The impact of EU Digital Services Act and Digital Markets Act on health information systems

The European Parliament has approved new legislation, the Digital Services Act (DSA) and Digital Markets Act (DMA) to improve the functioning of the internal market of intermediary services in the European Union (EU) where there is a risk that the major so-called gatekeeper companies can exercise unfair control of core platform services. The purpose of this study was to investigate, what health information systems could be in the scopes of these acts and what requirements the acts may have for the production, the sale and the use of health information systems. The act texts were examined bearing in mind what types of health information systems exist and what their user bases are. Those health information systems that can belong or do not belong to the groups of systems regulated by the DMA and DSA were identified. The most relevant requirements for these systems were also identified from these acts. The result of the study is that these acts have only minor consequences for the healthcare information systems sector as they are not often intermediary (hosting) services in the meaning of the DSA or gatekeepers in the meaning of the DMA. The emerging digital healthcare platforms are most affected by the new DSA and secondly such peer support patient portals where patients can supply content for others to see. Apparently, no digital healthcare platform has yet reached such a size or a dominant role within the EU that it would fall under the scope of the DMA. The two above mentioned healthcare related intermediary services have due diligence obligations to remove illegal contents from their services and to treat their business and consumer customers fairly. The obligations include clear and fair terms and conditions, the provision of a single point of contact for users and authorities, content moderation, complaint handling, marking advertising clearly, annual reporting, and responding to the contacts from the authorities. The obligations increase when the size of the enterprise increases. It is still too early to produce healthcare information systems specific guidance to support the implementation of these two acts as the acts themselves and potential upcoming general guidance documents can serve the health information systems community sufficiently well

Experiments of the sonification of the sleep electroencephalogram

It is becoming possible to perform sleep recordings at home with equipment targeted for the regular consumers. This alleviates the pressures to increase capacity in sleep clinics. The interpretation of the sleep recordings is not very easy for the laymen and alternative assisting methods should be sought for this. Sonification is a method by which a phenomenon is converted to a sound for human listeners. This paper describes experiments made for the sonification of the electric activity of the brain, the electroencephalography (EEG) for the purpose of recognizing the presence and absence of the necessary refreshing components of sleep, deep sleep and rapid eye movement (REM) sleep. The methods are based on the calculation of features of the EEG signal which are characteristic to the deep and REM sleep as well as wakefulness. The features are converted to amplitude modulation functions of artificial and musical instrument sounds by using mathematical transforms such as Principal Component Analysis and Linear Discriminant Analysis. The results indicate that modulated sinusoidal signals are not appropriate for the sonification of sleep EEG but that modulating the sound of musical instruments could be a viable option for making the recognition of good and bad sleep possible

Survey of health informatics education in Finland in 2017

The European Union and the USA collaborate in developing the skills of the application of information technology in the health care workforce. A part of this activity is a project which studies the gaps in the present education and proposes methods of filling these gaps. The objective of this paper is to identify the existing IT related education to the health care work force in Finland. A secondary objective was to get an impression of the experience and attitudes of the members of this workforce about health IT education. This paper presents the results of the survey of how information technology is educated to the students of the health care professions in Finland in the year 2017. In addition to literature search including also the study guides of many major health care professional education organizations, 24 telephone interviews of health care professionals in different fields in Finland were made. The results show that although basic information technology education is often available at every level of education, it is expected that the health care professionals learn to use the health information systems during their training periods or later in working life. The interviews showed that the given education varied considerably and some of the personnel had received no or only a little education on IT during studies. As the amount and quality of on-the-job information technology education varies, many health care professionals are not able to fully benefit from the information systems if their general feeling is that they just “survive” from daily activities with them. The results lead to suggest that the health professional degrees should contain at least a minimal amount of relevant health IT education which is tested with an exam and that the present health care workforce should receive ear-marked in-service training in the use of health information technology based on the needs of the individual.The European Union and the USA collaborate in developing the skills of the application of information technology in the health care workforce. A part of this activity is a project which studies the gaps in the present education and proposes methods of filling these gaps. The objective of this paper is to identify the existing IT related education to the health care work force in Finland. A secondary objective was to get an impression of the experience and attitudes of the members of this workforce about health IT education. This paper presents the results of the survey of how information technology is educated to the students of the health care professions in Finland in the year 2017. In addition to literature search including also the study guides of many major health care professional education organizations, 24 telephone interviews of health care professionals in different fields in Finland were made. The results show that although basic information technology education is often available at every level of education, it is expected that the health care professionals learn to use the health information systems during their training periods or later in working life. The interviews showed that the given education varied considerably and some of the personnel had received no or only a little education on IT during studies. As the amount and quality of on-the-job information technology education varies, many health care professionals are not able to fully benefit from the information systems if their general feeling is that they just “survive” from daily activities with them. The results lead to suggest that the health professional degrees should contain at least a minimal amount of relevant health IT education which is tested with an exam and that the present health care workforce should receive ear-marked in-service training in the use of health information technology based on the needs of the individual

Lääkintätekniikan prosessien järjestäminen sairaanhoitopiirin tietohallinnossa

Pirkanmaan sairaanhoitopiirin lääkintätekniikka on osa tietohallinnon ja teknologian vastuualuetta TAYS palvelukeskuksessa. Tietohallinto vastaa perustietotekniikan palveluiden lisäksi tietohallinnon palveluista, potilastietopalveluista ja tietohallinnon muutostöiden suunnittelusta. Lääkintätekniikka vastaa strategisista palveluista, kun taas operatiivisista palveluista vastaa Istekki Oy. Lääkintälaitteiden lainsäädäntö vaatii laitteiden laadun, turvallisuuden ja toiminnan mittaamista kvantitatiivisesti, minkä prosessinäkökulma mahdollistaa. Yhteiset toimintatavat kaikille tietoteknisille laitteille sairaanhoitopiirissä mahdollistavat tehokkaan ja turvallisen hoitoympäristön.Lääkintätekniikan ja tietohallinnon prosesseissa on paljon yhteisiä rajapintoja, sillä useat lääkintälaitteet ovat verkotettuja ja yhteydessä muihin laitteisiin. Verkotettujen lääkintälaitteiden elinkaaren aikainen ylläpito vaatii erikoisosaamista sekä tietotekniikasta että laitteen toiminnasta ja lainsäädännöstä. Lääkintätekniikan yhä enemmän digitalisoituessa tulisi huolehtia siitä, että prosesseja uudistetaan ja toimintatavoista pidetään kiinni yhteistyössä prosesseissa toimivien asiantuntijoiden kanssa. Lääkintälaitteiden elinkaaren hallinnalle on eduksi, jos palvelujen tuottaminen keskittyy sairaanhoitopiirissä samalle toimijalle.The Medical Technical Department of Pirkanmaa Hospital District is part of the Information Management Unit of the Hospital Service Center. Medical Technology is responsible of the strategic services, whereas Istekki Oy is responsible of the operative services of medical devices. Information Management Unit is responsible of the computer services, information management, patient information services and changes of information management. Medical devices are strictly regulated and the legislation requires quantitative measurements of quality, safety and functionality. This is possible by using a process approach of medical device management. Common policies for all interactive devices in the hospital district enables efficient and safe environment for healthcare.Medical technology and information management processes have common interfaces, since most of the current medical devices are in a network and connected to other devices. Medical devices connected to a network require maintenance with special competences from both computer sciences and medical devices functionalities, as well as legislation of medical devices. As digitalization makes progress also in medical technology, the organization should ensure that processes are being renewed and the policies are kept in cooperation with the medical technology professionals. Medical technology life cycle control benefits if the services are focused on one actor.<br/

Henkilökohtaisen terveyden seuranta ja liityntästandardit. Kartoitus tilanteesta vuoden 2010 alussa

Henkil&ouml;kohtaisen terveyden seuranta kasvattaa nopeasti suosiotaan. Laitteiden yhteentoimivuus on merkitt&auml;v&auml;ss&auml; roolissa henkil&ouml;kohtaisen terveyden seurannassa. Laiteliitynn&auml;t muodostavat perustan yhteentoimivuudelle. Standardoidut laiteliitynn&auml;t pyrkiv&auml;t v&auml;hint&auml;&auml;n syntaktiseen yhteentoimivuuteen. T&auml;ss&auml; artikkelissa selvitet&auml;&auml;n henkil&ouml;kohtaisen terveyden seurantaan liittyvi&auml; laiteliitynt&auml;standardeja ja niiden k&auml;ytt&ouml;&auml; edist&auml;vi&auml; organisaatioita. ISO/IEEE 11073 on merkitt&auml;vin terveystekniikan laiteliitynt&auml;standardi joka on saanut taakseen kolmen merkitt&auml;v&auml;n yleisk&auml;ytt&ouml;isen liitynt&auml;standardin, Bluetooth, USB, ja Zigbee, tuen. Sen merkitt&auml;vin haastaja on IP‐tekniikan yleistyminen ja IP:n p&auml;&auml;lle kehitetyt yhteentoimivuusstandardit. Artikkelissa k&auml;yd&auml;&auml;n lis&auml;ksi l&auml;pi standardeja kehitt&auml;vi&auml; organisaatioita ja pohditaan laiteliitynn&auml;n standardoinnin kehityssuuntia

The definitions of health care and social welfare informatics competencies

Digital transformation is changing the ecosystem and at the same time professionals’ competencies worldwide. Minimising health care and social welfare costs while increasing citizens’ health and well-being is challenging. Technology and digital tools play an important role in reaching this goal. However, there are inequalities concerning technology, and this has many impacts. Digitalisation brings challenges not only to health care and social welfare professionals but to citizens, too. Working with or using services in digital environments demands new skills. This has social and ethical impacts, e.g. how is equal access to services ensured. Health and social care professionals should have different competencies to respond to this, such as societal competencies. The purpose of this article is to describe how the definition of competencies in health care and social welfare version 1.0 (developed in the national SotePeda 24/7 project) was finalised as the final version 2.0 for Finnish healthcare and social welfare education by experts’ evaluation. Data was collected through an electronic questionnaire administered to selected experts (N=140) during January 2020. The number of experts who responded to the study was 52. These experts (social and health, business and IT) work or have worked in tasks related to the digitalisation of social and health care. The questionnaire was based on version 1.0 of the definition of digital competencies of health care and social welfare informatics. The questionnaire was mainly quantitative, but it also included open-ended qualitative questions. The experts agreed to a large extent on the version 1.0 definition, but some adjustments were made to the definition based on our study. The resulting definition is intended for use in the planning, implementation and evaluation of health care and social welfare education, but it can also be used for polytechnic education. The aim is to develop the digital skills of educators, degree students and in-service trainees in a multidisciplinary way (social and health, business and IT) to meet the needs of working life.Digital transformation is changing the ecosystem and at the same time professionals’ competencies worldwide. Minimising health care and social welfare costs while increasing citizens’ health and well-being is challenging. Technology and digital tools play an important role in reaching this goal. However, there are inequalities concerning technology, and this has many impacts. Digitalisation brings challenges not only to health care and social welfare professionals but to citizens, too. Working with or using services in digital environments demands new skills. This has social and ethical impacts, e.g. how is equal access to services ensured. Health and social care professionals should have different competencies to respond to this, such as societal competencies. The purpose of this article is to describe how the definition of competencies in health care and social welfare version 1.0 (developed in the national SotePeda 24/7 project) was finalised as the final version 2.0 for Finnish healthcare and social welfare education by experts’ evaluation. Data was collected through an electronic questionnaire administered to selected experts (N=140) during January 2020. The number of experts who responded to the study was 52. These experts (social and health, business and IT) work or have worked in tasks related to the digitalisation of social and health care. The questionnaire was based on version 1.0 of the definition of digital competencies of health care and social welfare informatics. The questionnaire was mainly quantitative, but it also included open-ended qualitative questions. The experts agreed to a large extent on the version 1.0 definition, but some adjustments were made to the definition based on our study. The resulting definition is intended for use in the planning, implementation and evaluation of health care and social welfare education, but it can also be used for polytechnic education. The aim is to develop the digital skills of educators, degree students and in-service trainees in a multidisciplinary way (social and health, business and IT) to meet the needs of working life

The Digi-NewB project for preterm infant sepsis risk and maturity analysis

It is known from the literature that the careful analysis of the heart rate variability of a preterm infant can be used as a predictor of sepsis. The Digi-NewB project aims at collecting a database of at least 750 preterm infants including physiological signals, video and clinical observations. These data are used to design a decision support system for the early detection of sepsis and for the evaluation of the infant maturity. The preparation of the data for the exploratory analysis has turned out to be time-consuming. 190 infants have been recorded by March 2018 and of these, the R-R interval analysis of the ECG signals has been completed of 136 infants. The results of the project are still preliminary but seven heart rate variability parameters have been found to be different in preterm and full-term infants with a P value less than 0.01. The video analysis algorithm detecting the presence of personnel or relatives reached 96.8% of sensitivity and 95.1% of specificity.It is known from the literature that the careful analysis of the heart rate variability of a preterm infant can be used as a predictor of sepsis. The Digi-NewB project aims at collecting a database of at least 750 preterm infants including physiological signals, video and clinical observations. These data are used to design a decision support system for the early detection of sepsis and for the evaluation of the infant maturity. The preparation of the data for the exploratory analysis has turned out to be time-consuming. 190 infants have been recorded by March 2018 and of these, the R-R interval analysis of the ECG signals has been completed of 136 infants. The results of the project are still preliminary but seven heart rate variability parameters have been found to be different in preterm and full-term infants with a P value less than 0.01. The video analysis algorithm detecting the presence of personnel or relatives reached 96.8% of sensitivity and 95.1% of specificity

ENVISION – Improvement of intensive care of COVID-19 patients with artificial intelligence

The Envision project aims at developing artificial intelligence-based tools for supporting the treatment of critically ill COVID-19 patients in the intensive care unit. Twelve European hospitals participate in the collection of patient data for the development and validation of the artificial intelligence tools. Ten potential use cases have been identified as development targets. Data analysis and results from expert interviews are applied to define the clinically most relevant parameters and functional use cases to be used in providing decision support for the clinicians in the intensive care units for this patient group. The resulting artificial intelligence-based tool may be beneficial in the management of the next similar epidemics, as well.The Envision project aims at developing artificial intelligence-based tools for supporting the treatment of critically ill COVID-19 patients in the intensive care unit. Twelve European hospitals participate in the collection of patient data for the development and validation of the artificial intelligence tools. Ten potential use cases have been identified as development targets. Data analysis and results from expert interviews are applied to define the clinically most relevant parameters and functional use cases to be used in providing decision support for the clinicians in the intensive care units for this patient group. The resulting artificial intelligence-based tool may be beneficial in the management of the next similar epidemics, as well

Artificial intelligence research in the COVend COVID-19 clinical trial project

The COVend project aims at delivering a new effective therapy, FX06, against the SARS-CoV-2 virus infection for the management of the COVID-19 disease in hospitals. Nine of the 17 partners of the project consortium are hospitals responsible for collecting study subjects and administering the FX06 therapy to the patients. Although the clinical trial (IXION) has the main role in the project, the project has also a work package which develops and applies artificial intelligence (AI) methods to the data collected during the 28-day study period from the patients receiving the therapy. The AI work package applies exploratory data analysis methods to find patterns and profiles of the patients. Combined with the data about treatment methods and patient outcomes, the aim is to provide decision support for the therapy intervention in the later stage of the project.publishedVersionNon peer reviewe