The Extent and Coverage of Current Knowledge of Connected Health: Systematic Mapping Study

Background: This paper examines the development of the Connected Health research landscape with a view on providing a historical perspective on existing Connected Health research. Connected Health has become a rapidly growing research field as our healthcare system is facing pressured to become more proactive and patient centred. Objective: We aimed to identify the extent and coverage of the current body of knowledge in Connected Health. With this, we want to identify which topics have drawn the attention of Connected health researchers, and if there are gaps or interdisciplinary opportunities for further research. Methods: We used a systematic mapping study that combines scientific contributions from research on medicine, business, computer science and engineering. We analyse the papers with seven classification criteria, publication source, publication year, research types, empirical types, contribution types research topic and the condition studied in the paper. Results: Altogether, our search resulted in 208 papers which were analysed by a multidisciplinary group of researchers. Our results indicate a slow start for Connected Health research but a more recent steady upswing since 2013. The majority of papers proposed healthcare solutions (37%) or evaluated Connected Health approaches (23%). Case studies (28%) and experiments (26%) were the most popular forms of scientific validation employed. Diabetes, cancer, multiple sclerosis, and heart conditions are among the most prevalent conditions studied. Conclusions: We conclude that Connected Health research seems to be an established field of research, which has been growing strongly during the last five years. There seems to be more focus on technology driven research with a strong contribution from medicine, but business aspects of Connected health are not as much studied

Computerized Support in the Hospital "Universitätsklinikum Schleswig-Holstein, Campus Lübeck"

The introduction of the G-DRGs (German Diagnosis Related Groups) in the year 2002 and the gradual use as a reimbursement system beginning from 2005 forces hospitals to meet enormous challenges with respect to organizational and IT-issues. The quality of the basic data set in terms of case and data completeness, accuracy and timeliness has to be ensured because with that the DRG case group and hence, the associated revenue is determined. From the economic point of view the costs of providing the corresponding health care services are of interest. These are determined by cost-unit accounting based on the mentioned patient and case related data and furthermore, on performance and cost data. Especially the latter data is available in a distributed and heterogeneous hospital information system and has to be integrated technically, syntactically and semantically by suitable mechanisms.Considering the IT infrastructure of the hospital "Universitätsklinikum Schleswig-Holstein, Campus Lübeck" suitable software systems supporting the mentioned tasks have been developed that are described in this paper, referring to one continuous example. As the G-DRG-system is subject to running modifications self-developed software regarding house-specific knowledge is needed. This is true as long as commercial supplied software systems are functionally unsatisfying and not flexible enough, especially with respect to interfaces to other software systems. Usually tools for analyzing costs are in the focus of financial controllers. The same data can be used by physicians for analyzing the delivery of healthcare. Based on the detailed data underlying the cost accounting the individual healthcare process from admission to discharge can be analyzed, e.g. what is done for the patient diagnostically and therapeutically? The case data can be aggregated and can be compared with available grouped and calculated data on a national basis; the data set of the German DRG institute (InEK). An insight into the characteristics of the own actual health care processes can improve the next step of defining target processes or clinical paths.Mit der Einführung der G-DRGs (German Diagnosis Related Groups) im Jahre 2002 und dem sukzessiven Einsatz als pauschaliertes Abrechnungssystem ab dem Jahr 2005 stehen die Krankenhäuser vor großen organisatorischen und informationstechnischen Herausforderungen. Die Qualität der Basisdokumentation im Sinne von Vollzähligkeit, Vollständigkeit, Korrektheit und Rechtzeitigkeit ist sicherzustellen, denn die definierten DRG-Basisdaten legen die DRG-Fallgruppe und den assoziierten Erlös fest. Aus wirtschaftlicher Sicht interessieren die mit der Leistungserbringung entstandenen Kosten eines Behandlungsfalles. Diese werden mit einer Kostenträgerrechnung ermittelt, die neben den Patienten- und Falldaten zusätzlich auf korrekt ermittelte Leistungs- und Kostendaten angewiesen ist. Alle diese Daten stehen in einem verteilten heterogenen Krankenhausinformationssystem zur Verfügung und müssen über geeignete Mechanismen technisch, syntaktisch und semantisch zusammengeführt werden.Mit Berücksichtigung der IT-Infrastruktur im Klinikum Universitätsklinikum Schleswig-Holstein, Campus Lübeck wurden zur Unterstützung der genannten Aufgaben geeignete Softwaresysteme entwickelt und in diesem Aufsatz anhand eines durchgängigen Beispiels vorgestellt. Aufgrund der hohen Änderungsdynamik rund um das G-DRG-System sind hausintern entwickelte Werkzeuge insbesondere für das Controlling erforderlich, solange die kommerziell angebotenen funktionell eingeschränkt oder zu unflexibel sind, insbesondere hinsichtlich Schnittstellen zu anderen Systemen. Neben den bislang im Vordergrund stehenden Werkzeugen zur Kostenanalyse, wurde für Mediziner das VIKAP-System zur Prozessanalyse entwickelt. Basierend auf den extrahierten Leistungsdaten können individuelle Abläufe von der Aufnahme bis zur Entlassung mit ihren in Anspruch genommen Ressourcen visualisiert und analysiert werden. Behandlungsfälle können "beliebig" aggregiert und über interessierende Merkmale mit dem "InEK"-Datenkörper, d.h. mit bundesweit übermittelten, gruppierten und kalkulierten Datensätzen, verglichen werden. Eine solche Kenntnis von IST-Prozessen ist eine sinnvolle Voraussetzung für die Definition von SOLL-Prozessen im Sinne von Behandlungspfaden

Alternaria infectoria phaeohyphomycosis in a renal transplant patient.

Contains fulltext : 50598.pdf (publisher's version ) (Closed access)A male renal transplant patient developed a tumor on the dorsum of his right hand. After excision, histological examination of the tumor showed hyphal structures, but growth developed very slowly. Therapy consisted of surgery alone. A definitive identification of Alternaria infectoria was only possible with molecular techniques