The use of HL7 as an interoperability framework in a regional healthcare system in Greece, Journal of Telecommunications and Information Technology, 2005, nr 4

The integration of information systems represents one of the most urgent priorities of a regional healthcare authority in order to meet its clinical, organizational and managerial needs. Current practice shows that the most promising approach to achieve a regional healthcare information system is to use a health level 7 (HL7) messagebased communication system implemented by an asynchronous common communication infrastructure between healthcare sites. The system is a complete and integrated information system at a regional level that comprises all types of healthcare levels, that includes interoperability issues, that covers most of the needed components, and that is able to work efficiently in a secure wide area network to ensure data privacy and confidentiality. Another important feature of the proposed solution is that it creates an interoperability framework that can be replicated from one healthcare institution to another. In that sense, common interoperability messages can be used to interconnect heterogeneous information systems. In response to this strategy, more than 10 different consortiums have submitted proposals to the Greek government and the proposed interoperability framework seems to be widely accepted as a solution to enhance information and communication technologies developments in the healthcare sector in Greece

A roadmap towards healthcare information systems interoperability in Greece, Journal of Telecommunications and Information Technology, 2006, nr 2

The advantages of the introduction of information and communication technologies (ICT) in the complex healthcare sector are already well known and well stated in the past. It is common knowledge that in order to install any type of information system in healthcare, six main groups of issues have to be dealt with: organizational and cultural matters related to healthcare, technological gap between healthcare professionals and information science experts, legal requirements on the confidentiality of personal data, of patient related data and on data privacy, industrial and market position of healthcare informatics and interoperability complexity, lack of vision and leadership of the health care managers and health authorities and user acceptability and usability of the proposed information systems. In order to meet these issues stated above, a special focus group (Z3) performed an assessment of the situation of healthcare informatics in Greece and of the main key points that would lead to success. In that sense it is now common knowledge that Greece is lagging information and communication technology progress in healthcare because almost none of the above mentioned issues were dealt with. This assessment is the result of the interaction of more than 150 decision makers, medical informaticians, healthcare practitioners and other individual involved in healthcare. As a conclusion, this focus group resulted in 4 major propositions that will lead to healthcare informatics introduction with better success chances: focus on terminologies and standards, focus on interoperability and information systems sustainability, focus on clear goals and system metrics that can create a healthcare performance management cockpit, and focus on people and what they have to say, by creating a e-health forum. These conclusions were taken into consideration by the Greek government and are incorporated the IASYS project, the national healthcare informatics framework for the next ten years

Future of Data Analytics in the Era of the General Data Protection Regulation in Europe

The development of evidence to demonstrate ‘value for money’ is regarded as an important step in facilitating the search for the optimal allocation of limited resources and has become an essential component in healthcare decision making. Real-world evidence collected from de-identified individuals throughout the continuum of healthcare represents the most valuable source in technology evaluation. However, in the European Union, the value assessment based on real-world data has become challenging as individuals have recently been given the right to have their personal data erased in the case of consent withdrawal or when the data are regarded as being no longer necessary. This act may limit the usefulness of data in the future as it may introduce information bias. Among healthcare stakeholders, this has become an important topic of discussion because it relates to the importance of data on one side and to the need for personal data protection on the ot

Clinical outcomes of a digitally supported approach for self-management of type 2 diabetes mellitus

BackgroundSelf-management of Type 2 diabetes mellitus (T2D) is challenging. Regular self-monitoring of blood glucose and healthy lifestyles are required to improve glycometabolic control, thus delaying diabetes complications, and reducing hospitalizations. Digital technologies can empower patients in their disease management promoting self-management and motivation to change behaviors. We report the results of an exploratory trial aimed at evaluating the metabolic outcomes of using digital solutions for T2D self-management developed in the ProEmpower project, a European Commission funded Pre-Commercial Procurement.MethodsTwo digital solutions, DM4All and DiaWatch, which were codesigned with providers, patients, and caregivers, enabled the collection of clinical parameters by the patient using a smartphone integrated with the medical devices (glucometer, sphygmomanometer, scale, smart watch for heart rate monitoring and step counter). Data were automatically sent to the shared care plan allowing professionals to monitor adherence to treatment, set goals, and communicate more effectively with patients. At baseline and after an average follow-up of 8 months, glycosylated hemoglobin (HbA1c), body weight, blood pressure, and blood lipids were measured in 100 T2D patients using the ProEmpower solutions across different diabetes centers in Campania Region, age 45–79  years, both genders, and compared with a Control cohort of T2D patients (n = 100) with similar clinical characteristics and followed for a comparable period of observation in the same centers.ResultsAt baseline, the ProEmpower participants and the Control subjects were on average overweight, with a similar BMI in the two cohorts, and mean HbA1c was at acceptable levels (around 7.0%). After the 8 month exploratory trial, body weight, HbA1c, systolic and diastolic blood pressure, and plasma and LDL-cholesterol significantly decreased in the ProEmpower participants compared to baseline (p < 0.05 for all). The changes in systolic and diastolic blood pressure, and plasma and LDL-cholesterol were significantly different from those observed in the Control cohort (p < 0.05 for all).ConclusionThis pilot study showed positive effects on metabolic outcomes relevant to cardiovascular risk in T2D of adopting digital telemedicine self-monitoring solutions based on automation of measurements and coaching on healthy lifestyles promotion

Information and communication technology applications in the process and transfer of biological signals related to telemedicine: service oriented information model in a citizen centred regional healthcare network

This study is about the creation and implementation of a service oriented information model in a citizen centred regional healthcare network. The study initially describes intensively the technical & functional background i.e. medical informatics/healthcare information management, public health issues, etc. Then the model is analytically deployed with the methodological approach used (Donabedian, Zachman, UML, Norton & Kaplan) well analysed. Finally, the study describes how this model was used and implemented in real practice during the implementation of the regional healthcare information system in Greece, make an assessment of the implementation process and propose new functional and research development for the future.Η παρούσα διατριβή αφορά στο σχεδιασμό και υλοποίηση ενός μοντέλου διαχείρισης ιατρικής πληροφορίας σε περιβάλλον περιφερειακού πολιτοκεντρικού δικτύου υγείας. Η διατριβή πραγματεύεται αναλυτικά τον ερευνητικό τομέα και το πεδίο εφαρμογής ήτοι θέματα δημόσιας υγείας, στρατηγικών σχεδιασμών υγείας, ιατρικής πληροφορικής, ιατρικών πληροφοριακών συστημάτων και ποιότητας της υγείας. Στη συνέχεια αναλύονται οι μεθοδολογίες που αξιοποιήθηκαν για την ανάπτυξη του μοντέλου (Donabedian, Zachman, UML, Norton & Kaplan), αναλύεται το προτεινόμενο μοντέλο και περιγράφονται αναλυτικά τα δομικά του στοιχεία (τεχνολογικές προσεγγίσεις, διαδικασίες, κλπ.). Στο τέλος περιγράφεται η πειραματική υλοποίηση (έργα ολοκληρωμένων πληροφοριακών συστημάτων υγείας στο πλαίσιο του Γ΄ΚΠΣ) καθώς και τα συμπεράσματα από την υλοποίηση αυτή. Στο τέλος προτείνονται νέες ερευνητικές ιδέες και προτάσεις για την επέκταση του προτεινόμενου μοντέλου

'Without data, you're just another person with an opinion'

Introduction: Given the recent impressive digital transformation worldwide, the importance of data has reached a new dimension. It is, therefore, provocative to ask whether data can save healthcare systems from bankruptcy.Areas covered: We reviewed published examples in the search for the evidence on how the growing amount of data could change the way we used to assess the value of healthcare technologies, ensuring a more holistic approach in the decision-making process while reducing the waste in the healthcare.Expert opinion: The growing amount of data will continue to provide a multitude of valuable insights that can save healthcare systems from bankruptcy. Electronic medical records, IoT, wearables, and mobile applications generate constant data streams that can be utilized endlessly thanks to methodological advancements such as SNA, unsupervised and supervised machine learning, and natural language programming. However, interoperability across these multiple data sources still pose a challenge for the future development of data-driven healthcare. Already today however, decision makers can utilize Big Data to develop conditional coverage schemes for very expensive and complicated health technologies suitable for personalized healthcare. More advanced payers may utilize even data analytics even further and develop AI-based pricing schemes

'Without data, you're just another person with an opinion'

Introduction: Given the recent impressive digital transformation worldwide, the importance of data has reached a new dimension. It is, therefore, provocative to ask whether data can save healthcare systems from bankruptcy.Areas covered: We reviewed published examples in the search for the evidence on how the growing amount of data could change the way we used to assess the value of healthcare technologies, ensuring a more holistic approach in the decision-making process while reducing the waste in the healthcare.Expert opinion: The growing amount of data will continue to provide a multitude of valuable insights that can save healthcare systems from bankruptcy. Electronic medical records, IoT, wearables, and mobile applications generate constant data streams that can be utilized endlessly thanks to methodological advancements such as SNA, unsupervised and supervised machine learning, and natural language programming. However, interoperability across these multiple data sources still pose a challenge for the future development of data-driven healthcare. Already today however, decision makers can utilize Big Data to develop conditional coverage schemes for very expensive and complicated health technologies suitable for personalized healthcare. More advanced payers may utilize even data analytics even further and develop AI-based pricing schemes

Business model canvas for adoption of International Patient Summary standards in mHealth industry

Purpose This article intends to present and discuss two promising business models for deploying international patient summary standards in mobile health (mHealth) apps, enhancing the value brought by standards, in particular by HL7 (Health Level Seven International) FHIR (Fast Healthcare Interoperability Resources) IPS (International Patient Summary). More specifically, it will explain how these standards may be understood as the strategic and financial incentives for organisations – and nations – to adopt the IPS. Approach A thorough analysis of concepts will be followed by the presentation of a business canvas for mHealth applications, that aggregates basic information on a common framework for the adoption of IPS standards. Findings To better understand this framework, two illustrative use cases (Disaster management and MOCHA - Models of Child Health Appraised/Vaccination) are presented and the benefits of IPS standard adoption in these situations are specifically highlighted as they may translate better quality care and well-being and, at the same time, represent reduction of costs on health-related expenditure. Originality This article is a summary of work developed specifically as part of the Trillium II project, primarily by collaboration by the organisations represented by the authors. Logically, it uses concepts previously developed, and referenced in the text as appropriate, however the authors maintain that the business models presented represent an original synthesis of these concepts specifically appropriate to the task of encouraging widespread adoption of the HL7 FHIR IPS