Patient Lifecycle Management: An Approach for Clinical Processes

Clinical processes can be described, inside the Biomedical scope, like a systematic guideline to assist practitioner and patient decisions about appropriate health care for specific clinical circumstances. In industry, Product Lifecycle Management (PLM) is the process of managing the entire lifecycle of a product from inception, through engineering design and manufacture, to service and disposal of manufactured products. Applying the concepts of PLM to Biomedical processes we create a synergy between the product’s concept in the industrial case and the patient into the health care environment. This point of view improves the actual clinical processes with a most specific treatment for each patient, by modifying the statements to assist the patient according to the needs of the patient and his illness. This research proposal tries to shift the focus of the eHealth systems onto the patient, adapts the existing and defined clinical processes or clinical paths to the patient’s needs, applies Big Data principles to bring even more attentions for the patient, and provides an easy to use system for the medical staff.Ministerio de Economía y Competitividad TIN2013-46928-C3-3-RMinisterio de Economía y Competitividad TIN2014-52382-

A methodological proposal and tool support for the HL7 standards compliance in the development of health information systems

Health information systems are increasingly complex, and their development is presented as a challenge for software development companies offering quality, maintainable and interoperable products. HL7 (Health level 7) International, an international non-profit organization, defines and maintains standards related to health information systems. However, the modelling languages proposed by HL7 are far removed from standard languages and widely known by software engineers. In these lines, NDT is a software development methodology that has a support tool called NDT-Suite and is based, on the one hand, on the paradigm of model-driven engineering and, on the other hand, in UML that is a widely recognized standard language. This paper proposes an extension of the NDT methodology called MoDHE (Model Driven Health Engineering) to offer software engineers a methodology capable of modelling health information systems conforming to HL7 using UML domain models

Role of age and comorbidities in mortality of patients with infective endocarditis

Purpose: The aim of this study was to analyse the characteristics of patients with IE in three groups of age and to assess the ability of age and the Charlson Comorbidity Index (CCI) to predict mortality. Methods: Prospective cohort study of all patients with IE included in the GAMES Spanish database between 2008 and 2015. Patients were stratified into three age groups:<65 years, 65 to 80 years, and = 80 years.The area under the receiver-operating characteristic (AUROC) curve was calculated to quantify the diagnostic accuracy of the CCI to predict mortality risk. Results: A total of 3120 patients with IE (1327 < 65 years;1291 65-80 years;502 = 80 years) were enrolled.Fever and heart failure were the most common presentations of IE, with no differences among age groups.Patients =80 years who underwent surgery were significantly lower compared with other age groups (14.3%, 65 years; 20.5%, 65-79 years; 31.3%, =80 years). In-hospital mortality was lower in the <65-year group (20.3%, <65 years;30.1%, 65-79 years;34.7%, =80 years;p < 0.001) as well as 1-year mortality (3.2%, <65 years; 5.5%, 65-80 years;7.6%, =80 years; p = 0.003).Independent predictors of mortality were age = 80 years (hazard ratio [HR]:2.78;95% confidence interval [CI]:2.32–3.34), CCI = 3 (HR:1.62; 95% CI:1.39–1.88), and non-performed surgery (HR:1.64;95% CI:11.16–1.58).When the three age groups were compared, the AUROC curve for CCI was significantly larger for patients aged <65 years(p < 0.001) for both in-hospital and 1-year mortality. Conclusion: There were no differences in the clinical presentation of IE between the groups. Age = 80 years, high comorbidity (measured by CCI), and non-performance of surgery were independent predictors of mortality in patients with IE.CCI could help to identify those patients with IE and surgical indication who present a lower risk of in-hospital and 1-year mortality after surgery, especially in the <65-year group

Quality Evaluation for Model-Driven Web Engineering Methodologies

STS nº 700/2016, de 24 de noviembre de 2016, nº de recurso 837/2014. El alto tribunal afirma que el consumidor hubiera podido oponer al vendedor la excepción de contrato defectuosamente cumplido, dada la gravedad y la reiteración de las averías en el vehículo. Por esa razón puede oponer esa excepción al financiador que reclama el cumplimiento del contrato de préstamo