HEALTHINF 2012 Abstracts

Full Papers Short Papers
Full Papers
Paper Nr: 4
Title:

ENABLING FACTORS FOR ACHIEVING GREATER SUCCESS IN ELECTRONIC MEDICAL RECORD INITIATIVES
Authors:

Wilfred Bonney
Abstract: The introduction of Electronic Medical Record (EMR) systems in the healthcare industry has brought anticipation as to whether the use of the system is enabling or constraining healthcare providers’ efforts in providing efficient healthcare services and evidence-based practice. Although few EMR systems have managed to achieve success in the healthcare industry, many have failed to meet the expectations of healthcare providers and the general public. In this paper, a literature review was used to explore the possible trends or factors which may help future electronic medical record initiatives achieve greater success and less failure. The practical and research implications for implementing successful EMR initiatives are also discussed.
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Paper Nr: 10
Title:

BREATH AND POSITION MONITORING DURING SLEEPING WITH A DEPTH CAMERA
Authors:

Meng-Chieh Yu, Huan Wu, Jia-Ling Liou, Ming-Sui Lee and Yi-Ping Hung
Abstract: Sleep monitoring is increasingly seen as a common and important issue. In this paper, a depth analysis technique was developed to monitor user’s sleep conditions without any physical contact. In this research, a cross-section method was proposed to detect user’s head and torso from the depth images. Then, the system can monitor user’s breathing rate, sleep position, and sleep cycle. In order to evaluate the measurement accuracy of this system, two experiments were conducted. In the first experiment, eight participants with various body shapes were asked to join the experiment. They were asked to change the sleep positions (supine and side-lying) every fifteen breathing cycles in two circumstances (sleep with and without a thin quilt) on the bed. The experimental results showed that the system is promising to detect the head and torso with various sleeping postures. In the second experiment, a realistic over-night sleep monitoring experiment was conducted. The experimental results demonstrated that this system is promising to monitor the sleep conditions in realistic sleep conditions. To conclude, this study is important for providing a non-contact technology to detect multiple sleep conditions and assist users in better understanding of their sleep quality.
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Paper Nr: 18
Title:

MOBILE TIMELINE - Mobile Charting System that Provides a Graphical Summary of a Patient’s Medical Record
Authors:

Keisuke Ogawa, Kazunori Matsumoto, Masayuki Hashimoto, Tatsuaki Hamai, Akiko Shibuya and Yoshiaki Kondo
Abstract: In this paper, we introduce a novel medical information system that works on smartphones. This system provides chronological graphs of a patient’s medications and medical examinations over an extended period of years as graphical summaries of the patient’s medical history so that physicians can gain a clear understanding of the patient’s status and develop treatment plans easily. In our system, we implemented the original algorithm that reduces the amount of medical data by merging adjacent data hierarchically when the time span for displaying the data is changed. By implementing this algorithm, the system proposed here was shown to be about 30 times faster than the system with a conventional method. Also, we evaluated our system through the experiment in medicine using real medical records. The results indicate that physicians would benefit significantly by using our system especially in situations where they cannot use another medical information system through their PC, such as the patient’s bedside.
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Paper Nr: 21
Title:

A HEART RATE PREDICTION MODEL FOR THE TELEREHABILITATION TRAINING OF CARDIOPULMONARY PATIENTS
Authors:

Axel Helmer, Riana Deparade, Friedrich Kretschmer, Okko Lohmann, Andreas Hein, Michael Marschollek and Uwe Tegtbur
Abstract: Chronic obstructive pulmonary disease (COPD) and coronary artery disease are severe diseases with increasing prevalence. They cause dyspnoea, physical inactivity, skeletal muscle atrophy and are associated with high costs in health systems worldwide. Physical training has many positive effects on the health state and quality of life of these patients. Heart Rate (HR) is an important parameter that helps physicians and (tele-) rehabilitation systems to assess and control exercise training intensity and to ensure the patients’ safety during the training. On the basis of 668 training sessions (325 F, 343 M), demographic information and weather data, we created a model that predicts the training HR for these patients. To allow prediction in different use cases, we designed five application scenarios. We used a stepwise regression to build a linear model and performed a cross validation on the resulting model. The results show that age, load, gender and former HR values are important predictors, whereas weather data and blood pressure just have minor influence. The prediction accuracy varies with a median root mean square error (RMSE) of ≈11 in scenario one up to ≈3.2 in scenario four and should therefore be precise enough for the application scenarios mentioned above.
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Paper Nr: 37
Title:

MOVING FROM REMOTE PATIENT MONITORS TO CLOUD-BASED PERSONAL HEALTH INFORMATION SYSTEMS - A Way to Practicing Patient-centered Chronic Care Model
Authors:

Juha Puustjärvi and Leena Puustjärvi
Abstract: Recent advances in remote patient monitoring allow patient to transmit vital health data from their home to physicians’ offices and receive health coaching from their healthcare providers based on the clinical data they have sent. Unfortunately such a remote monitoring technology only provides the connection between patients and healthcare providers and thus does not support new emerging healthcare models such as patient-centered care, pharmaceutical care or chronic care models. These healthcare models need technology solutions that (i) support the co-operation within patient’s healthcare team (i.e., connect patients, patient’s family members and healthcare professionals), (ii) provide a platform for sharing patient’s healthcare data among the healthcare team, and (iii) provide a mechanism for disseminating relevant educational material for the patient and the healthcare team. In this paper, we describe our work on designing a personal health information system, which supports patient remote monitoring and the new emerging healthcare models as well. The key idea is to develop the system by integrating relevant e-health tools through a shared ontology and to exploit the flexibility of cloud computing in its implementation. In developing the ontology we have used semantic web technologies such as OWL and RDF.
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Paper Nr: 41
Title:

ENABLING INTEROPERABILITY THROUGH AN ONTOLOGY APPROACH IN THE HETEROGENEOUS DOMAINS OF COMPLEX CHRONIC CONDITIONS
Authors:

Tara Sampalli, Michael Shepherd and Jack Duffy
Abstract: Complex and chronic health conditions have domain knowledge that is multidisciplinary, inconsistent, non-standardized and poorly categorized making them heterogeneous. Consequently, challenges for collaborative care management are widely prevalent due to lack of interoperability. Ontologies have come to the forefront as effective method to improve interoperability in a domain due to their ability to enable higher levels of specification. The primary objective of this study was to develop, test and evaluate a model and a methodology for creating ontologies in heterogeneous domains of complex conditions, an area where there is great paucity for research. The methodology in this research applied a two-staged approach for enabling interoperability in the heterogeneous domain of two complex chronic health conditions, namely, multiple chemical sensitivity and chronic pain. Four hundred and eight and three hundred forty five multidisciplinary concepts were specified in the profile ontologies for multiple chemical sensitivity and chronic pain. A testing and an evaluation process conducted in this research demonstrated that a high percentage of the multidisciplinary clinicians (>80%) agreed on the overall usefulness of the ontologies in improving the collaborative environment. The results from the research are promising in terms of the potential applications of ontologies in heterogeneous knowledge domains.
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Paper Nr: 59
Title:

WORKPLACE STRESS ESTIMATION METHOD BASED ON MULTIVARIATE ANALYSIS OF PHYSIOLOGICAL INDICES
Authors:

Hirohito Ide, Guillaume Lopez, Masaki Shuzo, Shunji Mitsuyoshi, Jean-Jacques Delaunay and Ichiro Yamada
Abstract: In this research, we have been developing a new integrated analysis method of multiple physiological signals to estimate stress in daily life, which is important in depression screening and life-style related diseases prevention. Experiments have been carried out on 100 participants, measuring electrocardiogram, pulse wave, breath rhythm, and skin temperature in four patterns of psychological states; relax state, normal stress state, monotonous stress state, and nervous state. The newly developed stress state estimation method relies on the integrated analysis of nine physiological indices related to stress that have been extracted from the four measured physiological signals. Because variation range of each index is different between individuals and types of stress, we divided estimation process into three steps. For each step, we performed cross-validation using various classification schemes to select the most relevant set of indices that enable estimation of stress state with few influences of individual variations. Through this method we could achieve 87% accuracy for stress detection, and 63% accuracy for stress type classification. Finally a validation study was performed to confirm this method can be an effective solution to estimate various types of stress state regardless of individuals.
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Paper Nr: 75
Title:

TWITTER IMPROVES SEASONAL INFLUENZA PREDICTION
Authors:

Harshavardhan Achrekar, Avinash Gandhe, Ross Lazarus, Ssu-Hsin Yu and Benyuan Liu
Abstract: Seasonal influenza epidemics causes severe illnesses and 250,000 to 500,000 deaths worldwide each year. Other pandemics like the 1918 “Spanish Flu” may change into a devastating one. Reducing the impact of these threats is of paramount importance for health authorities, and studies have shown that effective interventions can be taken to contain the epidemics, if early detection can be made. In this paper, we introduce the Social Network Enabled Flu Trends (SNEFT), a continuous data collection framework which monitors flu related tweets and track the emergence and spread of an influenza. We show that text mining significantly enhances the correlation between the Twitter and the Influenza like Illness (ILI) rates provided by Centers for Disease Control and Prevention (CDC). For accurate prediction, we implemented an auto-regression with exogenous input (ARX) model which uses current Twitter data, and CDC ILI rates from previous weeks to predict current influenza statistics. Our results show that, while previous ILI data from CDC offer a true (but delayed) assessment of a flu epidemic, Twitter data provides a real-time assessment of the current epidemic condition and can be used to compensate for the lack of current ILI data. We observe that the Twitter data is highly correlated with the ILI rates across different regions within USA and can be used to effectively improve the accuracy of our prediction. Our age-based flu prediction analysis indicates that for most of the regions, Twitter data best fit the age groups of 5-24 and 25-49 years, correlating well with the fact that these are likely, the most active user age groups on Twitter. Therefore, Twitter data can act as supplementary indicator to gauge influenza within a population and helps discovering flu trends ahead of CDC.
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Paper Nr: 79
Title:

MACHINE LEARNING OF HUMAN SLEEP PATTERNS BASED ON STAGE BOUT DURATIONS
Authors:

Francis W. Usher, Chiying Wang, Sergio A. Alvarez, Carolina Ruiz and Majaz Moonis
Abstract: This paper explores the discovery of patterns in human sleep data based on the duration statistics of continuous bouts in individual sleep stages during a full night of sleep. Hypnograms from 244 patients are examined. Stage bout durations are described in terms of the quartiles of their stage bout duration distributions, yielding 15 descriptive variables corresponding to wake after sleep onset, NREM stage 1, NREM stage 2, slow wave sleep, and REM sleep. Unsupervised Expectation-Maximization clustering is employed to identify distinct groups of hypnograms based on stage bout durations. Each group is shown to be characterized by bout duration quartiles of specific sleep stages, the values of which differ significantly from those of other groups (p<0.05). Among other sleep-related and health-related variables, several are shown to be significantly different among the bout duration groups found through clustering, while multivariate linear regression fails to yield good predictive models based on the same bout duration variables used in the clustering analysis. This provides an example of the successful use of machine learning to uncover naturally occurring dynamical patterns in sleep data that can also provide sleep-based indicators of health.
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Paper Nr: 81
Title:

SUPPORTING NURSING CARE ASSESSMENT PROTOCOLS WITH SMARTPHONES
Authors:

Ilídio C. Oliveira, Nelson Silva, Ivo da Veiga and João P. S. Cunha
Abstract: Technological advances in mobile phones make them appealing to support nursing care at the point of treatment, especially by combining the easy-of-use, mobility and wireless communications. Novel capabilities, such as picture capturing, enlarge the applications scope. In this work, we present the HOPE system to facilitate nursing care documentation, by leveraging on standard off-the-shelf mobile phones. The proposed system moves a substantial part of the work usually deferred and performed at desktop computers to the moment and place of care. In addition, health professionals can document the clinical cases with photos, using the mobile phone built-in camera, which is being applied in diabetic foot consultation. Basic support for wound measurement is available. The information acquired is integrated in the patient’s Electronic Health Record and can be shared using the mobile devices or the workstations. The proposed system is in pilot use at two Portuguese hospitals targeting inpatient care and diabetic foot consulting.
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Paper Nr: 85
Title:

EVALUATING A SPOKEN LANGUAGE INTERFACE OF A MULTIMODAL INTERACTIVE GUIDANCE SYSTEM FOR ELDERLY PERSONS
Authors:

Cui Jian, Frank Schafmeister, Carsten Rachuy, Nadine Sasse, Hui Shi, Holger Schmidt and Nicole von Steinbüchel
Abstract: This paper presents a multimodal interactive guidance system for elderly persons for the use in navigating in hospital environments. We used a unified modelling method combining the conventional recursive transition network based approach and agent-based dialogue theory to support the development of the central dialogue management component. Then we studied and specified a list of guidelines addressing the needs of designing and implementing multimodal interface for elderly persons. As an important step towards developing an effective, efficient and elderly-friendly multimodal interaction, the spoken language interface of the current system was evaluated by an elaborated experiment with sixteen elderly persons. The results of the experimental study are overall positive and provide evidence for our proposed guidelines, approaches and frameworks on interactive system development while advising further improvements.
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Paper Nr: 90
Title:

WEB INFORMATION SYSTEM FOR THE STUDY OF ORAL HEALTH
Authors:

José Melo, Joel P. Arrais, Pedro Lopes, Nuno Rosa, Maria José Correia, Marlene Barros and José Luis Oliveira
Abstract: The human oral cavity is a complex ecosystem where multiple interactions occur and whose comprehension is critical to understand several disease mechanisms. In order to comprehend the composition of the oral cavity at a molecular level, it is needed to compile and integrate the biological information resulting from specific techniques, especially from proteomic studies of saliva. The objective for this work was to compile and curate a specific group of proteins related to the oral cavity, providing a tool to conduct further studies over the salivary proteome. Despite previous efforts to identify the protein components of saliva in healthy individuals and in several oral and systemic disorders, a resource compiling and reviewing all of these proteins is still lacking. In this paper we present a platform that integrates in a single endpoint all available information for proteins associated with the oral cavity. The proposed tool allows researchers in the biomedical sciences to explore organisms, proteins and diseases, constituting a unique tool to analyse meaningful interactions for oral health.
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Paper Nr: 107
Title:

ONTO-MAMA - An Unified Ontology and 3D Graphic Model of the Female Breast Anatomy
Authors:

P. B. L. Klavdianos, M. Parente, L. M. Brasil and J. M. Lamas
Abstract: The science of ontology has been widely used in knowledge management, either to define and organize concepts for the purpose of future preservation or to provide more efficient information processing by our computers. From this, the use of ontology in medical field has become increasingly consolidated, either to simply describe the correct meaning of technical terms or to completely depict the anatomical structure of the human body or medical procedures. In addition, the use of ontology has been associated to artificial intelligence and virtual reality in order to provide simulation of medical environments with the aim of better understand the complexities of the human anatomy and the medical procedures. Accordingly, this article presents the elaboration of an ontology and a 3D graphic model of the female breast anatomy to be used in a virtual reality environment containing an intelligent tutor system which will eventually be able to assist learners in the practice of the core needle biopsy. This article reports our experience so as to share information about the process used, the artifacts generated and the systematic involved in the structuring of such unified model.
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Short Papers
Paper Nr: 7
Title:

UNDERSTANDING AND ADDRESSING THE ‘FIT’ BETWEEN USER, TECHNOLOGY AND ORGANIZATION IN EVALUATING USER ACCEPTANCE OF HEALTHCARE TECHNOLOGY
Authors:

Noor Azizah K. S-Mohamadali and Jonathan M. Garibaldi
Abstract: In this paper, we discuss the importance of addressing the ‘fit’ between user, technology and organization in evaluating user acceptance of healthcare technology. We give an overview of evaluation dimensions and explore two models that are related to ‘fit’. We demonstrate how users’ acceptance factors in previous studies could be better explained through the perspective of ‘fit’ between user, technology and organization. We believe that the importance of ‘fit’ needs to be understood in greater detail among the evaluation research community. The ‘fit’ between user, technology, and organization needs to be addressed together with the factors that influence user acceptance. This paper attempts to gain empirical support for the inclusion of ‘fit’ between user, technology and organization when evaluating user acceptance of the healthcare technology.
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Paper Nr: 16
Title:

IT DEVELOPMENT AND MANAGEMENT OF A LIVE E-RESEARCH SYSTEM - Experiences with the Australian Schizophrenia Research Bank
Authors:

D. Paul, F. A. Henskens, C. M. Loughland, J. Bridge, K. McCabe, V. J. Carr, S. V. Catts, A. Jablensky, P. T. Michie, B. J. Mowry, C. Pantelis, U. Schall and R. J. Scott
Abstract: The Australian Schizophrenia Research Bank (ASRB) is a nationwide eResearch project that aims to facilitate scientific research into one of the most perplexing and challenging mental disorders facing researchers today. The system is accessed through a Web portal and, subject to ethics approvals, allows researchers access to subsets of the clinical, neuropsychological, and genetic data collected by the project. This paper describes the day-to-day experiences in the on-going development and management of the ASRB IT systems, including current practices, lessons learned, and areas where improvement is required.
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Paper Nr: 20
Title:

THE RELEVANCE OF DICOM-RT IN RADIOTHERAPY INFORMATION SYSTEMS - Preliminary Results from a National Survey
Authors:

Celeste Marques Oliveira and Pedro Pereira Rodrigues
Abstract: Currently, in radiotherapy (RT) departments, there are different manufacturers and stand-alone information systems (IS) for single-purpose applications. These systems have most of the data distributed through different IS. The DICOM-RT extension has six objects that provide a standardized way of transferring the information circulating in the external beam RT. The aim of this study is to assess expert’s opinion about DICOM-RT and IS interoperability in the RT context, through the characterization of Portuguese RT facilities, in terms of equipment and IS with the identification of existing interoperability problems. This study is cross-sectional, and the preliminary results presented in this paper are relative to the period May-July 2011. All Portuguese RT departments (i.e. 20) were invited to cooperate in the survey; the response rate was 40% (n=8), while 10% (n=2) of the institutions did not authorize the RT departments to participate. The preliminary results show that the RT departments have some equipment and IS from different vendors contributing for heterogeneity of RT workflows. The experts somehow attribute importance to interoperability, but have low knowledge about their own IS integrations, and DICOM-RT. Compliance with DICOM-RT is recommended when acquiring new RT IS to optimise the interoperability.
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Paper Nr: 23
Title:

HEALTH INFORMATION EXCHANGE NETWORK INTEROPERABILITY THROUGH IHE TRANSACTIONS ORCHESTRATION
Authors:

Francois Andry and Lin Wan
Abstract: Integrating the Healthcare Enterprise (IHE) is an initiative designed to facilitate the integration of healthcare information systems in order to exchange health care information in a secure, private and efficient manner. Solution vendors now offer IHE integration profiles as web services that can be integrated locally or regionally to coordinate standard heath care activities such as clinical documents management. Although IHE profiles promote the use of standards, the federation of health information systems is difficult because each node to integrate is generally very different. Each individual node has its own services, communication protocol, security scheme, performance, customization and extensibility capabilities. In addition, IHE profiles do not address workflow management process such as the mediation, routing and aggregation of the content of IHE transaction messages. In this paper, we describe an architecture solution that addresses these needs and provides the orchestration of IHE transactions (XCPD, XCA, ATNA) to support state wide-Health Information Exchanges.
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Paper Nr: 26
Title:

THE JUSTIFICATION OF THE USE OF INFORMATION TECHNOLOGY IN PATIENT SAFETY INITIATIVES
Authors:

Kathleen Detar Gennuso
Abstract: Using information technology (IT) to reduce adverse events in healthcare has been a growing trend since its endorsement in the 1999 Institute of Medicine (IOM) report. The implementation of comprehensive information systems in healthcare practices has proved to be a path riddled with pitfalls. Not unlike other industries, initially there are more failure stories than successes. Unfortunately the more comprehensive the technology, or the wider the span of the implementation, the more difficult it is to achieve success. This paper looks at the need for information technology (IT) in patient safety initiatives. Based on this foundation, it examines critical concepts in the process of implementation of systems supporting patient safety initiatives. Last, the paper identifies a sampling of ethical issues that commonly arise when IT is utilized in patient safety initiatives. Even though a transformational application of IT in this type of endeavor is difficult, it does not undermine the significant benefits that automation can provide and is required to provide by society and the law.
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Paper Nr: 28
Title:

INFORMATION SECURITY MANAGEMENT SYSTEM - A Case Study in a Brazilian Healthcare Organization
Authors:

Carlos Eduardo Ribas, Marcelo Nascimento Burattini, Eduardo Massad and Jorge Futoshi Yamamoto
Abstract: ISO 27001 is the international standard for an Information Security Management System (ISMS) that helps to address the triad of information security: Confidentiality, Integrity, and Availability (CIA). An ISMS is a systematic approach focused on managing information security within an organization. It encompasses all the information assets, such as: people, processes and IT systems. This paper describes the implementation process of an ISMS in a Brazilian healthcare organization. We use an information system based on ISO standards as an indicator to assess the information security. Using Chi-square with Yates' correction or Fisher's exact test to compare the proportion of adequacy to the requirements of reference standard used, our case study showed positive results in the first ten months of implementation with significant results on multiple items analysed. However, in an environment of limited budgets, better results were not achieved in the following months due to the financial problems to implement specific controls in the organization. The aim of this paper is to present the experience obtained during the implementation of an ISMS in a healthcare organization and to discuss some critical success factors.
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Paper Nr: 29
Title:

AN ACTIVE APPROACH IN HEALTH MONITORING
Authors:

Doan B. Hoang, Nor Faizah Ahmad and Congduc Pham
Abstract: Specific-purpose hardware or software modules are often designed to provide timely response to conditions or events that required attention. However, these application-specific mechanisms are not flexible and often can not be reused or adapted to different situations and applications. This paper proposes an approach whereby an active database with triggering mechanisms is deployed for surveillance and health monitoring applications. The paper presents a comprehensive monitoring architecture and an application to demonstrate its use in an Active Maternity Care system.
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Paper Nr: 32
Title:

FEDERATED HEALTH REGISTERS - A Literature Review
Authors:

Liliana Leite, Alice Miranda, Carla Esteves and Luis Antunes
Abstract: Electronic Health Records (EHR) are a collection of all individuals health data, in an electronic form, generated during relevant interactions with the healthcare system. The federated database systems provides intercommunication between different and autonomous data units, which enables sharing data. This paper aims to be a state-of-art on the requirements to take into account when developing a federated system. For that, we did a literature review on PubMed, ISI Web of Knowledge, Scopus and Google Scholar. Federated systems must ensure interoperability using open standards; guarantee the system value through high quality services; have modular architecture to allow developments, maintenance and evolutions, and finally, enable the “monotonic” systems with an incremental evolution. When developing these systems we have to avoid semantic, functional and instance conflicts to ensure the correct functionality. We concluded that federated systems are a good option in health's domain. They allow a high volume of data storage in healthcare that can be accessed in any place, at any time, by health professionals. Thus, we believe that federated systems are a tool to improve the quality and efficiency of health care.
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Paper Nr: 33
Title:

A LOW COST ERGONOMIC EEG SENSOR FOR PREDICTING MENTAL ILLNESS
Authors:

Dennis Majoe, Jurg Gutknecht and Hong Peng
Abstract: The EEG recording of a person has been considered as one potential component within an overall wearable sensor system that predicts the onset of mental health problems. Such a smart EEG sensor should provide detailed sensory information, be easy to use, and to put on and take off and whilst being very ergonomic the design should aim at a very low final end user cost to ensure the widest possible take up by the e-Health community. The work reported here describes the design of such a sensor, the performance and its use during extensive clinical trials aimed to establish the rules that link physiology sensing to mental health prediction.
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Paper Nr: 38
Title:

THE DESIGN OF AN AUTONOMIC CONTROLLER FOR SELF-MANAGED EMERGENCY DEPARTMENTS
Authors:

Serene Almomen and Daniel A. Menascé
Abstract: Improving the operational efficiency of an Emergency Department (ED) is a complex task due the very large number of ED configurations that involve human and physical resources and due to the unpredictable nature of the ED’s workload. Thus, managing the performance of EDs becomes difficult and expensive when carried out by human beings alone. A new approach, called self-managed EDs, consists of building into the ED the mechanisms required to self-adjust the ED’s configuration parameters so that its Quality of Service (QoS) is constantly met. This paper presents the design of an autonomic controller for a self-managed Emergency Department and evaluates its effectiveness in maximizing a utility function of the ED subject to cost-constraints. The controller uses a combination of combinatorial search techniques with simulation models. Experimental results illustrate the operation of the controller and how it reacts to variations of patient interarrival times.
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Paper Nr: 43
Title:

RESPIRATORY SOUND ANNOTATION SOFTWARE
Authors:

João Dinis, Guilherme Campos, João Rodrigues and Alda Marques
Abstract: Significant research efforts have been dedicated to the automatic detection of adventitious lung sounds, using, for this purpose, different algorithms. The validation of these algorithms is based on the comparison of their results with reference annotations and therefore requires the development of user-friendly annotation software. This paper presents an application, developed in Matlab®, for the annotation of respiratory sounds. The user can identify respiratory cycles and adventitious sounds – crackles and wheezes – directly on the waveforms displayed on the screen, which may be simultaneously played back. The audio playback speed is user-adjustable and synchronised with the cursor display. Specific annotation file storage formats were defined. Preliminary usability tests performed by three health professionals using twenty respiratory sound files from six patients (with pneumonia and cystic fibrosis) indicate that the software is user-friendly and effective, allowing simple and quick annotations.
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Paper Nr: 45
Title:

DETECTION OF INCONSISTENCIES IN HOSPITAL DATA CODING
Authors:

Juliano Gaspar, Fernando Lopes and Alberto Freitas
Abstract: Introduction: Health professionals need data, in sufficient quantity and quality, and tools that can manage the vast amount of available data. They need help for data management and appropriate support for decision making. Introduction: Health professionals need data, in sufficient quantity and quality, and tools that can manage the vast amount of available data. They need help for data management and appropriate support for decision making. Aim: The focus of this study is to develop a prototype that can contribute to the identification of data quality problems in clinical and administrative data. Methods: Methods involve the definition of requisites and business rules, the prototype development and testing, and the realization of two studies using the prototype. Results: Studies performed using the prototype resulted in the detection of many data problems and inconsistencies. Amongst those we can point out, for instance, that 82,000 (15%) episodes had ‘diagnostic code does not exist in ICD-9-CM table’ and that 783 (0,2%) episodes within ‘female breast cancer’ had the variable gender equal to ‘male’. Discussion: This prototype, besides contributing to the detection of data quality problems, is also expected to be an incentive to the improvement of information system architectures. It shows the importance of the development of mechanisms to detect and validate data in health environments.
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Paper Nr: 48
Title:

QUALITY OF DATA FROM CENTRAL AND DEPARTMENTAL INPATIENT DATABASES - A Comparative Study
Authors:

Bernardo Marques, Eliana Sousa, Tiago Silva-Costa, Ricardo Correia and Alberto Freitas
Abstract: This paper is a preliminary study over the problems resulting from the integration of a departmental information system database over a central database. This work will allow the comparison between the quality of the data collected for clinical purposes by a medical department, and the data collected for administrative and epidemiological purposes in a central hospital database. It is expected that the different purposes for these two data collections can have an impact on data consistency, namely on it completeness and detail of information, among other data quality problems. We expect to detect the type of variables that are better recorded in each information system, by calculating and comparing the quality of similar variables. We also expect to detect differences between both systems in the registries of the same patients. This paper can play an important role for better understanding the quality of the integration of departmental systems in the general hospital information system, pointing out some limitations about consistency and information flow. It is also our goal to suggest some recommendations and strategies to prevent data quality problems and to improve communication between central and departmental databases.
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Paper Nr: 60
Title:

A PROPOSAL OF A WORKFLOW-BASED CBR FOR INTERVENTIONAL CDSS - Application to Transcatheter Aortic Valve Implantation (TAVI)
Authors:

Andres El-Fakdi, Joaquim Meléndez and Roberto Petite
Abstract: A Clinical Decision Support System (CDSS) is an interactive software designed to assist physicians, and other health professionals, with health decision-making tasks through an inference process that associates observations with conclusions supported by objective and expert knowledge on a specific application domain. As complexity of surgical processes arises, there is a demand from the clinicians to extend the capabilities from a pure research database towards a clinically integrated decision support system. The work presented in this paper details a proposal of a CDSS designed to to assess clinicians during interventions by retrieving and reusing past similar cases. Following an operative workflow, the designed software will use a Case-Based Reasoning (CBR) methodology to retrieve similar past cases from a case base to give case-specific advice at any particular point of the process, specially during preoperative and intraoperative stages. The proposal intends to develop a monitoring mechanism capable to recognize relevant data to every stage in the intervention workflow. Thus, measures and observations generated during the intervention will be used to retrieve the most similar cases occurred in previous occasions. The paper proposes an example application of the CBR strategy, where it is adapted to a recent complex minimally invasive intervention which is receiving growing attention lately, the Transcatheter Aortic Valve Implantation (TAVI).
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Paper Nr: 62
Title:

OPTIMISING CONTROL ALGORITHMS IN BIOFEEDBACK-SYSTEMS - First Steps Towards Model Identification Adaptive Controllers
Authors:

Carolin Zschippig, Carsten Rachuy and Kerstin Schill
Abstract: We explore the potential of model identification adaptive controllers (MIAC) within a biofeedback system. Through the application of an adaptive control algorithm, the system performance could be optimised with respect to time. In a series of experiments the galvanic skin resistance of test subjects playing a computer game was recorded. On this data, a system identification was performed, utilising an Adaptive-Network-based Fuzzy Inference System (ANFIS). The results serve as a basis for the development of the adaption laws of the MIAC and allow conclusions about suitable controllers.
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Paper Nr: 63
Title:

FOOD TEXTURE ESTIMATION FROM CHEWING SOUND ANALYSIS
Authors:

Hao Zhang, Guillaume Lopez, Ran Tao, Masaki Shuzo, Jean-Jacques Delaunay and Ichiro Yamada
Abstract: In recent years, an increasing number of people have been suffering from over-weight, indicating the importance of a balanced dietetic lifestyle. Researches in nutrition and oral health have raised the importance of not only calorific consumption, but also eating habits quality such as the regularity of meals, eating speed, and food texture. A new model for the estimation of food texture by analyzing chewing sound collected from a wearable sensor is presented in this paper. The proposed model combining effective sound features extraction and classification methods make it possible to estimate quantitatively detailed texture of food a person is eating. The model has been implemented and shown being efficient (more than 90% accuracy) to estimate three food texture indices at eight detailed levels for each, with little influence of individual chewing differences.
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Paper Nr: 68
Title:

PROCESS-ORIENTED INCIDENT REPORTING IN HEALTH CARE ORGANIZATIONS - Web Application Architecture and Modeling Experiences
Authors:

Martin Schmollinger, Eric Stricker, Tibor Bazlen, Thomas Eßlinger, Christopher Röhl and Brian Walter
Abstract: In Germany more than 17,000 people die per year because of ”medical errors”, in the USA it is about 98,000. The number of avoidable malpractice cases or major complications is about tenfold higher. Nearly everyone will be a patient in a hospital sooner or later. A key concept to improve patient safety are modern, anonymous adverse event reporting systems in hospitals. These are known as incident reporting systems. The introduction of modern process-oriented technologies optimizes the efficiency of such systems and increases patient safety. IT saves lives, if it is possible to improve the analysis of medical incidents and to accelerate the detection of the underlying causes by optimizing the IRS processes. In this paper we present a generic process-oriented architecture and its application for incident reporting systems in health care organizations. Further, we formulate lessons learned concerning business process modeling and implementation for process-oriented architectures.
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Paper Nr: 70
Title:

FRAMEWORK FOR COMPUTER AIDED ANALYSIS OF MEDICAL PROTOCOLS IN A HOSPITAL
Authors:

Rene Schult, Pawel Matuszyk and Myra Spiliopoulou
Abstract: We study the potential of analyzing medical protocols with data mining methods for resource planing. Background. Medical protocols can be exploited in several resource planing applications, such as optimizing occupancy of surgery rooms or scheduling teams for surgery operations. Literature has identified many variables that can be used to predict resource demand; some of them can be extracted from medical protocols. Contribution. We propose a high-level framework for knowledge discovery from medical protocols, and present a first instantiation in a German hospital. We report on the findings of this instantiation for the task of predicting surgical room occupancy time.
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Paper Nr: 72
Title:

DESIGN AND EVOLUTION OF HOME-CARE WORKFLOWS USING ONTOLOGIES AND MODEL TRANSFORMATIONS
Authors:

Sabrina Zefouni, Elyes Lamine, Rémi Bastide and Hervé Pingaud
Abstract: This paper investigates the use of workflows to automate the delivery, coordination and monitoring of home-care processes. Workflow models of these processes need to be customized, resilient to change, collaborative and also need to account for the temporal aspects of care (treatment duration, frequency of a medical acts, etc.). To this end, an approach based on ontologies (home-care ontology and BPMN ontology), rules and patient’s profile is proposed for the construction of workflows supporting the coordination and continuity of home-care processes.
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Paper Nr: 74
Title:

A MOBILE COLLABORATION AND DECISION SUPPORT SYSTEM FOR THE MEDICAL EMERGENCY DEPARTMENT
Authors:

Dominique Brodbeck, Markus Degen and Maximilian Reiss
Abstract: A hospital emergency department is a complex work environment, where the availability of the right information at the right time is crucial for efficient and safe operation. The current technology in use for communication and information management is mostly based on telephones and stationary personal computers. Modern smartphones with their computational power, voice, image, and video capabilities have the potential to play a significant role in improving the flow of information in the emergency department. We developed a system that explicitly supports the work flows of an emergency department. In addition to mobile access to patient data and notifications about the availability of diagnostic findings, it provides the possibility to supply media captured on-site to the patient record, and directly supports the consultation process.
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Paper Nr: 78
Title:

A SECURE PERSONAL HEALTH RECORD REPOSITORY
Authors:

Tiago Pedrosa, Rui Pedro Lopes, João C. Santos, Carlos Costa and José Luis Oliveira
Abstract: Due to strict regulatory, ethic and legal issues, Electronic Health Record (EHR) systems have been mainly deployed in federated health care scenarios. This situation have been hindering the wide adoption of EHRs, contributing to delaying the establishment of a competitive market where contributions from different providers could take full advantage of information exchange and regular practitioners’ collaboration. Moreover, with the increasing awareness of medical subjects, patients are demanding more control over their own personal data - Personal Health Record (PHR). This paper presents a secure PHR repository which access is controlled through the joint use of a Virtual Health Card Service (VHCS) and an access Broker. This solution can be deployed in any public or private storage service since it behaves as a sandbox system which access policy is defined externally. To assure a friendly query-retrieve interaction the whole repository is indexed, and separated clinical events are kept independently to increase the efficiency of cipher and encipher algorithms.
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Paper Nr: 94
Title:

ONE WAY TO PATIENT EMPOWERMENT - The Proposal of an Authorization Model
Authors:

Cátia Santos-Pereira, Luis Antunes, Ricardo Cruz-Correia and Ana Ferreira
Abstract: American and European Legislation for protection of medical data agree that the patient has the right to play a pivotal role in the decisions regarding the content and distribution of her/his medical records. The Role Based Access Control (RBAC) model is the most commonly used authorization model in healthcare. The first goal of this work is to review if existing models and standards provide for patients accessing their medical records and customizing access control rules, the second goal is to define and propose an authorization model based on RBAC to be used and customized by the patient. A literature review was performed and encompassed 22 articles and standards from which 12 were included for analysis. Results show that existing standards define guidelines for these issues but they are too generic to be directly applied to real healthcare settings. The proposed authorization model combines characteristics of RBAC, ISO/TS 13606-4, temporal constraints and break the glass. With this model we hope to start bridging the gap between legislation and what really happens in practice in terms of patients controlling and being actively involved in their healthcare. Future work includes the implementation and evaluation of the proposed model in a healthcare setting.
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Paper Nr: 97
Title:

EVALUATION OF A MATERNAL AND CHILD ELECTRONIC HEALTH RECORD IN A DEVELOPING COUNTRY - Preliminary Results from a Field Pilot
Authors:

Martins Mupueleque, Juliano Gaspar, Ricardo Cruz-Correia and Altamiro Costa-Pereira
Abstract: Introduction: The poor quality of health indicators data such as maternal and perinatal mortality prevents an adequate planning and evaluation of public health interventions. Objective: To evaluate the viability and usability of a prototype of a maternal and child electronic health record, in Northern Mozambique. Methods: The prototype was based on existing paper forms and the system was assessed at a maternity ard in a healthcare center of Nampula. The usability was evaluated using in loco observations, interviews and self-administered questionnaires to health professionals, after a 6 hours training period. Results: During the evaluation period, 205 clinical forms were registered, corresponding to 58% of all childbirths. From a total of 19 health professionals, 9 nurses answered the questionnaire. The prototype was well accepted among these respondents but the recording time was higher than in its paper version (12 vs. 5 minutes per record). Data quality problems were identified. The absence of a unique citizen identifier was a major obstacle regarding the mother-child data linkage. Conclusion: Although this system may contribute to the improvement of the quality of the healthcare provided to women and children in Mozambique, there are still many technical and organizational challenges to be overcome.
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Paper Nr: 121
Title:

A CASE STUDY - On Patient Empowerment and Integration of Telemedicine to National Healthcare Services
Authors:

Surayya Urazimbetova
Abstract: Patient empowerment in the digitalized healthcare can be supported by means of telemedicine. As opposed to Electronic Patient Records developed by a few large business suppliers for healthcare professionals, telemedical applications include innovative solutions of small-medium size suppliers and are targeted at specific groups of patients (e.g., hip operated or dermatology patients) and their care network. Based on an integration experiment we argue that in order to support the national visions for patient empowerment and connectedness of healthcare at the same time, it is necessary to achieve the integration of telemedicine to the national healthcare services on a business logic (functional) integration level. In this paper, (1) we identify the lack of business logic (functional) level integration opportunities for patient oriented telemedical applications with national healthcare services; (2) we summarize on processes, products and organizations which are part of the integration procedure and provide places for shortening the time-to-market of SMBs. (3) we identify the need of supporting telemedicine uptake by extending access rights policies of the confidential patient data to decentralized citizens level access control.
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Paper Nr: 122
Title:

A TELEMEDICINE SYSTEM FOR IMPROVED REHABILITATION OF STROKE PATIENTS
Authors:

Steffen Ortmann and Peter Langendörfer
Abstract: Analysis showed that costs of long-term care for stroke patients have increased from 13% to 49% of overall costs in average in recent years. Therefore there is an urgent need for devising an effective long-term care and rehabilitation strategy for stroke patients, which will involve the patients actively in the process. The goal of our approach is the development of a telemedicine system which supports ambulant rehabilitation at home settings for stroke patients with minimal human intervention. This system will combine state-of-the-art monitoring devices forming a wireless Body Area Network that enable simultaneous measurement of multiple vital parameters and currently executed movements that are particularly of interest from a Stroke rehabilitation point of view. It will empower the patient to do more for fast recovery than today and provides clinical experts with data not available today. By that, it leads also to a better understanding of the stroke recovery process, higher recovery speed and thus, to reduced healthcare cost while improving patients’ quality of life.
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Paper Nr: 123
Title:

TOWARDS DATA AND DATA QUALITY MANAGEMENT FOR LARGE SCALE HEALTHCARE SIMULATIONS - Position Paper
Authors:

Philipp Baumgärtel and Richard Lenz
Abstract: The approach of ProHTA (Prospective Health Technology Assessment) is to understand the impact of medical processes and technologies as early as possible. Therefore, simulation techniques are utilized to estimate the effects of innovative health technologies and find potentials of efficiency enhancement within the supply chain of healthcare. Data management for healthcare simulations is required as heterogeneous data is needed both as simulation input data and for validation purposes. The main problem is the heterogeneity of the data and the initially unknown and continuously changing demands of the simulation. Also, data quality considerations are necessary to quantify the reliability of simulation output. A solution has to consider all of these aspects and must be extensible to cope with changing requirements. As the structure of the data is not known in advance, a generic database schema is required. This paper proposes an approach to store heterogeneous statistical data in an RDF-triplestore. Semantic annotations based on conceptual models are utilized to describe the datasets. Additionally, a special query language helps loading the data into the simulation. The feasibility of the approach has been demonstrated in a prototype implementation. We discuss the benefits of this approach as well as remaining challenges and issues.
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Paper Nr: 124
Title:

BRIDGING THE GAP BETWEEN CLINICAL RESEARCH AND CARE - Approaches to Semantic Interoperability, Security & Privacy
Authors:

Richard Vdovjak, Brecht Claerhout and Anca Bucur
Abstract: Efficient collaboration and data sharing are essential prerequisites for improving efficiency, safety and outcomes in medicine. Current separation of clinical research and care creates a significant knowledge gap, especially in the case of complex diseases such as cancer, hampering research and slowing down the transfer of the latest research results to patient care. The momentum gained by initiatives focusing on these aspects indicates that under the right circumstances, the biomedical community is ready and willing to open up. However, main technological barriers concerning semantic interoperability, security and privacy need to be addressed to make this change possible. In this paper we describe our scalable, standards-based and open approach towards addressing these issues in the context of a large initiative with focus in oncology.
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Paper Nr: 129
Title:

RE-EXAMINING PERCEPTIONS ON HEALTHCARE PRIVACY - Moving from a Punitive Model to an Awareness Model
Authors:

Mowafa Househ
Abstract: In this position paper, I argue that, in the near future, the advent of social media, patient empowerment, and post-privacy will lead individuals to openly share their personal health information online with other individuals and groups. These actions will undermine the need for current privacy legislation, which cannot prevent individuals from divulging their own personal health information. As a result, current privacy legislation must change from a punitive and restrictive model to a model that empowers and promotes awareness about how individuals use their personal health information online.
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Paper Nr: 132
Title:

HEALTHCARE BUSINESS PROCESSES RISKS IDENTIFICATION AND MANAGEMENT - Approach for Medication Administration Processes Re-engineering
Authors:

Leandro Paulo Bogoni, Ganna Frankova, Cristina Matteotti, Fabio Casati, Duncan Dubugras Ruiz and Giampaolo Armellin
Abstract: Medication administration in healthcare institutions is one of the critical processes that need to be carefully considered from the risk management point of view. Medical administration errors are costly from several perspectives as they lead to injuries, illness or even death and finally, significantly increase hospital expense. In this article, we argue that efficient risk management approaches for medication administration business processes are needed. Risks should be identified and mitigated well before critical error occurs. The presented work describes issues of healthcare business process risk individuation and propose a methodology for business process re-engineering to mitigate the identified risks. To show the potential impact of the approach, we illustrate the functioning of the methodology on the scenario derived from the application domain of the Nursy RollyTM industrial R&D project.
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Paper Nr: 133
Title:

A PILOT STUDY OF SHORT-TERM EFFECTS OF NON-SEDENTARY BEHAVIOUR ON MOOD CHANGES
Authors:

Aleksandar Matic, Venet Osmani, Andrei Popleteev and Oscar Mayora-Ibarra
Abstract: Sedentary behaviour is considered to be a major factor impacting a number of health outcomes while use of technology in the workplace is increasingly contributing to the amount of sedentary time. Even if guidelines on the amount of physical activity are followed outside of workplace, sedentary work style still has a deleterious impact on health. There have been a number of studies that investigated the impact of sedentary behaviour on general health while no study has reported investigation of effects of sedentary behaviour on mood changes. The aim of this pilot study, which included 14 knowledge workers, was to objectively measure sedentary time using accelerometers and investigate correlation with the self-reported mood changes in short term. The results show that sedentary behaviour has negative effects on the mood even over a short period of one day. Although a pilot study, this is the first study to examine short term psychological implications of sedentary behaviour. Randomised controlled experiments are needed to further clarify these findings.
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Paper Nr: 135
Title:

ICT TO IMPROVE SAFETY, TRACEABILITY AND RELIABILITY OF CLINICAL PROCESSES WITH QUALITY ASSURANCE ISSUES - The Case of Stem Cells
Authors:

Vittorio Montefusco, Elena Sini, Michele Torresani, Paolo Locatelli, Nicola Restifo and Roberta Facchini
Abstract: Traceability and quality assurance of bedside processes are often still manual, without the appropriate support of information systems. Automatic Identification and Data Capture (AIDC) solutions integrated with Mobile&Wireless devices are key solutions to meet the needs of secure identification of persons and items and of traceability of processes in healthcare organizations. These technologies can fit a variety of processes, like enterprise-wide person/item identification, blood transfusions, surgical samples identification, therapy management. The challenge is to extend the use of these solutions also to other processes like biobanking, where stem cellular products require strict procedures of collection and manipulation, even in critical environmental conditions. Fondazione IRCCS Istituto Nazionale dei Tumori in Milan (Italy) has a wide experience in RFId projects and is starting to lead a project aimed to design, develop and implement a set of organizational models, acknowledged procedures and ICT tools in order to improve actual support to collection and transplantation of Human Stem Cells. In this paper we present a literature overview of cases of implementation of AIDC technology solution and of how its character of ubiquity and versatility could fit well with process requirements, discussing the Istituto’s business case.
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Paper Nr: 138
Title:

DESIGN OF A PROTOTYPE FOR PERFORMING HOSPITAL BENCHMARKING - Production and Management of Hospital Quality Indicators
Authors:

Juliano Gaspar, Nuno Rocha and Alberto Freitas
Abstract: Introduction: Hospitals are complex organizations and the quality and efficiency of care and the hospital assessment performance are complex features to measure and estimate. Aim: To extract an useful knowledge from hospital databases to develop a hospital dashboard for quality and management indicators and to generate sufficient information, relevant and timely, to assist in decision-making processes. Methods: This study was structured with four distinct phases: preliminary study, literature review, definition and development, and evaluation results. Results: The preliminary studies were grouped in production and quality hospital indicators. In 2010 there was a reduction (3.5%) in the total number of episodes, a reduction (30%) on exceptional short LOS episodes, a significant reduction of obstetric complications, and an increase the problems related to clinical coding. Discussion: In a preliminary way, it can be observed the importance in a hospital management of such results synthesized and summarized in groups of production and quality hospital indicators. Conclusion: This work comprises the study of solutions can contribute to the improvement of healthcare delivery, aiming towards management support and the desired hospital operating costs reduction.
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Paper Nr: 141
Title:

NETWORK-AWARE BIOMEDICAL SIGNAL PROCESSING - Loss Concealment or Loss Awareness
Authors:

Beatriz Barros, Ana Aguiar and Daniel E. Lucani
Abstract: The development of biomedical signal processing algorithms typically assumes that the data can be sampled at an uniform rate and without loss of samples. Although this is a valid assumption for Holter applications or clinical testing, these assumptions become questionable in the presence of remote monitoring of patients through inherently lossy communication networks. The task for the networking engineers has been to create better, more reliable protocols to avoid packet losses from affecting the signal processing algorithms. However, inherent constraints from resource-constrained devices and lossy networks used for remote monitoring make this objective infeasible in many situations. Given irreparable losses due to data transmission, this paper poses the following questions: (i) how would the current algorithms react to losses, and (ii) what alternatives are available to still guarantee reliable monitoring and detection of emergency events. For the latter, we consider two options: the use of current algorithms after a loss concealment stage, and the design of loss aware algorithms. We argue that a joint design of network protocols and signal processing algorithms is instrumental for providing reliable biomedical monitoring. We propose a simple, yet powerful model of the network under a variety of packet loss channels as well as data packetization mechanisms. Extensive numerical results are provided for addressing question (i), focusing on the sensitivity and positive predictivity of standard ECG algorithms under a variety of network scenarios. We use the MIT-BIH arrhythmia database and simple loss concealment mechanisms and show that even small percentages of packet losses can have a significant impact on a algorithm’s performance.
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Paper Nr: 9
Title:

AN EXPERT SYSTEM MODEL IN PSYCHIATRY FOR CASE FORMULATION AND TREATMENT DECISION SUPPORT
Authors:

Irosh Fernando, Frans Henskens and Martin Cohen
Abstract: Whilst case formulation is a critical task in psychiatry, it is an unexplored area in the field of medical expert systems development, which has mostly focused on the diagnostic inference. Case formulation plays a more important role in planning, and individualising treatments compared to categorical diagnoses. Nevertheless, case formulation is considered to be challenging task even for clinicians due to the highly subjective nature of the psychiatric knowledge, and lack of defined criteria, which are available for diagnoses. Lack of conceptual model, which captures the depth and the complexity of the clinical knowledge and reasoning demonstrated by expert clinicians, is considered to be a one of the root causes of failures in previous approaches. Whilst the authors have described a conceptual model for diagnostic consultation in a separate paper, this paper describes the conceptual model for case formulation and treatment decision support, thus laying down a domain-specific theoretical foundation required for successful implementation of expert systems in psychiatry. The knowledgebase has been conceptualised as a hierarchically organised set of entities spanning the domains of diagnostic knowledge, etiological knowledge and treatment knowledge, through which an iterative inference is made using the logical inferences of abduction, deduction and induction.
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Paper Nr: 15
Title:

COMPLIANCE OF PUBLICLY AVAILABLE MAMMOGRAPHIC DATABASES WITH ESTABLISHED CASE SELECTION AND ANNOTATION REQUIREMENTS
Authors:

Inês C. Moreira, Gustavo Bacelar-Silva and Pedro Pereira Rodrigues
Abstract: Mammographic databases play an important role in the development of algorithms aiming to improve Computer-Aided Detection and Diagnosis systems (CAD). However, these often do not take into consideration all the requirements needed for a proper study, previously discussed at the Biomedical Image Processing Meeting in 1993. Case selection and annotation requirements are the most commonly referenced in literature, when describing a database used for the development of such algorithms. This work aims to assess the compliance and suitability of case selection and annotation requirements in the publicly available mammographic databases for development and optimization of CADs. A literature review has been made, applying proper selection criteria related to the research question. In the literature, we found citations to 3 publicly available mammographic databases and ten having restricted access. Through the analysis of the results attained, we noticed that none of the two requirements previously described is on its way to be fully complied in mammographic databases. We can conclude that researchers need a database that fulfils all the mentioned requirements in order to develop efficacious and effective CAD systems. We also believe that the requirements, discussed in 1993, need to be reviewed and updated. New paradigms and ideas to increase algorithms' performance are needed in order to improve CAD schemes.
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Paper Nr: 17
Title:

INCLUDING EXPLICITLY THE QUESTION OF ‘WHICH’ IN EVALUATION STUDIES
Authors:

Noor Azizah K. S-Mohamadali and Jonathan M. Garibaldi
Abstract: Existing studies of user acceptance factors try to provide answers to the questions of ‘why’, ‘what’, ‘who’, ‘when’ and ‘how’. In this paper, we propose to include the explicit question of ‘which’ into future evaluation studies. Two distinct approaches are discussed to address the question of ‘which’. The aim is not to show which is the best, but rather to demonstrate the potential of some alternative approaches to addressing ‘which’.
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Paper Nr: 25
Title:

APPLYING TOC BUFFER MANAGEMENT IN HEALTH INFORMATION SYSTEMS TO IMPROVE HOSPITAL PERFORMANCE
Authors:

Gustavo Marísio Bacelar-Silva and Pedro Pereira Rodrigues
Abstract: Health care systems around the world are under pressure, the costs are high and rising, and the population is growing and ageing. Health information technology is expected to help improving the health care processes capacity. The aim of this work is to analyze the benefits of the Theory of Constraints (TOC) buffer management implementation in the health care environment concerning the improvement in the patient flow and its management. A literature review was conducted, with an automated search on four databases to identify relevant published articles, written in English language between 2000 and 2010, about the TOC buffer management applied to the health care patient flow. Only three relevant articles were included. The analysis was based on the measurements of the implementations realized in seven different hospitals and for three different purposes: Accident & Emergency department (A&E), admissions and discharge. A statistical analysis conducted in the A&E and admissions post-implementation results demonstrated a significant improvement achieved. Four management control functions improvements were also obtained: prioritize, expedite, escalate and improve. Although few papers were available, TOC buffer management appears to be a good solution to improve performance and management in health care.
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Paper Nr: 31
Title:

SEMANTIC WEB IN EEG/ERP PORTAL - Extending of Data Layer using Java Annotations
Authors:

Petr Ježek and Roman Mouček
Abstract: Because the Semantic Web uses its technologies for presenting data/metadata on the web and common systems are based on object-oriented languages a need for suitable mapping is emerging. This paper describes the difficulties during transformation of data layer represented by object-oriented code into the semantic web structures (OWL, RDF). Since there is difference between semantic expressivity of these data representations it is necessary to fill this semantic gap. Authors investigate these differences in semantics and provide a preliminary idea to add missing semantics into the Java code using Java annotations. These annotations are consequently processed by the proposed framework. The transformation is demonstrated within the EEG/ERP Portal.
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Paper Nr: 36
Title:

SECURITY AND PRIVACY IN EUROPEAN EHRS - Should Portugal Follow Denmark and Sweden’s Examples?
Authors:

Catarina Travassos, Inês C. Moreira, Patrícia Ferreira and Gustavo Bacelar-Silva
Abstract: EHR implementation is an important yet challenging technology that provides better patient care by allowing and providing more accurate and available patient information. An efficient digital health service should ensure not only the quality of data processing, but also the confidentiality and safety of patient data. Portugal is now designing a national EHR and discussing its main characteristics and contents. Our study analyses the experiences of two countries where EHRs were implemented: Denmark and Sweden. The aim was to compare them when it comes to measures taken regarding privacy and security of data and also to what Portugal has planned to achieve as described in available documentation.
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Paper Nr: 39
Title:

DETECTION OF DAILY LIFESTYLE CHANGE FROM PULSE RATE MEASURED DURING SLEEP
Authors:

Wenxi Chen, Hiroo Watanabe, Xin Zhu, Kei-ichiro Kitamura and Tetsu Nemoto
Abstract: This study aims at detecting changes in daily lifestyle by using pulse rate measured during sleep. A convenient system for pulse rate measurement during sleep and an algorithm for detection of lifestyle changes were developed in this study. The data collection system consists of a home unit and a database server. The home unit includes a Bluetooth-enabled SpO2 sensor and a relay station. The sensor measures pulse rate (PR) and SpO2 beat-by-beat. The relay station receives the measured PR and SpO2 data via Bluetooth connection with the sensor, and then transmits these data to the database server through Internet automatically. The database server manages the data and performs data analysis. Daily PR data were preprocessed to suppress spike-like noise and movement artefact. Changes in daily lifestyle were detected by a dynamic time warping (DTW) algorithm. Vital data were collected from a healthy college student during daily sleep time over one year, and were used to examine the prototype system. The results showed that unusual or irregular events, such as too much alcohol drink, physical illness and mental stress, could be identified successfully. The system seems promising in application of health care and management under daily life environment.
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Paper Nr: 49
Title:

OPTIMAL AUTO-REMINDER-CALLING ALGORITHM FOR SELF-REPORTING TYPE SAFETY MONITORING SYSTEM BY USING TELEPHONE FOR ELDERLY PEOPLE
Authors:

Jun Sasaki, Takuhide Kikuchi, Masanori Takagi, Keizo Yamada, Michiru Tanaka and Akiko Ogawa
Abstract: An increasingly aging society is a significant problem in advanced countries. Safety monitoring is required for elderly people especially in a rural area. This paper describes a self-reporting type safety monitoring system by using telephone and the field experimental results in Iwate prefecture and Aomori Prefecture in Tohoku area of Japan. In this system, a user (an elderly person) makes a daily wellness call to the Iwate Prefecture Council of Social Welfare (IPCSW). The IPCSW staff calls the user to check his/her wellness if no wellness-report is received from the user. However, the system introduced a new work load to the IPCSW staff when many users forgot to make the call. Our project is to reduce the staff’s phone work load by an automatic wellness-report reminder call. In this paper, the daily reporting time of long-term using users is analyzed and a new algorithm to determine an optimal auto-calling scheduler for each user based on the analyzed results is proposed.
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Paper Nr: 52
Title:

GIS-SAPIO - Automated Aedes Aegypti Web-based Analysis and Prevention Monitor
Authors:

Georges D. A. Nze, Lourdes M. Brasil, Josiane S. A. Souza and Marco A. B. Rodrigues
Abstract: This work proposes the creation of a fully automated and dynamic web platform to analyze and prevent the Aedes aegypti mosquito's proliferation in Brazil. The Web Based Geographic Information System for SAPIO (GIS-SAPIO) is part of a project denominated: System Acquisition and Image Processing Ovitraps (SAPIO) for obtaining and processing ovitraps – traps where the mosquito’s eggs are deposited – and algorithms are used for the automation of eggs counting. The data obtained from image processing is processed thru an automated script and sent to SAPIO´s database, and finally displayed on a web platform. This technique should help for monitoring and prevent Dengue overall Brazil dynamically.
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Paper Nr: 57
Title:

ACTIVE MONITORING USING REAL-TIME METRIC LINEAR TEMPORAL LOGIC SPECIFICATIONS
Authors:

Gabor Simko and Janos Sztipanovits
Abstract: Monitoring temporal relationships among events in event streams has wide scale applicability in health information systems. From detecting violations of privacy policies in message sequences to diagnosing conditions in physiological data streams real-time event monitoring of temporal invariants is becoming an important tool for system design. We developed an Active Real-Time Event Monitoring and Integration System (ARTEMIS) capable of integrating event streams and monitoring the existence of temporal invariants among events expressed in a safety fragment of metric first-order temporal logic (MFOTL). The paper discusses the mathematical foundations of the monitor, and demonstrates the application concepts in a physiological alarm generator and clinical information workflow system.
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Paper Nr: 64
Title:

MASTICATION COUNTING METHOD ROBUST TO FOOD TYPE AND INDIVIDUAL
Authors:

Hao Zhang, Guillaume Lopez, Masaki Shuzo, Jean-Jacques Delaunay and Ichiro Yamada
Abstract: In recent years, an increasing number of people have been suffering from over-weight, reminding the importance of a balanced dietetic lifestyle. Researches in nutrition and oral health have reported that not only the calorie intake amount, but also eating speed and the number of chews per bite were also important factors in obesity. Automatic mastication counting systems based on chewing sound processing have been proposed, though most of them have difficulties in detecting chewing strokes for various food types, and often require training logic or threshold that need to be customized for each user. To overcome these problems, we have developed a new model for automatic mastication counting based on new chew feature extraction and detection methods from natural chewing sound. Chewing sounds collected from 15 persons eating six different food types were recorded using a wearable bone-conduction microphone placed in ear. The chewing sound analysis model combining proposed chew feature extraction and detection methods was applied on the collected data set, showing a good overall accuracy while having better stability to different individuals and food types comparing to conventional models.
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Paper Nr: 65
Title:

ENHANCING PATIENT INFORMATION SHARING THROUGH SOCIAL NETWORKS
Authors:

M. Poulymenopoulou, D. Papakonstantinou, F. Malamateniou and G. Vassilacopoulos
Abstract: Currently, there is an effort for empowering patient self-care and improving the traditional healthcare delivery models by expanding the concept of healthcare though the provision of advanced online healthcare services. Those services require increased level of information flow and collaboration among patients and healthcare professionals. This collaboration and patient information sharing can be achieved by integrating social networks functionality with personal health records, based on open standards. In fact, social networking exists to facilitate communication and collaboration and make possible what was only recently impractical in healthcare, such as trans-regional clinician collaboration through web-based broadcasting systems, therefore integrating the information included into personal health records. Along these lines, this paper presents a secure middleware that aims at enabling patient information sharing among patients and healthcare professionals through social networks functionality and applications, giving particular emphasis to a security architecture that enforces access control services for protecting the disclosure of patient private information to unauthorized users.
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Paper Nr: 82
Title:

MODEL BASED CONTINUAL PLANNING AND CONTROL FOR ASSISTIVE ROBOTS
Authors:

A. Anier and J. Vain
Abstract: The paper presents a model-based robot planning and control framework for human assistive robots - namely for Scrub Nurse Robots. We focus on endoscopic surgery as one of the most relevant surgery type for applying robot assistants. We demonstrate that our framework provides means for seamless integration of sensor data capture, cognitive functions for interpretation of sensor data, model based continual planning and actuation control. The novel component of the architecture is a distributed continual planning system implemented based on the Uppaal timed automata model-based verification and control tool suite. The distributed and modular architecture of the framework enables flexible online reconfiguration and easy adaptability to various application contexts. Online learning and safety monitoring functions ensure timely and safe updates of software components on-the-fly.
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Paper Nr: 86
Title:

AN OPENEHR REPOSITORY BASED ON A NATIVE XML DATABASE
Authors:

Linda Velte, Tiago Pedrosa, Carlos Costa and José Luís Oliveira
Abstract: openEHR is an open standard specification that describes the management, storage, retrieval and exchange of data in Electronic Health Record (EHR). Despite its growing importance in the field, the lack of open source solutions is hindering a larger visibility. In this paper we present an openEHR-based repository supported by a native XML database, which allows to store and query openEHR records through the DB service layer and a set of REST web services. The obtained results highlight the efficiency of this API and show that it can be used as a persistence component in any openEHR solution.
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Paper Nr: 87
Title:

EMPIRICAL SURVEY OF HSPA NETWORKS TO DELIVER MEDICAL APPLICATIONS
Authors:

Christopher I. Iyawe and John Doucette
Abstract: Population explosion coupled with a decline in medical personnel are forcing governments in the developed and developing nations to look at new ways to deliver healthcare to their citizens. The cost of providing healthcare put so much pressure on the delivery system that many find it difficult to access the system. The most affected are often the elderly and/or those who are highly immobile, particularly those who reside in remote communities. This group is often laden with chronic illnesses and diseases requiring home care, and ambulatory services to access the healthcare system. Such services are generally quite expensive to provide. Developing an eHealth network to drive applications to deliver healthcare services to homes is very costly. Such dedicated networks will also be difficult to manage. We can observe the manner in which other industries use information and communications technology (ICT) through the public network to influence ways services are delivered to the public, and ask why the same (i.e., use of ICT applications through the public network) cannot be done for the healthcare system. In this paper, we assess the capability of local HSPA public networks to deliver healthcare applications to home care clients.
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Paper Nr: 89
Title:

RULE EXTRACTION FROM MEDICAL DATA WITHOUT DISCRETIZATION OF NUMERICAL ATTRIBUTES
Authors:

Juan L. Domínguez-Olmedo, Jacinto Mata, Victoria Pachón and Manuel J. Maña
Abstract: Association rule mining is a popular technique used to find associations between attributes in a dataset. When using deterministic algorithms, if the attributes have numerical values the usual approach is to discretize them defining proper intervals. But the discretization can notably affect the quality of the rules generated. This work presents a method based on a deterministic exploration of the interval search space without a previous discretization of the numerical attributes. It has been applied to medical data from an atherosclerosis study. The quality of the obtained rules seems to support this method as a valid alternative for this kind of rule extraction.
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Paper Nr: 92
Title:

ADVANCED PEDOMETER FOR SMARTPHONE-BASED ACTIVITY TRACKING
Authors:

Michal Tomlein, Pavol Bielik, Peter Krátky, Štefan Mitrík, Michal Barla and Mária Bieliková
Abstract: This paper describes the design of an advanced smartphone pedometer developed as part of a larger solution aimed at encouraging a healthier lifestyle through regular physical activity, called Move2Play. Move2Play provides several motivational methods to promote exercise, some of which are based on the use of points derived from tracked activity. While current pedometers are easily tricked into counting steps by shaking the device, our advanced pedometer uses a neural network to detect and prevent this kind of cheating. In this paper, we discuss both the method for counting steps and our innovative approach to the recognition of cheating.
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Paper Nr: 93
Title:

TRANSFORMING A HIGH BLOOD PRESSURE CLINICAL GUIDELINE INTO A CDSS - Difficulties in Understanding
Authors:

Gustavo Marísio Bacelar-Silva, Rong Chen and Ricardo Cruz-Correia
Abstract: Introduction. Due to the increasing use of Electronic Health Records there is a tendency to implement clinical decision support system (CDSS) based on existing clinical guidelines. The Seventh Report of the Joint National Committee on the Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7) is well known and widely used worldwide guideline. Transforming published guidelines into CDSS is a process that still needs to be improved. Aim. To describe the difficulties in understanding the guideline, to recommend better suited descriptions for the contents. Methods. Systematic reading of the guideline for the extraction of the main patient variables, processes and evaluation suggested. The issues were evaluated considering the Domain 4 of the Appraisal of Guidelines for Research & Evaluation II Instrument. Results. Several problems were identified considering whether the recommendations are specific and unambiguous, the different options for management of the condition or health issue are clearly presented and key recommendations are easily identifiable. Discussion. Some initiatives have been made, as the Guideline Elements Models and the development of guideline model representations. This attempt to formalise the JNC 7 guideline allowed to discover many ambiguities, concepts related to prior knowledge and issues related to the distribution of the content presentation.
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Paper Nr: 95
Title:

A DICOM RELAY SERVICE SUPPORTED ON CLOUD RESOURCES
Authors:

Luís A. Bastião Silva, Carlos Costa and José Luis Oliveira
Abstract: Over the past decades, healthcare institutions adopted Picture Archive and Communication Systems in their workflows. The exchange and interaction between different equipment is performed with Digital Imaging Communication in Medicine (DICOM), which is a very extensive protocol covering many areas of imaging laboratories. However, the communication of a wide domain composed by several medical institutions is not well supported. This paper presents a solution to share DICOM services across healthcare institutions. The proposed implementation is supported on public cloud resources, creating the opportunity to exchange information between medical devices across several institutions.
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Paper Nr: 98
Title:

MEDICAL TERMINOLOGY BROWSERS - How Usable are them for Describing Clinical Archetypes?
Authors:

Jesús Cáceres Tello, Miguel-Angel Sicilia, Adolfo Muñoz Carrero, Carlos Rodriguez-Solano Nuzzi and Juan-José Sicilia
Abstract: Clinical terminologies are a major concern in medical informatics, as they are key to provide medical systems with higher levels of interoperability. Large terminologies as SNOMED CT are gaining presence in practical applications. In a related but different direction, archetypes or data type templates are becoming widespread as interchange mechanisms for medical information. Archetypes support mapping to terminologies, in a process that is typically done by the experts developing or revising the archetype. It has been argued that terminology browsers are not appropriate for the task of helping clinical experts in the mapping process. This paper reports usability studies on two widely used SNOMED CT browsers when used as tools for mapping archetypes.
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Paper Nr: 102
Title:

GEOGRAPHIC INFORMATION SYSTEMS APPLIED TO PATIENT DISTRIBUTION FOR FAMILY HEALTH TEAMS IN PRIMARY HEALTH CARE
Authors:

João Azevedo, Carlos Oliveira, Juliano Gaspar and Alberto Freitas
Abstract: Background: Family focused environment in Primary care is considered to be the future and help is required to implement new conceptualities. One theory consists in dividing patients accordingly to geographic clusters. Aim: To study and implement methodologies for distribution of patients of a health unit, and develop a tool to aid in this process. Methods: A health unit was selected to recollect and process bio-geographic data of patients. A manual division was executed and various methods were tested. An information system was developed in order to help divide and compare between manual and automatic. Results: The original data contained a significant percentage of errors (25%). This led to the cross validation of addresses. This process took months. Only after, various patient division techniques could be applied. One showed itself as having the most advantages. A robust GIS system was developed. Discussion: The analysis took a significant amount of time. The method of dividing the patients proved itself appropriate to this situation, and could probably be applied in many urban locations. The obtained GIS provided time saving and better data comprehension. Conclusion: Technologies in general and the system developed in particular can help patient allocation and represent a breakthrough in time-saving.
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Paper Nr: 103
Title:

GATHERING AND MANAGING GENOTYPE AND PHENOTYPE INFORMATION ABOUT RARE DISEASES PATIENTS
Authors:

Rafael Mendonça, Pedro Lopes, Hugo Rocha, Jorge Oliveira, Laura Vilarinho, Rosário Santos and José Luís Oliveira
Abstract: Information technology is increasingly present in medicine, and is emerging as a crucial tool both in clinical monitoring and knowledge dissemination, increasing the success rate in diagnosis and subsequently during treatment. A particular sub-group of diseases are designated rare or orphan due to the small number of people suffering from these illnesses. They are sometimes disabling, reducing the quality of life of patients and affect all relatives around them. The aim of this project was to build a Web information system to support practice and clinical research in rare diseases, and to facilitate the collection of scientific information, diagnosis, treatment and patient support. Through this system, one can optimize specialized medical resources, computing resources and data quality, so that the information is available for consulting and supporting future decisions. This developed system also allows health professionals to share information that will be important for enhancing the quality and technological advancement in this area of public health.
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Paper Nr: 111
Title:

THE QUANTUM OF NLP - Cognitive Metaphor as a Mind Discovering Device
Authors:

Svetlana Machova and Jana Kleckova
Abstract: Our research has been established on the comparative findings from cognitive and computational linguistics, philosophical and phenomenological mind’s theories, modern physics discoveries and the natural language semantics dealing with meanings on the quantum level, which is pilot research mentioned as “The Elegant Mind” project. This project was created for implementing in artificial intelligence metaphoric reasoning algorithms. We have been particularly studied expressions describing a realm of mind in Czech and English. The data has been acquired by online Free Association Experiment (FEA) to visualize the latent connection between particular states of mind. A multilingual mind semantic dependency networks founded on the knowledge based system of authentic association data has been generated by Gephi dynamic graphs.
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Paper Nr: 116
Title:

IS E-HEALTHCARE CHART CONTRIBUTORY TO PATIENT SAFETY?
Authors:

Kiyomu Ishikawa, Takeshi Tanaka, Minoru Ikeuchi and Hidehiko Tsukuma
Abstract: Toward 503 hospitals evaluated by Japan Council Health Care (JCHC), the questionnaire survey was conducted and analysed according to 2 groups of pre-2005 and post-2006 system introduction. As the result, it was found that despite with the annual improvement in the e-healthcare chart system function, both information system and users’ operation were insufficient with concern of medical accidents: About sixty per cent of the hospitals have experienced information-system-related harmful incidents. Among the hospitals that implemented information security education of health information system, 60% had triggered harmful incidents, and preavoid experience. In contrast, 40% of hospitals without information security education had triggering experience. We found preavoid experiences in 70% of those reported no preavoid experiences. There is a possibility that the organizational development for information literacy raises the consciousness of users towards harmful incidents through the accumulation of information on such incidents.
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Paper Nr: 118
Title:

EHEALTH SMART HOME ENVIRONMENT SERVICE PLATFORM - Enabling Remote Monitoring and Service Composition through Social Media
Authors:

Yohanes Baptista Dafferianto Trinugroho, Frank Reichert and Rune Fensli
Abstract: Demographic changes with the growth of elderly populations implies a need of developing efficient technology tools in order for the patients to stay in their own home for as long time as possible feeling safe and secured, and where the medical follow up can be achieved by remote home monitoring equipment. The lack of actual international standards has the consequence of proprietary solutions being used by vendors, making interoperability difficult. On the other hand, social media has become an integral part of modern society and has changed the way people interact with one another. It can potentially be extended to support well-being at home as well. In this paper we argue that social media have the potential to play an important role in remote home monitoring and remote service composition for provisioning health-care-related services in the future. An overview of a proposed platform based on Service-Oriented Architecture (SOA) paradigm for interoperability between different devices is also presented.
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Paper Nr: 125
Title:

DEVELOPMENT OF A PROTOTYPE WELLNESS SUPPORT SYSTEM FOR ELDERLY PEOPLE
Authors:

Jun Sasaki, Koki Ito, Manato Saikachi, Masanori Takagi and Keizo Yamada
Abstract: An increasingly aging society and higher prevalence of lifestyle-related diseases are significant problems in advanced countries. There are social requirements of integrated services for medical care, welfare, and healthcare. In this paper, we propose the concept of a Wellness Support System (WSS), which is an integrated information system that can be used to prevent the solitary death of elderly people, provide daily life support services, and improve the health of those at risk for lifestyle-related diseases. The WSS enables ease of use and a helpful information environment using a newly developed type of IP telephone for elderly people. This paper introduces the concept and describes the development of a prototype WSS.
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Paper Nr: 126
Title:

MOBILE APPLICATION SUPPORTED LIFESTYLE INTERVENTION TO LOWER PROSTATE CANCER RISK
Authors:

Luuk P. A. Simons and J. Felix Hampe
Abstract: There is an existing Health (e)Coach Solution for supporting intensive lifestyle changes, which may help reduce cancer progression risks in men with low grade prostate cancer. An important challenge is to support and motivate healthy behaviors for the long term (4 years). Smart phones are increasingly used also in this age group. And mobile apps offer significant opportunities for personalized health behavior monitoring and support. Our overall proposition is that an mApps suite, as an extension to an existing online dashboard with automated emails and interpersonal coach sessions, appears promising for improving long term health behavior support. That is, if three conditions are met: 1) Using best of breed mApps from the market (benefits like ease-of-use, continuity, customer support); 2) creating easy and meaningful score conversions (from mApps to personal dashboard); 3) using automated emails as glue between three key aspects personal progress/dashboarding, user attention and motivation, mApp usage.As methodological approach, this paper focuses on two phases from a design research cycle: requirements analysis and a preliminary design solution exploration. In the analysis phase, two questions are addressed: What are effective lifestyle intervention components according to literature? What are solution properties that may enhance motivation and improve health behaviors? In the solution exploration phase our design question is how a proposed mApp extension may likely add value to the existing Health (e)Coach solution.
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Paper Nr: 127
Title:

UNIFIED PARALLEL EXPERIMENT INTERFACE FOR MEDICAL RESEARCH SYSTEM
Authors:

Michal Kratochvíl, Petr Vcelák and Jana Klecková
Abstract: When we are processing large quantity of a data, and/or we are computing complex tasks, computational performance of one computer is not enough. Solution is parallel processing. However proper approach to parallel programming doesn’t need to well-known to medical experts or computational tool doesn’t have native support for parallel programming. Our goal is to design unified interface, which allows parallel approach to our medical researchers. It must provide support for existing medical experiments and it must provide full interoperability.
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Paper Nr: 128
Title:

PREDICTION MODEL OF INPATIENT MORTALITY FOR PATIENTS WITH MYOCARDIAL INFARCTION
Authors:

Hynek Kružík, Jiří Vomlel, Václav Kratochvíl, Petr Tůma and Petr Somol
Abstract: We propose and investigate a prediction model of inpatient mortality for patients with myocardial infarction. The model is based on complex clinical data from a hospital information system used in the Czech Republic. The prediction of the outcome is an important risk-adjustment factor for objective measurement of the quality of healthcare; thus it is a very important factor in healthcare quality assessment. For our experiments we studied hospital mortality in acute myocardial infarction, because: (1) this indicator is reliably detectable from available data; (2) treatment of acute myocardial infarction has a significant socio-economic impact; and (3) the prediction of mortality based on admission findings is the subject of many research papers and thus, we have a good benchmark for our experimental results. We considered only variables that convey information about the patient at the time of admission. We selected 21 out of 637 variables and used them as predictors in logistic regression to form a prediction model for hospital mortality. The achieved prediction accuracy was 85% and the size of the area under the ROC curve was 0.802. The results are based on a relatively small data sample of 486 patient records. Our future work will aim at increasing the accuracy by using a larger data set.
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Paper Nr: 130
Title:

SOCIAL MEDIA AND GAMES AS SELF-MANAGEMENT TOOLS FOR CHILDREN AND ADOLESCENTS WITH TYPE 1 DIABETES MELLITUS
Authors:

J. Lauritzen, E. Årsand, A. Horsch, L. Fernandez-Luque, T. Chomutare, J. G. Bellika, O. Hejlesen and G. Hartvigsen
Abstract: INTRODUCTION: Insufficient treatment of Type 1 Diabetes Mellitus (T1DM) can cause unpleasant and dangerous short-term complications, and disabling long-term complications. Children and adolescents are often associated with poor blood glucose regulation and poor treatment adherence. Motivating this group into achieving better illness knowledge, self-management and treatment adherence is difficult through ordinary diabetes education methods, which necessitates the need for alternate methods. METHODS: Health educational video games and social media are investigated as potential platforms for providing diabetes education and motivation. Publications were reviewed in order to estimate clinical and personal effects. RESULTS: 6 publications on children and adolescents’ use of health educational video games displayed increased patients knowledge regarding their illness and treatment hereof, improved treatment adherence and positive clinical results. Social media is identified in 2 publications as a promising platform for online communities, where patients and next of kin can seek advise, help others and share experiences. DISCUSSION: Video games and social media constitute platforms that children and adolescents are familiar with, engage in and enjoy and are for diabetes educational purposes. Tromsø Telemedicine Laboratory propose that by combining these platforms to make a social game experience that educates children and adolescents and motivates them conduct self-management and achieve better clinical results, thereby lowering their risk of diabetes complications.
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Paper Nr: 137
Title:

DESIGN OF THE ARTIFICIAL NEURAL NETWORK MODEL FOR THE PREDICTION OF OUTCOME AFTER STROKE
Authors:

Jiri Polivka Jr., Petr Kratochvil, Vladimir Rohan, Jiri Polivka and Jana Kleckova
Abstract: In our contemporary research we are trying to develop the artificial neural network (ANN) model for the prediction of outcome after the occurrence of stroke. This paper mentions some important facts about stroke as well as the urgent need for Computer Assisted Decision Support (CAMS) systems in the relation to clinical practice. The short review of related studies of ANN in medicine is included. The model input and output parameters were selected and are also described. The basic ANN design for the predictive model is mentioned together with the future directions of our research.
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Paper Nr: 142
Title:

REQUIREMENTS FOR THE NEW GENERATION OF HOSPITAL INFORMATION SYSTEMS
Authors:

I. Evgeniev and V. Gueorguiev
Abstract: The aim of this paper is to present some ideas about new directions in hospital information systems’ design. They are based on results obtained in the context of joint research with Medical University Sofia, requirements from other hospitals and discussions with industrial providers of such systems. We target investigations, design, organisation and future expansion of a hospital information system, new concepts and methods for continuous acquisition of patient’s vital data, transmission, collection and binding of that data for diagnostic and disease tracking purposes, investigations on relevance of life quality and healthcare based on the e-Health technologies and medication and drug tracking. Some of these new investigations are oriented to build data mining background.
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