Software systems used for healthcare delivery should satisfy the stated and implied needs of its various stakeholders, in other words, to have a high software quality degree to reduce, for instance, prescription or diagnose errors, and to avoid negative effects on a patient’s health status. In this context, software quality models are developed to measure how a software system is operating with quality. These models decompose the concept of quality into more manageable characteristics and sub-characteristics. However it is not trivial to evaluate the perception of software quality by the end users in Information and Communication Technology (ICT) based healthcare systems – an umbrella term that encompasses a wide range of remote healthcare delivery domains, like telemedicine (the use of telecommunications for medical diagnosis and patient care) and telehealth (health promotion and disease prevention using ICT). We have performed a systematic literature review on software quality models focusing specifically on the evaluation of software quality from the viewpoint of the end user. This research has synthesized the state-of-the-art in software quality evaluation models in the context of ICT-based healthcare systems.

Large-scale telemedicine systems provide extensive amounts of data that can be used to gather epidemiological information. Epidemiologists have been using GIS systems for the easy and quick visualization of data and to perform georeferenced epidemiological analysis. This paper presents GISTelemed, a georeferenced epidemiological analysis tool developed as part of the Santa Catarina State Integrated Telemedicine and Telehealth System (STT/SC), a statewide telemedicine infrastructure in Brazil. The GISTelemed module offers an architecture supporting real-time recovery, information visualization and epidemiological analysis from structured and semi-structured data. The architecture uses controlled vocabularies for data catalogization and a specially developed ETL process that allows sending and receiving data on a large number of protocols, including DICOM SR and SQL. We performed a case study with users that indicates good perceived ease of use and usefulness of GISTelemed by both medical staff and health care managers.

A laboratory information system (LIS) manages information about patients, examinations, results, and quality control. In this context, software quality is important in order to prevent risks for the patient. Studies show that many LISs have a low quality degree, and although the ISO/IEC 25010 standard defines software quality in general, so far there is no specific customization for a quality evaluation model tailored for such systems. This paper presents a case study applying a customized evaluation model - the AdEQUATE model - in order to evaluate the software quality of a LIS widely used in the State of Santa Catarina, Brazil - the LACEN system - from the perspective of its end users. Analyzing the characteristics of the LACEN system, we customized the AdEQUATE model - a model for quality evaluation of telemedicine systems based on the ISO/IEC 25010 standard through the use of a questionnaire. The questionnaire has been answered by 69 users (including physicians and biochemists), and its answers were analyzed using descriptive statistics. In general, the quality of the LACEN system has been considered as good, specifically for characteristics like effectiveness, efficiency, satisfaction, freedom from risk, functional suitability, and security. On the other hand, few characteristics have been considered of low quality, including performance efficiency and compatibility. Also, the collected data shows that it is feasible to use AdEQUATE's systematically derived questionnaire for detailed observations of quality degrees of the ISO/IEC 25010 standard characteristics and subcharacteristics.

Este trabalho apresenta o GISTelemed, uma ferramenta de análise epidemiológica georreferenciada que é integrada à infraestrutura do Sistema Catarinense Integrado de Telemedicina e Telessaúde (STT/SC). O GISTelemed integra o STT/SC com o Sistema de Informações Geográficas de Santa Catarina (SIG@SC) e permite a recuperação, visualização georreferenciada e análise epidemiológica em dados estruturados e semiestruturados. Resultados obtidos através de um estudo de caso indicam uma percepção positiva em relação à utilidade do GISTelemed por especialistas e gestores de sa´ude.

Telemedicine and Telehealth are disciplines dedicated to provide health care and health care education when distance is an issue. Nowadays, Telemedicine and Telehealth Stations (TTSs) are used to provide physicians and educators with tools that concentrate and integrate different technologies, contributing to organize and simplify their workload. To support scenarios involving features related to teleconsultation and tele-education, TTSs must consider the adoption of hardware platforms robust enough to reach minimal requirements while providing service deliverability and continuity. Despite being usually built for execution on desktops and laptops, it is possible that TTSs be reorganized to use Single-Board Computers (SBCs) as a most portable-and cost-effective solution. Aiming to evaluate such possibility, this work presents a performance study of four of the most popular SBCs available on the market, focusing the execution of web conferences in the context of the Santa Catarina State Integrated Telemedicine and Telehealth System (STT/SC), in Brazil. Using descriptive statistics, we concluded that the Raspberry Pi 2 SBC is the best option to be adopted, considering its results regarding CPU consumption, memory utilization, and video delay.

Poison Control Centres (PCCs) provide information and advise about poisoning, poisoning case management, and toxicovigilance activities. They are supported by information systems that help physicians and toxicologists to attend cases of patient exposure to poisonous agents. Still, there is no consensus on how to evaluate software quality of such systems. This work performs a case study applying a customized software quality evaluation model -- the AdEQUATE model -- in order to assess the software quality of a poison control information system widely used in Brazil - the DATATOX information system. Analysing the specificities of DATATOX we customized AdEQUATE, a model for evaluating the quality of telemedicine systems based on the ISO/IEC 25010 standard through the use of a questionnaire. The questionnaire has been answered by 49 end users, and the acquired data were analysed employing descriptive statistics. Overall, the DATATOX information system has been perceived as having a good quality, specifically for characteristics like effectiveness, efficiency, and satisfaction. Nevertheless, few characteristics have been considered of low quality, including reliability, compatibility, and age. As a complement, the work attest the feasibility on using AdEQUATE's questionnaires as an evaluation tool for software quality evaluation.

Sistemas de teletoxicologia são sistemas de informação que auxiliam médicos e toxicologistas a registrar casos de exposição de pacientes a agentes tóxicos. Tais sistemas fornecem informações sobre intoxicações, gerenciam casos de intoxicações e providenciam atividades de vigilância toxicológica. Contudo, ainda não há um consenso em como avaliar a qualidade de tais sistemas. Este trabalho realiza um estudo de caso aplicando um modelo de avaliação de qualidade customizado – o AdEQUATE – com o objetivo de determinar o grau de qualidade de software de um sistema de teletoxicologia largamente usado no Brasil, o sistema DATATOX. Analisando as especificidades do DATATOX, customizou-se o AdEQUATE, um modelo para avaliação de qualidade de sistemas de telemedicina baseado na norma ISO/IEC 25010 através do uso de um questionário. Os dados coletados foram analisados usando estatística descritiva. No geral, o sistema DATATOX foi considerado como tendo uma boa qualidade, especificamente em termos de eficácia, eficiência e satisfação. Contudo, algumas caracter´ısticas foram consideradas como de baixa qualidade, incluindo confiança e compatibilidade. Este trabalho também comprova a viabilidade de usar o AdEQUATE como ferramenta para avaliação de qualidade de software.

Usabilidade e um atributo de qualidade de software relacionado a facilidade de se utiliza-lo. Esse atributo e relevante para varios tipos de sistemas incluindo Sistemas de Laboratorios Clinicos (SLCs) – sistemas esses que gerenciam as informacoes geradas em laboratorios responsaveis pela execucao de exames clinicos, tais como exames de sangue – onde erros podem comprometer a saude do paciente. O presente trabalho descreve um conjunto de heuristicas de usabilidade especifico para uso em sistemas de laboratorios clinicos por meio de um checklist baseado nas heuristicas tradicionais de Nielsen. A aplicabilidade das heuristicas descritas e verificada usando-se uma avaliacao heuristica, um teste de usabilidade e uma analise de Keystroke Level Model (KLM). Os resultados obtidos atestam que o checklist proposto pode ser usado para avaliacao heuristica de SLCs.

Telemedicine and telehealth are disciplines of e-Health that can facilitate access to treatment, enhance treatment quality and reduce costs. With the advances in information technologies, its is easier to use telemedicine and telehealth applications instead of direct contact with the health care provider. In this scenario, telehealth represents the delivery of health care through distance and telemedicine is a specialization that represents the delivery of medical services through distance. Both use telecommunication and information technologies to cover the bridge between health care receiver and health care provider. But even in this case, where the contact between the two parts are not physical, quality of the health care service can not be affected by the change in paradigm. The behavior of a information system can influence the health care quality and – in severe cases – the incorrect software behavior may cause death or serious implications to a patient's health. To improve the software quality, the software industry uses quality models that represent quality attributes that should be present in any software. Today the most used quality software model is ISO/IEC 25010 that decompose quality properties into characteristics and again into subcharacteristic such as: Accessibility, time behavior or confidentiality. Nevertheless this standard is generic, so we propose a soft ware quality evaluation model – the AdEQUATE – using a customization of ISO/IEC 25010 characteristics and subcharacteristics for telemedicine and telehealth systems. The objective of AdEQUATE is to measure the software quality of telemedicine and telehealth systems using the user's perspective. So we systematically developed a questionnaire to gather data to analyze the respondent opinion regarding a system quality.

This work presents a systematic review of state-of-the-art usability heuristics in the area of clinical laboratories, and compiles evaluates usability heuristics customized for clinical laboratory systems by unifying and mapping them. In addition, the resulting set of heuristics is evaluated through a case study comparing results from the application of heuristics and usability tests.

Message from General Chairs ...................................................................................................................xi Message from Program Chairs.................................................................................................................xii Conference Organization..........................................................................................................................xiii Program Committee..................................................................................................................................xiv Keynotes....................................................................................................................................................xvi