Background: The driving force for information and communication technology in healthcare has been directed towards better-coordinated care but high cost and time consumption in addition to difficulties with cooperation with resident practitioners has hampered progress. Therefore, due to the underestimation of difficulties to manage national eHealth activities, the potential of eHealth in Europe is still to be realized. Methods: An evaluation of the national eHealth in Slovenia grounded on open platform theory based organizational design principles for eHealth platforms has been conducted. We used a running use case of an eDiabetes digital health intervention as a potential new central service of the national eHealth platform. We discussed all the design principles and also constructed a questionnaire during the process to additionally help with the evaluation. Results: We have identified a gap that needs to be bridged in order for Slovenia to achieve all the benefits of an open eHealth platform that could become a strategic direction for the future. We constructed a questionnaire that is based on the open platform theory grounded design principles for open eHealth platforms which we used as a helping tool to perform the analysis. Conclusion: By evaluating the national eHealth in Slovenia against the open eHealth platform organizational design principles, we identified a gap that needs to be bridged to benefit from the positive effects of open eHealth platforms. Being open suggests participation, extension and growth both in terms of demand side users (e.g. patients and doctors) and supply side platform users (e.g. IT companies, HCPs etc.) Shortage of a business model is just one principle that still needs to be met in addition to several others. With this, Slovenia can ground its national eHealth vision and strategy on the results of this analysis.
It has been previously shown that human cardiac disorders can be modeled with induced pluripotent stem cell differentiated cardiomyocytes (iPSC-CM), which enables to study disease characteristics and pathophysiology in more detail. We have shown that some genetic cardiac diseases can be separated from each other and from healthy controls by applying machine learning methods to calcium transient signals measured from these cells. In this study, separation of four genetic cardiac diseases and controls were studied by applying classification methods such as nearest neighbor searching algorithm, decision trees, least squares support vector machines and random forests to peak data computed from calcium transient signals measured from beating induced pluripotent stem cell-derived (iPSC) cardiomyocytes. The best classification accuracy obtained was 77.8% being very promising. The result strengthens our previous finding that the machine learning method can be exploited to identification of several genetic cardiac diseases, but also to separate mutations in different genes resulting in the same clinical phenotype.
BACKGROUND:Obtaining informed consent from research study participants continues to meet difficulties. New ways to connect with potential participants are necessary to address barriers, expand enrollment and offer more services to underserved populations.OBJECTIVES:Electronic consent is designed to complete consenting sessions remotely and may help combat the obstacles inherent in the traditional informed consent process. We investigate the implementation of an electronic consent platform, Teleconsent, to broaden and diversify recruitment for clinical research.METHODS:Semi-structured interviews were conducted with community members to assess their perceptions regarding the acceptability and usability of Teleconsent, a form of electronic consent. Interviews were structured to determine the main benefits, challenges and concerns as detailed by each participant. Participants were divided into rural and urban groupings.RESULTS:We interviewed 40 participants to gather first-time perceptions of Teleconsent. We found overall positive results. Predominately in urban communities, participants possessed the technological skills and amenities to support smooth implementation of this technology. However, many participants reflect on the challenges regarding logistics, privacy and reliability of utilizing Teleconsent in underserved, rural areas. 5 of 19 participants, more than a quarter for the rural group, experienced Teleconsent software problems. During these sessions, an alternative process with paper templates was employed to complete interviews.CONCLUSION:Perceptions regarding Teleconsent demonstrate current challenges along with potential acceptance within different communities. This is despite the fact that on its own it will not be able to overcome the barriers currently found in the informed consent process. Still, investment in electronic consent, including the development of enhanced and interactive content, can potentially revolutionize this process. Our findings offer a preliminary step towards determining the feasibility and acceptance of Teleconsent, a form of electronic consent, in different communities. More research surrounding the logistics of adoption is necessary in order to determine success.
IntroductionElectronic medical records (hereafter called "EMRs") are designed for the primary use of data, such as the efficiency of medical work by order entry systems and medical accounting systems.Secondary data, such as medical research, decision support, and educational support for young doctors, are expected to accumulate via promoting the computerization of medical data.Especially, computer-based clinical decision support systems (hereafter called "CDSS") to support doctor's clinical decision making is an important example of secondary use of EMRs [1].The CDSS is a system that provides better medical care to patients by reducing decision mistakes and sharing medical evidence when medical staff makes decisions, such as diagnosis and prescription [2].
The development of medical informatics goes back to the second half of the twentieth century with the start of the automation of processes. Medical informatics education plays an important role in the education of health care providers and medical providers. Education in medical informatics is not only important for medical students but also for other medical staff at all professional levels of education. Integrating medical Informatics into the full spectrum of medical education is a vital step required for the understanding and practice of modern medicine. There are curricula in the field of medical informatics at many universities in Europe. Great roles in this field had the International Medical Informatics Association (IMIA) and – the European Federation for Medical Informatics (EFMI). Working groups of IMIA and EFMI defined and recommended concepts and methodologies of education for medical informatics on three levels. Generally in all European countries medical education at universities is organized on the basis of the Bologna concept, which has improved the quality of teaching process in plenty matters, but it has brought a big number of highly educated staff, that are younger than average, but also have average level of knowledge. Basically, the Bologna system has brought averageness we tried to escape from. With the introduction of the Bologna process in Bosnia and Herzegovina and other countries, a new process is being introduced which introduces a new curriculum, a greater number of subjects, a complemented systematization of knowledge and the need to correct past attitudes. Since the curriculum of medical informatics varies between countries and universities and faculties in the country, it is necessary to take steps towards the unification of the curriculum at the international level. Aim of the article is to show the status of medical informatics education in Bosnia and Herzegovina and Europe.
Objective: We aimed to identify the population in which encouraging participation in the general health check-up would be helpful using a prediction model based on a machine-learning method. A secondary analysis of data obtained from the health promotion program using a randomized controlled design, aimed at improving participation in the general health check-up, was performed. Methods: The retrospective analysis was conducted using data from a health promotion program in the Fukuoka branch of Japan Health Insurance Association, Japan, between November 2015 and March 2016. Subjects were extracted from dependents (family members) of insured persons aged 40-74 years who had participated in general health check-up at least once in the past five years (2010-2014). Subjects were divided into two groups; the intervention group received a printed reminder saying “you are due to general health check-up” through mail, while the control group received nothing. The participation rates of both groups for each participation probability group (participation probability was calculated by the prediction model) were assessed after 4 month follow-up. Results: The numbers in the intervention group and in the control group were 1,911 and 3,294, respectively. Regarding the prediction model, the AUC value for test data was 0.668 (95%CI: 0.635–0.701). With regard to the effectiveness of the intervention for each probability group, there was a significant difference between the groups only for the moderate participation probability groups as follows: 30-39% (P=0.005), 40-49% (P=0.003), 50-59% (P=0.004) and 60-69% (P=0.039). Conclusion: The intervention with printed reminder was effective for improving participation of general health check-up among the group with moderate participation probability. The targeting using the results of prediction model was useful for identifying appropriate intervention targets. Conclusions: More studies are needed to assess the cost and benefits of adopting a system like this and then the appropriate actions could be taken.
IntroductionThe number of death due to traffic accidents in 2013 reached 1.25 million, summarized by World Health Organization [1], this report also pointed out the road traffic injuries leaded the main reasons of death in 2012 among young people aged 15-29 years, followed by suicide and AIDS/HIV.Driver errors involving poor steering skills were recognized as the main causes of vehicle accidents [2].Discussion about how drivers place their hands and change hand position usually used language of clocks.A '10 and 2 clock' steering technique is frequently advocated at driving schools in the UK and on the highway [3].Now in the United States, '9 and 3 clock' is also optional even '8 and 4 clock' is accepted when driving for long distance on the freeway.It cannot be denied that some drivers ignored the strict traffic laws and regulations, which undoubtedly placed passengers and drivers themselves in high risk of car accident.For this reason, recent study tried to assess different steering techniques in order to characterize the drivers' steering profile by tracking hand position using simulators and motion capture system [4].However, only focusing on hand position can hardly ensure maintenance of car control and react ability at any time.Topics on how drivers hold the steering wheel should be paid more attention, so that we can take a close look at drivers' performance.Unfortunately, understanding how human exploit hand function and sensory feedback of hand griping pattern is a challenging topic that still is not completely understood [5].Besides inappropriate steering pattern behind the steering wheel, drowsy driving should take responsibility for 12.5% of vehicle crashes requiring medical treatment both for drivers and passengers, which were surveyed by The American Automobile Association [6].This is not surprised because most commercial drivers especially truck drivers frequently drive on a long, monotonous and high-speed roadway at irregular time that may conflict with natural
Comprehensive and accurate information about the status and processes directly and indirectly related to the health of the subject of care
I am a radiologist and I developed and introduced first radiology information system (RIS) in Japan in 1993 with a hard time, after the analysis of workflows. DICOM had not MWM and MPPS at that time. I developed and operated EPR and PACS sharing system using global standard XDS and XDS-I and Japanese standard SS-MIX2. The introduction took in only a year. However, it was found that standardization of contents was delayed for the first time by operation.
Introduction: Zika Virus (ZIKV) infection is a major public health concern, affecting almost each country in the western hemisphere. A more than 20-fold increase in microcephaly risks is associated to ZIKV infection in pregnancy. A new vaccine is not expected before 2019, and alternative prophylactic and therapeutic approaches are encouraged. We expect that the Resonant Recognition Model, developed by Irena Cosic, might lay on the basis for an alternative approach to handle ZIKV. Objective: We tried to identify the resonant frequencies associated to the ZIKV polyprotein and their use for an automatic taxonomy of different ZIKV strains. We put to test the hypothesis of interaction between ZIKV envelope protein and the AXL receptor, one of the plausible mechanisms proposed for ZIKVassociated microcephaly. Results: Four relevant frequencies (fRRM) were found in ZIKV polyprotein consensus spectrum. Corresponding four spectral amplitudes allowed separating African from Asian/American ZIKV isolates (k-means clustering). Peak 3 (fRRM= 0.2754) and Peak 4 (fRRM= 0.334) yielded a finer separation between Asian sequences and those from the current outbreak collected in 2015 (Asian/American). Consensus spectrum for pooled Dengue virus and ZIKV polyprotein sequences suggest that Peak 4 might be a specific hallmark of ZIKV. RRM results support the interaction between ZIKV envelope protein and AXL membrane receptor. The interacting frequency of fRRM= 0.167 seems to be a sub-harmonic of Peak 4. Conclusions: Resonant recognition model provides a plausible view of processes involved in the interactions of ZIKV with the human host, and is suggesting the exchange of electromagnetic radiation at the frequencies of 601.8nm (yellow light) and 1203.6 (near infrared) during ZIKV envelope protein with the AXL receptor in the human fetal tissue. This information might be relevant for alternative approaches to new therapeutic approaches to treat ZIKV-associated damage to newborns.
Objectives:The authors developed and evaluated a method of selecting accurate diagnosis procedure combination (DPC) codes based on standardized treatment information relative to the number of hospitalization days. Methods:The authors used machine learning methods to generate DPC codes based on treatment data.The machine learning methods utilized were the Naïve Bayes method, the SVM method, and a combined method of the two methods.We prepared DPC code data and standardized treatment data corresponding to cases occurring in fiscal year 2008 at Kyoto University Hospital.To produce classification models, machine learning methods require a moderate amount of data corresponding to each DPC code; accordingly, we selected 166 DPC codes that were each related to at least 20 cases.The number of cases with these DPC codes was 10,123.Results: DPC code selection was attempted using the Naïve Bayes method, the SVM method, and the combined method of the two; of these, the combined method yielded the best results, producing accurate DPC codes in 73.8% of cases.In addition, we were able to improve the precision of DPC code selection to 76.5% by utilizing partial treatment data gathered up to the 11th day of each hospitalization. Conclusion:The present study confirmed the feasibility of automatic DPC code selection through machine learning methods based on treatment information.Our future work will include the construction of a system to select DPC codes automatically and the evaluation of this system to determine whether it can reduce doctors' workloads.
The history of science has shown that the development of any field is the result of many researchers’ efforts, some of whom put a specific footprint on certain important aspects in some stages of the field’s development. When we think of Jana Zvárová, we have first to reveal her efforts in promoting the field of medical informatics, while this field was still seeking its proper definition, and mainly to underline her role in favouring and supporting direct contacts and collaborations between the scientists, in the political context of a Europe still politically divided into “East and West” [1].
In 2018 Polish health IT community faces critical challenges related to the national eHealth agenda. The mission of HL7 Poland is to establish a community around interoperability standards and integration profiles with health IT vendors, medical providers and public authorities. One of the activities that would support this goal is providing tooling for specification publication and implementation validation. HL7 Poland has started a project to create a central hub for specifications and tools. The Tukan is an online platform dedicated to Polish healthcare IT community, where national specifications for interoperability are published together with a set of testing tools supporting their implementation. The platform is based on software components originating from various sources: open source release of IHE Gazelle components, development tooling of Polish National Implementation Guide of HL7 CDA, ART-DECOR platform software components, HAPI FHIR reference implementation for FHIR STU3 standard and Central Authentication Server (CAS) software components. Tukan platform is ready to be used as an environment supporting peer-to-peer testing in connectathon-like events. The pilot phase of Tukan platform has shown that there is a significant interest in testing services, especially when there are official specifications of interoperability standards published. In 2018 the first Polish connectathon will be held by HL7 Poland on Tukan platform in cooperation with national and regional projects.
Background: Prevalence of visual impairment is increasing all around the world and this impairment makes the medication management process more complicated.According to literature, Technology, particularly mobile technology has a significant impact on both medication adherence and improving quality of life for people with visual impairment.Due to aforementioned facts, the researchers decided to identify the user's goals for a mHealth-based medication management system for visually impaired individuals to help the developers to design and develop a medication management system for visually impaired individuals considering to improve their medication adherence and also preserve their independence.Methods: A goal directed approach, introduced by Cooper, has been used in order to extract the goals of visually impaired users who would employ a medication management system.One the most important concepts of this method are designing personas.The needed data for designing personas were extracted from two literature reviews and interviews with 14 visually impaired individuals and three experts of this area.Therefore the personas' different goals were defined. Results:As the results of this study, three personas were designed according to the extracted data and three categories of user goals including experience goals, end goals and life goals were determined for this system. Conclusion:This study could help the researchers and developers to design and develop an appropriate digital product for people with visual impairment, in order to increase their medication adherence.In addition, the findings of this study could help the policy makers of different areas to increase the quality of life for the people with visual impairment by eliminating the barriers of independent and effective medication adherence.nt..
This Special Issue of the European Journal for Biomedical Informatics is dedicated to the International HL7 Interoperability Conference 2018 “Mastering the Interoperability Challenge” (IHIC 2018), 11-12 July 2018 in Portsmouth, UK (http://ihic.info/2018). It contains papers selected by an independent peer review process, strictly performed by experts from countries different from the authors’ country of residence.
Origins of multivariate statistics trace back to Karl Pearson (1857Pearson ( -1936)), who developed the first multivariate statistical methods for the needs of anthropology and forensic science.The first applied statisticians of the beginning of the 20th century are at the same time well known by biologists.In 1911, Pearson founded the first statistical department at the world in London called Department of Applied Statistics, where
Background: Health IT adoption is high in Austria, but health IT targeted at the patient is still rare. Objectives: To analyse the shift from eHealth to ePatient and the role that patient portals may have in this shift, from an Austrian perspective. Methods: Analysis of the situation in Austria regarding the use of eHealth and patient portals. Results: While eHealth applications are broadly used in Austria, only few applications address the patient as user and aim at facilitating patient empowerment. Patient portals are one approach to foster patient empowerment. In Austria, a national patient portal is introduced at the moment, but only with limited functionalities. Systematic reviews show that the evidence on the impact of patient portals on patient empowerment is still unclear, which may explain low adoption rates. It seems to be still a long way to support a new generation of ePatients who are equipped, enabled, empowered and engaged in their health and health care decisions. Conclusion: Patient portals and other eHealth interventions aiming at fostering patient empowerment can only show impact when health care professionals are willing to engage in a true partnership with the patient, and when patients are willing to take over responsibility for their own health management.
