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Sreejith R, Senthil S. Smart Contract Authentication assisted GraphMap-Based HL7 FHIR architecture for interoperable e-healthcare system. Heliyon 2023; 9:e15180. [PMID: 37089400 PMCID: PMC10114202 DOI: 10.1016/j.heliyon.2023.e15180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 03/28/2023] [Accepted: 03/29/2023] [Indexed: 04/05/2023] Open
Abstract
The exponential growth in the global population and significant advancements in healthcare broadened the scope of intervention for e-Healthcare through decentralized data access and information exchange, making complex clinical decisions. e-Healthcare can perform several functionalities, including EHR communication, telemedicine, and complex clinical decision systems (CCDS), but large-scale users still find it challenging to maintain interoperability, stability, and scalability. Accommodating an extensive array of stakeholders, which includes patients, doctors, hospitals, and laboratories, demands interoperability to serve scalable services. FHIR frameworks have played a vital role in e-Healthcare designs. Most of the existing HL7-FHIR frameworks have used REST-API using HTTP-query for CRUD tasks that impose numerous rules and constraints, making the process more complex and time-consuming, violating the quality-of-service (QoS) standards on different levels. This paper develops a novel, robust Smart-Contract Authentication Assisted HL7-FHIR framework toward an interoperable e-Healthcare solution. Unlike classical REST API-based FHIR, our proposed method applies a Graph-mapping concept that transforms each resource variable into an equivalent Graph-Mapped Data Structure (GMS), which is subsequently stored in the NoSQL MongoDB database, reducing computational costs and time to meet QoS demands. The proposed model employs three key components, GMS-driven HL7 FHIR Gateway Model, Smart Contract Authentication and Client Model. The Smart Contract function helped verify and authenticate users to ensure privacy and secure EHR exchange. The assessment of the performance of the proposed model reveals a significant reduction in computational time with optimal resource utilization making it a significant and viable option to better the real-world e-Healthcare mechanisms.
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Khope SR, Elias S. Strategies of Predictive Schemes and Clinical Diagnosis for Prognosis Using MIMIC-III: A Systematic Review. Healthcare (Basel) 2023; 11:710. [PMID: 36900715 PMCID: PMC10001415 DOI: 10.3390/healthcare11050710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Revised: 02/18/2023] [Accepted: 02/21/2023] [Indexed: 03/05/2023] Open
Abstract
The prime purpose of the proposed study is to construct a novel predictive scheme for assisting in the prognosis of criticality using the MIMIC-III dataset. With the adoption of various analytics and advanced computing in the healthcare system, there is an increasing trend toward developing an effective prognostication mechanism. Predictive-based modeling is the best alternative to work in this direction. This paper discusses various scientific contributions using desk research methodology towards the Medical Information Mart for Intensive Care (MIMIC-III). This open-access dataset is meant to help predict patient trajectories for various purposes ranging from mortality forecasting to treatment planning. With a dominant machine learning approach in this perspective, there is a need to discover the effectiveness of existing predictive methods. The resultant outcome of this paper offers an inclusive discussion about various available predictive schemes and clinical diagnoses using MIMIC-III in order to contribute toward better information associated with its strengths and weaknesses. Therefore, the paper provides a clear visualization of existing schemes for clinical diagnosis using a systematic review approach.
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Affiliation(s)
| | - Susan Elias
- School of Electronics Engineering, Vellore Institute of Technology, Chennai 600127, Tamil Nadu, India
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Barbalho IMP, Fernandes F, Barros DMS, Paiva JC, Henriques J, Morais AHF, Coutinho KD, Coelho Neto GC, Chioro A, Valentim RAM. Electronic health records in Brazil: Prospects and technological challenges. Front Public Health 2022; 10:963841. [PMID: 36408021 PMCID: PMC9669479 DOI: 10.3389/fpubh.2022.963841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 10/18/2022] [Indexed: 11/06/2022] Open
Abstract
Electronic Health Records (EHR) are critical tools for advancing digital health worldwide. In Brazil, EHR development must follow specific standards, laws, and guidelines that contribute to implementing beneficial resources for population health monitoring. This paper presents an audit of the main approaches used for EHR development in Brazil, thus highlighting prospects, challenges, and existing gaps in the field. We applied a systematic review protocol to search for articles published from 2011 to 2021 in seven databases (Science Direct, Web of Science, PubMed, Springer, IEEE Xplore, ACM Digital Library, and SciELO). Subsequently, we analyzed 14 articles that met the inclusion and quality criteria and answered our research questions. According to this analysis, 78.58% (11) of the articles state that interoperability between systems is essential for improving patient care. Moreover, many resources are being designed and deployed to achieve this communication between EHRs and other healthcare systems in the Brazilian landscape. Besides interoperability, the articles report other considerable elements: (i) the need for increased security with the deployment of permission resources for viewing patient data, (ii) the absence of accurate data for testing EHRs, and (iii) the relevance of defining a methodology for EHR development. Our review provides an overview of EHR development in Brazil and discusses current gaps, innovative approaches, and technological solutions that could potentially address the related challenges. Lastly, our study also addresses primary elements that could contribute to relevant components of EHR development in the context of Brazil's public health system. Systematic review registration: PROSPERO, identifier CRD42021233219, https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021233219.
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Affiliation(s)
- Ingridy M. P. Barbalho
- Laboratory of Technological Innovation in Health (LAIS), Federal University of Rio Grande do Norte (UFRN), Natal, RN, Brazil
| | - Felipe Fernandes
- Laboratory of Technological Innovation in Health (LAIS), Federal University of Rio Grande do Norte (UFRN), Natal, RN, Brazil
| | - Daniele M. S. Barros
- Laboratory of Technological Innovation in Health (LAIS), Federal University of Rio Grande do Norte (UFRN), Natal, RN, Brazil
| | - Jailton C. Paiva
- Laboratory of Technological Innovation in Health (LAIS), Federal University of Rio Grande do Norte (UFRN), Natal, RN, Brazil
| | - Jorge Henriques
- Department of Informatics Engineering, Center for Informatics and Systems of the University of Coimbra, Universidade de Coimbra, Coimbra, Portugal
| | - Antônio H. F. Morais
- Laboratory of Technological Innovation in Health (LAIS), Federal University of Rio Grande do Norte (UFRN), Natal, RN, Brazil
| | - Karilany D. Coutinho
- Laboratory of Technological Innovation in Health (LAIS), Federal University of Rio Grande do Norte (UFRN), Natal, RN, Brazil
| | - Giliate C. Coelho Neto
- Departamento de Medicina Preventiva, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil
| | - Arthur Chioro
- Departamento de Medicina Preventiva, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil
| | - Ricardo A. M. Valentim
- Laboratory of Technological Innovation in Health (LAIS), Federal University of Rio Grande do Norte (UFRN), Natal, RN, Brazil
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Seth M, Jalo H, Högstedt Å, Medin O, Björner U, Sjöqvist BA, Candefjord S. Technologies for Interoperable Internet of Medical Things Platforms to Manage Medical Emergencies in Home Care and Prehospital Care: Protocol for a Scoping Review (Preprint). JMIR Res Protoc 2022; 11:e40243. [PMID: 36125863 PMCID: PMC9533201 DOI: 10.2196/40243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Revised: 08/25/2022] [Accepted: 08/30/2022] [Indexed: 12/03/2022] Open
Abstract
Background Population growth and aging have highlighted the need for more effective home and prehospital care. Interconnected medical devices and applications, which comprise an infrastructure referred to as the Internet of Medical Things (IoMT), have enabled remote patient monitoring and can be important tools to cope with these demographic changes. However, developing IoMT platforms requires profound knowledge of clinical needs and challenges related to interoperability and how these can be managed with suitable technologies. Objective The purpose of this scoping review is to summarize the best practices and technologies to overcome interoperability concerns in IoMT platform development for medical emergencies in home and prehospital care. Methods This scoping review will be conducted in accordance with Arksey and O’Malley’s 5-stage framework and adhere to the PRISMA-P (Preferred Reporting Items for Systematic Reviews and Meta-analyses Protocols) guidelines. Only peer-reviewed articles published in English will be considered. The databases/web search engines that will be used are IEEE Xplore, PubMed, Scopus, Google Scholar, National Center for Biotechnology Information, SAGE Journals, and ScienceDirect. The search process for relevant literature will be divided into 4 different steps. This will ensure that a suitable approach is followed in terms of search terms, limitations, and eligibility criteria. Relevant articles that meet the inclusion criteria will be screened in 2 stages: abstract and title screening and full-text screening. To reduce selection bias, the screening process will be performed by 2 reviewers. Results The results of the preliminary search indicate that there is sufficient literature to form a good foundation for the scoping review. The search was performed in April 2022, and a total of 4579 articles were found. The main clinical focus is the prevention and management of falls, but other medical emergencies, such as heart disease and stroke, are also considered. Preliminary results show that little attention has been given to real-time IoMT platforms that can be deployed in real-world care settings. The final results are expected to be presented in a scoping review in 2023 and will be disseminated through scientific conference presentations, oral presentations, and publication in a peer-reviewed journal. Conclusions This scoping review will provide insights and recommendations regarding how interoperable real-time IoMT platforms can be developed to handle medical emergencies in home and prehospital care. The findings of this research could be used by researchers, clinicians, and implementation teams to facilitate future development and interdisciplinary discussions. International Registered Report Identifier (IRRID) DERR1-10.2196/40243
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Affiliation(s)
- Mattias Seth
- Department of Electrical Engineering, Chalmers University of Technology, Gothenburg, Sweden
| | - Hoor Jalo
- Department of Electrical Engineering, Chalmers University of Technology, Gothenburg, Sweden
| | - Åsa Högstedt
- Prehospen - Centre for Prehospital Research, Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, Sweden
| | | | - Ulrica Björner
- Äldre Samt Vård och Omsorgsförvaltningen, Gothenburg, Sweden
| | - Bengt Arne Sjöqvist
- Department of Electrical Engineering, Chalmers University of Technology, Gothenburg, Sweden
| | - Stefan Candefjord
- Department of Electrical Engineering, Chalmers University of Technology, Gothenburg, Sweden
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Chatterjee A, Pahari N, Prinz A. HL7 FHIR with SNOMED-CT to Achieve Semantic and Structural Interoperability in Personal Health Data: A Proof-of-Concept Study. SENSORS (BASEL, SWITZERLAND) 2022; 22:3756. [PMID: 35632165 PMCID: PMC9147872 DOI: 10.3390/s22103756] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 05/10/2022] [Accepted: 05/13/2022] [Indexed: 02/06/2023]
Abstract
Heterogeneity is a problem in storing and exchanging data in a digital health information system (HIS) following semantic and structural integrity. The existing literature shows different methods to overcome this problem. Fast healthcare interoperable resources (FHIR) as a structural standard may explain other information models, (e.g., personal, physiological, and behavioral data from heterogeneous sources, such as activity sensors, questionnaires, and interviews) with semantic vocabularies, (e.g., Systematized Nomenclature of Medicine-Clinical Terms (SNOMED-CT)) to connect personal health data to an electronic health record (EHR). We design and develop an intuitive health coaching (eCoach) smartphone application to prove the concept. We combine HL7 FHIR and SNOMED-CT vocabularies to exchange personal health data in JavaScript object notion (JSON). This study explores and analyzes our attempt to design and implement a structurally and logically compatible tethered personal health record (PHR) that allows bidirectional communication with an EHR. Our eCoach prototype implements most PHR-S FM functions as an interoperability quality standard. Its end-to-end (E2E) data are protected with a TSD (Services for Sensitive Data) security mechanism. We achieve 0% data loss and 0% unreliable performances during data transfer between PHR and EHR. Furthermore, this experimental study shows the effectiveness of FHIR modular resources toward flexible management of data components in the PHR (eCoach) prototype.
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Affiliation(s)
- Ayan Chatterjee
- Department of Information and Communication Technology, Center for eHealth, University of Agder, 4630 Kristiansand, Norway;
| | - Nibedita Pahari
- Department of Software Development, Knowit As, 4836 Arendal, Norway;
| | - Andreas Prinz
- Department of Information and Communication Technology, Center for eHealth, University of Agder, 4630 Kristiansand, Norway;
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de Mello BH, Rigo SJ, da Costa CA, da Rosa Righi R, Donida B, Bez MR, Schunke LC. Semantic interoperability in health records standards: a systematic literature review. HEALTH AND TECHNOLOGY 2022; 12:255-272. [PMID: 35103230 PMCID: PMC8791650 DOI: 10.1007/s12553-022-00639-w] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 01/07/2022] [Indexed: 01/03/2023]
Abstract
The integration and exchange of information among health organizations and system providers are currently regarded as a challenge. Each organization usually has an internal ecosystem and a proprietary way to store electronic health records of the patient’s history. Recent research explores the advantages of an integrated ecosystem by exchanging information between the different inpatient care actors. Many efforts seek quality in health care, economy, and sustainability in process management. Some examples are reducing medical errors, disease control and monitoring, individualized patient care, and avoiding duplicate and fragmented entries in the electronic medical record. Likewise, some studies showed technologies to achieve this goal effectively and efficiently, with the ability to interoperate data, allowing the interpretation and use of health information. To that end, semantic interoperability aims to share data among all the sectors in the organization, clinicians, nurses, lab, the entire hospital. Therefore, avoiding data silos and keep data regardless of vendors, to exchange the information across organizational boundaries. This study presents a comprehensive systematic literature review of semantic interoperability in electronic health records. We searched seven databases of articles published between 2010 to September 2020. We showed the most chosen scenarios, technologies, and tools employed to solve interoperability problems, and we propose a taxonomy around semantic interoperability in health records. Also, we presented the main approaches to solve the exchange problem of legacy and heterogeneous data across healthcare organizations.
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Using Knowledge Graph Structures for Semantic Interoperability in Electronic Health Records Data Exchanges. INFORMATION 2022. [DOI: 10.3390/info13020052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
Information sharing across medical institutions is restricted to information exchange between specific partners. The lifelong electronic health records (EHR) structure and content require standardization efforts. The existing standards such as openEHR, HL7, and CEN TC251 EN 13606 (Technical committee on Health Informatics of the European Committee for Standardization) aim to achieve data independence along with semantic interoperability. This study aims to discover knowledge representation to achieve semantic health data exchange. OpenEHR and CEN TC251 EN 13606 use archetype-based technology for semantic interoperability. The HL7 Clinical Document Architecture is on its way to adopting this through HL7 templates. Archetypes are the basis for knowledge-based systems as these are means to define clinical knowledge. The paper examines a set of formalisms for the suitability of describing, representing, and reasoning about archetypes. Each of the information exchange technologies such as XML, Web Ontology Language, Object Constraint Language, and Knowledge Interchange Format is evaluated as a part of the knowledge representation experiment. These examine the representation of Archetypes as described by Archetype Definition Language. The evaluation maintains a clear focus on the syntactic and semantic transformations among different EHR standards.
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Roehrs A, da Costa CA, Righi RR, Mayer AH, da Silva VF, Goldim JR, Schmidt DC. Integrating multiple blockchains to support distributed personal health records. Health Informatics J 2021; 27:14604582211007546. [PMID: 33853403 DOI: 10.1177/14604582211007546] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Blockchain technologies have evolved in recent years, as have the use of personal health record (PHR) data. Initially, only the financial domain benefited from Blockchain technologies. Due to efficient distribution format and data integrity security, however, these technologies have demonstrated potential in other areas, such as PHR data in the healthcare domain. Applying Blockchain to PHR data faces different challenges than applying it to financial transactions via crypto-currency. To propose and discuss an architectural model of a Blockchain platform named "OmniPHR Multi-Blockchain" to address key challenges associated with geographical distribution of PHR data. We analyzed the current literature to identify critical barriers faced when applying Blockchain technologies to distribute PHR data. We propose an architecture model and describe a prototype developed to evaluate and address these challenges. The OmniPHR Multi-Blockchain architecture yielded promising results for scenarios involving distributed PHR data. The project demonstrated a viable and beneficial alternative for processing geographically distributed PHR data with performance comparable with conventional methods. Blockchain's implementation tools have evolved, but the domain of healthcare still faces many challenges concerning distribution and interoperability. This study empirically demonstrates an alternative architecture that enables the distributed processing of PHR data via Blockchain technologies.
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Affiliation(s)
| | | | | | - André H Mayer
- Universidade do Vale do Rio dos Sinos (UNISINOS), Brazil
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9
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Donida B, da Costa CA, Scherer JN. Making the COVID-19 Pandemic a Driver for Digital Health: Brazilian Strategies. JMIR Public Health Surveill 2021; 7:e28643. [PMID: 34101613 PMCID: PMC8244723 DOI: 10.2196/28643] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 05/31/2021] [Accepted: 06/07/2021] [Indexed: 02/06/2023] Open
Abstract
The COVID-19 outbreak exposed several problems faced by health systems worldwide, especially concerning the safe and rapid generation and sharing of health data. However, this pandemic scenario has also facilitated the rapid implementation and monitoring of technologies in the health field. In view of the occurrence of the public emergency caused by SARS-CoV-2 in Brazil, the Department of Informatics of the Brazilian Unified Health System created a contingency plan. In this paper, we aim to report the digital health strategies applied in Brazil and the first results obtained during the fight against COVID-19. Conecte SUS, a platform created to store all the health data of an individual throughout their life, is the center point of the Brazilian digital strategy. Access to the platform can be obtained through an app by the patient and the health professionals involved in the case. Health data sharing became possible due to the creation of the National Health Data Network (Rede Nacional de Dados em Saúde, RNDS). A mobile app was developed to guide citizens regarding the need to go to a health facility and to assist in disseminating official news about the virus. The mobile app can also alert the user if they have had contact with an infected person. The official numbers of cases and available hospital beds are updated and published daily on a website containing interactive graphs. These data are obtained due to creating a web-based notification system that uses the RNDS to share information about the cases. Preclinical care through telemedicine has become essential to prevent overload in health facilities. The exchange of experiences between medical teams from large centers and small hospitals was made possible using telehealth. Brazil took a giant step toward digital health adoption, creating and implementing important initiatives; however, these initiatives do not yet cover the entire health system. It is expected that the sharing of health data that are maintained and authorized by the patient will become a reality in the near future. The intention is to obtain better clinical outcomes, cost reduction, and faster and better services in the public health network.
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Affiliation(s)
- Bruna Donida
- SOFTWARELAB - Software Innovation Laboratory, Universidade do Vale do Rio dos Sinos, São Leopoldo, Brazil
| | - Cristiano André da Costa
- SOFTWARELAB - Software Innovation Laboratory, Universidade do Vale do Rio dos Sinos, São Leopoldo, Brazil
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Secure decentralized electronic health records sharing system based on blockchains. JOURNAL OF KING SAUD UNIVERSITY - COMPUTER AND INFORMATION SCIENCES 2021. [DOI: 10.1016/j.jksuci.2021.05.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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11
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Lin HC, Kuo YC, Liu MY. A health informatics transformation model based on intelligent cloud computing - exemplified by type 2 diabetes mellitus with related cardiovascular diseases. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2020; 191:105409. [PMID: 32143073 DOI: 10.1016/j.cmpb.2020.105409] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2019] [Revised: 12/08/2019] [Accepted: 02/18/2020] [Indexed: 06/10/2023]
Abstract
BACKGROUND AND OBJECTIVE Many studies regarding health analysis request structured datasets but the legacy resources provide scattered data. This study aims to establish a health informatics transformation model (HITM) based upon intelligent cloud computing with the self-developed analytics modules by open source technique. The model was exemplified by the open data of type 2 diabetes mellitus (DM2) with related cardiovascular diseases. METHODS The Apache-SPARK framework was employed to generate the infrastructure of the HITM, which enables the machine learning (ML) algorithms including random forest, multi-layer perceptron classifier, support vector machine, and naïve Bayes classifier as well as the regression analysis for intelligent cloud computing. The modeling applied the MIMIC-III open database as an example to design the health informatics data warehouse, which embeds the PL/SQL-based modules to extract the analytical data for the training processes. A coupling analysis flow can drive the ML modules to train the sample data and validate the results. RESULTS The four modes of cloud computation were compared to evaluate the feasibility of the cloud platform in accordance with its system performance for more than 11,500 datasets. Then, the modeling adaptability was validated by simulating the featured datasets of obesity and cardiovascular-related diseases for patients with DM2 and its complications. The results showed that the run-time efficiency of the platform performed in around one minute and the prediction accuracy of the featured datasets reached 90%. CONCLUSIONS This study helped contribute the modeling for efficient transformation of health informatics. The HITM can be customized for the actual clinical database, which provides big data for training, with the proper ML modules for a predictable process in the cloud platform. The feedback of intelligent computing can be referred to risk assessment in health promotion.
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Affiliation(s)
- Hsueh-Chun Lin
- Department of Health Services Administration, China Medical University, 91 Hsueh-Shih Road, Taichung 40402, Taiwan, ROC.
| | - Yu-Chen Kuo
- Institute of Information System and Applications, National Tsing Hua University, Hsinchu, Taiwan
| | - Meng-Yu Liu
- Department of Health Services Administration, China Medical University, 91 Hsueh-Shih Road, Taichung 40402, Taiwan, ROC
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Eccher C, Gios L, Zanutto A, Bizzarri G, Conforti D, Forti S. TreC platform. An integrated and evolving care model for patients' empowerment and data repository. J Biomed Inform 2020; 102:103359. [PMID: 31917253 DOI: 10.1016/j.jbi.2019.103359] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Revised: 11/12/2019] [Accepted: 12/15/2019] [Indexed: 02/01/2023]
Abstract
INTRODUCTION Health care has been deeply revolutionized by the new wave of information and communication technology (ICT) development, particularly related to the electronic/personal health record (PHR). The present paper describes the original design and implementation approach followed in the Trentino Province (Italy) to promote an Integrated Care Model for patients' empowerment and data repository, by means of an evolving Personal Health Record - PHR platform, named TreC (Trentino Citizens Clinical Record). MATERIALS AND METHODS The TreC Platform is conceived as a communication hub among different stakeholders. The core assumption of the TreC platform strategy is to consider the citizen/patient as main manager and owner of both his/her own health and his/her contacts with the health care systems. RESULTS Over the years, the TreC platform has represented the core pillar in the digitalization process promoted at Province level. This has been strategically embedded in the multi-faceted e-government strategy endorsed by the Province of Trento. So far (October 2018), more than 89,000 citizens within the Province of Trento are using TreC platform as a way to communicate with the health care system and access their own personal health records. CONCLUSIONS The experience gained through the TreC platform implementation and its results are promising, supporting the idea that a PHR platform can represent a key driving factor in improving health care quality and efficiency, both from a patient and a health care staff perspective.
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Affiliation(s)
- Claudio Eccher
- Center for Information and Communication Technology, Fondazione Bruno Kessler, Trento, Italy.
| | - Lorenzo Gios
- TrentinoSalute 4.0, Competence Center for Digital Health, Trento, Italy
| | - Alberto Zanutto
- Center for Information and Communication Technology, Fondazione Bruno Kessler, Trento, Italy
| | | | | | - Stefano Forti
- Center for Information and Communication Technology, Fondazione Bruno Kessler, Trento, Italy
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Saripalle R, Runyan C, Russell M. Using HL7 FHIR to achieve interoperability in patient health record. J Biomed Inform 2019; 94:103188. [DOI: 10.1016/j.jbi.2019.103188] [Citation(s) in RCA: 85] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2018] [Revised: 04/09/2019] [Accepted: 04/22/2019] [Indexed: 11/16/2022]
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14
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El-Sappagh S, Ali F, Hendawi A, Jang JH, Kwak KS. A mobile health monitoring-and-treatment system based on integration of the SSN sensor ontology and the HL7 FHIR standard. BMC Med Inform Decis Mak 2019; 19:97. [PMID: 31077222 PMCID: PMC6511155 DOI: 10.1186/s12911-019-0806-z] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Accepted: 03/31/2019] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Mobile health (MH) technologies including clinical decision support systems (CDSS) provide an efficient method for patient monitoring and treatment. A mobile CDSS is based on real-time sensor data and historical electronic health record (EHR) data. Raw sensor data have no semantics of their own; therefore, a computer system cannot interpret these data automatically. In addition, the interoperability of sensor data and EHR medical data is a challenge. EHR data collected from distributed systems have different structures, semantics, and coding mechanisms. As a result, building a transparent CDSS that can work as a portable plug-and-play component in any existing EHR ecosystem requires a careful design process. Ontology and medical standards support the construction of semantically intelligent CDSSs. METHODS This paper proposes a comprehensive MH framework with an integrated CDSS capability. This cloud-based system monitors and manages type 1 diabetes mellitus. The efficiency of any CDSS depends mainly on the quality of its knowledge and its semantic interoperability with different data sources. To this end, this paper concentrates on constructing a semantic CDSS based on proposed FASTO ontology. RESULTS This realistic ontology is able to collect, formalize, integrate, analyze, and manipulate all types of patient data. It provides patients with complete, personalized, and medically intuitive care plans, including insulin regimens, diets, exercises, and education sub-plans. These plans are based on the complete patient profile. In addition, the proposed CDSS provides real-time patient monitoring based on vital signs collected from patients' wireless body area networks. These monitoring include real-time insulin adjustments, mealtime carbohydrate calculations, and exercise recommendations. FASTO integrates the well-known standards of HL7 fast healthcare interoperability resources (FHIR), semantic sensor network (SSN) ontology, basic formal ontology (BFO) 2.0, and clinical practice guidelines. The current version of FASTO includes 9577 classes, 658 object properties, 164 data properties, 460 individuals, and 140 SWRL rules. FASTO is publicly available through the National Center for Biomedical Ontology BioPortal at https://bioportal.bioontology.org/ontologies/FASTO . CONCLUSIONS The resulting CDSS system can help physicians to monitor more patients efficiently and accurately. In addition, patients in rural areas can depend on the system to manage their diabetes and emergencies.
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Affiliation(s)
- Shaker El-Sappagh
- Department of Information and Communication Engineering, Inha University, Incheon, South Korea
- Information Systems Department, Faculty of Computer and Informatics, Benha University, Banha, Egypt
| | - Farman Ali
- Department of Information and Communication Engineering, Inha University, Incheon, South Korea
| | - Abdeltawab Hendawi
- Computer Science, University of Virginia, Charlottesville, USA
- Faculty of Computers and Information, Cairo University, Giza, Egypt
| | - Jun-Hyeog Jang
- Department of Biochemistry, School of Medicine, Inha University, Incheon, 400-712, South Korea
| | - Kyung-Sup Kwak
- Department of Information and Communication Engineering, Inha University, Incheon, South Korea.
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