bluuebunny/crossref_metadata_2025 huggingface dataset:
E-health in Australia and elsewhere: A comparison and lessons for the near future
Authors: Gajanayake Randike  , Sahama Tony  , Iannella Renato
Published: February 2025

Meticulous planning and preparation do not always guarantee that e-health programs unfold as predicted. e-health entails interdependent social interactions which are difficult to predict without past experience or reference to lessons learned. Judicious insight into past case studies and eventualities, therefore, is essential towards building a successful e-health solution. Australia's e-health program is at a crucial stage where appropriate policy considerations and operational changes are in order. In this paper, we present an initial exploration of prominent e-health initiatives of other countries to identify similarities, differences and to seek lessons towards making Australia's e-health initiative a better journey.
Neuro-Physical Rehabilitation by Means of Novel Touch Technologies
Authors: Confalonieri Michele  , Tomasi Piergiorgio  , Depaul Miriam  , Guandalini Giovanni  , Baldessari Matteo  , Oss Daniele  , Prada Fabrizio  , Mazzalai Alessandro  , Da Lio Mauro  , De Cecco Mariolino
Published: February 2025

In this work, we present the results of collaboration between an engineering department and a rehabilitation hospital in using innovative touch interfaces properly designed for both neurocognitive and physical rehabilitation. The novel touch interface also measures force, thereby enabling dexterity training through ‘direct’ manipulation of virtual objects in 3D. Two dimensions are recorded via touch screen, the third by the force channel. We believe that this tool could increase the degree of effectiveness of traditional rehabilitation treatments thanks to its capability to merge physical and cognitive rehabilitation. Furthermore, the exergames implemented allow an easy personalization of the exercise structure and difficulty level. The effectiveness of the FP technology compared with more traditional methods of rehabilitation is measured according to specific parameters observed in an experimental group in comparison with a control group.
Ethicted (Evaluation Process Model to Improve Personalised ICT Services for Independent Living and Active Ageing) – Future Scenario
Authors: Kärki Anne  , Sävel Jaana  , Sallinen Merja  , Kuusinen Jere
Published: February 2025

ICT innovations are constantly developed, and there is no lack of elderly customers, as the number of the elderly is dramatically increasing. Elderly are willing to use ICT to increase their own safety and social activity, but they need trust on the reliability, accessibility and other ethical aspects of ICT including the maintenance of privacy and self-determination. Ethical standards for ICT are usually not considered. “Ethicted” characterizes an ICT service or product as ethically evaluated. As a standardized procedure, it will not only increase the acceptability of ICT, but also provide services for ICT developers. In the future scenario, ICT under development should be evaluated by using a process model that is specifically built to find the lacks in ethical aspects. The model would then be tested by end-users, the formal and informal care givers, to receive direct feedback for redeveloping solutions. As final outcomes, there should be standards for ICT in elderly care and a service for ICT developers to utilize the evaluation model. This future scenario work included partners from 6 EU member countries. The combination of academic research and industrial/commercial interest of ICT developers should and can bring new value to assistive ICT for elderly care.
Me4DCAP V0.1: a Method for the Development of Dublin Core Application Profiles
Authors: Curado Malta Mariana  , Baptista Ana Alice
Published: February 2025

Recent studies show that there is no method to develop a Dublin Core Application Profile (DCAP). A DCAP is a very important construct to implement interoperability, therefore it is essential to have a method to be able to develop such a construct, in order to give DCAP developers a common ground of work. This paper presents the first version of a method to develop Dublin Core Application Profiles (Me4DACP V0.1) that has been developed in a PhD project with a Design Science Research (DSR) approach. Me4DCAP was built having as starting point the Singapore Framework for DCAP and shows the way through the DCAP development. It encompasses a group of pre-defined interconnected activities, explicitly states when they should take place, what techniques could be used to execute them and what artifacts should result from their execution.
Breadth, Depth and Visibility: A Design Guide for Information Architectures Aimed at Elderly Users
Authors: Bruun Anders  , Hahn Claudia  , Voight Benjamin  , Schultz Martin
Published: February 2025

This study extends previous research by exploring the quality of the interaction experienced by a group of elderly participants interacting with a healthcare portal when applying a touch screen remote control. This is compared to a standard remote control with physical buttons.
Video Segmentation of Moving Humans for Assistive Environments
Authors: Maglogiannis Ilias  , Delibasis K.K.  , Goudas T.  , Prentza Andriana  , Malamateniou Flora  , Vassilacopoulos George
Published: February 2025

In this paper, we present two recently proposed efficient methods for human segmentation from video in indoor environments: the illumination sensitive background method and the self-organizing background subtraction (SOBS) method. Both methods maintain multiple background models. The SOBS method has been modified in this work for gray-scale frames, in order to decrease processing times. The video data are acquired indoors from a fixed fish-eye camera in the living environment. The paper presents the algorithmic implementation and modifications details, while results are also presented for a small number of video sequences.
An Analytic Approach to Understanding and Predicting Healthcare Coverage
Authors: Delen Dursun  , Fuller Christie
Published: February 2025

The inequality in the level of healthcare coverage among the people in the US is a pressing issue. Unfortunately, many people do not have healthcare coverage and much research is needed to identify the factors leading to this phenomenon. Hence, the goal of this study is to examine the healthcare coverage of individuals by applying popular analytic techniques on a wide-variety of predictive factors. A large and feature-rich dataset is used in conjunction with four popular data mining techniques—artificial neural networks, decision trees, support vector machines and logistic regression—to develop prediction models. Applying sensitivity analysis to the developed prediction models, the ranked importance of variables is determined. The experimental results indicated that the most accurate classifier for this phenomenon was the support vector machines that had an overall classification accuracy of 82.23% on the 10-fold holdout/test sample. The most important predictive factors came out as income, employment status, education, and marital status. The ability to identify and explain the reasoning of those likely to be without healthcare coverage through the application of accurate classification models can potentially be used in reducing the disparity in health care coverage.
Web site construction for information and treatment on liver cancer
Authors: Roussakis Sotiris  , Ponirou Paraskevi  , Bizopoulou Zoi  , Diomidous Marianna
Published: February 2025

Liver cancer requires a considerable attention of health care scientists worldwide. A holistic treatment includes patient information about risk factors, education on pragmatic evaluation of the symptoms, as well as presentation of best and individualized treatment methods. In this direction, Internet seems to be a powerful tool that has an essential role. The aim of this study is the development of a web site in order to inform and present treatment options on liver cancer, it consists of four parts. In the first part, the presentation of the disease's knowledge base is attempted, whereas in the second part this knowledge base is organized in two conceptual entities: (a) information and (b) treatment. In the third part the importance of internet in the health care sector is highlighted. In the fourth and last part the web site is presented and a brief illustration of several relevant theories and specific implementation tools. The critical success factor of the implementation phase is considered to be the selection of the appropriate methods and development tools. Finally, the constant need for ongoing site maintenance is discussed and thus, is proposed to formulate one of the main aspects for further research, along with several issues concerning site usability.
Tele-Medicine Systems In The Coordination Process Of Organ Transplantation
Authors: Mammas Constantinos S.  , Kostopanagiotou Georgia  , Geropoulos Spyros  , Zogas Spyros  , Lemonidou Chryssa
Published: February 2025

Aim: To search feasibility and reliability of Telemedicine Systems (TS) in the Coordination Process (CP) of Organ Transplantation (OT). Material & Methods; Forty participants (n=40) were divided in two groups, the specialists and the non specialists and comparatively simulated the telephone/fax and the TS based CP of a renal transplant scenario. Results: There was no statistically significant difference between the two groups regarding feasibility and reliability of TS in CP. Specialists found TS significantly more reliable in the fulfillment of all medicolegal requirements of OT (p<.001). Conclusion: Coordinators found TS in the CP of OT feasible and reliable.
Cognitive Rehabilitation of Schizophrenia Through Neurovr Training
Authors: La Paglia Filippo  , La Cascia Caterina  , Rizzo Rosalinda  , Sideli Lucia  , Francomano Antonio  , La Barbera Daniele
Published: February 2025

Cognitive difficulties are prevalent in people with diagnosis of schizophrenia and are associated with poor long-term functioning. In particular, memory, selective, divided and sustained attention and executive functions are altered by this disease. We used a Virtual Reality environment (developed via the NeuroVr2.0 software) for the rehabilitation of shifting, sustained attention and action planning functions using tasks reminiscent of daily life tasks. Test and retest showed significant differences in the assessed cognitive dimensions.
Virtual Multiple Errands Test: Reliability, Usability and Possible Applications
Authors: Pedroli Elisa  , Cipresso Pietro  , Serino Silvia  , Pallavicini Federica  , Albani Giovanni  , Riva Giuseppe
Published: February 2025

Recently, many studies demonstrated the efficacy of using Virtual Reality (VR) in clinical setting, and in particular for neuropsychological assessment. However reliability and usability of the test developed within virtual reality paradigm are often neglect. In this study we test both reliability and usability using well-known psychometrics methods for the Virtual Multiple Errands Test (VMET). In a first experiment, for the reliability, two independent researchers scored the test through several videos. For the usability assessment we analyzed 21 healthy participants and 3 patients with Parkinson's disease.
Virtual Reality as a Method For Evaluation And Therapy After Traumatic Hand Surgery
Authors: Nica Adriana Sarah  , Brailescu Consuela Monica  , Scarlet Rodica Gabriela
Published: February 2025

In the last decade, Virtual Reality has encountered a continuous development concerning medical purposes and there are a lot of devices based on the classic “cyberglove” concept that are used as new therapeutic method for upper limb pathology, especially neurologic problems [1;2;3]. One of the VR devices is Pablo (Tyromotion), with very sensitive sensors that can measure the hand grip strenght and the pinch force, also the ROM (range of motion) for all the joints of the upper limb (shoulder, elbow, wrist) and offering the possibility of interactive games based on Virtual Reality concept with application in occupational therapy programs. We used Pablo in our study on patients with hand surgery as an objective tool for assessment and as additional therapeutic method to the classic Rehabilitation program [4;5]. The results of the study proved that Pablo represents a modern option for evaluation of hand deficits and dysfunctions, with objective measurement replacement of classic goniometry and dynamometry, with computerized data base of patients with monitoring of parameters during the recovery program and with better muscular and neuro-cognitive feedback during the interactive therapeutic modules.
The Development of a Haptic Virtual Reality Environment to Study Body Image and Affect
Authors: Tremblay Line  , Bouchard Stephane  , Chebbi Brahim  , Wei Lai  , Monthuy-Blanc Johana  , Boulanger Dominic
Published: February 2025

We report the results of a preliminary study testing the effect of participants' mood rating on visual motor performance using a haptic device to manipulate a cartoonish human body. Our results suggest that moods involving high arousal (e.g. happiness) produce larger movements whereas mood involving low arousal (e.g. sadness) produce slower speed of performance. Our results are used for the development of a new haptic virtual reality application that we briefly present here. This application is intended to create a more interactive and motivational environment to treat body image issues and for emotional communication.
Visualizing Health: A Novel Visualization Method for Personalized Health Summarization and Guidance
Authors: Hsiao Jen-Hao  , Chang Henry
Published: February 2025

How to report and summarize a user's health or wellness status from the Electronic Health Records (EHR) is a important topic since a well-designed health report can provide not only a valued information source for users to exam their physical health status but also a guidance to a better health level. Existing health reports are not totally satisfying and easily bores a user by words and numeral data in them. Facial complexion is one of important indicator in the clinical diagnosis. The pathological changes of health status could often be diagnosed by inspecting the changes of facial complexion. Based on this facial complexion idea, a visualized health report, which reversely visualizes a user's health status directly on his/her outside appearance, is proposed to provide a better alternative than conventional text-based report. Due to its unique characteristic, the proposed visualized health information and guidance is expected to provide valued personalized health information and also effectively encourage users toward healthier lifestyle.
Medical Concept Representation: The Years Beyond 2000
Authors: Balkanyi Laszlo  , Schulz Stefan  , Cornet Ronald  , Bodenreider Olivier
Published: February 2025

This work aims at understanding the state of the art in the broad contextual research area of “medical concept representation”. Our data support the general understanding that the focus of research has moved toward medical ontologies, which we interpret as a paradigm shift. Both the opinion of socially active groups of researchers and changes in bibliometric data since 1988 support this opinion. Socially active researchers mention the OBO foundry, SNOMED CT, and the UMLS as anchor activities.
Unifying Acute Stroke Treatment Guidelines for a Bayesian Belief Network
Authors: Love Alexa  , Arnold Corey W.  , El-Saden Suzie  , Liebeskind David S.  , Andrada Lewellyn  , Saver Jeffrey  , Bui Alex A.T.
Published: February 2025

With the large number of clinical practice guidelines available, there is an increasing need for a comprehensive unified model for acute ischemic stroke treatment to assist in clinical decision making. We present a unified treatment model derived through review of existing clinical practice guidelines, meta-analyses, and clinical trials. Using logic from the treatment model, a Bayesian belief network was defined and fitted to data from our institution's observational quality improvement database for acute stroke patients. The resulting network validates known relationships between variables, treatment decisions and outcomes, and enables the exploration of new correlative relationships not defined in current guidelines.
Palliative Care from a Medical Informatics Perspective in Chile, Germany, and Peru
Authors: Capurro Daniel  , Ganzinger Matthias  , Pérez-Lu José E.
Published: February 2025

This work explores a) the use of e-health systems in the context of palliative care and b) the information needs of patients, care givers and healthcare professionals in palliative care. To achieve this we conducted a systematic literature review and interviewed health professionals in Germany, Peru, and Chile. All countries have in common that specific e-health systems are rarely used in this context and the presence of a gradient of available care between rural and urban areas.
Machine Learning Methods for Clinical Forms Analysis in Mental Health
Authors: Strauss John  , Peguero Arturo Martinez  , Hirst Graeme
Published: February 2025

In preparation for a clinical information system implementation, the Centre for Addiction and Mental Health (CAMH) Clinical Information Transformation project completed multiple preparation steps. An automated process was desired to supplement the onerous task of manual analysis of clinical forms. We used natural language processing (NLP) and machine learning (ML) methods for a series of 266 separate clinical forms. For the investigation, documents were represented by feature vectors. We used four ML algorithms for our examination of the forms: cluster analysis, k-nearest neigh-bours (kNN), decision trees and support vector machines (SVM). Parameters for each algorithm were optimized. SVM had the best performance with a precision of 64.6%. Though we did not find any method sufficiently accurate for practical use, to our knowledge this approach to forms has not been used previously in mental health.
Do We Have the Reliable Data? An Exploration of Data Quality for AIDS Information System in China
Authors: Chen Hong  , Yu Ping  , Wang Ning
Published: February 2025

A national AIDS program evaluation system has been applied to the ranking of the performance of involved public health organizations in China since 2007. The system provides quantitative performance comparison information based on automatic mining of the data stored in a unified web-based national information system, China AIDS Comprehensive Response Information Management System (the CRIMS). Hence, the quality of the AIDS program evaluation system is directly related to the data quality in the CRIMS. This study aims to evaluate the performance of the AIDS program evaluation system. The research method is qualitative interview of public health practitioners in Jiangxi Province. The public health practitioners believed that the introduction and ongoing usage of the CRIMS has significantly transformed the practice of AIDS prevention and control. They believed that the AIDS program evaluation system has brought in increased accountability of public health. They suggested that the accuracy and completeness of AIDS program evaluation needs to go beyond the data from the CRIMS. Further research will continue to identify the unknown factors that undermine the performance of AIDS programs in China.
Use of Controlled Vocabularies to Improve Biomedical Information Retrieval Tasks
Authors: Pasche Emilie  , Gobeill Julien  , Vishnyakova Dina  , Ruch Patrick  , Lovis Christian
Published: February 2025

The high heterogeneity of biomedical vocabulary is a major obstacle for information retrieval in large biomedical collections. Therefore, using biomedical controlled vocabularies is crucial for managing these contents. We investigate the impact of query expansion based on controlled vocabularies to improve the effectiveness of two search engines. Our strategy relies on the enrichment of users' queries with additional terms, directly derived from such vocabularies applied to infectious diseases and chemical patents. We observed that query expansion based on pathogen names resulted in improvements of the top-precision of our first search engine, while the normalization of diseases degraded the top-precision. The expansion of chemical entities, which was performed on the second search engine, positively affected the mean average precision. We have shown that query expansion of some types of biomedical entities has a great potential to improve search effectiveness; therefore a fine-tuning of query expansion strategies could help improving the performances of search engines.
The Use of a Mathematical Model in the Adoption of an Integrated EHR System
Authors: Pecoraro Fabrizio  , Tamburis Oscar  , Ricci Fabrizio L.
Published: February 2025

The development of healthcare information systems is broadly considered a promising strategy to ensure, enhance and deliver of quality patient services, thus improving the healthcare economic sustainability [1]. However, their systematic evaluation needs to implement economic evaluation models that can help decision makers to determine a feasible and suitable analysis of the impact of an information system in the appropriate healthcare setting [2]. Aim of this paper is to define a mathematical model to provide an “ex-ante” measure of adequacy and significance in the adoption process of Electronic Healthcare Records (EHRs). In particular, the model establishes how different subjects (General Practitioners, GPs and patients) are involved in the testing process and how the resources provided can be invested to find out the most suitable intervention strategies.
Query Engine Optimization for the EHR4CR Protocol Feasibility Scenario
Authors: Soto-Rey Iñaki  , Bache Richard  , Dugas Martin  , Fritz Fleur
Published: February 2025

An essential step when recruiting patients for a Clinical Trial (CT) is to determine the number of patients that satisfy the Eligibility Criteria (ECs) for that trial. An innovative feature of the Electronic Health Records for Clinical Research (EHR4CR) platform is that when automatically determining patient counts, it also allows the user to view counts for subsets of the ECs. This is helpful because some combinations of ECs may be so restrictive that they yield very few or zero patients.
Toward Image Analysis and Decision Support for Ultrasound Technology
Authors: Crofts Gillian  , Padman Rema  , Maharaja Nisha
Published: February 2025

Ultrasound is a low cost and efficient method of detecting diseases and abnormalities in the body. Yet there is a lack of precision and reliability associated with the technology, partly due to the operator dependent nature of ultrasound scanning. When scanning is performed to an agreed protocol, ultrasound has been shown to be highly reliable. This research aims to minimize these limitations that arise during ultrasound training, scanning and reporting by developing and evaluating an image analysis and decision support system that can aid the decision making process. We hypothesize that this intervention will likely increase the role of ultrasound in diagnosis when compared with other imaging technologies, particularly in low resource settings.
Development of Digital Dashboard System for Medical Practice: Maximizing Efficiency of Medical Information Retrieval and Communication
Authors: Lee Kee Hyuck  , Yoo Sooyoung  , Shin HoGyun  , Baek Rong-Min  , Chung Chin Youb  , Hwang Hee
Published: February 2025

It is reported that digital dashboard systems in hospitals provide a user interface (UI) that can centrally manage and retrieve various information related to patients in a single screen, support the decision-making of medical professionals on a real time basis by integrating the scattered medical information systems and core work flows, enhance the competence and decision-making ability of medical professionals, and reduce the probability of misdiagnosis. However, the digital dashboard systems of hospitals reported to date have some limitations when medical professionals use them to generally treat inpatients, because those were limitedly used for the work process of certain departments or developed to improve specific disease-related indicators. Seoul National University Bundang Hospital developed a new concept of EMR system to overcome such limitations. The system allows medical professionals to easily access all information on inpatients and effectively retrieve important information from any part of the hospital by displaying inpatient information in the form of digital dashboard. In this study, we would like to introduce the structure, development methodology and the usage of our new concept.
Health Information System Model for Monitoring Treatment and Surveillance for Leprosy Patients in Indonesia (Case Study in Pekalongan District, Central Java, Indonesia)
Authors: Rachmani Enny  , Kurniadi Arif  , Hsu Chien Yeh
Published: February 2025

After India and Brazil, Indonesia has the third highest incidence/prevalence of leprosy in the world. Every year thousands of new cases and case with grade-2 disability are reported and, while the recovery rate lingers only 80–90 %. Therefore, more than 10 % of leprosy patients drop out of treatment and can be a source of new infections in the community. Our research was aimed at determining apparent difficulties in the leprosy control program as well as how a health information system (HIS) could assist the Indonesian leprosy control program. We used qualitative method with deep interview and observation of document. One of the difficulties which the Indonesian leprosy control program faces is discontinuity of patient's data due to rotating staff as well as the treatment monitoring and queries patients which should be monitored after treatment has ceased. Technology implementation is feasible through short message service (sms) reminders and web base applications. The leprosy control program urgently needs to implement continuous monitoring and recording of patients because of the particular characteristics of this contagious disease.
Clinical Similarities: An Innovative Approach for Supporting Medical Decisions
Authors: Vallati M.  , Gatta R.  , De Bari B.  , Magrini S.M.
Published: February 2025

Taking decisions in the medical domain is a very complex task. The context is strongly affected by uncertainty and the possible undesired side effects of the treatments have to be carefully considered. Currently, these decisions are based on the physician's own experience and the evidences of the published literature, according, when available, with the philosophy of Evidence Based Medicine. The main issues of this approach are that the own experience can be different, and the results in the literature are sometimes contrasting.
Sentiment Analysis on Smoking in Social Networks
Authors: Sofean Mustafa  , Smith Matthew
Published: February 2025

Online social networks play a vital role in daily life to share the opinions or behaviors on different topics. The data of social networks can be used to understand health-related behaviors. In this work, we used Twitter status updates to survey of smoking behaviors among the users. We introduce approach to classify the sentiment of smoke-related tweets into positive and negative tweets. The classifier is based on the Support Vector Machines (SVMs) and can achieve high accuracy up to 86%.
Text Mining Electronic Health Records to Identify Hospital Adverse Events
Authors: Gerdes Lars Ulrik  , Hardahl Christian
Published: February 2025

Manual reviews of health records to identify possible adverse events are time consuming. We are developing a method based on natural language processing to quickly search electronic health records for common triggers and adverse events. Our results agree fairly well with those obtained using manual reviews, and we therefore believe that it is possible to develop automatic tools for monitoring aspects of patient safety.
In-Situ Eye-Tracking of Emergency Physician Result Review
Authors: Nielsona Jeffrey A.  , Mamidala Raja Naresh  , Khan Javed
Published: February 2025

Optimized retrieval of test results is important to patient care and patient safety. The time during which a physician is retrieving results is a vital aspect of the diagnostic process since it is when the preliminary diagnosis is confirmed or the differential is adjusted. Better characterization of the time spent while results are displayed allows for more accurate and appropriate study of this human-computer interaction and visualization in future studies.
Improve Threshold Segmentation Using Features Extraction to Automatic Lung Delimitation
Authors: França Cleunio  , Vasconcelos Germano  , Diniz Paula  , Melo Pedro  , Diniz Jéssica  , Novaes Magdala
Published: February 2025

Abstract: With the consolidation of PACS and RIS systems, the development of algorithms for tissue segmentation and diseases detection have intensely evolved in recent years. These algorithms have advanced to improve its accuracy and specificity, however, there is still some way until these algorithms achieved satisfactory error rates and reduced processing time to be used in daily diagnosis. The objective of this study is to propose a algorithm for lung segmentation in x-ray computed tomography images using features extraction, as Centroid and orientation measures, to improve the basic threshold segmentation. As result we found a accuracy of 85.5%.
Visualizing Sets of SNOMED CT Concepts to Support Consistent Terminology Implementation and Reuse of Clinical Data
Authors: Randorff Højen Anne  , Sundvall Erik  , Kirstine Rosenbeck Gøeg and
Published: February 2025

Inconsistent use of concepts is an obstacle when implementing SNOMED CT to improve comparability of information. Terminology implementation should be approached by common strategies for navigating and selecting proper concepts. This study aims to explore ways of illustrating common pathways and ancestors of particular sets of concepts, to support consistent use of SNOMED CT in EHR-system implementation processes. The prototype presented is an interactive web-based re-implementation of the terminology visualization tool TermViz. The open source prototype contains terminological features that are of relevance when exploring and comparing sets of concepts in SNOMED CT. Future work should focus on evaluating the developed prototype in order to assess its applicability in EHR-system-implementation contexts.
Rebuilding and the Private Cloud of the Hospital Information System by the Virtualization Technology
Authors: Yamashita Yoshinori  , Ogaito Tatoku
Published: February 2025

In our hospital, we managed an electronic health record system and many section subsystems as a hospital information system. By the expansion of these information systems, a system becomes complicated, and maintenance and operative cost increased. Furthermore, the environment that is available to medical information is demanded anywhere anytime by expansion of the computerization. However, the expansion of the information use becomes necessary for the expansion such as the personal protection of information for security. We became rebuilding and the private cloud of the hospital information system by the virtualization technology to solve such a problem. As a result, we were able to perform a decrease in number of the servers which constituted a system, a decrease in network traffic, reduction of the operative cost.
Representing Second Opinion Requests from Primary Care within the Brazilian Tele-health Program: International Classification of Primary Care, Second Edition
Authors: Resnick Melissa P.  , Santana Filipe  , de Araujo Novaes Magdala  , Shamenek Frank S.  , Frieden Lex  , Iyengar M. Sriram
Published: February 2025

Standardization of second opinion question-answer pairs with a classification system can be used to facilitate data sharing and reuse. The Brazilian telehealth program faces the problem of representing biomedical knowledge from the primary care second opinion demands generated by rural health care teams. The objective is to determine if one of the medical classification systems has a superior ability to standardize Portuguese-language second opinion question-answer pairs. Data from 2,638 second opinions from 2010 were randomly reduced to a 264 question-answer pair data set. The semantic meaning of the question-answer pairs was manually assigned to an International Classification of Primary Care, Second edition (ICPC2) code. Eight question-answer pairs did not contain sufficient medical semantic meaning to allow for mapping to an ICPC2 code; 53 question-answer pairs did contain sufficient medical semantic meaning for mapping, however an appropriate ICPC2 code did not exist; and 203 question-answer pairs did contain sufficient medical semantic meaning for mapping to an ICPC2 code. A review of the literature indicates that there is no baseline to compare the 77% success rate against.
KidsETransplant: A Platform for Liver-Transplanted Children
Authors: McLin Valérie  , Spahni Stéphane  , Boggini Thomas  , Guardia Alberto  , Wildhaber Barbara E.  , Geissbuhler Antoine
Published: February 2025

Since 1989, all pediatric liver transplants in Switzerland are centralized at the University Hospitals of Geneva (HUG). Approximately 125 children have received transplants since then, and their survival rate is greater than 90% – one of the highest in Europe. Maximizing the chances of success requires that patients understand and comply with follow-up treatment. The KidsETransplant project aims at helping the child – and his family – to better understand his health situation, to have access to shared resources and to be able to better communicate with healthcare professionals and other patients.
A Model-Driven Approach to Clinical Practice Guidelines Representation and Evaluation Using Standards
Authors: Farkash Ariel  , Timm John T.E.  , Waks Zeev
Published: February 2025

Clinical Practice Guidelines (CPGs) contain a set of schematic plans for the treatment and management of patients who have a particular clinical condition. CPGs are increasingly being used to support physician decision making. Many groups develop tools for the representation of CPGs. These differ in their approaches to addressing particular modeling challenges. Despite this strong effort, physicians still primarily rely on free-text narrative descriptions. Thus, a core challenge is to develop a formal representation of CPGs that physicians can easily read and verify, yet a machine can process, analyze and apply directly to a patient's EHR data. Our paper proposes a solution to this fundamental problem by describing an approach to CPG formalization using the Natural Rule Language (NRL), coupled with transformation to Object Constraint Language (OCL) constraints that are applied on a patient's clinical data record, in our case an HL7 Continuity of Care Document (CCD). We illustrate our approach on a simple guideline directive for Essential Hypertension.
Nordic eHealth Indicators: Organisation of Research, First Results and Plan for the Future
Authors: Hyppönen Hannele  , Faxvaag Arild  , Gilstad Heidi  , Hardardottir Gudrun Audur  , Jerlvall Lars  , Kangas Maarit  , Koch Sabine  , Nøhr Christian  , Pehrsson Thomas  , Reponen Jarmo  , Walldius Åke  , Vimarlund Vivian
Published: February 2025

eHealth indicator and benchmarking activities are rapidly increasing nationally and internationally. The work is rarely based on a transparent methodology for indicator definition. This article describes first results of testing an indicator methodology for defining eHealth indicators, which was reported at the Medical Informatics Europe conference in 2012. The core elements of the methodology are illustrated, demonstrating validation of each of them in the context of Nordic eHealth Indicator work. Validation proved the importance of conducting each of the steps of the methodology, with several scientific as well as practical outcomes. The article is based on a report to be published by the Nordic Council of Ministers [4].
Ensuring Clinical Utility and Function in a Large Scale National Project in Australia by Embedding Clinical Informatics into Design
Authors: Pearce Christopher  , Macdougall Cecily  , Bainbridge Michael  , Davidson Jane
Published: February 2025

Across the globe, healthcare delivery is being transformed by electronic sharing of health information. Such large scale health projects with a national focus are a challenge to design and implement. Delivering clinical outcomes in the context of policy, technical, and design environments represents a particular challenge. On July 1, 2012, Australia delivered the first stage of a personally controlled electronic health record – a national program for sharing a variety of health information between health professionals and between health professionals and consumers. As build of the system commenced, deficiencies of the traditional stakeholder consultation model were identified and replaced by a more structured approach, called clinical functional assurance. Utilising clinical scenarios linked to detailed design requirements, a team of clinicians certified clinical utility at implementation and release points.
Clinical Computer Systems Survey (CLICS): Learning about Health Information Technology (HIT) in its Context of Use
Authors: Lichtner Valentina  , Cornford Tony  , Klecun Ela
Published: February 2025

Successful health information technology (HIT) implementations need to be informed on the context of use and on users' attitudes. To this end, we developed the CLinical Computer Systems Survey (CLICS) instrument. CLICS reflects a socio-technical view of HIT adoption, and is designed to encompass all members of the clinical team. We used the survey in a large English hospital as part of its internal evaluation of the implementation of an electronic patient record system (EPR). The survey revealed extent and type of use of the EPR; how it related to and integrated with other existing systems; and people's views on its use, usability and emergent safety issues. Significantly, participants really appreciated ‘being asked’. They also reminded us of the wider range of administrative roles engaged with EPR. This observation reveals pertinent questions as to our understanding of the boundaries between administrative tasks and clinical medicine – what we propose as the field of ‘administrative medicine’.
Seeking Evidence to Support Usability Principles for Medication-Related Clinical Decision Support (CDS) Functions
Authors: Marcilly Romaric  , Beuscart-Zéphir Marie-Catherine  , Ammenwerth Elske  , Pelayo Sylvia
Published: February 2025

There is a need for evidence-based usability principles to support the design of usable medication-related computerized CDS functions and systems. Such evidence requires establishing scientific relationships between usability principles, their violation in terms of usability flaws, issuing usage problems and their consequences or outcomes in the clinical work and patient care. This kind of evidence is not currently directly available in scientific evaluation studies of medication CDS functions. A possible proxy to seek evidence is systematic review of existing scientific evaluation reports. We rely on a four-stage framework describing the chain of consequences and inferences linking usability principles to clinical outcomes to design the systematic review methodology and interpretation principles. This paper describes the four-stage framework and the resulting consequences for the systematic review design.
The Consequences of Seniors Seeking Health Information Using the Internet and Other Sources
Authors: Medlock Stephanie  , Eslami Saeid  , Askari Marjan  , Sent Danielle  , de Rooij Sophia E.  , Abu-Hanna Ameen
Published: February 2025

The internet is viewed as an important channel for patient empowerment, enabling patients to feel more knowledgeable and take action to improve their own health. Internet use among seniors in the Netherlands is increasing, but it is not known if they also use it for health information, nor if seeking information on the internet has different consequences for empowerment than seeking information from other sources. We sought to investigate seniors' use of the internet compared to other resources for health information, and the consequences in terms of both subjective responses and actions taken. Using an email invitation and a web survey, we surveyed 100 elderly internet users, of which 85% had used the internet for health information. The consequences were similar for information found via internet and other sources, and generally positive. Over half reported feeling more knowledgeable and 51% reported making lifestyle changes, but fewer reported having taken other actions (e.g. discussing the information with their doctor). Encouraging the translation of knowledge into action represents an opportunity for empowerment in this population.
Concepts for a Standard based Cross-organisational Information Security Management System in the Context of a Nationwide EHR
Authors: Mense Alexander  , Hoheiser-Pförtner Franz  , Schmid Martin  , Wahl Harald
Published: February 2025

Working with health related data necessitates appropriate levels of security and privacy. Information security, meaning ensuring confidentiality, integrity, and availability, is more organizational, than technical in nature. It includes many organizational and management measures, is based on well-defined security roles, processes, and documents, and needs permanent adaption of security policies, continuously monitoring, and measures assessment. This big challenge for any organization leads to implementation of an information security management system (ISMS). In the context of establishing a regional or national electronic health record for integrated care (ICEHR), the situation is worse. Changing the medical information exchange from on-demand peer-to-peer connections to health information networks requires all organizations participating in the EHR system to have consistent security levels and to follow the same security guidelines and rules. Also, the implementation must be monitored and audited, establishing cross-organizational information security management systems (ISMS) based on international standards. This paper evaluates requirements and defines basic concepts for an ISO 27000 series-based cross-organizational ISMS in the healthcare domain and especially for the implementation of the nationwide electronic health record in Austria (ELGA).
Smartphones : Evidence-based User-Interface Design
Authors: Ehrler Frederic  , Walesa Magali  , Sarrey Evelyne  , Lovis Christian
Published: February 2025

Smartphones have become increasingly popular among every segment of the population. Caregivers do not want to miss out on this evolution and express interest in using mobile devices to perform their everyday care. This tendency has been well understood by many software providers who have produced many medical applications for smartphones. Before going a step further and developing tools to manage Clinical Information System data on handheld devices, it is wise to ask ourselves whether these new tools are well adapted to the healthcare environment. Indeed, some studies have raised concerns regarding the efficiency of these handheld devices to input medical data, especially with the induced errors. In this paper, we look to adopt a rigorous approach to acquire evidence about these concerns through a prospective study. In order to get this evidence, the study compares several input interfaces in the context of recording vital signs on mobile devices. We would like to discover not only which interface is the most efficient, but also which one is the least prone to errors.
CONSORT-EHEALTH: Implementation of a Checklist for Authors and Editors to Improve Reporting of Web-Based and Mobile Randomized Controlled Trials
Authors: Eysenbach Gunther
Published: February 2025

Background: Randomized trials of web-based and mobile interventions pose very specific issues and challenges. A set of best practices on how to conduct and report such trials was recently summarized in the CONSORT-EHEALTH statement (Consolidated Standards of Reporting Trials of Electronic and Mobile HEalth Applications and onLine TeleHealth), published in August 2011 as draft and in December 2011 as journal article (V1.6.1). The purpose of this presentation is to review the results of the pilot implementation at the Journal of Medical Internet Research (JMIR), a leading eHealth journal, where reporting of trials in accordance with CONSORT-EHEALTH became mandatory in late 2011.
Disseminating Context-Specific Access to Online Knowledge Resources within Electronic Health Record Systems
Authors: Del Fiol Guilherme  , Curtis Clayton  , Cimino James J.  , Iskander Andrew  , Kalluri Aditya S.D.  , Jing Xia  , Hulse Nathan C.  , Long Jie  , Overby Casey L.  , Schardt Connie  , Douglas David M.
Published: February 2025

Clinicians' patient care information needs are frequent and largely unmet. Online knowledge resources are available that can help clinicians meet these information needs. Yet, significant barriers limit the use of these resources within the clinical workflow. Infobuttons are clinical decision support tools that use the clinical context (e.g., institution, user, patient) within electronic health record (EHR) systems to anticipate clinicians' questions and provide automated links to relevant information in knowledge resources. This paper describes OpenInfobutton (www.openinfobutton.org): a standards-based, open source Web service that was designed to disseminate infobutton capabilities in multiple EHR systems and healthcare organizations. OpenInfobutton has been successfully integrated with 38 knowledge resources at 5 large healthcare organizations in the United States. We describe the OpenInfobutton architecture, knowledge resource integration, and experiences at five large healthcare organizations.
Navigating Longitudinal Clinical Notes with an Automated Method for Detecting New Information
Authors: Zhang Rui  , Pakhomov Serguei  , Lee Janet T.  , Melton Genevieve B.
Published: February 2025

Automated methods to detect new information in clinical notes may be valuable for navigating and using information in these documents for patient care. Statistical language models were evaluated as a means to quantify new information over longitudinal clinical notes for a given patient. The new information proportion (NIP) in target notes decreased logarithmically with increasing numbers of previous notes to create the language model. For a given patient, the amount of new information had cyclic patterns. Higher NIP scores correlated with notes having more new information often with clinically significant events, and lower NIP scores indicated notes with less new information. Our analysis also revealed “copying and pasting” to be widely used in generating clinical notes by copying information from the most recent historical clinical notes forward. These methods can potentially aid clinicians in finding notes with more clinically relevant new information and in reviewing notes more purposefully which may increase the efficiency of clinicians in delivering patient care.