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摘要:Securing large amounts of electronic medical records stored in different forms and in many locations, while making availability to authorized users is considered as a great challenge. Maintaining protection and privacy of personal information is a strong motivation in the development of security policies. It is critical for health care organizations to access, analyze, and ensure security policies to meet the challenge and to develop the necessary policies to ensure the security of medical information. The problem, then, is how we can maintain the availability of the electronic medical records and at the same time maintain the privacy of patients' information. This paper will propose a novel architecture model for the Electronic Medical Record (EMR), in which useful statistical medical records will be available to the interested parties while maintaining the privacy of patients' information....
摘要: style="text-align:justify;"> style="line-height:2;font-family:Verdana;">Telestroke is an integral platform for physicians to provide accurate diagnosis and treatment to patients with a possible stroke in remote locations. We evaluated the performance of two iPad applications, Clear Sea and Cisco Jabber for potential usability in telestroke. We conducted a single blind study wherein 15 volunteers underwent 4 separate assessments using abbreviated versions of the National Institutes of Health on-site and off-site, each using Cisco Jabber and Clear Sea. Both volunteer and investigator surveys were collected. Perceptions and usability of each application were measured by grading each variable on a score of 1 - 5 on the Likert scale. The Cisco Jabber mean (±SD) total score was 4.15 ± 0.78 versus 3.88 ± 0.82 for Clear Sea (P = 0.18) indicating 91% probability that Jabber was superior to Clear Sea. A sample of 60 volunteers would have 80% power. The maximum difference was noted in image quality, where Cisco Jabber scored 3.93 ± 0.82 and Clear Sea scored 3.60 ± 0.78 (P = 0.13). Since the directionality of the experiment was not predetermined, a two-tailed pared t-test was used to arrive at a conclusion. With the statistical results shown above we concluded that there was a modest preference for Cisco Jabber over Clear Sea, but a larger trial with stroke patients was still warranted.
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摘要: class="MsoNormal" style="text-align:justify;"> lang="EN-US" style="font-family:Verdana;">In order to reduce the effort in the integration and actualization of heterogeneous healthcare legacy systems that should share a common database, we propose the creation of an lang="EN-US"> lang="EN-US" style="font-family:Verdana;">interoperability bus using the HL7 standard—the HL7Middleware. This interoperability bus is an intermediate layer responsible for the communication between a database, health information systems and medical equipment, called HL7Server. Connected systems use the HL7 messaging semantics to store and retrieve data from the database. We validate our approach with respect lang="EN-US" style="font-family:Verdana;">to lang="EN-US"> style="font-family:Verdana;">two different criteria: performance and integration costs. Benchmark tests were executed with and without the use of HL7Middleware and with different network bandwidths. These results demonstrated that the performance of the interoperability bus is higher when compared to traditional database access for larger volumes of data and when the bandwidth of the user is considerably lower than the bandwidth of th style="font-family:Verdana;">e connection between HL7Server and database. style="font-family:Verdana;">The overall development and deployment cost lang="EN-US" style="font-family:Verdana;">was lang="EN-US" style="font-family:Verdana;"> considered low lang="EN-US"> lang="EN-US" style="font-family:Verdana;">and the reusability degree of wrapper code was considered high, thus suggesting a progressive reduction of the integration costs of additional services and subsystems of an organization. lang="EN-US">

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摘要: style="font-family:Verdana;color:black;font-size:10pt;">Physical activity is critical to improve the condition of patients with chronic leg and foot ulcers, especially those who are obese and experienced multiple co-morbid conditions. Unfortunately, these individuals are unable to engage in guideline based physical activity (PA) programs. A prototype of Bluetooth style="font-family:Verdana;color:black;font-size:6.5pt;">TM style="font-family:Verdana;color:black;font-size:10pt;">enabled acceleration tracking (BEAT) mHealth system was developed and manufactured for remote monitoring and stimulation of adherence to PA in deconditioned patients. The system consists of a miniature accelerometer-based sensor, smartphone application, and a network service. Validation testing showed high reliability and reproducibility of the BEAT sensors. Pilot study with human subjects demonstrated high accuracy of the BEAT system in recognition of different exercises and calculating overall outcomes of PA. Taken together, these results indicate that BEAT system could become a valuable tool for realtime monitoring of PA in deconditioned patients.

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摘要:Through engineering projects, we have integrated software engineering, geographical information systems and HL7 standard to propose a model of an eHealth management platform for Down's syndrome screening, replicable in all the country. It will use real time sample information acquired from the local population and will geographically reference this information in the territory of Panama for future research....
摘要:In this paper we consider the transmission of stored video from a server to a client for medical applications such as, Telemonitoring, to optimize medical quality of service (m-QoS) and to examine how the client buffer space can be used efficiently and effectively towards reducing the rate variability of the compressed variable bit rate (VBR) video. Three basic results are presented. First, we show how to obtain the greatest possible reduction in rate variability when sending stored video to client with a given buffer size. Second, how to reduce high peak data rate of compressed VBR video when a patient is moving/walking very fast in hospital. Third, we evaluate the impact of optimal smoothing algorithm on the network parameters such as, peak-to-mean ratio, standard deviation, delay, jitter, average delay and average jitter to optimize the m-QoS. To resolve these all problems we used optimal smoothing algorithm and show its performance over a set of long MPEG-4 encoded video traces. Simulation results show that m-QoS is optimized by minimizing network metrics....
摘要:Biomedical applications of body area networks (BANs) are evolving, where taking periodic medical readings of patients via means wireless technologies at home or in the office will aid physicians to periodically supervise the patient's medical status without having to see the patient. Thus, one important objective of BANs is to provide the doctor with the medical readings that can be collected electronically without being in close proximity to the patient. This is done through the measurement of the patient's physiological signals via means of wearable sensors. This paper investigates wireless BAN cooperation via actual measurements of human movement kinematics and electrocardiogram (ECG), which are believed to provide patients with easy healthcare for continuous health-monitoring. The collected information will be processed using specially designed software, which in turn will enable the patient to send a full medical chart to the physician's electronic device. In this way, physicians will have the ability to monitor their patients more efficiently....
摘要:Dementia is a syndrome of chronic and progressive nature, characterized by the deterioration of cognitive functions and behavior, which causes a disability and dependence on others. Alzheimer's Disease is a type of dementia that affects cognitive functioning, behavior, and overall functionality of those who suffer from the irremediably progressive form, as it is a neurodegenerative disease. For this reason, development of a reactive interface is proposed to be inserted in a cognitive stimulation program. This program offers a series of exercises of mental functions, in order to delay or slow down the progress of this illness. The reactive interface allows access to these exercises and incorporates a user profile that predicts the possible emotions that may be experienced during the work sessions. In order to accomplish this, a cognitive structure of emotions is developed to be included in the reactive profile. This will allow enhancement of the interaction between the system and the patient. The user's emotional state may interfere, considering within the design stage the phenomenon of altered consciousness during this degenerative process. The consciousness represents the interface of human beings with our environment. This proposal allows us to obtain information related to the user's emotional state during the performance of specific cognitive tasks, permitting us to optimize the proposed stimulation activities....
摘要:The goal of this research was to develop a digital system that could allow managing electronic medical records (EMRs) codified under specifications of the Health Level 7/Clinical Document Architecture (HL7/CDA) international standard, and saving them in a portable digital storage device called iButton?. To this end, an USB-based hardware interface for reading and storing EMRs in iButtons was designed and implemented. In addition, a software application for invoking read/write operations on stored EMRs and showing their content on a graphical user interface was also developed, following the Extreme Programming (XP) software development methodology and using Visual Basic .NET as programming language. Tests conducted on the hardware interface showed that it was able to recognize any iButton type, reading and writing data on them as well. Moreover, the system helped in creating empty EMRs in conformance with the HL7/CDA standard, adding and viewing information, and updating it in the iButton. This system offers an easy way for managing and visualizing medical records codified in HL7/CDA, and allows patients to take their updated medical history with them everywhere....
摘要: style="text-align:justify;"> style="line-height:2;font-family:Verdana;">The article reviews the questions related to building the e-health systems. The key element of the system is electronic healthcare record to be formed according to the modular approach in the form of primary and satellite electronic medical records. Person-centred healthcare is proposed as a foundation for e-health. Such an approach provides a potential opportunity for all the medical doctors to obtain necessary information about their patients at any time via the teleconsultations in particular. Transition to e-health is associated with the creation of new opportunities for making diagnostic and therapeutic decisions based on the use of build-in decision support modules. The computer-assisted software design or hybrid systems are considered as the fourth generation medical information systems. It is reasonable to implement the entire information space of e-health, including the information systems of medical institutions and regional data repositories, based on cloud-optimized storage and computing solutions. This approach is expected to be implemented in Russia as a part of the unified state health information system. The authorized access to integrated databases for medical doctors of various specialties is required. In the framework of e-health, telemedicine is considered as an important component. Main elements comprise the real-time access of medical consultants to personified medical databases and remote follow-up of patients by the means of personal or home-based telemedicine. The use of personal portable devices for the control of vital signs of the organism is especially promising. Electronic stethoscopes and specialized video cameras for acquiring objective information should be increasingly used by remote consultants. Unfortunately, this trend is still underdeveloped in Russia. In perspective, e-health as unified medical space will provide a transition to the integrated analysis of population health by medical doctors of various specialties from different countries and will open new prospects for studying health based on the intelligent analysis of integrated data of patients.
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摘要: style="font-family:Verdana;">A system that allows computer interaction by disabled people with very low mobility and who cannot use the standard procedure based on keyboard and mouse is presented. The development device uses the patient's voluntary biomechanical signals, specifically, winks style="font-family:Verdana;">— style="font-family:Verdana;">which constitute an ability that generally remains in this kind of patients—, as interface to control the computer. A prototype based on robust and low-cost elements has been built and its performance has been validated through real trials by 16 users without previous training. The system can be optimized after a learning period in order to be adapted to every user. Also, good results were obtained in a subjective satisfaction survey that was completed by the users after carrying out the test trials....
摘要: style="font-size:12px;font-family:Verdana;">Rationale style="font-size:10.0pt;font-family:""> style="font-family:Verdana;font-size:12px;">: Medical treatment on short-term primary care medical service trips (MSTs) is generally symptom-based and supplemented by point-of-care testing. This pilot study contributes to the effective planning for such austere settings based on predicted symptomology. style="font-family:Verdana;font-size:12px;">Objective style="font-family:Verdana;font-size:12px;">: We aimed to prospectively document the epidemiology of patients seen during two low-resource clinics on a MST in Honduras and apply predefined case definitions adapted from guidelines used by international healthcare organizations (e.g. World Health Organization). style="font-family:Verdana;font-size:12px;">Methods style="font-family:Verdana;font-size:12px;">: An observational design was used to track the epidemiology during two clinics on an MST in Limon, Honduras in March 2015. The QuickChart mobile electronic medical record (EMR) application was piloted to document diagnoses according to predefined case definitions. style="font-family:Verdana;font-size:12px;">Results style="font-family:Verdana;font-size:12px;">: The most commonly diagnosed syndromes were upper respiratory complaints (20.19%), nonspecific abdominal complaints (20.19%), general pain (15.38%), hypertension (9.62%), pruritus (6.73%), and asthma/ COPD (4.81%). The case definitions accounted for 94% of all complaints and diagnoses on the brigade. style="font-family:Verdana;font-size:12px;">Discussion style="font-family:Verdana;font-size:12px;">: The distribution of common patient diagnoses on this MST was similar to that which had been reported elsewhere. The use of broader symptom-based case definitions for epidemiologic surveillance could also facilitate the syndromic management of patients seen on MSTs, and improve the consistency of treatment offered. style="font-family:Verdana;font-size:12px;">Conclusion style="font-family:Verdana;font-size:12px;">: Case definitions for common syndromes on primary care MSTs may be a feasible method of standardizing patient management. Preliminary use of the QuickChart EMR was acceptable for documentation of epidemiology in the field. Further study is necessary to investigate the reliability of syndromic diagnostic criteria between different clinicians and in a variety of MST settings....
摘要: style="text-align:justify;"> style="font-size:10.0pt;line-height:96%;font-family:;" "=""> style="line-height:1.5;font-family:Verdana;">The usage of mobile-phone among children increased significantly. Children are in their growing phase and cells of their body are rapidly dividing, therefore propagation of electro-magnetic (EM) radiation occurs quickly in children. The aim of the present study was to evaluate the extent of mobile-phone usage as well as its possible health effect. A total number of 455 (398 children and 57 adults, 396 urban and 59 rural) students of age group ranging from 10-29 years participated in this study. An “Information Gathering Chronological (IGC) model” was used for the collection and evaluation of information. The four major parameters, style="line-height:1.5;font-family:Verdana;">i.e. style="line-height:1.5;font-family:Verdana;"> demographic and public uniqueness, mobile-phone consumption patterns, grievance of the style="font-size:10pt;line-height:1.5;font-family:Verdana;">“forgetfulness” style="font-size:10.0pt;line-height:96%;font-family:;" "=""> style="line-height:1.5;font-family:Verdana;">symptom to the subjects and awareness about the safety measures were included to get the concise information from participants. We have observed that the prevalence of “forgetfulness” was 23.95% among mobile-phone users. The incidence of overall “forgetfulness” symptoms was 23.59%, 17.46%, 25.00% and 37.50% in low (LU), normal (NU), moderate (MU) and heavy (HU) mobile-phone users respectively. A trend for risk for “forgetfulness” was observed in HU as compared to LU in overall mobile-phone users. Three folds and nearly five folds increased risk for “forgetfulness” was found among HU as compared to LU in children (p 0.0210) and urban area mobile-phone users respectively. No significant difference for “forgetfulness” symptoms was found in other categories ( style="line-height:1.5;font-family:Verdana;">i.e. style="line-height:1.5;font-family:Verdana;"> adult and rural mobile-phone users). These results suggested that the incidences of “forgetfulness” among children from urban area mobile-phone users were significantly increased.

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摘要:This paper presents several informative and educational tools aimed to explain some mechanisms of Miocardial Infarction and Stroke, their risk factors and their prevention. Such educational and informative documents are in English and consist of texts, images, videos, animations and games. They are downloadable for free and can be used with the method considered by the teacher as most appropriate. Among the aims of the study is to provide information on the effects which some of our daily actions may have on the circulatory system. The pathological processes affecting blood vessels may start to develop during childhood or adolescence as a consequence of physical inactivity, unhealthy diet, smoking and alcohol abuse. Notoriously, unhealthy behaviours learned in early age are very likely to be continued in the adulthood. By the time they can lead to important car-diovascular risk factors, such as high blood pressure, overweight or obesity, raised blood sugars and lipids. Some of the documents presented in this manuscript suggest that complying with cardivascular prevention measures may also, at the same time, reduce the risk of other diseases....
摘要:This paper presents a system with real-time classification of human movements based on smartphone mounted on the waist. The built-in tri-accelerometer was utilized to collect the information of body motion. At the same time, the smartphone is able to classify the data for activity recognition. By our algorithm, body motion can be classified into five different patterns: vertical activity, lying, sitting or static standing, horizontal activity and fall. It alarms falling by Multimedia Messaging Service (MMS) with map of suspected fall location, GPS coordinate and time etc. If a fall was suspected, an automatic MMS would be sent to preset people. The major advantage of the proposed system is the novel application of smartphone which already have the necessary sensors and can monitor fall ubiquitously without any additional devices....
摘要:M-health, which is known as the practice of medical and public health supported by mobile devices such as mobile phones and PDAs for delivering medical and healthcare services, is currently being heavily developed to keep pace with the continuously rising demand for personalized healthcare. To this end, the MobiHealthcare system, which provides a personalized healthcare based on body sensor network, is developed. The system includes various body sensors to collect physiological signals specifically for different requirements, a cell phone to facilitate the joint processing of spatially and temporally collected medical data from different parts of the body for resource optimization and systematic health monitoring, a server cluster with great data storage capacity, powerful analysis capabilities to provide data storage, data mining and visualization. Compared with existing M-Health system, the MobiHealthcare system is characteristics of low coupling and powerful parallel computing capabilities. Various healthcare applications have been implemented in the proposed system to demonstrate its effectiveness in providing a powerful platform....
摘要: style="font-family:Verdana;color:black;font-size:10pt;">This paper starts with a literature survey that introduces possibilities of wearable electronics (WE) in different healthcare and childcare applications. Next, 24 personal interviews and an Internet forum survey were conducted in Finland about the use of WE in applications mentioned above. According to the results, most of the people feel positive about clothes used for wireless identification purposes in healthcare and childcare, but when more information about the person is added that can be wirelessly read, the feelings become more negative. Several important points to consider before implementation of WE for healthcare and childcare environments were brought up....
摘要:Models of services, processes and technology are useful tools for conceptualizing complex systems such as healthcare. The application of a component architecture helps illustrate the processes and technologies that are important to the operation of a health service and conceptualize the relationships between each component. Telehealth services are relatively recent and have characteristics that do not fit neatly into established models of health services. This paper analyzes the components used to build a telehealth in the home service in South Australia and the design choices that were taken. The service used commodity-based devices and systems to deliver simple to use, low-cost in the home care. Building on this analysis, the components required in an architectural component model of a telehealth service are identified enabling a provisional architecture for telehealth services to be derived from an existing internationally recognized architectural model for eHealth systems. Situated within the broad family of eHealth architectures, a Telehealth Architectural Model of telehealth processes, software, devices, common systems and ICT infrastructure is proposed that represents the components required to support telehealth and allows for customization of services according to clinical models of care....
摘要: class="MsoNormal"> lang="EN-US">Objectives: In this paper data flow and executive model of Mobile Health services risk management by the use of context aware systems are provided. Materials and Methods: Mobile health (M-Health) refers to using portable electronic devices having application for delivering health services and patient's information management. M-Health can offer various services remotely in prevention, detection, control, and treatment of disease or in the conditions of disaster for a patient or an environment. These services can have more acceptable quality by the help of Context Aware Systems which are defined as the capacity of computing equipment for detection, feeling, interpreting, and replying to user's local environmental aspects and computing equipment itself. In this paper, executive model is offered for managing services of M-Health based on context aware systems. One of the supplies of developing a context aware system is having a clear and well-defined definition of context and developing appropriate context information provider. In order to deliver high quality and well-managed M-Health services in the form of context aware systems, having clinical risk management plan is necessary. Conclusions: M-Health services need to develop appropriate communication strategies for interacting with stockholders at each stage of clinical risk management process. Risks, which are primarily resides in service providers, communicating channels or service receiver sides, can be well identified and managed using clinical risk management, M-Health and context aware systems. Thereby, these systems can offer qualified and precise services.

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摘要:An electronic (web-based) questionnaire was devised to find out the extent of teleconsultation and e-mail use for patient-provided communications in dentistry. This project was carried out in 2011 inthe health care district of South-Ostrobothnia, in South-Western Finland.The questionnaire was sent by e-mail to all 120 regional dentists, to which 76 replies were obtained (response rate 63%). The responses indicated a surprisingly positive attitude towards teleconsultation. A clear majority of 91% indicated that it could bring additional benefits to the current consultation methods.This study revealed that a slight majority of dentists in the region use e-mail for patient communication and 53% used e-mail for consultation. Approximately 10% use videoconferencing for consultation.The study also revealed that the majority of those who do not yet use electronic consultation are willing to try them out in the future. Security issues are a concern for many dentists. Practically all respondents wish for written instructions on the use of electronic consultation....
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