2D Fast Vessel Visualization Using a Vessel Wall Mask Guiding Fine Vessel Detection

The paper addresses the fine retinal-vessel's detection issue that is faced in diagnostic applications and aims at assisting in better recognizing fine vessel anomalies in 2D. Our innovation relies in separating key visual features vessels exhibit in order to make the diagnosis of eventual retinopathologies easier to detect. This allows focusing on vessel segments which present fine changes detectable at different sampling scales. We advocate that these changes can be addressed as subsequent stages of the same vessel detection procedure. We first carry out an initial estimate of the basic vessel-wall's network, define the main wall-body, and then try to approach the ridges and branches of the vasculature's using fine detection. Fine vessel screening looks into local structural inconsistencies in vessels properties, into noise, or into not expected intensity variations observed inside pre-known vessel-body areas. The vessels are first modelled sufficiently but not precisely by their walls with a tubular model-structure that is the result of an initial segmentation. This provides a chart of likely Vessel Wall Pixels (VWPs) yielding a form of a likelihood vessel map mainly based on gradient filter's intensity and spatial arrangement parameters (e.g., linear consistency). Specific vessel parameters (centerline, width, location, fall-away rate, main orientation) are post-computed by convolving the image with a set of pre-tuned spatial filters called Matched Filters (MFs). These are easily computed as Gaussian-like 2D forms that use a limited range sub-optimal parameters adjusted to the dominant vessel characteristics obtained by Spatial Grey Level Difference statistics limiting the range of search into vessel widths of 16, 32, and 64 pixels. Sparse pixels are effectively eliminated by applying a limited range Hough Transform (HT) or region growing. Major benefits are limiting the range of parameters, reducing the search-space for post-convolution to only masked regions, representing almost 2% of the 2D volume, good speed versus accuracy/time trade-off. Results show the potentials of our approach in terms of time for detection ROC analysis and accuracy of vessel pixel (VP) detection

Using digital watermarking to enhance security in wireless medical image transmission

This is the published version of the article. Copyright 2010 Mary Ann Liebert Inc.During the last few years, wireless networks have been increasingly used both inside hospitals and in patients’ homes to transmit medical information. In general, wireless networks suffer from decreased security. However, digital watermarking can be used to secure medical information. In this study, we focused on combining wireless transmission and digital watermarking technologies to better secure the transmission of medical images within and outside the hospital. Methods: We utilized an integrated system comprising the wireless network and the digital watermarking module to conduct a series of tests. Results: The test results were evaluated by medical consultants. They concluded that the images suffered no visible quality degradation and maintained their diagnostic integrity. Discussion: The proposed integrated system presented reasonable stability, and its performance was comparable to that of a fixed network. This system can enhance security during the transmission of medical images through a wireless channel.The General Secretariat for Research and Technology of the Hellenic Ministry of Development and the British Council

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

A web-based system for personalized patient education and compliance monitoring, Journal of Telecommunications and Information Technology, 2005, nr 4

The economic importance of therapy compliance has grown steadily in recent years, not only because of the efficacy of newer therapeutic methods but also because of the increased costs of treating the consequences of poor compliance. Improved compliance can lead to significant savings by preserving or restoring a patient’s health, improving quality of life, by reducing the number of medical services required when therapy fails or appears ineffective, and by helping limit the rise in national health care costs. Within the framework of the TEN-Telecom European Commission Programme, C-Monitor project developed an integrated health telematics platform to enhance chronic patient compliance to therapy and interactive communication with their attending physicians. The overall aim of the project was to study the potential benefits, both in clinical and financial aspects, of such innovative systems and services along cost-efficiency of care provision. The platform developed has been validated in controlled small-scale trials in a number of European countries. The Greek pilot involved installation of the system in a private hospital in Athens and the validation scenario dealt with morbid obesity patients that have undergone surgical operation. A number of 30 patients were recruited for the trial. Results of the trial indicated the technological robustness of the proposed system and the potential clinical and economic benefits of running such services. Further trials are required to better address cost-efficiency issues with respects to the service goals

EHealth and Its Role in Supporting Audiological Rehabilitation: Patient Perspectives on Barriers and Facilitators of Using a Personal Hearing Support System With Mobile Application as Part of the EVOTION Study

BACKGROUND: Hearing loss is a major public health challenge. Audiology services need to utilise a range of rehabilitative services and maximise innovative practice afforded by technology to actively promote personalized, participatory, preventative and predictive care if they are to cope with the social and economic burden placed on the population by the rapidly rising prevalence of hearing loss. Digital interventions and teleaudiology could be a key part of providing high quality, cost-effective, patient-centred management. There is currently very limited evidence that assesses the hearing impaired patient perspective on the acceptance and usability of this type of technology. AIM: This study aims to identify patient perceptions of the use of a hearing support system including a mobile smartphone app when used with Bluetooth-connected hearing aids across the everyday life of users, as part of the EVOTION project. METHODS: We applied a questionnaire to 564 participants in three countries across Europe and analysed the following topics: connectivity, hearing aid controls, instructional videos, audiological tests and auditory training. KEY FINDINGS: Older users were just as satisfied as younger users when operating this type of technology. Technical problems such as Bluetooth connectivity need to be minimised as this issue is highly critical for user satisfaction, engagement and uptake. A system that promotes user-controllability of hearing aids that is more accessible and easier to use is highly valued. Participants are happy to utilise monitoring tests and auditory training on a mobile phone out of the clinic but in order to have value the test battery needs to be relevant and tailored to each user, easy to understand and use. Such functions can elicit a negative as well as positive experience for each user. CONCLUSION: Older and younger adults can utilise an eHealth mobile app to complement their rehabilitation and health care. If the technology works well, is tailored to the individual and in-depth personalised guidance and support is provided, it could assist maximisation of hearing aid uptake, promotion of self-management and improving outcomes

Cost-effective health services for interactive lifestyle management: the PANACEIA-iTV and the e-Vital concepts, Journal of Telecommunications and Information Technology, 2005, nr 4

Information technology applications in medicine are rapidly expanding, and new methods and solutions are evolving since they are considered pivotal in the success of preventive medicine. In this paper two different concepts will be presented, the PANACEIA-iTV and the e-Vital concept. PANACEIA-iTV is a home care service provision system based on interactive TV technology and supported by the IST programme of the European Commission. The e-Vital service, supported by the eTEN programme of the European Commission, regards an integrated home care and telemonitoring service chain aimed at large sensitive parts of the European population, the "at-risk" citizens, who are usually patients with a stable medical condition that allow a near normal life but may suddenly deteriorate and put life at risk