Information architecture for a federated health record server

This paper describes the information models that have been used to implement a federated health record server and to deploy it in a live clinical setting. The authors, working at the Centre for Health Informatics and Multiprofessional Education (University College London), have built up over a decade of experience within Europe on the requirements and information models that are needed to underpin comprehensive multi-professional electronic health records. This work has involved collaboration with a wide range of health care and informatics organisations and partners in the healthcare computing industry across Europe though the EU Health Telematics projects GEHR, Synapses, EHCR-SupA, SynEx and Medicate. The resulting architecture models have fed into recent European standardisation work in this area, such as CEN TC/251 ENV 13606. UCL has implemented a federated health record server based on these models which is now running in the Department of Cardiovascular Medicine at the Whittington Hospital in North London. The information models described in this paper reflect a refinement based on this implementation experience

Design and implementation of a federated health record server

This paper describes the practical implementation of a federated health record serverbased on a generic and comprehensive public domain architecture and deployed in alive clinical setting.The authors, working at the Centre for Health Informatics and MultiprofessionalEducation (University College London), have built up over a decade of experiencewithin Europe on the requirements and information models that are needed to underpincomprehensive multi-professional electronic health records. This work has involvedcollaboration with a wide range of healthcare and informatics organisations and partnersin the healthcare computing industry across Europe though the EU Health Telematicsprojects GEHR, Synapses, EHCR-SupA, SynEx and Medicate. The resultingarchitecture models have influenced recent European standards in this area, such asCEN TC/251 ENV 13606. UCL has now designed and built a federated health recordserver based on these models which is now running in the Department ofCardiovascular Medicine at the Whittington Hospital in north London. A new EC FifthFramework project, 6WINIT, is enabling new and innovative IPv6 and wirelesstechnology solutions to be added to this work.The north London clinical demonstrator site has provided the solid basis from which toestablish "proof of concept" verification of the design approach, and a valuableopportunity to install, test and evaluate the results of the component engineeringundertaken during the EC funded projects

Horizons and Perspectives eHealth

EHealth platform represents the combined use of IT technologies and electronic communications in the health field, using data (electronically transmitted, stored and accessed) with a clinical, educational and administrative purpose, both locally and distantly. eHealth has the significant capability to increase the movement in the direction of services centered towards citizens, improving the quality of the medical act, integrating the application of Medical Informatics (Medical IT), Telemedicine, Health Telematics, Telehealth, Biomedical engineering and Bioinformatics. Supporting the creation, development and recognition of a specific eHealth zone, the European Union policies develop through its programs FP6 and FP7, European-scale projects in the medical information technologies (the electronic health cards, online medical care, medical web portals, trans-European nets for medical information, biotechnology, generic instruments and medical technologies for health, ICT mobile systems for remote monitoring). The medical applications like electronic health cards ePrescription, eServices, medical eLearning, eSupervision, eAdministration are integral part of what is the new medical branch-eHealth, being in a continuous expansion due to the support from the global political, financial and medical organizations; the degree of implementation of the eHealth platform varying according to the development level of the communication infrastructure, allocated funds, intensive political priorities and governmental organizations opened to the new IT challenges.eHealth, telemedicine, telehealth, bioinformatics, telematics

A socio-technical analytical framework on the EHR-organizational innovation interplay: Insights from a public hospital in Greece

The healthcare sector globally is confronted with increasing internal and external pressures that urge for a radical reform of health systems' status quo. The role of technological innovations such as Electronic Health Records (EHR) is recognized as instrumental in this transition process as it is expected to accelerate organizational innovations. This is why the widespread uptake of EHR systems is a top priority in the global healthcare agenda. The successful co-deployment though of EHR systems and organizational innovations within the context of secondary healthcare institutions is a complex and multifaceted issue. Existing research in the field has made little progress thus emphasizing the need for further research contribution that will incorporate a holistic perspective. This paper presents insights about the EHR-organizational innovation interplay from a public hospital in Greece into a socio-technical analytical framework providing a multilevel set of action points for the eHealth roadmap with worldwide relevance

A Review of Trip Planning Systems.

This report reviews current information provision in all modes of transport and assesses the needs for and benefits of trip planning systems. The feasibility of trip planning systems is discussed given the current state of technology and information availability and supply. The review was stimulated by technological developments in telecommunications and information technology which are providing the possibility of a greatly enhanced quality of information to aid trip planning decisions. Amongst the conclusions reached were the following: Current information provision is considered deficient in many respects. Travellers are often unaware of alternative routes or services and many are unable to acquire adequate information from one source especially for multi-modal journeys. In addition, there is a lack of providing real time information where it is required (bus stops and train stations) and of effective interaction of static and real time information. Most of the projects, which integrate static and dynamic data, are single mode systems. Therefore there is a need for an integrated trip planning system which can inform and guide on all aspects of transport. Trip planning systems can provide assistance in trip planning (before and during the journey) using one or a number of modes of travel, taking into account travellers preferences and constraints, and effectively integrating static and dynamic data. Trip planning systems could adversely affect traffic demand as people who become aware of new opportunities might be encouraged to make more journeys. It could also affect travellers choice as a result of over-saturation of information, over-reaction to predictive information, and concentration on the same 'best' routes. However, it can be argued, based on existing evidence, that such a system can benefit travellers, and transport operators as well as the public sector responsible for executing transport policies. Travellers can benefit by obtaining adequate information to help them in making optimal decisions and reducing uncertainty and stress associated with travel. Public transport operators can benefit by making their services known to customers, leading to increased patronage. Public transport authorities can use the supply of information to execute their transport policies and exercise more control over traffic management

Fast watermarking of MPEG-1/2 streams using compressed-domain perceptual embedding and a generalized correlator detector

A novel technique is proposed for watermarking of MPEG-1 and MPEG-2 compressed video streams. The proposed scheme is applied directly in the domain of MPEG-1 system streams and MPEG-2 program streams (multiplexed streams). Perceptual models are used during the embedding process in order to avoid degradation of the video quality. The watermark is detected without the use of the original video sequence. A modified correlation-based detector is introduced that applies nonlinear preprocessing before correlation. Experimental evaluation demonstrates that the proposed scheme is able to withstand several common attacks. The resulting watermarking system is very fast and therefore suitable for copyright protection of compressed video

Smartphones

Many of the research approaches to smartphones actually regard them as more or less transparent points of access to other kinds of communication experiences. That is, rather than considering the smartphone as something in itself, the researchers look at how individuals use the smartphone for their communicative purposes, whether these be talking, surfing the web, using on-line data access for off-site data sources, downloading or uploading materials, or any kind of interaction with social media. They focus not so much on the smartphone itself but on the activities that people engage in with their smartphones

Optimal Bundle of Multimedia Services in Emerging Mobile Markets

Although various emerging technologies have been launched, they present limitations as far as offering full-scale ubiquitous services independently is concerned. In view of this fact, service providers are likely to provide bundled services among possible combinations of services. Indeed, making a timely decision regarding the value maximization of bundled service is directly related to service providers' future growth and success in the turbulent market environment. This paper aims to find the optimal service bundle among five emerging mobile services: T-DMB, S-DMB, WiBro, HSDPA, and Telematics. Considering what kinds of service features among the five emerging services offer differentiation to customers, we examine four attributes (TV, voice, portable wireless internet, and location-based services) using conjoint analysis to distinguish the service features. Our results show that TV service is the most favored among the attributes, followed by voice service in second position, and the internet and location-based service in third and fourth place respectively. Our result implies that mobile operators would be better off bundling HSDPA and S-DMB first, and then adding other services later, while fixed operators would be better off bundling WiBro and S-DMB first and other services later.telecommunications and broadcasting convergence; emerging service; 4G Technology; T-DMB; S-DMB; WiBro; HSDPA; telematics; customer preference

Electronic health record standards

Objectives: This paper seeks to provide an overview of the initiatives that are proceeding internationally to develop standards for the exchange of electronic health record (EHR) information between EHR systems.Methods: The paper reviews the clinical and ethico-legal requirements and research background on the representation and communication of EHR data, which primarily originates from Europe through a series of EU funded Health Telematics projects over the post thirteen years. The major concept that underpin the information models and knowledge models are summarised. These provide the requirements and the best evidential basis from which HER communications standards should be developed.Results. The main focus of EHR communications standardisation is presently occurring at a European level, through the Committee for European Normalisation (CEN). The major constructs of the CEN 13606 model ate outlined. Complementary activity is taking place in ISO and in HL7, and some of these efforts are also summarised.Conclusior: There is a strong prospect that a generic EHR interoperability standard can be agreed at a European (and hopefully international) level. Parts of the challenge of EHR i interoperability cannot yet he standardised, because good solutions to the preservation of clinical meaning across heterogeneous systems remain to be explored. Further research and empirical projects are therefore also needed