonstrates that for specific scenarios (such as when using WLANs), DICOM specifications should be adjusted to accommodate for the reduced WLAN bandwidth. Near lossless compression has been used to send still images through the WLANs and the results have been evaluated by a number of consultants to decide whether they retain their diagnostic value. The thesis further suggests improvements on the existing 802.11b protocol. In particular, as the typical hospital environment suffers from heavy RF reflections, it suggests that an alternative method of modulation (OFDM) can be embedded in the 802.11b hardware to reduce the multipath effect, increase the throughput and thus the video quality sent by the MedLAN system. Finally, realising that the trust between a patient and a doctor is fundamental this thesis proposes a series of simple actions aiming at securing the MedLAN system. Additionally, a concrete security system is suggested, that encapsulates the existing WEP security protocol, over IPSec

Multimedia data mining for automatic diabetic retinopathy screening

International audience— This paper presents TeleOphta, an automatic sys-tem for screening diabetic retinopathy in teleophthalmology networks. Its goal is to reduce the burden on ophthalmologists by automatically detecting non referable examination records, i.e. examination records presenting no image quality problems and no pathological signs related to diabetic retinopathy or any other retinal pathology. TeleOphta is an attempt to put into practice years of algorithmic developments from our groups. It combines image quality metrics, specific lesion detectors and a generic pathological pattern miner to process the visual content of eye fundus photographs. This visual information is further combined with contextual data in order to compute an abnormality risk for each examination record. The TeleOphta system was trained and tested on a large dataset of 25,702 examination records from the OPHDIAT screening network in Paris. It was able to automatically detect 68% of the non referable examination records while achieving the same sensitivity as a second ophthalmologist. This suggests that it could safely reduce the burden on ophthalmologists by 56%

Telemedicine

Telemedicine is a rapidly evolving field as new technologies are implemented for example for the development of wireless sensors, quality data transmission. Using the Internet applications such as counseling, clinical consultation support and home care monitoring and management are more and more realized, which improves access to high level medical care in underserved areas. The 23 chapters of this book present manifold examples of telemedicine treating both theoretical and practical foundations and application scenarios

Insight into the Digital Health System of Ukraine (eHealth): Trends, Definitions, Standards, and Legislative Revisions

Purpose. This article aims to provide an in-depth examination of the digital health system of Ukraine, focusing on the emerging trends, precise definitions, established standards, and recent legislative revisions that shape the practice and implementation of eHealth solutions within the country. Background. The digital health landscape in Ukraine has witnessed significant transformations, especially in the wake of the COVID-19 pandemic and subsequent military conflicts. These events have catalyzed the expansion of telemedicine services, leading to innovative approaches in healthcare delivery. The national strategy underscores the necessity for human-centric and accessible telemedicine, reinforced by technological neutrality, and harmonization with global standards. Methods. A review of the current literature, national strategies, and legal documents was conducted, alongside an analysis of data usage and service provision patterns in various Ukrainian regions. Participation in the "Science for Safety and Sustainable Development of Ukraine" competition facilitated project initiatives like the development of a cloud-based platform for patient-centered telerehabilitation for oncology patients. Findings. The utilization of telemedicine has significantly increased in conflict-affected regions, demonstrating the need for, and the effective deployment of, digital health strategies under crisis conditions. Private health facilities and entrepreneurs have been pivotal in the provision of telemedicine services. Legislative efforts have been geared toward framing telemedicine as an integral component of the national eHealth system, ensuring interoperability, and aligning with international standards and the Internet of Medical Things (IoMT). Interpretation. The findings underscore the resilience and adaptability of the Ukrainian healthcare system in the face of adversity. There is a clear trend towards a more integrated, patient-focused, and technologically advanced healthcare model, aligning with international trends and prioritizing public health goals over private profits. This progress, however, is contingent upon continuous development, investment in technological infrastructure, and legislative support to sustain and advance digital health initiatives