A Framework for eHealth Interoperability Management

Reliable and secure access to and sharing of medical data can help patients practice self-care, promote patient engagement and improve their communication with healthcare professionals. This requires overcoming several interoperability, usability, ethics, security, and regulatory issues. The existence of a common interoperability framework can accelerate digital transformation in support of disease specific solutions. This paper presents a useful and relevant interoperability management framework with the potential to improve the quality of life and better control costs for the development and provision of electronic health services to individuals, within a coordinated care environment, under a local, regional, national, or cross-border setting

An architecture for regional health information networks addressing issues of modularity and interoperability, Journal of Telecommunications and Information Technology, 2005, nr 4

A fundamental pre-requisite for the establishment of a scaleable regional health information network (RHIN) is the development of an architectural framework and tools for the integration of specialized autonomous systems and e-health service platforms supported by an underlying health information infrastructure (HII). In this context, HYGEIAnet, which is the RHIN of Crete in Greece, has identified and utilized a number of critical software components enabling integrated access to clinically significant information, based on an open architecture addressing successfully the various interoperability challenges at hand. HYGEIAnet provides the framework for the reuse of standardized common components and public interfaces, thus enabling integrated and personalized delivery of healthcare

Status and recommendations of technological and data-driven innovations in cancer care:Focus group study

Background: The status of the data-driven management of cancer care as well as the challenges, opportunities, and recommendations aimed at accelerating the rate of progress in this field are topics of great interest. Two international workshops, one conducted in June 2019 in Cordoba, Spain, and one in October 2019 in Athens, Greece, were organized by four Horizon 2020 (H2020) European Union (EU)-funded projects: BOUNCE, CATCH ITN, DESIREE, and MyPal. The issues covered included patient engagement, knowledge and data-driven decision support systems, patient journey, rehabilitation, personalized diagnosis, trust, assessment of guidelines, and interoperability of information and communication technology (ICT) platforms. A series of recommendations was provided as the complex landscape of data-driven technical innovation in cancer care was portrayed. Objective: This study aims to provide information on the current state of the art of technology and data-driven innovations for the management of cancer care through the work of four EU H2020-funded projects. Methods: Two international workshops on ICT in the management of cancer care were held, and several topics were identified through discussion among the participants. A focus group was formulated after the second workshop, in which the status of technological and data-driven cancer management as well as the challenges, opportunities, and recommendations in this area were collected and analyzed. Results: Technical and data-driven innovations provide promising tools for the management of cancer care. However, several challenges must be successfully addressed, such as patient engagement, interoperability of ICT-based systems, knowledge management, and trust. This paper analyzes these challenges, which can be opportunities for further research and practical implementation and can provide practical recommendations for future work. Conclusions: Technology and data-driven innovations are becoming an integral part of cancer care management. In this process, specific challenges need to be addressed, such as increasing trust and engaging the whole stakeholder ecosystem, to fully benefit from these innovations

Materialization of Regional Health Information Networks in Greece: Electronic Health Record Barriers & Enablers

This paper draws upon the experience of production level implementations, initiated through public procurement, of four regional health information networks (RHINs). The RHINs are being implemented in four regional health authorities (RHAs) in Greece to support patient-centred services. This paper focuses on three key areas: (i) engineering issues related to the deployment of an integrated electronic health record (EHR) system, (ii) management issues regarding implementation and planning, and (iii) socio-organizational issues influencing the outcome of large scale EHR implementations. The complexity of the health sector is also presented focusing on EHR barriers and enablers at institutional and regional levels. Reasons why EHR system implementations have not progressed as expected are also discussed

An Infrastructure for Integrated Electronic Health Record Services: The Role of XML (Extensible Markup Language)

BACKGROUND: The sharing of information resources is generally accepted as the key to substantial improvements in productivity and better quality of care. In addition, due to the greater mobility of the population, national and international healthcare networks are increasingly used to facilitate the sharing of healthcare-related information among the various actors of the field. In the context of HYGEIAnet, the regional health telematics network of Crete, an Integrated Electronic Health Record environment has been developed to provide integrated access to online clinical information, accessible throughout the island. OBJECTIVES: To make available comprehensive medical information about a patient by means of incorporating all the distributed and heterogeneous health record segments into an Integrated Electronic Health Record that can be viewed on-line through a unified user interface and visualization environment. METHODS: The technological approach for implementing this Integrated Electronic Health Record environment is based on the HYGEIAnet Reference Architecture, which provides the necessary framework for the reuse of services, components, and interfaces. Seamless presentation of information is achieved by means of the Extensible Markup Language (XML), while its underlying capabilities allow for dynamic navigation according to personalized end-user preferences and authorities. RESULTS: The Integrated Electronic Health Record environment developed in HYGEIAnet provides the basis for consistent and authenticated access to primary information over the Internet in order to support decision-making. Primary information is always kept at the place where it has been produced, and is maintained by the most appropriate clinical information system, contrasting traditional store and forward techniques, or centralized clinical data repositories. CONCLUSIONS: Since documents are much more easily accessible rather than data inside a database, Extensible Markup Language has the potential of becoming a very cheap technology provided, of course, that the underlying Healthcare Information Infrastructure exists. XML can be introduced incrementally and its implementation is completely transparent to the end user

Developing an AI-Enabled Integrated Care Platform for Frailty

Informal care is considered to be important for the wellbeing and resilience of the elderly. However, solutions for the effective collaboration of healthcare professionals, patients, and informal caregivers are not yet widely available. The purpose of this paper is to present the development of a digital platform that uses innovative tools and artificial intelligence technologies to support care coordination and shared care planning for elder care, with a particular focus on frailty. The challenges of shared care planning in the coordination of frailty care are demonstrated, followed by presentation of the design and technical architecture of an integrated platform. The platform incorporates all elements essential for the support of daily activities, coordinated care, and timely interventions in case of emergency and need. This paper describes the challenges involved in implementing the platform and concludes by reporting the necessary steps required in order to establish effective smart care for the elderly

A Digital Health Intervention for Stress and Anxiety Relief in Perioperative Care: Protocol for a Feasibility Randomized Controlled Trial

BackgroundStress and anxiety are psychophysiological responses commonly experienced by patients during the perioperative process that can increase presurgical and postsurgical complications to a comprehensive and positive recovery. Preventing and intervening in stress and anxiety can help patients achieve positive health and well-being outcomes. Similarly, the provision of education about surgery can be a crucial component and is inversely correlated with preoperative anxiety levels. However, few patients receive stress and anxiety relief support before surgery, and resource constraints make face-to-face education sessions untenable. Digital health interventions can be helpful in empowering patients and enhancing a more positive experience. Digital health interventions have been shown to help patients feel informed about the possible benefits and risks of available treatment options. However, they currently focus only on providing informative content, neglecting the importance of personalization and patient empowerment. ObjectiveThis study aimed to explore the feasibility of a digital health intervention called the Adhera CARINAE Digital Health Program, designed to provide evidence-based, personalized stress- and anxiety-management methods enabled by a comprehensive digital ecosystem that incorporates wearable, mobile, and virtual reality technologies. The intervention program includes the use of advanced data-driven techniques for tailored patient education and lifestyle support. MethodsThe trial will include 5 hospitals across 3 European countries and will use a randomized controlled design including 30 intervention participants and 30 control group participants. The involved surgeries are cardiopulmonary and coronary artery bypass surgeries, cardiac valve replacement, prostate or bladder cancer surgeries, hip and knee replacement, maxillofacial surgery, or scoliosis. The control group will receive standard care, and the intervention group will additionally be exposed to the digital health intervention program. ResultsThe recruitment process started in January 2022 and has been completed. The primary impact analysis is currently ongoing. The expected results will be published in early 2023. ConclusionsThis manuscript details a comprehensive protocol for a study that will provide valuable information about the intervention program, such as the measurement of comparative intervention effects on stress; anxiety and pain management; and usability by patients, caregivers, and health care professionals. This will contribute to the evidence planning process for the future adoption of diverse digital health solutions in the field of surgery. Trial RegistrationClinicalTrials.gov NCT05184725; https://www.clinicaltrials.gov/ct2/show/NCT05184725 International Registered Report Identifier (IRRID)DERR1-10.2196/3853