The integration of information systems represents one of the most urgent priorities of a regional... more The integration of information systems represents one of the most urgent priorities of a regional healthcare authority in order to meet its clinical, organizational and managerial needs. Current practice shows that the most promising approach to achieve a regional healthcare information system (RHIS) is to use a health level 7 (HL7) message-based communication system implemented by an asynchronous common communication infrastructure between healthcare sites. The RHIS is a complete and integrated information system at a regional level that comprises all types of healthcare levels, that includes interoperability issues, that covers most of the needed components, and that is able to work efficiently in a secure wide area network to ensure data privacy and confidentiality. Another important feature of the proposed solution is that it creates an interoperability framework that can be replicated from one healthcare institution to another. In that sense, common interoperability messages can be used to interconnect heterogeneous information systems. In response to this strategy, more than 10 different consortiums have submitted proposals to the Greek government and the proposed interoperability' framework seems to be widely accepted as a solution to enhance information and communication technologies developments in the healthcare sector in Greece.
Studies in health technology and informatics, 2016
The European Patient Summary (PS) guideline specifies a minimal dataset of essential and importan... more The European Patient Summary (PS) guideline specifies a minimal dataset of essential and important information for unplanned or emergency care initially defined in the epSOS project with aim to improve patients' safety and quality of Care. The eHealth Network of European Union (EU) Member State (MS) representatives established under Article 14 of the EU directive 2011/24 on patient rights to cross-border healthcare adopted PS guideline in November 2013 and since then the guideline has been part of MS strategic eHealth implementation plans, standardization efforts, and concrete regional, national, European and international projects. This paper reviews implementation efforts for the implementation of an operational patient summary service in Greece drawing on challenges and lessons learned for sustainable standards-based large scale eHealth deployment in Europe and abroad, as well as the reuse of best practices from international standards and integration profiles.
Key Performance Indicators and Information Flow: The Cornerstones of Effective Knowledge Manageme... more Key Performance Indicators and Information Flow: The Cornerstones of Effective Knowledge Management for Managed Care (9781599049335): Alexander Berler, Sotiris Pavlopoulos, Dimitris Koutsouris: Book Chapters.
Proceedings of the 20th Annual International Conference of the IEEE Engineering in Medicine and Biology Society. Vol.20 Biomedical Engineering Towards the Year 2000 and Beyond (Cat. No.98CH36286), 1998
ABSTRACT Medical institutions have felt the need for a well structured computer-based patient rec... more ABSTRACT Medical institutions have felt the need for a well structured computer-based patient record (CPR) for at least 20 years now. Hospital information systems (HIS) were conceived to serve that purpose. A pilot application is being developed to serve the needs of management of inpatient and outpatient medical record, the mechanism of patients' visits and bed reservation from the GPs (general practitioners) as well as the management of the drug store. Having these needs in mind we developed an intranet Web client-server application. The developed system provides a user-friendly graphical interface and features such as Internet access, access to complete electronic patient records, remote access, etc. The whole application was developed as an ActiveX Document that can be downloaded from a Web server and run from within a Web browser. The scope of this intranet based hospital information system is to improve the quality of health care provision, to minimise the institution's costs, to ameliorate time management, to increase training capabilities and to improve remote patient record access. This system will increase patient satisfaction by reducing waiting times and staff morale through high quality information systems and infrastructure
Proceedings of the Second Joint 24th Annual Conference and the Annual Fall Meeting of the Biomedical Engineering Society] [Engineering in Medicine and Biology, 2002
... [2] James Rumbaugh, Ivar Jacobson, Grady Booch, The Unified Modeling Language ReferenceManu... more ... [2] James Rumbaugh, Ivar Jacobson, Grady Booch, The Unified Modeling Language ReferenceManual, Addison-Wesley ... and biomedical engineering, Chicago 2000, Chicago, USA, 23-28July 2000 [8] S Moehrs, G. Brelstaff, P. Anedda, G. Zanetti, M. Tuveri, Internet Patient ...
Recent studies conclude that early and specialized prehospital management contributes to emergenc... more Recent studies conclude that early and specialized prehospital management contributes to emergency case survival. Ambulance personnel, who usually are the first to handle emergency situations, do not have the required theoretical knowledge and experience. Financial and practical reasons do not allow the participation of specialized physicians on ambulance vehicles. Within the framework of the health telematics programme, we have developed a portable medical device that allows telediagnosis, long distance support and teleconsultation of mobile health care providers by specialized physicians. The device allows the transmission of vital biosignals and still images of the patient from the incident place to the hospital. The transmission is performed through the GSM mobile telephony network. The device can telematically “bring” a specialist doctor to the site of the medical emergency, allow him to evaluate patient data and issue directions to the emergency personnel on treatment procedures until the patient is brought to hospital. Due to the need for storing and archiving data being interchanged during the telemedicine sessions, we have equipped the consultation site with a multimedia database able to store and manage the data collected by the “AMBULANCE” system. The performance of the system has been validated in four different countries using a controlled medical protocol
Studies in health technology and informatics, 2015
The continuity of cross-border health care in the European Union depends on the ability to set up... more The continuity of cross-border health care in the European Union depends on the ability to set up shared practices with respect to patient data exchange across Member States. This flow of data must comply with demanding security, legal and interoperability requirements, as defined by the epSOS project specifications. In this paper, we describe the OpenNCP framework that offers a comprehensive set of interoperability services to enable national and regional e-Health platforms to set up cross-border health information networks compliant with epSOS, with minimal adaptation of the existing infrastructure. The OpenNCP, available as open source software, has been adopted in 10 Member States, allowing them to securely interconnect their eHealth infrastructures.
Studies in health technology and informatics, 2012
This paper presents an overview and comparison of national efforts on ePrescribing in Finland and... more This paper presents an overview and comparison of national efforts on ePrescribing in Finland and Greece focusing on aspects of interoperability and standards. Building on experience of HL7 affiliates in Finland and Greece, the role of HL7 Clinical Document Architecture (CDA) in assuring interoperability within the national and cross-border framework for ePrescription is addressed underlining current use of standards and interoperability challenges for large scale adoption.
Technology and health care : official journal of the European Society for Engineering and Medicine, 1998
Recent studies conclude that early and specialised pre-hospital patient management contributes to... more Recent studies conclude that early and specialised pre-hospital patient management contributes to emergency cases survival. Recent developments in telecommunication and medical informatics by means of telemedicine can be extremely useful to accomplish such tasks in a cost-effective manner. Along that direction, we have designed a portable device for emergency telemedicine. This device is able to telematically "bring" the expert doctor at the emergency site, have him perform an accurate diagnosis, and subsequently direct the Emergency Medical Technicians on how to treat the patient until he arrives to the hospital. The need for storing and archiving all data being interchanged during the telemedicine sessions is very crucial for clinical, legal and administrative purposes. For this, we have developed a multimedia database able to store and manage the data collected by the AMBULANCE system. The database was equipped with a user-friendly graphical interface to enable use from...
The 1st and 2nd Regional Health Care System Authority of Central Macedonia (1st and 2nd PeSY) are... more The 1st and 2nd Regional Health Care System Authority of Central Macedonia (1st and 2nd PeSY) are two of the seventeen Regional Healthcare System Authorities in Greece. Every single PeSY aims to improve the level of quality that health care organisations offer as well as to control the expenditure of health care services provided by the health care organisations, Hospitals and Primary Care Health units. There is currently an urgent need for Regional Health Authorities to deploy integrated healthcare information system, based on secure networks. The limited interoperability of current hospital information systems (HIS) poses a risk for the management of patient related information since there is a difficulty to transform processed data into useful information and knowledge. Thus, a pilot system was developed to achieve data integration record synchronisation using the Health Level 7 protocol between the existing HIS of two Hospitals of Thessaloniki and the central Offices of the PeSY. The pilot was funded by the Third Community Support Framework (jointly funded by EU and Greece) funds in order to prepare the forthcoming major healthcare IT projects in Greece. It is shown that such a system is pragmatic, achieves data integration and provides acceptable integration costs.
IEEE Transactions on Information Technology in Biomedicine, 2005
The advantages of the introduction of information and communication technologies in the complex h... more The advantages of the introduction of information and communication technologies in the complex health-care sector are already well-known and well-stated in the past. It is, nevertheless, paradoxical that although the medical community has embraced with satisfaction most of the technological discoveries allowing the improvement in patient care, this has not happened when talking about health-care informatics. Taking the above issue of concern, our work proposes an information model for knowledge management (KM) based upon the use of key performance indicators (KPIs) in health-care systems. Based upon the use of the balanced scorecard (BSC) framework (Kaplan/Norton) and quality assurance techniques in health care (Donabedian), this paper is proposing a patient journey centered approach that drives information flow at all levels of the day-to-day process of delivering effective and managed care, toward information assessment and knowledge discovery. In order to persuade health-care decision-makers to assess the added value of KM tools, those should be used to propose new performance measurement and performance management techniques at all levels of a health-care system. The proposed KPIs are forming a complete set of metrics that enable the performance management of a regional health-care system. In addition, the performance framework established is technically applied by the use of state-of-the-art KM tools such as data warehouses and business intelligence information systems. In that sense, the proposed infrastructure is, technologically speaking, an important KM tool that enables knowledge sharing amongst various health-care stakeholders and between different health-care groups. The use of BSC is an enabling framework toward a KM strategy in health care.
The integration of information systems represents one of the most urgent priorities of a regional... more The integration of information systems represents one of the most urgent priorities of a regional healthcare authority in order to meet its clinical, organizational and managerial needs. Current practice shows that the most promising approach to achieve a regional healthcare information system (RHIS) is to use a health level 7 (HL7) message-based communication system implemented by an asynchronous common communication infrastructure between healthcare sites. The RHIS is a complete and integrated information system at a regional level that comprises all types of healthcare levels, that includes interoperability issues, that covers most of the needed components, and that is able to work efficiently in a secure wide area network to ensure data privacy and confidentiality. Another important feature of the proposed solution is that it creates an interoperability framework that can be replicated from one healthcare institution to another. In that sense, common interoperability messages can be used to interconnect heterogeneous information systems. In response to this strategy, more than 10 different consortiums have submitted proposals to the Greek government and the proposed interoperability' framework seems to be widely accepted as a solution to enhance information and communication technologies developments in the healthcare sector in Greece.
Studies in health technology and informatics, 2016
The European Patient Summary (PS) guideline specifies a minimal dataset of essential and importan... more The European Patient Summary (PS) guideline specifies a minimal dataset of essential and important information for unplanned or emergency care initially defined in the epSOS project with aim to improve patients' safety and quality of Care. The eHealth Network of European Union (EU) Member State (MS) representatives established under Article 14 of the EU directive 2011/24 on patient rights to cross-border healthcare adopted PS guideline in November 2013 and since then the guideline has been part of MS strategic eHealth implementation plans, standardization efforts, and concrete regional, national, European and international projects. This paper reviews implementation efforts for the implementation of an operational patient summary service in Greece drawing on challenges and lessons learned for sustainable standards-based large scale eHealth deployment in Europe and abroad, as well as the reuse of best practices from international standards and integration profiles.
Key Performance Indicators and Information Flow: The Cornerstones of Effective Knowledge Manageme... more Key Performance Indicators and Information Flow: The Cornerstones of Effective Knowledge Management for Managed Care (9781599049335): Alexander Berler, Sotiris Pavlopoulos, Dimitris Koutsouris: Book Chapters.
Proceedings of the 20th Annual International Conference of the IEEE Engineering in Medicine and Biology Society. Vol.20 Biomedical Engineering Towards the Year 2000 and Beyond (Cat. No.98CH36286), 1998
ABSTRACT Medical institutions have felt the need for a well structured computer-based patient rec... more ABSTRACT Medical institutions have felt the need for a well structured computer-based patient record (CPR) for at least 20 years now. Hospital information systems (HIS) were conceived to serve that purpose. A pilot application is being developed to serve the needs of management of inpatient and outpatient medical record, the mechanism of patients' visits and bed reservation from the GPs (general practitioners) as well as the management of the drug store. Having these needs in mind we developed an intranet Web client-server application. The developed system provides a user-friendly graphical interface and features such as Internet access, access to complete electronic patient records, remote access, etc. The whole application was developed as an ActiveX Document that can be downloaded from a Web server and run from within a Web browser. The scope of this intranet based hospital information system is to improve the quality of health care provision, to minimise the institution's costs, to ameliorate time management, to increase training capabilities and to improve remote patient record access. This system will increase patient satisfaction by reducing waiting times and staff morale through high quality information systems and infrastructure
Proceedings of the Second Joint 24th Annual Conference and the Annual Fall Meeting of the Biomedical Engineering Society] [Engineering in Medicine and Biology, 2002
... [2] James Rumbaugh, Ivar Jacobson, Grady Booch, The Unified Modeling Language ReferenceManu... more ... [2] James Rumbaugh, Ivar Jacobson, Grady Booch, The Unified Modeling Language ReferenceManual, Addison-Wesley ... and biomedical engineering, Chicago 2000, Chicago, USA, 23-28July 2000 [8] S Moehrs, G. Brelstaff, P. Anedda, G. Zanetti, M. Tuveri, Internet Patient ...
Recent studies conclude that early and specialized prehospital management contributes to emergenc... more Recent studies conclude that early and specialized prehospital management contributes to emergency case survival. Ambulance personnel, who usually are the first to handle emergency situations, do not have the required theoretical knowledge and experience. Financial and practical reasons do not allow the participation of specialized physicians on ambulance vehicles. Within the framework of the health telematics programme, we have developed a portable medical device that allows telediagnosis, long distance support and teleconsultation of mobile health care providers by specialized physicians. The device allows the transmission of vital biosignals and still images of the patient from the incident place to the hospital. The transmission is performed through the GSM mobile telephony network. The device can telematically “bring” a specialist doctor to the site of the medical emergency, allow him to evaluate patient data and issue directions to the emergency personnel on treatment procedures until the patient is brought to hospital. Due to the need for storing and archiving data being interchanged during the telemedicine sessions, we have equipped the consultation site with a multimedia database able to store and manage the data collected by the “AMBULANCE” system. The performance of the system has been validated in four different countries using a controlled medical protocol
Studies in health technology and informatics, 2015
The continuity of cross-border health care in the European Union depends on the ability to set up... more The continuity of cross-border health care in the European Union depends on the ability to set up shared practices with respect to patient data exchange across Member States. This flow of data must comply with demanding security, legal and interoperability requirements, as defined by the epSOS project specifications. In this paper, we describe the OpenNCP framework that offers a comprehensive set of interoperability services to enable national and regional e-Health platforms to set up cross-border health information networks compliant with epSOS, with minimal adaptation of the existing infrastructure. The OpenNCP, available as open source software, has been adopted in 10 Member States, allowing them to securely interconnect their eHealth infrastructures.
Studies in health technology and informatics, 2012
This paper presents an overview and comparison of national efforts on ePrescribing in Finland and... more This paper presents an overview and comparison of national efforts on ePrescribing in Finland and Greece focusing on aspects of interoperability and standards. Building on experience of HL7 affiliates in Finland and Greece, the role of HL7 Clinical Document Architecture (CDA) in assuring interoperability within the national and cross-border framework for ePrescription is addressed underlining current use of standards and interoperability challenges for large scale adoption.
Technology and health care : official journal of the European Society for Engineering and Medicine, 1998
Recent studies conclude that early and specialised pre-hospital patient management contributes to... more Recent studies conclude that early and specialised pre-hospital patient management contributes to emergency cases survival. Recent developments in telecommunication and medical informatics by means of telemedicine can be extremely useful to accomplish such tasks in a cost-effective manner. Along that direction, we have designed a portable device for emergency telemedicine. This device is able to telematically "bring" the expert doctor at the emergency site, have him perform an accurate diagnosis, and subsequently direct the Emergency Medical Technicians on how to treat the patient until he arrives to the hospital. The need for storing and archiving all data being interchanged during the telemedicine sessions is very crucial for clinical, legal and administrative purposes. For this, we have developed a multimedia database able to store and manage the data collected by the AMBULANCE system. The database was equipped with a user-friendly graphical interface to enable use from...
The 1st and 2nd Regional Health Care System Authority of Central Macedonia (1st and 2nd PeSY) are... more The 1st and 2nd Regional Health Care System Authority of Central Macedonia (1st and 2nd PeSY) are two of the seventeen Regional Healthcare System Authorities in Greece. Every single PeSY aims to improve the level of quality that health care organisations offer as well as to control the expenditure of health care services provided by the health care organisations, Hospitals and Primary Care Health units. There is currently an urgent need for Regional Health Authorities to deploy integrated healthcare information system, based on secure networks. The limited interoperability of current hospital information systems (HIS) poses a risk for the management of patient related information since there is a difficulty to transform processed data into useful information and knowledge. Thus, a pilot system was developed to achieve data integration record synchronisation using the Health Level 7 protocol between the existing HIS of two Hospitals of Thessaloniki and the central Offices of the PeSY. The pilot was funded by the Third Community Support Framework (jointly funded by EU and Greece) funds in order to prepare the forthcoming major healthcare IT projects in Greece. It is shown that such a system is pragmatic, achieves data integration and provides acceptable integration costs.
IEEE Transactions on Information Technology in Biomedicine, 2005
The advantages of the introduction of information and communication technologies in the complex h... more The advantages of the introduction of information and communication technologies in the complex health-care sector are already well-known and well-stated in the past. It is, nevertheless, paradoxical that although the medical community has embraced with satisfaction most of the technological discoveries allowing the improvement in patient care, this has not happened when talking about health-care informatics. Taking the above issue of concern, our work proposes an information model for knowledge management (KM) based upon the use of key performance indicators (KPIs) in health-care systems. Based upon the use of the balanced scorecard (BSC) framework (Kaplan/Norton) and quality assurance techniques in health care (Donabedian), this paper is proposing a patient journey centered approach that drives information flow at all levels of the day-to-day process of delivering effective and managed care, toward information assessment and knowledge discovery. In order to persuade health-care decision-makers to assess the added value of KM tools, those should be used to propose new performance measurement and performance management techniques at all levels of a health-care system. The proposed KPIs are forming a complete set of metrics that enable the performance management of a regional health-care system. In addition, the performance framework established is technically applied by the use of state-of-the-art KM tools such as data warehouses and business intelligence information systems. In that sense, the proposed infrastructure is, technologically speaking, an important KM tool that enables knowledge sharing amongst various health-care stakeholders and between different health-care groups. The use of BSC is an enabling framework toward a KM strategy in health care.
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Papers by Alexander Berler