bluuebunny/crossref_metadata_2025 huggingface dataset:
The Challenges of Balancing Safety and Security in Implantable Medical Devices
Authors: Katzis Konstantinos  , Jones Richard W.  , Despotou George
Published: February 2025

Modern Implantable Medical Devices (IMDs), implement capabilities that have contributed significantly to patient outcomes, as well as quality of life. The ever increasing connectivity of IMD's does raise security concerns though there are instances where implemented security measures might impact on patient safety. The paper discusses challenges of addressing both of these attributes in parallel.
Collecting Patient Data from Sensor-Based Systems: Benefits and Challenges
Authors: Gashgari Horeya  , Attallah Nora  , Al Muallem Yahya  , Al Dogether Majed  , Al Moammary Eman  , Almeshari Meshari  , Househ Mowafa
Published: February 2025

The purpose of this study is to review the literature on the use of sensor-based technology in the collection of healthcare data from health consumers and/or patients. A literature search was conducted in November 2015 through the PubMed database. A total of 4,800 articles were retrieved using the terms “sensors-based systems in healthcare” and “sensor monitoring in healthcare”. After scanning the articles, and applying the inclusion and exclusion criteria, 10 articles were found relevant and included in the review. This study highlights the benefits and challenges when using sensor-based systems in the collection of health consumer and/or patient information. Some of the benefits in the collection of data are remote monitoring features and the real-time data collection features. Some of the challenges are privacy, security, and sensitivity to technology issues. Future work should evaluate the quality of the research evidence on sensor-based technologies and how such information impacts quality of care.
Reducing Emergency Department Crowding: Evidence Based Strategies
Authors: Khalifa Mohamed  , Zabani Ibrahim
Published: February 2025

Emergency department (ED) crowding has become a major barrier to receiving timely care. King Faisal Specialist Hospital & Research Center, Saudi Arabia worked on identifying evidence based strategies for reducing the ED crowding by improving the intake. In addition to a review of literature, qualitative survey methods were used to identify strategies, which were classified into 10 suggested procedures categorized into three types of changes. Physical improvements include using physician cubicles, creating a team triage area and an internal waiting area for less acute patients instead of occupying beds. Technology improvements; include using informatics to update the electronic emergency record with information, using palmar scanning to instantly identify patients and using radio communication devices. Process improvements; include a scribe program to decrease clerical documentation tasks, switching between low flow and high flow processes, placing a physician in triage and using patient segmentation methods.
A User-Centred Approach to Designing an eTool for Gout Management
Authors: Fernon Anna  , Nguyen Amy  , Baysari Melissa  , Day Richard
Published: February 2025

Introduction: Gout is a chronic inflammatory arthritis with increasing prevalence in Australia and rates of non-adherence to therapy higher than for any other chronic disease. Electronic health interventions can increase adherence to treatment for many chronic diseases. This study set out to involve end-user patients in the design of a gout self-management eTool.
Creating a Regional Healthcare Network: People First
Authors: Michel-Verkerke Margreet B.
Published: February 2025

Care organizations in the Dutch region Apeldoorn want to collaborate more in order to improve the care provision to elderly and psychiatric patients living independently. In order to support the collaboration they intend to create a regional digital healthcare network. The research was focused on the relevance of a regional healthcare network for care providers. Eleven semi-structured interviews based on the USE IT-model, were conducted with care providers and staff members. Results show that care providers need to tune their activities for this target group and create an agreement on integrated care. The relevance of a digital communication and collaboration platform is high. The regional healthcare network should support the collaboration between care providers by: 1. Offering a communication platform to replace the time consuming communication by telephone; 2. Making patient information available for patient and care provider at patients' homes; 3. Giving insight in who is giving what care to whom; and 4. Giving access to knowledge about the target group: elderly and psychiatric patients living independently.
Building a Semantic Model to Enhance the User's Perceived Functionality of the EHR
Authors: Lasierra Nelia  , Schweitzer Marco  , Gorfer Thilo  , Toma Ioan  , Hoerbst Alexander
Published: February 2025

In order to facilitate and increase the usability of Electronic Health Records (EHRs) for healthcare professional's daily work, we have designed a system that enables functional and flexible EHR access, based on the execution of clinical workflows and the composition of Semantic Web Services (SWS). The backbone of this system is based on an ontology. In this paper we present the strategy that we have followed for its design, and an overview of the resulting model. The designed ontology enables to model patient-centred clinical EHR workflows, the involved sequence of tasks and its associated functionality and managed clinical data. This semantic model constitutes also the main pillar for enabling dynamic service selection in our system.
Metadata Repository for Improved Data Sharing and Reuse Based on HL7 FHIR
Authors: Ulrich Hannes  , Kock Ann-Kristin  , Duhm-Harbeck Petra  , Habermann Jens K.  , Ingenerf Josef
Published: February 2025

Unreconciled data structures and formats are a common obstacle to the urgently required sharing and reuse of data within healthcare and medical research. Within the North German Tumor Bank of Colorectal Cancer, clinical and sample data, based on a harmonized data set, is collected and can be pooled by using a hospital-integrated Research Data Management System supporting biobank and study management. Adding further partners who are not using the core data set requires manual adaptations and mapping of data elements. Facing this manual intervention and focusing the reuse of heterogeneous healthcare instance data (value level) and data elements (metadata level), a metadata repository has been developed. The metadata repository is an ISO 11179-3 conformant server application built for annotating and mediating data elements. The implemented architecture includes the translation of metadata information about data elements into the FHIR standard using the FHIR Data Element resource with the ISO 11179 Data Element Extensions. The FHIR-based processing allows exchange of data elements with clinical and research IT systems as well as with other metadata systems. With increasingly annotated and harmonized data elements, data quality and integration can be improved for successfully enabling data analytics and decision support.
Accompanying Depression with FINE – A Smartphone-Based Approach
Authors: Dang Marcel  , Mielke Corinna  , Diehl Alexander  , Haux Reinhold
Published: February 2025

Major depression is the most prevalent mental disorder and one of the main reasons for disability. To be successful in treating depression, it is necessary to have early identification and intervention. Therefore, it is important to design more objective and more efficient depression screening techniques. Such interventions provided by mobile apps shows promise due to their capabilities to support people in their everyday lives. Until very recently, the design of mental health apps that works effectively in the context of diagnostics had not been widely explored. For this reason, we have investigated potentially significant depression-correlated parameters derived from self reports, smartphone usage pattern and sensor data to specify our concept. Following the results of the requirement analysis, we developed the Android app ‘Fine’. A feasibility check with a specific target audience has shown that the app can record most of the selected parameters reliably. It has also shown that the overall concept has been accepted positively with the target audience. Further work is planned to improve the functionalities and to adapt specific needs for depression attendance.
Using Arden Syntax for the Generation of Intelligent Intensive Care Discharge Letters
Authors: Kraus Stefan  , Castellanos Ixchel  , Albermann Matthias  , Schuettler Christina  , Prokosch Hans-Ulrich  , Staudigel Martin  , Toddenroth Dennis
Published: February 2025

Discharge letters are an important means of communication between physicians and nurses from intensive care units and their colleagues from normal wards. The patient data management system (PDMS) used at our local intensive care units provides an export tool to create discharge letters by inserting data items from electronic medical records into predefined templates. Local intensivists criticized the limitations of this tool regarding the identification and the further processing of clinically relevant data items for a flexible creation of discharge letters. As our PDMS supports Arden Syntax, and the demanded functionalities are well within the scope of this standard, we set out to investigate the suitability of Arden Syntax for the generation of discharge letters. To provide an easy-to-understand facility for integrating data items into document templates, we created an Arden Syntax interface function which replaces the names of previously defined variables with their content in a way that permits arbitrary custom formatting by clinical users. Our approach facilitates the creation of flexible text sections by conditional statements, as well as the integration of arbitrary HTML code and dynamically generated graphs. The resulting prototype enables clinical users to apply the full set of Arden Syntax language constructs to identify and process relevant data items in a way that far exceeds the capabilities of the PDMS export tool. The generation of discharge letters is an uncommon area of application for Arden Syntax, considerably differing from its original purpose. However, we found our prototype well suited for this task and plan to evaluate it in clinical production after the next major release change of our PDMS.
CDA Templates – Utilizing the MediCUBE
Authors: Burwitz Martin  , Benedict Martin  , Schlieter Hannes
Published: February 2025

The specification and customization of clinical document types are tasks that need a strong collaboration between domain experts and IT specialists. However, these collaborators are often faced with difficulties due to different interpretation of domain knowledge. Therefore, an adequate method for sharing domain knowledge about documents is necessary. Even though there are some tools that help to define medical document types, there is a lack of approaches that focus on the understandability of the specification for the domain experts. This paper proposes a modeling approach based on the Clinical Document Architecture to address this gap.
Implications of Swedish National Regulatory Framework of the Patient Accessible Electronic Health Record
Authors: Scandurra Isabella  , Lyttkens Leif  , Eklund Benny
Published: February 2025

Online access to your own electronic health record is a controversial issue. In a Swedish county such eHealth service has been in operation since 2012 and it is now being widely deployed in the other counties. This first review presents work regarding current National Regulatory Framework (NRF) related to the public eHealth service Patient Accessible Electronic Health Record (PAEHR) and points out how electable paragraphs have been applied in different counties. Potential implications due to the different decisions made are discussed in terms of patient centricity and health information outcome. In current PAEHR, care providers have assessed differently how to apply the NRF. For the patients, this means that information gathered from the health record may be displayed differently, depending on where, when and why they seek treatment. When a patient visits different care providers such solution may cause confusion and its purpose may go lost. Consequently a revised NRF with less electable paragraphs is recommended, as well as adherence to the next NRF by all county councils.
Health On the Net's 20 Years of Transparent and Reliable Health Information
Authors: Boyer Célia  , Appel Ron D.  , Ball Marion J.  , van Bemmel Jan H.  , Bergmans Jean-Paul  , Carpentier Michel  , Hochstrasser Denis  , Lindberg Donald  , Miller Randolph  , Peterschmitt Jean-Claude  , Safran Charlie  , Thonnet Michèle  , Geissbühler Antoine
Published: February 2025

The Health On the Net Foundation (HON) was born in 1996, during the beginning of the World Wide Web, from a collective decision by health specialists, led by the late Jean-Raoul Scherrer, who anticipated the need for online trustworthy health information. Because the Internet is a free space that everyone shares, a search for quality information is like a shot in the dark: neither will reliably hit their target. Thus, HON was created to promote deployment of useful and reliable online health information, and to enable its appropriate and efficient use. Two decades on, HON is the oldest and most valued quality marker for online health information. The organization has maintained its reputation through dynamic measures, innovative endeavors and dedication to upholding key values and goals. This paper provides an overview of the HON Foundation, and its activities, challenges, and achievements over the years.
How Juries Assess Universal Design in Norwegian Architectural School Competitions
Authors: Houck Leif D.
Published: February 2025

This paper investigates how architectural school competition juries assess Universal Design. The method used is a case study of 18 recent architectural school competitions in Norway. The results show that most competition briefs ask for Universal Designed buildings. In 8 of the 18 cases, Universal Design is mentioned as an assessment criterion. In 11 of the 18 cases, Universal Design is commented on by the juries in the jury reports, but only in 3 of the cases, do the juries assess this aspect consistently on every competition project. The overall impression is that some amount of uncertainty looms concerning how Universal Design should be assessed in the competition stage. Based on the findings, future juries should concentrate on orientation and overview prior to technicalities and details.
Implementing Universal Design Strategies in Municipalities – A Multidisciplinary Approach to Universal Design and Public Health
Authors: Jensen Roger
Published: February 2025

Based on a national program, the regional authorities stimulated each of the 18 municipalities in Telemark 2012–15 to plan and build promenades with universal design. The cooperation between different disciplines was an important factor for good results. The project continues from 2016.
Universal Design and the Smart Home
Authors: Pennick Tim  , Hessey Sue  , Craigie Roland
Published: February 2025

The related concepts of Universal Design, Inclusive Design, and Design For All, all recognise that no one solution will fit the requirements of every possible user. This paper considers the extent to which current developments in smart home technology can help to reduce the numbers of users for whom mainstream technology is not sufficiently inclusive, proposing a flexible approach to user interface (UI) implementation focussed on the capabilities of the user. This implies development of the concepts underlying Universal Design to include the development of a flexible inclusive support infrastructure, servicing the requirements of individual users and their personalised user interface devices.
Existential Design Applied in Universal Design Settings
Authors: Torkildsby Anne Britt
Published: February 2025

The critical design method aims to discuss ways of opening up the (design) brief when planning, designing, building, operating and maintaining the future of the built environment – public as well as private, indoor as well as outdoor. Focusing on “designials” (fundamental forms of design being), the methodology intends to illustrate the fact that objects; including buildings, parks, transportation systems, etc. may directly encroach upon certain “existentials” (fundamental forms of human being) – thus shed light on how a design process is normally conducted, and furthermore, how that affects people's existential well-being.
Functioning and Challenges in Equality and Accessibility Among People with Short Stature
Authors: Pesola Kirsti  , Anttila Heidi  , Mäkitie Outi  , Leppäjoki Sanna  , Hiekkala Sinikka
Published: February 2025

Accessibility is not the same for all of us. This study concerns people with short stature, their functioning and challenges in equality and accessibility in our environment based on average measures.
Qualitative Description of Spatial Quality in Inclusive Architecture
Authors: Ryhl Camilla  , Kajita Masashi  , Sørensen René
Published: February 2025

Universal design (UD) has gained global significance and is in the process of institutionalisation in the Nordic Region. This is despite an urgent necessity for developing the theoretical basis and practical applicability of UD. Reflecting this need for furthering the comprehensive understanding of spatial implication of UD, this paper aims to contribute for articulating a means to assess the quality of UD in architecture. Drawing upon numerous cases from research conducted at the Danish Building Research Institute, the paper focuses on sensory aspects of spatial quality, and discusses as well as reflects an applied method for producing the qualitative description of selected buildings that embody UD through creative solutions. The qualitative description of collected examples appears to be effective in delineating sensory aspects of spatial experience; however the systematic development of assessment criteria is essential in order to support students and designers to make responsible decisions in shaping built environments that are accessible and inclusive but also enjoyable.
Emergency Data Management – Overcoming (Information) Borders
Authors: Born Judith  , Albert Jürgen  , Borycki Elizabeth M.  , Butz Norbert  , Ho Kendall  , Koczerginski Josh  , Kushniruk Andre W.  , Schenkel Johannes  , Juhra Christian
Published: February 2025

Background: In order to improve access to critical patient data in case of emergency, many countries have begun or intend to implement emergency datasets. In Germany, the German Medical Association developed a medical emergency dataset (MED), which provides the possibility to store information on prior diagnoses, medications, allergies and other emergency-relevant information on the German Electronic Health Card.
The Same Language Speak We Do – Consensus Terminology for Telehealth
Authors: Scott Richard E.  , Mars Maurice
Published: February 2025

e-Health has grown to become interjurisdictional in scope and in practice. Central to successful implementation and scaling of e-heath solutions is clear and concise communication of ideas and principles, and instructions during construction. This paper addresses the need for an agreed taxonomy and terminology and focuses on explaining, proposing, and recommending terms and action for an international consensus-based terminology for telehealth.
Nursing Informatics Competencies for Entry to Practice: The Perspective of Six Countries
Authors: Honey Michelle L.L.  , Skiba Diane J.  , Procter Paula  , Foster Joanne  , Kouri Pirkko  , Nagle Lynn M.
Published: February 2025

Internationally, countries are challenged to prepare nurses for a future that has ever increasing use of technology and where information management is a central part of professional nursing practice. There has been a growing trend to move nursing to competency-based education, especially for those students undertaking their first nursing qualification. This first nursing qualification may be linked to pre-registration, pre-licensure or undergraduate education; the term used depending on the country. The authors are drawn from the International Medical Informatics Association special interest group, Nursing Informatics (IMIA-NI) Education Working Group and represent New Zealand, the United States of America, England, Australia, Finland and Canada.
Information Exchange Between Providers During Transitions of Surgical Care: Communication, Documentation and Sometimes Both
Authors: Slager Stacey  , Beckstrom Julie  , Weir Charlene  , Del Fiol Guilherme  , Brooke Benjamin S.
Published: February 2025

Poor communication of health information between healthcare providers is associated with over 80% of medical errors that occur during transitions of care [1]. We interviewed a diverse sample of primary care providers and surgical providers during their patient's transitions of care before and after surgery at a Veteran's Health Administration hospital and a large tertiary academic medical center to understand how providers communicate and exchange health information for medically complex older patient across different care settings. Our objective was to identify factors that lead to poor communication as well as strategies to optimize provider-provider communication. This paper highlights the methods providers use to communicate and document health information within two separate electronic medical record (EMR) systems during transition of care and presents a conceptual diagram of how information exchange occurs within these two EMR systems.
Model-Driven Paediatric Cardiomyopathy Pathways – A Clinical Impact Assessment
Authors: Stroetmann Karl A.  , Thiel Rainer
Published: February 2025

Intermediate results from an ongoing health technology assessment exercise of a simulation model of paediatric cardiomyopathy are reported. Comprehensive data on paediatric cardiomyopathy/heart failure, treatment options, incidence and prevalence, prognoses for different outcomes to be expected were collected. Based on this knowledge, a detailed clinical pathway model was developed and validated against the clinical workflow in a tertiary paediatric care hospital. It combines three disease stages and various treatment options with estimates of the probabilities of a child moving from one stage to another. To reflect the complexity of initial decision taking by clinicians, a three-stage Markov model was combined with a decision tree approach – a Markov decision process. A Markov Chain simulation tool was applied to compare estimates of transition probabilities and cost data of present standard of care treatment options for a cohort of children over ten years with expected improvements from using a clinical decision support tool based on the disease model under development. Early results indicate a slight increase of overall costs resulting from the extra cost of using such a tool in spite of some savings to be expected from improved care. However, the intangible benefits in life years saved of severely ill children and the improvement in QoL to be expected for moderately ill ones should more than compensate for this.
Technology-Induced Errors and Adverse Event Reporting in an Organizational Learning Perspective
Authors: Vinther Line Dausel  , Jensen Christian Møller  , Hjel-Mager Ditte Meulengracht  , Lyhne Nicoline  , Nøhr Christian
Published: February 2025

This paper addresses the possibilities of evaluating technology-induced errors, through the utilization of experiences of the Danish adverse event reporting system. The learning loop in the adverse event reporting system is identified and analyzed, to examine which elements can be utilized to evaluate technologies. The empirical data was collected through interviews and a workshop with members of the nursing staff at a nursing home in Aalborg, Denmark. It was found that, the establishment of sustainable feedback learning loops depends on shared visions in the organization and how creating shared visions requires involvement and participation. Secondly, care workers must possess fundamental knowledge about the technologies available to them. Thirdly comprehensive classification of adverse events should be established to allow for a systematic and goal directed feed-back process.
Multi-EMR Structured Data Entry Form: User-Acceptance Testing of a Prototype
Authors: Zavar Abbas  , Keshavjee Karim
Published: February 2025

Capturing standardized data from multiple EMRs at the point of care is highly desirable for a variety of uses, including quality improvement programs, multi-centered clinical trials and clinical decision support. In this paper, we describe the design, development and user acceptance testing of a prototype web-based form (the Form) that can integrate with multiple EMRs. We used the validated UTAUT questionnaire to assess the likelihood of uptake of the Form into clinical practice. The Form was found to be easy to use, elicits low anxiety, supports productivity and is perceived to have good support. Users would benefit from training and from better social signaling about the importance of using the Form in their practice. Making the Form more fun and interesting could help increase uptake.
Using Medical Informatics to Improve Clinical Trial Operations
Authors: Eisenstein Eric L.  , Nordo Amy Harris  , Zozus Meredith Nahm
Published: February 2025

The continued escalation of clinical trial costs is becoming a public health concern. During the past decade, medical research funding peaked and there is growing concern that there may be insufficient resources to test many promising medical products. Recent changes in the regulatory environment create opportunities for the use of medical informatics to improve clinical trial operations and reduce costs. We report on a Medical Informatics Europe 2016 workshop conducted during the Health – Exploring Complexity (HEC) 2016 conference. We review presentation given on Secondary Data Use, eSource, and Data Quality in Clinical Trials and report on the workshop's discussions.
Informative Observation in Health Data: Association of Past Level and Trend with Time to Next Measurement
Authors: Sperrin Matthew  , Petherick Emily  , Badrick Ellena
Published: February 2025

In routine health data, risk factors and biomarkers are typically measured irregularly in time, with the frequency of their measurement depending on a range of factors – for example, sicker patients are measured more often. This is termed informative observation. Failure to account for this in subsequent modelling can lead to bias. Here, we illustrate this issue using body mass index measurements taken on patients with type 2 diabetes in Salford, UK. We modelled the observation process (time to next measurement) as a recurrent event Cox model, and studied whether previous measurements in BMI, and trends in the BMI, were associated with changes in the frequency of measurement. Interestingly, we found that increasing BMI led to a lower propensity for future measurements. More broadly, this illustrates the need and opportunity to develop and apply models that account for, and exploit, informative observation.
Global eHealth, Social Business and Citizen Engagement
Authors: Liaw Siaw-Teng  , Ashraf Mahfuz  , Ray Pradeep
Published: February 2025

The UNSW WHO Collaborating Centre (WHOCC) in eHealth was established in 2013. Its designated activities are: mHealth and evidence-based evaluation, including use case analyses. The UNSW Yunus Social Business Health Hub (YSBHH), established in 2015 to build on the Yunus Centre/Grameen Bank eHealth initiatives, added social business and community participation dimensions to the UNSW global eHealth program. The Grameen Bank is a social business built around microcredit, which are small loans to poor people to enable them to “produce something, sell something, earn something to develop self-reliance and a life of dignity”. The vision revolves around global partnerships for development, Millennium Development Goals (MDGs) and Sustainable Development Goals (SDGs). The scope includes mHealth implementation and evaluation in the context of the Internet of Things (IoT), with a growing focus on social business and citizen engagement approaches. This paper summarises a critical case study of the UNSW WHOCC (eHealth) designated activities in collaboration with Bangladesh institutions (International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDRB) and Yunus Centre). Issues and challenges are highlighted.
Project PEACH at UCLH: Student Projects in Healthcare Computing
Authors: Ramachandran Navin  , Mohamedally Dean  , Taylor Paul
Published: February 2025

A collaboration between clinicians at UCLH and the Dept of Computer Science at UCL is giving students of computer science the opportunity to undertake real healthcare computing projects as part of their education. This is enabling the creation of a significant research computing platform within the Trust, based on open source components and hosted in the cloud, while providing a large group of students with experience of the specific challenges of health IT.
Facilitators and Barriers of Electronic Health Record Patient Portal Adoption by Older Adults: A Literature Study
Authors: Wildenbos Gaby Anne  , Peute Linda  , Jaspers Monique
Published: February 2025

Patient portal usage by older adults, patients aged 50 years old and above, is intended to improve their access and quality of care. Acceptance of patient portals by this target group is low. This paper discusses the results of a literature review to determine the facilitators and barriers that drive or inhibit older patients to adopt patient portals. Articles were included when they described an acceptance, adoption or usability evaluation study of a patient portal. From a total of 245 potentially relevant articles, 8 articles were finally included. We used the Unified Theory of Acceptance and Use of Technology (UTAUT) as a classification model to analyze factors influencing older adults' acceptance of patient portals. Main facilitators for acceptance were ‘performance expectancy’ and ‘voluntariness of use’ related to a higher level of education and experienced health. Main barriers were limited health literacy and motivation related to involuntariness to use a patient portal. Poor facilitation conditions (limited technology access and no prior knowledge on existence of a patient portal) hampered access to a portal. More thorough insight into the latter is needed to improve the reach and effectiveness of patient portals among older patients.
Design, Implementation and Operation of a Reading Center Platform for Clinical Studies
Authors: Clin Lucien  , Leitritz Martin A.  , Dietter Johannes  , Dynowski Marek  , Burgert Oliver  , Ueffing Marius  , Thies Christian
Published: February 2025

Clinical reading centers provide expertise for consistent, centralized analysis of medical data gathered in a distributed context. Accordingly, appropriate software solutions are required for the involved communication and data management processes. In this work, an analysis of general requirements and essential architectural and software design considerations for reading center information systems is provided. The identified patterns have been applied to the implementation of the reading center platform which is currently operated at the Center of Ophthalmology of the University Hospital of Tübingen.
Use and Adaptation of Open Source Software for Capacity Building to Strengthen Health Research in Low- and Middle-Income Countries
Authors: Hochwarter Stefan  , Atkins Salla  , Diwan Vinod K.  , Zary Nabil
Published: February 2025

Health research capacity strengthening is of importance to reach health goals. The ARCADE projects' aim was to strengthen health research across Africa and Asia using innovative educational technologies. In the four years of the EU funded projects, challenges also of technical nature were identified. This article reports on a study conducted within the ARCADE projects. The study focused on addressing challenges of video conferencing in resource constrained settings and was conducted using action research. As a result, a plugin for the open source video conferencing system minisip was implemented and evaluated. The study showed that both the audio and video streams could be improved by the introduced plugin, which addressed one technical challenge.
Designing an E-Learning Platform for Postoperative Arthroplasty Adverse Events
Authors: Krumsvik Ole Andreas  , Babic Ankica
Published: February 2025

This paper presents a mobile software application development for e-learning based on the adverse events data within the field of arthroplasty. The application aims at providing a learning platform for physicians, patients, and medical students. Design of user interface aims to meet requirements of several user groups concerned with the adverse events of the knee and hip implants. Besides the clinical patient data, the platform wants to include even electronic patient data as a result of self-monitoring. Two different modules were created, one for medical staff and one for patients, both divided into the knee and hip areas. Knowledge is represented in forms of statistics, treatment options, and detailed, actual adverse event reports. Patients are given a choice of recommendation for two main situations: ‘about your diagnosis’, and ‘what if you get a problem’ as advice and guidance during the postoperative rehabilitation. Expert evaluation resulted in acceptance of the concept and provided feedback ideas. The patient evaluation has also been positive. Implementation will mean that a high-fidelity prototype will be developed and tested in larger user groups (medical staff, patients).
Web Validation Service for Ensuring Adherence to the DICOM Standard
Authors: Silva Jorge Miguel  , Marques Godinho Tiago  , Silva David  , Costa Carlos
Published: February 2025

The DICOM Standard has been fundamental for ensuring the interoperability of Picture Archive and Communications Systems (PACS). By compiling rigorously to the standard, medical imaging equipment and applications from different vendors can share their data, and create integrated workflows which contributes to better quality healthcare services. However, DICOM is a complex, flexible and very extensive standard. Thus, it is difficult to attest the conformity of data structures produced by DICOM applications resulting in unexpected behaviors, errors and malfunctions. Those situations may be critical for regular PACS operation, resulting in serious losses to the healthcare enterprise. Therefore, it is of paramount importance that application vendors and PACS administrators are confident that their applications follow the standard correctly. In this regard, we propose a method for validating the compliance of PACS application with the DICOM Standard. It can capture the intricate dependency structure of DICOM modules and data elements using a relatively simple description language. The modular nature of our method allows describing each DICOM module, their attributes, and dependencies on a re-usable basis. As a result, our validator is able to encompass the numerous modules present in DICOM, as well as keep up with the emergence of new ones.
Building SNOMED CT Post-Coordinated Expressions from Annotation Groups
Authors: Miñarro-Giménez Jose Antonio  , Martínez-Costa Catalina  , López-García Pablo  , Schulz Stefan
Published: February 2025

SNOMED CT supports post-coordination, a technique to combine clinical concepts to ontologically define more complex concepts. This technique follows the validity restrictions defined in the SNOMED CT Concept Model. Pre-coordinated expressions are compositional expressions already in SNOMED CT, whereas post-coordinated expressions extend its content. In this project we aim to evaluate the suitability of existing pre-coordinated expressions to provide the patterns for composing typical clinical information based on a defined list of sets of interrelated SNOMED CT concepts. The method produces a 9.3% precision and a 95.9% recall. As a consequence, further investigations are needed to develop heuristics for the selection of the most meaningful matched patterns to improve the precision.
Communication of Children Symptoms in Emergency: Classification of the Terminology
Authors: Rochat Jessica  , Siebert Johan  , Galetto Annick  , Lovis Christian  , Ehrler Frédéric
Published: February 2025

The significant part of non-urgent visits to the emergency highlight the necessity to advise people on the actions to take according to their symptoms. Although information sources are accessible through different channels their content often employs medical terminologies that are difficult to understand by laypersons. Our goal is to provide a terminology of the most common symptoms in pediatric emergency adapted to laypersons. This terminology is organized in a hierarchy by the mean of a card-sorting study. The resulting classification separates the symptoms into two main categories: “accident” and “illness” that are subdivided in 9 and 10 sub-categories. The study also revealed that some symptoms were not understood by the participants and had to be reformulated, confirming the importance of user-centered method. The classification resulting from this study will be evaluated through a tree-test.
Discovering Central Practitioners in a Medical Discussion Forum Using Semantic Web Analytics
Authors: Rajabi Enayat  , Abidi Syed Sibte Raza
Published: February 2025

The aim of this paper is to investigate semantic web based methods to enrich and transform a medical discussion forum in order to perform semantics-driven social network analysis. We use the centrality measures as well as semantic similarity metrics to identify the most influential practitioners within a discussion forum. The centrality results of our approach are in line with centrality measures produced by traditional SNA methods, thus validating the applicability of semantic web based methods for SNA, particularly for analyzing social networks for specialized discussion forums.
Towards an Open Infrastructure for Relating Scholarly Assets
Authors: Munro Christopher  , Couch Philip  , Johnson Jon  , Ainsworth John  , Buchan Iain
Published: February 2025

Discovery of useful relationships between scholarly assets on the web is challenging, both in terms generating the right metadata around the assets, and in connecting all relevant digital entities in chain of provenance accessible to the whole community. This paper reports the development of a framework and tools enabling scholarly asset relationships to be expressed in a standard and open way, illustrated with use-cases of discovering new knowledge across cohort studies. The framework uses Research Objects for aggregation, distributed databases for storage, and distributed ledgers for provenance. Our proposal avoids management by a single central platform or organization, instead leveraging the use of existing resources and platforms across natural partnerships. Our proposed infrastructure will support a wide range of users from system administrators to researchers.
An Approach for the Support of Semantic Workflows in Electronic Health Records
Authors: Schweitzer Marco  , Hoerbst Alexander
Published: February 2025

With the unprecedented increase of healthcare data, technologies need to be both, highly efficient for the meaningful utilization of accessible data and flexible to adapt to future challenges and individual preferences. The OntoHealth system makes use of semantic technologies to enable flexible and individual interaction with Electronic Health Records (EHR) for physicians. This is achieved by the execution of formally modelled clinical workflows and the composition of Semantic Web Services (SWS). Several seamless components provide a service-oriented structure defined by individual designed EHR-workflows. This work gives an overview of the planned architecture and its main components. The architecture constitutes the basis for the prototype implementation of all components. With its highly dynamic structure based on SWS, the architecture will be able to cope with both, the individual users' needs as well as the quick evolving healthcare domain.
Square
Authors: Schmidt Carsten Oliver  , Krabbe Christine  , Schössow Janka  , Albers Martin  , Radke Dörte  , Henke Jörg
Published: February 2025

Valid scientific inferences from epidemiological and clinical studies require high data quality. Data generating departments therefore aim to detect data irregularities as early as possible in order to guide quality management processes. In addition, after the completion of data collections the obtained data quality must be evaluated. This can be challenging in complex studies due to a wide scope of examinations, numerous study variables, multiple examiners, devices, and examination centers. This paper describes a Java EE web application used to monitor and evaluate data quality in institutions with complex and multiple studies, named Square2. It uses the Java libraries Apache MyFaces 2, extended by BootsFaces for layout and style. RServe and REngine manage calls to R server processes. All study data and metadata are stored in PostgreSQL. R is the statistics backend and LaTeX is used for the generation of print ready PDF reports. A GUI manages the entire workflow. Square2covers all steps in the data monitoring workflow, including the setup of studies and their structure, the handling of metadata for data monitoring purposes, selection of variables, upload of data, statistical analyses, and the generation as well as inspection of quality reports. To take into account data protection issues, Square2comprises an extensive user rights and roles concept.
Exploring the Notion of Hazards for Health IT
Authors: Habli Ibrahim  , White Sean  , Harrison Stuart  , Pujara Manpreet
Published: February 2025

Safety analysis is centred on identifying a set of hazards that form the basis of risk assessment. In healthcare, hazards are potential sources of harm to patients and as such the risk of these has to be assessed and managed. With the increased reliance on Health IT systems in health and social care settings, some of these hazards are associated with the development and use of these systems. In this paper we examine current practices in hazard identification, focusing on how clinicians and engineers approach this task within the Health IT safety assurance process. We highlight certain technical and organisational challenges and discuss approaches to improving current practices and promoting learning initiatives.
Rehabilitation Risk Management: Enabling Data Analytics with Quantified Self and Smart Home Data
Authors: Hamper Andreas  , Eigner Isabella  , Wickramasinghe Nilmini  , Bodendorf Freimut
Published: February 2025

A variety of acute and chronic diseases require rehabilitation at home after treatment. Outpatient rehabilitation is crucial for the quality of the medical outcome but is mainly performed without medical supervision. Non-Compliance can lead to severe health risks and readmission to the hospital. While the patient is closely monitored in the hospital, methods and technologies to identify risks at home have to be developed. We analyze state-of-the-art monitoring systems and technologies and show possibilities to transfer these technologies into rehabilitation monitoring. For this purpose, we analyze sensor technology from the field of Quantified Self and Smart Homes. The available sensor data from this consumer grade technology is summarized to give an overview of the possibilities for medical data analytics. Subsequently, we show a conceptual roadmap to transfer data analytics methods to sensor based rehabilitation risk management.
Frequent Treatment Sequence Mining from Medical Databases
Authors: Tóth Krisztina  , Kósa István  , Vathy-Fogarassy Ágnes
Published: February 2025

The huge amount of data stored in healthcare databases allows wide range possibilities for data analysis. In this article, we present a novel multilevel analysis methodology to generate and analyze sequential healthcare treatment events. The event sequences can be generated on different abstraction levels automatically from the source data, and so they describe the treatment of patients on different levels of detail. To present applicability of the proposed methodology, we introduce a short case study as well, in which some analysis results are presented arising from the analysis of a group of patients suffering from colorectal cancer.
A Hybrid Algorithm for Fall Detection
Authors: Turkeli Serkan  , Elmas Fikri  , Atay Huseyin Tanzer  , Kurt Kenan Kaan  , Sonmez Remzi Yalın
Published: February 2025

Falling is a major problem among the people globally, frequently due to some health problems including vision loss or balance disorder as a consequence of aging. As a result of the falling in elder people; injuries, complications, neurological problems and mortality are generally occurred. This situation also affects the patients' families psychologically. A large number of studies show that significant fractures, injuries and in some cases death are commonly encountered in elderly. Nonetheless, in the immediate intervention, the rate of damage is reduced and the life quality can be significantly restored. The purpose of this paper is to reduce fall-related problems by developing a new fall detector that we called Tesodev fall detector. In addition, a proper algorithm and a wearable electronic device attaching the sensor to patient's clothes are provided. The electronic device is an IOT device which can send and receive data wirelessly, which means that the device can inform the medical centres to improve medical attention time. Also, this device is modular and device allows keeping other medical data such as blood sugar, tension, heart rate, SPO2. Sensitivity, error rate and classification accuracy in this study are 89.8%, 23.4%, 76%, respectively.
Patient Summaries in Context of Large Scale EHR Networks with Fine Granular Access Control Restrictions
Authors: Mangesius Patrick  , Saboor Samrend  , Schabetsberger Thomas
Published: February 2025

Background: Large Scale Electronic Health Record (EHR) systems tend to contain a significant higher amount of patient data compared to traditional local Electronic Medical Record (EMR) silos. This demands the requirement of providing a user context and role specific summary of the patient record. Security and Access Control systems are a crucial part of modern EHR systems controlling legal policies and patient consents. Goal of this paper is to elaborate a concept enhancing an already existing, commonly based on IHE XDS and XACML based, EHR systems with summarization functionalities.
Knowledge of Palliative Care Among Nursing Students
Authors: Ismaile Samantha  , Alshehri Hanan H.
Published: February 2025

The aim of this study was to evaluate nursing undergraduate students' knowledge with regard to palliative care in Saudi Arabia. A quantitative descriptive research study was conducted by the use of validated tool. A total of 204 students were included in the study. There is little evidence in Saudi Arabia to demonstrate if nursing undergraduates receives education on palliative care. The results indicate that 57.9% of the nursing undergraduates had received educational sessions and 42.1% of nursing undergraduates did not. In conclusion, palliative care nursing education is crucial to improve quality of patient care in nursing practices. It is recommended that a palliative care education should be integrated within the nursing programme courses. Hence, in order to improve students' knowledge of palliative care, course content should cover the principles of palliative care as a part of any nursing bachelor programme.