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Special Issue "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)

Special Issue Editor

Guest Editor
Prof. Dr. Po-Hsun Cheng

Department of Software Engineering, National Kaohsiung Normal University, Kaohsiung 82444, Taiwan
Website | E-Mail
Phone: +886-9-888-810-006
Interests: healthcare informatics; software engineering; telemedicine; hardware/software co-design

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

Submission

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. Papers will be published continuously (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as 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.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are refereed through a peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed Open Access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 1600 CHF (Swiss Francs).


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

Open AccessArticle Patients’ Perspective of the Design of Provider-Patients Electronic Communication Services
Int. J. Environ. Res. Public Health 2014, 11(6), 6231-6245; doi:10.3390/ijerph110606231
Received: 27 February 2014 / Revised: 3 June 2014 / Accepted: 6 June 2014 / Published: 12 June 2014
PDF Full-text (503 KB) | HTML Full-text | XML Full-text
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.
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 described. The architecture and the methodology for the healthcare service portal are set out in the proposed system design. Full article
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Open AccessArticle Importance-Satisfaction Analysis for Primary Care Physicians’ Perspective on EHRs in Taiwan
Int. J. Environ. Res. Public Health 2014, 11(6), 6037-6051; doi:10.3390/ijerph110606037
Received: 27 February 2014 / Revised: 28 May 2014 / Accepted: 3 June 2014 / Published: 6 June 2014
Cited by 3 | PDF Full-text (574 KB) | HTML Full-text | XML Full-text
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
[...] Read more.
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
Open AccessArticle The Next Generation of Interoperability Agents in Healthcare
Int. J. Environ. Res. Public Health 2014, 11(5), 5349-5371; doi:10.3390/ijerph110505349
Received: 3 March 2014 / Revised: 24 April 2014 / Accepted: 28 April 2014 / Published: 16 May 2014
Cited by 15 | PDF Full-text (4480 KB) | HTML Full-text | XML Full-text
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
[...] Read more.
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
Open AccessArticle Integrating Social Capital Theory, Social Cognitive Theory, and the Technology Acceptance Model to Explore a Behavioral Model of Telehealth Systems
Int. J. Environ. Res. Public Health 2014, 11(5), 4905-4925; doi:10.3390/ijerph110504905
Received: 27 February 2014 / Revised: 21 April 2014 / Accepted: 29 April 2014 / Published: 7 May 2014
Cited by 9 | PDF Full-text (499 KB) | HTML Full-text | XML Full-text
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
[...] Read more.
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
Open AccessArticle Promoting Positive Psychology Using Social Networking Sites: A Study of New College Entrants on Facebook
Int. J. Environ. Res. Public Health 2014, 11(5), 4652-4663; doi:10.3390/ijerph110504652
Received: 28 February 2014 / Revised: 10 April 2014 / Accepted: 18 April 2014 / Published: 29 April 2014
Cited by 1 | PDF Full-text (611 KB) | HTML Full-text | XML Full-text
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
[...] Read more.
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
Open AccessArticle A Lightweight Web of Things Open Platform to Facilitate Context Data Management and Personalized Healthcare Services Creation
Int. J. Environ. Res. Public Health 2014, 11(5), 4676-4713; doi:10.3390/ijerph110504676
Received: 26 February 2014 / Revised: 11 April 2014 / Accepted: 14 April 2014 / Published: 29 April 2014
Cited by 4 | PDF Full-text (1485 KB) | HTML Full-text | XML Full-text
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
[...] Read more.
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
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Open AccessArticle An Interactive Wireless Communication System for Visually Impaired People Using City Bus Transport
Int. J. Environ. Res. Public Health 2014, 11(5), 4560-4571; doi:10.3390/ijerph110504560
Received: 20 February 2014 / Revised: 9 April 2014 / Accepted: 15 April 2014 / Published: 25 April 2014
Cited by 2 | PDF Full-text (936 KB) | HTML Full-text | XML Full-text
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
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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
Open AccessArticle A ZigBee-Based Location-Aware Fall Detection System for Improving Elderly Telecare
Int. J. Environ. Res. Public Health 2014, 11(4), 4233-4248; doi:10.3390/ijerph110404233
Received: 19 February 2014 / Revised: 1 April 2014 / Accepted: 3 April 2014 / Published: 16 April 2014
Cited by 7 | PDF Full-text (912 KB) | HTML Full-text | XML Full-text
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
[...] Read more.
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
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Open AccessArticle Design of a Real-Time and Continua-Based Framework for Care Guideline Recommendations
Int. J. Environ. Res. Public Health 2014, 11(4), 4262-4279; doi:10.3390/ijerph110404262
Received: 1 March 2014 / Revised: 3 April 2014 / Accepted: 4 April 2014 / Published: 16 April 2014
Cited by 3 | PDF Full-text (738 KB) | HTML Full-text | XML Full-text
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
[...] Read more.
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
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Open AccessArticle Gait Recognition and Walking Exercise Intensity Estimation
Int. J. Environ. Res. Public Health 2014, 11(4), 3822-3844; doi:10.3390/ijerph110403822
Received: 30 December 2013 / Revised: 18 March 2014 / Accepted: 19 March 2014 / Published: 4 April 2014
Cited by 2 | PDF Full-text (1595 KB) | HTML Full-text | XML Full-text
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.
[...] Read more.
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
Open AccessArticle An FPGA-Based Rapid Wheezing Detection System
Int. J. Environ. Res. Public Health 2014, 11(2), 1573-1593; doi:10.3390/ijerph110201573
Received: 30 December 2013 / Revised: 24 January 2014 / Accepted: 24 January 2014 / Published: 29 January 2014
Cited by 4 | PDF Full-text (1657 KB) | HTML Full-text | XML Full-text
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
[...] Read more.
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
Open AccessArticle Detection of Potential Drug-Drug Interactions for Outpatients across Hospitals
Int. J. Environ. Res. Public Health 2014, 11(2), 1369-1383; doi:10.3390/ijerph110201369
Received: 17 December 2013 / Revised: 13 January 2014 / Accepted: 14 January 2014 / Published: 27 January 2014
Cited by 3 | PDF Full-text (442 KB) | HTML Full-text | XML Full-text
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
[...] Read more.
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
Open AccessArticle IAServ: An Intelligent Home Care Web Services Platform in a Cloud for Aging-in-Place
Int. J. Environ. Res. Public Health 2013, 10(11), 6106-6130; doi:10.3390/ijerph10116106
Received: 3 September 2013 / Revised: 5 November 2013 / Accepted: 5 November 2013 / Published: 12 November 2013
Cited by 12 | PDF Full-text (1194 KB) | HTML Full-text | XML Full-text
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
[...] Read more.
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
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