Tài liệu MEDICAL AND CARE COMPUNETICS 3 ppt

MEDICAL AND CARE COMPUNETICS 3

Studies in Health Technology and

Informatics

This book series was started in 1990 to promote research conducted under the auspices of the EC

programmes’ Advanced Informatics in Medicine (AIM) and Biomedical and Health Research

(BHR) bioengineering branch. A driving aspect of international health informatics is that

telecommunication technology, rehabilitative technology, intelligent home technology and many

other components are moving together and form one integrated world of information and

communication media. The complete series has been accepted in Medline. Volumes from 2005

onwards are available online.

Series Editors:

Dr. J.P. Christensen, Prof. G. de Moor, Prof. A. Famili, Prof. A. Hasman, Prof. L. Hunter,

Dr. I. Iakovidis, Dr. Z. Kolitsi, Mr. O. Le Dour, Dr. A. Lymberis, Prof. P.F. Niederer,

Prof. A. Pedotti, Prof. O. Rienhoff, Prof. F.H. Roger France, Dr. N. Rossing,

Prof. N. Saranummi, Dr. E.R. Siegel, Dr. P. Wilson, Prof. E.J.S. Hovenga,

Prof. M.A. Musen and Prof. J. Mantas

Volume 121

Recently published in this series

Vol. 120. V. Hernández, I. Blanquer, T. Solomonides, V. Breton and Y. Legré (Eds.),

Challenges and Opportunities of HealthGrids – Proceedings of Healthgrid 2006

Vol. 119. J.D. Westwood, R.S. Haluck, H.M. Hoffman, G.T. Mogel, R. Phillips, R.A. Robb and

K.G. Vosburgh (Eds.), Medicine Meets Virtual Reality 14 – Accelerating Change in

Healthcare: Next Medical Toolkit

Vol. 118. R.G. Bushko (Ed.), Future of Intelligent and Extelligent Health Environment

Vol. 117. C.D. Nugent, P.J. McCullagh, E.T. McAdams and A. Lymberis (Eds.), Personalised

Health Management Systems – The Integration of Innovative Sensing, Textile,

Information and Communication Technologies

Vol. 116. R. Engelbrecht, A. Geissbuhler, C. Lovis and G. Mihalas (Eds.), Connecting Medical

Informatics and Bio-Informatics – Proceedings of MIE2005

Vol. 115. N. Saranummi, D. Piggott, D.G. Katehakis, M. Tsiknakis and K. Bernstein (Eds.),

Regional Health Economies and ICT Services

Vol. 114. L. Bos, S. Laxminarayan and A. Marsh (Eds.), Medical and Care Compunetics 2

Vol. 113. J.S. Suri, C. Yuan, D.L. Wilson and S. Laxminarayan (Eds.), Plaque Imaging: Pixel to

Molecular Level

Vol. 112. T. Solomonides, R. McClatchey, V. Breton, Y. Legré and S. Nørager (Eds.), From

Grid to Healthgrid

Vol. 111. J.D. Westwood, R.S. Haluck, H.M. Hoffman, G.T. Mogel, R. Phillips, R.A. Robb and

K.G. Vosburgh (Eds.), Medicine Meets Virtual Reality 13

ISSN 0926-9630

Medical and Care Compunetics 3

Edited by

Lodewijk Bos

President ICMCC

Laura Roa

Escuela Superior de Ingeniería, University of Seville, Spain

Kanagasingam Yogesan

Centre of Excellence in e-Medicine Lions Eye Institute, Australia

Brian O’Connell

Department of Computer Science, Central Connecticut State University, USA

Andy Marsh

VMW Solutions, UK

and

Bernd Blobel

eHealth Competence Center, University of Regensburg Medical Center,

Germany

Amsterdam • Berlin • Oxford • Tokyo • Washington, DC

© 2006 The authors.

All rights reserved. No part of this book may be reproduced, stored in a retrieval system,

or transmitted, in any form or by any means, without prior written permission from the publisher.

ISBN 1-58603-620-3

Library of Congress Control Number: 2006925767

Publisher

IOS Press

Nieuwe Hemweg 6B

1013 BG Amsterdam

Netherlands

fax: +31 20 687 0019

e-mail: [email protected]

Distributor in the UK and Ireland Distributor in the USA and Canada

Gazelle Books Services Ltd. IOS Press, Inc.

White Cross Mills 4502 Rachael Manor Drive

Hightown Fairfax, VA 22032

Lancaster LA1 4XS USA

United Kingdom fax: +1 703 323 3668

fax: +44 1524 63232 e-mail: [email protected]

e-mail: [email protected]

LEGAL NOTICE

The publisher is not responsible for the use which might be made of the following information.

PRINTED IN THE NETHERLANDS

v

This page intentionally left blank

Medical and Care Compunetics 3 vii

L. Bos et al. (Eds.)

IOS Press, 2006

© 2006 The authors. All rights reserved.

Preface

This book accompanies the third annual ICMCC Event. In the 12 months since our

previous conference we established the goals of the ICMCC Foundation.

To become the leading source for citizen/patient-related information using the lat￾est medical and care compunetics is the first of these goals. ICMCC has been one of the

first organizations recognizing the possible thread to patient safety of the information

available on the internet.

ICMCC also recognizes the problems of professionals to find information on the

latest developments in medical and care compunetics in a structured way.

These two aspects form the basis for becoming the leading Knowledge Centre on

medicine and care.

To realize this goal our third annual event covers aspects concerning:

• Information supply to patient and professional

• Electronic health records, its standards, its social implications

• New developments in medical & care compunetics.

Our third goal is to serve as the central meeting place for exchanging information

on all aspects related to medical and care compunetics and for all those concerned. We

are therefore pleased to be a platform once again for a number of European Commis￾sion (IST) funded projects.

And we are proud to be the platform for the EFMI (European Federation for Medi￾cal Informatics) Working Groups “Electronic Health Records”, “Security, Safety and

Ethics” and “Cards” and we would like to thank Dr. Bernd Blobel and Dr. Peter

Pharow for their work to organise this session.

On September 29, 2005 our co-founder Prof. Swamy Laxminarayan passed away.

We will be forever in his debt for his believe in our organisation and goals and his re￾lentless support. To honour the memory of one of the greatest minds in biomedicine

and biotechnology of the twentieth century ICMCC will this year initiate an annual

Swamy Laxminarayan lecture.

On behalf of the ICMCC Foundation board we wish to thank the IFMBE and the

WABT-ICET-UNESCO for accepting us as members and for their support for this con￾ference. We are equally grateful for the endorsement by the IEEE-SSIT.

Finally we would like to thank all the authors who have contributed to making the

third ICMCC Event into an interesting and challenging conference.

Lodewijk Bos

Laura Roa

Brian O’Connell

Kanagasingam Yogesan

Andy Marsh

Bernd Blobel

viii

Board Lists

Council Board

Drs Lodewijk Bos, president, The Netherlands

Robert von Hinke Kessler (vice-president, treasurer, secretary general),

The Netherlands

Denis Carroll, (vice-president), Westminster University, UK

Dr Andy Marsh (vice-president), VMWSolutions, UK

Prof. Brian O’Connell (vice-president), Central Connecticut State University, USA

Prof. Kanagasingam Yogesan (vice-president), Centre of Excellence in e-Medicine,

Australia

Organizing Committee

Event chair

Drs Lodewijk Bos, president of ICMCC, The Netherlands

Scientific chair

Prof. Laura Roa, Biomedical Engineering Program, University of Sevilla, Spain

Chair Electronic health records, its standards, its social implications

Prof. Brian O’Connell, Central Connecticut State University, USA

Co-chair: Bryan Manning, UK

Chair Developments in Medical & Care Compunetics

Prof. Kanagasingam Yogesan, Director, Centre of Excellence in e-Medicine, Australia

Scientific Advisory Board

Prof. Dr Emile Aarts, Philips, Technical University Eindhoven, The Netherlands

Dr Hamideh Afsarmanesh, Universiteit van Amsterdam, The Netherlands

Prof. Metin Akay, Dartmouth University, USA

Prof. Andreas S. Anayiotos, University of Alabama at Birmingham, USA

Prof. Hamid R. Arabnia, PhD, The University of Georgia, USA

Dr. Rajeev Bali Coventry University, UK

Drs Iddo Bante, Centre for Telematics and Information Technology (CTIT)/

Technology Circle Twente (TKT), The Netherlands

PD Dr Bernd Blobel, Institute of Biometry and Medical Informatics, Universität

Magdeburg, Germany

Dr Charles Boucher, University Medical Center Utrecht, The Netherlands

Prof. Peter Brett, Aston University, Birmingham, UK

Dr Jimmy Chan Tak-shing, Alice Ho Miu Ling Nethersole Hospital, Hong Kong,

China

ix

Juan Carlos Chia, Proventis, UK

Dr Thierry Chaussalet, University of Westminster, London, UK

Dr Malcolm Clarke, Brunel University, UK

Dr Ir Adrie Dumay, TNO, The Netherlands

Ad Emmen, Genias Benelux, The Netherlands

Prof. Ken Foster, University of Pennsylvania, USA

Dr Walter Greenleaf, Greenleaf Med. Group, USA

Prof. Dr. Dr. h.c. Helmut Hutten, University of Technology Graz, Austria

Bob Ireland, Kowa Research Europe, UK

Prof. Robert Istepanian, Kingston University, UK

Prof. Dr Chris Johnson, SCI, University of Utah, USA

Prof. Ida Jovanovic, Children’s Hospital of Belgrade, Serbia and Montenegro

Prof. Zoran Jovanovic, University of Belgrade, Serbia and Montenegro

Donald W. Kemper, Healthwise, USA

Makoto Kikuchi, National Defense Medical College, Japan

Prof. Dr Luis G. Kun, National Defense University, USA

Prof. Dr Michael Lightner, University of Colorado Boulder, President IEEE, USA

Prof. DrSc. Ratko Magjarevic, University of Zagreb, Croatia

Prof. Dr Joachim Nagel, University of Stuttgart, President IFMBE, Germany

Prof. Raouf Naguib, Coventry University, UK; University of Carleton, Canada

Ron Oberleitner, TalkAutism, e-MERGE Medical Marketing, USA

Prof. Marimuthu Palaniswami, University of Melbourne Parkville, Australia

Prof. Dr Neill Piland, Idaho State University, USA

Michael L. Popovich MS SE, STC, Tucson, USA

Prof. Dr Ir Hans Reiber, Leiden University Medical Center, The Netherlands

Dr George Roussos, SCSIS, Univ. of London, UK

Sandip K. Roy, PhD, Novartis Pharmaceuticals, USA

Prof. Dr-Ing. Giorgos Sakas, Fraunhofer IGD, Germany

Clyde Saldanha, JITH, UK

Prof. Dr Niilo Saranummi, VTT Information Technologies, Past-President EAMBES,

Finland

Prof. Corey Schou, Idaho State University, USA

Anna Siromoney PhD, Womens Christian College, India

Prof. Dr Peter Sloot, Universiteit van Amsterdam, The Netherlands

Prof. Dr Jasjit Suri, Senior Director, R & D., Fischer Imaging Corporation, Denver,

USA

Basel Solaiman, INSERM-ENST, France

Prof. Mihai Tarata, University of Medicine and Pharmacy of Craiova, Romania

Dr. Joseph Tritto, World Academy of Biomedical Technologies, UNESCO, France

Prof. Dr Bertie Zwetsloot-Schonk, Leiden University Medical Center, The Netherlands

This page intentionally left blank

xi

Contents

Preface vii

Lodewijk Bos, Laura Roa, Brian O’Connell, Kanagasingam Yogesan,

Andy Marsh and Bernd Blobel

Board Lists viii

PARKSERVICE: Home Support and Walking Aid for People with

Parkinson’s Disease 1

U. Delprato, R. Greenlaw and M. Cristaldi

Assistive Technology – Behaviourally Assisted 7

S. Benton and B. Manning

Empowering the Impaired Through the Appropriate Use of Information

Technology and Internet 15

Ishita Sanyal

Telemedicine Odyssey Customised Telemedicine Solution for Rural and

Remote Areas in India 22

Jagjit Singh Bhatia and Sagri Sharma

A Deployable Framework for Mobile Telemedicine Applications 36

N.A. Ikhu-Omoregbe, C.K. Ayo and S.A. Ehikioya

Applications of ePerSpace Service Management Platform in Health Care 42

Kambiz Madani and Mahi Lohi

Context-Aware Workflow Management of Mobile Health Applications 47

Alfons Salden and Remco Poortinga

Health Inequalities and Emerging Themes in Compunetics 62

M. Chris Gibbons

Integrated Multimedia Medical Data Agent in E-Health 70

P. di Giacomo, Fabrizio L. Ricci and Leonardo Bocchi

Developing Health Surveillance Networks: An Adaptive Approach 74

Suzanne Tamang, Danny Kopec, Tony McCofie and Karen Levy

Using UMLS to Map from a Library to a Clinical Classification: Improving

the Functionality of a Digital Library 86

Judas Robinson, Simon de Lusignan, Patty Kostkova and Bruce Madge

Methodological Issues for the Information Model of a Knowledge-Based

Telehealthcare System for Nephrology (Nefrotel) 96

Manuel Prado, Laura M. Roa and Javier Reina-Tosina

xii

HEARTFAID: A Knowledge Based Platform of Services for Supporting

Medical-Clinical Management of Heart Failure Within Elderly Population 108

Domenico Conforti, Domenico Costanzo, Francesco Perticone,

Gianfranco Parati, Kalina Kawecka-Jaszcz, Andrew Marsh,

Christos Biniaris, Manolis Stratakis, Riccardo Fontanelli,

Davide Guerri, Ovidio Salvettis, Manolis Tsiknakis, Franco Chiarugi,

Dragan Gamberger and Mariaconsuelo Valentini

The State of the Art in the Reduction of Medical Errors 126

Danny Kopec, Suzanne Tamang, Karen Levy, Ronald Eckhardt

and Gene Shagas

e-Care Integration: To Meet the Demographic Challenge 138

Bryan R.M. Manning and Mary McKeon Stosuy

Applied Medical & Care Compunetics to Public Health Disease Surveillance

and Management: Leveraging External Data Sources – A Key to Public Health

Preparedness 151

Michael L. Popovich and Todd Watkins

Patient Record Access – The Time Has Come 162

Brian Fisher, Richard Fitton, Charline Poirier and David Stables

New Trends in the Virtualization of Hospitals – Tools for Global e-Health 168

Georgi Graschew, Theo A. Roelofs, Stefan Rakowsky, Peter M. Schlag,

Paul Heinzlreiter, Dieter Kranzlmüller and Jens Volkert

Monitoring the Integration of Hospital Information Systems: How It May

Ensure and Improve the Quality of Data 176

Ricardo Cruz-Correia, Pedro Vieira-Marques, Ana Ferreira,

Ernesto Oliveira-Palhares, Pedro Costa and Altamiro Costa-Pereira

MedIEQ – Quality Labelling of Medical Web Content Using Multilingual

Information Extraction 183

Miquel Angel Mayer, Vangelis Karkaletsis, Kostas Stamatakis,

Angela Leis, Dagmar Villarroel, Christian Thomeczek, Martin Labský,

Fernando López-Ostenero and Timo Honkela

Improving Uptake of a Breast Screening Programme: A Knowledge

Management Approach for Opportunistic Intervention 191

Vikraman Baskaran, Rajeev K. Bali, Hisbel Arochena, Raouf N.G. Naguib,

Margot Wheaton and Matthew Wallis

EHR Standards – A Comparative Study 198

Bernd Blobel and Peter Pharow

Developing a Strategic Framework for Healthcare Standards 207

Bryan R.M. Manning

Lowering the Barrier to a Decentralized NHIN Using the Open Healthcare

Framework 214

Eishay Smith and James H. Kaufman

xiii

Knowledge Management and Electronic Care Records: Incorporating Social,

Legal and Ethical Issues 221

James Bassinder, Rajeev K. Bali and Raouf Naguib

Integrated Electronic Health Records Management System 228

P. di Giacomo, Fabrizio L. Ricci and Leonardo Bocchi

Standards for Medical Device Communication: X73 PoC-MDC 242

Miguel Galarraga, Luis Serrano, Ignacio Martínez and Paula de Toledo

A Standard Ontology for the Semantic Integration of Components in

Healthcare Organizations 257

I. Román, L.M. Roa, G. Madinabeitia and L.J. Reina

A Novel Management Database in Obstetrics and Gynaecology to Introduce

the Electronic Healthcare Record and Improve the Clinical Audit Process 266

Khaled El Hayes, Conor Harrity and Tahani Abu Zeineh

EFMI Session

SNOMED-CT: The Advanced Terminology and Coding System for eHealth 279

Kevin Donnelly

EHR in the Perspective of Security, Integrity and Ethics 291

Ragnar Nordberg

Personal Health – The Future Care Paradigm 299

Thomas Norgall, Bernd Blobel and Peter Pharow

Formal Policies for Flexible EHR Security 307

Bernd Blobel and Peter Pharow

Citizen Empowerment Using Healthcare and Welfare Cards 317

Paul Cheshire

BioHealth – The Need for Security and Identity Management Standards

in eHealth 327

Claudia Hildebrand, Peter Pharow, Rolf Engelbrecht, Bernd Blobel,

Mario Savastano and Asbjorn Hovsto

Formal Design of Electronic Public Health Records 337

Diego M. Lopez and Bernd Blobel

Specific Interoperability Problems of Security Infrastructure Services 349

Peter Pharow and Bernd Blobel

Sharable EHR Systems in Finland 364

Kari Harno and Pekka Ruotsalainen

xiv

Invited Paper

Information Therapy: The Strategic Role of Prescribed Information in

Disease Self-Management 373

Molly Mettler and Donald W. Kemper

Author Index 385

PARKSERVICE: Home Support and

Walking Aid for People with Parkinson’s

Disease

U. Delpratoa,1

, R. Greenlawb

, M. Cristaldic

a

PARKAID Srl, Italy

b

Oxford Computer Consultants Ltd, UK c

IES Srl, Via del Babuino 99, Italy

Abstract. PARKSERVICE is a telemedical application currently being validated

in the EU. The objectives are to provide a combination of home clinical and social

support for people with Parkinson’s disease with a revolutionary walking aid that

uses “visual cues” to enable improved mobility. Early results are presented and the

outlook of home telemedicine and visual cueing for people with PD is discussed.

Keywords. Telemedicine, Parkinson’s disease, visual cueing

Introduction

PARKSERVICE is a new telemedical application combining home-based support for

people with Parkinson’s disease (PD) and a PD-specific walking aid which uses a

strategy known as visual cueing. PD is estimated to affect 100-180 per 100,000 of the

population (with most surveys favoring the higher estimate) and has an annual

incidence of 4-20 per 100,000[1],[2]. Taking a population of approximately 450M

citizens this implies 450,000-900,000 people with PD (PWP) in the EU.

PD is a progressive, incurable neurological disease resulting in depletion of the

neurotransmitter dopamine in the brain. Currently all therapy is symptomatic and

primarily based on pharmacological enhancement of dopamine levels via the drug

levadopa.

The three cardinal signs of PD are bradykinesia (decrease in movement), resting

tremor (shaking, usually of the extremities of the limbs) and rigidity (muscular stiffness,

cramps). As the disease progresses PWP typically suffer from gait abnormalities,

falling and periods of complete immobility (akinesia or “freezing”). Additionally there

are complications associated with long-term use of levadopa, including daily

fluctuations between “on” periods of good symptom control (normal mobility) with

“off” periods of poor symptom control (poor mobility) and even dyskinetic periods of

exaggerated poorly controlled mobility. Transitions between these phases are primarily

1

Corresponding Author: Uberto Delprato, ParkAid srl, Via del Babuino 99, 00131

Roma, Italy; [email protected]

Medical and Care Compunetics 3

L. Bos et al. (Eds.)

IOS Press, 2006

© 2006 The authors. All rights reserved.

1