Development of Computer Vision Applications to Automate the Measurement of the Dimensions of Skin Wounds

[EN] This paper shows the progress in the development of two computer vision applications for measuring skin wounds. Both applications have been written in Python programming language and make use of OpenCV and Scipy open source libraries. Their objective is to be part of a software that calculates the dimensions of skin wounds in an objective and reliable way. This could be useful in the clinical follow-up, assessing the evolution of skin wounds, as well as in research, comparing the efficacy of different treatments. Merging these two applications into a single one would allow to generate two-dimensional results in real time, and three-dimensional results after a few hours of processingThis work is part of the Ph.D. research of D.S., which is supported by a grant from Generalitat Valenciana - Consellería de Educación, Investigación, Cultura y Deporte and the European Social Fund (ACIF/2018/160)Sánchez-Jiménez, D.; Buchón Moragues, FF.; Escutia-Muñoz, B.; Botella-Estrada, R. (2019). Development of Computer Vision Applications to Automate the Measurement of the Dimensions of Skin Wounds. Proceedings. 19(18):1-4. https://doi.org/10.3390/proceedings2019019018S14191

BPFlexTemplate: A Business Process template generation tool based on similarity and flexibility

In large organizations with multiple organizational units, process variants emerge due to many aspects, including local management policies, resources or socio-technical limitations. Organizations then struggle to improve a business process which has no longer a single process model to redesign, implement and adjust. In this paper, we propose an approach to tackle these two challenges: decrease the proliferation of process variants in these organizations, and foresee, at the same time, the need of having flexible business processes that allow for a certain degree of adjustment. To validate our approach, we first conducted case studies where we collected six real-world business process variants from two organizational units of the same healthcare organization. We then proposed an algorithm to derive a template process model from all the variants, which includes common and flexible process elements. We implemented our approach in a software tool called BPFlexTemplate, and tested it with the elicited variants

Design and Evaluation of Domain-Specific Platforms and the Special Case of Digital Healthcare

The implementation of digital innovations in the healthcare sector is faced with different barriers and challenges. The complex system of regulations, the lack of interoperability, and highly dynamic interorganisational networks lead to missing widespread adoption of eHealth solutions. Digital platforms can help to overcome these barriers by providing a holistic infrastructure. They create a modularised foundation that innovators can use to create own innovations and provide them to demanders of digital solutions. As intermediaries, they can be accessed both by healthcare professionals and eHealth solution providers. Providers can offer their eHealth services via the platform. Healthcare professionals can use these services to create own interorganisational information systems. In the field of information systems research, effects and strategies for two-sided platforms are well researched and the potentials of eHealth platforms are also discussed. However, the organisational and technological design and methods for the construction of platforms are fewer questioned. Nonetheless, platform owners can benefit from implementation strategies and architectural guidance to create sustainable platforms and surrounding ecosystems. This doctoral thesis questions how domain-specific platforms can be designed systematically. Conducting a design-science research process, it develops both a modelling system and the Dresden Ecosystem Management Method (DREEM) to support the development of platforms in different domains. Furthermore, it describes the design characteristics of two-sided platforms in the healthcare sector and provides an evaluation approach to analyse the platforms’ ability to create a viable innovation ecosystem in the healthcare sector. The doctoral thesis contributes by providing methodical guidance for platform owners and researchers to design and evaluate digital platforms in different domains and improves the understanding of platform theory in the healthcare sector.:A. Synopsis of the Doctoral Thesis 1. Introduction 2. Foundational Considerations 3. Requirements for Design Artefacts and Knowledge 4. Structure of the Doctoral Thesis 5. Conclusion B. Paper 1 - Governance Guidelines for Digital Healthcare Ecosystems C. Paper 2 - Revise your eHealth Platform! D. Paper 3 - Business Model Open ”E-Health-Platform” E. Paper 4 - Modelling Ecosystems in Information Systems F. Paper 5 - Designing Industrial Symbiosis Platforms G. Paper 6 - Management of Digital Ecosystems with DREEM H. Paper 7 - Guiding the Development of Digital Ecosystems I. Paper 8 - Towards Maintenance Analytics Ecosystems J. Paper 9- Sustainability of E-Health-Projects K. Paper 10 - ISO 11354-2 for the Evaluation of eHealth-Platform

Analysis of Android Device-Based Solutions for Fall Detection

Falls are a major cause of health and psychological problems as well as hospitalization costs among older adults. Thus, the investigation on automatic Fall Detection Systems (FDSs) has received special attention from the research community during the last decade. In this area, the widespread popularity, decreasing price, computing capabilities, built-in sensors and multiplicity of wireless interfaces of Android-based devices (especially smartphones) have fostered the adoption of this technology to deploy wearable and inexpensive architectures for fall detection. This paper presents a critical and thorough analysis of those existing fall detection systems that are based on Android devices. The review systematically classifies and compares the proposals of the literature taking into account different criteria such as the system architecture, the employed sensors, the detection algorithm or the response in case of a fall alarms. The study emphasizes the analysis of the evaluation methods that are employed to assess the effectiveness of the detection process. The review reveals the complete lack of a reference framework to validate and compare the proposals. In addition, the study also shows that most research works do not evaluate the actual applicability of the Android devices (with limited battery and computing resources) to fall detection solutions.Ministerio de Economía y Competitividad TEC2013-42711-

User-centred Design and Evaluation of Health Information Technology

Doktorgradsavhandling i informasjons- og kommunikasjonsteknologi, Fakultet for teknologi og naturvitenskap, Universitetet i AgderHealth information technologies play an important role in exchange of information and coordination of continuity of care in health care services. This thesis explores the approach of user-centred design and evaluation in the development of health information technology, with the main research focus on end-user involvement. A study on user-centred design and evaluation in the externally funded research projects United4Health and eHealth- extended Care Coordination was conducted. In addition, the internal project Visually impaired users touching the screen - A user evaluation evaluated visually impaired users using mobile technology. In the EU project United4Health, a collaborative telemedicine system for remote monitoring of chronic obstructive pulmonary disease patients was developed. The regional project eHealth- extended Care Coordination addressed the information flow within inter-municipal health care teams to build a collaborative information system that facilitated coordination between municipalities. In both projects, end-users were involved in workshops in an early design phase and participated in usability evaluations during the iterative development. A mixed methods research approach including observations, semi-structured interviews and a questionnaire was used for data collection in the user-centred design process. The data analysis was based on a qualitative content analysis from a human-computer interaction perspective. This thesis also addresses the topic of the usability evaluation of health information technology from the perspective of the technical infrastructure necessary for optimisation of data collection and retrospective analysis of data. In this regard, a usability evaluation of a mobile touchscreen together with visually impaired users was made. The results from the user-centred design and evaluation research are presented in this dissertation through a collection of 9 scientific published papers in international peer-reviewed journals and conference proceedings. This study contributes to the knowledge of user-centred design in several ways. Firstly, this thesis provides an understanding on how to actively and efficiently involve users in design and development of health information technology by conducting empirical research. Secondly, it contributes to the knowledge on how to run usability evaluations of health information technology in high fidelity laboratory settings, health care environment and patients’ homes. Thirdly, it provides recommendations for a technical infrastructure in order to optimise the outcome of usability evaluations. The Norwegian Social Science Data Services approved the studies presented here

Improvement of the portuguese breast cancer screening through process modelling (BPM)

Dissertation presented as the partial requirement for obtaining a Master's degree in Information Management, specialization in Knowledge Management and Business IntelligenceBreast cancer is a malignant epithelial neoplasm with high incidence and mortality in women. Focusing the clinical performance on screening processes has proven to be the way to improve morbidity and mortality statistics of this recognized public health problem. Business process management (BPM) is a management field that improves and analyzes business processes according to organizations’ strategies. BPM may help manage patient and information flow, improving waiting time in healthcare delivery while integrating healthcare processes with IT. The early diagnosis of breast cancer is of great importance since it will enable more conservative treatments and a longer disease-free survival. Organized oncology screenings programs, with all elements properly prepared, revealed to be more efficient than the opportunistic screenings. The aim of this study is to identify and model BPM processes for the healthcare sector, namely, for the breast cancer screening in Portugal. To achieve this goal, the main processes were identified and new frameworks were proposed and validated through individual interviews with experts. In this study was concluded that BPM techniques can be applied to the healthcare. Through the application of these techniques it was possible to identify the main issues within the organized breast cancer screening and suggest changes to it. These changes focus on reducing the time of the process, improving its efficiency and offering greater support to the health user

eHealth's potential in providing healthcare for the elderly with risk of falling due to balance disorders, in a global health perspective

Introdução: O processo global e progressivo de envelhecimento populacional e a vulnerabilidade a doenças crónicas, distúrbios do equilíbrio e quedas têm representado um dos principais desafios aos sistemas de saúde. Isto tem motivado o desenvolvimento de estratégias, incluindo a utilização de tecnologia na prestação de cuidados de saúde. Portugal e Cabo Verde têm acompanhado esta tendência, investindo em sistemas e tecnologias de informação. Contudo, a aplicabilidade clínica das soluções digitais no contexto do idoso com alterações do equilíbrio e risco de queda precisa ser explorada. Objetivo: O objetivo desta investigação foi estudar, elaborar, implementar, demonstrar e avaliar uma solução digital para a prestação complementar de cuidados de saúde a idosos com alterações do equilíbrio e risco de queda no contexto português, alinhando posteriormente a sua utilização numa perspetiva global, com o exemplo de Cabo Verde. Métodos: Utilizando Design Science Research Methodology, foi realizado um estudo de métodos mistos com estratégia explanatória sequencial. Inicialmente, foi disponibilizado um questionário no website da Ordem dos Médicos de Portugal para identificar a satisfação e constrangimentos quanto aos dados clínicos disponíveis e a relevância do eHealth no contexto da prestação de cuidados de saúde a idosos com distúrbio do equilíbrio. Foram conduzidas entrevistas individuais a médicos, explorando estratégias para o desenvolvimento de uma solução digital neste contexto. As sugestões contribuíram para o desenho e elaboração do serviço digital, inicialmente testado por cinco idosas e seus cuidadores, como prova de conceito. Este serviço foi avaliado por estes utilizadores e oito médicos com experiência em coordenação de serviços, através de dois grupos focais. Relativamente a Cabo Verde, foi conduzido um Policy Dialogue Workshop (PDW), incluindo a Direção do Hospital Central Doutor Agostinho Neto (HCDAN), para explorar o interesse e potencial utilização do serviço digital no contexto cabo-verdiano. Resultados: A identificação de constrangimentos médicos quanto aos dados clínicos disponíveis e a verificação da relevância do eHealth neste contexto motivaram a elaboração de uma solução digital. Considerando as sugestões dos entrevistados, foi desenhado o serviço digital “EQUILÍBRIO” para monitorização remota, deteção precoce de agravamento clínico, atempada adequação do tratamento e maior interação médica com os doentes. As avaliações dos doentes, cuidadores e médicos foram positivas, com o reconhecimento de vários benefícios, tais como, conforto do doente, maior proximidade médico-doente e potencial redução de recursos presenciais. No caso de Cabo Verde, a Direção do HCDAN e participantes do PDW manifestaram interesse e reconheceram o potencial de utilização do serviço digital, inclusive junto a doentes mais jovens. Conclusão: O serviço digital “EQUILÍBRIO” foi desenhado, implementado e avaliado em contexto clínico. Verificou-se um significativo potencial para aplicabilidade clínica na prestação complementar de cuidados de saúde, permitindo monitorização remota, maior interação médico-doente e participação ativa dos doentes. A implementação deste serviço em Cabo Verde representa uma oportunidade para futura investigação. O envolvimento de outros profissionais de saúde e outros países podem ser considerados como uma promissora cooperação de cuidados de saúde entre os Estados membros da Comunidade dos Países de Língua Portuguesa.Introduction: The global and progressive aging of the populations and vulnerability to chronic diseases, balance disorders and falls have represented one of the main challenges to health systems. This has motivated the development of strategies, including the use of technology for provision of health care. Portugal and Cape Verde have followed this trend, investing in technology-based information systems. However, the clinical applicability of these digital solutions in the context of elderly people with balance disorders and risk of falling needs to be explored. Objective: The objective of this research was to study, develop, implement, demonstrate and evaluate a digital solution for the complementary provision of health care for elderly people with balance disorders and risk of falling in the Portuguese context, subsequently aligning its use in a global perspective, with the example of Cape Verde. Methods: Using the Design Science Research Methodology, an explanatory sequential mixed methods study was performed. Initially, a questionnaire was made available on the website of the Portuguese General Medical Council to identify the satisfaction and difficulties with clinical data availability, and the relevance of eHealth in the context of elderly people with balance disorders. Individual interviews were carried out with physicians, exploring strategies for the development of a digital solution in this context. The suggestions contributed to the design and development of the digital service, initially tested with five elderly women and their caregivers, as a proof-of-concept. This service was evaluated through two focus groups, including these users and eight physicians with experience in coordinating services. In the case of Cape Verde, a Policy Dialogue Workshop (PDW) was carried out, including the Direction of the Hospital Central Doutor Agostinho Neto (HCDAN), to explore the interest and potential use of the digital service in the Cape Verdean context. Results: The identification of medical constraints with availability of clinical data and the identification of the relevance of eHealth in this context encouraged the development of a digital solution. Considering the suggestions of the interviewees, the digital service “BALANCE” was designed, allowing remote monitoring, early detection of clinical deterioration, timely optimization of treatment and greater medical interaction with patients. The patient, caregiver and medical evaluations were positive, with the recognition of several benefits, such as patient comfort, closer physician-patient interaction and potential lower consumption of face-to-face resources. Regarding Cape Verde, the Direction of HCDAN and the participants of the PDW expressed interest and recognized the potential for using the digital service, including among younger patients. Conclusion: The digital service “BALANCE” was designed, implemented and evaluated in the clinical context. There was significant potential for clinical applicability in the provision of complementary health care, allowing remote monitoring, closer physicianpatient interaction and active patient participation. The implementation of this service in Cape Verde is an opportunity for future research. The involvement of other health professionals and countries could be considered as a promising health care cooperation between the member states of Community of Portuguese-Speaking Countries