HEALTHINF 2015 Abstracts

Full Papers Short Papers
Full Papers
Paper Nr: 20
Title:

Automated Cryptanalysis of Bloom Filter Encryptions of Health Records
Authors:

Martin Kroll and Simone Steinmetzer
Abstract: Privacy-preserving record linkage with Bloom filters has become increasingly popular in medical applications, since Bloom filters allow for probabilistic linkage of sensitive personal data. However, since evidence indicates that Bloom filters lack sufficiently high security where strong security guarantees are required, several suggestions for their improvement have been made in literature. One of those improvements proposes the storage of several identifiers in one single Bloom filter. In this paper we present an automated cryptanalysis of this Bloom filter variant. The three steps of this procedure constitute our main contributions: (1) a new method for the detection of Bloom filter encrytions of bigrams (so-called atoms), (2) the use of an optimization algorithm for the assignment of atoms to bigrams, (3) the reconstruction of the original attribute values by linkage against bigram sets obtained from lists of frequent attribute values in the underlying population. To sum up, our attack provides the first convincing attack on Bloom filter encryptions of records built from more than one identifier.
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Paper Nr: 22
Title:

Agent-based Modelling for Simulating Patients Flow in a Community Hospital
Authors:

Thomas Ostermann
Abstract: One of the most innovative tools in health care informatics is agent-based modelling. Such models change dynamically and help to understand interactions in complex systems especially when simulating competitive and cooperative behaviors in human systems. In our approach we use multi-agent modelling for simulating and evaluating patients flow in a community hospital. The model proposed in this context consists of three different types of agents: the hospital agent, the unit-agent and the patient-agent. Calculation of waiting times was performed using previously collected data from elective patients entering the community hospital ambulance. Poisson distribution was used to model waiting times. The simulation was carried out using the JAVA-based multi-agent-modelling environment Quicksilver. After solving convergence problems, we found, that the simulation especially for the ambulance entrance unit did show completely unexpected results. We were able to prove that the waiting times did not solely refer to the service times of the modelled units. To assure an unobstructed patient flow, we also showed that the mean service time at the entrance unit should not exceed 25 min. Although no evidence was given by the isolated analysis of waiting times, the simulation gave hints for a “hidden patient queue”, which after presenting the results in the quality circle meeting was confirmed by the ambulance staff.
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Paper Nr: 24
Title:

ZiZo: Modeling, Simulation and Verification of Reconfigurable Real-time Control Tasks Sharing Adaptive Resources - Application to the Medical Project BROS
Authors:

Mohamed Oussama Ben Salem, Olfa Mosbahi, Mohamed Khalgui and Georg Frey
Abstract: This research paper deals with the modeling, simulation and model checking of reconfigurable discrete-event control systems to be distributed on networked devices. A system is composed of software tasks with shared resources to control physical processes. A reconfiguration scenario is assumed to be a run-time automatic operation that modifies the system’s structure by adding or removing tasks or resources according to user requirements in order to adapt the whole architecture to its environment. Nevertheless, a reconfiguration can bring the system to a blocking problem that is sometimes unsafe, or violates real-time properties. We define new Petri Nets-based modeling solutions for both tasks and resources to meet these constraints. These solutions are applied to a real case study named Browser-based Reconfigurable Orthopedic Surgery (abbrev. BROS) to illustrate the paper’s contribution. A new Petri Nets-based editor and random-simulator named ZiZo is developed to model and simulate the BROS reconfigurable architecture. It is based also on the model checker SESA to apply an exhaustive CTL-based formal verification of this architecture to ensure safe reconfiguration scenarios of tasks and resources.
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Paper Nr: 27
Title:

Patient Flow Management - Combining Analytical and Observational Data to Uncover Flow Patterns
Authors:

Omar Badreddin and Ricardo Castillo
Abstract: Background: Hospitals must improve patient flow to achieve better efficiency and improve patients’ outcomes. Recent advancements in real time monitoring have provided immediate feedback for clinicians to address any bottlenecks. However, root causes of delays remain embedded in the details of clinicians’ activities. This work presents an observational study of a clinical pathway within a heart unit at a community hospital in North America. Observational data is correlated with multiple sources to uncover flow patterns. Materials and Methods: We observe heart patients as they arrive in at the heart unit and throughout their care up until their discharge. Data is correlated with electronic healthcare records and paper trails to enhance data reliability and accuracy. Results: Single data source alone is not sufficient to uncover process patterns. In our study, we discovered a negative correlation between the number of patients arriving at the hospital, and the total wait time each patient has experienced. We also identified key inefficiencies in the first and last hours of work shifts. Conclusion: Correlating multiple data sources can provide insights into details of process activities and uncover patterns and inefficiencies.
Paper Nr: 30
Title:

Temporal Detection of Guideline Interactions
Authors:

Luca Piovesan, Luca Anselma and Paolo Terenziani
Abstract: Clinical practice guidelines are widely used to support physicians, but only on individual pathologies. On the other hand, the treatment of patients affected by multiple diseases is one of the main challenges for the modern healthcare. This requires the development of new methodologies, supporting physicians in the detection of interactions between guidelines. In a previous work, we proposed a flexible and user-driven approach, helping physicians in the detection of possible interactions between guidelines, supporting focusing and analysis at multiple levels of abstractions. However, it did not cope with the fact that interactions occur in time. For instance, the effects of two actions may potentially conflict, but practical conflicts happen only if such effects overlap in time. In this paper, we extend the ontological model to deal with the temporal aspects, and the detection algorithms to cope with them. Different types of facilities are provided to physicians, supporting the analysis of interactions between both guidelines “per se”, and the concrete application of guidelines to specific patients. In both cases, different temporal facilities are provided to user physicians, based on Artificial Intelligence temporal reasoning techniques.
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Paper Nr: 47
Title:

Thrombophilia Screening - An Artificial Neural Network Approach
Authors:

João Vilhena, M. Rosário Martins, Henrique Vicente, Luís Nelas, José Machado and José Neves
Abstract: Thrombotic disorders have severe consequences for the patients and for the society in general, being one of the main causes of death. These facts reveal that it is extremely important to be preventive; being aware of how probable is to have that kind of syndrome. Indeed, this work will focus on the development of a decision support system that will cater for an individual risk evaluation with respect to the surge of thrombotic complaints. The Knowledge Representation and Reasoning procedures used will be based on an extension to the Logic Programming language, allowing the handling of incomplete and/or default data. The computational framework in place will be centered on Artificial Neural Networks.
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Paper Nr: 49
Title:

Towards Guidelines for the Design of Patient Feedback in Stroke Rehabilitation Technology
Authors:

Lilha Willems, Daniel Tetteroo and Panos Markopoulos
Abstract: Feedback is known to play a key role for the effective rehabilitation of patients after stroke. Although general guidelines exist for UI design for people with physical and cognitive disabilities, and feedback systems have been evaluated with non-disabled persons, little is known about how best to design feedback for interactive technologies supporting rehabilitation after stroke. This paper describes the iterative design process of a feedback module for TagTrainer, a tangible interactive tabletop technology supporting armhand training. Based on the evaluation of this technology with seven stroke patients, we propose five guidelines for the design of patient feedback for stroke rehabilitation technology.
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Paper Nr: 52
Title:

Tracking of Monthly Health Condition Change from Daily Measurement of Systolic Blood Pressure
Authors:

Wenxi Chen and Toshiyo Tamura
Abstract: This paper presents an approach to detect monthly biorhythmic change using daily measurement of systolic blood pressure (SBP) at home. As a part of health promotion campaign initiated in 1994, more than 600 households in West Aizu village of northern Japan were provided devices for daily measurement of blood pressure, electrocardiogram, body temperature and body weight. This paper demonstrates an outcome of data analysis of daily SBP collected in two years from an elder couple at age of seventies. The personal reference profile is gained by averaging individual monthly profiles over 24 months. Dynamic time warping algorithm estimates the similarity between personal reference profile and monthly SBP profile. The results show that an extraordinary deviation from usual biorhythmicity can be found in both the wife and the husband happened in July and February which respectively indicates individual health condition change confirmed by personal medical record. The results suggest that even it is difficult to identify any significant variation from the daily SBP directly, proper analysis of the raw SBP measured over a long-term period helps tracking functional information of health condition change and serving as an effective evidence for health management.
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Paper Nr: 59
Title:

Automatic Fall Risk Estimation using the Nintendo Wii Balance Board
Authors:

Gert Mertes, Greet Baldewijns, Pieter-Jan Dingenen, Tom Croonenborghs and Bart Vanrumste
Abstract: In this paper, a tool to assess a person´s fall risk with the Nintendo Wii Balance Board based on Center of Pressure (CoP) recordings is presented. Support Vector Machine and K-Nearest Neighbours classifiers are used to distinguish between people who experienced a fall in the past twelve months and those who have not. The classifiers are trained using data recorded from 39 people containing a mix of students and elderly. Validation is done using 10-fold cross-validation and the classifiers are also validated against additional data recorded from 12 elderly. A cross-validated average accuracy of 96.49% +/- 4.02 is achieved with the SVM classifier with radial basis function kernel and 95.72% +/- 1.48 is achieved with the KNN classifier with k=4. Validation against the additional dataset of 12 elderly results in a maximum accuracy of 76.6% with the linear SVM.
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Paper Nr: 61
Title:

Strategic Planning of Hospital Service Portfolios - The DRGee Viewer
Authors:

Dominique Brodbeck, Markus Degen, Andreas Walter, Serge Reichlin and Christoph Napierala
Abstract: In 2012 inpatient financing for hospitals in Switzerland was changed from a system based on cost per case to a system based on a fixed fee per case. The fixed-fee model makes medical services comparable from a financial point of view. Characterizing medical service portfolios in this way, creates large amounts of high-dimensional data. In order to operationalize this information and use it as a factual basis for decision support, we developed a visualization tool and a methodology to support strategic planning of hospital service portfolios. The method centers around a visual metaphor that provides the basis for strategic thinking. It is complemented by a visualization tool that allows visualization, analysis, and modification of service portfolios. Extensive support is provided for visual comparison of different scenarios. Special features enable the tool to be used during live planning sessions. The system was used in strategy workshops in over forty hospitals, and has contributed to infrastructure planning, reorganization, and resource optimization decisions.
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Paper Nr: 76
Title:

Finding Evidence for Updates in Medical Guidelines
Authors:

Roelof Reinders, Annette Ten Teije and Zhisheng Huang
Abstract: Medical guidelines are documents that describe optimal treatment for patients by medical practitioners based on current medical research (evidence), in the form of step-by-step recommendations. Because the field of medical research is very large and always evolving, keeping these guidelines up-to-date with the current state of the art is a difficult task. In this paper, we propose a method for finding relevant evidence for supporting the medical guideline updating process. Our method that takes from the evidence-based medical guideline the recommendations and their corresponding evidence as its input, and that queries PubMed, the world’s largest search engine for medical citations, for potential new or improved evidence. We built a prototype and performed a feasibility study on a set of old recommendations, and compared the output to evidence for the newer version. The system succeeded in finding goal articles for 11 out of 16 recommendations, but in total, only 20 out of 71 articles were retrieved. Our ranking method for most relevant articles worked well for small result sets, but for large result sets it failed to rank the goal articles in the top 25 results.
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Paper Nr: 78
Title:

Descriptive Modelling of Clinical Conditions with Data-driven Rule Mining in Physiological Data
Authors:

Hadi Banaee, Mobyen Uddin Ahmed and Amy Loutfi
Abstract: This paper presents an approach to automatically mine rules in time series data representing physiological parameters in clinical conditions. The approach is fully data driven, where prototypical patterns are mined for each physiological time series data. The generated rules based on the prototypical patterns are then described in a textual representation which captures trends in each physiological parameter and their relation to the other physiological data. In this paper, a method for measuring similarity of rule sets is introduced in order to validate the uniqueness of rule sets. This method is evaluated on physiological records from clinical classes in the MIMIC online database such as angina, sepsis, respiratory failure, etc.. The results show that the rule mining technique is able to acquire a distinctive model for each clinical condition, and represent the generated rules in a human understandable textual representation.
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Paper Nr: 79
Title:

Certification of Service-oriented eHealth Platforms - Derivation of Structured Criteria for Interoperability and Expandability
Authors:

Martin Benedict, Martin Burwitz and Hannes Schlieter
Abstract: Certification of interoperability is an important quality measure, which can foster the success of eHealth projects. Often these projects test and certify interoperability for specific purposes. The achievement of long-term interoperability is often not in the scope of these projects. In this paper we describe the importance of expandability for the long-term interoperability. Further we show, how a structured criteria catalogue for the certification process can be derived for these two quality factors.
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Paper Nr: 80
Title:

Lung Function Classification of Smartphone Recordings - Comparison of Signal Processing and Machine Learning Combination Sets
Authors:

João Teixeira, Luís Teixeira, João Fonseca and Tiago Jacinto
Abstract: Worldwide, over 250 million people are affected by chronic lung conditions such as Asthma and COPD. These can cause breathlessness, a harsh decrease in quality of life and, if not detected and duly managed, even death. In this paper, we aim to find the best and most efficient combination of signal processing and machine learning approaches to produce a smartphone application that could accurately classify lung function, using microphone recordings as the only input. A total of 61 patients performed the forced expiration maneuver providing a dataset of 101 recordings. The signal processing comparison experiments were conducted in a backward selection approach, reducing from 54 to 12 final envelopes, per recording. The classification experiments focused first on differentiating Normal from Abnormal lung function, and second in multiple lung function patterns. The results from this project encourage further development of the system.
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Paper Nr: 82
Title:

Mapping Elderly Citizen’s Computer and ICT Use in a Small-sized Norwegian Municipality

Authors:

Elin Thygesen, Ragni MacQueen Leifson and Santiago Martinez
Abstract: In Norway, many citizens’ services are exclusively or at least delivered online. They usually require sufficient knowledge to use information and communication technologies (ICT). As part of an Interreg IV European project focused on e-inclusion for elderly, this work presents a study to map computer and Internet use among the elderly. The study was carried out in a small municipality of 10 000 inhabitants in Southern Norway, of whom15% were 65-year-olds or older. 178 replies out of 500 were obtained. Results showed that 9 out of 10 had access to and frequently used a computer at home. However, there still was 1 out of 5 who did not make effective use of ICT. Importantly, half of the respondents reported to have learned how to use the Internet through attending specific courses and others through guidance from relatives or acquaintances. Answers about monitoring technologies were practically oriented towards considering that topics, such as security and privacy, could have a subordinate role if the technology was used for a good and fair purpose. This work provides an insight into the current access to and use of computer and Internet, which becomes useful to inform ICT use policies among elderly population.
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Paper Nr: 83
Title:

A Proposal to Incorporate Digital Auscultation and Its Processing into an Existing Electronic Health Record
Authors:

Pedro Gomes, Samuel Frade, Ana Castro, Ricardo Cruz-Correia and Miguel Coimbra
Abstract: This paper aims to describe and discuss a proposal to incorporate digital auscultation and its processing into an existing EHR. The architecture was planned to be used in both primary and hospital care, and includes a digital stethoscope; an exam collection module; an integration module; an EHR web service; and an EHR. Special attention was given to standardize communications using HL7 and openEHR. The proposed implementation uses a commercial stethoscope, an android app to collect the data, a mirth integration engine that communicates using HL7 or openEHR through REST or SOAP calls. The signal processing of the sounds is also included. The auscultation sound files are made available to the EHR users. This solution will open the possibility to have richer patient records than can be very important for patient care, research and medical teaching. It also raises issues regarding ethical and legal concerns that must be considered in future research.
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Paper Nr: 90
Title:

BROS - A New Robotic Platform for the Treatment of Supracondylar Humerus Fracture
Authors:

Ben Salem Mohamed Oussama, Mosbahi Olfa, Khalgui Mohamed and Frey Georg
Abstract: The supracondylar humerus fracture is one of the most common and challenging injury faced by pediatric orthopedic surgeons. Its treatment may lead to many neurological and vascular complications. This is mainly due to the "blind" pinning performed by surgeons to fix the fractured elbow's fragments. Furthermore, the medical staff is usually exposed to a high level of radiations during the surgery because of the fluoroscopically assisted treatment. Thus, a new robotized platform baptized BROS is developed in Tunisia to remedy this issue and allow performing a safer surgery. BROS is reconfigurable and may run under several operating modes, meeting, thus, the surgeon's requirements and the environment constraints. This paper introduces this new robotic platform and a real case of robot-assisted surgery is simulated to check the performances of BROS.
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Paper Nr: 99
Title:

Migrating Healthcare Applications to the Cloud through Containerization and Service Brokering
Authors:

Francois Andry, Richard Ridolfo and John Huffman
Abstract: New business models and technologies offer unique opportunities of combining patient demographics and clinical data with general consumer data. We are building a digital health platform using a new paradigm based on an open platform as a service (PaaS) that delivers data and analytics across a wide variety of cloud computing topologies. This new architecture gives us the ability to integrate devices, data sources and services very quickly to create, refactor, migrate, deploy and maintain scalable, secure, high quality healthcare and wellness applications while reducing the total cost of ownership.
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Paper Nr: 124
Title:

Model-based Clustering of Ischemic Stroke Patients
Authors:

Ahmedul Kabir, Carolina Ruiz, Sergio Alvarez, Nazish Riaz and Majaz Moonis
Abstract: The objective of our study is to find meaningful groups in the data of ischemic stroke patients using unsupervised clustering. The data are modeled using Gaussian mixture models with a variety of covariance structures. Cluster parameters in each of these models are estimated by maximum likelihood via the Expectation-Maximization algorithm. The best models are then selected by relying on information-theoretic criteria. It is observed that the stroke patients can be grouped into a small number of medically relevant clusters that are defined primarily by the presence of diabetes and atrial fibrillation. Characteristics of the clusters found are discussed, using statistical comparisons and data visualization.
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Paper Nr: 136
Title:

Information Model for Radiology Performance Indicators based on DICOM
Authors:

Milton Santos, Luis Bastião, Alexandra Queirós, Augusto Silva and Nelson Fernando Pacheco da Rocha
Abstract: The paper presents the information model of the DICOM - Radiology Performance Indicator (DICOMRPI). This model can be used to aggregate information related to the characterization of medical imaging health care services, namely information incorporated in the studies according to the format of the Digital Imaging and Communication in Medicine (DICOM). The model comprises several components including the ones required to define the context of medical imaging health care services (e.g. the entities involved) and the context of use of the indicator (e.g. Quality Dimensions). For the validation of the proposed information model 51,277 Digital Radiography (DX) studies performed on 27,559 patients from a single health care facility were considered. The results of this validation within the scope of DX modality make possible to anticipate the DICOM-RPI relevance in other imaging modalities and its contribution for comprehensive analysis of medical imaging health care services.
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Paper Nr: 138
Title:

Sitting Posture Detection using Fuzzy Logic - Development of a Neuro-fuzzy Algorithm to Classify Postural Transitions in a Sitting Posture
Authors:

Bruno Ribeiro, Leonardo Martins, Hugo Pereira, Rui Almeida, Claudia Quaresma, Adelaide Ferreira and Pedro Vieira
Abstract: In a previous work, a chair prototype was used to detect 11 standardized seating postures of users, using just 8 air bladders (4 in the chair’s seat and 4 in the backrest) and one pressure sensor for each bladder. In this paper we describe a new classification algorithm, which was developed in order to classify the postures using as input the Centre of Pressure, the Posture Adoption Time and the Posture Output from the existing Neural Network Algorithm. This new Posture Classification Algorithm is based on Fuzzy Logic and is able to determine if the user is adopting a good or a bad posture for specific time periods. The newly developed Classification Algorithms will prompt the improvement of new Posture Correction Algorithms based on Fuzzy Actuators.
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Paper Nr: 141
Title:

Physical Activity Support Community TogetherActive - Architecture, Implementation and Evaluation
Authors:

Lamia Elloumi, Bert-Jan van Beijnum and Hermie Hermens
Abstract: Reducing sedentary lifestyle and physical inactivity is getting an increased attention of researchers and health organizations due to its significant benefits on health. In the same direction we are proposing a virtual community system, TogetherActive, which supports people in their daily physical activity. The community is connected to physical activity sensors and provide social support (informational, emotional, instrumental and appraisal supports). In order to increase motivation, individual and group goals, comparison, competition and cooperation are the key concepts considered in the system. This paper presents the design, implementation and usability evaluation of the TogetherActive system.
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Paper Nr: 146
Title:

Eyetrace2014 - Eyetracking Data Analysis Tool
Authors:

Katrin Sippel, Thomas Kübler, Wolfgang Fuhl, Guilherme Schievelbein, Raphael Rosenberg and Wolfgang Rosenstiel
Abstract: Over the last years eye tracking became more and more popular. A variety of new eye-tracker models and algorithms for eye tracking data processing emerged. On the one hand this multitude of hard- and software brought many advantages, on the other hand the diversity of devices and measures impedes the comparability and repeatability of eye-tracking studies. While supply of eye tracking software is high, the functioning of the algorithms, e.g. how fixations are identified, is often intransparent and unflexible. The Eyetrace software bundle approaches these problems by providing a variety of different evaluation methods compatible with many eye-tracker models. Eyetrace2014 combines state-of-the-art algorithms with established approaches and provides a continuous visualization of the analysis process. All calculations provide user adaptable parameters and are well documented and referenced in order to make the whole analysis transparent. Our software is available free of charge well suited for exploratory data analysis and education (http://www.ti.uni-tuebingen.de/Eyetrace.1751.0.html).
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Short Papers
Paper Nr: 15
Title:

Experience with a 3D Kinect Exergame for Elderly
Authors:

Ellen Brox, Gunn Evertsen, Heidi Åaheim-Olsen, Santiago Hors-Fraile and James Browne
Abstract: Physical activity is important for all, but for the elderly balance and sufficient strength is vital to function in daily life. It can be difficult for all of us to find motivation to exercise at home, and seniors are no exception. We have experienced that exergaming can be motivational for elderly since it is fun, but most commercial games are not optimal for elderly due to speed, required movements, colours, the amount of information, etc. In a project we designed an exergame specifically with the elderly in mind based on user requirements both for specific needs for elderly, for games in general and for good exercises. A first prototype of an online 3D exergame using KinectTM was developed and tested on a group of six seniors. KinectTM was chosen since after our experience users in the target group can handle exergaming with this technology, and also it is possible to control that the exercises are performed correctly. Our aim was to investigate how seniors would react to a 3D first person environment before we continued the development. A user centred method was applied in the design and development, and the user test is part of that. The results are encouraging.
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Paper Nr: 26
Title:

A Mathematical Formulation for Estimating Age Levels in the Carolina Curriculum
Authors:

Salvatore Cuomo, Antonella Olivo, Pasquale De Michele, Francesco Piccialli, Vincenzo Schiano Di Cola and Ennio Del Giudice
Abstract: The study of medical protocols for monitoring and analyzing the development of children with disabilities is a fundamental research area. A well established curriculum-based assessment is the Carolina Curriculum for Infants and Toddlers with Special Needs (CCITSN) together with the Carolina Curriculum for Preschoolers with Special Needs (CCPSN). These are suitable curriculums for early intervention programs, where sequenced item data collection and analysis are used to monitor incremental changes of the program and to recognize the areas of relative strength and weakness in an individual infant, or child, with mild and moderate disabilities. In many recent papers, Cuomo, et al. introduced the client-server software C@rolin@ to carry out all features of CCITSN, afterwards a Social Framework and an App (CarolApp). Despite of all these technological advantages, the software uses mathematical formulas that do not fully satisfy operators and do not help them to correctly establish useful parameters. We address this problem by developing a more formalized mathematical model in the determination of age levels that can be successfully used in the Carolina software.
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Paper Nr: 29
Title:

Mobility, Accessibility and Safety of People with Cerebral Palsy
Authors:

Ana Marta Amaral de Carvalho, Alireza Asvadi, Carlos Carona, Ana Lopes and Urbano Nunes
Abstract: This research characterizes mobility, accessibility and safety of individuals with severe motor impairment such as users suffering from Cerebral Palsy (CP). Through the analysis of enabling factors, constraints associated and the search of possible improvements, it is possible to identify the needs in these fields and subsequently develop strategies accordingly. The sample was collected in Coimbra Cerebral Palsy Association (APCC) and it included 16 individuals with CP. To these individuals we gave an evaluation protocol with a form with clinical and sociodemographic data and a questionnaire. The main limiting factors include building/vehicle access, difficulty in reverse drive and lack of safety. The most valued features of a powered wheelchair are comfort and structure, easy navigation and wheelchair control and safety. The lack of safety in the outdoors was a relevant limiting factor. Almost all individuals requested improvements of the powered wheelchair. The most requested improvements were safety related or related with navigation problems. An assistive navigation solution based on a shared control algorithm is presented, where a powered wheelchair is equipped with the Kinect sensor, in order to help the user maneuvering the wheelchair safely.
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Paper Nr: 31
Title:

Automatic Prevention of Medication Errors - Mobile System Based on Near Field Communication (NFC) Technology
Authors:

Ana-María López, Eduardo Pascual, Ana-María Salinas, Guillermo Azuara and Rafael Gómez
Abstract: In this paper a mobile system aimed to avoid medication error in home environments is described. It is based on unambiguous identification of pillboxes or drugs packages with a Near Field Communication (NFC) tag. This tag, whose information can be quickly read with a mobile phone equipped with an NFC interface, can also store information about the patient and the prescribed dose. These data can be actualized with the smartphone whenever the patient confirms a new medication-take just by approaching the smartphone to the labelled box. The information is also locally saved in the phone and can be sent by SMS to caregivers if necessary. The information into the NFC tag converts a simple mobile app into an ubiquitous computing (ubicomp) context aware tool that avoids drug or patient confusion. To ensure that even patients with low technological experience will be able and, more important, wish to use this system, we have followed a user centered design methodology. The system adapts to different patients profiles, and to different degrees of digital literacy.
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Paper Nr: 32
Title:

Designing a Data Warehouse Dimensional Model based on the HL7 Clinical Document Architecture
Authors:

Fabrizio Pecoraro, Daniela Luzi and Fabrizio L Ricci
Abstract: This paper proposes a conceptual framework to map the data warehouse dimensional model primitives with HL7 Clinical Document Architecture (CDA) elements. To accomplish this purpose features both schemas are defined based on a first-order logic. Based on this formalism the mapping steps have been performed following the dimensional model lifecycle. This approach facilitates the integration of heterogeneous information systems in a clinical data warehouse simplifying the transformation procedures as well as improving the quality and consistency of data.
Paper Nr: 35
Title:

Comparing Computerized Physician Order Entry Usability between Expert and Novice Primary Care Physicians
Authors:

Martina Clarke, Jeffery L. Belden and Min Soon Kim
Abstract: Objectives: To examine usability gaps between expert and novice primary care physicians when using computerized provider order entry (CPOE). Methods: To analyze usability gaps between ten novice and seven expert physicians, using the triangular method approach, usability tests involving video analysis were conducted. Results: While most novice physicians completed tasks less proficiently, and provided a lower System Usability Scale (SUS) score than expert physicians, the result of ‘percent task success rate’ (t(8) = 2.31, p=0.98) was not significant for both physician groups on all five tasks. Seven common and four unique usability issues were identified between the two physician groups. Three themes emerged during analysis: user interface issues, ambiguous terminologies, and training and education issues. Discussion and Conclusion: This study identified varying usability issues for users of CPOE with different expertise. Two additional iterations of the usability data collections are undergoing to uncover comprehensive usability issues and measure the learnability.
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Paper Nr: 45
Title:

HIS Scoring Qualifiers - A Novel Gathering Expert Map-based Weighting Scheme from Survey
Authors:

Marcelo Carvalho, Ivan Torres Pisa and Cristina Lucia Feijo Ortolani
Abstract: The task to score or evaluate a Health Information System (HIS) is complex and lays mostly on comparisons. Reference elements used for system evaluation during auditing or tests includes standards, requirement list and other documents that are technical in general. A system under evaluation must therefore meet or exceed reference elements characteristics after careful assessment to be consider equivalent. The limitation of this traditional evaluation method is related to the highly specialized manpower needed to scrutinize all system against reference. This article proposes a novel method for construction of a simplified reference element based on Concept Maps (CM), which represents HIS common requirement documents in a digested format. CMs are weighted node-link conceptual graphs used to represent a knowledge within a domain. In our particular experiment, this knowledge is obtained from expert’s survey and its suggested to be used as a pre-assessment tool for system evaluation.
Paper Nr: 46
Title:

An Information-theoretical Approach to Classify Hospitals with Respect to Their Diagnostic Diversity using Shannon’s Entropy

Authors:

Thomas Ostermann and Reinhard Schuster
Abstract: In Germany hospital comparisons are part of health status reporting. This article presents the application of Shannon’s entropy measure for hospital comparisons using reported diagnostic data. We used Shannon’s entropy to measure the diagnostic diversity of a hospital department by means of reported ICD–9–codes. Entropy values were compared both with respect to the hospital status (i.e. primary, secondary, tertiary or specialized hospital) and specialisations (e.g. surgery, gynaecology). There were relevant differences in entropy values between the different types of hospitals. Primary hospitals differed from specialized hospitals (0.535 ± 0.09 vs. 0.504 ± 0.07). Furthermore, specialized departments like obstetrics or ophthalmology did generate lower entropy values than area-spanning departments like paediatrics or general internal medicine, having significantly higher values. In conclusion, we showed how entropy can be used as a measure for classifying hospitals. Besides of hospital comparisons, this approach can be implemented in all fields of health services research for measuring variability in nominal or ordinal data. The use of entropy as a measure for health services research and classification algorithms should be encouraged to learn more about this measure, which unreasonably has fallen into oblivion in health services research.
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Paper Nr: 50
Title:

Framing Self-quantification for Individual-level Preventive Health Care
Authors:

Zilu Liang and Mario Alberto Chapa Martell
Abstract: Preventive health care is considered a promising solution to the prevalence of chronic diseases. Nevertheless, preventive health care at the population-level adopts an one-fit-all approach. We intend to solve the problem through promoting preventive health care at the individual level based on self-quantification. Nowadays millions of people are tracking their health conditions and collecting huge quantity of data. We propose a Preventive Health care on Individual Level (PHIL) framework that guides people to leverage their self-tracking data to improve personal health, which forms a data-driven but objective-oriented methodology. The PHIL framework consists of five phases: Define, Track, Analyze, Improve and Control (DTAIC), covering the whole process of a complete self health care project. While the proposed PHIL framework can be implemented to achieve various health benefit, we selectively present one case study where the subject designed and conducted a self health care project for sleep quality improvement under the PHIL framework. We hope the proposed framework can help change the passive role of health care receivers in traditional health care system, and empower people to actively participate in the health care ecosystem and take the initiative in managing and improving personal health.
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Paper Nr: 53
Title:

Design Considerations and Evaluation Methodology for Adapted Navigational Assistants for People with Cognitive Disabilities
Authors:

Javier Gomez and Germán Montoro
Abstract: Assisting pedestrians with cognitive disabilities in their movements through a city is not a simple task. Despite of the new mobile navigational software available in the market, many of these users (and their caregivers) are still resistant to use them. In some cases, due to the lack of adaptation to their needs. This issue motivated us to elaborate a set of design considerations to keep in mind when designing navigational assistants for people with cognitive disabilities. Besides, we developed a navigational prototype for smartphones that was evaluated with two users with Down syndrome. Therefore, we also propose some hints about how the evaluation should be carried out.
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Paper Nr: 54
Title:

Implementation of Data Security Requirements in a Web-based Application for Interactive Medical Documentation
Authors:

Anja Perlich, Andrey Sapegin and Christoph Meinel
Abstract: Keeping data confidential is a deeply rooted requirement in medical documentation. However, there are increasing calls for patient transparency in medical record documentation. With Tele-Board MED, an interactive system for joint documentation of doctor and patient is developed. This web-based application designed for digital whiteboards will be tested in treatment sessions with psychotherapy patients and therapists. In order to ensure the security of patient data, security measures were implemented and they are illustrated in this paper. We followed the major information security objectives: confidentiality, integrity, availability and accountability. Next to technical aspects, such as data encryption, access restriction through firewall and password, and measures for remote maintenance, we address issues at organizational and infrastructural levels as well (e.g., patients’ access to notes). With this paper we want to increase the awareness of information security, and promote a security conception from the beginning of health software research projects. The measures described in this paper can serve as an example for other health software applications dealing with sensitive patient data, from early user testing phases on.
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Paper Nr: 58
Title:

Arousal Recognition Method using Electroencephalography Signals to Construct Emotional Database
Authors:

Yujun Niu, Hao Zhang, Shin'ichi Warisawa and Ichiro Yamada
Abstract: Improving arousal recognition accuracy by using EEG signals is important for emotion recognition. In this research, discrete wavelet transform is used to extract features, and a cross-level method is adopted to select effective features. The cross-level method shows great potential for two-level arousal classification, and the recognition accuracy reaches 91.8%. The sensitivity of EEG channels is also discussed based on two ranking methods of SCP (single-channel performance) and ANOVA (analysis of variance). Finally, arousal recognition method based on EEG signals is applied to construct a Japanese emotion database.
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Paper Nr: 64
Title:

Self-serve ICT-based Health Monitoring to Support Active Ageing
Authors:

Mobyen Uddin Ahmed, Jesica Rivero Espinosa, Alenka Reissner, Àlex Domingo, Hadi Banaee, Amy Loutfi and Xavier Rafael-Palou
Abstract: Today, the healthcare monitoring is not limited to take place in primary care facilities simply due to deployment of ICT. However, to support an ICT-based health monitoring, proper health parameters, sensor devices, data communications, approaches, methods and their combination are still open challenges. This paper presents a self-serve ICT-based health monitoring system to support active ageing by assisting seniors to participate in regular monitoring of elderly’s health condition. Here, the main objective is to facilitate a number of healthcare services to enable good health outcomes of healthy active living. Therefore, the proposed approach is identified and constructed three different kinds of healthcare services: 1) real time feedback generation service, 2) historical summary calculation service and 3) recommendation generation service. These services are implemented considering a number of health parameters, such as, 1) blood pressure, 2) blood glucose, 3) medication compliance, 4) weight monitoring, 5) physical activity, 6) pulse monitoring etc. The services are evaluated in Spain and Slovenia through 2 prototypical systems, i.e. year2prototype (Y2P) and year3prototype (Y3P) by 46 subjects (40 for Y2P and 6 for Y3P). The evaluation results show the necessity and competence of the proposed healthcare services. In addition, the prototypical system (i.e. Y3P) is found very much accepted and useful by most of the users.
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Paper Nr: 69
Title:

The Potential of the m-Health Platform to Safeguard Public Health - The Nigerian Example
Authors:

Allen Adum, Uche Ekwugha and Ngozi Emmanuel
Abstract: Nigeria has a problem with fake drugs. This issue got to an intolerable height in 1989 when over 150 children died as a result of ingesting paracetamol syrup containing diethylene glycol. The National Agency for Food and Drug Administration and Control (NAFDAC) was formed in 1993, as an agency under the Nigerian federal ministry of health, to check the tide of fake drugs and adulterated products. To achieve this mission, NAFDAC, in 2010, launched the Mobile Authentication Service (MAS) – a mobile-phone mHealth platform, which empowers medication drug users to instantaneously verify the authenticity or otherwise of a medication drug before purchase. This study sought to ascertain the workability of MAS among medication drug users; and factors negating this platform. The study was designed as a survey. Data was collected from 400 medication drug users in Lagos state, Nigeria, through a structured survey. Results show that 91 percent of the respondents were aware of MAS and 53 percent among these utilized it prior to purchasing medication drugs, while 9 percent were neither aware of MAS nor utilize it. The notable barriers to the use of MAS found in this study were lack of awareness and the unreliable nature of the MAS.
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Paper Nr: 71
Title:

Heart Disease Diagnosis Using C4.5 Algorithms - A Case Study
Authors:

Ali Idri, Ilham Kadi and Halima Benjelloun
Abstract: Data mining (DM) is a powerful process to extract knowledge and discover new patterns embedded in large data sets. DM has been increasingly used in medicine, particularly in cardiology. In fact, data mining applications can greatly benefits all parts involved in cardiology such as patients, cardiologists and nurses. Among the various units of a cardiology department, Autonomic Nervous System (ANS) is one of the most important and active unit. Thus, the aim of this study is to build a decision tree-based classifier using a data set collected from an ANS unit of the Moroccan university hospital Avicenne. The decision tree construction algorithm used in this study is C4.5. The classifier obtained presented a high level of accuracy measured in terms of error rate.
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Paper Nr: 73
Title:

Supporting Multi-level User-driven Detection of Guideline Interactions
Authors:

Luca Piovesan, Gianpaolo Molino and Paolo Terenziani
Abstract: Clinical practice guidelines are widely used to support physicians, but only on individual pathologies. The treatment of patients affected by multiple diseases (comorbid patients) requires the development of new approaches, supporting physicians in the detection of interactions between guidelines. We propose a new methodology, supporting flexible and physician-driven search and detection. In particular, we provide a flexible and interactive mechanism to navigate guidelines and our ontology of interactions (between drugs, or between actions’ goals) at multiple levels of detail, focusing on specific parts of it (e.g., on a specific pair of actions, or of drugs) to look for interactions. We introduce the notion of “navigation tree”, as the basic data structure to support multiple-level interaction analysis, and describe navigation and focusing algorithms operating on it. We also introduce a visualization tool that is based on the “navigation tree”, and further enhances the user-friendliness of our approach.
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Paper Nr: 81
Title:

User-centred Design of the User Interface of a Collaborative Information System for Inter-municipal Dementia Team

Authors:

Berglind Smaradottir, Elisabeth Holen-Rabbersvik, Elin Thygesen, Rune Fensli and Santiago Martinez
Abstract: In the Norwegian Health sector there are currently undergoing changes at local, regional and national level triggered by recent health reforms. Municipalities are facing for first time the duty of implementing new primary health services. Inter-municipal coordination (IMC) health care teams have been created to operate across borders to share costs, extend geographical range of operation and optimise resources. This study focuses on the development and evaluation of the user interface (UI) functional prototype of a collaborative information system for IMC dementia team in Norway. Employing a user-centred design approach, the interface prototype was built based on the information gathered on two workshops where the end-users described their current clinical workflow of dementia assessment and how the UI would best fit into their daily work. The outcome of the workshops creatively informed the design of a working prototype that was qualitatively usability tested. Results showed that the UI effectively and efficiently supported the work of the IMC dementia team, with a sufficient level of satisfaction among the end-users. The resulting prototype established the foundation for the system implemented in the FP7 EU project United4Health.
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Paper Nr: 84
Title:

Matching Task and Technology Characteristics to Predict mHealth Tool Use and User Performance - A Study of Community Health Workers in the Kenyan Context
Authors:

Maradona Gatara and Jason Cohen
Abstract: Equipping Community Health Workers (CHWs) in resource-constrained settings with mobile-health or ‘mHealth’ tools has the potential to improve healthcare service delivery. mHealth tool functionality must however match CHW task needs before these tools are likely to have any significant impacts on CHW performance. This paper contributes by drawing on Task-Technology Fit theory to test the extent to which a match between CHW tasks and mHealth technology characteristics influences the performance of 201 CHWs using an mHealth tool in the counties of Siaya, Nandi, and Kilifi in Kenya. Results showed that the interaction of paired task and technology characteristics did not always impact mHealth tool use and user performance in the manner expected. When mHealth tool functions matched the task interdependence and information dependency needs of the CHWs then CHW performance increased but CHW performance decreased for some CHWs when mHealth functionality for time criticality and mobility was high. Moreover, while information dependency had an independent positive effect on mHealth tool use, CHWs came to depend less on the mHealth tool to support time criticality, interdependence, and mobility needs when functional support was high. These findings have implications for the design and deployment of mHealth tools.
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Paper Nr: 88
Title:

A 3-Staged Approach to Identifying Patients at Risk of Deterioration in Emergency Departments
Authors:

Thomas Schmidt and Uffe K. Wiil
Abstract: The variety in patient demographics and admission reasons makes it challenging for Emergency Department clinicians to notice deterioration in patients. Recent research has found that up to 20% of non-critical patients deteriorate within the first 24 hours after admission. Unnoticed patient deterioration can lead to serious adverse events in a clinical setting where patient monitoring relies solely on manual observations of monitors at infrequent intervals. In this paper, we present a novel 3-Stage Patient Deterioration Warning System as a model to mitigate the risk of undetected deterioration while improving clinical alarm fatigue. This staged approach enables the monitoring of patients in levels of increasing descriptiveness based on multiple models of normality. The model is validated via related work, clinical observations, and patterns of patient data collected at a Danish Emergency Department bedside ward. The paper concludes with a presentation of plans for future implementation work.
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Paper Nr: 102
Title:

Method of Screening the Health of Persons with High Risk for Potential Lifestyle-related Diseases using LDA - Toward a Better Screening Method for Persons with High Health Risks
Authors:

Keisuke Ogawa, Kazunori Matsumoto, Masayuki Hashimoto and Ryoichi Nagatomi
Abstract: Recently, the number of patients with lifestyle-related diseases, such as diabetes mellitus, has increased dramatically. Lifestyle-related diseases are responsible for 60% of deaths in Japan. In order to screen persons at potentially high risk for these diseases, medical checkups for metabolic syndrome are used throughout Japan. Prediction and prevention of lifestyle-related diseases would yield a direct reduction in medical costs. However, many cases cannot be screened with a metabolic syndrome checkup. In this paper, we propose a new machine-learning-based screening method using medical checkup data and medical billings. By processing the medical data into a bag-of-words representation and classifying the health factors using latent Dirichlet allocation (LDA), the screening method achieves high accuracy. We evaluate the method by comparing the accuracy of predictions of the future incidence of the diseases. The results show that F-measure increases 0.17 compared with the conventional method. In addition, we confirmed that the proposed method classified persons with different health risk factors, such as a combination of metabolic disorders, hypertensive disorders, and mental disorders (stress).
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Paper Nr: 107
Title:

An Architecture to Support Ultrasound Report Generation and Standardisation

Authors:

Nur Zareen Zulkarnain, Gillian Crofts and Farid Meziane
Abstract: Ultrasound reports are developed in different ways by clinicians and radiologists. These variations in reporting style, content and format could impact on the value of the report and the way it is interpreted, which in turn have implications on patient management and decision making. There are many reasons for the poor success rate of some reporting systems which is usually down to poor adaptability and the main one being the human factor. In this paper, we present a system architecture model for a proposed medical ultrasound reporting system that attempt to address some of these problems. In this system, we propose a solution where humans will not need to adapt to the system, instead the system acknowledge the various styles, contents and format being produced by the humans and uses an ontology to standardise the terminology and Natural Language Processing techniques to transform free text reports to the preferred proposed model of a structured and standardised report.
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Paper Nr: 112
Title:

Smarter Healthcare - Built on Informatics and Cybernetics
Authors:

Fred Maymir-Ducharme, Lee Angelelli and Prithvi Rao
Abstract: Applying advanced analytics to big data in healthcare offers insights that can improve quality of care. This paper focuses on the application of health informatics in care coordination, payment, wellness, and healthcare decision management. Cognitive computing and analytics can be used to capture and extract information from large volumes of disparate medical data. Applying natural language processing, probabilistic computing, and dynamic learning can achieve intelligent healthcare systems that users can interact with to drive business and medical insights across patient populations and result in greater patient safety, care quality, wellness, and improvements in payer programs. As is the case for most organizations with large and disparate data sets, the ability to manage information across the enterprise becomes extremely challenging as the size and complexity of the knowledge management infrastructure grows. Interconnecting healthcare systems and applying advanced cognitive analytics and health informatics would provide medical organizations, clinicians, and payers with the information they need to make the best treatment decision at the point of care. The authors address related research in the following areas: image analysis for anomaly detection; electronic healthcare advisors for clinical trial matching and oncology treatments options; advanced models and tools that can accelerate geo-spatial disease outbreak detection and reporting.
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Paper Nr: 115
Title:

On the Need for Federated Authorization in Cross-organizational e-Health Platforms
Authors:

Maarten Decat, Dimitri Van Landuyt, Bert Lagaisse and Wouter Joosen
Abstract: Health care is currently witnessing increased specialization as well as a need for integrated care delivery. As a result, care organizations should collaborate and in order to facilitate this, e-health collaboration platforms are being created. Access control is a primary concern for such cross-organizational platforms and efficient access control management is crucial to their adoption. Federated access control is a potential technique to achieve this and our experience in multiple research projects shows that federated authorization is an essential building block for future collaboration platforms. However, this technology still faces open research challenges. This paper wants to spark research on these challenges by motivating the need for federated authorization in the context of a real-world collaborative care platform. Based on this case study, we also discuss the state of the art and present a set of key requirements to realize wide-scale adoption of federated authorization in practice.
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Paper Nr: 121
Title:

Framework for Collection of Electrophysiology Data
Authors:

Petr Ježek, Roman Moucek, Jakub Krauz, Jaroslav Hošek, Yann Le Franc, Thomas Wachtler and Jan Grewe
Abstract: Experiments in electrophysiology produce a lot of unstructured metadata collected in electrophysiology databases. The data are usually accessed through a web interface implemented on the top of data model respecting given data format. A lot of experiments are conducted outside the laboratory where access to these databases is not always available. The usage of mobile devices such as tablets or smart phones seems to be a practical solution, but users would welcome the same structured user interface such as they know from a common computer. When user interfaces of electrophysiology databases are tailored to a unique data structure, they cannot be easily reused on a mobile device. As a solution, a mapping of a general data structure to a graphical template is proposed. This mapping is implemented in a framework that generates a template representing the database structure. The parsing process is driven by supplemented annotations added to the code. Next, an Android tool visualizing a graphical layout generated from the template is developed. A use case study is presented on a database of EEG/ERP experiments.
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Paper Nr: 122
Title:

Categorize, Cluster & Classify - The 3C Strategy Applied to Alzheimer's Disease as a Case Study
Authors:

Alexis Mitelpunkt, Tal Galili, Netta Shachar, Mira Marcus-Kalish and Yoav Benjamini
Abstract: Health informatics is facing many challenges these days, in analysing current medical data and especially hospital data towards understanding disease mechanisms, predicting the course of a disease or assist in targeting potential therapeutic options. Alongside the promises, many challenges emerge. Among the major ones we identify: current diagnosis criteria that are too vague to capture disease manifestation; the irrelevance of personalized medicine when only heterogeneous classes of patients are available, and how to properly process big data to avoid false claims. We offer a 3C strategy that starts from the medical knowledge, categorizing the available set of features into three types: the patients' assigned disease diagnosis, clinical measurements and potential biological markers, proceeds to an unsupervised learning process targeted to create new disease diagnosis classes, and finally, classifying the newly proposed diagnosis classes utilizing the potential biological markers. In order to allow the evaluation and comparison of different algorithmic components of the 3C strategy a simulation model was built and put to use. Our strategy, developed as part of the medical informatics work package at the EU Human Brain flagship Project strives to connect between potential biomarkers, and more homogeneous classes of disease manifestation that are expressed by meaningful features. We demonstrate this strategy using data from the Alzheimer's Disease Neuroimaging Initiative cohort (ADNI).
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Paper Nr: 123
Title:

Development of Web-based System for a Cohort Study - The Brazilian e-NutriHS
Authors:

Luciana D. Folchetti, Isis Tande da Silva, Bianca de Almeida Pititto and Sandra R. G. Ferreira
Abstract: This study describes a web-based system developed to gather online information on health of college students and graduates in nutrition, the e-NutriHS. The Nutrititionist Health Study – NutriHS is planned to be a cohort study aiming to collect health-related data at a 3-year interval. The e-NutriHS consists of 6 questionnaires regarding demographic and socioeconomic data, dietary habits, physical activity, alcohol and tobacco uses, anti-fat attitudes and personal and family histories. Validated and internationally recognized lifestyle instruments were used. Our software and respective database are hosted in the School of Public Health server; the software is based on free programming languages. e-NutriHS data obtained from questionnaires can be transferred to excel format. An e-NutriHS prototype was created preceding online attachment. An improved version of website was released based on 20 volunteers’ opinions. 503 users were already registered. Our initiative of building a website designed for collecting data for epidemiological studies, tailored to our local reality, is innovative under the perspective of the health informatics available in the developing world. Considering that web-based systems produce reliable data, are easy to use, less costly and less time-consuming, we conclude that our experience deserves to be shared, particularly with middleincome economy countries.
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Paper Nr: 126
Title:

Modelling Domain Knowledge of Speech and Language Therapy with an OWL Ontology and OpenEHR Archetypes

Authors:

Vladimir Robles-Bykbaev, José J. Pazos-Arias, Martín López-Nores, Jorge García-Duque and Juan Ochoa-Zambrano
Abstract: Researchers in the area of health informatics have made significant progress in the standardization of ICT tools to support the management, storage, retrieval and exchange of health-related data. However, the adoption of these advances is largely uneven across different areas. We present a comprehensive knowledge model for the realm of Speech and Language Therapy (SLT), based on an OWL ontology, normalized vocabularies and OpenEHR constructs. This model, validated by several collaborating institutions, is being used as the cornerstone to build a comprehensive framework with supporting tools for the different people involved in SLT, including therapists, patients and their relatives, and students.
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Paper Nr: 128
Title:

Evaluation of Threshold-based Fall Detection on Android Smartphones
Authors:

Tobias Gimpel, Simon Kiertscher, Alexander Lindemann, Bettina Schnor and Petra Vogel
Abstract: This paper evaluates threshold-based fall detection algorithms which use data from acceleration sensors that are part of the current smartphone technology. Different detection algorithms are published in the literature with different threshold values. This paper presents the evaluation of 5 different algorithms which are suited for Android smartphones. In contradiction to prior work, our experiments indicate that the Free Fall detection Phase is necessary for a low False Positive Rate. Further, we present an empirical evaluation of currently available fall detection apps in the Google Play store.
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Paper Nr: 129
Title:

Patient Empowerment as a Cognitive Process
Authors:

Eleni Kaldoudi and Nikos Makris
Abstract: The concept of patient empowerment has emerged as a new paradigm that can help improve medical outcomes while lowering costs of treatment by facilitating self-directed behavior change. Patient empowerment has gained even more popularity since the 1990’s, due to the emergent of eHealth and its focus on putting the patient in the centre of the interest. Current literature provides systematic reviews of the area, and shows that well defined areas (or dimensions) have eventually emerged in the field. In this paper we argue that patient empowerment should be treated formally as a cognitive process. We thus propose a cognitive model that consists of three major levels of increasing complexity and importance: awareness, engagement and control. We also describe the different constituents of each level and their implications for patient empowerment interventions, focusing on interventions based on information and communication technologies. Finally, we discuss the implications of this model for the design and evaluation of patient empowerment interventions.
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Paper Nr: 132
Title:

The Transparent Representation of Medical Decision Structures Based on the Example of Breast Cancer Treatment
Authors:

Dennis Andrzejewski, Laura Tetzlaff, Julien DeBoer, Eberhard Beck and Nicole Haeusler
Abstract: Choosing the appropriate treatment for patients have a direct influence on each patient`s future. A doctor´s expertise, the patient´s preferences, and the current medical research have a highly influence on the choice of the treatment. Doctors shall be aware of their own decision patterns, the most influenced factors and the relevant literature by choosing the optimal patients treatments. By considering quality management and certifications, transparent representations of internal processes with simple decision-making notes are required. In support of the hypothesis, a decision analysis was conducted based on the S3 guideline for diagnosis, treatment and follow up care of breast cancer. A notation is required, which combines the process modeling and the representation of (medical) decisions.
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Paper Nr: 133
Title:

An Automatic System for Helping Health Consumers to Understand Medical Texts

Authors:

Marco Alfano, Biagio Lenzitti, Giosuè Lo Bosco and Valerio Perticone
Abstract: Medical texts (reports, articles, etc.) are usually written by professionals (physicians, medical researchers, etc.) who use their own language and communication style. On the other hand, these texts are often read by health consumers (as in the case of medical reports) who do not have the same skills and vocabularies of the experts and can have difficulties in text comprehension. To help a health consumer in understanding a medical text, it would be desirable to have an automatic system that, given a text written with medical (technical) terms, translates them in simple or plain language and provides additional information with the same kind of language. We have designed such a system. It processes online medical documents and provides health consumers with the needed information for their understanding. To this end, we use a medical vocabulary for finding the technical terms in the medical texts, a consumer health vocabulary (CHV) for translating the technical terms into their consumer equivalents and a health-consumer dictionary for finding supplementary information on the terms. We have built a prototype that processes Italian medical reports and uses infobuttons next to the technical terms for allowing easy retrieval of the desired information.
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Paper Nr: 134
Title:

Coexistence of Wireless Systems for Remote Monitoring of Vital Functions in the Unlicensed ISM Band
Authors:

Aleksandra Rashkovska, Roman Trobec and Mihael Mohorčič
Abstract: A recent trend in medical practice is the use of wearable wireless body sensors (WBS) to improve mobility of patients and medical personnel during surgery and other procedures, accelerate patients’ recovery, and facilitate remote monitoring of patients suffering from chronic diseases. Currently, Wireless Body Area Networks (WBANs) are being introduced in already crowded unlicensed frequency bands, such as the ISM band. This essentially leads to high interference with other electronic devices, low signal-to-noise ratio and links with high bit-error rate. This paper discusses the requirements, benefits and issues related to a WBS in a medical WBAN system for remote health monitoring, operating in the shared ISM frequency band. We investigate the applicability of the concepts of cognitive communications in such environment to enhance the coexistence, robustness, scalability, and utility of medical WBAN systems in heterogeneous wireless networks environment.
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Paper Nr: 135
Title:

Fundus Imaging Based Affordable Eye Care
Authors:

Kolin Paul and Vijay Kumar
Abstract: India is a developing country. It has a very low doctor to patient ratio and hence affordabe healthcare has always been a matter of concern. The high cost of diagnostic devices and unskilled or limited skilled clinicians exacerbate this problem. The treatment of visually impaired patients is a daunting task in India as it requires periodic examination of eyesight. Devices meant for this check up are expensive and often require high degree of expertise to operate. In this paper we propose a low-cost, lightweight, handheld, android phone based fundus imaging device. The application software makes it user-friendly and also can also provide a limited automatic screening capability of some retinal problems. In this paper, we report the use of this device for screening of patients for Glaucoma. The paper presents empirical results using patient data from hospitals. The results indicate that such a device can effectively scale the operations of screening of many eye related problems in under served areas.
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Paper Nr: 140
Title:

Robots Humanize Care - Moral Concerns Versus Witnessed Benefits for the Elderly
Authors:

Margo van Kemenade, Elly A. Konijn and Johan Hoorn
Abstract: Ageing in Europe comes more rapidly than many realize: In about 10 years, one fifth of the population will be 65+ with a further increase of 70% in the next 25 years. At the same time, healthcare is under extreme pressure due to budget cuts, limited resources and personnel together with increased demands. Robots may fulfill important tasks in this respect. Our research focuses on social robots to support tasks requiring interpersonal communication. Many moral concerns and objections are raised, however, in particular among care professionals. To examine the issue, we report on 1) a qualitative study among professional caregivers and 2) a documentary portraying healthy elderly meeting with Hanson’s Robokind “Alice”. Alice is under development in our lab, supplying her with abilities for emotional responses. The results show that the moral concerns are not in line with the benefits that the social robots appear to have for the lonely elderly. Our conclusion posits that new robot technology may not dehumanize care but rather may bring humanness back into professional health care.
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Paper Nr: 143
Title:

On the Validation of Computerised Lung Auscultation
Authors:

Guilherme Campos and João Quintas
Abstract: The development of computerised diagnosis tools based on lung auscultation necessitates appropriate validation. So far, this work front has received insufficient attention from researchers; validation studies found in the literature are largely flawed. We believe that building open-access crowd-sourced information systems based on large-scale repositories of respiratory sound files is an essential task and should be urgently addressed. Most diagnosis tools are based on automatic adventitious lung sound (ALS) detection algorithms. The gold standards required to assess their performance can only be obtained by human expert annotation of a statistically significant set of respiratory sound files; given the inevitable subjectivity of the process, statistical agreement criteria must be applied to multiple independent annotations obtained for each file. For these reasons, the information systems we propose should provide simple, efficient annotation tools; facilitate the formation of credible annotation panels; apply appropriate agreement criteria and metrics to generate goldstandard ALS annotation files and, based on them, allow easy quantitative assessment of detection algorithm performance.
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Paper Nr: 144
Title:

Tool Facilitating Construction of Ontologies on the KIM Platform
Authors:

Roman Mouček, Jan Smitka and Petr Ježek
Abstract: During research based on experimental work vast amounts of data and associated metadata are usually produced. This is also the case of experimental work using the techniques of electroencephalography and event related potentials. The collected data and associated metadata have to be stored, analyzed, and eventually shared among research groups. Beside storing data and metadata from experiments, it is often beneficial to collect additional information from other sources related to the kind of experiment performed. These information sources are mostly scientific and technical publications, manuals describing the used infrastructure, and topical discussions appearing on the web. This article deals deals with selection and use of a semantic repository for such information sources. Development of a simple prototype ontology is shortly presented and a tool that facilitates construction of ontologies on the KIM platform is described. Sets of test documents are used to verify the functionality of the tool.
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Paper Nr: 13
Title:

COPD and Urban Air Pollution - GIS Based Spatial Pattern and the Geostatistical Analysis of Izmir
Authors:

Cigdem Tarhan and Nur Sinem Ozcan
Abstract: In Turkey, starting from the 1950’s air pollution has been increasing because of rapid population increase, rapid urbanization and industrialization. These cause intense energy usage in settlement areas and this brings some problems in environmental health. The aim of the study is the examination of whether there is any statistical relationship between the level of air pollution with the number of COPD cases and incidence between 2006 and 2010 in Izmir City Center. The study area has six districts of Izmir City Center: Konak, Bornova, Buca, Karsiyaka, Cigli and Balcova. There are in total 89,776 COPD cases between 2006 and 2010. The spatial pattern of these cases is mapped via the GIS environment. Then, multivariate linear regression analysis is performed in the study. Additionally, the questionnaire was realized with 25 COPD inpatients in Dr.S.Seren Chest Diseases Hospital in Izmir in March - April 2014. The results show that there is a significant and positive relationship between the level of air pollution (PM and SO2) and the number of COPD cases and incidence. In general, the increasing of the level of air pollutant and population cause an increase in the number of COPD cases and incidence. It is observed that the level of air quality in Karsiyaka, Bornova and Konak districts is lower than and incidence rates are higher than the other case districts. According to questionnaire results, there is a significant relationship between the inpatients’ age and their period of smoking. Also, there are significant relationships among the diagnosis, sex, job, risk factor, genetic predisposition, smoking habits, environment lived in and heating preferences.
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Paper Nr: 17
Title:

A Study about Discovery of Critical Food Consumption Patterns Linked with Lifestyle Diseases using Data Mining Methods
Authors:

Farshideh Einsele, Leila Sadeghi, Rolf Ingold and Helena Jenzer
Abstract: Background: To date, the analysis of the implications of dietary patterns on lifestyle diseases is based on data coming either from clinical studies or food surveys, both comprised of a limited number of participants. This article demonstrates that linking big data from a grocery store sales database with demographical and health data by using data mining tools such as classification and association rules is a powerful way to determine if a specific population subgroup is at particular risk for developing a lifestyle disease based on its food consumption patterns. Objective: The objective of the study was to link big data from grocery store sales with demographic and health data to discover critical food consumption patterns linked with lifestyle diseases known to be strongly tied with food consumption. Design: Food consumption databases from a publicly available grocery store database dating from 1997–1998 were gathered along with corresponding demographics and health data from the U. S. west coast, pre-processed, cleaned and finally integrated to a unique database. Results: This study applied data mining techniques such as classification and association mining analysis. Firstly, the studied population was classified according to the demographical information “ age groups” and “race” and data for lifestyle diseases were correspondingly attributed. Secondly, association mining analysis was used to incorporate rules about food consumption and lifestyle diseases. A set of promising preliminary rules and their corresponding interpretation was generated and reported in the present paper. Conclusions: Association mining rules were successfully used to describe and predict rules linking food consumption patterns with lifestyle diseases. In the selected grocery store database, information about interesting aspects of the grocery store customers were found such as marital status, educational background, profession and number of children at home. An in-depth research on these attributes is needed to further expand the present demographical database. Since the search on the internet for demographical attributes back to the year of 2000 corresponding to the studied population subgroup was extremely laborious, the selected demographical attributes to prove the feasibility of the study were limited to age groups and race.
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Paper Nr: 23
Title:

Automatic Segmentation Methodology for Dermatological Images Acquired via Mobile Devices
Authors:

Luís Rosado and Maria Vasconcelos
Abstract: Nowadays, skin cancer is considered one of the most common malignancies in the Caucasian population, thus it is crucial to develop methodologies to prevent it. Because of that, Mobile Teledermatology (MT) is thriving, allowing patients to adopt an active role in their health status while facilitating doctors to early diagnose skin cancers. Skin lesion segmentation is one of the most important and difficult task in computerized image analysis process, and so far the attention is mainly turned to dermoscopic images. In order to turn MT more accurate, it is therefore fundamental to develop simple segmentation methodologies specifically designed for macroscopic images or images acquired via smartphones, which is the main focus of this work. The proposed method was applied in 80 images acquired via smartphones and promising results have been achieved: a mean Jaccard index of 81%, mean True Detection Rate of 96% and mean Accuracy around 98%. The major goal of this work is to develop a mobile application easily accessible for the general population, with the aim of raise awareness and help both patients and doctors in the early diagnosis of skin cancers.
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Paper Nr: 25
Title:

A New Risk Chart for Acute Myocardial Infarction by a Innovative Algoritm
Authors:

Federico Licastro, Manuela Ianni, Roberto Ferrari, Gianluca Campo, Massimo Buscema, Enzo Grossi and Elisa Porcellini
Abstract: Acute myocardial infarction (AMI) is complex disease; its pathogenesis is not completely understood and several variables are involved in the disease.. The aim of this paper was to assess: 1) the predictive capacity of Artificial Neural Networks (ANNs) in consistently distinguishing the two different conditions (AMI or control). 2) the identification of those variables with the maximal relevance for AMI. Genetic variances in inflammatory genes and clinical and classical risk factors in 149 AMI patients and 72 controls were investigated. From the data base of this case/control study 36 variables were selected. TWIST system, an evolutionary algorithm able to remove redundant and noisy information from complex data sets, selected 18 variables. Fitness, sensitivity, specificity, overall accuracy of the association of these variables with AMI risk were investigated. Our findings showed that ANNs are useful in distinguishing risk factors selectively associated with the disease. Finally, the new variable cluster, including classical and genetic risk factors, generated a new risk chart able to discriminate AMI from controls with an accuracy of 90%. This approach may be used to assess individual AMI risk in unaffected subjects with increased risk of the disease such as first relative with positive parental history of AMI.
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Paper Nr: 34
Title:

Calculation of Jump Flight Time using a Mobile Device
Authors:

Ivan Miguel Pires, Nuno M. Garcia and Maria Cristina Canavarro Teixeira
Abstract: This paper describes the research and implementation and validation method of a smartphone application that calculates a vertical jump flight time, using the data collected from the accelerometry sensors in a smartphone. To validate the algorithm results, a statistical number of experiments were performed. While recording the experimental data with a commodity smartphone, a bioPlux Research device equipped with a pressure sensor and with a tri-axial accelerometer was also used to estimate the time the user was airborne while jumping, as a golden standard. The pressure sensor was placed in a jump platform built in the laboratory, and a tri-axial accelerometer was placed on the user’s waist. The data collected by this device were compared with data obtained by smartphone in order to validate the algorithm and make the necessary corrections. The research data and the developed application are available for download and further research in a free and public repository.
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Paper Nr: 40
Title:

Knowledge Process Models in Health Care Organisations - Ideal-typical Examples from the Field
Authors:

Lars Rölker-Denker and Andreas Hein
Abstract: This paper summarizes the recent work of analysing knowledge process in health care organisations with a special focus on the geriatric disciplines. A study has been performed consisting of observations in the field and interviews with the professionals. It is shown that knowledge processes have evolved over the past years. New knowledge processes are introduced and modelled by using a combined method (3LGM2 and KMDL®). An outlook is given on measuring the dissemination of knowledge through the identified processes in ongoing work.
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Paper Nr: 48
Title:

Maintaining the Consistency of Electronic Health Record’s Medication List
Authors:

Juha Puustjärvi and Leena Puustjärvi
Abstract: An electronic health record (EHR) is a systematic collection of health information about an individual patient. It includes a variety of types of observations entered over time by health care professionals, recording observations and administrations of drugs and therapies, orders for the administration of drugs and therapies, and test results. A well known problem is the consistency of EHR’s medication list: often some of the prescribed drugs are missing, or some information is no more valid, e.g., some prescribed drugs may be replaced by new drugs, or the dosage may be changed. In this paper we have focused on this problem. We have restricted on EHRs and on prescriptions that are applications of the HL7 Reference Information Model (RIM). Further, we have used the Refined Message Information Model (RMIM) to specify the components that are extracted from prescriptions and transmitted into EHR. We have also specified the criteria for medication list’s consistency, and the way it can be maintained. In addition, we have studied the ways the RIM can be used in linking patient’s prescriptions among themselves such that the name of the link indicates its semantics. By viewing patient’s prescriptions as a linked data structure we can improve the effectiveness of prescriptions’ retrieval as well as provide expressive queries on patient’s health documentation.
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Paper Nr: 63
Title:

Detection of Drug Administration Behavior with Swallowing Sounds
Authors:

Xiaolin Sang, Shin'ichi Warisawa, Hao Zhang, Katsumi Abe, Masahiro Kubo, Kenichiro Tsuda and Ichiro Yamada
Abstract: In recent years, chronic diseases have become the main causes of death around the world, and medication non-adherence among patients with chronic diseases is a common problem. A system for detecting drug administration behavior in daily life is strongly required. Currently, there is not a system for detecting this behavior by using wearable sensors. In this paper, we propose a wearable sensing method for detecting drug administration behavior in daily life by using swallowing sound, which is available and suitable for daily monitoring. To recognize the behavior from swallowing activities, a classification methodology using wavelet based features as feature vectors and artificial neural network as classifier is proposed. A high classification accuracy of 85.4% was achieved in classifying two swallowing activities of drinking water and taking a capsule with water. Furthermore, we also propose a compensation method for time-dependent change based on the frequency characteristics of swallowing sound.
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Paper Nr: 70
Title:

An Observational Study to Improve the Surgical Safety Checklist Viability
Authors:

Vanessa Estima, Ana Castro, Pedro Gomes, Victor Nunes and Daniel Pereira
Abstract: To improve safety, and to reduce the mortality and complication rates during surgeries, the World Health Organization developed the Surgical Safety Checklist (SSC). The SSC has been recently implemented in Portuguese hospitals and we have performed an observational study where several health professionals were observed during their normal surgical routine and interviewed. The objective of this study was to understand the current use of the SSC, and how it may be improved in terms of usability, taking advantage of current technological advancements. During two days, in a public health center in Portugal, a clinical team (surgeons, anesthesiologists and nurses) was observed in 14 surgeries. Some observations disclose that several health professionals are not familiarized with the SSC guidelines, which demonstrates that it is urgent to change the mindset of health professionals, and that the addition of some features in the SSC may be necessary. With the results of the observational study, we have designed and developed a web application for the SSC with new functionalities to improve and aid the health professionals in its use.
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Paper Nr: 72
Title:

Applying ISO/IEC 25010 on Mobile Personal Health Records
Authors:

Sofia Ouhbi, Ali Idri, José Luis Fernández-Alemán, Ambrosio Toval and Halima Benjelloun
Abstract: Software product quality requirements reflect the stockholders’ needs in terms of quality. They play a central role in the success of the system and the software product quality. This paper lists mobile personal health record (mPHR) requirements extracted from literature and identifies the requirements which should be included in the mPHR quality evaluation. Moreover, the ISO/IEC 25010 software product quality model is used to present a checklist with which to calculate the influence of the mPHR requirements on software product quality. Furthermore, the degrees of influence of mPHR requirements on software product quality are calculated and analyzed. A set of recommendations for mPHRs developers and stakeholders is provided.
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Paper Nr: 74
Title:

Visualization of Passively Extracted HL7 Production Metrics
Authors:

Ricardo Ferreira, Manuel Eduardo Correia, Francisco Rocha-Gonçalves and Ricardo Cruz-Correia
Abstract: The improvements made to healthcare IT systems made over the past years led to the creation of a multitude of different applications essential to the institutions daily operations. Aim: We aim to create and install a system capable of displaying production metrics for healthcare management with little requirements, efforts and software providers involved. Methods: We propose a system capable of displaying production metrics for healthcare facilities, by extracting HL7 messages and other eHealth relevant protocols directly from the institution´s network infrastructure. Our system is then able to populate a knowledge database with meaningful information derived from the gathered data. Results: Our system is currently being tested on a large healthcare facility where it extracts and analyses a daily average of 44,000 HL7 messages. The system is currently capable of inferring and displaying the daily distribution of healthcare related activities such as laboratory orders or even relevant billing information. Conclusion: HL7 messages moving over the network contain valuable information that can then be used to assess many relevant production metrics for the entire facility and from otherwise non-interoperable production systems that, in most cases, can only be seen as black boxes by other system integrators.
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Paper Nr: 75
Title:

Incremental Learning Versus Batch Learning for Classification of User’s Behaviour in Medical Imaging
Authors:

Carlos Viana-Ferreira, Sérgio Matos and Carlos Costa
Abstract: Communication latency still hinders the adoption of Cloud computing paradigms in medical imaging environments where it could serve as a reliable technology to support repository outsourcing solutions or inter-institutional workflows, for instance. One way to overcome this is by implementing cache repositories and prefetching mechanisms. Nevertheless, such solutions are usually based on static rules that may inefficiently manage the cache storage capacity. For that reason, this paper compares a pattern recognition system using incremental learning versus batch learning, in order to assess which one could be more appropriately used in a medical imaging cache mechanism.
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Paper Nr: 77
Title:

Modulation of Existent Obstetrics EHRs to the openEHR Specification
Authors:

João Carlos Menezes de Magalhães and Ricardo João Cruz Correia
Abstract: Objective: Create templates in OpenEHR through the modulation of existing electronic health records defined in OpenObsCare platform. Materials and Methods: Apply a 4 step process: select data fields already existent in OpenObscare; search both in openEHR and NEHTA clinical knowledge manager (CKM) for the archetypes that contain these data fields; create new archetypes when a data field doesn’t have an existent one in both CKM’s; develop templates from all the information gathered in the previous steps. Results: Development of 6 templates available online via http://joaomagalhaes.me/admission\_templates and 1 archetype (openEHR-EHR-CLUSTER.exam-vagina.v1). Discussion: The process of modulation from existent EHR to the openEHR was possible since the standardization of clinical concepts allowed the re-utilization of a lot of already existent archetypes. This speeds up the development process by defining earlier the domain knowledge necessary for the HIS. Some hurdles faced in the process were due to the necessity of translation of all the archetypes to use at a national level and also due to the lack of national wide accepted terminologies. As this process is eased by the robustness of existent archetypes, the creation of default obstetric templates validated by a special commission, would probably be advantageous since the interoperability and semantics standardization would allow effective transmission of information between all the health care agents. Conclusion: The modulation of admission data existent in the HIS OpenObsCare to openEHR was easier than the ”traditional” way of doing it which is by specifying requirements. This is due to the fact that a lot of the existent archetypes are already robust enough and the number of them is enough to represent several clinical concepts contained in the created templates.
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Paper Nr: 85
Title:

Medical Device Software Process Improvement - A Perspective from a Medical Device Company
Authors:

Marie Travers and Ita Richardson
Abstract: When manufacturing medical devices there are many constraints that have to be taken into account such as safety, compliance with regulations and traceability. To do this, well-defined processes are used. With this in mind we examine how process improvement is implemented in a medical device company while managing the resultant change. The case study presented in this paper investigates the use of Kotter’s Change Model to support the implementation of process improvement in a medical device company. The results of the case study demonstrate that Kotter’s change model was an appropriate model to use. The sense of urgency Kotter stipulates was inherent in the company. The team was aware that change was needed. A flaw in Kotter’s approach is that there is no recommendation for a pilot project. Having a pilot project worked well for this company as it helped to eliminate stress and anxiety. A further case study is planned in the company to observe how the process is working after implementation of the full project.
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Paper Nr: 89
Title:

Study on E-Health Utilization among Nigerian University Undergraduate Students
Authors:

Ngozi Marion Emmanuel, Ogochukwu Charity Ekwenchi and Allen Nnanwuba Adum
Abstract: E-health is a relatively new area in healthcare delivery largely supported by electronic processes and communication. The increasing need to better inform people about health practices and actions has been fingered to be the primary reason for the rise of e-health communication as a means of introducing ideas and information on better health practices and safer solutions to health issues. Driven on the wheels of new media technologies like the internet, it is arguably a way of getting health information without stress and almost without cost. This paper, conducted as a study, focuses on Nigerian University undergraduate students and the extent they utilize e-health resources and subsequently take appropriate health actions. It also explores how useful e-health has been in improving undergraduate students’ health practices in Nigeria. One of the major questions posed in this study is whether Nigerian University undergraduate students are knowledgeable about e-health and as such are they exposed to e-health resources? The paper employed the survey research design where 400 respondents were studied across two Universities in South-East Nigeria. Findings revealed that about 60% of Nigerian undergraduate students rely on e-health to take proactive health actions.
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Paper Nr: 93
Title:

The Analysis of Relationship between Diabetes and Cancer from 2006-2013 Hospital Inpatients
Authors:

Shumei Miao, Xiaoping Zhou, Xin Zhang, Hongwei Shan, Xinyi Huang, Yixin Zhu, Kai Leng, Zhongmin Wang, Jianqiu Kou and Yun Liu
Abstract: Diabetes and cancer have become two major chronic diseases concerning human health. More and more studies indicate that diabetes can increase the risk of cancer and affect the prognosis of cancer patients. In this paper, the information technology tools and statistical knowledge are used to analyse the clinical data of hospital inpatients from year 2006 to year 2013, and explore the relationship between diabetes and cancer. This paper analyses statistical characteristics and reasoning of suffering diabetes and cancer, makes preliminary research on clinical big-data, and provides statistical basis for clinical researchers, thus helps to enhance the level of diagnosis and treatment of disease and improve public health.
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Paper Nr: 94
Title:

Identifying Risk Prone Hip Prostheses based on Predicate Ancestry
Authors:

W. Melo, P. Mork, D. Simonson and J. Stanford
Abstract: Our research hypothesis is that we can build a risk model based on the predicate ancestor trees of medical devices approved via the 510(k) process. To validate this research hypothesis, we have analysed the hip implants approved from 1994 to 2004. Hip implants have been selected for analysis since Food Drug Administration (FDA) and the medical community has raised several issues regarding the hip implants approved via the 510(k) process. We have been able to validate our research hypothesis and built a risk model that yield an accuracy of 71% using two data sets: one for training and another one for validation. This risk model indicated that the medical device generation, which is calculated based on the device predicate ancestry tree, can be used for risk identification purposes, where risk was defined as the probability to have a Medical Device Report (MDR).
Paper Nr: 98
Title:

Pervasive Health and Regulatory Frameworks
Authors:

Alexandra Queirós, Anabela Silva, Hilma Caravau, Alina Ferreira, Margarida Cerqueira, Joaquim Alvarelhão, Milton Santos and Nelson Pacheco Rocha
Abstract: Pervasive health deals with the application of pervasive computing for health and wellness management and its developments should be subject of regulatory oversight. The paper presents a general overview of pervasive health concepts and applications, and aims to verify the level of conformity of current developments with existing regulatory frameworks.
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Paper Nr: 108
Title:

Usability Improvements to Electronic Health Records - Finding Realistic Paths to Success
Authors:

Rebecca A. Meehan
Abstract: There is a need to develop more effective strategies for improving usability within information and communication technologies, specifically, electronic health record (EHR) systems. Usability incorporates the ease of use, learnability, efficiency, effectiveness and satisfaction of a system by the end user. When an EHR incorporates principles of usability, the system does a better job of meeting the needs of the end users intuitively, resulting in fewer errors and better quality outcomes for patients. Health systems and governments have been urging the widespread adoption of EHR systems to help lower costs and increase efficiency, putting themselves and vendors under pressure to develop and implement the best solution quickly. Too often stakeholders rely on future releases and enhancements to fix issues not originally planned for in the initial release of the product. Hospital system end users and vendors need better strategies for improving usability in EHR solutions. Poor usability can result in frustrated end-users, inefficient and more costly processes, and, at worst, compromises to patient safety. Proposed strategies and areas for future development are discussed.
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Paper Nr: 111
Title:

Design of a Mobile Application for Eye Signs Screening
Authors:

A. R. Silva, P. Gomes, D. Pereira, S. Guimarães and A. Castro
Abstract: Advances in technology make mobile phones very attractive to everyone, specially smartphones, with a large number of applications. In this paper we describe the necessary features of a mobile application for eye signs screening, describing some of the ocular pathologies that can be detected with a photograph using a smartphone, and the data collection protocol necessary to obtain this data and later process it. A first version of the developed application and some results are also presented. This application is simple to use, since the main target are the parents, who can use it at home as a tool to trace the visual health of their children, given that an ophthalmologist follow-up is scarce or nonexistent in many places.
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Paper Nr: 114
Title:

Classification of the Heart Auscultation Signals
Authors:

Primož Kocuvan and Drago Torkar
Abstract: Listening to the internal body sounds (auscultation) is one of the oldest techniques in medicine to diagnose heart and lung diseases. The digital heart auscultation signals are obtained with digital electronic stethoscope and can be processed automatically to obtain some coarse indications about the heart or lung condition. There are many ways of how to process the auscultation signals and quite some were published in the last years. In this paper we present one possible set of methods to reach the goal of heart murmur recognition up to the level to distinguish between the pathological murmurs from the physiological ones. The special attention was devoted to signal feature selection and extraction where we used the distribution of signal power over frequencies as the key difference between the normal and the pathological murmurs. The whole procedure including the signal processing, the feature extraction and the comparison of four machine learning classification methods is adequately described. It was tested on a balanced and on an unbalanced dataset with the best achieved classification accuracy of 87.5%.
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Paper Nr: 119
Title:

Design of a Remote Treatment Monitoring and Seizure Warning System Framework for Epilepsy Patients
Authors:

C. L. Martínez-González, J. Mendizabal Navarro and N. I. Plascencia Álvarez
Abstract: Personal health care technologies in chronic diseases face the challenge to design holistic approaches where health care involves not only the medical specialist for treatment and monitoring, but the patient and the family. Epilepsy is a term used for a group of chronic disorders with diverse etiology characterized by recurrent seizures, caused by an abnormal electrical activity in the brain. Treatment monitoring requires continuous collaboration of the patient and the family to register manually a diary of activities, seizures, seizures triggers and symptoms associated to medication in order to reach optimal therapy. Patients with non-controlled seizures and their families have to deal with a restricted quality of life: the patient is exposed to physical risks when seizures appear under any circumstance and place. In this paper a remote patient treatment monitoring and warning system framework design based on mobile technology is proposed, with multiple input, seizure detection with a smartphone accelerometer, automatic and manual seizure warning and location of the patient through GPS and a social support network. This design approach is patient-and family-centred, as they are the source of individual information in a particular environment, condition and treatment response. It also represents a first proposal of a potential ubiquitous health care system through a wearable device.
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Paper Nr: 120
Title:

Remote Mobile Patient Monitoring using Diffuse Optical Transmissions
Authors:

Pascal Toumieux, Stéphanie Sahuguede and Anne Julien-Vergonjanne
Abstract: In the context of remote patient monitoring, we propose in this paper a radio free solution based system to transmit health related data. We investigate wireless optical technology based on diffuse infrared links, which presents the advantage to be secure regarding electromagnetic interference, low-cost and easy to deploy. Two different monitoring scenarios are considered, both composed of an emitter worn by a mobile patient and receivers fixed in the environment. The first scenario is the continuous remote monitoring of heart rate and temperature and the second one involves accelerometer data. To evaluate the wireless mobile link reliability for the two scenarios, we have developed custom made systems using commercially available components. The experimental performance is established in terms of packet loss to evaluate the potentiality of wireless optical technology.
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Paper Nr: 125
Title:

Exposome, Health and Biomedical Informatics - An Emerging Discipline and Its Interaction with Current Biomedical Informatics
Authors:

Guillermo Lopez-Campos, Riccardo Bellazzi and Fernando Martin-Sanchez
Abstract: In the last decade we have witnessed the raising of the exposome (the set of a life-long individual exposures) as an increasingly interesting area and discipline due to its relationship with health. These new approaches rely heavily in the use of different informatics related methods and are generating new data types that in the future should be handled by biomedical informatics. This position paper refers to some of the challenges that are related with these new approaches from a biomedical informatics perspective, describing the interactions with related disciplines such as bioinformatics, public health informatics and others. We discuss as well the role of the exposome in bringing new data types that might be handled by biomedical informatics in the context of Big and small data generated in this approaches and its relationship with the participatory medicine and how they could influence future health information systems. Finally, we consider that the current situation of the exposome resembles the early years of genomics, when it was clear that genomic information had a great potential for health and drove a discussion about how to better integrate and analyse the most relevant pieces of information for health purposes.
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Paper Nr: 127
Title:

Study on Synchronization of Brain Waves and Injection Technology
Authors:

Naohisa Kishida, Atsushi Ishigame and Yukie Majima
Abstract: In recent years, the inheritance to the next generation the skills and know-how which the skilled technician has have become problems. In this paper, we focused the inheritance of technology that nurse injected into the patient among that problems. Compared to rookie nurses, it is often said that a skilled nurse’s injection is less degree of pain. It is thought that the reason is that a skilled nurse make a patient relaxed state and reduces the pain of injection. In order to relax the patient state, the authors believe that nurses make themselves relaxed and synchronize their states to the patients. In this paper, we stated the relationship between synchronous and relaxed state in between nurse-patient. In particular, we paid attention to the alpha waves of brain waves to evaluate the state of relaxation, and discussed synchronization of brain waves.
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Paper Nr: 130
Title:

Archetypes Development in Electrophysiology Domain - Electroencephalography as a Personal EHR System Module
Authors:

Václav Papež and Roman Mouček
Abstract: The work presents the concept of a new personal electronic health record (EHR) system. The system is based on openEHR standards/framework. A fundamental part of openEHR is domain description by two layer modelling - reference data models and archetypes. Archetypes are building blocks of the EHR system, which provide structure and semantics for stored data. As common ontologies and terminologies, even archetypes are based on reusability. Although the public archetype repositories (clinical knowledge managers, CKM) contain hundreds of archetypes from various domains, the electrophysiology domain is not described yet. The work is focused on the development of the archetypes dealing with the electroencephalography domain.
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Paper Nr: 139
Title:

Clinical Processes and Its Data, What Can We Do with Them?
Authors:

Eric Rojas, Michael Arias and Marcos Sepúlveda
Abstract: Global healthcare services have evolved over time, and nowadays they are expected to follow high-quality optimized standards. Analyzing healthcare processes has become a relevant field of study, and different techniques and tools have been developed to promote improvements in the efficiency and effectiveness of these processes. There is a research field called process mining that can be used to extract knowledge from the event data stored in the hospital information systems. With the help of this, it is possible to discover the real executed process, examine its performance and analyze the resource interaction during its execution. The goal of this article is to provide a bibliographic survey about the use of process mining algorithms, techniques, and tools in the analysis of healthcare processes, providing a general overview about the main approaches previously used and the information required to apply them in the medical field. We provide important insights about data, algorithms, techniques and methodologies that are required to help answer medical expert questions about their processes, motivating and inspiring a broader usage. So, if we have the information and it is possible to analyze and understand the healthcare processes, why are we not doing it?
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