bluuebunny/crossref_metadata_2025 huggingface dataset:
Modeling interdependencies between business and communication processes in hospitals
Authors: Brigl Birgit  , Wendt Thomas  , Winter Alfred
Published: February 2025

The optimization and redesign of business processes in hospitals is an important challenge for the hospital information management who has to design and implement a suitable HIS architecture. Nevertheless, there are no tools available specializing in modeling information-driven business processes and the consequences on the communication between information processing tools. Therefore, we will present an approach which facilitates the representation and analysis of business processes and resulting communication processes between application components and their interdependencies. This approach aims not only to visualize those processes, but also to evaluate if there are weaknesses concerning the information processing infrastructure which hinder the smooth implementation of the business processes.
Concerted Actions for an Interoperable Health Telematics Platform in Germany
Authors: Sembritzki Jürgen
Published: February 2025

In Germany many commitments have been made to build a telematics infrastructure. The Centre for Telematics in Healthcare first published the concept for such a platform in 2001. This concept is introduced amongst others and information is given about the actions and initiatives of the last two years in Germany.
Representation of Relationships between Data in Healthcare Documents
Authors: Dudeck Joachim  , Schweiger Ralf
Published: February 2025

In healthcare data are to a large extent represented in narrative textual documents. The analysis of narrative text has not been solved successfully up to now. The results of natural language processing or fully indexing systems have not been completely satisfying. It is in particular difficult to detect and describe reliably relationships between data items in narrative text. The eXtensible Markup Language XML has opened new and very promising perspectives in this environment which could improve the storage, processing and analysis of narrative textual documents in particular in healthcare [1, 2].
Open, Flexible and Portable Secure Web-based Health Applications
Authors: Vlachos Michael  , Stassinopoulos George
Published: February 2025

This paper presents a totally generic client - server model for accessing legacy and new databases according to the three tier architecture principles It is based on an integrated environment that eases the dynamic creation and instantiation of secure web applications that access multiple database management systems. Emphasis is placed on the ability to query almost any type of relational database and queries can simultaneously address a multitude of data sources. The information is collected, assembled and presented to users depending on a possible set of user profiles. These profiles originate from work on securing the conduct of clinical studies. This has been achieved in the context of the E U funded project HARP (Harmonisation for the Security of Web Technologies and Applications). The generic character of the model is exploited through an accompanying set of development tools. This permits efficient and effective creation and maintenance of applications in several domains of health telematics and beyond. Main merit is the lightweight character of the resulting platform, whereby all necessary instantiations are accomplished through a set of related XML documents.
NOAH – A Mobile Emergency Care System
Authors: Schaechinger Ulrich  , Rockelein Wolfgang  , Perk Alexander  , Asbach Patrick  , Nerlich Michael
Published: February 2025

The German emergency care system is a very sophisticated one. However, negative headlines like “emergency Patient Tourism” appearing from time to time, have provoked a thorough deficit analysis which revealed two weak points: communication and documentation. The communication system presentiy used is a rather outdated one employing analogue voice radio between the ambulance cars/helicopters and the dispatch center and telephone communication between the dispatch center and the emergency rooms. To document the emergency case the on-scene physician is required to fill out a form. A survey showed that many of these forms are filled out incompletely and/or inconsistently or are even missing completely.
StapSim: A Virtual Reality-based Stapling Simulator for Laparoscopic Herniorrhaphy
Authors: Gopalakrishnan Girish  , Devarajan Venkat
Published: February 2025

The growing interest in laparoscopic hernia surgery and in surgical simulators has motivated our current research. In this paper, we present our work in simulating the process of stapling used in laparoscopie herniorrhaphy. By connecting two separate deformable preperitoneal meshes together, our model has simulated the repair process for a bilateral hernia correction. The task of mesh placement and stapling of corners was simulated, to allow surgeons to practice their hand-eye coordination. Various deformable models and numerical methods were researched to comply with the real time requirements. The stapling simulator can either be independently used as a part-task (sub-task) trainer or be integrated as a module of a complete VR-based simulator. A phantom device was used to provide haptic-based force feedback during task rehearsals.
REALISTIC ANATOMICAL TEXTURE FOR LAPAROSCOPIC SURGERY SIMULATION
Authors: Gupta Vivek  , Devarajan Venkat
Published: February 2025

Visual realism in laparoscopic surgery simulation is very desirable. Previously, much work has been done to extract the organs and textures from the visible human data (VHD) using various rendering techniques. We present here a technique to extract the true texture from visible human data for the laparoscopic herniorrhaphy simulation. A VHD slice provides texture only in the direction in which it was visualized whereas the surgeons visualize the facet of an organ during a laparoscopic surgery. Our paper describes an approach for the extraction and mapping facet texture from the VHD.
Visualization of Muscle Function for Medical Education
Authors: Hurmusiadis Vassili  , Barrick Simon  , Briscoe Chris
Published: February 2025

We developed a muscle shape model with a view to visualizing muscle functionality for medical education purposes. In our model a muscle is represented by a set of fibers, which run the length of the body of the muscle from origin to insertion. The fiber curves are equipped with contractile and elastic elements and are used as deformation guides that re-shape the muscle surface. This enables us to specify the timing and the level of contraction of a muscle as well as its volume and shape changes. The model can be configured to animate muscles, tendons and ligaments. EMG (electromyography) data have been used to drive the contractile element of the model. We researched and implemented 34 basic skeleton movements and 4 gross motor movements involving 15 joints and over 165 muscles in the human body. Complex bone movements were based on motion captured data combined with live video reference. We used interactive movies in order to present a bone/muscle action from a wide range of views.
Virtual Patient: a Photo-real Virtual Human for VR-based Therapy
Authors: Kiss Bernadette  , Benedek Balázs  , Szijártó Gábor  , Csukly Gábor  , Simon Lajos  , Takács Barnabás
Published: February 2025

A high fidelity Virtual Human Interface (VHI) system was developed using low-cost and portable computers. The system features realtime photo-realistic digital replicas of multiple individuals capable of talking, acting and showing emotions and over 60 different facial expressions. These virtual patients appear in a high-performance virtual reality environment featuring full panoramic backgrounds, animated 3D objects, behavior and AI models, a complete vision system for supporting interaction and advanced animation interfaces. The VHI takes advantage of the latest advances in computer graphics. As such, it allows medical researchers and practitioners to create real-time responsive virtual humans for their experiments using computer systems priced under $2000.
Phantom-Based Interactive Simulation System for Dental Treatment Training
Authors: Sae-Kee Bundit  , Riener Robert  , Frey Martin  , Pröll Thomas  , Burgkart Rainer
Published: February 2025

In this paper, we propose a new interactive simulation system for dental treatment training. The system comprises a virtual reality environment and a force-torque measuring device to enhance the capabilities of a passive phantom of tooth anatomy in dental treatment training processes. The measuring device is connected to the phantom, and provides essential input data for generating the graphic animations of physical behaviors such as drilling and bleeding. The animation methods of those physical behaviors are also presented.
Virtual Vision Loss Simulator
Authors: Toufaili Feras M.  , Seibel Eric J.  , Mcintyre David J.
Published: February 2025

Vision loss is common among people over the age of 65 and the condition is irreversible in most cases. Our simulator is a means to effectively and accurately inform people about the nature of common vision problems, initially limited to medically accurate simulations of cataract and macular degeneration. Using an eye tracker that continuously determines the subject's fixation point, a systematically degraded digital image displayed on an HMD can be a powerful educational tool. This article presents our Virtual Vision Loss (VVL) simulator and the developed simulation techniques based on calibration from 27 subjects.
An AR System with Intuitive User Interface for Manipulation and Visualization of 3D Medical Data
Authors: Vogt Sebastian  , Khamene Ali  , Niemann Heinrich  , Sauer Frank
Published: February 2025

We report on a stereoscopic video-see-through augmented reality system which we developed for medical applications. Our system allows interactive in-situ visualization of 3D medical imaging data. For high-quality rendering of the augmented scene we utilize the capabilities of the latest graphics card generations. Fast highprecision MPR generation (“multiplanar reconstruction”) and volume rendering is realized with OpenGL 3D textures. We provide a tracked hand-held tool to interact with the medical imaging data in its actual location. This tool is represented as a virtual tool in the space of the medical data. The user can assign different functionality to it: select arbitrary MPR cross-sections, guide a local volume rendered cube through the medical data, change the transfer function, etc. Tracking works in conjunction with retroreflective markers, which frame the workspace for head tracking respectively are attached to instruments for tool tracking. We use a single head-mounted tracking camera, which is rigidly fixed to the stereo pair of cameras that provide the live video view of the real scene. The user's spatial perception is based on stereo depth cues as well as on the kinetic depth cues that he receives with the viewpoint variations and the interactive data visualization. The AR system has a compelling real-time performance with 30 stereo-frames/second and exhibits no time lag between the video images and the augmenting graphics. Thus, the physician can interactively explore the medical imaging information in-situ.
Level Set Based Auto Segmentation of the Tagged Left Ventricle MR Images
Authors: Chen Q.  , Zhou Z.M.  , Qu Y.G.  , Heng P.A.  , Xia D.S.
Published: February 2025

To facilitate automatic segmentation, we adopt SVM (Support Vector Machine) to localize the left ventricle, and the segmentation is then carried out with narrow band level set. The method of generating the narrow band is improved such that the time used is reduced. Based on the imaging characteristics of the tagged left ventricle MR images, BPV (block-pixel variation) and intensity comparability are introduced to improve the speed term of level set and to increase the precision of segmentation. Our method can perform the segmentation of the tagged left ventricle MR images accurately and automatically.
A One Degree of Freedom Haptic System to Investigate Issues in Human Perception with Particular Application to Probing Tissue
Authors: Dibble Edward  , Zivanovic Aleksandar  , Davies Brian
Published: February 2025

This paper presents the results of several early studies relating to human haptic perception sensitivity when probing a virtual object. A 1 degree of freedom (DoF) rotary haptic system, that was designed and built for this purpose, is also presented. The experiments were to assess the maximum forces applied in a minimally invasive surgery (MIS) procedure, quantify the compliance sensitivity threshold when probing virtual tissue and identify the haptic system loop rate necessary for haptic feedback to feel realistic.
New tools in cybertherapy: the VEPSY Web Site
Authors: Castelnuovo Gianluca  , Buselli Claudio  , Ferrari Roberta DE  , Gaggioli Andrea  , Mantovani Fabrizia  , Molinari Enrico  , Villamira Marco  , Riva Giuseppe
Published: February 2025

In the last years the rapid development of the Internet and new communication technologies has had a great impact on psychology and psychotherapy. Psychotherapists seem to rely with more and more interest on the new technological tools such as videophone, audio and video chat, e-mail, SMS and the new Instant Messaging Tools (IMs). All these technologies outline a stimulating as well as complex scenario: in order to effectively exploit their potential, it is important to study which is the possible role played by the Internet-based tools inside a psychotherapeutic iter. Could the technology substitute the health care practitioners or are these tools only a resource in addition to the traditional ones in the therapist's hand? The major aim of this chapter is to provide a framework for the integration of old and new tools in mental health care. Different theoretical positions about the possible role played by e-therapy are reported showing the possible changes that psychotherapy will necessarily face in a cyber setting. The VEPSY website, an integration of different Internet-based tools developed within the VEPSY UPDATED Project, is described as an example of clinical application matching between old (and functional) practices with new (and promising) media for the treatment of different mental disorders. A rationale about the possible scenarios for the use of the VEPSY website in the clinical process is provided.
Ergonomics of Virtual Environments for Clinical Use
Authors: Spagnolli Anna  , Gamberini Luciano  , Cottone Paolo  , Mantovani Giuseppe
Published: February 2025

Usability is defined by the International Standards Organization as “the effectiveness, efficiency and satisfaction with which a certain user may achieve a specific objective in a particular environment” (ISO DIS 9241-11). This definition highlights the need for considering the specific destination of a certain technology and reflects the current trends in Human-Computer Interaction (HCI). In compliance with these remarks, the evaluation will be described here of a Virtual Environment (VE) for the treatment of male sexual dysfunctions; the common assumption will be avoided according to which a VE is a space separated from its ‘real’ surroundings [6, 7] and the full environment where the Virtual session takes place will be addressed instead. After a description of the conceptual framework adopted, the paper will dwell on one method among those deployed for the evaluation, namely the analysis of ‘situated actions’. Four aspects will be dealt with: (a) the interplay of various concurrent settings during the virtual session; (b) the users' comprehension of the symbols used in the VE; (c) the structure of the relationship between users and guide; (d) the breakdowns during the human-VE interaction. The goals and the intended meanings of the simulation as set by the designers became the main parameters for the evaluation.
The future of Cybertherapy: Improved options with advanced technologies
Authors: Wiederhold Brenda K.  , Wiederhold Mark D.
Published: February 2025

Cybertherapy is a field that is growing rapidly due to today's technology and information boom. Virtual reality and advanced technologies have been used successfully to in a variety of healthcare issues, including treatment of anxiety disorders and phobias, treatment of eating and body dysmorphic disorders, neuropsychological assessment and rehabilitation and distraction during painful or unpleasant medical procedures. The novel applications of these technologies yield many advantages over traditional treatment modalities, and the disadvantages that accompanied the first trials of virtual reality are quickly being addressed and eliminated. Virtual reality peripherals such as data gloves, physiological monitoring and Internet worlds are swiftly demonstrating their usefulness in cybertherapy applications. Future directions for research include improvements of objective measures of efficacy such as fMRI and physiological monitoring devices, and investigations are being carried out to determine if virtual reality and advanced technologies can be used to treat a broader scope of disorders, including depression, schizophrenia, drug addiction, and autism.
Decision Support and Knowledge Management in Oncology using Hierarchical Classification
Authors: d'Aquin Mathieu  , Brachais Sébastien  , Lieber Jean  , Napoli Amedeo
Published: February 2025

This paper presents the KASIMIR research project for the management of decision protocols in oncology. A decision protocol is a kind of decision tree implemented in an object-based representation formalism. A reasoner based on such a formalism and on hierarchical classification is coupled with a knowledge editor. This association provides an assistance for editing and maintenance of protocols, enabling the detection of errors and the comparison between versions of the protocol. In this way, a management of protocols takes fully advantage of the underlying knowledge representation and reasoning tools. This straightforward use of the protocol may be insufficient in some situations. Then, the protocol may have to be adapted for these situations. A study of protocol adaptation is presented. In particular a reasoner based on a combination of hierarchical classification and fuzzy logic is introduced.
Advanced Temporal Data Abstraction for Guideline Execution
Authors: Seyfang Andreas  , Miksch Silvia
Published: February 2025

Temporal data abstraction bridges the gap between snap shot values delivered by monitoring devices and laboratory tests on one side and high-level medical concepts used in guidelines and by medical professionals on the other side. Within this field, the detection and abstraction of repeated patterns is a complex and important challenge. A repeated pattern is a combination of events or intervals which occur multiple times in a formally describable temporal relation.
Evolving from Standard Vocabularies to Formal Ontology for an Information System Dedicated to Organ Transplantation
Authors: Burgun Anita  , Golbreich Christine  , Jacquelinet Christian
Published: February 2025

Semantic heterogeneity is a key issue in the deployment of medical applications. In this paper, we examine solutions to address semantic heterogeneity for a complex organ transplantation information system. The information system that has been developed by the French agency for transplantation (EfG) has to gather medical information concerning patients and donors for organ allocation, epidemiological studies, and public health decisions. We analyze in this context the limits of the traditional approach based on a standard vocabulary and a relational database for the transplantation domain. We present its evolution towards a system that combines a terminology server and a data warehouse. The perspective is now to build a formal ontology that may support semantic integration in an advanced transplantation information system. Two open issues in formal ontology design are discussed. First, providing definitions of all medical concepts is not an obvious task if we want those definitions be meaningful, formal, and compatible with other ontologies. Second, propagation of properties along relations raises the needs for extending description logics with rules.
MET System: a New Approach to m-Health in Emergency Triage
Authors: Michalowski Wojtek  , Slowinski Roman  , Wilk Szymon
Published: February 2025

The MET (Mobile Emergency Triage) system is an m-health application that supports emergency triage of various types of acute pain at the point of care. The system is designed for use in the Emergency Department (ED) of a hospital and to aid physicians in disposition decisions. Given patient's condition, MET recommends a triage by consulting decision rules stored in the system's knowledge base. The rules have been created using a data mining method (based on rough set methodology) applied to data collected during a retrospective chart study and verified by the clinicians.
The impact of structuring multidisciplinary team conferences mediated by ICT in the treatment of patients with rheumatic diseases
Authors: Verhoef J.  , Toussaint P.J.  , Vliet Vlieland T.P.M.  , Zwetsloot-Schonk J.H.M.
Published: February 2025

Communication processes are pervasive in the daily practice of health professionals. Reorganizing these daily practices by introducing ICT, inevitably effects one or more communication processes. Understanding exactly what these effects are, is a major problem in designing and implementing ICT-applications. In this paper we present an analysis of these effects, based on a theory of communication processes. The concept of ‘decoupling’ is pivotal in our analysis. Based on the identified effects, and some preconditions that have to be met in order for these effects to take place, we derive a number of guidelines for reorganizing communication processes by means of applying ICT. The application of these guidelines will be demonstrated and discussed in the context of the reorganization of a team conference at the Rehabilitation Clinic of the Rheumatology Department of the Le iden University Medical Center (RCRD/LUMC), a multidisciplinary team care setting.
Stereopsis in Medical Virtual-Learning-Environments
Authors: Luursema J-M.  , Kommers P.A.M.  , Verweij W.B.  , Geelkerken R.H.
Published: February 2025

In surgical training a lot of effort is directed at developing virtual learning environments (VLE's). These environments usually include one or more of the following features: haptic feedback, the sending of a slightly different computer-generated image to both eyes (affording an user's experience of stereoptical depth), and a transparant interface that allows ‘natural’ interaction.
JUST in Time Health Emergency Interventions: An innovative approach to training the citizen for emergency situations using Virtual Reality Techniques and Advanced IT Tools (The VR Tool)
Authors: Manganas A.  , Tsiknakis M.  , Leisch E.  , Ponder M  , Molet T  , Herbelin B  , Magnetat-Thalmann N  , Thalmann D  , Fato M.  , Schenone A.
Published: February 2025

This paper reports the results of the second of the two systems developed by JUST, a collaborative project supported by the European Union under the Information Society Technologies (IST) Programme. The most innovative content of the project has been the design and development of a complementary training course for non-professional health emergency operators, which supports the traditional learning phase, and which purports to improve the retention capability of the trainees. This was achieved with the use of advanced information technology techniques, which provide adequate support and can help to overcome the present weaknesses of the existing training mechanisms.
High Level Security Policies for Health: From Theory to Practice
Authors: Defteraios Spyros  , Lambrinoudakis Costas  , Gritzalis Dimitris
Published: February 2025

The design and implementation of a security policy for a healthcare organisation is by no means trivial but it is, at least, feasible, taking into account the wide range of information security and privacy enhancing technologies that are currently available. Considering, however, a shared care environment with the participation of many independent healthcare organisations and the requirement for exchanging electronic healthcare records, the situation becomes much more complex since the implementation of global security policy may turn out to be an over ambitious task. This paper aims to highlight the main sources of complexity and to provide pointers for managing or/and resolving them.
Ten Critical Steps for a Successful Telemedicine Program
Authors: Vander Werf Mark
Published: February 2025

This chapter is based on a study of the characteristics that drive successful and unsuccessful telemedicine programs. In 2000 the International Society for Telemedicine (ISfT) asked AMD Telemedicine to present our observations of what characteristics appeared to be common to successful telemedicine and telehealth programs. To find out, AMD Telemedicine conducted a study of over 60 telemedicine programs in three countries. During this review, we identified ten basic points and documented successful and unsuccessful approaches to each. There are exceptions, but the approach to each of these issues appears to maximize the likelihood of success or failure. The findings were initially presented to the ISfT membership at their conference in Denmark. The study has been updated continuously as new information becomes available. The most current observations are as follows.
Integrated Telehealth: Putting It All Together and Addressing the Challenges
Authors: Harum Hishamuddin
Published: February 2025

The Integrated Telehealth Project of Malaysia is considered a principal enabler for the nation's Vision 2020 as well as the National Health Vision. Being in such an unenviable position, of being not only the pioneer for such an integrated project, but also with no benchmark to compare with, the project implementers have faced manifold challenges along the way. This chapter deals with some of the challenges and lessons learnt that have accumulated as the project progressed.
Archetypes: the PropeR way
Authors: van der Linden Helma  , Grimson Jane  , Tange Huibert  , Talmon Jan  , Hasman Arie
Published: February 2025

The PropeR project studies the effect of Decision Support in an Electronic Health Record system (EHR) on the quality of care. One of the applications supports a multidisciplinary primary care team rehabilitating stroke patients in their home environment. This project required an EHR system that could handle information of multiple disciplines and multiple, distributed data sources. It should also be flexible enough to handle an entirely different domain with only minor modifications. The resulting EHR system is a distributed system based on international standards and reusable components. It is generic in nature since all references to the domain are stored in separateXML documents: the clinical data are defined through a modified version of the OpenEHR archetypes, described in XML and views on the data, either for review or for data entry are also described in XML documents. Currently, the system is being evaluated by a care team using laptops with a wireless internet connection.
Evaluation of consumer health website accessibility by users with sensory and physical disabilities
Authors: Chiang Michael F.  , Starren Justin
Published: February 2025

Growth of the World Wide Web is beginning to create new opportunities for direct patient access to health care resources. At the same time, advances in medical care have produced demographic shifts in which an increasing number of patients have sensory and physical disabilities that may limit their ability to access these new information tools. This study uses automated and manual methods to measure the compliance of 30 popular consumer health websites with the World Wide Web Consortium (W3C) content accessibility guidelines. Among these 30 sites, 22 failed to satisfy at least one W3C Priority-1 accessibility checkpoint, making it impossible for some groups of disabled users to access information from them. All websites failed to satisfy at least one Priority-2 checkpoint, making it difficult for some groups to access information from the sites. These results suggest that accessibility of many consumer health websites to disabled users is very limited. The health informatics community must become more aware of this problem, particularly because many critical accessibility problems may be easily addressed if they are recognized.
Strategies for Supporting Consumer Health Information Seeking
Authors: McCray Alexa T.  , Ide Nicholas C.  , Loane Russell R.  , Tse Tony
Published: February 2025

Despite a growing number of available Web-based health information resources, consumers continue to face a variety of barriers as they attempt to access these resources. Developing a system that appropriately responds to user queries poses several challenges. Guided by an earlier study that analyzed a large number of queries submitted to ClinicaITrials.gov, we developed a variety of techniques to assist user information seeking. We tested the efficacy of these techniques by submitting the original user queries to our new search engine to determine if these techniques would result in better system performance. Overall, the number of query failures was reduced, but the largest improvement was found in the system’s query suggestion capability. For a subset of queryfailures, the current system was able to cut the earlier failure rate almost in half, in most cases providing a suggestion rather than directly finding records. The techniques described here provide a new approach for responding to user queries. The techniques are tolerant of certain types of errors and providefeedback to assist users in reformulating their queries.
A Patient-Controlled Journal for an Electronic Medical Record: Issues and Challenges
Authors: Wald Jonathan S.  , Middleton Blackford  , Bloom Amy  , Walmsley Dan  , Gleason Mary  , Nelson Elizabeth  , Li Qi  , Epstein Marianna  , Volk Lynn  , Bates David W.
Published: February 2025

Partners Healthcare System, Boston, MA, has developed a patient Web portal that features a patient-controlled electronic “Journal” to allow patients to interact with their physician's electronic medical record. Patients can view and respond to health reminders, critique electronic chart information maintained by their doctor's office, enter additional clinical information, and prepare information summaries before an office visit. Creating shared information resources to support a collaborative care model required analysis of the business, architectural, and workflow requirements of the patient-controlled clinical portal and the physician-controlled electronic medical record system. In this paper we describe the challenges in aligning the two systems and serving the different user groups. Coupling the Patient Gateway system, serving over 8700 patients of 90 physicians as of September, 2003, with the Longitudinal Medical Record system, serving over 4000 physicians, has required a clear definition of user goals and workflow, well-defined interfaces, and careful consideration of system assumptions to succeed.
The Brazilian Health Informatics and Information Policy: building the consensus
Authors: Leão Beatriz F.  , Costa Cláudio G.  , Facchini Luiz Augusto  , Bandarra Ernani B.  , Gonçalves Sibele F.  , Júnior Nilo Bretas  , Ferla Alcindo
Published: February 2025

This paper describes the construction of the Brazilian Health Information Policy. The Introduction gives an overview of the health informatics scenario in the country and the motivation for the definition of a national policy for the area. The process adopted and the strategies to reach consensus among the different players ofthe healthcare arena are discussed. The interface with the national health card project and the standards already established are also depicted. The current document and the strategies so far proposed are presented with their respective time table andgoals. At the end, a comparison with other national initiatives is drawn.
We Did the Right Thing: An Intervention Analysis Approach to Modeling Intervened SARS Propagation in Singapore
Authors: Han Bin  , Leong Tze-Yun
Published: February 2025

In this paper, we adopt the Intervention Analysis approach to model an intervened natural process, i.e., propagation ofthe severe acute respiratory syndrome (SARS) in Singapore, which is affected not only by its own evolutionary history but also by the control measures taken. Using this model, the propagation trend of the epidemic and the effects of different control measures on the outcomes of this epidemic can be simulated and quantitatively analyzed. Based on the model, we have performed an evaluation and sensitivity analysis of the Singapore government's responses to this epidemic. Preliminary results have shown that the control measures taken are effective in controlling the outbreak.
An Exploratory Study to Assess the Computer Knowledge, Attitude and Skill Among Nurses in Health care Setting of a Selected Hospital, Ludhiana, Punjab, India
Authors: Raja Emans Evangel Joel  , Mahal Rajinder  , Masih Veena Barkat
Published: February 2025

Explorative study conducted to assess and identify deficit areas of computer knowledge, attitudes and skills among nurses working in the hospital and to examine the relationship among these factors. 120 staff nurses were surveyed by systematic random sampling. Computer knowledge, attitudes and skills were measured by a self-structured computer knowledge questionnaire, computer attitude and skill scale respectively. Data analysis showed that the majority 75% staff nurses had good computer knowledge. 100% of nurses had positive attitudes towards computer utilization. 50.8% and 30.8% had average and fair computer skills respectively. No significant correlation was found between nurses' computer knowledge, attitude and skills. The relationships of computer knowledge, attitude and skill were analyzed among nurses with the selected variables like age, sex, designation, years of nursing service, professional qualification, area of nursing service, type of computer training received, frequency of computer usage and monthly family income. Strategies to enhance nurses' computer knowledge, attitudes and skills were proposed.
Evaluating the impact of information communication technologies on complex organizational systems: a multi-disciplinary, multi-method framework
Authors: Westbrook Johanna I  , Braithwaite Jeffrey  , Iedema Rick  , Coiera Enrico W
Published: February 2025

The health informatics research community has been undertaking work at the organization-technology intersection for some time now. However there is no one place in the literature which presents a rigorously-defined evaluation framework for use by practitioners and researchers seeking to assess the impact of information and communication technologies on organizational processes and outcomes. There are two main challenges. One is to conceptualize the design features of such an evaluation framework. The second is to specify what data will be gathered and how. This paper aims to address each of these problems.
Relationships among Different Subjective Measurements of Consumer Health Information Retrieval Performance
Authors: Zeng Qing T.  , Kogan Sandra  , Ngo Long  , Greenes Robert A.
Published: February 2025

Background: Millions of consumers perform health information retrieval (HIR) online. To better understand the consumers'perspective on HIR performance, we conducted an observation and interview study of 97 health information consumers.
Patient opinion – EHR assessment from the users perspective
Authors: Zurita Laura  , Nøhr Christian
Published: February 2025

Electronic Health Records (EHR) are becoming an integrated part of modern health care. The introduction of EHR in healthcare has been evaluated by many actors and from many perspectives. However, there is hardly any study exploring the opinion of the ultimate users of the system, the patients. This study aims to provide information about patient values and communication that will be useful in the design of a more patient friendly health system. We have asked patients in three different hospitals about their opinions about EHR, using semi structured individual interviews and focus groups. The patients are open to the use of EHR, but they have some concerns: they want their privacy to be respected, and the systems to be safe from the intrusion from outsiders. These results underline the general societal tendencies of citizen accepting the use of new technology, but being very keen to protect their privacy.
Clinical Validation of Different Echocardiographic Motion Pictures Expert Group-4 Algorythms and Compression Levels for Telemedicine
Authors: Barbier Paolo  , Alimento Marina  , Berna Giovanni  , Cavoretto Dario  , Celeste Fabrizio  , Muratori Manuela  , Guazzi Maurizio D.
Published: February 2025

Tele-echocardiography is not widely used because of lengthy transmission times when using standard Motion Pictures Expert Groups (MPEG)-2 lossy compression algorythms, unless expensive high bandwidth lines are used. We sought to validate the newer MPEG-4 algorythms to allow further reduction in echocardiographic motion video file size. Four cardiologists expert in echocardiography read blindy 165 randomized uncompressed and compressed 2D and color Doppler normal and pathologic motion images. One Digital Video and 3 MPEG-4 compression algorythms were tested, the latter at 3 increasing compression levels (0%, 35% and 60%). Mean diagnostic and image quality scores were computed for each file and compared across the 3 compression levels using uncompressed files as controls. File dimensions decreased from a range of uncompressed 12-83 MB to MPEG-4 0.03-2.3 MB. All algorythms showed mean scores that were not significantly different from uncompressed source, exept the MPEG-4 DivX algorythm at the highest selected compression (60%, p= .002). These data support the use of MPEG-4 compression to reduce echocardiographic motion image size for transmission purposes, allowing cost reduction through use of low bandwidth lines.
Achieving a “Therapeutic Dose” of IT
Authors: Bodell Richard  , Covvey H. Dominic  , Fader Christina
Published: February 2025

Our health systems face a number of critical challenges over the next several decades, not the least of which is the aging of our baby boomers. Many have suggested that information technologies will be an essential tool, which will increase health system productivity and in so doing will help us manage our way through these challenging times. Unfortunately, little evidence exists supporting the hypothesis that IT creates productivity gains in any sector, let alone health. This paper reviews the “Productivity Paradox” and the challenges associated with measuring the effects that IT may have on health system productivity, and proposes potential directions for new work.
A Clinical Care Costing Method
Authors: Saba Virginia K.  , Arnold Jean M.
Published: February 2025

The Clinical Care Costing Method (CCCM for the Home Health Care Classification (HHCC) System provides an innovative way to determine the cost of clinical nursing practice. This costing methodology consists of three major nursing indicators – Diagnostic Components, Actions and Outcomes. These three indicators require Clinical Care Pathways (CCP) to document, track, and code clinical care using the HHCC. The clinical care costs and/or resources are derived from the time and frequencies of the Type Actions for the specific interventions performed by the different type of health care providers to achieve the Outcomes and resolve the Diagnostic Components. This method can also be used to determine the reimbursement for nursing care services retrospectively and once validated prospectively. The Clinical Pathway data provide the evidence that the nursing care achieved the desired outcomes..
Vaidurya – A Concept-Based, Context-Sensitive Search Engine For Clinical Guidelines
Authors: Moskovitch Robert  , Hessing Alon  , Shahar Yval
Published: February 2025

A major problem in the effective use of clinical guidelines is fast and accurate access at the point of care. Thus, we are developing a digital electronic guideline library (DeGeL) and a set of tools for incremental conversion of free-text guidelines into increasingly machine-comprehensible representations, which support automated application. Even if guidelines are represented, in electronic fashion, care providers need to be able to quickly retrieve the guidelines that best fit the clinical situation at hand. We describe Vaidurya, a search and retrieval engine that exploits the hybrid nature of guideline representation in the De-. GeL architecture. Vaidurya can use not only free-text keywords, but also multiple semantic indices along which the guidelines are classified, and the mark up of guidelines in DeGeL, using the semantic roles of one or more guideline-representation languages. Preliminary evaluation of Vaidurya in a standard information task and a large guideline repository is encouraging; formal evaluation is under way.
Design and Development of a Search Interface for an Information Gathering Tool
Authors: Gong Yang  , Zhang Tao  , Rukab Jamie  , Johnson-Throop Kathy  , Malin Jane  , Zhang Jiajie
Published: February 2025

In order to design effective and usable search interfaces it is essential to fully understand the characteristics of the users and the tasks they perform. In this paper, we describe how to use a human-centered approach to design a usable search interface. We first conducted user and task analyses of the application domain -- Biomedical Engineers' log notes at NASA Johnson Space Center. From these analyses, we identified what functions the users want, the tasks they perform, and a coding system for the vocabulary used by the users to log entries in the log notes. We then implemented a prototype of a human-centered search interface by using the results of the user and task analyses and by applying other human-centered principles. Finally, we discussed the implications of human-centered design for general health information systems.
A Methodology for Modular Representation of Guidelines
Authors: Scott-Wright Alicia O.  , Fischer Robert P.
Published: February 2025

Computer-based clinical practice guidelines often need to be modified when medical knowledge evolves or when guidelines are implemented in a local setting with specific constraints and preferences. To enable easy modifications to guidelines and maintain their integrity, we have developed a methodology for modular representation of guidelines. Using this approach, we create guidelines in a hierarchical and modular manner. We use the Axiomatic Design methodology to facilitate the development of independent modules. Design matrices capture the interactions among modules. The design matrices can be used during guideline modification to create a change process and to enable identification of other modules that are affected by a change to a module. We implemented this modular knowledge representation approach by incorporating it into the Guideline Interchange Format (GLIF) language. We applied this approach to encode parts of three outdated guidelines released during 2000-2001, and we revised these designs to model updated releases of the guideline. Qualitative and quantitative metrics were developed to assess the types of changes made to the encoded guidelines.
Analysis of Dutch general practice guidelines for inconsistencies with respect to the management of cardiovascular disease risk factors
Authors: Van Wyk Jacobus T.  , Van Wijk Marc A.M.
Published: February 2025

Presenting guidelines relating to cardiovascular disease (CVD) in a clinical decision support system (CDSS) is viewed as a mechanism for introducing evidence based practice in to daily practice. Analysis of guidelines on consistency is needed before constructing such a system. We analyzed 74 electronically available Dutch general practice guidelines for statement inconsistencies with respect to the management of CVD, and for each inconsistency, whether incomplete cross referencing existed between the guidelines.
Implementation and Initial Evaluation of a Web-based Nurse Order Entry System for Multidrug-Resistant Tuberculosis Patients in Peru
Authors: Choi Sharon S  , Jazayeri Darius G  , Mitnick Carole D  , Chalco Katiuska  , Bayona Jaime  , Fraser Hamish S F
Published: February 2025

Socios En Salud uses directly observed therapy to treat a majority of the multidrug-resistant tuberculosis in Peru. The nurses play an important role in this community-based model as the patients’ primary care givers. Since nurses, rather than physicians, are involved in patients’ daily care, we developed a nurse-order entry system to test whether such a system would improve the accuracy and quality of medication data. We compared regimen information from patient electronic medical records, paper charts and pharmacy records. After a two-month training period on the new system, we conducted the trial for 52 days in two of Lima’s six geographic treatment areas, and re-reviewed the three sources of medication data. We measured the error rates after the trial period and found there was no significant difference in the control group’s (Lima Este), error rate (8.6% vs. 6.9%, P=O.66) after the trial. The intervention group (Lima Callao), however, showed a significant drop in the error rate (17.4% vs. 3.1%, P=0.0074) after the same time interval. Additionally, the nurse expressed satisfaction with the order entry system and its ease of use. The decrease in error rates and user satisfaction regarding the system are promising measures of our order entry system’s success.
A Guideline Management System
Authors: Ciccarese Paolo  , Caffi Ezio  , Boiocchi Lorenzo  , Quaglini Silvana  , Stefanelli Mario
Published: February 2025

This paper describes the architecture of NewGuide, a guideline management system for handling the whole life cycle of a computerized clinical practice guideline. NewGuide components are organized in a distributed architecture: an editor to formalize guidelines, a repository to store them, an inference engine to implement guidelines instances in a multi-user environment, and a reporting system storing the guidelines logs in order to be able to completely trace any individual physician guideline-based decision process. There is a system “central level” that maintains official versions of the guidelines, and local Healthcare Organizations may download and implement them according to their needs. The architecture has been implemented using the Java 2 Enterprise Edition (J2EE) platform. Simple Object Access Protocol (SOAP) and a set of contracts are the key factors for the integration of NewGuide with healthcare legacy systems. They allow maintaining unchanged legacy user interfaces and connecting the system with whatever electronic patient record. The system functionality will be illustrated in three different contexts: homecare-based pressure ulcer prevention, acute ischemic stroke treatment and heart failure management by general practitioners.