Non-invasive lightweight integration engine for building EHR from autonomous distributed systems

[EN] In this paper we describe Pangea-LE, a message-oriented lightweight data integration engine that allows homogeneous and concurrent access to clinical information from disperse and heterogeneous data sources. The engine extracts the information and passes it to the requesting client applications in a flexible XML format. The XML response message can be formatted on demand by appropriate Extensible Stylesheet Language (XSL) transformations in order to meet the needs of client applications. We also present a real deployment in a hospital where Pangea-LE collects and generates an XML view of all the available patient clinical information. The information is presented to healthcare professionals in an Electronic Health Record (EHR) viewer Web application with patient search and EHR browsing capabilities. Implantation in a real setting has been a success due to the non-invasive nature of Pangea-LE which respects the existing information systems.This work was partially funded by the Spanish Ministry of Science and Technology (MEC-TSI2004-06475-102-01) and the Spanish Ministry of Health (PI052245)Angulo Fernández, C.; Crespo Molina, PM.; Maldonado Segura, JA.; Moner Cano, D.; Perez Cuesta, D.; Abad, I.; Mandingorra Gimenez, J.... (2007). Non-invasive lightweight integration engine for building EHR from autonomous distributed systems. International Journal of Medical Informatics. 76(Supplement 3):417-424. https://doi.org/10.1016/j.ijmedinf.2007.05.002S41742476Supplement

Healthcare Process Support: Achievements, Challenges, Current Research

Healthcare organizations are facing the challenge of delivering high-quality services to their patients at affordable costs. To tackle this challenge, the Medical Informatics community targets at formalisms for developing decision-support systems (DSSs) based on clinical guidelines. At the same time, business process management (BPM) enables IT support for healthcare processes, e.g., based on workflow technology. By integrating aspects from these two fields, promising perspectives for achieving better healthcare process support arise. The perspectives and limitations of IT support for healthcare processes provided the focus of three Workshops on Process-oriented Information Systems (ProHealth). These were held in conjunction with the International Conference on Business Process Management in 2007-2009. The ProHealth workshops provided a forum wherein challenges, paradigms, and tools for optimized process support in healthcare were debated. Following the success of these workshops, this special issue on process support in healthcare provides extended papers by research groups who contributed multiple times to the ProHealth workshop series. These works address issues pertaining to healthcare process modeling, process-aware healthcare information system, workflow management in healthcare, IT support for guideline implementation and medical decision support, flexibility in healthcare processes, process interoperability in healthcare and healthcare standards, clinical semantics of healthcare processes, healthcare process patterns, best practices for designing healthcare processes, and healthcare process validation, verification, and evaluation

Unobtrusive Health Monitoring in Private Spaces: The Smart Vehicle

Unobtrusive in-vehicle health monitoring has the potential to use the driving time to perform regular medical check-ups. This work intends to provide a guide to currently proposed sensor systems for in-vehicle monitoring and to answer, in particular, the questions: (1) Which sensors are suitable for in-vehicle data collection? (2) Where should the sensors be placed? (3) Which biosignals or vital signs can be monitored in the vehicle? (4) Which purposes can be supported with the health data? We reviewed retrospective literature systematically and summarized the up-to-date research on leveraging sensor technology for unobtrusive in-vehicle health monitoring. PubMed, IEEE Xplore, and Scopus delivered 959 articles. We firstly screened titles and abstracts for relevance. Thereafter, we assessed the entire articles. Finally, 46 papers were included and analyzed. A guide is provided to the currently proposed sensor systems. Through this guide, potential sensor information can be derived from the biomedical data needed for respective purposes. The suggested locations for the corresponding sensors are also linked. Fifteen types of sensors were found. Driver-centered locations, such as steering wheel, car seat, and windscreen, are frequently used for mounting unobtrusive sensors, through which some typical biosignals like heart rate and respiration rate are measured. To date, most research focuses on sensor technology development, and most application-driven research aims at driving safety. Health-oriented research on the medical use of sensor-derived physiological parameters is still of interest

Henkilökohtaisen terveyden seuranta ja liityntästandardit. Kartoitus tilanteesta vuoden 2010 alussa

Henkilökohtaisen terveyden seuranta kasvattaa nopeasti suosiotaan. Laitteiden yhteentoimivuus on merkittävässä roolissa henkilökohtaisen terveyden seurannassa. Laiteliitynnät muodostavat perustan yhteentoimivuudelle. Standardoidut laiteliitynnät pyrkivät vähintään syntaktiseen yhteentoimivuuteen. Tässä artikkelissa selvitetään henkilökohtaisen terveyden seurantaan liittyviä laiteliityntästandardeja ja niiden käyttöä edistäviä organisaatioita. ISO/IEEE 11073 on merkittävin terveystekniikan laiteliityntästandardi joka on saanut taakseen kolmen merkittävän yleiskäyttöisen liityntästandardin, Bluetooth, USB, ja Zigbee, tuen. Sen merkittävin haastaja on IP‐tekniikan yleistyminen ja IP:n päälle kehitetyt yhteentoimivuusstandardit. Artikkelissa käydään lisäksi läpi standardeja kehittäviä organisaatioita ja pohditaan laiteliitynnän standardoinnin kehityssuuntia

The interplay between global standards and local practice in nursing

Submitted manuscript version. Published version available at https://doi.org/10.1016/j.ijmedinf.2013.02.005.Purpose: The paper assesses the extent, form, and transformation of global nursing classifications (NANDA) in a nursing practice during a period of 5 years. Method: A longitudinal case study was used to trace implementation, adoption and use of nursing classifications as an integral part of an electronic nursing module. A mixed method of data collection was used, including semi-structured interviews, observation and document analysis. Results: A surprisingly high proportion of nursing diagnoses was consistent with the global standard, in spite of a gradual increase of user-generated concepts. This is elaborated more thoroughly through a co-constructing perspective, emphasizing how the global standard and the practice mutually shaped each other over several years. Conclusion: Standardization is an iterative process that is performed in close relationship with practice. The mutual interrelation between formal classifications (NANDA) and local practices are co-constructed in a dynamic interplay that evolves over time. In such a process, the use of local classifications and local strategies can be a means to bridge the gap between these two extreme points. Highlights: ► Extensive use of standardized classification after implementation of electronic care plan. ► Local classifications evolved during long-term use. ► Co-construction of classifications was used to bridge the gap between global classifications and local needs

ENABLING EHEALTH IN TRADITIONAL MEDICINE: A SYSTEMATIC REVIEW OF INFORMATION SYSTEMS INTEGRATION REQUIREMENTS

This paper shall investigate the information systems integration needs towards eHealth implementation in Traditional Medicine. This review seeks to answer questions related to the locations of the integration points for integrated systems for the accessibility of electronic health records in both Traditional Medicine and modern medicine to identify of the most suitable health information systems model and the selection of the concrete integration technologies and standards to be implemented. A systematic literature review was conducted to select the relevant studies. A total of 11 articles were finally included for assessment. The findings of this review revealed that data integration is considered the most important precondition for the basis of further integration and is the backbone or starting point of a successful integration project. Other information systems integration needs are information model, interoperability standards, workflow or process integration and access to multiple repositories from different platforms. Establishment of Traditional Medicine databases of medications, procedures, information and diseases is crucial to ensure a generic and extensible information model can be designed so that new data sources can be integrated without major changes to the data schema

Dado e Granularidade na perspectiva da Informação e Tecnologia: uma interpretação pela Ciência da Informação

O desenvolvimento acelerado de recursos tecnológicos e sua utilização nos processos de acesso a dados, de uso da informação e de geração de conhecimento solicitam da Ciência da Informação (CI) uma revisão e ampliação de seu quadro referencial sobre as possibilidades interpretativas e de análise dos conceitos sobre dado e granularidade. O conceito de dado precisa ser redimensionado, entendido e percebido como elemento básico nos fluxos informacionais, especialmente em um momento em que tanto se discute e se legisla sobre o seu acesso na administração de conteúdos, no favorecimento de sua visibilidade e na sua utilização e reutilização. O objetivo é iniciar a reflexão e o debate sobre os conceitos de dado, conjunto de dados e granularidade no domínio da CI. Os conceitos de dado e de granularidade são apresentados sob o enfoque da Informação e Tecnologia, no interior da CI, com reflexão sobre dados estruturados e não estruturados, apontando a relevância dos metadados na complementação da estrutura semântica mínima de um determinado dado e na análise de sua granularidade