INTRODUCTION: The ongoing coronavirus pandemic is affecting the lives of millions of people, changing society by enacting new rules for social life, business and travel. The world community (i.e. international organizations, public administrations, businesses, and citizens) has conducted a huge effort in delivering digital solutions to properly address the challenges imposed. A multitude of approaches have been followed, towards achieving a wide spectrum of side goals. OBJECTIVES: This work presents a platform, designed for public health authorities, to effectively track suspect, probable and confirmed incidence cases in a pandemic by means of a mobile app used by citizens to provide immediate feedback. The aim has been to better support human tracers, and the platform must not be confused with proximity tracking apps. METHODS: The outbreak response tool was developed based on official information and guidelines, on top of an already existing personal health record app which has been extended, to properly accommodate specific needs that emerged during the crisis. RESULTS: The developed platform provides the framework to support return to the “new normal” in less time, with reduced stress and more security for individuals, more direct and safer management of patients by physicians, and better possibilities for monitoring the epidemic by public health authorities. Issues relevant to privacy concerns, and interoperability with available patient registries and data analytics tools were also examined to better support public healthcare delivery and contain the spread of the infection. CONCLUSION: In order for the foreseen benefits to be realized, there is a need to respect safety and security regulations, while at the same time conform to international standards and widely accepted medical protocols. Cross-border interoperability and the availability of appropriate links (i.e. publicly available interfaces) to relevant open data and national registries is considered to be of paramount importance.

An open eHealth platform for health management using adaptable service profiles for different medical specialties is currently being validated in the regional health information network (RHIN) of South Aegean in Greece. The core of the installation is an electronic health record (EHR), customized for primary care, that has been extended with advanced eHealth services. Users of the EHR can create an active episode folder by selecting an eHealth service profile. Relevant clinical data can be added to the folder and users will be aware or be notified of updates. Once in a folder, a connected user perceives the actions of other users in the same folder and may use medical devices in a collaborative manner. The underlying service engineering framework allows maintenance of service profiles without disrupting the operation of the system. Preliminary results show that end-users have recognized the efficiency of the system and are eager to use it in managing the health of their patients both in their office and at the patients' home.

A risk assessment (RA) framework was employed to determine what protection would be adequate and reasonable for the assets of a cardiology eHealth service deployed on the island of Crete. In the context of HYGEIAnet, the regional health telematics network of Crete, teleconsultation services for cardiology patients have been installed and are in routine use since December 2000. The novelty of the framework for model-based RA of security critical systems, which developed within the CORAS IST project, lays in its synthesis of risk analysis methods with semiformal specification, supported by an adaptable tool-integration platform. This paper presents the use of the CORAS framework to assess the cardiology eHealth service and the implementation of security controls and mechanisms.

The Center for Medical Informatics and Health Telematics Applications (CTI-HTA) at the Institute of Computer Science, FO.R.T.H. is actively involved in the creation and evolution of the regional healthcare network of Crete. In this context, a web-based environment that allows healthcare personnel to collaborate with their peers regardless of their actual geographic location has been developed. Healthcare related collaboration will be facilitated through a number of integrated web-based services such as electronic mail, ICnet postings, annotations, and on-line collaboration.

Prompt consultation with medical experts is in many cases critical to the health of the patient. One such case is acute myocardial infarction, where early thrombolytic treatment can significantly improve prognosis. A recent study found that a 30 minute delay in the initiation of thrombolysis reduces the patient’s life expectancy by approximately one year [1]. The author concluded that “the magnitude of the benefit from early thrombolysis is such that giving thrombolytic therapy to patients with acute myocardial infarction should be accorded the same degree of urgency as treatment of cardiac arrest” and advised that “policies should be developed for giving thrombolytic therapy on-site if practicable and by the first qualified person to see the patient”. Studies in the Netherlands indicate that the average time gained by the pre-hospital initiation of thrombolysis can be as much as 50 minutes [2,3]. Since the decision to administer thrombolytic agents must normally be made by a qualified cardiologist, providing telecardiology consultation facilities to primary health care centers, especially to those in relatively remote rural areas, is clearly of paramount importance. Consider the following scenario. A GP at a primary healthcare facility admits a patient suffering severe chest pain. If the clinical findings raise the suspicion of myocardial infarction, the GP may request assistance from a central hospital offering specialized telecardiology consultation services. The GP submits a consultation request that includes clinical findings and the patient’s electrocardiogram (ECG) to a Telecardiology Service Provider (TSP). The submission of the request triggers an alert in the selected TSP. A specialized cardiologist reviews the clinical data in the request and establishes communication with the GP. This communication may involve asynchronous transfer of objective medical data, tele-monitoring of the patient’s vital signs and ECG, and video/desktop conferencing. The cardiologist may advise the GP that the patient should be given thrombolytic treatment. An ambulance is requested, while the cardiologist cooperates closely with the GP and monitors the condition of the patient. Finally, the patient is transferred to the hospital and comes under the direct care of the cardiologist, while the telecardiology consultation records become part of the patient’s Electronic Healthcare Record (EHR).