Connected for Health: Day One

“Bouncing from the Health 2.0 event last week to Connected for Health Symposium here in Boston, organized by Partners Healthcare, I’ll be reporting on some of the key presentations. Will also be moderating the afternoon session on the major platform plays, Dossia, Google Health, HealthVault and WebMD who is not exactly a platform but certainly the 800 lbs. gorilla in the PHR market.”
Article
John Moore, Chilmark Research, 27 October 2008

Community nurses get mobile access to iPM

“Community nurses at Wolverhampton Primary Care Trust have gone live with 3G technology that allows them to access its iPM system and record patient activity.
A total of 60 nurses working for the community out-of-hours service in Wolverhampton have been given 3G enabled-laptops to enable remote access to the system provided by its local service provider.”
Article
e-Health Insider Primary Care, 2 October 2008

Mobile Medicine for the Developing World

“Mention telemedicine and mobile health care in the United States or Europe and thoughts turn to multimillion-dollar suites of high-tech equipment or personal digital assistants (PDAs) with hefty monthly data charges.
In the developing world, however, the concept is as simple as a cell phone.”
Article
Neil Versel, Digital Healthcare & Productivity, 29 July 2008

Public views of mobile medical devices and services: A US national survey of consumer sentiments towards RFID healthcare technology

“A 2007 national public opinion survey of 1404 Americans revealed variations in sentiments concerning the desirability of several mobile healthcare technologies based on RFID. The survey appears to be the first reasonably national public opinion survey of US adults concerning their attitudes towards mobile healthcare technology. The survey revealed high levels of interest in emergency intervention services, but much less so in health information and monitoring services. Interest in RFID personal medical technology was positively associated with high levels of trust in others and social support. At the same time, a small minority were negatively disposed towards such applications. In those cases, the negative sentiment appears heightened when the mobile healthcare application is offered in a modality attached to the body as opposed to a somewhat more physically remote option, i.e., attached to one’s cell phone.”
Abstract
James E. Katz and Ronald E. Rice, International Journal of Medical Informatics, In Press, Corrected Proof, Available online 10 July 2008, doi:10.1016/j.ijmedinf.2008.06.001

German communications firm brings Bluetooth to Continua

“Stollmann Entwicklungs, a German supplier of Bluetooth SIG’s Health Device Profile for medical devices, has made the mobile technology available to members of the Continua Health Alliance.”
Article
Chip Means, Healthcare IT News EU, 13 June 2008

The deployment of integrated care services for chronic patients (NEXES project)

“Abstract: The societal adaptations required for reducing the burden of chronic disorders and ageing have been recently framed by the WHO initiative on Innovative Care for Chronic Conditions. With this scenario in place, a successful deployment of innovative integrated care services to support healthier and independent living for chronic patients and elderly has emerged as an urgent unmet need. The NEXES project aims at undertaking the deployment of four integrated care programs addressing various aspects of chronic disorders selected because of promising outcomes generated by previous small-scale randomized controlled trials:

• Wellness-rehabilitation: Early diagnosis, promotion of healthy life-styles and patient self-management. Physical activity and cognitive aspects being main components
• Enhanced Care Support of unplanned hospitalizations
• Home hospitalization of patients with exacerbations
• Support: Transient remote support to diagnosis and/or treatment

The project focuses on the main factors modulating the success of an integrated care approach in delivering the services, namely: a) the co-morbidity challenge; b) articulation of healthcare and community services; c) organizational and educational issues; d) modularity, scalability and interoperability of the ICT platform, and, e) identification of business models ensuring service sustainability. Accordingly, the validation strategy prioritises the discovery of evidence supporting the extensive use of the services, applicable at the level of policy decision makers.
Technologically, the Linkcare platform (Linkcare eTEN 517435) sets the reference architecture. Modularity, flexibility and scalability are based on Service Oriented Architectures (SOA) using the IBM UML 2.0 Profile for Software Services. Briefly, the platform consist of a web-based application addressed to management of chronic patients and elderly, facilitating organizational interoperability following a distributed model. The following services are available at the moment: a) Health portal, b) Call centre service, c) Professional mobile access, d) Patient wireless monitoring service, e) Collaborative work service, f) Security modules, and g) Interoperability module with hospital information systems and shared electronic patient records. In the future, it will incorporate knowledge management applications and it is foreseen its evolution towards an IMS platform.”

Bárbara Vallespín, David Fonollosa, Albert Alonso, Josep Roca
Hospital Clinic de Barcelona. Villarroel, 170, 08036 Barcelona, Spain

To be presented at the ICMCC Event

Mobile Monday 6 Review-Why Hospitals Must Develop Mobile Tech NOW

“HIT’s major weakness is that designers, innovators, and executives aren’t paying intimate attention to what’s going on in the world of mobile tech development.
Sure, we talk about being addicted to our Crackberries the latest Apple device, and what laptop we’ll purchase next, but the experience of using high tech mobile and electronic devices is largely divorced from healthcare strategic communications planning. Some of us are working on harnessing gaming and web-based worlds like Second Life and wrestling them into applicability for the healthcare sector. Yay, us. The problem is that resurfacing gaming tech and bending it to health and wellness utility (a la Wiihabiliation) is just not enough.
As a result, we always seem to be several steps behind. Strike that - it’s an almost criminally gross understatement. In HIT, we always seem to be several evolutionary stages behind. And even worse, some so-called HIT firms still don’t get it.”
Article
Jen McCabe Gorman, Health Management RX, 3 June 2008

Health Care Embraces Mobility

“Enterprise mobility has emerged as a top strategic initiative among leading health care organizations. The ability of a health care organization to connect the right information with the right caregiver regardless of location or circumstance, enterprise mobility has the potential to increase patient safety and caregiver efficiency. To benchmark the current state of adoption, Motorola’s Enterprise Mobility business conducted independent research among a representative sample of various decision-makers, the chief purchasers of mobility solutions and mobile workers within the health care industry.”
Article
Jeff Schou, HHNMostWired, 4 June 2008

Open source, ehealth and Africa panel

MIE2008: This panel session is titled “Open source eHealth applications and the Millennium Development goals for Africa”.
Article
Peter, hi-blogs.info - the blog, 28 May 2008

Usability of a mobile electronic medical record prototype: a verbal protocol analysis

Background.
Point of care access to electronic medical records may provide clinicians with the information they want when they need it and may in turn improve patient safety. Yet providing an electronic medical record on handheld devices presents many usability challenges, and it is unclear whether clinicians will use them.
Methods.
An iterative design process for the development and evaluation of a prototype of a mobile electronic medical record was performed. Usability sessions were conducted in which physicians were asked to ‘think aloud’ while working through clinical scenarios using the prototype. Verbal protocol analysis, which consists of coding utterances, was conducted on the transcripts from the sessions and common themes were extracted.
Conclusions.
While physicians can use mobile electronic medical records in realistic scenarios, certain requirements likely need to be met including a fast system with easy data selection, easy data entry and improved display before widespread adoption occurs.
Article
Robert C. Wu; M. Scott Orr; Mark Chignell; Sharon E. Straus, Informatics for Health and Social Care, Volume 33, Issue 2 June 2008, pages 139 - 149, DOI: 10.1080/17538150802127223

Researchers develop mobile diagnosis system

“A new system to transmit medical images via mobile phones has been developed by researchers at the Hebrew University of Jerusalem.
Developed by Yissum, the Hebrew University’s technology transfer company, the system provides an independent data acquisition device (DAD) at a remote patient site where users have no image display capabilities. The device is then connected to a hardware control multiserver unit at a central site via mobile phone technology with an advanced image reconstruction capabilities, with the processed data then returned to the DAD site.”
Article
eHealth Europe, 15 May 2008

New Hampshire Blue gives doctors access to EHRs via mobile phones

“Anthem Blue Cross Blue Shield of New Hampshire announced Wednesday it will provide doctors with access to patients’ electronic health records via mobile phones.
The new access is part of Anthem’s expansion of its e-prescribing program, which also allows doctors access to electronic medical records from their office or home computers.”
Article
Diana Manos, Healthcare IT News, 8 May 2008

The Wisdom of Patients - Social Media In Health Care

“Social media on the Internet are empowering, engaging, and educating health care consumers and providers. While consumers use social media — including social networks, personal blogging, wikis, video-sharing, and other formats — for emotional support, they also heavily rely on them to manage health conditions.
The Internet has evolved from the information-retrieval of “Web 1.0” to “Web 2.0,” which allows people who are not necessarily technologically savvy to generate and share content. The collective wisdom harnessed by social media can yield insights well beyond the knowledge of any single patient or physician, writes report author Jane Sarasohn-Kahn. The outcome of this development is “Health 2.0” — a new movement that challenges the notion that health care happens only between a single patient and doctor in an exam room.
Using examples, this report describes how the Web is becoming a platform for convening people with shared concerns and creating health information that is more relevant to consumers. Social networks, ranging from MySpace to specific disease-oriented sites, are proliferating so rapidly that new services are already under development to help health consumers navigate through the networks.
The report details how innovative collaborations online are changing the way patients, providers, and researchers learn about therapeutic regimens and disease management. It examines the benefits and concerns regarding Health 2.0 and it also includes an extensive listing of health media resources.
According to the report, the growing demand for transparency will drive the evolution of social media in health. A growing array of tools will become available that are increasingly mobile, as well as personal health data storage in commercial products like Microsoft Health Vault, Google Health, and others. The author concludes that the ongoing demands of a consumer-driven health marketplace will inspire innovation in applications that integrate clinical, financial, and ratings information.”
Report
Jane Sarasohn Kahn, THINK Health for California Healthcare Foundation, April 2008

Equipping a Mobile Nurse

“The advent of wireless technology has made it possible for mobile health care professionals to access patient records, test results and other critical information from the field. While much of this focus is centered on computing from within the traditional hospital campus, a growing number of clinicians are traveling to patients’ homes, which requires remote connectivity to improve communication and to keep patient records up to date.”
Article
Andy Willett, HHNMostWired, 23 April 2008

NEXES

NEXES project concerns the deployment of integrated care services for chronic patients based on structured interventions addressing prevention, healthcare and social support. Services are selected from positive outcomes of work done in previous EU projects and in collaboration with industrial partners. Innovation relies on the interplay of three factors: adoption of an integrative approach including profound organizational changes, facing the co-morbidity challenge and the use of ICT as modular and scalable tools supporting interoperability among actors. Two groups of target users are identified and addressed: on one side the citizens at risk, patients and care providers and on the other side Health and community professionals. The former ones are the beneficiaries and active users of the services, the latter ones provide services in their respective domains, but they are also beneficiaries since they receive input/support from reference professionals. The Linkcare platform (Linkcare eTEN 517435, 2005-07) sets the reference architecture. Modularity, flexibility and scalability are based on Service Oriented Architectures (SOA) using the IBM UML 2.0 Profile for Software Services. The ICT platform is a web-based application addressed to management of chronic patients and elderly, facilitating organizational interoperability following a distributed model. It will incorporate knowledge management applications and evolve to an IMS platform.

The list of main programs includes:

1. Wellness-rehabilitation: Early diagnosis, promotion of healthy life-styles and patient self-management. Physical activity and cognitive aspects being main components
2. Enhanced Care Support of unplanned hospitalizations
3. Home hospitalization of patients with exacerbations
4. Support: Transient remote support to diagnosis and/or treatment

The service portfolio includes:

a) Health portal
b) Call centre service
c) Professional mobile access
d) Patient wireless monitoring service
e) Collaborative work service
f) Security modules
g) Interoperability module with hospital information systems and shared electronic patient records.

To be presented at the ICMCC Event 2008.

Dangerous Devices

“Mobile computing devices represent a patient safety conundrum. While they bring decision support, bar-code and RFID-assisted medication administration, and the latest patient data to the point of care, they also can serve as vehicles for germs and increase the potential for hospital-acquired infections.”
Article
Steven J. Davidson, Gregg Malkary, HHNMostWired, 9 January 2008

Nurse Survey: Mobile Tech Unreliable

“Sixty-four percent of nurses believe their organization’s wireless infrastructure isn’t reliable enough to support point-of-care computing, according to a recent survey. Further, the nurses sometimes have to log in and out of their wireless clinical systems up to 80 times a day because of frequent dropped connections as a result of dead zones or poor access point transitions, according to the survey.”
Article
Health Data Management, 17 December 2007

Improvements in health by consultations using mobile videophones among participants in a community health promotion programme

“We conducted a health promotion programme using mobile videophones and examined changes in the participants’ health conditions, health practices and their subjective sense of health. The subjects were volunteers (mean age, 59 years) recruited from a community-based health promotion group. A focus group interview was conducted to evaluate the quality of the programme. All subjects expressed concerns about lifestyle-related diseases. The subjects participated in group activities at least twice a month under the supervision of public health professionals. Six of them participated in mobile care in addition to group activities (mobile care group) and the other eight subjects (control group) participated in the regular group activities. Three consecutive health examinations were carried out at intervals of 12 weeks. There were significant reductions in low-density lipoprotein cholesterol (P = 0.01) and health locus of control internal score (P = 0.05) in the mobile care group. The subjects who used mobile phones were highly accepting of the use of the device for further health consultations. There is potential for wider application of mobile videophones in health promotion programmes for people who have concerns about lifestyle-related diseases and are seeking healthier lifestyles.”
Abstract
Nakajima, Rie; Nakamura, Keiko; Takano, Takehito; Seino, Kaoruko; Inose, Tomoko, Journal of Telemedicine and Telecare, Volume 13, Number 8, December 2007 , pp. 411-415(5)

Experte: Telemedizin wird allmählich alltagstauglich

Mobile applications should realize breakthrough in treatment of chronic diseases like diabetes and obesity.

“Mobile Anwendungen sollen den Durchbruch in der Behandlung chronischer Krankheiten wie Diabetes oder Adipositas schaffen. Christoph Kunze, Bereichsleiter Embedded Systems am Forschungszentrum FZI in Karlsruhe, nennt die jüngsten Entwicklungen.”
Article (German)
Ulrich Schmitz, Computer Zeitung, 5 December 2007

Hospitals help nurses get more from IT

“According to results of a recent American Academy of Nursing survey, healthcare IT has a long way to go before it fully serves nurses in their environment. Yet some hospitals have already begun trying new ways to make healthcare IT more user-friendly to nurses, increasing the time they can spend with patients.”
Article
Diana Manos, Healthcare IT News, 4 December 2007

Exploring mobile information systems for chronically ill adolescent patients

“Adolescent cancer patients have to deal with many dependencies and obligations. Very often they are torn out of their social environment and become isolated because of changing therapy cycles and different treatment locations. This causes significant social and economic damage. The objective of this article is to present the first steps of an empirical exploration of the possibilities of mobile IT support for communication and coordination for this target group during treatment and aftercare. Special emphasis is put on the effects of mobile systems on the patient’s perceived quality of life. The background we bring to the fore is a four-month field experiment conducted together with the cancer station of the hospital of Heidelberg University. We focus on particularities of and challenges for mobile information systems for patients in Germany and outline necessary future research aspects in this field.”
Abstract
Jan Marco Leimeister, Uta Knebel, Helmut Krcmar, International Journal of Web Based Communities 2007 - Vol. 3, No.4 pp. 404 - 415, 10.1504/IJWBC.2007.015866

Context-Aware Workflow Management of Mobile Health Applications

Alfons Salden and Remco Poortinga
Telematica Instituut, The Netherlands

Abstract

We propose a medical application management architecture that allows medical (IT) experts readily designing, developing and deploying context-aware mobile health (m-health) applications or services. In particular, we elaborate on how our application workflow management architecture enables chaining, coordinating, composing, and adapting context-sensitive medical application components such that critical Quality of Service (QoS) and Quality of Context (QoC) requirements typical for m-health applications or services can be met. This functional architectural support requires learning modules for distilling application-critical selection of attention and anticipation models. These models will help medical experts constructing and adjusting on-the-fly m-health application workflows and workflow strategies. We illustrate our context-aware workflow management paradigm for a m-health data delivery problem, in which optimal communication network configurations have to be determined.

A Deployable Framework for Mobile Telemedicine Applications

Ikhu-Omoregbe N.A., Ayo C. K., and Ehikioya S. A.
Department of Computer and Information Sciences, Covenant University, Ota, Nigeria

Abstract

In recent years, the shortage of medical specialists and access to medical information has necessitated a growing interest for cost effective and efficient telemedicine tools for healthcare delivery. Mobile telemedicine applications are aimed at meeting the mobility requirements of patients and doctors by integrating wireless communications for different health care services and education.

Although, telemedicine holds great promises in enhancing health care delivery in rural area and developing countries, only a few applications exist because of poor frameworks for their deployments. This paper, aims at providing a deployable framework for Mobile Telemedicine Applications for Tropical Diseases (MTATD).

MTATD presented here, provides access to a telemedicine unit via hand held devices over a PSTN/GSM and the Internet for a collaborative health care delivery and education between patients and care providers.

Context Aware Tele-Monitoring and Tele-Treatment Services

Miriam MR Vollenbroek-Hutten*, Hermie J Hermens*,** , Rianne MHA Huis in ‘t Veld*
*Roessingh Research and Development, Enschede, The Netherlands
**University of Twente, The Netherlands

Abstract:

This report describes the Awareness project which attempts to make a step forward new kind of e-health services by realizing remote monitoring of health functions and by demonstrating the feasibility of free health treatment concepts; meaning monitoring and treatment independent of time and place utilizing a mobile service infrastructure.

Patient Centered (Health) Care Solutions

Workhop Organizers:
Dr Andy Marsh, VMW Solutions, UK
Denis Carroll, Westminster University, UK

Description

Maturing telemedicine technologies, struggling mobile networking revenues and increased personal healthcare awareness have provided the foundations for a new market niche that of “Healthcare Compunetics”. During the last 5 years, telemedicine (based on internet and web technologies) is becoming a reality both in terms of developing technologies and supportive legislation. Within Europe, wireless infrastructures have received a huge investment and although not well defined in how it will be achieved healthcare has been identified as a major stream of revenue with personal healthcare (e.g. EHCR on the handset) being a key issue especially for the handset manufactures.

Patients in the 21st Century are expecting a patient-centred service, safe, high quality treatment, comfortable accommodation services, fast access and an integrated joined-up system. The uptake of integrated Information and Communication technologies (ICT) will be crucial. Healthcare compunetics, the combination of computing and networking customized for healthcare, will provide the common policy and framework for combined multidisciplinary research, development and implementation.

Accepted papers

• Safety Aspects of (Not) Using ICT in Health Care
  A.C.M. Dumay, G. Freriks, TNO, The Netherlands
  Presentation (1,6 Mb)
• Emotional Prosody Measurement (EPM): A Voice-based Evaluation Method for Psychological Therapy Effectiveness
  E. van den Broek, University of Nijmegen, The Netherlands
  Presentation
• MET System: a New Approach to M-health in Emergency Triage
  W. Michalowski, University of Ottawa, Canada
  R. Slowinski, S. Wilk, Poznan Technical University, Poland
  Presentation
• The Changes Caused by Modification of Biomechanical Properties of a Bone
  M. Binkowski, Z. Wróbel, A. Dyszkiewicz, Silesian University, Poland
• Web-based Asthma Collaboration Management and Public Awareness
  M. Glykas, P. Chytas, University of Aegean, Greece
• Extended Possibilities of Pharmaceuticals Delivery to Patients Using Dematerialized Prescriptions
  A.P. Urbansky, Technical University Poznan, Poland
• Vibroacoustic Sound Therapy:
  Case Studies with Children with Profound and Multiple Learning Difficulties and the Elderly in Long-Term Residential Care
  P. Ellis, University of Sunderland, UK
• An Electronic Patient Record Implementation Using Clinical Document Architecture
  M. Poulymenopoulou, G. Vassilacopoulos, University of Piraeus, Greece
• Mobile Guidelines for Pharmacologic Treatment of Hypertension
  P. Eklund, Annica Näslund, Umeå University, Sweden
• Artificial Neural Networks as an Engine of Internet Based Hypertension Prediction Tool
  S. Polak, A. Mendyk, Jagiellonian University, Poland
• Development of a Clinical Pathways Analysis System with Adaptive Bayesian Nets and Data Mining Techniques
  D. Kopec, Brooklyn College, USA
  G. Shagas, Brooklyn College, USA
  D. Reinharth, Albert Einstein School of Medicine, USA
  S. Tamang, Brooklyn College, USA
• Development of an Expert System for Differentiating Tension Type Headaches from Migraines
  D. Kopec, Brooklyn College, USA
  G. Shagas, Brooklyn College, USA
  J. Selman, Albert Einstein School of Medicine, USA
  D. Reinharth, Albert Einstein School of Medicine, USA
  S. Tamang, Brooklyn College, USA
• Power to the Patient, Using DI@L-log
  L. Black, M. McTear, N.D. Black, University of Ulster, Northern Ireland
• Robotic Technology Applied to Meet the Requirements of Tools to Support Microsurgery and Cellular Surgery
  P. Brett, Xianghong Ma, University of Aston, Birmingham, UK
  G. Tritto, Hopital Saint Louis, Paris, France
• Errors in Medical Practice: Identification, Classification and Steps Towards Reduction
  D. Kopec, Brooklyn College, USA
  G. Shagas, Brooklyn College, USA
  M. Kabir, McGill University, Montreal, Canada
  D. Reinharth, Brooklyn College, USA
  J. Castiglione, Albert Einstein School of Medicine, USA
  S. Tamang, Brooklyn College, USA
• Interactive Telemedicine as a Tool to Avoid a Digital Divide in the World
  G. Graschew, T.A. Roelofs, S. Rakowsky, P.M. Schlag, Max-Delbrueck-Center for Molecular Medicine and Robert-Roessle-Klinik, Charité - University Medicine Berlin, Germany

Papers only published in Proceedings:

• An Implementation of the Trigram Phrase Matching Method for Text Similarity Problems
  Adalberto O. Tardelli, Centro Latino-Americano e do Caribe de Informação em Ciências da Saúde, Brasil
  M.S. Anção, Universidade Federal de São Paulo, Brasil
  A.L. Packer, Centro Latino-Americano e do Caribe de Informação em Ciências da Saúde, Brasil
  D. Sigulem, Universidade Federal de São Paulo, Brasil
• Using the Sense of Smell in Telemedical Environments
  B.S. Spencer, Nova Southeastern University, Fort Lauderdale, USA

The Challenges in the Migration to 4G Mobile System;

Workshop Organizers:
Robert. S. H. Istepanian (Kingston University, UK)
Swamy Laxminarayan (Idaho State University, USA)

Abstract

The last few years has witnessed rapid development of wireless communication networks and especially on the research efforts on the Fourth Generation (4G) mobiles.

This surge of interest in the 4G networks systems that are expected to be launched within the next decade is due to the fundamental change that such network will present in the re-shaping the current mobile communication systems. The major reasons for this interest, follows the major features of 4G Networks that can be summarised as follows:

• High usability; any time, anywhere and with any technology
• Support for high speed multimedia services at low transmission cost
• Personalised services and Integrated applications

However, whilst there remains major research challenges in the implementation issues of the system, in the mobile station, heterogeneous systems and services levels in the 4G research domain. These are currently being addressed by the research in mobile communications community. However, still remains no clear vision or research strategy is yet developed for a research framework from the healthcare perspective.

The aim of this workshop is to bring a number of leading industrial, academic and healthcare experts to address the relevant issues and future challenges from the 4G healthcare prespective.