E Health

Abstract: Hospital web sites need to operate as effective web resources of information and interactive communication mediums to address the multifaceted requirements of their main stakeholders, (i.e. patients, healthy citizens, healthcare professionals and local communities). In case of public hospitals, web sites should also be considered as a mean to provide governmental electronic services. The main objective of this study is to provide an evaluation framework for hospital web sites. The proposed framework focuses on three main criteria: information, communication and electronic services. A total of 53 Greek hospital web sites within the Public Sector were evaluated based on a 67-item scale. The main findings of the study were the following: (a) the majority of the web sites in the analysis failed to support necessary web-based transactions between the institutions and their stakeholders (b) web sites are lacking important features regarding provision of information and communica...

The European Network for the Joint Evaluation of Connected Health Technologies (ENJECT) is a COST action that brings together an international consortium, including business and revenue modellers, clinicians, technologists, engineers, economists, ethnographers, and health researchers to help society to answer one question – how to connect therapies, patients, and care-givers to deliver optimum health results in an era of stretched resources and increasing demands. This report, which has grown out of an ENJECT survey of 19 European countries, examines the situation of Connected Health in Europe today. It focuses on creating a clear understanding of the current and developing presence of Connected Health throughout European healthcare systems under five headings: The Policy Environment, Education, Business and Health Models, Interoperability, and The Person. Quality, privacy, and safety, major elements of Connected Health, were evident policy concerns in the Connected Health context. ...

Falls are not an inevitable consequence of aging. The risk and rate of falls can be reduced. Recent improvements in smartphone technology enable implementation of a wide variety of services and applications, thus making the smartphone more of a digital companion than simply a communication tool. This paper presents the results obtained by the FARSEEING project where smartphones are one example of intervention in a population-based scenario. The applications developed take advantage of the smartphone-embedded inertial sensors and require that subjects wear the smartphone by means of a waist belt. The uFall Android application has been developed for monitoring the user’s motor activities at home. The application does not require any direct interaction with the user and it is also capable of running a real-time fall-detection algorithm. uTUG is a stand-alone application for instrumenting the Timed Up and Go test, which is a test often included in fall risk assessment protocols. The application acts like a pocket-sized motion laboratory, since it is capable not only of recording the trial but also of processing the data and immediately displaying the results. uTUG is designed to be self-administrable at home. Stürze sind keine notwendige Folge des Alterns, sie können verhindert werden. Die jüngsten Entwicklungen der Smartphonetechnologie ermöglichen eine Vielzahl von Anwendungen und Applikationen, wodurch das Gerät nicht nur als Kommunikationswerkzeug, sondern zunehmend als digitaler Alltagsbegleiter dient. In diesem Artikel werden Ergebnisse des FARSEEING-Projekts präsentiert, bei dem Smartphones ein Interventionsbeispiel in einem populationsbezogenen Szenario sind. Die hier vorgestellten Applikationen nutzen die im Gerät integrierten Inertialsensoren. Das Smartphone wird dabei mit einem Hüftgurt getragen. Die uFall-Applikation dient zur innerhäuslichen Beobachtung der körperlichen Aktivität des Nutzers und ermöglicht eine algorithmusbasierte Echtzeitsturzerkennung. Die uTUG-Applikation instrumentalisiert den Timed-up-and-go(TUG)-Test (Zeit bis zum Aufstehen und Gehen), welcher häufig zur Messung des Sturzrisikos verwendet wird. Dieses „miniaturisierte Bewegungslabor“ erlaubt nicht nur die Durchführung einzelner Messungen, sondern stellt auch prozessierte Daten zur direkten Auswertung bereit. Die Applikationen ermöglichen die Eigenanwendung und erfordern keine direkte Interaktion des Nutzers mit dem Gerät.

In conventional e-health initiatives, customers (patients) are mostly perceived as recipients of medical care, where they play little roles in the process of health decision making. Empowerment in e-health enables individuals to access their health data and consult online with medical staff. The proposed concept is intended to improve the existing e-health theory in relation to patient empowerment. The study suggests a model that expands the role of customers (patient) in three dimensions: as an individual health actor, social health agent, and medical partner. This study is theoretically significant because it explores a comprehensive approach of patient empowerment in e-health systems to achieve best practice customer service, establish long-term customer relationships to improve customer satisfaction, and achieve better health literacy of individuals.

This article proposes a framework to design and implement e- Health interventions in a comprehensive manner. We draw on complexity science to study the interplay of the ecosystem, the behavior and interactions among its agents. We provide a platform to estimate the Quality of Experience (QoE) to assess the relationship between technology and human factors involved in e-Health projects. Our aim is to estimate QoE in e-Health ecosystems from the perspective of complexity by adopting a methodology that uses fuzzy logic to study the behavior of the ecosystem’s agents. We apply the proposed framework to a remote diagnosis case by means of an ultrasound probe through a satellite link. Despite the ambiguities for determining QoE, the experiment demonstrates the applicability of the framework and allows to stressing the importance of human factors in the implementation of e-Health projects.

Summary Objectives: To present the importance of Evidence-based Health Informatics (EBHI) and the ethical imperative of this approach; to highlight the work of the IMIA Working Group on Technology Assessment and Quality Improvement and the EFMI Working Group on Assessment of Health Information Systems; and to introduce the further important evaluation and evidence aspects being addressed. Methods: Reviews of IMIA, EFMA and other initiatives, together with literature reviews on evaluation methods and on published systematic reviews. Results: Presentation of the rationale for the health informatics domain to adopt a scientific approach by assessing impact, avoiding harm, and empirically demonstrating benefit and best use; reporting of the origins and rationale of the IMIA- and EQUATOR-endorsed Statement on Reporting of Evaluation Studies in Health Informatics (STARE-HI) and of the IMIA WG's Guideline for Good Evaluation Practice in Health Informatics (GEP-HI); presentation of othe...

Recently the Kurdistan Region of Iraq has experienced an explosion in exposure to new technologies in different sectors especially in media and telecommunication. Internet is one of those technologies that have opened a way for information proliferation amongst a previously censored region. Developing web sites to deliver news and other information is a relatively new phenomenon in Kurdistan; this means that the design and development of web pages may lack the quality standard required. In this paper the quality of webpage interface design and usability in the field of news journalism in the KRI is examined against a set of web interface design and usability criterion. For the purpose of data collection 9 available popular news websites are chosen and 900 questionnaires are sent to 100 random users. The result is analyzed and we have found that the majority of users are satisfied with the interface design and usability of the news WebPages, however the result points out some weaknes...

To present the importance of Evidence-based Health Informatics (EBHI) and the ethical imperative of this approach; to highlight the work of the IMIA Working Group on Technology Assessment and Quality Improvement and the EFMI Working Group on Assessment of Health Information Systems; and to introduce the further important evaluation and evidence aspects being addressed. Reviews of IMIA, EFMA and other initiatives, together with literature reviews on evaluation methods and on published systematic reviews. Presentation of the rationale for the health informatics domain to adopt a scientific approach by assessing impact, avoiding harm, and empirically demonstrating benefit and best use; reporting of the origins and rationale of the IMIA- and EQUATOR-endorsed Statement on Reporting of Evaluation Studies in Health Informatics (STARE-HI) and of the IMIA WG's Guideline for Good Evaluation Practice in Health Informatics (GEP-HI); presentation of other initiatives for objective evaluation...

The provision of health care services have changed rapidly and extensively over the past century, from the, what we now belief to be cruel and inhumane treatments of the past, to the brilliant advances in technology available already and the promise by medical scientists of even greater evolution in the near future. However, despite this growing range of new and improved treatments, medicines and techniques, the provision of health care services are still hindered by problems with regard to the high cost of health care, the accessibility to health care services for all and the quality of health care available. Especially in developing countries one of the greatest obstacles in the provision of health care services is to ensure that quality services is also provided for in rural and isolated areas and that these services are accessible to all, including the very poor. This article focus on telehealth and more specifically telemedicine, a development in the health care industry which  are incorporated on various levels of service providing and which may address some of the current problems areas in the industry. The article aims to provide the reader with some insight into the development and use of telemedicine services and more importantly, the legal consequences and how the use of telemedicine services may influence the healthcare industry specifically in South Africa.

Background Having a tax-funded and supposedly ‘National’ Health Service (NHS), one might assume that the UK is well-positioned to roll out eHealth innovations at scale. Yet, despite a strong policy push, the English NHS has been limited in the extent to which it has exploited the potential of eHealth. Main body This paper considers a range of macro, meso and micro factors influencing eHealth innovation in the English NHS. Conclusions While barriers to eHealth innovation exist at all scales, the fragmentation of the NHS is the most significant factor limiting adoption and diffusion. Rather than addressing problems of fragmentation, national policy seems to have intensified the digital divide. As the recently published NHS Long Term Plan places great emphasis on the role of digital transformation in helping health and care professionals communicate better and enabling people to access the care they need quickly and easily, the implications for the digital divide are likely to be signi...

Shortage of healthcare workers (HCWs) hampers treatment outcomes in Sub-Sahara Africa (SSA), there is also a great need for scalable, cost-effective and long-term strategies in curative care services. The benefits of e-Government, the integration of innovative Information and Communication Technologies (ICTs) to conveniently provide access to services are yet to be realized. m-Health is an emerging concept with potential to revolutionize delivery of healthcare, mobile phone technologies potential to change healthcare for the better when used as an enabler to immediate and secure access to critical clinical information when needed in the provision of patient care has not been fully exploited. The study an exploratory research design aims to discover ideas and insights on the use of Electronic Medical Records integrating mobile phone technologies. The research hopes to identify potential problems of EMR system setup and available opportunities for integrating mobile phone technologies...

Referrals from rural health centers to urban hospitals join waiting lists as outpatients for hospital admission and hospital treatment. This influences quality of life (QoL) of the rural population and retired people who require medical attention without traveling, provided no risks are involved. For this reason, a rural region of Spain has adopted a strategy to deliver telemedicine (TM) specialized care (Extremadura model) as a political decision. The present study aimed at objectively assessing QoL on aspects of health and well-being for citizens benefiting from this system. We performed a randomized study of 800 primary care patients referred for specialized care: 420 regular face-to-face hospital referrals and 380 referred to a hospital specialist at a distance by TM. The study used two questionnaires: a modified version of the classical SF-12v2 short form questionnaire for health and well-being and a specific author-elaborated questionnaire. The latter focused on major patient ...

This article examines the relationship that exists among the media, the development of digital health technologies, and the implications of the trend on Africa. Reviewing four articles published on digital health technology-related issues, it is found that media, particularly social media which complement conventional media, tend to be influential in the aspect of digital health. The social communication devices such as mobile phones and tablets PCs enable social networks to promote healthcare through platforms for interaction. Similarly, mobile applications help in offering other medical services. The conventional media hence appear to be useful mainly in creating awareness about such developments. This trend however, is found to be of implication to Africa, particularly Nigeria where the level of development in technology is still low and conventional media coverage of digital health technology appears to be a new ground. Thus, this article recommends to journalists and social med...

Personal Health Monitoring (PHM) uses electronic devices which monitor and record health-related data outside a hospital, usually within the home. This paper examines the ethical issues raised by PHM. Eight themes describing the ethical implications of PHM are identified through a review of 68 academic articles concerning PHM. The identified themes include privacy, autonomy, obtrusiveness and visibility, stigma and identity, medicalisation, social isolation, delivery of care, and safety and technological need. The issues around each of these are discussed. The system / lifeworld perspective of Habermas is applied to develop an understanding of the role of PHMs as mediators of communication between the institutional and the domestic environment. Furthermore, links are established between the ethical issues to demonstrate that the ethics of PHM involves a complex network of ethical interactions. The paper extends the discussion of the critical effect PHMs have on the patient's ide...