Informed citizen and empowered citizen in health: results from an European survey

Background: The knowledge about the relationship between health-related activities on the Internet (i.e. informed citizens) and individuals? control over their own experiences of health or illness (i.e. empowered citizens) is valuable but scarce. In this paper, we investigate the correlation between four ways of using the Internet for information on health or illness and citizens attitudes and behaviours toward health professionals and health systems and establish the profile of empowered eHealth citizens in Europe. Methods: Data was collected during April and May 2007 (N = 7022), through computer-assisted telephone interviews (CATI). Respondents from Denmark, Germany, Greece, Latvia, Norway, Poland and Portugal participated in the survey. The profiles were generated using logistic regressions and are based on: a) socio-demographic and health information, b) the level of use of health-related online services, c) the level of use of the Internet to get health information to decide whether to consult a health professional, prepare for a medical appointment and assess its outcome, and d) the impact of online health information on citizens? attitudes and behavior towards health professionals and health systems. Results: Citizens using the Internet to decide whether to consult a health professional or to get a second opinion are likely to be frequent visitors of health sites, active participants of online health forums and recurrent buyers of medicines and other health related products online, while only infrequent epatients, visiting doctors they have never met face-to-face. Participation in online health communities seems to be related with more inquisitive and autonomous patients. Conclusions: The profiles of empowered eHealth citizens in Europe are situational and country dependent. The number of Europeans using the Internet to get health information to help them deal with a consultation is raising and having access to online health information seems to be associated with growing number of inquisitive and self-reliant patients. Doctors are increasingly likely to experience consultations with knowledgeable and empowered patients, who will challenge them in various ways

A Year in the Life of the OpenECG Network

The OpenECG network formed in 2002, is a European initiative with global reach, which aims to lower the barriers for ECG interoperability and make digital ECGs available as part of the integrated electronic health record. Currently, SCP-ECG, the European standard for ECG record communication and storage, has been implemented by some manufacturers. However, these implementations are not consistent with each other, hindering ECG exchange, processing, and serial analysis. Furthermore, the presence of alternative ECG storage formats, proprietary or open, raises issues of harmonization and quality assurance. In the first year of its life, the OpenECG network numbers 105 committed members, while its portal and associated help desk have already provided valuable information and development support to several manufacturers and integrators. Recently, the OpenECG certification service has become available to members who may submit their ECG records for interoperability validation and SCP-ECG conformance testing. Still, only the first step for the OpenECG network has been taken. Future plans involve contributing to the definition of integration profiles for ECG-related examinations and addressing issues related to quality assurance of eHealth services in general

XML-BSPM: an XML format for storing Body Surface Potential Map recordings

<p>Abstract</p> <p>Background</p> <p>The Body Surface Potential Map (BSPM) is an electrocardiographic method, for recording and displaying the electrical activity of the heart, from a spatial perspective. The BSPM has been deemed more accurate for assessing certain cardiac pathologies when compared to the 12-lead ECG. Nevertheless, the 12-lead ECG remains the most popular ECG acquisition method for non-invasively assessing the electrical activity of the heart. Although data from the 12-lead ECG can be stored and shared using open formats such as SCP-ECG, no open formats currently exist for storing and sharing the BSPM. As a result, an innovative format for storing BSPM datasets has been developed within this study.</p> <p>Methods</p> <p>The XML vocabulary was chosen for implementation, as opposed to binary for the purpose of human readability. There are currently no standards to dictate the number of electrodes and electrode positions for recording a BSPM. In fact, there are at least 11 different BSPM electrode configurations in use today. Therefore, in order to support these BSPM variants, the XML-BSPM format was made versatile. Hence, the format supports the storage of custom torso diagrams using SVG graphics. This diagram can then be used in a 2D coordinate system for retaining electrode positions.</p> <p>Results</p> <p>This XML-BSPM format has been successfully used to store the Kornreich-117 BSPM dataset and the Lux-192 BSPM dataset. The resulting file sizes were in the region of 277 kilobytes for each BSPM recording and can be deemed suitable for example, for use with any telemonitoring application. Moreover, there is potential for file sizes to be further reduced using basic compression algorithms, i.e. the deflate algorithm. Finally, these BSPM files have been parsed and visualised within a convenient time period using a web based BSPM viewer.</p> <p>Conclusions</p> <p>This format, if widely adopted could promote BSPM interoperability, knowledge sharing and data mining. This work could also be used to provide conceptual solutions and inspire existing formats such as DICOM, SCP-ECG and aECG to support the storage of BSPMs. In summary, this research provides initial ground work for creating a complete BSPM management system.</p

Preliminary Results from the Deployment of Integrated Teleconsultation Services in Rural Crete

Teleconsultation services for cardiology patients have been installed and are in routine use since December 2000, connecting a primary health center in rural Crete to a regional hospital. Since efficiency and effectiveness are key factors in the acceptance of the service, integration of the services with the primary health record, support of clinical protocols and guidelines, and continuous evaluation of the services are primary foci of the overall effort

European Union initiatives in child immunization-the need for child centricity, e-health and holistic delivery

BACKGROUND: Low childhood immunization rates in Europe are causing concern and have triggered several EU initiatives. However, these are counter-factual as they make immunization a stand-alone issue and cut across best practice in integrated child health services. They also focus unduly on 'anti-vax' pressures, generalize 'vaccine hesitancy' and overlook practical difficulties and uncertainties encountered by parents in real world situations about presenting children for immunization. Meanwhile European expertize in child health electronic record systems and relevant standards are ignored despite their being a potentially sound foundation ripe for enhancement. METHODS: Situation and literature reviews, and cohesion of two European research projects, led to shared investigation. As a result, two cross-sectoral expert workshops were held to consider digital health standards for harmonizing integrated preventive child health including immunization, and the work of other stakeholders such as the World Health Organisation and the European Centre for Disease Control. RESULTS: Progress in child health information models and digital health standards was assessed, areas needing further standards development identified and desirable steps towards innovation in service delivery and record keeping agreed. CONCLUSION: The European Commission, member states and child health stakeholders should take an integrated approach to child health with immunization as a component. Service delivery should be sensitive to parental concerns and challenges, and the way child- and family-centric data are recorded and used should be enhanced. Services should be enabled by the International Patient Summary and related electronic health record standards and linkages, and evaluated to assess most effective systems and practice

Risk assessment of a cardiology eHealth service in HYGEIAnet

A Risk Assessment (RA) framework was employed to determine what protection would be adequate and reasonable for the assets of a cardiology eHealth service deployed on the island of Crete. In the context of HYGEIAnet, the regional health telematics network of Crete, teleconsultation services for cardiology patients have been installed and are in routine use since December 2000. The novelty of the framework for modelbased RA of security critical systems, which developed within the CORAS IST project, lays in its synthesis of risk analysis methods with semiformal specification, supported by an adaptable tool-integration platform. This paper presents the use of the CORAS framework to assess the cardiology eHealth service and the implementation of security controls and mechanisms. 1