Recent advances in medical and electronic technologies have introduced the use of Body Area Networks as a part of e-health, for constant and accurate monitoring of patients and the transmission as well as processing of the data to develop a holistic Electronic Health Record. The rising global population, different BAN manufacturers and a variety of medical systems pose the issue of interoperability between BANs and systems as well as the proper way to propagate medical data in an organized and efficient manner. In this paper, we describe BANs and propose the use of certain web technologies to address this issue.
The current paper summarises the research investigating associations between physiological data and hearing performance. An overview of state-of-the-art research and literature is given as well as promising directions for associations between physiological data and data regarding hearing loss and hearing performance. The physiological parameters included in this paper are: electrodermal activity, heart rate variability, blood pressure, blood oxygenation and respiratory rate. Furthermore, the environmental and behavioural measurements of physical activity and body mass index, alcohol consumption and smoking have been included. So far, only electrodermal activity and heart rate variability are physiological signals simultaneously associated with hearing loss or hearing performance. Initial findings suggest blood pressure and respiratory rate to be the most promising physiological measures that relate to hearing loss and hearing performance.
Pharmacovigilance is an important part of the patient safety and it has a great appeal to physicians. It is concerned with the safety of medical devices and treatments in the light of understanding the risks and dangers based on the already reported safety issues. Internet resources such as the Manufacturer And User Facility Device Experience (MAUDE) web-site are often retrieved due to the lack of internal, local safety databases. The research looked at how Human Computer Interaction could improve user experience. We have designed data entry for safety reporting and pharmacovigilance based on the web-bases system called WebBISS (Web-based implant search system). The expectation is not only to improve usability, but also to stimulate physicians to enter their safety data and become also contributors, and not only users of information. The expert evaluation has been generally positive and encouraged stronger help and error reporting functions. The high fidelity design has given a good impression of the future mobile solution.
This paper presents results of a study on the applicability of the intelligent phonocardiography in discriminating between Ventricular Spetal Defect (VSD) and regurgitation of the atrioventricular valves. An original machine learning method, based on the Time Growing Neural Network (TGNN), is employed for classifying the phonocardiographic recordings collected from the pediatric referrals to a children hospital. 90 individuals, 30 VSD, 30 with the valvular regurgitation, and 30 healthy subjects, participated in the study after obtaining the informed consents. The accuracy and sensitivity of the approach is estimated to be 86.7% and 83.3%, respectively, showing a good performance to be used as a decision support system.
Homeless women Veterans have a high prevalence of chronic mental and physical conditions that necessitate frequent healthcare visits, but travel burdens to specialty services may be overwhelming to navigate for this population, especially for those in rural settings. Access to specialty care is a key priority in the Veterans Health Administration (VHA) and understanding the geographic distribution and rural designation of this population in relation to medical centers (VAMC) can assist in care coordination. We identified 41,747 women Veterans age 18–44y with administrative evidence of homelessness in the VHA anytime during 2002–2015. We found 7% live in rural settings and 29% live >40miles from a VAMC. The mean travel distance for homeless women Veterans with a rural designation to a VAMC specialty center was 107 miles. Developing interventions to overcome this travel burden and engage vulnerable Veterans in necessary care can improve overall health outcomes for this high-risk population.
Ambient assisted living (AAL) may support ageing in place but is primarily driven by technology. The aim of this work is, to identifying reasons to move into assisted living institutions, their range of service and possible substitutability. We did semi-structured interviews with five experts from assisted living institutions and used results to design and implement assistive technologies in an AAL environment using BASIS, a cross domain bus system for smart buildings. Reasons for moving to assisted living institutions are expected benefits for chronic health problems, safety, social isolation and carefree living. We implemented six application systems for inactivity monitoring, stove shutdown, air quality monitoring, medication and appointment reminders, detection of unwanted situations before leaving and optical ringing of the doorbell. Substitution of selected assisted living services is feasible and has potential to delay necessity to move into assisted living institution if complement social services are installed.
In this project the potential of social media has been reviewed in terms how it can promote a healthy lifestyle utilized in an app. A mHealth app for smartphones has been developed using Design Science methodology, where various features from social media have been implemented with the goal of increasing physical activity. The application has been evaluated extensively in order to meet usability requirements. In addition, a focus group has contributed towards the application's potential to increase physical. The data collected is suggesting that social features have a positive impact on promoting physical activity.
The adoption of the Internet of Things (IoT) and mobile applications in the healthcare may transform the healthcare industry by offering better disease tracking and management as well as patient empowerment. Unfortunately, almost all of these new systems set up their own ecosystem and to be really valuable for the care process they need to be integrated or federated with user managed access control services based on international standards and profiles to enable interoperability. Thus, this work presents the results of an evaluation of available specifications for federated authorization, based on a set of basic requirements.
Sexual trauma survivors are reluctant to disclose such a history due to stigma. This is likely the case when estimating the prevalence of sexual trauma experienced in the military. The Veterans Health Administration has a program by which all former US military service members (Veterans) are screened for military sexual trauma (MST) using a questionnaire. Administrative data on MST screens and a change of status from an initial negative answer to positive and natural language processing (NLP) on electronic medical notes to extract concepts related to MST were used to refine initial estimates of MST among a random sample of 20,000 Veterans. The initial MST positive screen of 15.4% among women was revised upward to 21.8% using administrative data and further to 24.5% by adding NLP results. The overall estimate of MST status in women and men in this sample was revised from 8.1% to 13.1% using both data elements.
YouTube as an online video-sharing service in the context of Web 2.0 goes beyond the bounds of pure fun, for which the platform was primarily established. Nowadays, commonly to other social media, it serves also educational, informational and last but not least, marketing purposes. The importance of video sharing is supported by several predictions about video reaching over 90% of global internet traffic by 2020. Using qualitative content analysis over selected YouTube videos, paper examines the current situation of the platform's marketing potential usage by medical informatics organizations, researches and other healthcare professionals. Results of the analysis demonstrate several ways in which YouTube is already used to inform, educate or promote above-mentioned medical institutions. However, their engagement in self-promo or spreading awareness of their research projects via YouTube is considered to be low.
We investigate options for grouping templates for the purpose of template identification and extraction from electronic medical records. We sampled a corpus of 1000 documents originating from Veterans Health Administration (VA) electronic medical record. We grouped documents through hashing and binning tokens (Hashed) as well as by the top 5% of tokens identified as important through the term frequency inverse document frequency metric (TF-IDF). We then compared the approaches on the number of groups with 3 or more and the resulting longest common subsequences (LCSs) common to all documents in the group. We found that the Hashed method had a higher success rate for finding LCSs, and longer LCSs than the TF-IDF method, however the TF-IDF approach found more groups than the Hashed and subsequently more long sequences, however the average length of LCSs were lower. In conclusion, each algorithm appears to have areas where it appears to be superior.
Integrated care paradigms depend on multiple sources of data. The quality of data used in decision-making will ultimately affect the delivered care to the patient. Quality includes several dimensions, which may affect the result. This paper presents how data quality dimensions may affect the delivered service, and propose a conceptual framework for the classification of confidence in data used in clinical decision-making for integrated care.
The aim of this paper is to present the perceptions of the Health Informatics Scientists about the Big Data Technology in Healthcare. An empirical study was conducted among 46 scientists to assess their knowledge about the Big Data Technology and their perceptions about using this technology in healthcare. Based on the study findings, 86.7% of the scientists had knowledge of Big data Technology. Furthermore, 59.1% of the scientists believed that Big Data Technology refers to structured data. Additionally, 100% of the population believed that Big Data Technology can be implemented in Healthcare. Finally, the majority does not know any cases of use of Big Data Technology in Greece while 57,8% of the them mentioned that they knew use cases of the Big Data Technology abroad.
Emergency medical systems (EMS) are considered to be amongst the most crucial systems as they involve a variety of activities which are performed from the time of a call to an ambulance service till the time of patient's discharge from the emergency department of a hospital. These activities are closely interrelated so that collaboration and coordination becomes a vital issue for patients and for emergency healthcare service performance. The utilization of standard workflow technology in the context of Service Oriented Architecture can provide an appropriate technological infrastructure for defining and automating EMS processes that span organizational boundaries so that to create and empower collaboration and coordination among the participating organizations. In such systems, the utilization of leading-edge analytics tools can prove important as it can facilitate real-time extraction and visualization of useful insights from the mountains of generated data pertaining to emergency case management. This paper presents a framework which provides healthcare professionals with just-in-time insight within and across emergency healthcare processes by performing real-time analysis on process-related data in order to better support decision making and identify potential critical risks that may affect the provision of emergency care to patients.
The research aim of this study is to investigate the perceived innovation of the Big Data Technology in Healthcare. A survey was conducted using a theoretical model based on Rogers' Innovation Diffusion Theory, on Davis' Technology Acceptance Model, and relative research work. The results reveal that the Big Data Technology may be an innovation on the field of Health Informatics as it offers a lot of advantages compared to the traditional ways of data handling and processing, and it is compatible with the current technological status on the healthcare domain. Additionally, the current study presents the positive attitude of the Informatics Experts about the usage of the Big Data innovative technology on Health sector.
For years, hospitals have responded to inefficiencies by adding more resources, whereas research suggests that it is a flow problem. King Faisal Specialist Hospital and Research Center decided to improve efficiency and enhance patient flow through improving patient discharge and reducing length of stay. Eight interventions were implemented; dedicating slots in diagnostic services for discharges, improving communication, eliminating pending exams, identifying discharges the day before, prioritizing laboratory tests, coordinating discharge medication processing and utilizing case management. 14.1% of discharges after improvement, compared to 21.7% before, experienced delays. Discharge cycle duration was reduced from 17.9 to 9.2 hours. 4.1% of discharges after improvement, compared to 14.8% before, experienced procedures delays. Procedure turnaround time was reduced from 46.9 to 15.3 hours. Average length of stay (ALOS) was reduced from 12 days to less than 10. Improving hospital efficiency is an integrated process and the responsibility of all hospital staff.
The Information and Communication Technologies (ICT) combined with the development of innovative skills within the broader health sector, can significantly improve and upgrade health care quality services. The proposed DDP4BIT system supports an alternative channel for digital information recording and equipment handling of Biomedical Technology Departments (BITs) of Health Care Units. This technology is ideal for all types of procedures based on handwritten forms that are commonly used in Health Care Units. The collection of useful statistics for analyzing and exporting data indicators is used in order to reduce ratios, such as operating time ratio, ideal operating time indicator, number of repetitive quality failures, total maintenance cost, etc. and supports decision-making
Hospital information systems (HIS) and electronic medical records (EMR) are currently considered a major part of the healthcare system, on which all the processes of care delivery depend. They have the potential to provide substantial benefits to healthcare professionals, patients and healthcare organizations. The study used quantitative survey methods through a questionnaire to collect data and information directly from different categories of healthcare professionals of four Saudi hospitals. Valid responses were 153 and ten perceived benefits were validated and ranked, these are; 1) Improved information access, 2) Increased healthcare professionals productivity, 3) Improved efficiency and accuracy of coding and billing, 4) Improved quality of healthcare, 5) Improved clinical management (diagnosis and treatment), 6) Reduced expenses associated with paper medical records, 7) Reduced medical errors, 8) Improved patient safety, 9) Improved patient outcomes and 10) Improved patient satisfaction. There is still limited data regarding the direct economic benefits of HIS & EMR.
Adverse drug events could require a patient to visit the emergency department, many of these visits lead to hospital admissions. A retrospective study, October 2015 to March 2016, examined the severity and factors contributing to medications related emergency visits leading to admissions at King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia. Out of 698 reviewed patients, 92 were medications related admissions. Adverse drug reactions were the primary cause (46.7%), drug prescribing (30.4%), compliance (14.1%), and drug dosing (8.7%). The majority of cases were of moderate severity (82.6%). Most medications involved in emergency admissions were antihypertensive (18.4%), chemotherapy (17.4%), anticoagulant (15.2%), and anti-diabetics (12%). Emergency admissions secondary to medication could be minimized whenever the causes of problems are identified. Motivating physicians to apply shared decision making strategy during prescribing and involving pharmacists in emergency and ambulatory care setting is highly important and to educate patients and support healthcare providers in making best medications related decisions.
Registries are an essential source of information for clinical and non-clinical decision-makers; because they provide evidence for post-market clinical follow-up and early detection of safety signals for biomedical implants. Yet, many of todays biomedical implants registries are facing a variety of challenges relating to a poorly designed dataset, the reliability of inputted data and low clinician and patient participation. The purpose of this paper is to present a best practice model for the implementation and use of biomedical implants registries to monitor the safety and effectiveness of implantable medical devices. Based on a literature review and an analysis of multiple national relevant registries, we identified six factors that address contemporary challenges and are believed to be the keys for building a successful biomedical implants registry, which include: sustainable development, international comparability, data reliability, purposeful design, ease of patient participation, and collaborative development at the national level.
The paper studies the smart telecare utility in health & social care fields for the satisfactory increase of external and internal user through personalized approach and the capability proof of continuing management improvement through quality indicators. Primary survey studies of aged people's satisfaction through smart telecare in Greece – maybe in good health or patients or socially isolated – interviewing four types involved – aged, caregivers, health or social care providers and smart technology providers or producers. The sample seems positive to smart telecare for prevention, protection, safety and security. To sum up, they believe there are organizational problems in Greece due to lack of information.
Photodocumentation of allergic hyperemia induced during the conjunctival provocation test (CPT) is analyzed by digital imaging and by assessment from an external observer. Selected specific characteristics, derived from the measured conjunctival redness values, represent the relevance of digital imaging and reproducibility of the CPT. The characteristics discussed here are: the area under the ROC curve and Pearson's product-moment correlation coefficient.
Quality standards (QS) support and enhance health care services provided to patients and citizens, especially in sophisticated medical departments, such as Intensive Care Units (ICU). However, ICU staff lag behind in the adoption and compliance of QS protocols. In this paper, QS protocols implemented in the Intensive Care Unit of the Attiko University Hospital, a tertiary teaching hospital of the University of Athens, will be discussed. In this hospital, standardized procedures are implemented through the HIS, facilitating routine administration and services. We are aiming to facilitate educational processes and enhance staff compliance with the protocols by utilizing the Hospital Information System (HIS). In doing this, we propose the application of pop-up windows on the different user (medical or nursing) interfaces of the HIS, inter-connecting every electronic process with the corresponding QS protocol that has been developed in the ICU. This application may prove a valuable educational tool and may reinforce staff training and enhance compliance with the QS protocols.
Providing patients access to mental health records is a controversial topic that gains growing attention in research and practice. While it has great potential in increasing the patient engagement, skepticism is prevailing among therapists who fear detrimental effects and face a lack of feasibility when treatment notes are handwritten. We aim at empowering both therapists to new documentation approaches and patients to higher engagement, and develop the collaborative documentation system Tele-Board MED (TBM) as an adjunct to talk-based mental health interventions. We present an evaluation of TBM by comparing four prototypes and testing scenarios, reaching from early simulations to attempts of real-life implementations in clinical routines. This paper delivers a systematic need comparison of therapists as primary users and patients as secondary users, both during and beyond treatment sessions. While patient feedback is thoroughly positive, the therapist needs are only partially addressed; the benefits remain hidden behind the perceived effort.