A Pervasive System for Nuclear Medicine Department

Pervasive Computing technologies can be successfully adopted in designing smart and enhanced healthcare services and applications. Within a typical healthcare institution, one particular facility which can greatly benefit from pervasive technologies is the Nuclear Medicine Department, where nuclear medicine diagnostic tests like PET scan and nuclear scintigraphy are routinely carried out involving the use of radioactive substances. This paper presents a pervasive healthcare system which is intended to support clinicians in handling nuclear medicine test sessions within an appropriate, safety-aware context. The proposed system also includes features to easily interoperate with heterogeneous software and databases already present in traditional hospitals. Its design lies on a methodology which integrates RFID and photoelectric sensor technologies. An experimental prototype has been implemented and tested showing the feasibility of the system in a real healthcare facility.     

Smart Clothing: Connecting Human with Clouds and Big Data for Sustainable Health Monitoring

Traditional wearable devices have various shortcomings, such as uncomfortableness for long-term wearing, and insufficient accuracy, etc. Thus, health monitoring through traditional wearable devices is hard to be sustainable. In order to obtain healthcare big data by sustainable health monitoring, we design “Smart Clothing”, facilitating unobtrusive collection of various physiological indicators of human body. To provide pervasive intelligence for smart clothing system, mobile healthcare cloud platform is constructed by the use of mobile internet, cloud computing and big data analytics. This paper introduces design details, key technologies and practical implementation methods of smart clothing system. Typical applications powered by smart clothing and big data clouds are presented, such as medical emergency response, emotion care, disease diagnosis, and real-time tactile interaction. Especially, electrocardiograph signals collected by smart clothing are used for mood monitoring and emotion detection. Finally, we highlight some of the design challenges and open issues that still need to be addressed to make smart clothing ubiquitous for a wide range of applications.     

Quality improvement: what is in it for the patient?

The improvement of health care service has a great effect on patient satisfaction. During the service delivery, the health care organization attempts to answer the reasonable expectations of patients. The expectations relate to many service dimensions, among them the phone system, appointment availability and waiting times. The research questions of this study are: can the implementation of quality initiatives improve patient satisfaction with the phone system, appointment availability and waiting times and do patients from diverse cultural backgrounds exhibit different levels of satisfaction? The study was undertaken in a public clinic, with a culturally diverse clientele, including 194 patients. The authors use a combination of the longitudinal and cross-sectional research design to test the propositional model. The findings show that the implementation of the quality initiative significantly improved patient satisfaction with the appointment availability and waiting time. On the other hand, the implementation of the quality initiative did not improve patient satisfaction with the phone system. Some culturally diverse patients exhibited different levels of expectations of the care provider and quality in terms of patient satisfaction with the appointment availability     

An application of DMADV methodology for increasing the yield rate of surveillance cameras

Taiwan has officially been an “Aging society” since 1993, and a growing number of elderly people there cannot receive proper care from family members. Therefore, Taiwan’s “long-distance home care services” have been classified as an emerging service industry. This industry rests mainly on information and telecommunications technology to overcome the barriers of distance and, thereby, to deliver health services. Surveillance cameras constitute important transmission equipment whose function is to provide real-time monitoring services; therefore, the quality and the efficiency of the camera adopted in the long-distance home care industry are important.Some of Taiwan’s domestic products occupy dominant positions in their respective global markets, and there are also many foreign competitors that have exhibited a formidable challenge to the prominent position of these Taiwan manufacturers. The production strategy for mature manufacturers under steep competition is to increase their quality and yield rate, steps that can prevent unnecessary waste. Some research has adopted Six Sigma to improve products’ yield rates, and the results have been remarkable. In this research, the DMADV methodology will be implemented for improving the quality of surveillance cameras and for diminishing related excess costs.     

Home Health Gateway Based Healthcare Services Through U-Health Platform

The Ubiquitous Health, or u-Health, service is an IT health care service using the ubiquitous computing environment. U-Health provides customized medical services. As it is a service that has developed from the current hospital visiting medical system, the u-Health service provides a patient with healthcare anywhere and anytime. In this paper, we propose a home health gateway based healthcare services through the u-Health platform. Using home health gateway, u-Health can provide health monitoring, diet, and exercise services using the healthcare decision support module in the ubiquitous environment. This approach would offer specialized services using an external content provider of DB. In addition, a doctor can provide advice to patients using the monitoring service. The proposed u-Health platform provides effective services using home health gateway in ubiquitous environments to customers, which will improve the health of chronic patients.     

Satisfaction and switching intention in mobile services: Comparing lock-in and free contracts in the Spanish market

Switching costs are a relevant issue affecting market competition in the mobile services industry. However, customer switching costs have not disappeared, since numerous leading mobile services companies use lock-in strategies, such as obliged long-term contractual relationships. The present study provides and empirically test a conceptual model in order to analyze the creation of customer satisfaction and switching intention with mobile services, as well as to examine the differences between lock-in and free contracts in a South European mature market – Spain. For this purpose, drawing on a sample of 370 customers, we developed Structural Equation Modeling (SEM) through a multi-group analysis. Our findings suggest that service quality is one of the key determinants of satisfaction, while the availability of attractive alternatives is the main switching barrier. Moreover, some interesting differences were found between the two type of contracts analyzed. Consequently, we suggest shifting resources to customer retention through improved service quality for reducing customer churn rate.     

Technological development in the health services

Technology offers the health services potentials for improving the quality and scope of medical care, for extending the capacities of health workers, and for gaining control of costs. However, there are obstacles to achieving these potentials, some inherent in the nature and tradition of the medical care process, and some in the structure of management incentives in hospitals and industries that might contribute useful products and services. Spontaneously, professionals from the biomedical and physical sciences have formed coalitions to pursue a variety of technological developments. Most such projects seek an appropriate institutional setting, organizational relationship, and source of support. They seek an optimal balance of institutional, industrial, and government participation. This paper presents a basis for dividing the costs of development between public and private investment and proposes the staging of technological development through trials in government, private, and educational health services. An estimate of justifiable development investments in health technology is an order of magnitude higher than current levels, suggesting that development funds should be viewed as a tax on the revenue stream of the health services rather than a source of competition for research funds.     

An integrated healthcare information system for end-to-end standardized exchange and homogeneous management of digital ECG formats

This paper investigates the application of the enterprise information system (EIS) paradigm to standardized cardiovascular condition monitoring. There are many specifications in cardiology, particularly in the ECG standardization arena. The existence of ECG formats, however, does not guarantee the implementation of homogeneous, standardized solutions for ECG management. In fact, hospital management services need to cope with various ECG formats and, moreover, several different visualization applications. This heterogeneity hampers the normalization of integrated, standardized healthcare information systems, hence the need for finding an appropriate combination of ECG formats and a suitable EIS-based software architecture that enables standardized exchange and homogeneous management of ECG formats. Determining such a combination is one objective of this paper. The second aim is to design and develop the integrated healthcare information system that satisfies the requirements posed by the previous determination. The ECG formats selected include ISO/IEEE11073, Standard Communications Protocol for Computer-Assisted Electrocardiography, and an ECG ontology. The EIS-enabling techniques and technologies selected include web services, simple object access protocol, extensible markup language, or business process execution language. Such a selection ensures the standardized exchange of ECGs within, or across, healthcare information systems while providing modularity and accessibility.     

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。     

Wireless Technologies in Healthcare: Selected Papers from IEEE PIMRC 2011

The use of wireless technologies for medical device communication, health monitoring (at hospitals or homes) and mobile healthcare information delivery (i.e. m-Health) is one of the most rapidly growing areas in health-IT research today. The papers which appear in this special issue have been carefully selected from the best IEEE PIMRC 2011 conference. They are highlighting various challenging issues in using wireless technology for healthcare applications such as PHY & MAC innovations for wearable and implantable medical sensors, optical communication and location systems in hospital environments and interference mitigation issues.     

Strategic telecommunications networks planning in the context ofemerging technologies, architectures, and services

A methodology is presented for conducting strategic network planning studies under a new set of planning assumptions. The key element of the described methodology is a mathematical model of the equipment-replacement decision-making process that explicitly captures the economic impact of emerging technologies, architectures, and services. The general replacement decision model (GRDM) is a mathematical model that computes the optimal sequence of replacement times for particular pieces of telecommunications network equipment. GRDM takes information about costs and revenues and their trends in time associated with existing and emerging technologies and services and calculates the sequence of technology replacement intervals that minimizes the net present worth of expenditures associated with embedded plant and its replacements. The generality of the model supports its application to a broad range of network evolution issues, including the deployment of fiber optics and intelligent network features. An illustrative application of GRDM is presented which evaluates how the optimal economic lives of analog and digital switching equipment change as the assumed date of widespread broadband switching availability is varied     

Technological aspects of WBANs for health monitoring: a comprehensive review

According to the World Health Organization, most of the world population is affected by chronic diseases, obesity, cardiovascular diseases and diabetes while another dominant problem is of aging population. Thus, it is desirable to have cost effective solutions for health monitoring, especially for countries that have minimum conventionally trained healthcare staff and infrastructure. Healthcare has shifted from hospital dominant services to patient dominant services which has thrived WBANs to provide ubiquitous health monitoring by virtue of wearable or implantable sensor nodes that commonly monitor biological signals. As the society becomes more health conscious, WBANs have the potential to revolutionize the way people integrate their health and information technology. Hence, WBANs are desired to strengthen conventional healthcare systems. Notwithstanding the current achievements, technological advances, proposed solutions and commercialized products; WBANs still experience many obstacles in their foolproof adoption. This paper surveys the plethora of WBAN applications and network architecture in detail used for data collection, data transmission and data analysis that form sensor analyst system in the realm of Internet of Things. Wireless communicational technologies are also discussed in this paper. Also, we have categorized the routing protocols and have provided with their critical qualitative analysis. Towards the end we discuss several projects in the field of WBANs and some open research areas. These findings on how the sensor nodes, newest routing protocols and data analysis techniques influence ubiquitous health monitoring sets this survey apart from the already existing surveys on WBANs.

     

Cloud support for large scale e-healthcare systems

Rapid development of wearable devices and mobile cloud computing technologies has led to new opportunities for large scale e-healthcare systems. In these systems, individuals’ health information are remotely detected using wearable sensors and forwarded through wireless devices to a dedicated computing system for processing and evaluation where a set of specialists namely, hospitals, healthcare agencies and physicians will take care of such health information. Real-time or semi-real time health information are used for online monitoring of patients at home. This in fact enables the doctors and specialists to provide immediate medical treatments. Large scale e-healthcare systems aim at extending the monitoring coverage from individuals to include a crowd of people who live in communities, cities, or even up to a whole country. In this paper, we propose a large scale e-healthcare monitoring system that targets a crowd of individuals in a wide geographical area. The system is efficiently integrating many emerging technologies such as mobile computing, edge computing, wearable sensors, cloud computing, big data techniques, and decision support systems. It can offer remote monitoring of patients anytime and anywhere in a timely manner. The system also features some unique functions that are of great importance for patients’ health as well as for societies, cities, and countries. These unique features are characterized by taking long-term, proactive, and intelligent decisions for expected risks that might arise by detecting abnormal health patterns shown after analyzing huge amounts of patients’ data. Furthermore, it is using a set of supportive information to enhance the decision support system outcome. A rigorous set of evaluation experiments are conducted and presented to validate the efficiency of the proposed model. The obtained results show that the proposed model is scalable by handling a large number of monitored individuals with minimal overhead. Moreover, exploiting the cloud-based system reduces both the resources consumption and the delay overhead for each individual patient.     

Health care service delivery based on the Internet of things: A systematic and comprehensive study

Today, the Internet of Things (IoT) becomes a heterogeneous and highly distributed structure which can respond to the daily needs of people and different organizations. With the fast development of IT‐based technologies such as IoT and cloud computing, low‐cost health services and their support, efficient supervision of the centralized management, and monitoring of public health can be realized. Therefore, there has been increasing attention in the integration of IoT and health care both in academic and the business world. However, while the health care service industry fully holds the welfares of information systems for its personnel and patients, there is a need for an improved understanding of the issues and opportunities related to IoT‐based health care systems. But, as far as we know, the detailed review and deep discussion in this field are very rare. Hence, in this paper, we presented a literature review on the IoT‐based health care services from papers published until 2018. Moreover, the drawbacks and benefits of the reviewed mechanisms have been discussed, and the main challenges of these mechanisms are highlighted for developing more efficient IoT techniques over health care services in the future. The results of this paper will be valuable for both practitioners and academicians, and it can provide visions into future research areas in this domain. By providing comparative information and analyzing the current developments in this area, this paper will directly support academics and working professionals for better knowing the progress in IoT mechanisms. As a general result, we found that IoT could help the governments to improve health services in society and commercial interactions.     

Mobile-Based Self-Monitoring for Preventing Patients with Type 2 Diabetes Mellitus and Hypertension from Cardiovascular Complication

Currently, there is less attention to the prevention of patients with type 2 diabetes mellitus and hypertension from cardiovascular complication, although it is the significant cause of death for these patients worldwide. To be prevented from this complication, these patients should develop their self-monitoring skills along with their healthcare journey. Consequently, this paper aims to provide an efficient mobile-based self-monitoring that can encourage patients with type 2 diabetes mellitus and hypertension to improve their health status. The distinctive point of the proposed mobile application is the trend progression module for demonstrating the progression of four health statuses for the patients. This trend progression is modeled with a fuzzy logic-based method. The rules are generated based on clinical data, lifestyle data, and experience of healthcare professionals. There are eleven healthcare professionals involved in this paper. The experiment with one hundred twenty-one patients shows that the proposed mobile application provides 92% trend progression accuracy compared with healthcare professionals’ decisions. The developed mobile application obtains the function satisfaction and performance satisfaction in the “strongly satisfied” level. Besides, the developed mobile application can encourage 85% of patients to improve their health statuses. It can be seen that this paper is a new aspect of encouraging patients to concern more about the improvement of their health statuses anywhere and anytime.

     

海外移动医疗信息化进展

3G业务的普及以及医疗与信息通信技术的融合,为移动医疗提供了机会。当前美国是移动医疗服务部署应用最多。而在各种应用中,以信息/通信类和监测类应用部署最多I。T厂商和移动运营商积极参与医疗信息化工作,AT＆T、Voda-fone等针对医疗机构、相关企业和个人提供了解决方案和服务。未来远程监测系统将有巨大的需求空间。     

Telemedicine experience for chronic care in COPD.

Information and telecommunication technologies are called to play a major role in the changes that healthcare systems have to face to cope with chronic disease. This paper reports a telemedicine experience for the home care of chronic patients suffering from chronic obstructive pulmonary disease (COPD) and an integrated system designed to carry out this experience. To determine the impact on health, the chronic care telemedicine system was used during one year (2002) with 157 COPD patients in a clinical experiment; endpoints were readmissions and mortality. Patients in the intervention group were followed up at their homes and could contact the care team at any time through the call center. The care team shared a unique electronic chronic patient record (ECPR) accessible through the web-based patient management module or the home visit units. Results suggest that integrated home telemedicine services can support health professionals caring for patients with chronic disease, and improve their health. We have found that simple telemedicine services (ubiquitous access to ECPR, ECPR shared by care team, accessibility to case manager, problem reporting integrated in ECPR) can increase the number of patients that were not readmitted (51% intervention, 33% control), are acceptable to professionals, and involve low installation and exploitation costs. Further research is needed to determine the role of telemonitoring and televisit services for this kind of patients.