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Next Generation of Interoperability in Health Care: Standards and Application

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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601).

Deadline for manuscript submissions: closed (1 March 2014) | Viewed by 117419

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Prof. Dr. Po-Hsun Cheng

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Department of Software Engineering and Management, National Kaohsiung Normal University, Kaohsiung 82444, Taiwan
Interests: information education; software engineering; healthcare informatics; hardware/software co-design
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Healthcare Informatics plays an important role in public health. The annual Asia-Pacific HL7 Conference on Health Care Information Standards (APHL7) convenes the vanguard international research communities in healthcare informatics. The mission of the APHL7 conference is to provide the highest‐profile academic and industrial research forum and to develop an international community that will accelerate the development and adoption of a new vision for improving health, increasing healthcare quality and, ultimately, lowering costs of health care in the Asia-Pacific region. To further promote the work presented at APHL7 2013, we are planning a Special Issue in 2014. All authors who presented papers at APHL7 2013 are invited to submit extended versions of their papers to the International Journal of Environmental Research and Public Health (IJERPH) in this Special Issue. We also invite contributions which will increase shared understanding and adoption of healthcare informatics and related standards. Topics of interest include, but are not limited to:

Prof. Dr. Po-Hsun Cheng
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

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Keywords

health care information standards and applications
electronic health records
cloud computing in health care
ehealth
clinical decision support
clinical document architecture
telehealth and telecare
national health infrastructure
health care information security and privacy
health care wireless transmission
disease surveillance
multimedia technology and application
health care smart cards
medical information management
health information management
knowledge management and e-learning
public health informatics
biomedical informatics
international medical service
nursing informatics
other related topics

Published Papers (13 papers)

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Research

503 KiB

Open AccessArticle

Patients’ Perspective of the Design of Provider-Patients Electronic Communication Services

by Petr Silhavy, Radek Silhavy and Zdenka Prokopova

Int. J. Environ. Res. Public Health 2014, 11(6), 6231-6245; https://doi.org/10.3390/ijerph110606231 - 12 Jun 2014

Cited by 5 | Viewed by 5113

Abstract

Information Delivery is one the most important tasks in healthcare practice. This article discusses patient’s tasks and perspectives, which are then used to design a new Effective Electronic Methodology. The system design methods applicable to electronic communication in the healthcare sector are also [...] Read more.

(This article belongs to the Special Issue Next Generation of Interoperability in Health Care: Standards and Application)

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574 KiB

Open AccessArticle

Importance-Satisfaction Analysis for Primary Care Physicians’ Perspective on EHRs in Taiwan

by Cheng-Hsun Ho, Hsyien-Chia Wen, Chi-Ming Chu, Yi-SyuanWu and Jen-Leng Wang

Int. J. Environ. Res. Public Health 2014, 11(6), 6037-6051; https://doi.org/10.3390/ijerph110606037 - 06 Jun 2014

Cited by 13 | Viewed by 5627

Abstract

The Taiwan government has been promoting Electronic Health Records (EHRs) to primary care physicians. How to extend EHRs adoption rate by measuring physicians’ perspective of importance and performance of EHRs has become one of the critical issues for healthcare organizations. We conducted a comprehensive survey in 2010 in which a total of 1034 questionnaires which were distributed to primary care physicians. The project was sponsored by the Department of Health to accelerate the adoption of EHRs. 556 valid responses were analyzed resulting in a valid response rate of 53.77%. The data were analyzed based on a data-centered analytical framework (5-point Likert scale). The mean of importance and satisfaction of four dimensions were 4.16, 3.44 (installation and maintenance), 4.12, 3.51 (product effectiveness), 4.10, 3.31 (system function) and 4.34, 3.70 (customer service) respectively. This study provided a direction to government by focusing on attributes which physicians found important but were dissatisfied with, to close the gap between actual and expected performance of the EHRs. The authorities should emphasize the potential advantages in meaningful use and provide training programs, conferences, technical assistance and incentives to enhance the national level implementation of EHRs for primary physicians. Full article

(This article belongs to the Special Issue Next Generation of Interoperability in Health Care: Standards and Application)

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Open AccessArticle

The Next Generation of Interoperability Agents in Healthcare

by Luciana Cardoso, Fernando Marins, Filipe Portela, Manuel Santos, António Abelha and José Machado

Int. J. Environ. Res. Public Health 2014, 11(5), 5349-5371; https://doi.org/10.3390/ijerph110505349 - 16 May 2014

Cited by 51 | Viewed by 11222

Abstract

Interoperability in health information systems is increasingly a requirement rather than an option. Standards and technologies, such as multi-agent systems, have proven to be powerful tools in interoperability issues. In the last few years, the authors have worked on developing the Agency for Integration, Diffusion and Archive of Medical Information (AIDA), which is an intelligent, agent-based platform to ensure interoperability in healthcare units. It is increasingly important to ensure the high availability and reliability of systems. The functions provided by the systems that treat interoperability cannot fail. This paper shows the importance of monitoring and controlling intelligent agents as a tool to anticipate problems in health information systems. The interaction between humans and agents through an interface that allows the user to create new agents easily and to monitor their activities in real time is also an important feature, as health systems evolve by adopting more features and solving new problems. A module was installed in Centro Hospitalar do Porto, increasing the functionality and the overall usability of AIDA. Full article

(This article belongs to the Special Issue Next Generation of Interoperability in Health Care: Standards and Application)

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499 KiB

Open AccessArticle

Integrating Social Capital Theory, Social Cognitive Theory, and the Technology Acceptance Model to Explore a Behavioral Model of Telehealth Systems

by Chung-Hung Tsai

Int. J. Environ. Res. Public Health 2014, 11(5), 4905-4925; https://doi.org/10.3390/ijerph110504905 - 07 May 2014

Cited by 91 | Viewed by 24701

Abstract

Telehealth has become an increasingly applied solution to delivering health care to rural and underserved areas by remote health care professionals. This study integrated social capital theory, social cognitive theory, and the technology acceptance model (TAM) to develop a comprehensive behavioral model for analyzing the relationships among social capital factors (social capital theory), technological factors (TAM), and system self-efficacy (social cognitive theory) in telehealth. The proposed framework was validated with 365 respondents from Nantou County, located in Central Taiwan. Structural equation modeling (SEM) was used to assess the causal relationships that were hypothesized in the proposed model. The finding indicates that elderly residents generally reported positive perceptions toward the telehealth system. Generally, the findings show that social capital factors (social trust, institutional trust, and social participation) significantly positively affect the technological factors (perceived ease of use and perceived usefulness respectively), which influenced usage intention. This study also confirmed that system self-efficacy was the salient antecedent of perceived ease of use. In addition, regarding the samples, the proposed model fitted considerably well. The proposed integrative psychosocial-technological model may serve as a theoretical basis for future research and can also offer empirical foresight to practitioners and researchers in the health departments of governments, hospitals, and rural communities. Full article

(This article belongs to the Special Issue Next Generation of Interoperability in Health Care: Standards and Application)

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Open AccessArticle

A Lightweight Web of Things Open Platform to Facilitate Context Data Management and Personalized Healthcare Services Creation

by Iván Corredor, Eduardo Metola, Ana M. Bernardos, Paula Tarrío and José R. Casar

Int. J. Environ. Res. Public Health 2014, 11(5), 4676-4713; https://doi.org/10.3390/ijerph110504676 - 29 Apr 2014

Cited by 20 | Viewed by 7522

Abstract

In the last few years, many health monitoring systems have been designed to fullfil the needs of a large range of scenarios. Although many of those systems provide good ad hoc solutions, most of them lack of mechanisms that allow them to be easily reused. This paper is focused on describing an open platform, the micro Web of Things Open Platform (µWoTOP), which has been conceived to improve the connectivity and reusability of context data to deliver different kinds of health, wellness and ambient home care services. µWoTOP is based on a resource-oriented architecture which may be embedded in mobile and resource constrained devices enabling access to biometric, ambient or activity sensors and actuator resources through uniform interfaces defined according to a RESTful fashion. Additionally, µWoTOP manages two communication modes which allow delivering user context information according to different methods, depending on the requirements of the consumer application. It also generates alert messages based on standards related to health care and risk management, such as the Common Alerting Protocol, in order to make its outputs compatible with existing systems. Full article

(This article belongs to the Special Issue Next Generation of Interoperability in Health Care: Standards and Application)

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Open AccessArticle

Promoting Positive Psychology Using Social Networking Sites: A Study of New College Entrants on Facebook

by Shu-Man Chang, Yung-Hsiu Lin, Chi-Wei Lin, Her-Kun Chang and Ping Pete Chong

Int. J. Environ. Res. Public Health 2014, 11(5), 4652-4663; https://doi.org/10.3390/ijerph110504652 - 29 Apr 2014

Cited by 14 | Viewed by 9010

Abstract

This study explores the potential of promoting college students’ positive psychological development using popular online social networks. Online social networks have dramatically changed the ways college students manage their social relationships. Social network activities, such as checking Facebook posts dominates students’ Internet time and has the potential to assist students’ positive development. Positive psychology is a scientific study of how ordinary individuals can apply their strength effectively when facing objective difficulties and how this capability can be cultivated with certain approaches. A positive message delivery approach was designed for a group of new college entrants. A series of positive messages was edited by university counselors and delivered by students to their Facebook social groups. Responses from each posted positive messages were collected and analyzed by researchers. The responses indicated that: (1) relationships of individual engagement and social influence in this study can partially explain the observed student behavior; (2) using class-based social groups can promote a positive atmosphere to enhance strong-tie relationships in both the physical and virtual environments, and (3) promoting student’s positive attitudes can substantially impact adolescents’ future developments, and many positive attitudes can be cultivated by emotional events and social influence. Full article

(This article belongs to the Special Issue Next Generation of Interoperability in Health Care: Standards and Application)

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Open AccessArticle

An Interactive Wireless Communication System for Visually Impaired People Using City Bus Transport

by Hsiao-Lan Wang, Ya-Ping Chen, Chi-Lun Rau and Chung-Huang Yu

Int. J. Environ. Res. Public Health 2014, 11(5), 4560-4571; https://doi.org/10.3390/ijerph110504560 - 25 Apr 2014

Cited by 10 | Viewed by 7210

Abstract

Visually impaired people have difficulty accessing information about public transportation systems. Several systems have been developed for assisting visually impaired and blind people to use the city bus. Most systems provide only one-way communication and require high-cost and complex equipment. The purpose of this study is to reduce the difficulties faced by visually impaired people when taking city buses, using an interactive wireless communication system. The system comprised a user module and a bus module to establish a direct one-to-one connection. When the user inputs 4-digit numbers, the user module immediately sends out the information. If the bus module receives the matched bus number, it buzzes and the warning LED flashes to notify the bus driver that someone is waiting to board on the bus. User tests were conducted by two visually impaired people in a simulated vehicle and a city bus. The success rate of interactive wireless communication, recognizing the arrival of the bus and boarding the correct bus reached 100% in all of the tests. The interactive wireless communication aid system is a valid and low-cost device for assisting visually impaired people to use city buses. Full article

(This article belongs to the Special Issue Next Generation of Interoperability in Health Care: Standards and Application)

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738 KiB

Open AccessArticle

Design of a Real-Time and Continua-Based Framework for Care Guideline Recommendations

by Yu-Feng Lin, Hsin-Han Shie, Yi-Ching Yang and Vincent S. Tseng

Int. J. Environ. Res. Public Health 2014, 11(4), 4262-4279; https://doi.org/10.3390/ijerph110404262 - 16 Apr 2014

Cited by 13 | Viewed by 6237

Abstract

Telehealth is an important issue in the medical and healthcare domains. Although a number of systems have been developed to meet the demands of emerging telehealth services, the following problems still remain to be addressed: (1) most systems do not monitor/predict the vital signs states so that they are able to send alarms to caregivers in real-time; (2) most systems do not focus on reducing the amount of work that caregivers need to do, and provide patients with remote care; and (3) most systems do not recommend guidelines for caregivers. This study thus proposes a framework for a real-time and Continua-based Care Guideline Recommendation System (Cagurs) which utilizes mobile device platforms to provide caregivers of chronic patients with real-time care guideline recommendations, and that enables vital signs data to be transmitted between different devices automatically, using the Continua standard. Moreover, the proposed system adopts the episode mining approach to monitor/predict anomalous conditions of patients, and then offers related recommended care guidelines to caregivers so that they can offer preventive care in a timely manner. Full article

(This article belongs to the Special Issue Next Generation of Interoperability in Health Care: Standards and Application)

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Open AccessArticle

A ZigBee-Based Location-Aware Fall Detection System for Improving Elderly Telecare

by Chih-Ning Huang and Chia-Tai Chan

Int. J. Environ. Res. Public Health 2014, 11(4), 4233-4248; https://doi.org/10.3390/ijerph110404233 - 16 Apr 2014

Cited by 31 | Viewed by 9246

Abstract

Falls are the primary cause of accidents among the elderly and frequently cause fatal and non-fatal injuries associated with a large amount of medical costs. Fall detection using wearable wireless sensor nodes has the potential of improving elderly telecare. This investigation proposes a ZigBee-based location-aware fall detection system for elderly telecare that provides an unobstructed communication between the elderly and caregivers when falls happen. The system is based on ZigBee-based sensor networks, and the sensor node consists of a motherboard with a tri-axial accelerometer and a ZigBee module. A wireless sensor node worn on the waist continuously detects fall events and starts an indoor positioning engine as soon as a fall happens. In the fall detection scheme, this study proposes a three-phase threshold-based fall detection algorithm to detect critical and normal falls. The fall alarm can be canceled by pressing and holding the emergency fall button only when a normal fall is detected. On the other hand, there are three phases in the indoor positioning engine: path loss survey phase, Received Signal Strength Indicator (RSSI) collection phase and location calculation phase. Finally, the location of the faller will be calculated by a k-nearest neighbor algorithm with weighted RSSI. The experimental results demonstrate that the fall detection algorithm achieves 95.63% sensitivity, 73.5% specificity, 88.62% accuracy and 88.6% precision. Furthermore, the average error distance for indoor positioning is 1.15 ± 0.54 m. The proposed system successfully delivers critical information to remote telecare providers who can then immediately help a fallen person. Full article

(This article belongs to the Special Issue Next Generation of Interoperability in Health Care: Standards and Application)

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Open AccessArticle

Gait Recognition and Walking Exercise Intensity Estimation

by Bor-Shing Lin, Yu-Ting Liu, Chu Yu, Gene Eu Jan and Bo-Tang Hsiao

Int. J. Environ. Res. Public Health 2014, 11(4), 3822-3844; https://doi.org/10.3390/ijerph110403822 - 04 Apr 2014

Cited by 5 | Viewed by 6590

Abstract

Cardiovascular patients consult doctors for advice regarding regular exercise, whereas obese patients must self-manage their weight. Because a system for permanently monitoring and tracking patients’ exercise intensities and workouts is necessary, a system for recognizing gait and estimating walking exercise intensity was proposed. For gait recognition analysis, αβ filters were used to improve the recognition of athletic attitude. Furthermore, empirical mode decomposition (EMD) was used to filter the noise of patients’ attitude to acquire the Fourier transform energy spectrum. Linear discriminant analysis was then applied to this energy spectrum for training and recognition. When the gait or motion was recognized, the walking exercise intensity was estimated. In addition, this study addressed the correlation between inertia and exercise intensity by using the residual function of the EMD and quadratic approximation to filter the effect of the baseline drift integral of the acceleration sensor. The increase in the determination coefficient of the regression equation from 0.55 to 0.81 proved that the accuracy of the method for estimating walking exercise intensity proposed by Kurihara was improved in this study. Full article

(This article belongs to the Special Issue Next Generation of Interoperability in Health Care: Standards and Application)

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Open AccessArticle

An FPGA-Based Rapid Wheezing Detection System

by Bor-Shing Lin and Tian-Shiue Yen

Int. J. Environ. Res. Public Health 2014, 11(2), 1573-1593; https://doi.org/10.3390/ijerph110201573 - 29 Jan 2014

Cited by 29 | Viewed by 7539

Abstract

Wheezing is often treated as a crucial indicator in the diagnosis of obstructive pulmonary diseases. A rapid wheezing detection system may help physicians to monitor patients over the long-term. In this study, a portable wheezing detection system based on a field-programmable gate array (FPGA) is proposed. This system accelerates wheezing detection, and can be used as either a single-process system, or as an integrated part of another biomedical signal detection system. The system segments sound signals into 2-second units. A short-time Fourier transform was used to determine the relationship between the time and frequency components of wheezing sound data. A spectrogram was processed using 2D bilateral filtering, edge detection, multithreshold image segmentation, morphological image processing, and image labeling, to extract wheezing features according to computerized respiratory sound analysis (CORSA) standards. These features were then used to train the support vector machine (SVM) and build the classification models. The trained model was used to analyze sound data to detect wheezing. The system runs on a Xilinx Virtex-6 FPGA ML605 platform. The experimental results revealed that the system offered excellent wheezing recognition performance (0.912). The detection process can be used with a clock frequency of 51.97 MHz, and is able to perform rapid wheezing classification. Full article

(This article belongs to the Special Issue Next Generation of Interoperability in Health Care: Standards and Application)

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Open AccessArticle

Detection of Potential Drug-Drug Interactions for Outpatients across Hospitals

by Yu-Ting Yeh, Min-Hui Hsu, Chien-Yuan Chen, Yu-Sheng Lo and Chien-Tsai Liu

Int. J. Environ. Res. Public Health 2014, 11(2), 1369-1383; https://doi.org/10.3390/ijerph110201369 - 27 Jan 2014

Cited by 6 | Viewed by 7372

Abstract

The National Health Insurance Administration (NHIA) has adopted smart cards (or NHI-IC cards) as health cards to carry patients’ medication histories across hospitals in Taiwan. The aims of this study are to enhance a computerized physician order entry system to support drug-drug interaction (DDI) checking based on a patient’s medication history stored in his/her NHI-IC card. For performance evaluation, we developed a transaction tracking log to keep track of every operation on NHI-IC cards. Based on analysis of the transaction tracking log from 1 August to 31 October 2007, physicians read patients’ NHI-IC cards in 71.01% (8,246) of patient visits; 33.02% (2,723) of the card reads showed at least one medicine currently being taken by the patient, 82.94% of which were prescribed during the last visit. Among 10,036 issued prescriptions, seven prescriptions (0.09%) contained at least one drug item that might interact with the currently-taken medicines stored in NHI-IC cards and triggered pop-up alerts. This study showed that the capacity of an NHI-IC card is adequate to support DDI checking across hospitals. Thus, the enhanced computerized physician order entry (CPOE) system can support better DDI checking when physicians are making prescriptions and provide safer medication care, particularly for patients who receive medication care from different hospitals. Full article

(This article belongs to the Special Issue Next Generation of Interoperability in Health Care: Standards and Application)

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IAServ: An Intelligent Home Care Web Services Platform in a Cloud for Aging-in-Place

by Chuan-Jun Su and Chang-Yu Chiang

Int. J. Environ. Res. Public Health 2013, 10(11), 6106-6130; https://doi.org/10.3390/ijerph10116106 - 12 Nov 2013

Cited by 30 | Viewed by 9209

Abstract

As the elderly population has been rapidly expanding and the core tax-paying population has been shrinking, the need for adequate elderly health and housing services continues to grow while the resources to provide such services are becoming increasingly scarce. Thus, increasing the efficiency of the delivery of healthcare services through the use of modern technology is a pressing issue. The seamless integration of such enabling technologies as ontology, intelligent agents, web services, and cloud computing is transforming healthcare from hospital-based treatments to home-based self-care and preventive care. A ubiquitous healthcare platform based on this technological integration, which synergizes service providers with patients’ needs to be developed to provide personalized healthcare services at the right time, in the right place, and the right manner. This paper presents the development and overall architecture of IAServ (the Intelligent Aging-in-place Home care Web Services Platform) to provide personalized healthcare service ubiquitously in a cloud computing setting to support the most desirable and cost-efficient method of care for the aged-aging in place. The IAServ is expected to offer intelligent, pervasive, accurate and contextually-aware personal care services. Architecturally the implemented IAServ leverages web services and cloud computing to provide economic, scalable, and robust healthcare services over the Internet. Full article

(This article belongs to the Special Issue Next Generation of Interoperability in Health Care: Standards and Application)

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