bluuebunny/crossref_metadata_2025 huggingface dataset:
Towards Open-Source, Low-Cost Haptics for Surgery Simulation
Authors: Suwelack Stefan  , Sander Christian  , Schill Julian  , Serf Manuel  , Danz Marcel  , Asfour Tamim  , Burger Wolfgang  , Dillmann Rüdiger  , Speidel Stefanie
Published: February 2025

In minimally invasive surgery (MIS), virtual reality (VR) training systems have become a promising education tool. However, the adoption of these systems in research and clinical settings is still limited by the high costs of dedicated haptics hardware for MIS. In this paper, we present ongoing research towards an open-source, low-cost haptic interface for MIS simulation. We demonstrate the basic mechanical design of the device, the sensor setup as well as its software integration.
Automatic Detection of Inferior Alveolar Nerve Canal from Cone-Beam Computed Tomography Images for Dental Surgery Planning
Authors: Choi Jin Hyeok  , Baek Seung-Yeob  , Kim Youngjun  , Son Tae-Geun  , Park Sehyung  , Lee Kunwoo
Published: February 2025

The inferior alveolar nerve canal is an important nerve canal in the jaw bone, and any damage to this canal can cause pain or fatal complications. Since such damage can be caused by a wrong surgical procedure or surgery plan, accurate surgery planning is necessary. Cone-beam computed tomography (CBCT) is a three-dimensional medical imaging method that is mainly used in dental treatment; however, identifying the nerve canal is difficult in CBCT images as compared to conventional CT images. This paper proposes a new concept of a panoramic curve for nerve canal detection and a detection algorithm that is usually applied to facial recognition was introduced in this study for the automatic detection of nerve canal in CBCT images.
A Virtual Reality Platform for Assessment and Rehabilitation of Neglect Using a Kinect
Authors: Cipresso Pietro  , Serino Silvia  , Pedroli Elisa  , Gaggioli Andrea  , Riva Giuseppe
Published: February 2025

Unilateral Spatial Neglect (USN) is normally assessed with paper-and-pencil tests. Virtual reality can be an effective neuropsychological tool for a more ecological and functional assessment and rehabilitation of neglect. We developed a 3D Virtual Reality platform – NeuroVirtual 3D – for the assessment and rehabilitation of cognitive deficits, in particular for USN. Within the virtual environments it is possible to interact with virtual objects and execute specific exercises using a Microsoft Kinect. Through the analysis of different grasping tasks it is possible to evaluate in an ecological way the patients' ability to find and handle objects in both sides of the virtual space.
A Decoupled 2 DOF Force Feedback Mechanism for the Virtual Translumenal Endoscopic Surgical Trainer (VTEST
Authors: Dargar Saurabh  , Lam Benjamin  , Horodyski Crystal  , Sankaranarayanan Ganesh  , De Suvranu
Published: February 2025

Natural orifice translumenal endoscopic surgery (NOTES) is a minimally invasive procedure which utilizes the body's natural orifices to gain access to the peritoneal cavity. The VTEST is a virtual reality NOTES cholecystectomy simulator being built at the CeMSIM at RPI. We have developed a 2 DOF decoupled haptic device, which can provide translational and rotational haptic feedback to the user handling the flexible endoscope. Preliminary results indicate the device is capable of providing realistic feedback to the user while operating the device.
Supporting Diagnosis and Treatment in Medical Care Based on Big Data Processing
Authors: Lupşe Oana-Sorina  , Crişan-Vida Mihaela  , Stoicu-Tivadar Lăcrămioara  , Bernard Elena
Published: February 2025

With information and data in all domains growing every day, it is difficult to manage and extract useful knowledge for specific situations. This paper presents an integrated system architecture to support the activity in the Ob-Gin departments with further developments in using new technology to manage Big Data processing – using Google BigQuery – in the medical domain. The data collected and processed with Google BigQuery results from different sources: two Obstetrics & Gynaecology Departments, the TreatSuggest application – an application for suggesting treatments, and a home foetal surveillance system. Data is uploaded in Google BigQuery from Bega Hospital Timişoara, Romania. The analysed data is useful for the medical staff, researchers and statisticians from public health domain. The current work describes the technological architecture and its processing possibilities that in the future will be proved based on quality criteria to lead to a better decision process in diagnosis and public health.
Systematic Review of Interventions Supported by ICT for the Prevention Treatment of Occupational Stress
Authors: Narváez Santiago  , Tobar Ángela M.  , López Diego M.
Published: February 2025

Problem: Stress-related disorders have become one of the main problems of public health in many countries and of worldwide organizations, and they are expected to become more common in the forthcoming decades.
Usability of Patient-Centered Health IT: Mixed-Methods Usability Study of ePill
Authors: Schmidt-Kraepelin Manuel  , Dehling Tobias  , Sunyaev Ali
Published: February 2025

To facilitate use of patient-centered health IT applications in everyday life, a high degree of usability is required. Based on the example of a patient-centered web application, we propose a usability study design enabling developers and researchers to assess usability of patient-centered health IT applications and derive implications for their improvement. Our study design integrates tasks that subjects have to process, an associated questionnaire based on Perceived Ease of Use, Perceived Usefulness, Attitude Toward Using, and Behavioral Intention to Use, a System Usability Scale questionnaire, and focus groups. Application of the usability study design demonstrates its feasibility and provides insights for assessment of usability in related projects in research and practice.
A Dashboard to Support Management of Business Analytics Capabilities
Authors: Rivera David Santiago  , Shanks Graeme
Published: February 2025

Business analytics (BA) systems create value and provide competitive advantage for organisations. They involve technology and data infrastructure, BA capabilities, and business processes that provide useful insights and support decision-making. To provide value and competitive advantage, BA capabilities should be valuable, rare, inimitable and have organisational support (VRIO). In this paper, we develop and evaluate a prototype dashboard for the VRIO assessment of BA capabilities. The dashboard is intended to support the strategic management of BA capabilities. We discuss implications of the prototype dashboard for researchers and practitioners and suggest directions for future research.
Decision Support and Decision Guidance: A Case Study in the Financial Services – DSS2.0 is Still Far Away
Authors: Daly Mary  , Adam Frederic
Published: February 2025

The provision of decision support tools for highly uncertain and unstructured decision situations has occupied researchers in the Decision Support Systems (DSS) area since the term was coined by Gorry and Scott Morton in 1971. We propose an empirical evaluation of Silver's [20] concept of decisional guidance in a case study of Big Bank, a large financial services firm. Our analysis provides evidence of the impact of decision support on the decision making of managers, in ways that are qualitatively different at the different stages of development of management thinking. The conclusions deliver fresh insights into the difficulties which even large and well equipped firms face in developing applications that support managers in their day-to-day decision making processes, let alone in their tactical and strategic reasoning. Thus, despite all the renewed hype in the DSS area, the achievement of seemingly simple decision support is still problematic.
What Do We Mean by Social Networking Sites?
Authors: La Sala Louise  , Skues Jason  , Wise Lisa
Published: February 2025

The purpose of this study was to explore people's conceptual understanding of Social Networking Sites (SNSs) through exploring the combined use of a range of popular SNSs, including Facebook, Twitter, Myspace, Instagram, Tumblr, LinkedIn and Google Plus. Seventy-three adults, aged 18 to 63, participated in an online survey that used open-ended questions to ask how participants define and use different SNSs. Four themes were identified, including the explicit presentation and interpretation of different selves, the love-hate relationship with SNSs, privacy and danger concerns, and limited SNS knowledge. The findings from this study suggest that researchers need to consider how people use SNSs in combination as this influences the decisions people make about which SNS accounts they use and how they present themselves on these sites.
How Do Client and Therapists in Online Text Therapy Experience Their Exchanges and Relationship?
Authors: Reynolds D'Arcy J.
Published: February 2025

The impact of online therapy text exchanges and the client-therapist alliance was compared to previously published means and standard deviations on face-to-face therapy using an aggregate benchmarking strategy. Further, the moderating effects of 4 participant factors found significant in the face-to-face therapy literature was investigated using mixed modeling analytic techniques. Thirty therapists and 30 clients visited an online site to report weekly to complete session impact and therapeutic alliance measures for a minimum of six weeks, which allowed for a naturalistic and nuanced examination of the process of online text psychotherapy. The impact of exchanges and client-therapist alliance in text therapy were similar to but in some respects more positive than previous evaluations of face-to-face therapy. A notable exception was substantially lower Arousal scores replicating the previously-observed online calming effect. The significance of participant factors previously found to influence impact and alliance in face-to-face therapy was not replicated except that therapists with the more symptomatic clients rated their text exchanges as less smooth and comfortable.
Exploring Identity Motives in Twitter Usage in Saudi Arabia and the UK
Authors: Selim Heyla A.  , Long Karen M.  , Vignoles Vivian L.
Published: February 2025

This study explores identity motives for using a microblogging site (Twitter) among Internet users in Saudi Arabia and the UK. The former boasts the world's highest per capita use of Twitter, which provides a forum in which users have more opportunity for self-expression than they do in the offline world, and is not subject to the heavy censorship which the Saudi government imposes on other Internet content [1]. Approximately 5000 tweets from the period April-May 2013 were coded and analyzed, using Motivated Identity Construction Theory as a conceptual framework [2]. This theory proposes six universal identity motives of meaning, belonging, continuity, distinctiveness, efficacy, and self-esteem. We consider these motives in turn, and examine their relative prominence in an online context. Support was found for all six universal motives, but the relative prominence of motives and the ways in which they were pursued appeared to depend on the affordances of both the OSN in question, Twitter and the cultural context in which the user was posting: Saudi users appeared to seek distinctiveness, whereas for British users, belonging was a more salient motive. Themes related to meaning, efficacy, and self-esteem were detected frequently, whereas themes related to continuity were less apparent.
Virtual Reality Graded Exposure Therapy with Arousal Control for the Treatment of Combat Related Posttraumatic Stress Disorder: A Follow Up Case Series
Authors: Wood Dennis Patrick  , Mclay Robert L.  , Webb-Murphy Jennifer  , Wiederhold Mark D.  , Spira James L.  , Pyne Jeff M.  , Wiederhold Brenda K.
Published: February 2025

Important challenges confronting DOD/military medical care are that of maintaining or increasing quality of care and increasing the effectiveness of treatments for warriors diagnosed with Posttraumatic Stress Disorder (PTSD) secondary to their combat deployments to Iraq and/or Afghanistan. Virtual Reality Graded Exposure Therapy with Arousal Control (VR-GET) has demonstrated a positive treatment effectiveness resulting in significant reductions of PTSD symptom severity. This positive treatment effectiveness has been maintained for up to 22 weeks after VR-GET therapy was completed. A robust methodology for the assessment of Virtual Reality efficacy suggests that the ideal time for follow-up begins at twelve months. Others have suggested that follow-up should occur between two and four years post treatment. In this report we describe the outcome of VR-GET for the treatment of combat-related PTSD with three warriors between five and seven years following their having completed treatment.
Intersubjectivity in Video Interview
Authors: Haddouk Lise
Published: February 2025

The concept of relationship has rapidly evolved over the past few years, since the emergence of the internet network and the development of remote communication and exchanges. The emergence of cyberculture with the development of the internet has led to a new representation of the social link, in which communication never stops. In this context, computer mediated intersubjective relationships represent a main line of thinking and research. Thus, can we consider for example that relationship is only composed of an informational exchange? Would there be other dimensions possibly missing in computer mediated relationships? In this case, how could we re-introduce these aspects, “re-humanize” the remote relationships?
The Mediating Role of Facebook Fan Pages
Authors: Chih Wen-Hai  , Hsu Li-Chun  , Wang Kai-Yu  , Lin Kuan-Yu
Published: February 2025

Using the dual mediation hypothesis, this study investigates the role of interestingness (the power of attracting or holding one's attention) attitude towards the news, in the formation of Facebook Fan Page users' electronic word-of-mouth intentions. A total of 599 Facebook fan page users in Taiwan were recruited and structural equation modeling (SEM) was used to test the research hypotheses. The results show that both perceived news entertainment and informativeness positively influence interestingness attitude towards the news. Interestingness attitude towards the news subsequently influences hedonism and utilitarianism attitudes towards the Fan Page, which then influence eWOM intentions. Interestingness attitude towards the news plays a more important role than hedonism and utilitarianism attitudes in generating electronic word-of-mouth intentions. Based on the findings, the implications and future research suggestions are provided.
Does Student and Instructor Use of Social Media Facilitate Online Learning: A Look at Two Universities
Authors: Cole Michele T.  , Shelley Daniel J.  , Swartz Louis B.  , Adeoye Blessing
Published: February 2025

This paper presents partial results of a study conducted at two universities, Robert Morris University in Southwestern Pennsylvania and the University of Lagos, Nigeria in fall, 2013. Researchers developed a twenty-five question survey instrument based on the results of a pilot study conducted in summer, 2013. The purpose of the study was to determine how much and which social media students and instructors were using in their online courses to facilitate learning. Additionally, researchers were interested in learning if there were significant differences in the use of social media by students and instructors in different educational environments, such as a small private university in the United States compared with a much larger public institution in Nigeria. Comparing the use of social media in courses at both institutions, the pilot study of the same populations found significant differences in the use of certain types of social media in online course work. The pilot study also showed significant differences between the two student samples (RMU and U. Lagos) on the question of how helpful the use of certain technologies was to learning. In this study, a greater number of significant differences were found than were found in the pilot study for the same set of social media. In both studies, a significant difference was found in responses to a final question asking how soon students might adopt new technologies.
Clinical Documentation Improvement for Outpatients by Implementing Electronic Medical Records
Authors: Seto Ryoma  , Inoue Toshitaka  , Tsumura Hiroshi
Published: February 2025

This observational study was conducted before and after implementing an electronic medical record (EMR) system to evaluate the change in outpatient workflow by implementation of EMR and the effectiveness of clinical documentation improvement (CDI). The number of hours for patient care increased by 89.2% (p < .05) and the hours for writing medical records after consulting decreased after implementation of EMR by 27.3% (p < .01). Implementation of EMR reduced nurses' workload to handle medical records by 78.8 (p < .05) but not changed for physicians. The necessary change in the information management process occurred after using the CDI indicator. We recommend that the “working hours of health professionals” and “handling hours for information resources” should be used widely as CDI indicators to improve workflow when implementing EMR.
Refining Process of Nursing Skill Movie Manual by Peer Comments of Social Network System
Authors: Majima Yukie  , Maekawa Yasuko  , Shimada Satoshi  , Izumi Takako
Published: February 2025

The nursing practical knowledge represented by nursing skill is highly tacit and is therefore difficult to verbalize. The purpose of this study is to build a new learning community for nursing education (nursing social e-learning model) that is refined and developed autonomously and continuously. We used the social network system (SNS) that can be participated in a variety of stakeholder of medical personnel in order to hear comments for the content of learning to practice nursing skill. We had the nurses make the nursing skill movie manual. Through this process to get the opinions about the movie contents from others, we inspected what kind of opinions and feelings occurred to the nurses. As a result, the nurses were able to see objectively the own nursing skills, to do self-reflection. They had the awareness to improve the nursing skills.
Hospital Nurses' and Physicians' Use of Information Sources during their Production of Discharge Summaries: A Cross-Sectional Study
Authors: Hellesø Ragnhild  , Sogstad Maren Kristine Raknes
Published: February 2025

Hospital nurses' and physicians' production and exchange of accurate information between levels of care are crucial for ensuring safe and seamless care for patients in transition. We report on a study in which we explored hospital providers' use of information sources when they prepared discharge information for colleges in the community health-care sector. In this cross-sectional study, 510 nurses and 236 physicians responded through a questionnaire. Our findings show that nurses and physicians use different information sources in patient records when they produce their discharge summaries.
Using a Data Mining Approach to Discover Behavior Correlates of Chronic Disease: A Case Study of Depression
Authors: Yoon Sunmoo  , Taha Basirah  , Bakken Suzanne
Published: February 2025

The purposes of this methodological paper are: 1) to describe data mining methods for building a classification model for a chronic disease using a U.S. behavior risk factor data set, and 2) to illustrate application of the methods using a case study of depressive disorder. Methods described include: 1) six steps of data mining to build a disease model using classification techniques, 2) an innovative approach to analyzing high-dimensionality data, and 3) a visualization strategy to communicate with clinicians who are unfamiliar with advanced statistics. Our application of data mining strategies identified childhood experience living with mentally ill and sexual abuse, and limited usual activity as the strongest correlates of depression among hundreds variables. The methods that we applied may be useful to others wishing to build a classification model from complex, large volume datasets for other health conditions.
GRAPPA: A Semantical Framework for Graph-Based Argument Processing
Authors: Brewka Gerhard  , Woltran Stefan
Published: February 2025

Graphical models are widely used in argumentation to visualize relationships among propositions or arguments. The intuitive meaning of the links in the graphs is typically expressed using labels of various kinds. In this paper we introduce a general semantical framework for assigning a precise meaning to labelled argument graphs which makes them suitable for automatic evaluation. Our approach rests on the notion of explicit acceptance conditions, as first studied in Abstract Dialectical Frameworks (ADFs). The acceptance conditions used here are functions from multisets of labels to truth values. We define various Dung style semantics for argument graphs. We also introduce a pattern language for specifying acceptance functions. Moreover, we show how argument graphs can be compiled to ADFs, thus providing an automatic evaluation tool via existing ADF implementations. Finally, we also discuss complexity issues.
Exploring Three Perspectives on Feasibility of a Patient Portal for Older Adults
Authors: Barron Jeremy  , Bedra McKenzie  , Wood Jeffrey  , Finkelstein Joseph
Published: February 2025

Introduction: It is not clear whether older adults with chronic disease and their caregivers are likely to use patient portals.
Towards an Intelligent Decision Support System for Public Health Surveillance – A Qualitative Analysis of Information Needs
Authors: Mera Maritza  , González Carolina  , López Diego M.
Published: February 2025

Public health information systems are often implemented considering the functionalities and requirements established by administrative staff or researchers, but sometimes ignoring the particular needs of decision makers. This paper describes a proposal to support the design of a Decision Support System for Public Health Surveillance in Colombia, by conducting a qualitative study to identify the real needs of people involved in decision making processes. Based on the study results, an intelligent computational component that supports Data Analysis Automation, Prediction of future scenarios and the identification of new Behavioral Patterns is proposed. The component will be implemented using the Case Based Reasoning methodology, which will be integrated as a new component of the Open Source DHIS2 Platform, enabling public health decision-making.
Empowering Skills for an Active Ageing and Healthy Living
Authors: Antonietti Alessandro  , Balconi Michela  , Catellani Patrizia  , Marchetti Antonella
Published: February 2025

The chapter is aimed at describing four different approaches, each supported by experimental findings, which can be adopted to empower life skills in the elderly. The first approach consists in stimulating aged persons by asking them to carry out some tasks aimed at activating the brain and mental processes which are targeted by the intervention. In the second approach the elderly are hinted at thinking about their mental states to understand one's own and others' behavior to act as a reflective agent. The third approach is based on the assumption that the communication context can support and improve old people's skills, if the messages they receive are devised so to focus their attention on relevant information and to elicit relevant cognitive frameworks. According to the fourth approach, aged people can be engaged in activities which enjoy them so to express themselves in personal ways and to practice a wide set of mental functions. Becoming aware of the pros and cons of each approach enables us to choose the kind of intervention which is most suited to the elderly, taking into account the features of the context and the actual resources which can be employed. We also aim at integrating the different approaches so to devise a holistic intervention in which synergies among the methodologies to be applied occur.
Analysis of operating theatre utilisation to drive efficiency and productivity improvements
Authors: Thorburn Hamish  , Khanna Sankalp  , Boyle Justin  , Good Norm  , Steyn Michael
Published: February 2025

There is an urgent need in the acute health system to use resources as efficiently as possible. One such group of resources are operating theatres, which have an important impact on patient flow through a hospital. Data-driven insights into the use of operating theatres can suggest improvements to minimise wastage and improve theatre availability. In this paper, a short extract of surgical data from participating Queensland public hospitals was statistically analysed to examine the effects of session type, session specialty, scheduling the longest case first and day of the week on theatre utilisation. It was found that day-long sessions (as opposed to separate morning or afternoon sessions), mid-week sessions, certain specialties (eg. neurosurgery sessions) and not doing the longest case first were most beneficial to theatre utilisation. Awareness of these findings is important in any redesign activity aimed at improving flow performance.
Cluster analysis of medication adherence in Pacific patients with high cardiovascular risk
Authors: Warren Jim  , Gu Yulong  , Kennelly John
Published: February 2025

Introduction: The Caring Does Matter (CDM) programme aimed to improve cardiovascular disease risk (CVR) management in Pacific people, targeting medication adherence problems. This paper presents cluster analysis of CDM data to model medication adherence and cardiovascular risk factors in high-CVR patients.
iPad use during ward rounds: An observational study
Authors: Lehnbom Elin C.  , Adams Kristian  , Day Richard O.  , Westbrook Johanna I.  , Baysari Melissa T.
Published: February 2025

Much clinical information is computerised and doctors' use of mobile devices such as iPad tablets to access this information is expanding rapidly. This study investigated the use of iPads during ward rounds and their usefulness in providing access to information during ward rounds. Ten teams of doctors at a large teaching hospital were given iPads for ten weeks and were observed on ward rounds for 77.3 hours as they interacted with 525 patients. Use of iPads and other information technology devices to access clinical information was recorded. The majority of clinical information was accessed using iPads (56.2%), followed by computers-on-wheels (35.8%), stationary PCs (7.9%) and smartphones (0.1%). Despite having read-only access on iPads, doctors were generally happy using iPads on ward rounds. These findings provide evidence of the value of iPads as a tool to access information at the point of care.
Does SNOMED CT post-coordination scale?
Authors: Karlsson Daniel  , Nyström Mikael  , Cornet Ronald
Published: February 2025

SNOMED CT is a compositional terminology. Construction of post-coordinated expressions allows users to specify new meaning by referencing existing SNOMED CT concepts. The use of post-coordinated expressions in information systems requires special software, a reasoner, to give the exact relations between post-coordinated expressions and existing SNOMED CT content. Thus, the performance characteristics of reasoners are important for implementation of post-coordination in information systems. This study aims to test how reasoners perform when a large number of post-coordinated expressions are added to SNOMED CT. The time needed to classify an ontology consisting of SNOMED CT plus an increasing number of post-coordinated expressions is measured. The best performing reasoner in this test classifies SNOMED CT plus 1 million post-coordinated expressions in 42 seconds. The time to classify grows a little less than quadratic as the size of the ontology increases. In conclusion, classification time is not a problem using current reasoners and current SNOMED CT releases even if a large number of post-coordinated expressions are added.
Performance Comparison of Compression Algorithms for Archiving Segmented Volumetric Binary Medical Data
Authors: Fischer Felix  , Selver M. Alper  , Dicle Oguz  , Hillen Walter
Published: February 2025

Archiving result of a segmentation task allows the representation of the segmented volume at a later time. The segmented volume can be stored in a binary format, which can be restored by a simple combination of the original data with this binary information. Since, the sizes of the segmented binary data have high memory requirements; a lossless compression method should be employed for efficient archiving. Thus, this study examines different approaches for compression and their suitability for restoring binary segmentation results. To evaluate the compressive properties, multiple test cases with diverse spatial structures and acquired with different modalities from clinical practice have been used. The results show that best performance is achieved with JBIG2 method both in terms of compression ratio and processing time.
EPR-based, quality-related process parameters: a nationwide assessment
Authors: De Clercq E.  , Van Casteren V.  , Bossuyt N.  , Goderis G.  , Moreels S.
Published: February 2025

The aim of the study was to determine whether or not primary care EPR-based data can be used to measure specific process parameters that can then, in turn, be used to assess the quality of care provided to chronic patients. We analysed data from a large research network that collects data from all Belgian GP practices through both manual and automatic extraction procedures. We built a number of quality-related process parameters and observed the concordance of our results with two external databases: a nationwide reimbursement database and a regional EPR-based network. We found that only the automatic data extraction method was suitable for building process parameters. The current research network may lead to an underestimation of the quality of care processes. We suggested ways to improve this network.
Semantic Krippendorff's α for measuring inter-rater agreement in SNOMED CT coding studies
Authors: Karlsson Daniel  , Gøeg Kirstine Rosenbeck  , Örman Håkan  , HØjen Anne Randorff
Published: February 2025

Semantic interoperability requires consistency in use of terminologies such as SNOMED CT. Inter-rater agreement measurement can be used to quantify this consistency among terminology users. Increasingly, studies of SNOMED CT include inter-rater agreement measures. However, published studies do not consider distance between concepts when calculating the inter-rater agreement measures. In this paper we propose a semantic inter-rater agreement measure for use with SNOMED CT encoded data. A semantic Krippendorff's α measure is implemented using a path-length based difference function. The measure is tested using three different datasets. Results show that the proposed semantic measure is sensitive to seriousness of coding differences whereas a nominal measure is not. The proposed measure reflects the intuition that distance matters when comparing uses of SNOMED CT.
Localizing the HL7 Personal Health Monitoring Record for Danish Telemedicine
Authors: Christensen Henrik Bærbak
Published: February 2025

Telemedicine holds a promise of lowering cost in health care and improving the life quality of chronic ill patients by allowing monitoring in the home. The Personal Health Monitoring Record (PHMR) is an international HL7 standard data format for encoding measurements made by devices in the home. However, the standard needs localization to national requirements in order to facilitate semantic interoperability between clinical systems. In this paper, we report experiences and decisions from the current effort to localize PHMR in Denmark, and highlight issues relevant for any adoption of the standard.
Interoperability Standards enabling cross-border Patient Summary Exchange
Authors: Chronaki Catherine  , Estelrich Ana  , Cangioli Giorgio  , Melgara Marcello  , Kalra Dipak  , Gonzaga Zabrina  , Garber Larry  , Blechman Elaine  , Ferguson Jamie  , Kay Stephen
Published: February 2025

In an increasingly mobile world, many citizens and professionals are frequent travellers. Access during unplanned care to their patient summary, their most essential health information in a form physicians in another country can understand can impact not only their safety, but also the quality and effectiveness of care. International health information technology (HIT) standards such as HL7 CDA have been developed to advance interoperability. Implementation guides (IG) and IHE profiles constrain standards and make them fit for the purpose of specific use cases. A joint effort between HL7, IHE, and HealthStory created Consolidated CDA (C-CDA), a set of harmonized CDA IGs for the US that is cited in the Meaning Use II (MU-II) regulation. In the EU, the Patient Summary (PS) Guideline recently adopted, cites the epSOS IG also based on HL7 CDA, to support cross-border care in the EU and inform national eHealth programs. Trillium Bridge project supports international standards development by extending the EU PS Guideline and MU-II in the transatlantic setting. This paper presents preliminary findings from comparing patient summaries in the EU and US and reflects on the challenge of implementing interoperable eHealth systems in the cross-border or transatlantic setting.
How Google Glass Could Support Patients with Diabetes Mellitus in Daily Life
Authors: Hetterich Christian  , Pobiruchin Monika  , Wiesner Martin  , Pfeifer Daniel
Published: February 2025

Even long before it was published, many people regarded Google Glass as a Swiss army knife for nearly every task. There are some fields of application in which the best known wearable device could simplify daily life, such as car navigation or reading recipes. But does this also apply for medicine and health care? This paper will at first explain what Google Glass is and how it works. Afterwards, diabetes mellitus (DM), is discussed. Moreover, we try to answer the question whether a Glass-like device could support and improve people with DM. Therefore, several use cases for Glass-enabled chronic disease care are outlined.
Rule-based Interface Generation on Mobile Devices for Structured Documentation
Authors: Kock Ann-Kristin  , Andersen Björn  , Handels Heinz  , Ingenerf Josef
Published: February 2025

In many software systems to date, interactive graphical user interfaces (GUIs) are represented implicitly in the source code, together with the application logic. Hence, the re-use, development, and modification of these interfaces is often very laborious. Flexible adjustments of GUIs for various platforms and devices as well as individual user preferences are furthermore difficult to realize. These problems motivate a software-based separation of content and GUI models on the one hand, and application logic on the other. In this project, a software solution for structured reporting on mobile devices is developed. Clinical content archetypes developed in a previous project serve as the content model while the Android SDK provides the GUI model. The necessary bindings between the models are specified using the Jess Rule Language.
Improving Health Care Service Delivery with A National Code Service
Authors: Vuokko Riikka  , Mäkelä-Bengs Päivi  , Härkönen Mikko
Published: February 2025

An implementation of eHealth services including a national code service is ongoing in Finland. The code service shares and maintains all common codes and data structures used in electronic patient records. In this paper, we describe the code service process and the challenges of developing the process as a part of national eHealth services.
Providing Multilingual Access to Health-Related Content
Authors: Plumbaum Till  , Narr Sascha  , Eryilmaz Elif  , Hopfgartner Frank  , Klein-Ellinghaus Funda  , Reese Anna  , Albayrak Sahin
Published: February 2025

Finding health-related content is not an easy task. People have to know what to search for, which medical terms to use, and where to find accurate information. This task becomes even harder when people such as immigrants wish to find information in their country of residence and do not speak the national language very well. In this paper, we present a new health information system that allows users to search for health information using natural language queries composed of multiple languages. We present the technical details of the system and outline the results of a preliminary user study to demonstrate the usability of the system.
GlassAllergy: A Google Glass-based Solution to Empower Patients with Skin Allergies
Authors: Wiesner Martin  , Pobiruchin Monika  , Hetterich Christian  , Pfeifer Daniel
Published: February 2025

A variety of substances contained in cosmetic products can lead to allergic reactions for certain individuals. The names of such substances are predominantly printed onto a product in small-sized expert language. For this reason, consumers often have difficulties to assess whether some of the ingredients might be harmful for them. Consequently, patients are exposed to a risk of buying a cosmetic product that might cause a minor to severe allergic reaction. A Google Glass-based software solution for consumers suffering from skin allergies is presented. It enables users to check cosmetic products in a mobile context and empowers patients to make informed buying decisions. In particular, the solution could help to avoid or reduce the risk for allergic reactions.
Comparing Narrative versus Numerical Display of Functional Information: Impact on Sense-Making
Authors: Weir Charlene  , Dunlea Robert  , Staggers Nancy  , Dooing-Harris Kristina  , Mccormick Teresa  , Barrus Robyn
Published: February 2025

Contextual information consists of functional, social, and financial information about patients. Physicians routinely have difficulty incorporating contextual information into clinical decision-making despite the emphasis on patient-centered care and functional status. One reason for this difficulty is that such information is not well-represented in the patient medical record. This study assesses the impact of a “story-form” model versus a “medical” model on a practitioner's ability to recall and incorporate contextual information. We assessed this question through the analysis of responses of 30 clinicians to 2 vignettes presenting contextual information in both formats. Overall, there was a statistically significant difference between the narrative and numerical form with those receiving the narrative form for contextual information being more likely to consider it a top issue. Reference to goals in the report of key clinical factors was also significantly higher for the group receiving goal information. Implications for sharing contextual information in EMRs are discussed.
Improving Integrated Care in Chronic Kidney Failure Patients with a Standard-Based Interoperability Framework
Authors: Núñez-Benjumea Francisco  , Moreno-Conde Alberto  , Jódar-Sánchez Francisco  , Martínez-García Alicia  , Parra-Calderón Carlos L.
Published: February 2025

This paper introduces the evaluation report after fostering a Standard-based Interoperability Framework (SIF) between the Virgen del Rocío University Hospital (VRUH) Haemodialysis (HD) Unit and 5 outsourced HD centres in order to improve integrated care by automatically sharing patients' Electronic Health Record (EHR) and lab test reports. A pre-post study was conducted during fourteen months. The number of lab test reports of both emergency and routine nature regarding to 379 outpatients was computed before and after the integration of the SIF. Before fostering SIF, 19.38 lab tests per patient were shared between VRUH and HD centres, 5.52 of them were of emergency nature while 13.85 were routine. After integrating SIF, 17.98 lab tests per patient were shared, 3.82 of them were of emergency nature while 14.16 were routine. The inclusion of a SIF in the HD Integrated Care Process has led to an average reduction of 1.39 (p=0.775) lab test requests per patient, including a reduction of 1.70 (p=0.084) in those of emergency nature, whereas an increase of 0.31 (p=0.062) was observed in routine lab tests. Fostering this strategy has led to the reduction in emergency lab test requests, which implies a potential improvement of the integrated care.
Evaluation of the Usability of a Serious Game Aiming to Teach Facial Expressions to Schizophrenic Patients
Authors: Isleyen Filiz  , Gulkesen K. Hakan  , Cinemre Buket  , Samur M. Kemal  , Zayim Nese  , Sen Kaya Semiha
Published: February 2025

In some psychological disorders such as autism and schizophrenia, loss of facial expression recognition skill may complicate patient's daily life. Information technology may help to develop facial expression recognition skill by educational software and games. We designed and developed an interactive web-based educational program with which we performed a usability study before investigating its effectiveness on the schizophrenia patients' ability of emotion perception. The purpose of this study is to describe the usability evaluation for a web-based game set that has been designed to teach facial expressions to schizophrenic patients. The usability study was done at two steps; first, we applied heuristic evaluation and the violations were rated in a scale from most to least severe and the major problems were solved. In the second step, think-aloud method was used and the web site was assessed by five schizophrenic patients. Eight experts participated in the heuristic evaluation, in which a total of 60 violations were identified with a mean severity of 2.77 (range: 0–4). All of the major problems (severity over 2.5) were listed and the usability problems were solved by the development team. After solving the problems, five users with a diagnosis of schizophrenia used the web site with the same scenario. They reported to have experienced minor, but different problems. In conclusion, we suggest that a combination of heuristic evaluation and think-aloud method may be an effective and efficient way for usability evaluations for the serious games that have been designed for special patient groups.
Automatic Variance Analysis of Multistage Care Pathways
Authors: Li Xiang  , Liu Haifeng  , Zhang Shilei  , Mei Jing  , Xie Guotong  , Yu Yiqin  , Li Jing  , Lakshmanan Geetika T.
Published: February 2025

A care pathway (CP) is a standardized process that consists of multiple care stages, clinical activities and their relations, aimed at ensuring and enhancing the quality of care. However, actual care may deviate from the planned CP, and analysis of these deviations can help clinicians refine the CP and reduce medical errors. In this paper, we propose a CP variance analysis method to automatically identify the deviations between actual patient traces in electronic medical records (EMR) and a multistage CP. As the care stage information is usually unavailable in EMR, we first align every trace with the CP using a hidden Markov model. From the aligned traces, we report three types of deviations for every care stage: additional activities, absent activities and violated constraints, which are identified by using the techniques of temporal logic and binomial tests. The method has been applied to a CP for the management of congestive heart failure and real world EMR, providing meaningful evidence for the further improvement of care quality.
Clustering physical activity phenotypes using the ATLAS index on accelerometric data from an epidemiologic cohort study
Authors: Marschollek Michael
Published: February 2025

While many studies have identified associations of physical activity with both mortality and morbidity, the effects of different dose-patterns are still unclear. Employing the recently introduced ATLAS index, the aim of the research work for this paper was to investigate whether physical activity phenotypes can actually be extracted from a large-scale epidemiological accelerometer data set, and if these match the ones proposed. The ATLAS parameters were computed for 6386 data sets from the NHANES 2005-2006 cohort study, and x-Means clustering was performed on the results. Thus, four distinct clusters were identified, named: ‘insufficiently active’, ‘irregularly active’, ‘busy bee’ and ‘physical worker/weekend warrior’. In conclusion, it is possible to identify different activity phenotypes using the ATLAS index. More research is necessary with regard to the regularity component and the relation of activity patterns and medical parameters in the groups identified.
Requirements for Prototyping an Educational Electronic Health Record: Experiences and Future Directions
Authors: Kushniruk Andre  , Borycki Elizabeth  , Kuo Mu-Hsing  , Parapini Eric  , Wang Shu Lin  , Ho Kendall
Published: February 2025

Electronic health records and related technologies are being increasingly deployed throughout the world. It is expected that upon graduation health professionals will be able to use these technologies in effective and efficient ways. However, educating health professional students about such technologies has lagged behind. There is a need for software that will allow medical, nursing and health informatics students access to this important software to learn how it works and how to use it effectively. Furthermore, electronic health record educational software that is accessed should provide a range of functions including allowing instructors to build patient cases. Such software should also allow for simulation of a course of a patient's stay and the ability to allow instructors to monitor student use of electronic health records. In this paper we describe our work in developing the requirements for an educational electronic health record to support education about this important technology. We also describe a prototype system being developed based on the requirements gathered.
e-Literacy in health care
Authors: Klecun Ela  , Lichtner Valentina  , Cornford Tony
Published: February 2025

This paper explores notions of e-Literacy (otherwise IT literacy or digital literacy) in health care. It proposes a multi-dimensional definition of e-Literacy in health care and provides suggestions for policy makers and managers as to how e-Literacy might be accounted for in their decisions.
Interconnection of Electronic Medical Record with Clinical Data Management System by CDISC ODM
Authors: Matsumura Yasushi  , Hattori Atsushi  , Manabe Shiro  , Takeda Toshihiro  , Takahashi Daiyo  , Yamamoto Yuichiro  , Murata Taizo  , Mihara Naoki
Published: February 2025

EDC system has been used in the field of clinical research. The current EDC system does not connect with electronic medical record system (EMR), thus a medical staff has to transcribe the data in EMR to EDC system manually. This redundant process causes not only inefficiency but also human error. We developed an EDC system cooperating with EMR, in which the data required for a clinical research form (CRF) is transcribed automatically from EMR to electronic CRF (eCRF) and is sent via network. We call this system as “eCRF reporter”. The interface module of eCRF reporter can retrieves the data in EMR database including patient biography data, laboratory test data, prescription data and data entered by template in progress notes. The eCRF reporter also enables users to enter data directly to eCRF. The eCRF reporter generates CDISC ODM file and PDF which is a translated form of Clinical data in ODM. After storing eCRF in EMR, it is transferred via VPN to a clinical data management system (CDMS) which can receive the eCRF files and parse ODM. We started some clinical research by using this system. This system is expected to promote clinical research efficiency and strictness.