Integrating a mobile health applications for self-management to enhance Telecare system

A dramatic global increase in the pervasiveness of chronic illness has coincided with a reduction in the availability of healthcare resources, coupled with increased costs for care, forcing a fundamental reevaluation of care processes. These trends have driven interest in the use of advanced healthcare information systems and telematics applications to improve care availability while reducing overall costs, but such measures require taking an integrated approach to a range of interrelated social, economic, political and cultural impacts and challenges. Telecare technologies allow hospitals to continuously monitor biomedical indicators, while providing patients with online services such as clinical appointment scheduling, medical consulting, remote alerts, etc. Telecare has the potential to transform the healthcare industry by reducing costs, increasing quality, and enhancing patient satisfaction. The development of a real-time monitoring healthcare service model through the integration of information and communications technologies (ICT) has emerged as a research priority. This study explores the design, value creation, development and evaluation of Telecare systems and mobile health applications for autonomous health management to ensure appropriate home-based health monitoring and treatment while improving care performance. A well-defined methodology is needed to develop artifacts due to increasing disease complexity. This study develops an Android-based self-management application based on design science research methodology. The App assists users in collecting and monitoring indicators to prompt appropriate care services. This study uses individual home self-care as the basic Telecare unit to design a service model integrating six kinds of healthcare services. Usability testing is conducted to reflect five constructs: system usefulness, ease of learning, information quality, interface quality, and overall satisfaction. Experimental results support previous research findings regarding the Chronic Care Model and enhance the effectiveness of mobile-based services. Our work provides a useful reference to researchers and practitioners interested in understanding how hospitals can better facilitate more effective mobile-based technology adoption in today’s e-health environment.     

Moderne Informationstechnologien für die Steuerung von Transport und Verkehr

Intelligent transport systems are still in a stage of system introduction considering the existing market situation. Therefore there is the need to develop transport concepts acceptable to the political decision makers within which transport telematics provides contributions and on the basis of which then traffic control strategies and technical systems can be designed. The chances of transport telematics are shown for traveller information, traffic control and management. The functional, technical and institutional aspects of transport telematics are then discussed.     

智慧医院体系架构及关键技术应用

提出了一种新型的基于信息集成和通信协同的智慧医院体系架构。在该体系架构中,通过信息集成、统一通信、大数据分析及移动终端管理等关键技术的应用,为医院实现移动医疗、协同医疗、医疗知识库、商用智能分析等智能应用。具体的应用实践论证了该智慧医院体系架构的合理性与可行性。     

医疗机构患者主索引EMPI构建方案探讨

医疗机构作为患者原始临床诊疗数据产生的主要场所,保持患者标识的唯一性,不仅有利于改善医院临床和管理水平,提高患者满意度,同时也是实现医院内部系统集成与共享,建立居民健康档案,以及区域医疗联合的必要条件。本文结合上海某三甲医院信息平台项目案例,从患者基本信息框架,注册流程与核心算法,患者标识交叉索引,以及主索引管理等多方面,详细介绍了患者主索引的构建方案。     

Distributed enterprise information networking: A case example

A major health care provider is migrating its existing centralized computing system to a distributed computing infrastructure that will support advanced clinical, business, and workgroup applications and connectivity. Deploying a modern distributed architecture integrated with a traditional, heterogeneous mainframe-oriented enterprise data processing and information retrieval environment is an enormous undertaking. This process requires major changes for the enterprise, especially in the areas of the network, control and operations, systems deployment, integration and cost management tools, and personnel. Our case example is Kaiser Permanente Northern California Region (KPNCR). Information Technology Services (ITS), a division of KPNCR, provides network and computer support and operation, architecture and standards, and information technology. This division, in partnership with business planning and operational units, is responsible for creating the distributed architecture. The transition, estimated to take three to five years, is underway. ITS plans to deploy the proposed architecture at three medical facilities. This pilot will provide the technology foundation for a concurrent pilot of a planned enterprise-wide clinical information system. Results from the pilot will influence plans to deploy the distributed architecture enterprise-wide     

Telecommunication in healthcare for a better coordination betweenhospitals and GP's: routine application of the“ISAR-Telematics” project

With the development of new information and communication technologies, the nature of data exchange between healthcare professionals is modified by the use of telematics tools. With the implementation of the “Reseau Sante Social” of the smart cards CPS and Sesam-Vitale, hospitals and private clinics are installing their hospital information systems, while general practitioners are computing their patient records. The environment is therefore suitable for the installation and diffusion of telematics services, allowing a better exchange of information between the physicians of a geographical sector. The RITHME intercommunication platform was developed in the ISAR-Telematics and IRISI European projects. It ensures several communication functions, such as movements of patients (in/out/inside) the hospital, management and mailing of letters and reports, specific information on prescribed treatments, or data concerning the hospital structure. This platform is tested in the town of Armentieres in the large city of Lille (North of France). It is being routinely used to accelerate and secure data exchanges between all the physicians working in this area     

区域卫生信息化建设标准体系初探

卫生信息化建设是一项系统性的工程,涉及医疗卫生行业众多领域的应用需求.区域卫生信息化发展的不均衡以及国家医疗改革的要求,迫切需要卫生信息标准化来支撑.本文就区域卫生信息化的现状,建设过程中涉及到的标准体系进行了系统的梳理,并简要提出了标准体系的基本框架和标准内容.区域卫生信息标准化的具体内容包括数据标准、功能规范和技术规范.     

Managing medical images and clinical information: InCor's experience.

Patients usually get medical assistance in several clinics and hospitals during their lifetime, archiving vital information in a dispersed way. Clearly, a proper patient care should take into account that information in order to check for incompatibilities, avoid unnecessary exams, and get relevant clinical history. The Heart Institute (InCor) of S?o Paulo, Brazil, has been committed to the goal of integrating all exams and clinical information within the institution and other hospitals. Since InCor is one of the six institutes of the University of S?o Paulo Medical School and each institute has its own information system, exchanging information among the institutes is also a very important aspect that has been considered. In the last few years, a system for transmission, archiving, retrieval, processing, and visualization of medical images integrated with a hospital information system has been successfully created and constitutes the InCor's electronic patient record (EPR). This work describes the experience in the effort to develop a functional and comprehensive EPR, which includes laboratory exams, images (static, dynamic, and three dimensional), clinical reports, documents, and even real-time vital signals. A security policy based on a contextual role-based access control model was implemented to regulate user's access to EPR. Currently, more than 10 TB of digital imaging and communications in medicine (DICOM) images have been stored using the proposed architecture and the EPR stores daily more than 11 GB of integrated data. The proposed storage subsystem allows 6 months of visibility for rapid retrieval and more than two years for automatic retrieval using a jukebox. This paper addresses also a prototype for the integration of distributed and heterogeneous EPR.     

MobileMed: a PDA-based mobile clinical information system.

Patient clinical data are distributed and often fragmented in heterogeneous systems, and therefore the need for information integration is a key to reliable patient care. Once the patient data are orderly integrated and readily available, the problems in accessing the distributed patient clinical data, the well-known difficulties of adopting a mobile health information system, are resolved. This paper proposes a mobile clinical information system (MobileMed), which integrates the distributed and fragmented patient data across heterogeneous sources and makes them accessible through mobile devices. The system consists of four main components: a smart interface, an HL7 message server (HMS), a central clinical database (CCDB), and a web server. The smart interface and the HMS work in concert to generate HL7 messages from the existing legacy systems, which essentially send the patient data in HL7 messages to the CCDB to be stored and maintained. The CCDB and the web server enable the physicians to access the integrated up-to-date patient data. By proposing the smart interface approach, we provide a means for effortless implementation and deployment of such systems. Through a performance study, we show that the HMS is reliable yet fast enough to be able to support efficient clinical data communication.     

车载信息服务分析与研究

车载信息系统利用信息通信技术,提供综合化的信息服务,为驾乘人员提供人性化的服务。随着信息技术和汽车电子的发展,车载信息技术成为信息技术发展的新热点,车载信息服务越来越受到了电信运营商、车厂和车载信息运营商的关注。未来车载系统也将成为智慧城市、智能交通的重要组成部分。     

航空电子装备技术状态管理系统设计与实现

随着航空电子信息系统综合化、系统化深入发展,航空电子装备研制项目管理呈现复杂性、集成性、交联性特点。针对综合化航空电子装备技术状态管理要求,提出了综合化航空电子装备软硬件技术状态管理信息系统研制方案,并利用信息化平台构建了管理系统,实现了航空电子装备全生命周期内技术状态管理的信息化、规范化管理。     

LIS与HIS的集成技术探讨与实现

随着信息技术的发展,大多医院都使用各种信息系统(HIS,LIS,PACS等)来提高其服务和管理水平,医院各系统间的互联也成为医疗信息系统研究的热点.文中以此为背景,介绍了医院系统集成的几种方法和医疗信息交换标准HL7,并以Delphi为开发工具编程试验,用Socket组件实现了LIS和HIS的信息交换和系统集成.     

Using key performance indicators as knowledge-management tools at a regional health-care authority level.

The advantages of the introduction of information and communication technologies in the complex health-care sector are already well-known and well-stated in the past. It is, nevertheless, paradoxical that although the medical community has embraced with satisfaction most of the technological discoveries allowing the improvement in patient care, this has not happened when talking about health-care informatics. Taking the above issue of concern, our work proposes an information model for knowledge management (KM) based upon the use of key performance indicators (KPIs) in health-care systems. Based upon the use of the balanced scorecard (BSC) framework (Kaplan/Norton) and quality assurance techniques in health care (Donabedian), this paper is proposing a patient journey centered approach that drives information flow at all levels of the day-to-day process of delivering effective and managed care, toward information assessment and knowledge discovery. In order to persuade health-care decision-makers to assess the added value of KM tools, those should be used to propose new performance measurement and performance management techniques at all levels of a health-care system. The proposed KPIs are forming a complete set of metrics that enable the performance management of a regional health-care system. In addition, the performance framework established is technically applied by the use of state-of-the-art KM tools such as data warehouses and business intelligence information systems. In that sense, the proposed infrastructure is, technologically speaking, an important KM tool that enables knowledge sharing amongst various health-care stakeholders and between different health-care groups. The use of BSC is an enabling framework toward a KM strategy in health care.     

The Emerging Field of Clinical Engineering and Its Accomplishments

Clinical engineering has emerged during the past 20 years as a specialty area to apply the knowledge produced by biomedical engineering research. The clinical engineer is a member of the health care team in a clinical environment and interfaces with physicians, nurses, and allied health care personnel. The role of clinical engineering also includes management, information systems, and health care delivery systems. A survey was performed, and the results of the questionnaire identified the primary contributions of clinical engineering to be as follows: provide technical advice, expertise, and educational services; provide electrical safety programs; provide consultation to resolve and investigate equipment malfunctions or failures; and provide for the centralized management and maintenance of medical instrumentation and equipment. The role of clnical engineering is expanding as the use of advanced technology increases in health care delivery.     

基于B/S新生儿疾病筛查系统实现与应用

基于B/S架构的新生儿疾病筛查系统解决了区域范围内产科医院、妇幼保健院以及卫生管理单位的筛查、治疗、召回、工作监督等日常工作。同时与妇幼保健系统进行联动,达到信息共享和信息安全,实现信息管理规范化,提高各项管理指标。     

A Gateway and Framework for Telematics Systems Independent on Mobile Networks

In this letter, we analyze the problems with the existing telematics service systems that have been dependently developed and provided on a specific mobile network infrastructure. Then, we suggest methods to solve the problems and propose an architecture of the gateway and framework to implement our methods. We also verify the effectiveness of the suggested architecture through a comparison with an existing telematics system. With this architecture, it is possible to develop service applications without knowledge of the underlying mobile network technology and the system integration methods.     

基于SSH的高校后勤学生服务管理信息平台设计

为了适应高校信息化建设的需要,提高高校后勤服务效率和服务质量,跟踪目前先进的计算机技术,提出了采用SSH整合框架技术和RBAC模型并基于角色的权限管理机制的后勤学生服务管理信息系统解决方案,并将其运用在学校学生服务管理信息平台系统的开发中。基于Struts,Spring和Hibernate整合框架的web应用系统,具有良好的可扩充性和可重用性。     

Matching clinical and biological needs with emerging imaging technologies

Acquisition, analysis, and integration of medical images with nonimage biomedical information are essential for research and clinical practice. Individualization of health care, assessment of disease risk, tailoring of therapies, and lifelong monitoring places extraordinary demands on emerging technologies in medical imaging, information management, and molecular medicine. To achieve the anticipated benefits in outcomes that new technology can deliver, imaging informatics infrastructure and tools must be available to represent, store, integrate, and present the data in a useful manner. Currently, images are not well integrated with other forms of biological knowledge. This paper outlines the clinical and research requirements for imaging, and identifies barriers to progress and links these needs with the current and future informatics technologies that may overcome them.     

数字签名技术在电子病历中的设计与实现

目的:推进医疗行业的信息无纸化,大力发展数字化医院,完善身份识别和信息安全等问题。方法:通过对我院相关业务的需求分析,引入了数字签名技术来保障数据完整性和不可抵赖性。结果:数字签名技术使医院的业务环境更加安全有效,保证了身份真实和责任明确,用电子签名替代了传统的医生手写签名方式,优化了业务流程。结论:数字签名技术有效推进了医疗行业的信息无纸化,对于医疗信息系统在身份认证、授权管理、责任认定等方面的信息安全的需求有着非常重要的意义。     

The application of telepresence in medicine

Telemedicine is a wide ranging subject which encompasses teleconsultation, electronic patient records, continuing medical education and public health information systems. Telemedicine will impact every aspect of health care delivery from remote clinical analysis and consultation between experts based in specialist hospitals, to teleconsultation as a substitute for physical referral between the GP and a hospital, and ultimately the remote delivery of medical monitoring and care into the h ome. Telepresence, where remote human expertise is transported by communications networks to a remote location, has its own unique place within the spectrum of telemedicine applications. This paper describes some of those applications of medical telepresence into which BT have been researching with various clinical partners.