Digi-HTA, assessment framework for digital healthcare services: information security and data protection in health technology – initial experiences

It is well-known that security issues in medical devices, services and applications have potentially catastrophic consequences. To avoid compromising patient data or information systems, it is essential that healthcare services and products meet the relevant information security and data protection requirements. For these reasons, the Digi-HTA assessment includes information security and data protection assessment domains. The outcome of the Digi-HTA process is a recommendation that decision-makers can use during the procurement process. We present results and experiences from the first assessments made in the Digi-HTA process. We have assessed six products so far and multiple assessments are in progress. The results indicate that healthcare product manufacturers have found the process useful, and usually, the manufacturers have had to improve the security of their product during the Digi-HTA process to get a favourable recommendation for their product. The assessment processes have taken longer than expected due to shortcomings and ambiguities in the provided self-assessment forms, and due to feedback cycles and meetings prompted by assessment findings. Of the six assessed products, four received a green light in information security and data protection, whereas two have received a yellow light due to issues that were not fixed during the process. In addition to shortcomings in adhering to best practices, we have also found exploitable security issues.

Regional health information exchange outside of the centralized national services for public health care in Finland: A national survey

Health information exchange (HIE) is the mobilization of health care information electronically across organizations within a region, community, or hospital system. Nordic countries have been developing their health portals including national HIE services systematically. In Finland HIE begun with various regional health information exchange (RHIE) pilots in since 1998. The Kanta patient data repository component in the national HIE has been adopted in routine use since 2012. The current role of non-Kanta RHIE in relation to Kanta services is somewhat unclear. Our research questions are following: 1) Has the availability of RHIE services changed during 2017-2020? 2) What functional types of RHIE are there in Finland in 2020? 3) From the point of view of healthcare provider organizations, at what level is the availability to combine regional information seamlessly into the same view of local patient record systems? Data used in this study were collected using web-based questionnaires in 2017 and 2020 as part of the surveys for monitoring and assessment of social welfare and health care information system services in Finland. This study reported in this article covers all 21 public hospital districts and nearly all public primary health care centers. The quantitative data provided by the organizations were analyzed using SPSS software (version 25). The availability of a particular service or function was calculated as a percentage of all respondents in each sector. The results of this study show that the overall availability of RHIE services has not markedly changed 2017-2020. Functional types of RHIE meaning the role, use and types of RHIE in hospital districts in Finland varies greatly in 2020. We recognized three different types of non-Kanta RHIE in the non-combination organizations (one-way, symmetrical, full symmetrical). Seamless integration of at least some Kanta data into the same view as the main patient health record system data was more common than seamless integration of at least some non-Kanta regional data

Hoitoprosessien uudistamattomuus haastaa terveydenhuollon digitalisaatiota

Finland aims to be a pioneer in digitalization by reforming the processes of public services and digitalizing services. In healthcare, the introduction of digital transaction services is aimed at bettering health care services and cost benefits. The use of digital transaction services in recent years has increased, but the realization of digitalization is still low. One of the challenges in increasing the use of digital transaction services is the non-renewable state of the care processes. In order to improve digital services in Southern Ostrobothnia, this study aimed to find out how healthcare processes are taken into account in the development of digital services in Southern Ostrobothnia. In order to achieve this goal, studies were performed to find out what kind of digital services are being used and developed in healthcare, the prevalence of these digital services, how the consortium of e-services and health care processes is being developed, how the development of e-services is being carried out, and what the effects of the Covid-19 pandemic are on e-services in healthcare. The basis of the study is described in a literature review, in which information was sought on digital health services in the Nordic countries. Information on the consideration of health care processes in the development of digital transaction services was collected from interviews with health care and information management professionals. There are several different electronic transaction services in healthcare, which need to be developed for the possibility of a smoother transaction experience. In deploying digital services, care processes will be modified, but these processes are not being redesigned to ensure that the benefits of the digital services can be achieved. It was desired that the development of digital transaction services would be advanced and to include process planning more firmly in the development process. There are good preconditions for formulating electronic transaction services and processes into a unified whole. In the future, it will be important to define the benefit of goals for digital services and to craft a strategy to achieve them. The benefits of digital transaction services materialize when defined processes are digitalized in such a way that they are part of working practices and citizens' transactions.Suomi tavoittelee digitalisaation edelläkävijyyttä uudistamalla julkisten palvelujen prosesseja ja sähköistämällä palveluja. Terveydenhuollossa sähköisten asiointipalvelujen käyttöönotolla tavoitellaan yhä parempia terveydenhuollon palveluita ja kustannushyötyjä. Sähköisten asiointipalveluiden käyttö on viime vuosina lisääntynyt, mutta käyttömäärä on edelleen alhainen digitalisaation toteutumiseksi. Sähköisten asiointipalveluiden käytön lisääntymisen yhdeksi haasteeksi on havainnoitu hoitoprosessien uudistamattomuus. Etelä-Pohjanmaan sähköisten asiointipalveluiden parantamiseksi, tämän tutkimuksen tavoitteena oli selvittää, miten terveydenhuollon hoitoprosessit huomioidaan sähköisten asiointipalveluiden kehittämistyössä Etelä-Pohjanmaalla. Tavoitteen saavuttamiseksi tutkittiin, millaisia sähköisiä asiointipalveluja terveydenhuollossa on käytössä ja kehitteillä, millaiseksi sähköisten asiointipalveluiden käytön yleisyys arvioidaan, millainen sähköisten asiointipalveluiden ja terveydenhuollon hoitoprosessien yhteenliittymä on, millä tavoin sähköisten asiointipalveluiden kehittämistyötä toteutetaan ja mitkä ovat Covid-19-pandemian vaikutukset sähköisiin asiointipalveluihin terveydenhuollossa. Tutkimuksen lähtökohta kuvattiin kirjallisuuskatsauksella, jossa haettiin tietoa terveydenhuollon sähköisistä palveluista Pohjoismaista. Tiedot terveydenhuollon hoitoprosessien huomioimisesta sähköisten asiointipalveluiden kehittämistyössä kerättiin terveydenhuollon ja tietohallinnon ammattilaisten haastatteluista. Terveydenhuollossa on käytössä erilaisia sähköisiä asiointipalveluja, joita on tarpeen kehittää sujuvamman asiointikokemuksen mahdollistamiseksi. Sähköisten asiointipalveluiden käyttöönottojen yhteydessä tehdään muutoksia hoitoprosesseihin, mutta prosesseja ei uudisteta suunnittelemalla, miten sähköisten palvelujen hyödyt saavutetaan. Sähköisten asiointipalveluiden kehittämistyötä toivottiin edistettävän ja sisällyttämään työhön prosessisuunnittelu entistä vahvemmin. Sähköisten palveluiden ja prosessien muotoilulle yhtenäiseksi kokonaisuudeksi on olemassa hyvät edellytykset. Tulevaisuudessa on tärkeää määritellä sähköisten asiointipalveluiden hyötytavoitteet ja tehdä strategia niiden saavuttamiseksi. Sähköisten asiointipalveluiden hyödyt konkretisoituvat, kun määritellyt prosessivaiheet digitalisoidaan siten, että ne ovat osa työkäytänteitä ja kansalaisten asiointia

Digi-HTA: Health technology assessment framework for digital healthcare services

Health technology assessment (HTA) refers to the systematic evaluation of the properties, effects, and/or impacts of health technology. The main purpose of the assessment is to inform decisionmakers in order to better support the introduction of new health technologies. New digital healthcare solutions like mHealth, artificial intelligence (AI), and robotics have brought with them a great potential to further develop healthcare services, but their introduction should follow the same criteria as that of other healthcare methods. They must provide evidence-based benefits and be safe to use, and their impacts on patients and organizations need to be clarified. The first objective of this study was to describe the state-of-the-art HTA methods for mHealth, AI, and robotics. The second objective of this study was to evaluate the domains needed in the assessment. The final aim was to develop an HTA framework for digital healthcare services to support the introduction of novel technologies into Finnish healthcare. In this study, the state-of-the-art HTA methods were evaluated using a literature review and interviews. It was noted that some good practices already existed, but the overall picture showed that further development is still needed, especially in the AI and robotics fields. With the cooperation of professionals, key aspects and domains that should be taken into account to make fast but comprehensive assessments were identified. Based on this information, we created a new framework which supports the HTA process for digital healthcare services. The framework was named Digi-HTA.Health technology assessment (HTA) refers to the systematic evaluation of the properties, effects, and/or impacts of health technology. The main purpose of the assessment is to inform decisionmakers in order to better support the introduction of new health technologies. New digital healthcare solutions like mHealth, artificial intelligence (AI), and robotics have brought with them a great potential to further develop healthcare services, but their introduction should follow the same criteria as that of other healthcare methods. They must provide evidence-based benefits and be safe to use, and their impacts on patients and organizations need to be clarified. The first objective of this study was to describe the state-of-the-art HTA methods for mHealth, AI, and robotics. The second objective of this study was to evaluate the domains needed in the assessment. The final aim was to develop an HTA framework for digital healthcare services to support the introduction of novel technologies into Finnish healthcare. In this study, the state-of-the-art HTA methods were evaluated using a literature review and interviews. It was noted that some good practices already existed, but the overall picture showed that further development is still needed, especially in the AI and robotics fields. With the cooperation of professionals, key aspects and domains that should be taken into account to make fast but comprehensive assessments were identified. Based on this information, we created a new framework which supports the HTA process for digital healthcare services. The framework was named Digi-HTA

Tieto- ja viestintäteknologian käyttö terveydenhuollossa vuonna 2017 : Tilanne ja kehityksen suunta

Terveydenhuollon tietojärjestelmät ovat maassamme kattavasti käytössä. Kansalaisille suunnatut palvelut ovat yleistyneet ja potilaat voivat tuottaa omaa terveystietoaan ammattilaisten käyttöön. Alueellisesti tietojärjestelmien kypsyystasoissa on eroja. Tämä raportti kuvaa tieto- ja viestintäteknologian käyttöä Suomen terveydenhuollossa vaiheessa, jossa Kanta-palvelujen sähköinen resepti oli otettu käyttöön koko terveydenhuollossa ja Potilastiedon arkisto oli käytössä julkisessa terveydenhuollossa ja käyttöönottovaiheessa yksityisellä sektorilla. Sairaanhoitopiireissä, terveyskeskuksissa ja yksityisten terveyspalvelujen tuottajien toiminnassa tapahtuneita muutoksia verrataan aikaisempiin selvityksiin alkaen vuodesta 2003. Tuloksia tarkastellaan myös Sote-tieto hyötykäyttöön 2020 -strategian valossa ja tuloksilla on mielenkiintoa valmisteilla olevan sosiaali- ja terveydenhuollon uudistuksen vaikutusten ennakoinnissa. Selvitys on tehty sosiaali- ja terveysministeriön pyynnöstä Oulun yliopiston FinnTelemedicumin ja THL:n yhteishankkeena. Raportista on hyötyä sosiaali- ja terveydenhuollon palvelu- ja tietojärjestelmien kehittäjille ja digitalisaation parissa työskenteleville

Visuaalisen ilmeen luominen. CASE:CEMIS

Tämän opinnäytetyön tavoitteena on luoda toimeksiantajalle markkinointi- ja esitysmateriaalien valmiit pohjat joita yritys pystyy hyödyntämään markkinoinnissaan sekä parantaa yrityksen visuaalista ilmettä. Visuaalisen ilmeen suunnittelu vaiheessa perehdytään yrityksen nettisivujen visuaaliseen ilmeeseen ja siihen minkälaisia elementtejä sivuilta löytyy kuten värimaailma, erilaiset graafiset elementit. Toimeksiantaja työlleni on CEMIS. CEMIS eli Centre for Measurement and Information Systems koostuu Oulun ja Jyväskylän yliopistoista, Kajaanin Ammattikorkeakoulusta, VTT:n ja CSC - Tieteen tietotekniikan keskuksen yhteisestä mittaus- ja tietojärjestelmiin erikoistuneesta sopimuspohjaisesta tutkimus- ja koulutuskeskuksesta. Teoreettinen viitekehys rakentuu visuaalisen markkinointiviestinnän kirjallisuuden pohjalle, jossa käsitellään visuaalisesta markkinointiviestinnästä kuten yrityksen imagosta ja identiteetistä, yrityksen visuaalisesta ilmeestä.The purpose of this thesis was to provide the client with ready-made material for marketing and presentation materials that the company can use in its marketing and enhance the visual visibility of the company. During the design stage of the visual look, the visual appearance of the company's web site and the elements that can be found on the page, such as a color scheme and different graphic elements were studied. The thesis was commissioned by CEMIS. CEMIS, the Center for Measurement and Information Systems, is run by Oulu and Jyväskylä Universities, Kajaani University of Applied Sciences, VTT and the CSC-Center for Information Technology Center for Measurement and Information Systems, a contract-based research and training center. The theoretical framework was based on the visual marketing communications literature covering topics such as the image and identity of a company and the visual appearance of a company

Informing the product development of an mHealth solution for people with multiple sclerosis through early health technology assessment

Abstract The potential of mHealth is enormous for chronic conditions, yet the integration of these technologies into the clinical infrastructures and healthcare pathways remains an ongoing challenge. Digi-HTA has been developed to support health technology assessment activities for novel digital healthcare technologies. The use of Early Health Technology Assessment (EHTA) can help product development. The present study describes the way in which EHTA can guide the development of a product to anticipate future needs and market access

Informing the Product Development of an mHealth Solution for People with Multiple Sclerosis Through Early Health Technology Assessment

The potential of mHealth is enormous for chronic conditions, yet the integration of these technologies into the clinical infrastructures and healthcare pathways remains an ongoing challenge. Digi-HTA has been developed to support health technology assessment activities for novel digital healthcare technologies. The use of Early Health Technology Assessment (EHTA) can help product development. The present study describes the way in which EHTA can guide the development of a product to anticipate future needs and market access.Applied Ergonomics and Desig

Nonlinear effects of winter swimming and sauna recreational activities on the heart rate variability

Sauna sessions and winter swimming are traditional and popular recreational activities in certain countries. Their positive effects on health and relaxation, both as separate and combined activities, are commonly reported. However, systematic studies of these effects are relatively scarce, especially regarding the nonlinear analysis of the physiological measurements of the heart activity. We performed Multi-Scale Entropy (MSE) and Detrended Fluctuation (DFA) analyses on the inter-beat time series (about 72 h long) of 21 healthy volunteers studied in three distinct contexts: winter swimming combined with sauna bathing (W), sauna bathing alone (S), and control (C) with no related activities. We confirmed that the scaling exponents (DFA) and complexity indices (determined from MSE) stay within the variation observed for healthy individuals as compared to public data sets. Next, we showed that S and W interventions have uncorrelated effects on the whole time series complexity in each individual. Additionally, the long-range scaling properties of S and W groups are not correlated as determined by DFA. Thus, we speculate that winter swimming combined with sauna bathing and sauna bathing alone might have different physiological responses