Integration of Patient Health Portals into the German Healthcare Telematics Infrastructure

In this paper we describe a generic model of a patient health portal, which is suitable to implement patient access to the evolving German healthcare telematics infrastructure. The portal uses the telematics as a communication infrastructure to ensure the concise and secure exchange of medical data between professional medical personnel and patients. We aim at providing patients an application platform model for using and enhancing their data by processing or extending them with medical services offered via the internet or with local medical appliances. We show that a) specific functionalities (such as data import/export from/to the telematics) for patient health portals can be derived from the legal foundation in the German law b) the portal is conceptually suited to provide a link between the public health information infrastructure and other (maybe commercial) applications in the e-health environment via Personal Health Records (PHR) and c) patients’ rights can be mapped with a common data model

Information Systems and Healthcare XX: Toward Seamless Healthcare with Software Agents

Healthcare processes are frequently fragmented and often badly supported with IT. Inter- and intra-organizational communication and media frictions complicate the continuous provision of information according to the principle of information logistics. Based on extensive literature review, we present the vision of seamless healthcare with horizontally and vertically integrated healthcare processes enabled by seamless IT support. Its implementation requires the establishment of a communication infrastructure and the deployment of adequate standards in healthcare. There are already comprehensive approaches for dealing with integrating heterogeneous information systems. However, they lack a common communication infrastructure and do not support proactivity and flexibility which are dominant characteristics in healthcare. We propose a software agent-based approach for realizing the vision of seamless healthcare. We present a corresponding implementation for integrating heterogeneous information systems in the context of the German Health Telematics Infrastructure. Based on the concept and the implementation, we show that the modular approach is capable of supporting a wide range of different applications. We furthermore outline which facets of an agent-based solution could be implemented in an operative real-world environment. In closing we derive implications for IT decision makers in healthcare and show directions for future approaches for reducing information logistics related deficits in healthcare

FUTURE-ORIENTED AND PATIENT-CENTRIC? A QUALITATIVE ANALYSIS OF DIGITAL THERAPEUTICS AND THEIR INTEROPERABILITY

This paper focuses on the integration of digital therapeutics (DTx) into future-oriented and patient-centric care pathways. Based on a workshop series and problem-centered interviews in Germany, the current state-of-the-art of regulatory and technical integration of DTx was mapped as a landscape of DTx interoperability. The results focus on key interfaces of DTx, namely with Electronic Health Records (EHRs), devices, and other digital health innovations such as telemedicine, and highlight current challenges and potentials for future development. On a broader level, the results point to unresolved issues of care coordination, the optional role of the EHRs as regulated platforms for care, and the importance of integrating DTx data into public data spaces for research

The Failed Implementation of the Electronic Prescription in Germany - A Case Study

Many countries worldwide are striving for improving the quality of care and for reducing costs in the health care sector by establishing large IT infrastructures. In Germany, the introduction of the electronic health card and the national telematics infrastructure is lagging years behind the original schedule. In this paper, we describe and analyze a case study of one selected part of this ultra-large intervention. The selected part is the failed implementation of the electronic prescription. The related activities started in 2003 and ended in 2010 when a decision was made to abandon this part of the intervention. We present a detailed analysis of the project and identify 14 reasons in five categories for the project’s failure. Furthermore, we provide a multi-layered overview of the episodes and sub-projects

Analysis of Legal and Regulatory Frameworks in Digital Health: A Comparison of Guidelines and Approaches in the European Union and United States

The advent of digital technology in healthcare presents opportunities for the improvement of healthcare systems around the world and the move towards value-based treatment. However, this move must be accompanied by strong legal and regulatory frameworks that will not only facilitate but encourage the good use of technology. The goal of the study was to assess the amenability and furtherance of regulatory frameworks in digital health by evaluating and comparing the processes, effectiveness and outcomes of these frameworks in the European Union and United States. Methods: This study incorporated two research methodologies. The first was a research of current legal and regulatory frameworks in digital health in the European Union and United States. A comprehensive online search for publications was carried out which included laws, regulations, policies, green papers, guidelines and recommendations. This research was complemented with interviews of five purposively sampled key informants in the legal and regulatory landscape. Results: Mind-maps revealed key features and challenges of the digital health field in the topics of the current state of regulation of digital health in the EU, Germany and US, regulatory pathways for digital health devices, protection and privacy of health data, mobile health validation, risk-based classification of medical devices, regulation of clinical decision support systems, telemedicine, artificial intelligence and emerging technologies, reimbursement for digital health services and liability for digital health products. The experts expressed and explained key points where current regulation is deficient. The review of the legal frameworks revealed deficiencies which provide opportunities and recommendations to further develop and strengthen the regulatory landscape. Conclusions: A key element to a robust regulatory framework is the ability to ensure trust and confidence in using digital health technology. Technology must measure the impact on quality of life and burden of disease and not merely involve the collection of data

Opportunities And Challenges of E-Health and Telemedicine Via Satelite

The introduction of Information and Communication Technology (ICT) in the health scenario is instrumental for the development of sustainable services of direct benefit for the European citizen. The setting up of satellite based applications will enhance rapidly the decentralisation and the enrichment of the European territory driving it towards a homogenous environment for healthcare

Connectivity for Healthcare and Well-Being Management: Examples from Six European Projects

Technological advances and societal changes in recent years have contributed to a shift in traditional care models and in the relationship between patients and their doctors/carers, with (in general) an increase in the patient-carer physical distance and corresponding changes in the modes of access to relevant care information by all groups. The objective of this paper is to showcase the research efforts of six projects (that the authors are currently, or have recently been, involved in), CAALYX, eCAALYX, COGKNOW, EasyLine+, I2HOME, and SHARE-it, all funded by the European Commission towards a future where citizens can take an active role into managing their own healthcare. Most importantly, sensitive groups of citizens, such as the elderly, chronically ill and those suffering from various physical and cognitive disabilities, will be able to maintain vital and feature-rich connections with their families, friends and healthcare providers, who can then respond to, and prevent, the development of adverse health conditions in those they care for in a timely manner, wherever the carers and the people cared for happen to be