HEALTHINF 2016 Abstracts

Full Papers Short Papers
Full Papers
Paper Nr: 9
Title:

Evaluating Multiple Perspectives of a Connected Health Ecosystem
Authors:

Noel Carroll, Marie Travers and Ita Richardson
Abstract: Connected Health is an emerging model of care that engages technology to improve patient care and (re)habilitation. It encourages self-efficacy by developing client-centred care pathways and evidence-based interventions to reduce the need for hospital-led care and empower patients in their homes. It also promotes improved ‘connectivity’ between healthcare stakeholders by means of timely sharing and presentation of accurate and pertinent information about patient status. Connected Health initiatives can achieve this through smarter use of data, devices, communication platforms and people. However, there are few efforts which have established an evaluation model to encapsulate and assess the value and potential impact of Connected Health solutions from multiple stakeholders’ perspectives. We examined information systems (IS) and health information systems (HIS) literature to identify whether a model could apply to Connected Health. However, many of the evaluation models are narrow in focus but have influenced our development of the Connected Health Evaluation Framework (CHEF). CHEF offers a generic approach which encapsulates a holistic view of a Connected Health evaluation process. It focuses on four key domains: end-user perception, business growth, quality management and healthcare practice.
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Paper Nr: 13
Title:

Roadmap for mHealth Research
Authors:

Joshua D. Cameron, Arkalgud Ramaprasad and Thant Syn
Abstract: mHealth research has been growing exponentially in recent years. But, without a clear definition of the mHealth domain, the research has been ad hoc and selective. A roadmap is necessary to guide the research and harness mHealth’s full potential. We present an ontology of mHealth to define its domain. We map the extent research on mHealth in 2014 onto the ontology and highlight the frequency of coverage of different topics. We discuss how (a) a frequently researched topic may be important, but may also be simply easy, convenient, and overemphasized; (b) an infrequently researched topic may be unimportant, but may also be simply difficult, inconvenient, and underemphasized; (c) and an unresearched topic may have been overlooked or simply infeasible. We then discuss how the emphases can be balanced in the roadmap for mHealth. Using ontological mapping the roadmap can be updated periodically to assess and guide mHealth research.
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Paper Nr: 17
Title:

Achieving Patient-Centered Fine-Grained Access Control in Hospital Information Systems - Using Business Process Management Systems
Authors:

Nahid AlThqafi, Hessah AlSalamah and Ahmad Daraiseh
Abstract: Access Control to patients’ medical information in Hospital Information Systems (HIS) is a challenge in modern Patient-Centered (PC) healthcare. Fine–Grained Access Control (FGAC) in particular has been identified as one of the security requirements in these systems. In FGAC, only parts of medical information that are relevant and required by healthcare providers are accessed at the point of care. This cannot be achieved without a holistic view of a medical condition through a Patient-Centered Fine-Grained Access Control (PCFGAC), in which patient-centricity is considered. This research proposes using Business Process Management (BPM) to achieve PCFGAC in order to provide a real-time access control based on a “need-to-know” principle. Through a prototype that uses BPM, security requirements of PCFGAC were met. These include: authority control, informed decision support, fine-grained access control, and dynamic policies support. Thus, a contribution to the knowledge and practice has been introduced.
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Paper Nr: 35
Title:

Intelligent Robotic Approach for After-stroke Hand Rehabilitation
Authors:

Nirvana Popescu, Decebal Popescu and Mircea Ivănescu
Abstract: This paper presents the design of an intelligent haptic robotic glove (IHRG) model for the rehabilitation of the patients that have been diagnosed with a cerebrovascular accident (CVA). Total loss or loss of range of motion, decreased reaction times and disordered movement organization create deficits in motor control, which affect the patient’s independent living. The control system for a rehabilitation hand exoskeleton is discussed. One contribution is given by using a velocity observer and a force observer for performance evaluation. The disturbance effects are eliminated by a cascade closed loop control with velocity and force observers. The performance of the control system is demonstrated by the simulation. The second proposed control implementation version has a great advantage - the possibility to specify some vocal commands, which will help the patient to make a lot of medical exercises by themselves.
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Paper Nr: 39
Title:

Temporally Synchronized Reversible Data Hiding of EEG to MREG
Authors:

Angelos Fylakis, Anja Keskinarkaus, Vesa Kiviniemi and Tapio Seppänen
Abstract: Simultaneous MREG and EEG recordings are vastly used in neurobiology, but so far they are stored and handled as separate files. This paper proposes a method to combine those two entities with the objective of establishing data management efficiency, while secondary objectives are confidentiality, availability and reliability in data. To be more specific, it is a reversible data hiding method for hiding EEG in MREG with the ability of fully recovering MREG and the embedded EEG signal. It is based on histogram shifting, exploiting data quantization and Region of Interest segmentation. The embedding procedure maintains temporal synchronization between EEG and 32-bit MREG making it a novel data hiding application. It is demonstrated through experiments that MREG maintains high perceptual fidelity and also verified that after EEG extraction and acquisition of every electrode’s sample, MREG is fully reversed to its exact initial state.
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Paper Nr: 52
Title:

Comparing Electronic Health Record Usability of Primary Care Physicians by Clinical Year
Authors:

Martina A. Clarke, Jeffery L. Belden and Min Soon Kim
Abstract: Objectives: To examine usability gaps among primary care resident physicians by clinical year: year 1 (Y1), year 2 (Y2), and year 3 (Y3) when using electronic health record (EHR). Methods: Twenty-nine usability tests with video analysis were conducted involving triangular method approach. Performance metrics of percent task success rate, time on task, and mouse activities were compared along with subtask analysis among the three physician groups. Results: Our findings showed comparable results for physicians of all three years in mean performance measures, specifically task success rate (Y1: 95%, Y2: 98%, Y3: 95%). However, varying usability issues were identified among physicians from all three clinical years. Twenty-nine common usability issues across five themes emerged during sub task analysis: inconsistencies, user interface issues, structured data issues, ambiguous terminologies, and workarounds. Discussion and Conclusion: This study identified varying usability issues for users of the EHR with different experience level, which may be used to potentially increase physicians’ performance when using an EHR. While three physician groups showed comparable performance metrics, these groups encountered numerous usability issues that should be addressed for effective EHR training and patient care.
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Paper Nr: 56
Title:

Respiratory Effort Belts in Postoperative Respiratory Monitoring: Pilot Study with Different Patients
Authors:

Tiina M Seppänen, Olli-Pekka Alho, Merja Vakkala, Seppo Alahuhta and Tapio Seppänen
Abstract: Respiratory complications are common in patients after the general anaesthesia. Respiratory depression often occurs in association with postoperative opioid analgesia. Currently, there is a need for a continuous non-invasive respiratory monitoring of spontaneously breathing postoperative patients. We used calibrated respiratory effort belts for the respiratory monitoring pre- and postoperatively. Used calibration method enables accurate estimates of the respiratory airflow waveforms. Five different patients were measured with the spirometer and respiratory effort belts at the same time. Preoperative measurements were done in the operating room just before the operation, whereas postoperative measurements were done in the recovery room after the operation. We compared three calibration models pre- and postoperatively. Postoperative calibration produced more accurate respiratory airflows. Results show that not only the tidal volume, minute volume and respiratory rate can be computed precisely from the estimated respiratory airflow, but also the respiratory airflow waveforms are very accurate. The method produced accurate estimates even from the following challenging respiratory signals: low airflows, COPD, hypopneic events and thoracoabdominal asynchrony. The presented method is able to produce estimates of postoperative respiratory airflow waveforms to enable accurate, continuous, non-invasive respiratory monitoring postoperatively.
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Paper Nr: 59
Title:

mNetra: A Fundoscopy based Optometer
Authors:

Vijay Kumar and Kolin Paul
Abstract: Untreated refractive error in the eye is one of the leading causes of preventable blindness. The devices necessary for this is expensive and often requires skilled technicians to operate. In this paper, a common off the shelf ophthalmoscope has been modified and integrated with a smart phone to build an affordable optometer. The device has been tested on a statistically significant population with refractive error range from −8.00D to +3.50D. We found a reasonably good correlation with other prevalent methods of measuring refractive error in the eye.
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Paper Nr: 69
Title:

Predicting Glaucomatous Progression with Piecewise Regression Model from Heterogeneous Medical Data
Authors:

Kyosuke Tomoda, Kai Morino, Hiroshi Murata, Ryo Asaoka and Kenji Yamanishi
Abstract: This study aims to accurately predict glaucomatous visual-field loss from patient disease data. In general, medical data show two kinds of heterogeneity: 1) internal heterogeneity, in which the phase of disease progression changes in an individual patient’s time series dataset; and 2) external heterogeneity, in which the trends of disease progression differ among patients. Although some previous methods have addressed the external heterogeneity, the internal heterogeneity has never been taken into account in predictions of glaucomatous progression. Here, we developed a novel framework for dealing with the two kinds of heterogeneity to predict glaucomatous progression using a piecewise linear regression (PLR) model. We empirically demonstrate that our method significantly improves the accuracy of predicting visual-field loss compared with existing methods, and can successfully treat the two kinds of heterogeneity often observed in medical data.
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Paper Nr: 70
Title:

Generalizing the Detection of Internal and External Interactions in Clinical Guidelines
Authors:

Veruska Zamborlini, Rinke Hoekstra, Marcos da Silveira, Cedric Pruski, Annette ten Teije and Frank van Harmelen
Abstract: This paper presents a method for formally representing Computer-Interpretable Guidelines to deal with multimorbidity. Although some approaches for merging guidelines exist, improvements are still required for combining several sources of information and coping with possibly conflicting pieces of evidence coming from clinical studies. Our main contribution is twofold: (i) we provide general models and rules for representing guidelines that expresses evidence as causation beliefs; (ii) we introduce a mechanism to exploit external medical knowledge acquired from Linked Open Data (Drugbank, Sider, DIKB) to detect potential interactions between recommendations. We apply this framework to merge three guidelines (Osteoarthritis, Diabetes, and Hypertension) in order to illustrate the capability of this approach for detecting potential conflicts between guidelines and eventually propose alternatives.
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Paper Nr: 76
Title:

Online Stress Management: Design for Reflections and Social Support
Authors:

Åsa Smedberg, Hélène Sandmark and Andrea Manth
Abstract: An increasing number of people suffer from high levels of stress and experience strong and unhealthy reactions to different stressors. Various kinds of applications for self-help are available on the Internet. However, the technology for stress management purposes is still in its early phase. This paper presents the ideas behind the design of an artifact that combines different technologies and offers support for individual as well as social reflections. The work is anchored in conventional system development methods and interdisciplinary research in the field of e-health. It is based on the holistic idea of combining areas of self-help, evidence-based information and learning through feedback and communication in groups and with experts that have been manifested in a web-based stress management system. The work presented in this paper is a further development towards integration of different technologies and learning aids. It integrates a mobile phone app with a web-based system for people with stress management issues. The proposed system supports social reflections through the possibility to share reflections in various social forums.
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Paper Nr: 118
Title:

3D Gaze Estimation using Eye Vergence
Authors:

Esteban Gutierrez Mlot, Hamed Bahmani, Siegfried Wahl and Enkelejda Kasneci
Abstract: We propose a fast and robust method to estimate the 3D gaze position based on the eye vergence information extracted from eye-tracking data. This method is specially designed for Point-of-Regard (PoR) estimation in non-virtual environments with the aim to make it applicable to the study of human visual attention deployment in natural scenarios. Our approach starts with a calibration step at different depth distances in order to achieve the best depth approximation. In addition, we investigate the distance range, for which state-of-the-art eyetracking technology allows 3D gaze estimation based on eye vergence. Our method provides a mean accuracy of 1.2◦ at a working distance between 200 mm and 400 mm from the user without requiring calibrated lights or cameras.
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Paper Nr: 119
Title:

ICT-mediated Community Coaching to Improve Physical Activity
Authors:

Lamia Elloumi, Margot Meijerink, Bert-Jan van Beijnum and Hermie Hermens
Abstract: It is commonly known that physical activity is important to maintain health and prevent diseases. Many physical activity interventions have been developed to motivate people to be more physically active. Existing ICT-based interventions provide system-to-human feedback as a motivational strategy to be more physically active. In this paper we propose the ICT-mediated Community Coaching functionality as a novel motivational strategy based on human-to-human feedback where we transform the physical activity into a social activity. This paper presents the requirement elicitation, the design and implementation, and the evaluation of the Community Coaching system for physical activity.
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Short Papers
Paper Nr: 19
Title:

Bridging the Gap between Knowledge Representation and Electronic Health Records
Authors:

Roberto Gatta, Mauro Vallati, Carlo Cappelli, Berardino De Bari, Massimo Salvetti, Silvio Finardi, Maria Lorenza Muiesan, Vincenzo Valentini and Maurizio Castellano
Abstract: Decision Support Systems (DSSs) are systems that supports decision-making activities. Their application in medical domain needs to face the critical issue of retrieving information from heterogeneous existing data sources, such as Electronic Health Records (EHRs). It is well-known that there exists a huge problem of standardisation. In fact, EHRs can represent the same knowledge in many different ways. It is evident that the applicability of DSSs strongly relies on the availability of homogeneous collections of data. On the other hand, the gap between DSSs and different EHRs can be bridged by exploiting middleware technologies. In this paper, we tested CSL, a technology designed for working as a middleware between DSS and EHRs, which is able to combine data taken from different EHR sources and to provide abstract and homogeneous data to DSSs. Moreover, CSL has been used for implementing three Clinical Guidelines, in order to test its capability in representing complex work-flows. The performed analysis highlight strengths and limitations of the proposed approach.
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Paper Nr: 23
Title:

Software Design Principles for Digital Behavior Change Interventions - Lessons Learned from the MOPO Study
Authors:

Lauri Tuovinen, Riikka Ahola, Maarit Kangas, Raija Korpelainen, Pekka Siirtola, Tim Luoto, Riitta Pyky, Juha Röning and Timo Jämsä
Abstract: Using the Internet as a delivery channel has become a popular approach to conducting health promotion interventions, and the evidence indicates that such interventions can be effective. In this paper we propose a set of design principles and a generic architectural model based on experiences accumulated while developing a Web-based application for a physical activation intervention. The proposed principles address the development of an intervention application as an abstract entity, a platform for gathering data for the needs of three principal stakeholder groups. The principles are derived from the purposes for which the data is gathered and the constraints that may limit the availability of desired data; by observing these principles, developers of intervention applications can identify the design trade-offs they need to make to ensure that all stakeholder needs are adequately fulfilled. An evolutionary development process is proposed as a way of gradually working toward an application that induces the desired effect on the behavior of the users.
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Paper Nr: 24
Title:

Support for the Inclusion of Domain Knowledge in Prediction Models - User Evaluations of a Tool for Generating Prediction Models for Serious Adverse Events in Oncology
Authors:

Monique Hendriks
Abstract: As healthcare is becoming more personalized, prediction models have become an important tool for decision support. In order to create sensible, understandable and useful prediction models, it is often necessary to include domain knowledge. This requires multi-disciplinary communication which has proven to be difficult, as the different parties involved are not always aware of each other’s information needs. This paper presents the design process of a tool which supports the communication between clinical experts and data mining experts. Interviews and user tests were executed on four different sites and with 14 different users from both domains. The results from these user tests confirm the need for support on the communication process and provide evidence that the tool presented here indeed provides support by helping both parties to understand each other’s information needs. The tool provides a graphical user interface which guides the users through the steps required to create a prediction model. The graphical user interface helps the clinical expert to understand the choices to be made which rely on his/her expertise, while the fact that a ‘quick-and-dirty’ first version of a prediction model is generated in the process, helps the data mining expert to uncover all formal requirements for the model.
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Paper Nr: 25
Title:

An Interactive Digital Platform for Teaching Auditory Physiology using Two Classes of Electronic Basilare Membrane Models
Authors:

Gregor Hohenberg, Gebhard Reiss and Thomas Ostermann
Abstract: Teaching and understanding the principles of physiology is one of the most important and complex fields in medical education. This article describes the development of a digital learning platform for hearing physiology with computer experiments demonstrating the perceptual masking properties of the human ear. The basis for the development of this platform were two different hearing models: the sequential electronic model of the inner ear described by David in 1972 and the parallel Gammatone model by Patterson from 1988. The platform was evaluated from 44 undergraduate students of audiology. On a Likert Scale from 1= absolutely agree to 5=do not agree at all, students found the learning platform helpful for understanding “audiological physics” (2.10 ±0.67). After working on the learning module, the physiological hearing processes also became more evident to the students (2.24 ±0.69). They also were able to use the learning platform independently without relevant technical problems (1.93 ±0.80). As a conclusion, the usage of such interactive digital platforms might also lead to more efficient learning pathways which interconnect knowledge acquisition, skill development and life experience at the same time.
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Paper Nr: 29
Title:

An Overview of Nursing Informatics (NI) as a Profession: How we Evolved Over the Years
Authors:

Hanan Asiri
Abstract: Nursing informatics is a relatively new and expanding field. The evolutionary journey it has, that started more than thirty years ago, marks its rich history. Accordingly, its definition, role, education, competencies and the career path of its practitioners changed significantly through the years. Also, due to its unique nature, different issues emerged as challenges that need to be dealt with. On the other hand, some would view these issues as opportunities which we can benefit from. Nevertheless, the discipline of nursing informatics continues to evolve and progress rapidly over the years, as a result of the efforts and initiatives of its practitioners, scholars and organizations. This paper attempts to shed some light on this unique discipline by briefly examining how it evolved around the world over the past four decades. Yet, some challenges such as the lack of global NI literature could be considered as the main limitation of the scope of this review as there are plenty of resources in some parts of the world, while almost the opposite can be seen in some other regions. Therefore, a comprehensive review of the international historical development of the discipline of Nursing Informatics is beyond the scope of this paper.
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Paper Nr: 30
Title:

Towards an Access Control Model for Collaborative Healthcare Systems
Authors:

Mohamed Abomhara and Geir M. Køien
Abstract: In this study, an access control model for collaborative healthcare systems is proposed. Collaboration requirements, patient data confidentiality and the need for flexible access for healthcare providers through the actual work they must fulfill as part of their duties are carefully addressed. The main goal is to provide an access control model that strikes a balance between collaboration and safeguarding sensitive patient information.
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Paper Nr: 32
Title:

Extracting Patient Data from Tables in Clinical Literature - Case Study on Extraction of BMI, Weight and Number of Patients
Authors:

Nikola Milosevic, Cassie Gregson, Robert Hernandez and Goran Nenadic
Abstract: Current biomedical text mining efforts are mostly focused on extracting information from the body of research articles. However, tables contain important information such as key characteristics of clinical trials. Here, we examine the feasibility of information extraction from tables. We focus on extracting data about clinical trial participants. We propose a rule-based method that decomposes tables into cell level structures and then extracts information from these structures. Our method performed with a F-measure of 83.3% for extraction of number of patients, 83.7% for extraction of patient’s body mass index and 57.75% for patient’s weight. These results are promising and show that information extraction from tables in biomedical literature is feasible.
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Paper Nr: 34
Title:

Design of a Web-based Clinical Decision Support System for Guiding Patients with Low Back Pain to the Best Next Step in Primary Healthcare
Authors:

Wendy Oude Nijeweme-d'Hollosy, Lex van Velsen, Remko Soer and Hermie Hermens
Abstract: Low back pain (LBP) is the most common cause for activity limitation and has a tremendous socioeconomic impact in Western society. In primary care, LBP is commonly treated by general practitioners (GPs) and physiotherapists. In the Netherlands, patients can opt to see a physiotherapist without referral from their GP (so called ‘self-referral’). Although self-referral has improved the choice of care for patients, it also requires that a patient knows exactly how to select the best next step in care for his or her situation, which is not always evident. This paper describes the design of a web-based clinical decision support system (CDSS) that guides patients with LBP in making suitable choices on self-referral. We studied literature and guidelines on LBP and conducted semi-structured interviews with 3 general practitioners and 5 physiotherapists on the classification of LBP with respect to the best next step in care: visit a GP, visit a physiotherapist or perform self-care. The interview results were validated by means of an online survey, which resulted in a select group of key classification factors. Based on the results, we developed an ontology and a decision tree that models the decision making process of the CDSS.
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Paper Nr: 48
Title:

Could ICT Be Harnessed for Prehospital Emergency Medical Services? - The Case of the Lebanese Red Cross
Authors:

Nabil Georges Badr
Abstract: Of particular interest, this paper treats Information and Communication Technologies applied to the Emergency Medical Services Division of the Lebanese Red Cross. Information for the case study is gathered through semi- structured interviews with five informants and a database of Secondary data is collected from available management reports, assessments, feasibility studies, project reporting and documentation. The case of the ICT implementation investigated in this study offers insight into an implementation of a prehospital emergency medical services. Though ICT implementations in pre-hospital care systems, are now common practice, what makes this case particular is that it is starting from a volunteer-based.
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Paper Nr: 54
Title:

RadioBio data: A Moddicom Module to Predict Tumor Control Probability and Normal Tissue Complication Probability in Radiotherapy
Authors:

Nicola Dinapoli, Anna Rita Alitto, Mauro Vallati, Rosa Autorino, Roberto Gatta, Luca Boldrini, Andrea Damiani, Giovanna Mantini and Vincenzo Valentini
Abstract: In this work a system for analysing radiotherapy treatment planning dose-volume data is proposed. The work starts from the definition of a framework inside a statistical scripting environment (R) used for creating a software package. The analysis of dose-volume data in radiotherapy of malignant tumours is mandatory for evaluating the prescribed treatment and for feedback analysis of outcome, both in the direction of tumour control and in detection of parameters for estimating and predicting toxicity outcome. The statistical analysis of large amount of clinical data can be slowed by the lack of practice in statistical tools needed, by clinicians, to perform such kind of analysis. This is the reason that lead our working group in the creation of such a tool. Finally an example of clinical application of our software is given for the analysis of the outcome of patients undergoing to radiotherapy for prostate cancer.
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Paper Nr: 60
Title:

A Topic-centric Approach to Detecting New Evidences for Evidence-based Medical Guidelines
Authors:

Qing Hu, Zhisheng Huang, Annette ten Teije, Frank van Harmelen, M. Scott Marshall and Andre Dekker
Abstract: Evidence-based Medical guidelines are developed based on the best available evidence in biomedical science and clinical practice. Such evidence-based medical guidelines should be regularly updated, so that they can optimally serve medical practice by using the latest evidence from medical research. The usual approach to detect such new evidence is to use a set of terms from a guideline recommendation and to create queries for a biomedical search engine such as PubMed, with a ranking over a selected subset of terms to search for relevant new evidence. However, the terms that appear in a guideline recommendation do not always cover all of the information we need for the search, because the contextual information (e.g. time and location, user profile, topics) is usually missing in a guideline recommendation. Enhancing the search terms with contextual information would improve the quality of the search results. In this paper, we propose a topic-centric approach to detect new evidence for updating evidence-based medical guidelines as a context-aware method to improve the search. Our experiments show that this topic centric approach can find the goal evidence for 12 guideline statements out of 16 in our test set, compared with only 5 guideline statements that were found by using a non-topic centric approach.
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Paper Nr: 63
Title:

BioMed Wizard - An Approach for Gathering Personal Risk Factor Data
Authors:

Mohammad Shafahi, Hamideh Afsarmanesh and Stefan Paap
Abstract: People can be at risk of developing some serious diseases without being aware of it. Such diseases either do not present symptoms in early stages or have simple symptoms that are ignored or not properly identified by patients, due to their lack of medical know-how. On the other hand, in order to provide patients with early indications of their risk level on developing such diseases, specially for chronic diseases such as diabetes type 2, it is necessary to collect substantial amount of personal data about risk factors related to the disease. A smart wizard software applying the approach developed in our study, which brings awareness about some socio-economical concerns of patients, can increase patients’ engagement in providing their personal data. The case study focuses on the diabetes type 2 and some socio-economical concerns of patients, including privacy invasion, time, and cost. In this research, the willingness of a sample group of more than 100 people is surveyed, in providing their personal data, for three different scenarios and related to nine main risk factors. The results collected in this survey is then applied to develop four user-specific data collection flow models, to be implemented in a smart wizard software.
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Paper Nr: 68
Title:

Usability Evaluation of a Collaborative Health Information System - Lessons from a User-centred Design Process
Authors:

Berglind Smaradottir, Santiago Martinez, Elisabeth Holen-Rabbersvik, Torunn Vatnøy and Rune Fensli
Abstract: In Norway, a recent health reform urged municipalities to implement new primary health care services for their citizens. Small and medium size municipalities have since then, established inter-municipal services to collaborate across organisational borders and optimise their resources. Information systems become a necessary tool to support collaboration and shared access to information between health professionals and other employees from different municipalities that belong to the same inter-municipal team. In this context, the research project eHealth-extended Care Coordination identified a specific need for a collaborative information system for the process of evaluation and assessment of dementia in inter-municipal teams. This paper presents the usability evaluation of a collaborative information system for dementia assessment built using a user-centred design approach. Mixed methods such as observations, semi-structured interviews and a questionnaire were used for data collection. The results showed that the new information system supported the collaborative work of the inter-municipal dementia team, with a sufficient level of satisfaction among the end-users. The prototyped solution established the foundations for the system implemented in the Norwegian trials of the FP7 EU project United4Health, dedicated to Poinf-of-Care Services.
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Paper Nr: 72
Title:

Indoor Positioning: A Comparison of WiFi and Bluetooth Low Energy for Region Monitoring
Authors:

Alexander Lindemann, Bettina Schnor, Jan Sohre and Petra Vogel
Abstract: Mobile devices like smartphones equipped with several sensors make indoor positioning possible at low costs. This enables location based services, like mobile marketing, navigation, and assistive technologies in healthcare. In case of supporting disoriented people, the exact position of the person has not to be known, but it is sufficient to inform a caretaker when the attended person enters a critical region. This is the so-called region monitoring approach. The paper presents results from region monitoring implemented as an app for Android smartphones using WiFi and the low power protocol Bluetooth Low Energy respectively. Both networks are compared regarding accuracy and the power consumption on the mobile device.
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Paper Nr: 73
Title:

MyHealthFrame - Design and Evaluation of a Minimally Invasive Communication Platform for Telemedicine Services Aimed at Older Adults
Authors:

Mohammad Hossein Nassabi, Harm op den Akker, Marian Bittner, Coen Kemerink, Bert-Jan van Beijnum, Hermie Hermens and Miriam Vollenbroek
Abstract: MyHealthFrame is a communication platform that telemedicine (and well-being) services can leverage to deliver motivational messages and notifications to their end-users. Instead of being a telemedicine service in itself, MyHealthFrame is a channel through which external services can reach their users to provide reminders or deliver simple information such as number of steps. To its end-users, MyHealthFrame is a tablet device which is designed to be perceived as a photoframe and can be immersed in the users’ living environment. In this paper, we describe the design and the preliminary assessment of the platform. The results of the feasibility study with five older adults (65+) are promising.
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Paper Nr: 94
Title:

Emotional Resiliency of Families Dealing with Autism in Social Media
Authors:

Amit Saha and Nitin Agarwal
Abstract: Nowadays online social media is used extensively by families dealing with various health issues, such as autism, diabetes, obesity, etc., to share experiences with other members of the community. The interaction between members of health community can be systematically analyzed to build a knowledge base for others who are dealing with the same health conditions. In this study, we analyze one such health community, i.e., the autism community and evaluate stress dispersed among the community members using social network analysis along with sentiment analysis methodology. We found that the autism blogger community provides nominal stress during the interaction with other community members. Differences across various classified groups like autistic bloggers, mother bloggers with autistic kids, father bloggers with autistic kids, and autism support group blogs in different social media platforms (blogs and Twitter) were analyzed in context of stress. Families dealing with autism have a better quality of life with reduced stress by interacting with fellow autism community members in social media.
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Paper Nr: 97
Title:

On the Impact of Medical Device Regulations on Software Architecture
Authors:

Klaus Marius Hansen and Konstantinos Manikas
Abstract: Compliance to regulations and regulatory approval are requirements for many medical device software systems. In this paper, we investigate the implications of medical device software regulations to the design of software systems. We do so by focusing on the American and European regulatory authorities and review the legal requirements for regulatory approval of medical devices. We define a simplified process for regulatory approval, consisting of five steps, and enhance this process by descriptions of how to decide whether a software system is a medical device and how to identify the class of the device. Moreover, we review software modularity in the implementation of software medical device and propose a set of preliminary principles for architectural design of software medical device based on a set of constrains identified from the reviewed regulations.
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Paper Nr: 102
Title:

Optimization of Sitting Posture Classification based on Anthropometric Data
Authors:

Leonardo Martins, Bruno Ribeiro, Rui Almeida, Hugo Pereira, Adelaide Jesus, Cláudia Quaresma and Pedro Vieira
Abstract: An intelligent chair prototype was developed in order to detect and correct the adoption of bad sitting postures during long periods of time. A pneumatic system was enclosed in the chair (4 air bladders inside the seat pad and 4 in the backrest) to classify 12 standardized sitting postures, with a classification score of 80.9%. Recently we used algorithmic optimization applied to the existing classification algorithm (based on Neural Networks) to split users (using Classification Trees) by their sex and used two different previously trained Neural Networks (Male and Female) to get an improved classification of 89.0% when the user was identified and 87.1% for unidentified users. In this work we aim to investigate the usage of the anthropometric information (height and weight) to further optimize our classification process. Here we use four Machine Learning Techniques (Neural Networks, Support Vector Machines, Classification Trees and Naive Bayes) to automatically split the users in 2 classes (above and below the specific anthropometric median value). Results showed that Classification Trees worked best on automatically separating the body characteristics (i.e. Height) with a global optimization of 88.3%. During the classification process, if the user is identified, we skip the splitting step, and this optimization increases to 90.2%.
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Paper Nr: 106
Title:

Ontology based Description of Analytic Methods for Electrophysiology
Authors:

Jan Štebeták and Roman Moucek
Abstract: The growing electrophysiology research leads to the collection of large amounts of experimental data and consequently to the broader application, eventually development of analytic methods, algorithms, and workflows. Then appropriate metadata definition and related data description is critical for long term storage and later identification of experimental data. Although a detailed description of electrophysiology data has not become a commonly used procedure so far, publicly available and well described data have started to appear in professional journals. The next reasonable step is to shift attention to the analysis of electrophysiology data. Since the analysis of this kind of data is rather complex, identification and appropriate description of used methods, algorithms and workflows would help reproducibility of the research in the field. This description would also allow developing automatic or semi-automatic systems for data analysis or constructing complex workflows in a more user friendly way. Based on these assumptions authors present a custom ontology for description of analytic methods and workflows in electrophysiology that is proposed to be discussed within the scientific community.
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Paper Nr: 113
Title:

Linking Diagnostic-Related Groups (DRGs) to their Processes by Process Mining
Authors:

Alessandro Stefanini, Davide Aloini, Riccardo Dulmin and Valeria Mininno
Abstract: The knowledge of patient-flow is very important for healthcare organizations, because strongly connected to effectiveness and efficiency of resource allocation. Unfortunately, traditional approaches to process analysis are scarcely effective and low efficient: they are very time-consuming and they may not provide an accurate picture of healthcare processes. Process mining techniques help to overcome these problems. This paper proposes a methodology for building a DRG related patient-flow using process mining. Findings show that it is possible to discover the different sequences of activities associated with a DRG related process. Managerial implications concern both process identification, analysis and improvement. A case study, based on a real open data set, is reported.
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Paper Nr: 116
Title:

prasavGraph: Android based Labour Monitoring
Authors:

Shalini Singh, Kolin Paul, Geeta Yadav and Sanjiva Prasad
Abstract: The simplified Partograph is a concise charting mechanism used by skilled birth attendants for recording and communicating the important parameters and developments during the labour process. Compliance and correct plotting of partographs may be significantly improved with the use of technology. This paper reports the development of an Android-based smart phone/tablet application to plot the partograph. To date such a complete application is not available. We envisage that over a period of time, systematic plotting of partographs will encourage providers to use it as a decision-making tool and thereby reduce morbidity and mortality both of mother and foetus/newborn arising out of complications during labour and its sequelae.
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Paper Nr: 120
Title:

Towards Privacy by Design in Personal e-Health Systems
Authors:

George Drosatos, Pavlos S. Efraimidis, Garrath Williams and Eleni Kaldoudi
Abstract: Personal e-health systems are the next generation of e-health applications and their goal is to assist patients in managing their disease and to help both patients and healthy people maintain behaviours that promote health. To do this, e-health systems collect, process, store and communicate the individual’s personal data. This paper presents an analysis of personal e-health systems and identifies privacy issues as a first step towards a ‘privacy by design’ methodology and practical guidelines.
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Paper Nr: 121
Title:

Towards Providing Full Spectrum Antenatal Health Care in Low and Middle Income Countries
Authors:

Muhammad Abubakar, Amina Bibi, Rashad Hussain, Zohra Bibi, Asma Gul, Zahid Bashir, Salman Noshear Arshad, Momin Ayub Uppal and Safee Ullah Chaudhary
Abstract: The provision of Antenatal Care (ANC) for pregnant women plays a vital role in ensuring infant and maternal health. Limited access to antenatal care in Low and Middle Income Countries (LMIC) results in high Infant and Maternal Mortality Rate (IMR and MMR, respectively). In this work, we propose a cloud-based clinical Decision Support System (DSS) integrated with a wearable health-sensor network for patient self-diagnosis and real time health monitoring. Patient assessment is performed by evaluating the human-input coupled with sensor-generated symptomatic information using a Bayesian network driven DSS. High risk pregnancies can be identified and monitored along with dispensing of consultant advice directly to the patient. Patient and disease incidence data is stored on the cloud for tuning probabilities of the Bayesian network towards improving accuracy of predicting anomalies within the epidemiological context. The system therefore, aims to control IMR and MMR by providing ubiquitous access to ANC in LMICs. A scaled-up implementation of the proposed system can help reduce patient influx at the limited tertiary care centers by referring low-risk cases to primary or secondary care establishments.
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Paper Nr: 125
Title:

A Clinical Decision Support System for an Antimicrobial Stewardship Program
Authors:

F. Palacios, M. Campos, J. M. Juarez, S. E. Cosgrove, E. Avdic, B. Canovas-Segura, A. Morales, M. E. Martínez-Nuñez, T. Molina-García, P. García-Hierro and J. Cacho-Calvo
Abstract: The World Health Organization has declared that antimicrobial resistance is a major public health issue and one of the three greatest threats to human health. Antimicrobial Stewardship Programs, ASP, are institutional approaches to curb the threat of antimicrobial resistance, improve the safety of patients receiving antibiotics, and decrease antibiotic costs. Medical informatics in all areas, particularly the Electronic Health Record (EHR), has become a paradigm of modern medicine. An intelligent system integrated in EHR can play an important role in facilitating ASP activities. In this article we describe the experience of integration of a newly developed medical decision support system into an antimicrobial stewardship program in a mid-size hospital.
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Paper Nr: 129
Title:

A Health Virtual Community Perspective for Peripheral Arterial Disease - The Need of an E-solution for PAD
Authors:

Christo El Morr, Peggy Ng, Amber Purewal, Courtney Cole, Musaad Al Hamza and Mohamed Al Omran
Abstract: This paper summarizes the result of a survey conducted on 239 subject in Toronto to gauge their awareness of Peripheral Arterial Disease (PAD) and educate them about it. The results show that awareness of PAD is scarce and that the campaign resulted in a significant increase in awareness. This intervention suggest that an e-education tool is of paramount importance to address the lack of awareness. The paper argues that a PAD Virtual Community might play a pivotal role in educating the public about PAD and providing a platform for awareness and prevention.
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Paper Nr: 12
Title:

Managing Fragmented Personal Data: Going beyond the Limits of Personal Health Records
Authors:

Juha Puustjärvi and Leena Puustjärvi
Abstract: A personal health record (PHR) is a record of a consumer that includes data gathered from different sources such as from health care providers, pharmacies, insures, the consumer, and third parties. Gathering data is technically complicated and error-prone due to the heterogeneities of the data sources. Further, due to failed or missed transmissions patients’ PHRs are often incomplete. However, a consumer should have easy access to their own health information as well as to any relevant information they need in order to make decisions about their own heath care. Nevertheless, no holistic approach for managing personal data beyond PHRs has been developed. Satisfying this challenge requires a means to capture and interconnect information from a variety of personal data sources and from public data sources. In order to achieve this goal, we have designed a Personal Record (PR). It is virtually a single record in the sense that it gives an illusion of a traditional standalone tool, such as a traditional PHR, although its content may locate in a variety of sources, e.g., in systems storing data of health, gyms, smart homes, or personal notes. By means of PR we can also achieve synergy, e.g., in using health data together with welfare and smart home data we can produce outcomes that could not be achieved by functioning independently with single data sources. Moreover, using personal data together with public data sources we can also achieve more informal outcomes. The only requirement is that the data sources are in RDF-format, i.e., in the form of subject–predicate–object expressions. Then the SPARQL processor has the ability to process the data as well as to find the connections between triples from separate sources.
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Paper Nr: 18
Title:

Effect of the Named Entity Recognition and Sliding Window on the HONcode Automated Detection of HONcode Criteria for Mass Health Online Content
Authors:

Celia Boyer, Ljiljana Dolamic, Patrick Ruch and Gilles Falquet
Abstract: The Health On the Net’s Foundation (HON) Code of Conduct, HONcode, is the oldest and the most used ethical and trustworthy code for medical and health related information available on the Internet. Until recently, websites voluntarily applying for the HONcode seal were evaluated manually by an expert medical team according to 8 principles, referred to as criteria, and associated published guidelines. In the scope of the European project Kconnect, HON is developing an automated system to identify the 8 HONcode criteria within health webpages. When the research on the development of such a system evolved from simple algorithmic testing to a real full-content setting, it revealed a number of issues. The preceding study consisted in taking a set of 27 health-related websites and having them assessed for their compliance to each of the 8 HONcode criterion, first manually by senior HONcode experts, and then through supervised machine learning by the automated system. The results showed discrepancies mainly for two criteria: “submerged content” under the Complementarity criterion and “extremely low recall” under the Date Attribution criterion. In this article, the authors investigate different approaches to solve the problems related to each of these criteria, namely a customized Named Entity Recognition Model instead of a machine learning component for Date Attribution, and a sliding window instead of the whole document as a unit of detection for Complementarity. The results obtained show that the newly adapted automated system greatly improves accuracy: 74% vs. 41% for the Date Attribution criterion and 74% vs. 22% for the Complementarity criterion.
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Paper Nr: 21
Title:

A Real-World Case Scenario in Business Process Modelling for Home Healthcare Processes
Authors:

Latifa Ilahi, Sonia Ayachi Ghannouchi and Ricardo Martinho
Abstract: Organizations strive to improve the quality of provided services to their customers by making efficient use of Business Process Management (BPM). Home healthcare structures are considered as an enabler for linking daily life of patients with Information and Communication Technologies (ICTs). BPM relies first on business process model specifications that capture the desired workflows in the organization and how exceptional conditions should be handled. Home healthcare is still less developed in Tunisia than in other countries such as Canada, United States, Australia, France and Italy. This is due to many reasons, being one of the most relevant the expensive cost of hospitalization at home with no support from health insurances. In addition, it is badly organized, with many ad-hoc processes, making them hard to implement and improve. In this paper, we assess a real-world case scenario of home healthcare in Tunisia through interviews with involved actors in a private clinic. Also, we present the derived process models of home healthcare for this case. Our main goal is to have a sound starting point for the BPM cycle, by accurately modelling all business processes involved in home healthcare. With these models, we intent to: 1) optimize the processes by automating and rationalizing some activities, 2) implement them in a Business Process Management System (BPMS), 3) execute them, and 4) improve them through instance harvesting and remodeling.
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Paper Nr: 26
Title:

An Algorith to Derive Transfer Function Coefficients for an Auditory Filterbank from Experimental Tuning Curves
Authors:

Thomas Ostermann
Abstract: Auditory processing is one of the most complex and fundamental tasks in human psychophysiology. In the past 150 years researchers have tried to understand how sound and especially speech is processed in the human ear. Today, digital auditory filter models and nonlinear active silicon cochlea models are used to simulate cochlear sound processing. This article therefore aims at describing a simple algorithm to derive transfer functions coefficients for an auditory filterbank from tuning curves. Based on the model of the basilar membrane as a cascade of second order lowpass filters, the transfer functions are adopted to experimental data of tuning curves in the cochlea. With basic information on the shape of the travelling waves the presented algorithm is able to derive transfer function coefficients for an auditory filterbank. After the algorithm is explained this article shows how to use it in the presence of experimental data, and gives an application to a an operational amplifier filter circuit using active compensation.
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Paper Nr: 36
Title:

On the Reactivity of Sleep Monitoring with Diaries
Authors:

M. S. Goelema, M. M. Willems, R. Haakma and P. Markopoulos
Abstract: The declining costs of wearable sensors have made self-monitoring of sleep related behavior easier for personal use but also for sleep studies. Several monitor devices come with apps that make use of diary entries to provide people with an overview of their sleeping habits and give remotely advice. However, it could be that filling in a sleep diary impacts people’s perception of their sleep or the very behavior that is being measured. A small-scale field study about the effects of sleep monitoring (keeping a sleep diary) on a cognitive and a behavioral level is discussed. The method was designed to be as open as possible in order to focus on the effects of sleep monitoring where participants are not given a goal, motivation or feedback. Some behavioral modifications were observed, for example, differences in total sleep time and bedtimes were found (compared to a non-monitoring week and a monitoring week). Nevertheless, what the causes are of these changes remains unclear, as it turned out that the two actigraph devices used in this study differed greatly. In addition, some participants became more aware of their sleeping routine, but changing a sleeping habit was found challenging because of other priorities. It is important to know what the effects may be of sleep monitoring as the outcomes may already have an effect on the participant behavior which could cause researchers to work with data that do not represent a real life situation. In addition, the self-monitoring may serve as an intervention for facilitating healthier sleeping habits.
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Paper Nr: 38
Title:

Characterisation of Clinical Practice Guideline Changes
Authors:

Yamiko Joseph Msosa, C. Maria Keet and Melissa Densmore
Abstract: Sub-Saharan Africa is facing a double crisis of high disease burden and shortage of healthcare resources. To cope with this challenge, many countries have adopted the practice of task-shifting with clinical practice guidelines (CPGs) as a key component. It is not unusual for CPGs to be revised or proved wrong, spurring frequent updates of state-mandated CPGs. This negatively affects maintainability of healthcare applications using those CPGs. Therefore, it is essential that the types of CPG changes are understood in order to develop clinical decision support systems that are maintainable through adequate support for CPGs. We take a bottomup approach to analyse successive sets of CPGs so as to elucidate and characterise types of CPG changes over time. The identified 10 type of changes in decisions, actions, and recommendations are exhaustive and affect fine-grained structural components of a CPG. We also determined their occurrences using Malawi’s HIV CPGs of 2008, 2011, and 2014 as case study. The results showed that the number of changes, as well as the type of changes that occur in successive versions, varies widely.
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Paper Nr: 42
Title:

Design and Evaluation of Seamless Hand Hygiene Monitoring System
Authors:

Omar Badreddin, Ryan Simmons, Waylon Dixon, Ricardo Castillo, Michael Albanese, Duke Ayers and Ian Humphrey
Abstract: In-hospital infections pose a great risk for patients’ health; extend patients’ stay at hospitals, and increase per patient costs significantly. It is well recognized that better compliance to hand hygiene can significantly reduce such infections. Current monitoring approaches are difficult to deploy, and bring about significant level of overhead to clinicians. Therefore, many hospitals today still rely on direct observations, surveys, and dispenser usage measurements to assess sanitization compliance. We have developed a seamless monitoring technique that utilizes smart phones instead of additional dedicated devices. The key novelty of this approach is its compatibility with any existing hospital dispenser, and that it does not involve any overhead to participating clinicians. In addition, this approach enables the monitoring of missed-opportunities, where a clinician fails to utilize a sanitizer at key steps along a care delivery process. This paper presents the approach, and presents an experimental evaluation of the technology in the lab and at a large urban hospital.
Paper Nr: 44
Title:

Generating Temporal Network Paths from Hospital Data
Authors:

John Michael Finney and Laura Madrid Marquez
Abstract: Using data from electronic medical records we were able to rapidly generate temporal network data. This data can then be loaded into a modern graph database and used to generate a temporal graph of the data. Using a specialist graph language for rapidly querying these graph databases, we are able to rapidly extract temporal path information about patient to patient contact networks based on shared ward encounters. This information can then be used to calculate various network statistics of interest that may be important for clinical use.
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Paper Nr: 61
Title:

A Survey of Telecare Systems in Poland
Authors:

Grazyna Grabowska, Katarzyna Kaczmarek, Jan Owsiński, Izabella Zadrożna and Olgierd Hryniewicz
Abstract: In view of the demographic changes, the need for new telecare technologies is clearly growing. At the same time, in Polish law, there is still no provision allowing for the financing of the telemedicine and telecare services by the National Health Fund. The aim of this contribution is to survey the state-of-the-art telecare systems available on the Polish market and to discuss the main related problems. We also present results of interviews carried out in Social Welfare Centres. It turns out that the telecare system matching most of the identified key needs is not yet available on the Polish market.
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Paper Nr: 75
Title:

Comparative Study of Query Performance in a Remote Health Framework using Cassandra and Hadoop
Authors:

Himadri Sekhar Ray, Kausik Naguri, Poly Sil Sen and Nandini Mukherjee
Abstract: With the recent advancements in distributed processing, sensor networks, cloud computing and similar technologies, big data has gained importance and a number of big data applications can now be envisaged which could not be conceptualised earlier. However, gradually as technologists focus on storing, processing and management of big data, a number of big data solutions have come up. The objective of this paper is to study two such solutions, namely Hadoop and Cassandra, in order to find their suitability for healthcare applications. The paper considers a data model for a remote health framework and demonstrates mappings of the data model using Hadoop and Cassandra. The data model follows popular national and international standards for Electronic Health Records. It is shown in the paper that in order to obtain an efficient mapping of a given data model onto a big data solution, like Cassandra, sample queries must be considered. In this paper, health data is stored in Hadoop using xml files considering the same set of queries. Next, the performances of these queries in Hadoop are observed and later, performances of executing these queries on the same experimental setup using Hadoop and Cassandra are compared. YCSB guidelines are followed to design the experiments. The study provides an insight for the applicability of big data solutions in healthcare domain.
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Paper Nr: 79
Title:

Learning T2D Evolving Complexity from EMR and Administrative Data by Means of Continuous Time Bayesian Networks
Authors:

Simone Marini, Arianna Dagliati, Lucia Sacchi and Riccardo Bellazzi
Abstract: Predicting the complexity level (i.e. the number of complications and their related hospitalizations) in a T2D cohort is a critical step in prevention, resource optimization and overall patient management. Our data set was obtained by monitoring a T2D diabetic cohort along up to 10 years through electronic medical records of a local healthcare agency data warehouse. In order to conveniently handle temporarily sparse data, we designed a model describing the cohort evolution with Continuous Time Bayesian Networks (CTBN). The network structure and its parameters are entirely data driven. Compared to traditional Bayesian Networks, CTBNs admit cycles. As consequence, CTBNs fit the complexity of chronic metabolic syndromes where variables show a reciprocal influence. Network nodes represent metabolic (glycated hemoglobin, lipid profile (cholesterol, triglycerides), and biometric (BMI) data. We observed how these variables directly or indirectly affect the disease level of complexity, and how the variables influence the cumulative adverse events a patient undergoes.
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Paper Nr: 81
Title:

Semantic Knowledge Base Construction from Radiology Reports
Authors:

Eriksson Monteiro, Pedro Sernadela, Sérgio Matos, Carlos Costa and José Luís Oliveira
Abstract: The tremendous quantity of data stored daily in healthcare institutions demands the development of new methods to summarize and reuse available information in clinical practice. In order to leverage modern healthcare information systems, new strategies must be developed that address challenges such as extraction of relevant information, data redundancy, and the lack of associations within the data. This article proposes a pipeline to overcome these challenges in the context of medical imaging reports, by automatically extracting and linking information, and summarizing natural language reports into an ontology model. Using data from the Physionet MIMIC II database, we created a semantic knowledge base with more than 6.5 millions of triples obtained from a collection of 16,000 radiology reports.
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Paper Nr: 85
Title:

Generating SD-Rules in the SPECIALIST Lexical Tools - Optimization for Suffix Derivation Rule Set
Authors:

Chris J. Lu, Destinee Tormey, Lynn McCreedy and Allen C. Browne
Abstract: Suffix derivations (SDs) are used with query expansion in concept mapping as an effective Natural Language Processing (NLP) technique to improve recall without sacrificing precision. A systematic approach was proposed to generate derivations in the SPECIALIST Lexical Tools in which SD candidate rules were used to retrieve SD-pairs from the SPECIALIST Lexicon (Lu et al., 2012). Good SD candidate rules are gathered as SD-Rules in Lexical Tools for generating SDs that are not known to the Lexicon. This paper describes a methodology to select an optimized SD-Rule set that meets our requirement of 95\% system precision with best system performance from SD candidate rules. The results of the latest three releases of Lexical Tools show: 1) system precision and recall of selected SD-Rules are above 95\%. 2) a consistency between a computational linguistic approach and traditional linguistic knowledge for selecting the best Parent-Child rules. 3) a consistent approach yielding similar SD-Rule sets and system performance. Ultimately, it results in better precision and recall for NLP applications using Lexical Tools derivational related flow components.
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Paper Nr: 88
Title:

Organisational Maturity and Project Success in Healthcare - The Mediation of Project Management
Authors:

Jorge Gomes, Mário Romão and Helena Carvalho
Abstract: The challenges that face health organisations nowadays are to deliver more and better information, and to provide faster quality services at prices that are affordable to the entire population. To fulfil this objective, health organisations require more comprehensive and integrated technological solutions, in order to optimise their available resources, as a means to eliminate inefficiencies and to achieve planned benefits from investments. More and more, project management is recognised as being a key tool for use in developing initiatives that are aimed at promoting the implementation of organisations’ strategies. The focus of this research is to design a framework that combines different management approaches, in order to strengthen the outcomes of investments in Information and Technology Systems (IS/IT) in the health sector. The results encountered at the end of the pre-test phase indicated that the correct appropriation of technology by organisations, combined with the use of project management practices, are facilitators in achieving greater success from project outcomes.
Paper Nr: 90
Title:

Perspectives of Information-based Methods in Medicine: An Outlook for Mental Health Care
Authors:

Jan Kalina and Jana Zvárová
Abstract: Information-based medicine represents a concept characterizing the future ideal of medical practice overcoming the limitations of the popular concept of evidence-based medicine. The potential of information-based medicine is catalyzed by recent development of new technologies and basic research allowing to acquire a new medical knowledge relevant for an individual patient. The paper is focused on the specialty field of psychiatry. We discuss the challenges for the development of information-based psychiatry from the point of view of medical informatics together with its specific barriers and constraints. We discuss the development of telemedicine tools for psychiatric care, so far making mainly a disappointing experience. Medical informatics will also play the role in making results of basic research available to the psychiatrist at the point of care. Research results e.g. in molecular genetics or cognitive neuroscience will require to collect and analyze massive data on an individual patient. If these data are properly combined from various sources and analyzed, they represent an enormous potential for bringing a new psychiatric knowledge closer to an individual patient. This may contribute to improving the availability of psychiatric care and bringing its desirable destigmatization and humanization.
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Paper Nr: 93
Title:

Deployment of ARCS Model and Utilization of Communication Robot in Patient Education
Authors:

Keitaro Ishiguro, Yukie Majima and Nobuhiro Sakata
Abstract: “Medication non-compliance” is a failure to take medication properly. Therefore, medication is necessary for patients to be able to understand medication properly and to participate in treatment voluntarily with the right motivation. For this study, we design medication education based on the ARCS model(Attention, Relevance, Confidence, Satisfaction), which classifies concepts related to learning motivation (J.M. Keller, 1984), and which incorporates utilization of the communication robot "Pepper."
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Paper Nr: 96
Title:

Extraction of Useful Knowledge for Making Roster by Analyzing Nurse Scheduling Data and Incident Data
Authors:

Koichiro Okada, Masanori Akiyoshi, Yukie Majima, Hiroe Takahashi, Sayuri Tanaka, Misae Tanioka and Miwako Hori
Abstract: As described herein, we sought knowledge necessary to make a roster for nurses by analyzing nurse scheduling data and incident reports on the night shift. Even today, it is difficult to say that computers are used effectively producing nurse rosters. One reason is that algorithms suggested by researchers are not practical for nurses working at various sites because they are built without consideration of medical accidents known as “incidents”. Another reason is that the study of incidents from a team's perspective, which is the original mode of working as a nurse, is not available. Therefore, this study was conducted for discovery of knowledge to help produce a nursing roster by analyzing nurse scheduling data and incident data for night shifts from the viewpoint of teams, which is the original mode of working for nurses.
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Paper Nr: 96
Title:

Extraction of Useful Knowledge for Making Roster by Analyzing Nurse Scheduling Data and Incident Data
Authors:

Koichiro Okada, Masanori Akiyoshi, Yukie Majima, Hiroe Takahashi, Sayuri Tanaka, Misae Tanioka and Miwako Hori
Abstract: As described herein, we sought knowledge necessary to make a roster for nurses by analyzing nurse scheduling data and incident reports on the night shift. Even today, it is difficult to say that computers are used effectively producing nurse rosters. One reason is that algorithms suggested by researchers are not practical for nurses working at various sites because they are built without consideration of medical accidents known as “incidents”. Another reason is that the study of incidents from a team's perspective, which is the original mode of working as a nurse, is not available. Therefore, this study was conducted for discovery of knowledge to help produce a nursing roster by analyzing nurse scheduling data and incident data for night shifts from the viewpoint of teams, which is the original mode of working for nurses.
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Paper Nr: 99
Title:

Strengthening Existing Paper-based Health Records or Developing Electronic Health Records System in Africa: What Is Needful?
Authors:

Davies Adeloye, Nicholas Omoregbe and Charles K Ayo
Abstract: The interest in health information system is fast rising among global health experts. In Africa, there are ongoing calls among several stakeholders on the need to fully adopt an electronic-based health records system rather than the current widespread paper-based records system. While this has potential benefits on the long-term, the transition to a fully digitalised records system may not be without challenges, especially in Africa, where there is dearth of human and technical capacity. This review examined reported challenges in the adoption of electronic health records in some African settings, and suggested the need for African health systems to adopt a model that will strengthen existing paper-based health records while developing infrastructure for a full-fledged electronic-based records system
Paper Nr: 100
Title:

A Development Methodology for a Stroke Rehabilitation Monitoring Application
Authors:

Pilar Mata, Craig Kuziemsky and Liam Peyton
Abstract: The capabilities of mobile devices (e.g. flexibility, portability, and the ability to retrieve information quickly) have been leveraged for the development of clinical performance monitoring applications. In this paper we assess the suitability of a methodology for development of clinical performance monitoring applications to support stroke rehabilitation. We use a case study, with two use cases of patients recovering from stroke events, to design a monitoring application at a conceptual level and compare it to other clinical performance monitoring applications.
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Paper Nr: 103
Title:

eBooks to Facilitate Teaching and Evaluating Residents on the Intrinsic CanMEDS Roles
Authors:

Colla J. MacDonald and Derek Puddester
Abstract: The Postgraduate Medical Office at the Faculty of Medicine at the University of Ottawa initiated a five-year project to develop and implement a comprehensive system to assess the full spectrum of CanMEDS roles. Interviews with program directors suggested there were prerequisites needed, and preceptors require training in, and support with, understanding what the CanMEDS roles are and how to teach them, before they could expect them to evaluate them. The findings from a needs analysis guided the PGME department to design convenient faculty development to all departments with companion interactive eBooks, on each of the six CanMEDS roles, full of teaching and evaluation resources that can be accessed on mobile devices at the point of care. The eBooks were designed and developed by a collaborative process with subject matter experts, instructional designers, educational experts, computer programmers, videographers and graphic designers. The team approach to the development of the eBooks allowed us to combine the strengths of various professionals and design the most effective resource possible. The eBooks are now available free online. Future work will include assessment of the eBooks to determine their effectiveness in improving resident evaluation.
Paper Nr: 109
Title:

Information Technology for Medical Appropriateness Through Support Algorithms and Recovery of Patients’ Clinical History
Authors:

Enrico Serracca, Marco Brambilla, Tito Poli and Elena Martinelli
Abstract: In the health sector, the current intention of the Ministry of Health and of the Italian Government is to decrease healthcare squandering, to invest in research and to support the NHS. In this context the theme of appropriateness of treatment is essential; in fact the Health Ministry is committed to establish guidelines for the appropriateness of prescription, indicating the "conditions of provision" and "indications of appropriateness". A number of key actors however complain that this approach, along with others (e.g. multifaceted educational programs, electronic systems of frequency filtering, such as limiting the number of available tests to the requesting physicians) lead to uncertain and often ineffective results. This work highlights how the adoption and use of Information Technology (IT) in clinical settings is contributing to the optimization of NHS resources and to the governance of the healthcare delivery activities, in particular for the management and control of appropriateness of care. As an example, the adoption of a computerized alerting system by the University Hospital of Parma has brought out significant results. System integration through standard protocols such as HL7, fully normalized data repositories that univocally identify patients, diagnosis and health service provided are crucial in the healthcare context.
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Paper Nr: 111
Title:

Information System for Doping Control
Authors:

Francisco Medeiros, Juliana Medeiros, Fausto Ayres, Caio Viana, Josemary Rocha, Victor Viegas, Eder Mendes and Ana Santos
Abstract: It is apparent that regulators, sponsors, athletes and sports organizations have become more and more concerned about doping control. Despite the investments made in the past few years, recent studies show that Brazil´s sports federations have not systematized the doping control process nor have they yet dealt satisfactorily with problems to do with transparency with regard to disclosing the results of tests. This study puts forward an Information System to support the federations in reviewing and implementing anti-doping measures and procedures. It is also hoped that the proposed integrated database of doping tests can help managers to draw up a public policy for this area.
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Paper Nr: 114
Title:

The Potential of Smartwatches for Emotional Self-regulation of People with Autism Spectrum Disorder
Authors:

Juan C. Torrado, Germán Montoro and Javier Gomez
Abstract: This paper focuses on the potential of smartwatchers as interventors in the process of emotional self-regulation on individuals with ASD. Parting from a model of assistance in their self-regulation tasks, we review the main advantages of smartwatches in terms of sensors and pervasive interaction potential. We argue the suitability of smartwatches for this kind of assistance, including studies that had used them for related purposes, and the relation of this idea with the affective computing area. Finally, we propose a technological approach for emotional self-regulation assistance that uses smartwatches and applies to the mentioned intervention model.
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Paper Nr: 115
Title:

Link between Sentiment and Human Activity Represented by Footsteps - Experiment Exploiting IoT Devices and Social Networks
Authors:

Jaromir Salamon and Roman Moucek
Abstract: The Internet of Things world brings to our lives many opportunities to monitor our daily activities by collecting data from various devices. Complementary to it, the data expressing opinions, suggestions, interpretations, contradictions, and uncertainties are more accessible within variety of online resources. This paper deals with collection and analysis of hard data representing the number of steps and soft data representing the sentiment of participants who underwent a pilot experiment. The paper defines outlines of the problem and presents possible sources of reliable data, sentiment evaluation, sentiment extraction using machine learning methods, and links between the data collected from IoT devices and sentiment expressed by the participant in a textual form. Then the results provided by using inferential statistics are presented. The paper is concluded by discussion and summarization of results and future work proposals.
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Paper Nr: 117
Title:

Adequate Interval for the Recording of Vital Signs during a Hemodynamically Unstable Period - Interval for the Recording of Vital Signs
Authors:

Hyo-Jin Byon and Hyunkeun Lim
Abstract: In the perioperative period, it may be appropriate to record vital signs during a hemodynamically unstable period using the same interval as during a hemodynamically stable period. The aim of the present study was to determine if it is appropriate to record of vital signs using the same interval during the hemodynamically unstable period compared to the stable period in patients undergoing general anaesthesia. The mean arterial pressure (MAP) and heart rate (HR) were continuously measured during hemodynamically unstable (immediately after intubation) and stable (just before skin incision) periods in 24 general anaesthesia patients. Data was considered “missed” when continuously measured values were 30% more or less than the recorded value at 5- or 2.5-minute intervals. There was significantly more missed MAP data measured at 5 minute intervals during the hemodynamically unstable period than during the hemodynamically stable period. However, there was no difference in the incidence of missed MAP data at an interval of 2.5 minutes or HR data at intervals of 5 or 2.5 minutes during the hemodynamically unstable period compared to the stable period. During the hemodynamically unstable period, a 2.5-minute interval is recommended for recording the MAP.
Paper Nr: 122
Title:

Virtual Sensors in Remote Healthcare Delivery: Some Case Studies
Authors:

Nandini Mukherjee, Suman Sankar Bhunia and Sunanda Bose
Abstract: Delivery of healthcare services to the people living in remote places is a challenging task. A remote healthcare framework has been proposed in our earlier work based on sensor-cloud technologies. This paper explains the scenarios for deployment of such a framework in a remote healthcare delivery system. In our sensorcoud environment we propose to create virtual sensors and offer them on-demand to the health-care service providers for use in their services. In this paper, we discuss the purpose of using virtual sensors in healthcare domain and demonstrate how additional responsibilities that cannot be handled by physical sensor devices, can be delegated to virtual sensors in order to improve the efficiency of the system. Results of preliminary deployment of virtual sensors in two scenarios are discussed within limited scope and their advantages and related issues are put forward for future implementation of the sensor-cloud infrastructure.
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Paper Nr: 123
Title:

Increasing Alertness while Coding Secondary Diagnostics in the Medical Record
Authors:

Ghazar Chahbandarian, Nathalie Souf, Rémi Bastide and Jean-Christophe Steinbach
Abstract: In order to measure the medical activity, hospitals are required to manually encode information concerning a patient’s stay using International Classification of Disease (ICD-10). This task is time consuming and requires substantial training for the staff. We propose to help by speeding up and facilitating the tedious task of coding patient information, specially while coding some secondary diagnostics that are not well described in the medical resources such as discharge letter and medical records. Our approach consists of building a decision tree out of big variety of inpatient stay information in particular, contextual information such as age, sex, diagnostic count and other related information, next figure out missing secondary diagnostics. The results are still preliminary, we identify some important information variables that can be interesting to verify while coding certain secondary diagnostics.
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Paper Nr: 126
Title:

Mobile Health App for Biofeedback Response in Physiotherapy - Development and Validation
Authors:

Gonçalo Telo and Hugo Gamboa
Abstract: This work consists in developing an electromyographic biofeedback system in the form of a user-friendly mobile application which is simple to use, as it was designed to be an auxiliary component in physiotherapy sessions. This was achieved by implementing a framework that allows the integration of multi-platform plugins, as well as a web view based user interface, which assures the best of the designs allied to the specifications of the native APIs. The communication between the native and the JavaScript methods was tested, as the validation of the application was made internally.
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Paper Nr: 127
Title:

Inter-brain Synchronization between Nurse and Patient During Drawing Blood
Authors:

Tsuneo Kawano, Yukie Majima, Yasuko Maekawa, Mako Katagiri and Atsushi Ishigame
Abstract: Tacit knowledge such as "proficient skills" and "knacks" in nursing skills seems not to be applied by nurse alone but by the interaction between nurse and patient. The purpose of this study is to analyze their interaction from the point of interbrain synchrony. In this study blood drawing technique was adopted as nursing skills and experiments of drawing blood were carried out in nurse-patient pairs. Experimental participants were 4 nurses and 6 patients. The brain waves in the occipital portion of nurse and patient were simultaneously measured using portable EEG devices during drawing blood. The ratios of alpha-band power were calculated for each of the nurse and patient, and the cross-correlations were obtained between every pairs of them. The results indicated that the brain waves of patient were synchronized with those of nurse by several seconds behind. Furthermore the synchronization was not recognized in abnormal circumstances that nurses failed in the drawing blood.
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Paper Nr: 131
Title:

Prediction for Disease Risk and Medical Cost using Time Series Healthcare Data
Authors:

Masatoshi Nagata, Kazunori Matsumoto and Masayuki Hashimoto
Abstract: Foreseeing the medical expenditure is beneficial for both insurance companies and individuals. In this paper we propose a new methodology to predict disease risk and medical cost. Based on sequential latent dirichlet allocation (SeqLDA), which classifies hierarchical sequential data into segments of topics, we tried to predict the number of people with diseases and the one-year cost of lifestyle-related diseases. Using the health checkup information and medical claims of 6500 people for three years, we achieved that prediction error was less than conventional LDA, and for accuracy rate, AUC was more than 0.71. The results suggest that the SeqLDA method serve to predict the number of people with diseases and the related medical costs using time series healthcare data.
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Paper Nr: 132
Title:

Process-Oriented e-Learning System for Training Healthcare Professionals on Big Data Usage
Authors:

Vassiliki Karabetsou and Flora Malamateniou
Abstract: Big data technology promise to transform the way in which medical care is delivered and help the healthcare industry to address problems related to variability in healthcare quality and escalating healthcare costs. However, integrating Big Data use in healthcare professionals’ daily practice seems to be a challenging task as they are accustomed to making treatment decisions independently, using their own clinical judgement, rather than relying on protocols based on big data. Taking medical decisions based on Big Data - combined with physicians’ valuable clinical knowledge and experience - can lead them to safer and more accurate diagnosis and focused treatments. In order to support this transformation in medical practice healthcare professionals (e.g. physicians, nurses, pharmacists) will need to be trained in the collection, integration and analysis of large data sets. To this end, this paper presents a process-oriented e-learning system which aims at making healthcare professionals understand how to use big data tools and giving them the necessary skills to improve operations. The system uses workflow technology and Learning Analytics which has been specifically planned for learners’ custom needs.
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