bluuebunny/crossref_metadata_2025 huggingface dataset:
A Home-centered ICT Architecture for Health-enabling Technologies
Authors: Song Bianying  , Marschollek Michael  , Wolf Klaus-Hendrik  , Gietzelt Matthias  , Franken Thomas  , Haux Reinhold
Published: February 2025

Population ageing needs health-enabling technologies for delivering pervasive health care. Home care plays an import role in pervasive health care. In this paper, we aim to construct a home-centered health information system architecture which can efficiently manage multi sensors, actuators and decision support systems. Open Services Gateway initiative (OSGI) was used for constructing the service oriented architecture. HL 7 Arden Syntax for medical logic module (MLM) was used to describe the medical knowledge; An Arden compiler was used to interpret the MLMs. The Arden compiler was packed in an OSGI bundle. All of the knowledge bases can share the compiler within the OSGI platform. System within the OSGI-based architecture can change their behaviors during runtime. The proposed prototype architecture was deployed in a case study.
Exploring Feasibility of Home Telemanagement in African Americans with Congestive Heart Failure
Authors: Finkelstein Joseph  , Cha Eunme  , Dennison Cheryl R.
Published: February 2025

Existing telemonitoring systems provide limited support in implementing personalized treatment plans. We developed a Home Automated Telemanagement (HAT) system for patients with congestive heart failure (CHF) to provide support in following individualized treatment plans as well as to monitor symptoms, weight changes, and quality of life, while educating the patient on their disease. The system is designed to be placed in the patient's home and to communicate all patient data to a central server implementing real-time clinical decision support. The system questions the patient daily on their condition, monitors their weight, and provides the patient with instant feedback on their condition in the form of a 3-zone CHF action plan. Their medication regimen and suggested actions are determined by their care management team and integrated into the system, keeping a personalized approach to disease management while taking advantage of the technology available. The system is designed to be as simple as possible, making it usable by patients with no prior computer experience. A feasibility assessment in African American patients with CHF and without prior computer experience demonstrated high level of acceptance of the CHF HAT system.
Usage of international standards for integrating extramural monitoring and personal health device data into medical information infrastructure
Authors: Mense A.  , Sauermann S.  , Gerbovic G.  , Frohner M.  , Pohn B.  , Bruckner R.  , Urbauer Ph.  , Eckkrammer F.  , Wahl H.
Published: February 2025

Integrating extramural measured devices data into medical information systems is becoming more and more attractive for integrated medical care. A lot of devices already have the ability to transfer measured data to mobile devices or computers and a few systems offer submitting data to a centralized information database or information system. Unfortunately, all of these devices use proprietary protocols and processes which makes integration into other systems a major problem. To address this problem the Healthy Interoperability project has been created with the objective of creating a framework for transferring health data based on international standards. The paper outlines how the framework architecture takes full advantage from the definitions of the international standards ISO 11073, HL7, IHE and CEN 13606. Even the definition of the user profiles and the security framework is based on standards from ETSI, ISO and CEN. By using these standards the framework can also perfectly be used for intramural communication.
Earnings in E-learning: Knowledge, CME credits or both? Hints from Analysis of Attendance Dynamics and Users' Behaviour
Authors: Mazzoleni M. Cristina  , Rognoni Carla  , Finozzi Enrico  , Landro Mauro  , Capodaglio Edda  , Imbriani Marcello  , Giorgi Ines
Published: February 2025

Many papers report and convey positive opinion about the use of e-learning in the healthcare sector. The issue is how to exploit at best such a powerful instrument. Starting from data regarding the usage of a CME e-learning course, attendance dynamics and users' behaviour have been inspected with the aim of getting some hints about how to improve the development and the delivery of e-learning courses for CME, and to promote knowledge acquisition at best. The different paths followed by 7811 users have been modeled, from enrolment to conclusion/drop-out, then the behaviour in terms of effort, elapsed time, achieved result have been analyzed. The obtained results point out: good acceptance (retention rate 83%) of a not basic educational model and effectiveness (success rate 79%). At the same time the inspection of behaviour has shown that there is a good margin of possible improvement in terms of knowledge acquisition. Conclusions provide a list of issues to keep in mind during system development, in order to provide CME e-learning meeting both credit and knowledge acquisition goals.
eBug – teaching children hygiene principles using educational games
Authors: Kostkova Patty  , Farrell David  , de Quincey Ed  , Weinberg Julius  , Lecky Donna  , McNulty Cliodna
Published: February 2025

Technology enhanced education has been recently established as a new approach for all stages of education. However, among these new IT media it is computer games playing the central role in delivering education in particular to children and teenagers, however, real world sound evaluation is often given little attention. The EU funded e-Bug project developed web games aimed at children to teach basic principles of prudent antibiotics use, hand and respiratory hygiene and aims to reinforces an awareness of microbes, hand and respiratory hygiene among junior and senior school children in 10 countries in Europe. An educational pack implemented in schools across Europe is complemented by Internet web games for two age groups teaching a set of learning objectives (LOs) using a fast and interactive platform game design for junior children and investigate detective games based on PBL principles for senior children. In this paper, we present the design of e-Bug junior and senior games and evaluation results.
Informatics and Evidence-Based Medicine: Prescription for Success
Authors: Starmer John M.  , Wright Pinson C.  , Lorenzi Nancy M.
Published: February 2025

This article reports on the experience of one organization between 2004 and 2009 to develop an effective people-process-technology system to better manage the quality of health care. The creation of this system started with creating a strategic plan for quality and then establishing a structure to implement the plan. The next phase consisted of establishing a number of simultaneous steps that ranged from identifying and leveraging the appropriate informatics tools to the oversight process, and from the implementation team to strategies for working with clinical groups. The outcome as of 2009 is a well established evidence-based quality process and team in place. There are over 450 evidence-based medicine quality sets. More than 52% of all patients are admitted on quality evidence-based medicine pathways and protocols. This article reflects a successful prescription for combining informatics and evidence-based medicine to improve the quality of health care.
Ghost Charts and Shadow Records: Implication for System Design
Authors: Balka Ellen
Published: February 2025

Ghost charts, sometimes referred to as shadow charts, are duplicate medical records. Governance documents in several countries suggest that ghost charts present a risk to patient safety, to the extent that they contain information which may not appear in an official hospital record. Although most would agree ghost charts should not exist, their existence is widespread. This paper reports on an in depth multi-method qualitative study of ghost charts undertaken in two ambulatory care settings in a Canadian hospital. The study was undertaken in order to inform the design and implementation of a clinical information system which it is hoped will eliminate the need for duplicate charts. Our research demonstrated that ghost charts filled a variety of needs only some of which are typically accounted for in electronic record design. We suggest that if the functions ghost charts fill are not addressed, their existence will persist. This work is significant in that few studies of ghost charts have been undertaken, and in the in-depth understanding it contributes to design requirements for electronic record systems.
The Information Quality Triangle: A methodology to assess Clinical Information quality
Authors: Choquet Rémy  , Qouiyd Samiha  , Ouagne David  , Pasche Emilie  , Daniel Christel  , Boussaïd Omar  , Jaulent Marie-Christine
Published: February 2025

Building qualitative clinical decision support or monitoring based on information stored in clinical information (or EHR) systems cannot be done without assessing and controlling information quality. Numerous works have introduced methods and measures to qualify and enhance data, information models and terminologies quality. This paper introduces an approach based on an Information Quality Triangle that aims at providing a generic framework to help in characterizing quality measures and methods in the context of the integration of EHR data in a clinical datawarehouse. We have successfully experimented the proposed approach at the HEGP hospital in France, as part of the DebugIT EU FP7 project.
Combining Relevance Assignment with Quality of the Evidence to Support Guideline Development
Authors: Fiszman Marcelo  , Bray Bruce E.  , Shin Dongwook  , Kilicoglu Halil  , Bennett Glen C.  , Bodenreider Olivier  , Rindflesch Thomas C.
Published: February 2025

Clinical practice guidelines are used to disseminate best practice to clinicians. Successful guidelines depend on literature that is both relevant to the questions posed and based on high quality research in accordance with evidence-based medicine. Meeting these standards requires extensive manual review. We describe a system that combines symbolic semantic processing with a statistical method for selecting both relevant and high quality studies. We focused on a cardiovascular risk factor guideline, and the overall performance of the system was 56% recall, 91% precision (F0.5-score 0.81). If quality of the evidence is not taken into account, performance drops to 62% recall, 79% precision (F0.5-score 0.75). We suggest that this system can potentially improve the efficiency of the literature review process in guideline development.
A system for solution-orientated reporting of errors associated with the extraction of routinely collected clinical data for research and quality improvement
Authors: Michalakidis Georgios  , Kumarapeli Pushpa  , Ring Andre  , van Vlymen Jeremy  , Krause Paul  , de Lusignan Simon
Published: February 2025

Background: We have used routinely collected clinical data in epidemiological and quality improvement research for over 10 years. We extract, pseudonymise and link data from heterogeneous distributed databases; inevitably encountering errors and problems. Objective: To develop a solution-orientated system of error reporting which enables appropriate corrective action. Method: Review of the 94 errors, which occurred in 2008/9. Previously we had described failures in terms of the data missing from our response files; however this provided little information about causation. We therefore developed a taxonomy based on the IT component limiting data extraction. Results: Our final taxonomy categorised errors as: (A) Data extraction Method and Process; (B) Translation Layer and Proxy Specification; (C) Shape and Complexity of the Original Schema; (D) Communication and System (mainly Software-based) Faults; (E) Hardware and Infrastructure; (F) Generic/Uncategorised and/or Human Errors. We found 79 distinct errors among the 94 reported; and the categories were generally predictive of the time needed to develop fixes. Conclusions: A systematic approach to errors and linking them to problem solving has improved project efficiency and enabled us to better predict any associated delays.
Why is it so difficult to measure the effects of interruptions in healthcare?
Authors: Magrabi Farah  , Li Simon Y.W.  , Dunn Adam G.  , Coiera Enrico
Published: February 2025

Interruptions are a complex phenomenon where multiple variables including the characteristics of primary tasks, the interruptions themselves, and the environment may influence patient safety and workflow outcomes. Observational studies present significant challenges for recording many of the process variables that influence the effects of interruptions. Controlled experiments provide an opportunity to examine the specific effects of variables on errors and efficiency. Computational models can be used to identify the situations in which interruptions to clinical tasks could be disruptive and to investigate the aggregate effects of interruptions.
Optimizing Medication Reminders Using a Decision-Theoretic Framework
Authors: Pavel Misha  , Jimison Holly  , Hayes Tamara  , Larimer Nicole  , Hagler Stuart  , Vimegnon Yves  , Leen Todd  , Ozertem Umut
Published: February 2025

We discuss a new approach to patients' adherence to enhance to their medication-taking regimen by developing a context-aware alerting system that would optimize the expected utility of alerts. Each patient's instantaneous context is assessed using a real-time sensor network deploying a variety of sensors. The alerts are generated to optimize the expected value to the patient. This paper is focused on the initial assessment of the utility of alerts, including the tradeoff between effectiveness and annoyance.
Measurement of the Utilization of an Installed Electronic Health Record
Authors: Dullabh Prashila  , Moiduddin Adil  , Babalola Elizabeth
Published: February 2025

For the past decade, adoption of electronic health records (EHRs) has been proposed as one of the most viable approaches to improving the United States health care system [1]. Although there is evidence that EHR adoption is slowly progressing, current methods of assessing adoption have yielded significant variance in estimates of EHR utilization. We conducted an environmental scan consisting of a review of the literature as well as a series of discussions with health center and health center network representatives and experts in the field to understand the current state of EHR adoption and use in the United States and assess the feasibility of developing a systematic approach to tracking EHR usage.
Feature importance analysis for patient management decisions
Authors: Valko Michal  , Hauskrecht Milos
Published: February 2025

The objective of this paper is to understand what characteristics and features of clinical data influence physician's decision about ordering laboratory tests or prescribing medications the most. We conduct our analysis on data and decisions extracted from electronic health records of 4486 post-surgical cardiac patients. The summary statistics for 335 different lab order decisions and 407 medication decisions are reported. We show that in many cases, physician's lab-order and medication decisions are predicted well by simple patterns such as last value of a single test result, time since a certain lab test was ordered or time since certain procedure was executed.
Deployment of a Highly Secure Clinical Data Repository in an Insecure International Environment
Authors: Feldman Henry  , Reti Shane  , Kaldany Eli  , Safran Charles
Published: February 2025

We have designed and deployed a novel approach to protecting Personal Healthcare Information in environments where a data center is remote and its physical security cannot be assured. Our “KeyServer” methodology uses a server-client-server architecture to dynamically serve keys from a distant server in a separate secure data center in the US. The approach combines pre-existing and novel techniques into a layered protective barrier around compromise of patient data. We describe how this technology provides scalable security that makes security breaches highly unlikely. With some careful planning a Clinical Data Repositories fed by Electronic Health Records can be placed in relatively insecure settings, with a high-level of security surrounding data theft, even in the event of hardware theft. Such security architecture is ideal for not only developing nations, but for the evolution of health information to cloud computing platforms.
Complexities in securing sustainable IT infrastructures in Hospitals: The many faces of Local Technical Support
Authors: Petersen Lone Stub
Published: February 2025

This paper contributes to an understanding of the complexity of support work and stress the need for local technical support in hospitals in order to maintain a sustainable infrastructure of information systems (IS) and information technology (IT). Given this complexity it is pointed out that a naïve trust in formal stylized models of support organization is problematic. With an increasing number of critical systems in the hospitals technical support is becoming an essential service needed for maintenance, acute failure of systems and help with the everyday use of hardware and software. In order for the health informatics technologies and systems to work, the healthcare institutions need strong IT organizations to support and maintain the IS/IT infrastructure on which these technologies and systems rely. Through a qualitative study of IS/IT support at hospitals I have examined the work and competencies of the service level in the IT organization. On this basis I recommend a nuanced understanding of the complexity of the work of these local technical supporters. I contrast this to the understanding of the organization of IT support through rationalized, formal ‘best practice’ models that emphasize centralization and cost-effectiveness through single point of contact. It is argued that there is a need for local technical supporters in hospitals with organizational and local knowledge because a) the local circumstances are key to supplying effective support and b) the supporter supply pro-active support that aid to secure the sustainability of the IT infrastructure.
Ensuring HL7-based information model requirements within an ontology framework
Authors: Ouagne David  , Nadah Nadia  , Schober Daniel  , Choquet Rémy  , Teodoro Douglas  , Colaert Dirk  , Schulz Stefan  , Jaulent Marie-Christine  , Daniel Christel
Published: February 2025

This paper describes the building of an HL7-based Information Model Ontology (IMO) that can be exploited by a domain ontology in order to distribute querying over different clinical data repositories. We employed the Open Medical Development Framework (OMDF) based on a model driven development methodology. OMDF provides model transformation features to build an HL7-based information model that covers the conceptual scope of a target project. The resulting IMO is used to mediate between ontologically queries and information retrieval from semantically less defined Hospital Information Systems (HIS). In the context of the DebugIT project - which scope corresponds to the control of infectious diseases and antimicrobial resistances – Information Model Ontology is integrated to the DebugIT domain ontology in order to express queries.
Exploring Relations among Semantic Groups: A Comparison of Concept Co-occurrence in Biomedical Sources
Authors: Kandula Sasikiran  , Zeng-Treitler Qing
Published: February 2025

It has been observed and reported that the patient's mental model of the medical domain is different from that of a health professional and this difference is one of the primary obstacle in the effective communication of health information to patients. In this study, to better understand these mental models, we explored the relations among different semantic groups of concepts in consumer- and professional-generated health content by analyzing concept co-occurr information in three biomedical sources. We found significant differences in the prevalence of the semantic groups and the strength of co-occurrences between semantic groups in the three sources. The co-occurrence defined by consumers differs from that defined by professionals. The two professional sources have noticeable differences with each other as well. We believe that addressing these differences can help us generate more informative and consumer-friendly health content as well as develop better consumer health informatics applications.
Research on Reasoning Mechanism of Emergency Rescue Decision Support System of Geo-Hazards under the Conditions of Extreme Snow and Ice Disasters
Authors: Zou Liangchao  , Wang Shimei  , Huang Haifeng
Published: February 2025

A quick and effective emergency rescue of geo-hazards under the conditions of extreme snow and ice disasters relies heavily on information technology tools, particularly decision support system; as the core content of decision support system, reasoning mechanism is significant because it directly determined the decision efficiency of the system and the accuracy of decision results. According to the characteristics of decision of geo-hazards emergency rescue, a rule-based (RBR) and case-based (CBR) hybrid reasoning mechanism is introduced into the emergency rescue decision support system of geo-hazards under the conditions of extreme snow and ice disasters (ERDSS-GHESID). The reasoning mechanism of ERDSS-GHESID is designed by the object-oriented programming method. It is showed that RBR and CBR hybrid reasoning mechanism can better simulate the inference procedure of human experts in the process of emergency rescue decision of geo-hazards under the conditions of extreme snow and ice disasters, showing a high practical value in the ERDSS-GHESID.
Diagnosis of Ginza Line Subway Tunnel, the Oldest in Asia, by Acquiring Data on Deterioration Indices
Authors: Yamamoto Tsutomu  , Matsukawa Shunsuke  , Hisawa Haruo
Published: February 2025

The Ginza Line subway tunnel was opened for service in 1927. A large amount of data on various deterioration indices was acquired. This report describes the results of the diagnoses by utilizing these data. The results of the visual inspection, strength test, and structural analysis indicated the tunnel proved highly satisfactory in terms of load bearing capacity. As regards the durability, the tunnel was almost free of progressive corrosion because of limited water supply if there was no water leakage. Our projection of the progress of deterioration confirmed that there was no possibility of reinforcement corrosion and resultant cracks even 140 years later. Maintenance and repair work, including leak repair and recovery patching, will be implemented for those sections around water-leaking locations where the water content was high and thus the possibility of corrosion was high. We think that it is extremely significant that the maintenance and repair policy could be clearly defined on the basis of quantitative evaluation by acquiring deterioration index data.
The STREAM's Testdefinition Facilitates Type of Test Independent Database Storage
Authors: Schaminée Paul E.L.  , Klapwijk Ardt A.
Published: February 2025

Results of many different types of physical experiments have to be stored. To facilitate efficient archiving and exchange of test results a new method, STREAM, has been developed. This paper describes a database that utilizes the characteristics of STREAM, in order to create a flexible, robust and incorruptible tool to store data from a broad range of geotechnical experiments. The result is a type of test independent database. All information stored in the database is checked to be correct and complete. The principle structure of the database is a searchable set of both general metadata as type of test specific metadata to identify, to query and to select the data file. Using STREAM's standardized data description, this type of database is ‘prepared’ to accept any new type of test with corresponding data files, without specific programming. The described storage process is unique in its kind and currently operational at Deltares.
Using Qualitative Reasoning for a Recommender System
Authors: Roselló Llorenç  , Sánchez Mónica  , Agell Núria  , Prats Francesc
Published: February 2025

This paper presents the foundation for a new methodology for a collaborative recommender system (RS). This methodology is based on the degree of consensus of a group of users stating their preferences via qualitative orders-of-magnitude. The structure of distributive lattice is considered in defining the distance between users and the RSs new users. This proposed methodology incorporates incomplete or partial knowledge into the recommendation process using qualitative reasoning techniques to obtain consensus of its users for recommendations.
The Design of Electronic Service Process Using YAWL and CPN Tools
Authors: Stipravietis Peteris  , Ziema Maris
Published: February 2025

The article discusses the solution of common business process design-time problems using YAWL. The approach proposed by the authors is based on the creation of business process in the YAWL environment in order to simulate the process model which could resolve some of the design-time problems as well as provide hints to correct initial process. Simulation is based on transformation to colored Petri net – the net is then simulated to identify problems such as possible infinite loops, bottlenecks, process waits and others. The article also describes technique to acquire the primitive description of process from the YAWL workflow. The primitive description is represented as oriented graph and is used to transform the YAWL workflow to another hierarchic language, in this case BPEL.
Virtual Arthroscopy Trainer for Minimally Invasive Surgery
Authors: Hurmusiadis Vassilios  , Rhode Kawal  , Schaeffter Tobias  , Sherman Kevin
Published: February 2025

The presented work introduces an innovative technology solution to a major challenge in minimally invasive surgical training. It is focused on the development of a low-cost, real-time simulation of arthroscopy accessible online via the web. The aim is to enable users to develop their cognitive skills and to comprehend the disorientating images seen through arthroscopes. The simulation is incorporated into a software training tool that provides virtual arthroscopy and e-learning and assessment.
Real-Time Electrocautery Simulation for Laparoscopic Surgical Environments
Authors: Lu Zhonghua  , Arikatla Venkata Sreekanth  , Chen Dingfang  , De Suvranu
Published: February 2025

We present a novel real-time technique for cutting during electrocautery procedures in surgical training. Our algorithm is based on cauterizing the part of the tissue that exceeds the critical vaporization temperature. The resulting topology changes due to cutting are accounted for in real-time. Results presented for the overall electrocautery cutting algorithm show that the real-time costs are minimal and thus allow interactive simulation.
Modeling Surgical Skill Learning with Cognitive Simulation
Authors: Park Shi-Hyun  , Suh Irene H.  , Chien Jung-hung  , Paik Jaehyon  , Ritter Frank E.  , Oleynikov Dmitry  , Siu Ka-Chun
Published: February 2025

We used a cognitive architecture (ACT-R) to explore the procedural learning of surgical tasks and then to understand the process of perceptual motor learning and skill decay in surgical skill performance. The ACT-R cognitive model simulates declarative memory processes during motor learning. In this ongoing study, four surgical tasks (bimanual carrying, peg transfer, needle passing, and suture tying) were performed using the da Vinci©surgical system. Preliminary results revealed that an ACT-R model produced similar learning effects. Cognitive simulation can be used to demonstrate and optimize the perceptual motor learning and skill decay in surgical skill training.
Virtual Reality Stroop Task for Neurocognitive Assessment
Authors: Parsons Thomas D.  , Courtney Christopher G.  , Arizmendi Brian  , Dawson Michael
Published: February 2025

Given the prevalence of traumatic brain injury (TBI), and the fact that many mild TBIs have no external marker of injury, there is a pressing need for innovative assessment technology. The demand for assessment that goes beyond traditional paper-and-pencil testing has resulted in the use of automated cognitive testing for increased precision and efficiency; and the use of virtual environment technology for enhanced ecological validity and increased function-based assessment. To address these issues, a Virtual Reality Stroop Task (VRST) that involves the subject being immersed in a virtual Humvee as Stroop stimuli appear on the windshield was developed. This study is an initial validation of the VRST as an assessment of neurocognitive functioning. When compared to the paper-and-pencil, as well as Automated Neuropsychological Assessment Metrics versions of the Stroop, the VRST appears to have enhanced capacity for providing an indication of a participant's reaction time and ability to inhibit a prepotent response while immersed in a military relevant simulation that presents psychophysiologically arousing high and low threat stimuli.
Stereo Image-Based Arm Tracking for In Vivo Surgical Robotics
Authors: Psota Eric  , Strabala Kyle  , Dumpert Jason  , Pérez Lance C.  , Farritor Shane  , Oleynikov Dmitry
Published: February 2025

Motor-based tracking and image-based tracking are considered for three-dimensional in vivo tracking of the arms of a surgical robot during minimally invasive surgery. Accurate tracking is necessary for tele-medical applications and for the future automation of surgical procedures. An experiment is performed to compare the accuracy of the two methods, and results show that the positioning error of image-based tracking is significantly less than that of motor-based tracking.
NeuroSim – The Prototype of a Neurosurgical Training Simulator
Authors: Beier Florian  , Diederich Stephan  , Schmieder Kirsten  , Männer Reinhard
Published: February 2025

We present NeuroSim, the prototype of a training simulator for open surgical interventions on the human brain. The simulator is based on virtual reality and uses real-time simulation algorithms to interact with models generated from MRT- or CT-datasets. NeuroSim provides a native interface by using a real surgical microscope and original instruments tracked by a combination of inertial measurement units and optical tracking. Conclusively an immersive environment is generated. In a first step the navigation in an open surgery setup as well as the hand-eye coordination through a microscope can be trained. Due to its modular design further training modules and extensions can be integrated. NeuroSim has been developed in cooperation with the neurosurgical clinic of the University of Heidelberg and the VRmagic GmbH in Mannheim.
EEG-based “Serious” Games and Monitoring Tools for Pain Management
Authors: Sourina Olga  , Wang Qiang  , Nguyen Minh Khoa
Published: February 2025

EEG-based “serious games” for medical applications attracted recently more attention from the research community and industry as wireless EEG reading devices became easily available on the market. EEG-based technology has been applied in anesthesiology, psychology, etc. In this paper, we proposed and developed EEG-based “serious” games and doctor's monitoring tools that could be used for pain management. As EEG signal is considered to have a fractal nature, we proposed and develop a novel spatio-temporal fractal based algorithm for brain state quantification. The algorithm is implemented with blobby visualization tools for patient monitoring and in EEG-based “serious” games. Such games could be used by patient even at home convenience for pain management as an alternative to traditional drug treatment.
Clinical Performance of Dental Fiberscope Image Guided System for Endodontic Treatment
Authors: Yamazaki Yasushi  , Ogawa Takumi  , Shigeta Yuko  , Ikawa Tomoko  , Kasama Shintaro  , Hattori Asaki  , Suzuki Naoki  , Yamamoto Takatsugu  , Ozawa Toshiko  , Arai Takashi
Published: February 2025

We developed a dental fiberscope that can be navigated. As a result we are able to better grasp the device position relative to the teeth, aiming at the lesion more precisely. However, the device position and the precise target setting were difficult to consistently ascertain. The aim of this study is to navigate the position of tip of the dental fiberscope fiber in the root canal with our navigation system. A 3D tooth model was made from the raw dental CT data. In addition, the optical position of the measurement device, OPTOTRAK system was used for registration of the 3D model and actual teeth position and to chase the scope movement. We developed exclusive software to unify information. We were subsequently able to precisely indicate the relation of the position between the device and the teeth on the 3D model in the monitor. This allowed us to aim at the lesion more precisely, as the revised endoscopic image matched the 3D model. The application of this endoscopic navigation system could increase the success rate for root canal treatments with recalcitrant lesion.
Scenario-based Stress Testing of an Electronic Patient Record System in a Thin-client Computing Implementation
Authors: Teramoto Kei  , Kuwata Shigeki  , Kushniruk Andre W.  , Borycki Elizabeth M.  , Mochida Masaki  , Fujii Katsuhiro  , Kuranaka Kenta  , Kondoh Hiroshi
Published: February 2025

Implementation of thin-client computing (TCC) generally requires an elaborate process of determining appropriate specifications of the centralized servers (server sizing). This study aimed to assess the usefulness of the server sizing methods with eight scenarios based on practical usage of an electronic patient record. Actual data obtained from a hospital, where TCC was introduced based on the methods of the study, showed that the stress testing of one of server sizing methods contributed to steady operation of the system, while the scenarios should be improved to reflect more practical workflow in real settings to achieve more precise estimation of the centralized server performance in TCC.
e-Health Promises and Challenges: Some Ethical Considerations
Authors: Kluge Eike-Henner W.
Published: February 2025

eHealth is a cost-effective and efficient way of providing health care to patients who would otherwise be excluded or underserviced. However, eHealth also presents a series of ethical and legal challenges which, if not met before its implementation, can undermine its success. Among other things, privacy, consent and liability are implicated, as are changes in the health care professional-patient relationship and in the role of health informatics professionals. Legacy systems and interoperability present further challenges, and outsourcing may pose special problems. This paper highlights some of these issues and outlines their implications.
Developing a Medical Records System at the Ola During Children's Hospital, Freetown, Sierra Leone
Authors: Dawson John  , Clark Matthew  , Peloso Liz
Published: February 2025

The development of a paper based medical record system and the corresponding database at the Ola During Children's Hospital, Freetown, Sierra Leone are described. This project took place within an extremely resource constrained setting, through the partnership of local and international collaborators. The key factors which define the project are incremental progress, the intent to migrate the data to OpenMRS to ensure its sustainability and building local capacity for database management.
Usability Evaluation of a Pilot Implementation of the Electronic Clinical Transfusion Management System IT Specification for Blood Tracking
Authors: Golchin Kamran  , Gooch Philip  , Shabestari Omid  , Roudsari Abdul
Published: February 2025

Safe working practices and patient safety are of critical importance in the administration of blood transfusion. While the use of information technology has been proposed to ensure the safety of this process, the usability of such systems has not previously been studied. We present the results of a usability evaluation of an electronic clinical transfusion management system being piloted by the National Health Service in England. A number of major usability problems were recorded, largely relating to unnecessary action, limiting user control and recovery from user error. Such problems can, however, be resolved by relatively minor changes to system functionality and design.
Occurrence Detection and Selection Procedures in Healthcare Facilities: A Comparison Across Canada and Brazil
Authors: Morita Plinio P.  , Burns Catherine M.
Published: February 2025

Healthcare institutions face high levels of risk on a daily basis. Efforts have been made to address these risks and turn this complex environment into a safer environment for patients, staff, and visitors. However, healthcare institutions need more advanced risk management tools to achieve the safety levels currently seen in other industries. One of these potential tools is occurrence investigation systems. In order to be investigated, occurrences must be detected and selected for investigation, since not all institutions have enough resources to investigate all occurrences. A survey was conducted in healthcare institutions in Canada and Brazil to evaluate currently used risk management tools, the difficulties faced, and the possibilities for improvement. The findings include detectability difficulties, lack of resources, lack of support, and insufficient staff involvement.
Use of Qualitative Methods Across the Software Development Lifecycle in Health Informatics
Authors: Borycki Elizabeth M.  , Househ Mowafa  , Kushniruk Andre W.  , Kuziemsky Craig
Published: February 2025

In this paper the authors review and discuss four different qualitative approaches as they are used to evaluate health information systems: (1) grounded theory, (2) ethnography, (3) verbal protocol analysis/usability engineering and (4) action research. The authors describe the historical origins, current uses, strengths and weakness of the three qualitative methodologies that are frequently used in health informatics and they discuss an emerging approach: action research. More importantly, they identify how each of the approaches can be used across the SDLC to inform planning, analysis, design, implementation and support of health information systems.
Critical Success Factors for Implementing Healthcare e-Learning
Authors: Lee Te-Shu  , Kuo Mu-Hsing  , Borycki Elizabeth M.  , Yunyong David
Published: February 2025

The use of e-Learning in educational institutes has rapidly increased along with the development of information and communication technology (ICT). In healthcare, more medical educators are using e-Learning to support their curriculum design, delivery and evaluation. However, no systematic work exists on characterizing a collective set of Critical Success Factors (CSFs) for implementing e-Learning in the healthcare education institutions. The aim of this paper is to study the CSFs of implementing healthcare e-Learning
Ontologies, Knowledge Representation, Artificial Intelligence – Hype or Prerequisites for International pHealth Interoperability?
Authors: Blobel Bernd
Published: February 2025

Nowadays, eHealth and pHealth solutions have to meet advanced interoperability challenges. Enabling pervasive computing and even autonomic computing, pHealth system architectures cover many domains, scientifically managed by specialized disciplines using their specific ontologies. Therefore, semantic interoperability has to advance from a communication protocol to an ontology coordination challenge including semantic integration, bringing knowledge representation and artificial intelligence on the table. The resulting solutions comprehensively support multi-lingual and multi-jurisdictional environments.
Evaluation of Possibilities in Demographic Data Exchange Support in Czech Healthcare
Authors: Nagy Miroslav  , Seidl Libor  , Zvarova Jana
Published: February 2025

This paper summarizes the evaluation of two standardized approaches to implementation of messages for demographic data exchange between the preventive cardiology outpatient department located at the Institute of Computer Science AS CR, v.v.i. in Prague and the Outpatients Department of Cardiology of Municipal Hospital in Caslav. Our setting consists of four independent systems maintaining different clinical data (scheduling system, hospital information system, EHR system and a digital ECG). The aim is to avoid repetitive patient demographic data entry. We evaluate the suitability of IHE Patient Administration Management Profile (including HL7 v.2.5) and Czech national standard DASTA using Standard Evaluation Framework proposed and published in 2008 by J. Mykkänen et al. Besides the evaluation of standards, we also discuss some aspects of the framework.
The Role of Basic Data Registers in Cross-Border Interconnection of eHealth Solutions
Authors: Kregar Mirjana  , Marčun Tomaž  , Dovžan Irma  , Čehovin Lojzka
Published: February 2025

The increasingly closer international business cooperation in the areas of production, trade, transport and activities such as tourism and education is promoting the mobility of people. This increases the need for the provision of health care services across borders. In order to provide increasingly safer and effective treatment that is of ever higher quality in these cases as well, it is necessary to ensure that data accompanies patients even when they travel to other regions, countries or continents. eHealth solutions are one of the key tools for achieving such objectives. When building these solutions, it is necessary to take into account the different aspects and limitations brought about by the differences in the environments where such a treatment of a patient takes place. In the debates on the various types of cross-border interoperability of eHealth solutions, it is necessary to bring to attention the necessity of suitable management and interconnection of data registers that form the basis of every information system: data on patients, health care service providers and basic code tables. It is necessary to promote well-arranged and quality data in the patient's domestic environment and the best possible options for transferring and using those data in the foreign environment where the patient is receiving medical care at a particular moment. Many of the discussions dealing with conditions for the interoperability of health care information systems actually start with questions of how to ensure the interconnectivity of basic data registers.
Personal Information Protection – Exceptional Challenges of Integrated Systems of eHealth
Authors: Bolka Anka  , Zadel Blaž  , Zorko Martina
Published: February 2025

Informatization has been bringing important, quick and extensive changes into the healthcare environment for years. Individual systems still represent isolated information islands; however, the need for interconnectivity and mutual accessibility has become more pronounced. On the one hand, integration of systems brings numerous, financially measurable advantages, and on the other hand, personal information in such systems becomes more vulnerable. Providing personal information protection is therefore the permanent task of informatisation and, with elimination of national borders and integration of national systems, it is becoming a challenge from the legal, organisational, technical and financial standpoints.
Medication Related Computerized Decision Support System (CDSS): Make it a Clinicians' Partner!
Authors: Marcilly Romaric  , Leroy Nicolas  , Luyckx Michel  , Pelayo Sylvia  , Riccioli Costanza  , Beuscart-Zéphir Marie-Catherine
Published: February 2025

Medication related Computerized Decision Support System (CDSS) are known to have a positive impact on Adverse Drug Events (ADE) prevention but they face acceptance problems due to over alerting and usability issues. We present here a Human factors approach to the design of these Clinical Decision Support (CDS) functions and to their integration into different Electronic Health Record (EHR) / Computerized Physicians Order Entry (CPOE) systems, so that the resulting CDSS corresponds to the users needs and fits clinical workflows and cognitive processes. We used ethnographic observations completed with semi-structured interviews to analyse existing work situations and work processes. These were then described in detail using the SHEL (Software, Hardware, Environment & Liveware) formalism, which enables a structured description of the work system and provides an appropriate classification of human errors potentially leading to ADEs. We then propose a Unified Modelling Language (UML) model supporting the characterization by the CDSS of the drug monitoring and clinical context of patients at risk of ADE. This model combines the status of the lab test orders on the one hand with the validity and normality of the lab results on the other hand. This makes the system able to catch the context of the monitoring of the drugs through their corresponding lab tests and lab results (e.g. kalemia for potassium) and also part of the context of the clinical status of the patient (actual lab values, but also diseases and other pathologies that are identified as potential causes of the ADE e.g. renal insufficiency and potassium). We show that making the system able to catch the monitoring and clinical contexts opens interesting opportunities for the design of the CDS information content and display mode. Implementing this model would allow the CDSS to take into account the actions already engaged by the healthcare team and to adapt the information delivered to the monitoring and clinical context, thus making the CDSS a partner to the clinicians, nurses and pharmacists.
Perceived Stress and Life Satisfaction: Social Network Service Use as a Moderator
Authors: Niu Qikun  , Liu Yihao  , Sheng Zitong  , He Yue  , Shao Xiaolin
Published: February 2025

Social Network Service (SNS) has become a buzzword in recent media coverage with the development of the second generation of Web-based communities. In China, SNS has played an increasingly important role in its users' daily lives, especially among students. With a sample of 471 college students, we tested the direct relationship between perceived stress and life satisfaction using a regression analysis. Moreover, we found SNS use could buffer the negative effect of perceived stress. This study has practical implications on Internet users' SNS use.