Search

This issue of Methods of Information in Medicine celebrates the journal's first 50 years. As the oldest journal in biomedical and health informatics and, being broader in its scope, as the journal dealing with the methodology and scientific fundamentals of organizing, representing and analysing data, information and knowledge in biomedicine and health care, the journal publications during the last five decades also reflect the formation of a scientific field that deals with information in biomedicine and health care. Five papers that arose from a scientific symposium on "biomedical informatics: confluence of multiple disciplines" held in Heidelberg, Germany, in June 2011 are included in this volume. The papers reflect not only the broad interdisciplinary scope of the journal, but also the broad and evolving scope of the field itself. We can also recognise that there is an ongoing need for original and relevant research. As a discipline that has an impact on many other fields and is also influenced by them, scientific exchange and collaborative research continues to be needed. [ABSTRACT FROM AUTHOR]

Background: The journal Methods of Information in Medicine, founded in 1962, has now completed its 50th volume. Its publications during the last five decades reflect the formation of a discipline that deals with information in biomedicine and health care.Objectives: To report about 1) the journal's origin, 2) the individuals who have significantly contributed to it, 3) trends in the journal's aims and scope, 4) influential papers and 5) major topics published in Methods over the years.Methods: Methods included analysing the correspondence and journal issues in the archives of the editorial office and of the publisher, citation analysis using the ISI and Scopus databases, and analysing the articles' Medical Subject Headings (MeSH) in MEDLINE.Results: In the journal's first 50 years 208 editorial board members and/or editors contributed to the journal's development, with most individuals coming from Europe and North America. The median time of service was 11 years. At the time of analysis 2,456 articles had been indexed with MeSH. Topics included computerized systems of various types, informatics methodologies, and topics related to a specific medical domain. Some MeSH topic entries were heavily and regularly represented in each of the journal's five decades (e.g. information systems and medical records), while others were important in a particular decade, but not in other decades (e.g. punched-card systems and systems integration). Seven papers were cited more than 100 times and these also covered a broad range of themes such as knowledge representation, analysis of biomedical data and knowledge, clinical decision support and electronic patient records.Conclusions: Methods of Information in Medicine is the oldest international journal in biomedical informatics. The journal's development over the last 50 years correlates with the formation of this new discipline. It has and continues to stress the basic methodology and scientific fundamentals of organizing, representing and analysing data, information and knowledge in biomedicine and health care. It has and continues to stimulate multidisciplinary communication on research that is devoted to high-quality, efficient health care, to quality of life and to the progress of biomedicine and the health sciences. [ABSTRACT FROM AUTHOR]

Objective: To discuss international aspects as they relate to the convergence of disciplines in health informatics.Method: A group of international experts was invited at a symposium to present and discuss their perspectives on this topic. These have been collated in a single manuscript.Results and Conclusions: Significant challenges, as well as opportunities, appear when cumulating the intrinsic multidisciplinary nature of health informatics interventions with the diversity of contexts at the global level, in particular when considered in the perspective of a confluence, i.e., the mixing of different waters and their merging into a new, stronger entity. Health informatics experts reflect on key issues such as collaborative software development and distributed knowledge sourcing, social media and mobile technologies, the evolutions of the discipline from an historical perspective, as well as examples of challenges for implementing ubiquitous healthcare or for supporting disaster situations when infrastructures get disrupted. [ABSTRACT FROM AUTHOR]

Background: Falls are a predominant problem in our aging society, often leading to severe somatic and psychological consequences, and having an incidence of about 30% in the group of persons aged 65 years or above. In order to identify persons at risk, many assessment tools and tests have been developed, but most of these have to be conducted in a supervised setting and are dependent on an expert rater.Objectives: The overall aim of our research work is to develop an objective and unobtrusive method to determine individual fall risk based on the use of motion sensor data. The aims of our work for this paper are to derive a fall risk model based on sensor data that may potentially be measured during typical activities of daily life (aim #1), and to evaluate the resulting model with data from a one-year follow-up study (aim #2).Methods: A sample of n = 119 geriatric inpatients wore an accelerometer on the waist during a Timed 'Up & Go' test and a 20 m walk. Fifty patients were included in a one-year follow-up study, assessing fall events and scoring average physical activity at home in telephone interviews. The sensor data were processed to extract gait and dynamic balance parameters, from which four fall risk models--two classification trees and two logistic regression models--were computed: models CT#1 and SL#1 using accelerometer data only, models CT#2 and SL#2 including the physical activity score. The risk models were evaluated in a ten-times tenfold cross-validation procedure, calculating sensitivity (SENS), specificity (SPEC), positive and negative predictive values (PPV, NPV), classification accuracy, area under the curve (AUC) and the Brier score.Results: Both classification trees show a fair to good performance (models CT#1/CT#2): SENS 74%/58%, SPEC 96%/82%, PPV 92%/ 74%, NPV 77%/82%, accuracy 80%/78%, AUC 0.83/0.87 and Brier scores 0.14/0.14. The logistic regression models (SL#1/SL#2) perform worse: SENS 42%/58%, SPEC 82%/ 78%, PPV 62%/65%, NPV 67%/72%, accuracy 65%/70%, AUC 0.65/0.72 and Brier scores 0.23/0.21.Conclusions: Our results suggest that accelerometer data may be used to predict falls in an unsupervised setting. Furthermore, the parameters used for prediction are measurable with an unobtrusive sensor device during normal activities of daily living. These promising results have to be validated in a larger, long-term prospective trial. [ABSTRACT FROM AUTHOR]

Background: Founded in 1962 and, therefore, the oldest international journal in medical informatics, Methods of Information in Medicine will publish its 50th volume in 2011. At the start of the journal's sixth decade, a discussion on the journal's profile seems appropriate.Objectives: To report on the new opportunities for online access to Methods publications as well as on the recent strategic decisions regarding the journal's aims and editorial policies.Methods: Describing and analyzing the journal's aims and scope. Reflecting on recent publications and on the journal's development during the last decade.Results: From 2011 forward all articles of Methods from 1962 until the present can be accessed online. Methods of Information in Medicine stresses the basic methodology and scientific fundamentals of processing data, information and knowledge in medicine and health care. Although the journal's major focus is on publications in medical informatics, it has never been restricted to publications only in this discipline. For example, articles in medical biometry, in or close to biomedical engineering, and, later, articles in bioinformatics continue to be a part of this journal.Conclusions: There is a continuous and, as it seems, ever growing overlap in the research methodology and application areas of the mentioned disciplines. As there is a continuing and even growing need for such a publication forum, Methods of Information in Medicine will keep its broad scope. As an organizational consequence, the journal's number of associate editors has increased accordingly. [ABSTRACT FROM AUTHOR]

Background: Education has long been, and continues to be, one of the major thematic areas of the activities of IMIA, the International Medical Informatics Association.Objective: To report on IMIA's past activities and to discuss possible future perspectives on IMIA's role on biomedical and health informatics education.Methods: Summarizing past activities by searching in reports and publications. Making suggestions for wider discussion on possible future activities.Results: Since its inception, IMIA has been active in the field of education, mainly through its working group on education. Among other activities, nine working conferences have been held, many of which have resulted in publications as outcomes, which have helped to exchange knowledge on the development of high-quality health and biomedical informatics education. Recommendations on education in health and medical informatics were endorsed by IMIA in 1999, and a revised version is currently in preparation.Conclusions: IMIA should continue to stimulate the exchange of knowledge on a range of aspects of health and biomedical informatics education in the countries and regions of the world, with IMIA's academic institutional members playing an increasing role. Establishing procedures for the international accreditation of high-level programs in health and biomedical informatics through IMIA is one of several areas that need to be discussed as IMIA plans and develops its future activities. [ABSTRACT FROM AUTHOR]

Background: Supervised physical training has been shown to promote rehabilitation of patients affected by chronic obstructive pulmonary disease (COPD). Currently, due to limited resources, not all COPD patients can be trained by an expert supervisor.Objectives: The objective of our research is to construct a decision support system (DSS) which observes and controls physical ergometer training sessions of COPD patients.Methods: A systematic literature review and expert interviews were carried out to build up the knowledge base for the DSS.Results: Nine production rules were established and standardized by Drools and Arden Syntax. The developed software autonomously controls training sessions on a bicycle ergometer on the basis of vital signs data. Thus it offers a new way for the rehabilitation of COPD patients.Conclusion: Evaluation with nine healthy subjects in a laboratory environment has confirmed its correct function, but the effects of its use for COPD patients' rehabilitation and their quality of life have to be investigated in a further study. [ABSTRACT FROM AUTHOR]

The article discusses the methodology and scientific fundamentals of organizing, representing and analyzing data, information and knowledge in biomedicine and health care.

Background: In 2009, the journal Applied Clinical Informatics (ACI) commenced publication. Focused on applications in clinical informatics, ACI was intended to be a companion journal to Methods of Information in Medicine (MIM). Both journals are official journals of IMIA, the International Medical Informatics Association. Objectives: To explore, after five years, which congruencies and interdependencies exist in publications of these journals and to determine if gaps exist. To achieve this goal, major topics discussed in ACI and in MIM had to be analysed. Finally, we wanted to explore, whether the intention of publishing these companion journals to provide an information bridge from informatics theory to informatics practice and from practice to theory could be supported by this model. In this manuscript we will report on congruencies and interdependencies from practise to theory and on major topis in ACI. Further results will be reported in a second paper. Methods: Retrospective, prolective observational study on recent publications of ACI and MIM. All publications of the years 2012 and 2013 from these journals were indexed and analysed. Results: Hundred and ninety-six publications have been analysed (87 ACI, 109 MIM). In ACI publications addressed care coordination, shared decision support, and provider communication in its importance for complex patient care and safety and quality. Other major themes included improving clinical documentation quality and efficiency, effectiveness of clinical decision support and alerts, implementation of health information technology systems including discussion of failures and succeses. An emerging topic in the years analyzed was a focus on health information technology to predict and prevent hospital admissions and managing population health including the application of mobile health technology. Congruencies between journals could be found in themes, but with different focus in its contents. Interdependencies from practise to theory found in these publications, were only limited. Conclusions: Bridging from informatics theory to practise and vice versa remains a major component of successful research and practise as well as a major challenge. [ABSTRACT FROM AUTHOR]

Introduction: This article is part of the Focus Theme of Methods of Information in Medicine on "Using Data from Ambient Assisted Living and Smart Homes in Electronic Health Records". Objectives: In this paper, we present a prototype of a Home-Centered Health- Enabling Technology (HET-HC), which is able to capture, store, merge and process data from various sensor systems at people's home. In addition, we present an architecture designed to integrate HET-HC into an exemplary regional Health Information System (rHIS). Methods: rHIS are traditionally documentbased to fit to the needs in a clinical context. However, HET-HC are producing continuous data streams for which documents might be an inappropriate representation. Therefore, the HET-HC could register placeholder-documents at rHIS. These placeholder-documents are assembled upon user-authenticated request by the HET-HC and are always up-todate. Moreover, it is not trivial to find a clinical coding system for continuous sensor data and to make the data machine-readable in order to enhance the interoperability of such systems. Therefore, we propose the use of SNOCAP-HEX which is a nomenclature to describe the context of sensor-based measurements in health-enabling technologies. Results: We present an architectural approach to integrate HET-HC into rHIS. Our solution is the centralized registration of placeholder- docunnents with rHIS and the decentralized data storage at people's home. Conclusions: We concluded that the presented architecture of integrating HET-HC into rHIS might fit well to the traditional approach of document-based data storage. Data security and privacy issues are also duly considered. [ABSTRACT FROM AUTHOR]

Introduction: This article is part of a Focus Theme of METHODS of Information in Medicine on Health Record Banking.Background: Poor communication of health care information between health care providers (HCP) is still a major problem. One recent approach is the concept of Health Record Banking.Objectives: With this report we want to introduce the Lower Saxony Bank of Health (LSBH) to the international community. The main objective of this paper is to report and explain: 1) why this organization has been founded, 2) which basic principles have been set, 3) which services will be provided, 4) which type of organization has been chosen, and 5) which architectural framework has been selected.Methods: To report and discuss how we plan to achieve the intended objectives.Results: The LSBH was founded as an entrepreneurial company, regarding itself as a neutral third-party information broker. The bank does not store medical documents on its central servers but offers a document registry with links to documents stored at participating health care providers. Subject to valid patient consent, the LSBH grants access to these documents to authorized health care providers. To implement our services, we chose the established technical frameworks of the Integrating the Healthcare Enterprise (IHE) initiative using cross-enterprise document sharing (XDS).Conclusions: Different approaches to establish health information exchange (HIE) are in early stages and some have failed in the past. Health Record Banking can address major challenges described in the literature about HIE. The future will show if our provider-sponsored business model is sustainable. After reaching a stable network, we intend to add additional HCPs, e.g., care homes or ambulance services, to the network. [ABSTRACT FROM AUTHOR]

Context: Integration of electronic signatures embedded in health care processes in Germany challenges health care service and supply facilities. The suitability of the signature level of an eligible authentication procedure is confirmed for a large part of documents in clinical practice. However, the concrete design of such a procedure remains unclear. Objective: To create a summary of usable user authentication systems suitable for clinical workflows. Data Source: A Systematic literature review based on nine online bibliographic databases Search keywords included authentica - tion, access control, information systems, information security and biometrics with terms user authentication, user identification and login in title or abstract. Searches were run between 7 and 12 September 2011. Relevant conference proceedings were searched manually in February 2013. Backward reference search of selected results was done. Selection: Only publications fully describing authentication systems used or usable were included. Algorithms or purely theoretical concepts were excluded. Three authors did selection independently. Data Extraction and Assessment: Semistructured extraction of system characteristics was done by the main author. Identified procedures were assessed for security and fulfillment of relevant laws and guidelines as well as for applicability. Suitability for clinical workflows was derived from the assessments using a weighted sum proposed by Bonneau. Results: Of 7575 citations retrieved, 55 publications meet our inclusion criteria. They describe 48 different authentication systems; 39 were biometric and nine graphical password systems. Assessment of authentication systems showed high error rates above European CENELEC standards and a lack of ap - plicability of biometric systems. Graphical passwords did not add overall value compared to conventional passwords. Continuous authentication can add an additional layer of safety. Only few systems are suitable partially or entirely for use in clinical processes. Conclusions: Suitability strongly depends on national or institutional requirements. Four authentication systems seem to fulfill requirements of authentication procedures for clinical workflows. Research is needed in the area of continuous authentication with biometric methods. A proper authentication system should combine all factors of au - thentication implementing and connecting secure individual measures. [ABSTRACT FROM AUTHOR]

Context: Integration of electronic signatures embedded in health care processes in Germany challenges health care service and supply facilities. The suitability of the signature level of an eligible authentication procedure is confirmed for a large part of documents in clinical practice. However, the concrete design of such a procedure remains unclear.Objective: To create a summary of usable user authentication systems suitable for clinical workflows.Data Source: A Systematic literature review based on nine online bibliographic databases. Search keywords included authentication, access control, information systems, information security and biometrics with terms user authentication, user identification and login in title or abstract. Searches were run between 7 and 12 September 2011. Relevant conference proceedings were searched manually in February 2013. Backward reference search of selected results was done.Selection: Only publications fully describing authentication systems used or usable were included. Algorithms or purely theoretical concepts were excluded. Three authors did selection independently. DATA EXTRACTION AND ASSESSMENT: Semi-structured extraction of system characteristics was done by the main author. Identified procedures were assessed for security and fulfillment of relevant laws and guidelines as well as for applicability. Suitability for clinical workflows was derived from the assessments using a weighted sum proposed by Bonneau.Results: Of 7575 citations retrieved, 55 publications meet our inclusion criteria. They describe 48 different authentication systems; 39 were biometric and nine graphical password systems. Assessment of authentication systems showed high error rates above European CENELEC standards and a lack of applicability of biometric systems. Graphical passwords did not add overall value compared to conventional passwords. Continuous authentication can add an additional layer of safety. Only few systems are suitable partially or entirely for use in clinical processes.Conclusions: Suitability strongly depends on national or institutional requirements. Four authentication systems seem to fulfill requirements of authentication procedures for clinical workflows. Research is needed in the area of continuous authentication with biometric methods. A proper authentication system should combine all factors of authentication implementing and connecting secure individual measures. [ABSTRACT FROM AUTHOR]

Background: Gait analyses are an important tool to diagnose diseases or to measure the rehabilitation process of patients. In this context, sensor-based systems, and especially accelerometers, gain in importance. They are able to improve objectiveness of gait analyses. In clinical settings, there is usually a supervisor who gives instructions to the patients, but this can have an influence on patients' gait. It is expected that this effect will be smaller in field studies. Objective: Aim of this study was to capture and evaluate gait parameters measured by a single waist-mounted accelerometer during everyday life of subjects. Methods: Due to missing ground-truth in unsupervised conditions, another external criterion had to be chosen. Subjects of two different groups were considered: patients with dementia (DEM) and active older people (ACT). These groups were chosen, because of the expected difference in gait. The idea was to quantify the expected difference of accelerometricbased gait parameters. Gait parameters were e.g. velocity, step frequency, compensation movements, and variance of the accelerometric signal. Results: Ten subjects were measured in each group. The number of walking episodes captured was 1,187 (DEM) vs. 1,809 (ACT). The compensation and variance parameters showed an AUC value (Area Under the Curve) between 0.88 and 0.92. In contrast, velocity and step frequency performed poorly (AUC values of 0.51 and 0.55). It was possible to classify both groups using these parameters with an accuracy of 89.2%. Conclusion: The results showed a much higher amount of walking episodes in field studies compared to supervised clinical trials. The classification showed a high accuracy in distinguishing between both groups. [ABSTRACT FROM AUTHOR]

Background: Gait analyses are an important tool to diagnose diseases or to measure the rehabilitation process of patients. In this context, sensor-based systems, and especially accelerometers, gain in importance. They are able to improve objectiveness of gait analyses. In clinical settings, there is usually a supervisor who gives instructions to the patients, but this can have an influence on patients' gait. It is expected that this effect will be smaller in field studies.Objective: Aim of this study was to capture and evaluate gait parameters measured by a single waist-mounted accelerometer during everyday life of subjects.Methods: Due to missing ground-truth in unsupervised conditions, another external criterion had to be chosen. Subjects of two different groups were considered: patients with dementia (DEM) and active older people (ACT). These groups were chosen, because of the expected difference in gait. The idea was to quantify the expected difference of accelerometric-based gait parameters. Gait parameters were e.g. velocity, step frequency, compensation movements, and variance of the accelerometric signal.Results: Ten subjects were measured in each group. The number of walking episodes captured was 1,187 (DEM) vs. 1,809 (ACT). The compensation and variance parameters showed an AUC value (Area Under the Curve) between 0.88 and 0.92. In contrast, velocity and step frequency performed poorly (AUC values of 0.51 and 0.55). It was possible to classify both groups using these parameters with an accuracy of 89.2%.Conclusion: The results showed a much higher amount of walking episodes in field studies compared to supervised clinical trials. The classification showed a high accuracy in distinguishing between both groups. [ABSTRACT FROM AUTHOR]

Objective: To bridge the divide between health informatics 'bench research' and the application of informatics in clinical and health care settings.Method: Identifying weak points in translational activities, i.e. in the process from health informatics research outcomes to IT system design and information management in clinical practice.Results and Conclusions: The creation of a new peer-reviewed journal, designed to cultivate broad readership across health care, is suggested in order to communicate on informatics topics of translational interest and on the application of informatics principals. Such an applied informatics journal may appeal to practicing physicians, healthcare administrators and CIOs as well as medical informaticians. In a globalizing world with eHealth initiatives spanning across borders, such a journal should be an international effort. Close ties to the International Medical Informatics Association (IMIA) and to the journal Methods of Information in Medicine are suggested. [ABSTRACT FROM AUTHOR]

The article focuses on the healthcare network eHealth.Braunschweig and health information exchange in Germany in regional context. It mentions technical difficulties faced in networking and the need for collaboration in Braunschweig. It informs that the eHealth.Braunschweig network was started in April 2009 with the goal to establish a cross-sectoral information and communication technologies (ICT) supported network spanning all health care sectors.

Background: Health care network eHealth.Braunschweig has been started in the South-East region of Lower Saxony in Germany in 2009. It composes major health care players, participants from research institutions and important local industry partners.Objectives: The objective of this paper is firstly to describe the relevant regional characteristics and distinctions of the eHealth.Braunschweig health care network and to inform about the goals and structure of eHealth.Braunschweig; secondly to picture and discuss the main concepts and domain fields which are addressed in the health care network; and finally to discuss the architectural challenges of eHealth.Braunschweig regarding the addressed domain fields and defined requirements.Methods: Based on respective literature and former conducted projects we discuss the project structure and goals of eHealth.Braunschweig, depict major domain fields and requirements gained in workshops with participants and discuss the architectural challenges as well as the architectural approach of eHealth.Braunschweig network.Results: The regional healthcare network eHealth.Braunschweig has been established in April 2009. Since then the network has grown constantly and a sufficient progress in network activities has been achieved. The main domain fields have been specified in different workshops with network participants and an architectural realization approach for the transinstitutional information system architecture in the healthcare network has been developed. However, the effects on quality of information processing and quality of patient care have not been proved yet. Systematic evaluation studies have to be done in future in order to investigate the impact of information and communication technology on the quality of information processing and the quality of patient care.Conclusions: In general, the aspects described in this paper are expected to contribute to a systematic approach for the establishment of regional health care networks with lasting and sustainable effects on patient-centered health care in a regional context. [ABSTRACT FROM AUTHOR]

The article offers information of the 50th years of the journal "Methods of Information in Medicine." The journal's publications reflect the formation of a discipline that deals with information in biomedicine and health care. It continues to stress the basic methodology and scientific fundamentals of organizing and information and knowledge in biomedicine and health care.

The article discusses the convergence of disciplines in health informatics. It highlights the challenges, as well as opportunities, appear when cumulating the intrinsic multidisciplinary nature of health informatics interventions. It notes that health informatics reflect on key issues such as collaborative software development, social media, and the evolutions of the discipline from a historical perspective.

The article presents a study that aims to develop a method to determine individual fall risk based regarding the use of motion sensor data. The study describes a model that may be potentially be measured during typical activities of daily life. The study suggests that accelerometer data can be used to predict falls in an unsupervised setting.

The article offers information on the development of the periodical "Methods of Information in Medicine" which is considered the oldest international journal in medical informatics. It notes that the periodical upholds its aim to emphasize the basic methodology and scientific fundamentals of processing data, information and knowledge in medicine and health care. The periodical also provides online access to the articles published since its genesis in 1962 to archive past researches in medicine.

The article focuses on the international activities in health and biomedical informatics education organized by the International Medical Informatics Association (IMIA). It states that those activities have helped to exchange knowledge on the development of high-quality biomedical informatics and health education. Moreover, it recommends that IMA should pursue to stimulate the exchange of knowledge on the area of health education.

The article discusses the revisions made by the International Medical Informatics Association (IMIA) on its existing international recommendations on biomedical and health informatics (BMHI). It discusses IMIA's task force scheme way of refining updates by focusing on educational needs of health care professionals for communication technology. It notes that healthy care professionals' learning outcomes are determined in terms of their knowledge and skills as an IT user and as a BMHI specialist.

The article presents a study which aims to create a decision support system which will oversee the physical training of patients with chronic obstructive pulmonary disease. It states that the creation of a system was made through the help of interviews and systematic literature review. The result indicates the created system established and standardized by Drools and Arden Syntax. It suggests that its function is correct, however it use for COPD patients' rehabilitation must still be studied.

The article focuses on selected areas of health-enabling and ambient-assistive technologies including ambient environments, sensor technologies, medical conditions, and activity monitoring for the prevention of obesity. It discusses the usefulness of the technologies because it can improve quality of life and efficiency of health care in aging societies. In addition, it highlights the importance of research for the design and construction of sensors and sensor systems, health records, and data input analysis. The authors concluded that research on technical solutions in a social context is essential for the use of the technologies.

The United Nations has recently adopted 17 sustainable development goals for 2030, including ensuring healthy lives and promoting well-being for all at all ages, and making cities and human settlements inclusive, safe, resilient and sustainable. Road injuries remain among the ten leading causes of death in the world, and are projected to increase with rapidly increasing motorisation globally. Lack of comprehensive data on road injuries has been identified as one of the barriers for effective implementation of proven road safety interventions. Building, linking and analysing electronic patient records in conjunction with establishing injury event and care registries can substantially contribute to healthy lives and safe transportation. Appropriate use of new technological approaches and health informatics best practices could provide significant added value to WHO's global road safety work and assist Member States in identifying prevention targets, monitoring progress and improving quality of care to reduce injury-related deaths. This paper encourages the initiation of new multidisciplinary research at a global level. [ABSTRACT FROM AUTHOR]

The author offers information on the implementation of the International Medical Informatics Association (IMIA) strategic plan wherein its motto aims to stress the goal of promoting many ideas from many origins. The Integrated Strategic Framework Model is also known as IMIA "rainbow umbrella" in which it offers a multidimensional visual representation of the range of IMIA's areas of licit interest and activity, connections and integration possibilities. The 5 circles on the framework stands represents knowledge, science, application, impact, and people. The plan is to unite world leaders' knowledges which will contribute in advancing health and biomedical informatics' task of health and healthcare improvement.

The article focuses on the development of sensor-enhanced regional health information systems (rHIS). This study is based on experience in sensor-based rHIS and telemedicine projects, and on an analysis of HIS-related journal publications from 2003 to 2005 conducted in the consideration of publishing the "IMIA Yearbook of Medical Informatics." Health-connected parameters that are subject to sensor-based measurement in home care and telemonitoring were considered in this study. It is posed that the utilization of sensor technology in health care is an active field of research.

Objectives: To summarize background, challenges, objectives, and methods for the usability of patient data, in particular with respect to their multiple use, and to point out how to lecture medical data management.Methods: Analyzing the literature, providing an example based on Simpson's paradox and summarizing research and education in the field of medical data management, respectively health information management (in German: Medizinische Dokumentation).Results: For the multiple use of patient data, three main categories of use can be identified: patient-oriented (or casuistic) analysis, patient-group reporting, and analysis for clinical studies. A so-called documentation protocol, related to study plans in clinical trials, supports the multiple use of data from the electronic health record in order to obtain valid, interpretable results. Lectures on medical data management may contain modules on introduction, basic concepts of clinical data management and coding systems, important medical coding systems (e.g. ICD, SNOMED, TNM, UMLS), typical medical documentation systems (e.g. on patient records, clinical and epidemiological registers), utilization of clinical data management systems, planning of medical coding systems and of clinical data management systems, hospital information systems and the electronic patient record, and on data management in clinical studies.Conclusion: Usability, the ultimate goal of recording and managing patient data, requires, besides technical considerations, in addition appropriate methodology on medical data management, especially if data is intended to be used for multiple purposes, e.g. for patient care and quality management and clinical research. Medical data management should be taught in health and biomedical informatics programs. [ABSTRACT FROM AUTHOR]

Objectives: Hospitals are increasingly under pressure to optimize their processes. So far, an instrument to systematically identify the potentials for improvement of a given business process is missing. The aim of this project is to develop such an instrument.Methods: Initially, central aspects of the quality of a hospital process were identified on the basis of a systematic literature review. Secondary to that, criteria to measure quality aspects were defined: More than 300 criteria from medical and business informatics, economics and quality management publications were gathered and systematically aggregated.Results: As a result, the Process Potential Screening (PPS) instrument was developed. The PPS is a matrix containing two axes: Axis I comprises 30 quality aspects referring to results, execution and control of hospital processes. Axis II comprises 16 quality criteria (e.g., customer satisfaction, time). The PPS displays approximately 400 relevant combinations of those quality aspects and quality criteria that help to identify potentials for improvement of a given hospital process. It utilizes different methods for the measurement of the criteria and for application by way of individuals or groups.Conclusions: In using the PPS, relevant potentials for improvement were identified in ten typical hospital processes. The instrument's practicability must now be examined in further studies by the final target group (e.g., quality or project managers, and the staff responsible for processes). [ABSTRACT FROM AUTHOR]

Objectives: To report about the themes and about experiences with practicums in the management of information systems in health care settings (health information management) for medical informatics students.Methods: We first summarize the topics of the health information management practicums/projects that the authors organized between 1990 and 2003 for the medical informatics programs at Heidelberg/Heilbronn, Germany, UMIT, Austria, as well as for the informatics program at the University of Leipzig, Germany. Experiences and lessons learned, obtained from the faculty that organized the practicums in the past 14 years, are reported.Results: Thirty (of 32) health information management practicums focused on the analysis of health information systems. These took place inside university medical centers. Although the practicums were time-intensive and required intensively tutoring students with regard to health information management and project management, feedback from the students and graduates was mainly positive.Discussion: It is clearly recommended that students specializing in medical informatics need to be confronted with real-world problems of health information systems during their studies. [ABSTRACT FROM AUTHOR]

Objectives: To review recent research efforts in the field of ubiquitous computing in health care. To identify current research trends and further challenges for medical informatics.Methods: Analysis of the contents of the Yearbook on Medical Informatics 2005 of the International Medical Informatics Association (IMIA).Results: The Yearbook of Medical Informatics 2005 includes 34 original papers selected from 22 peer-reviewed scientific journals related to several distinct research areas: health and clinical management, patient records, health information systems, medical signal processing and biomedical imaging, decision support, knowledge representation and management, education and consumer informatics as well as bioinformatics. A special section on ubiquitous health care systems is devoted to recent developments in the application of ubiquitous computing in health care. Besides additional synoptical reviews of each of the sections the Yearbook includes invited reviews concerning E-Health strategies, primary care informatics and wearable healthcare.Conclusions: Several publications demonstrate the potential of ubiquitous computing to enhance effectiveness of health services delivery and organization. But ubiquitous computing is also a societal challenge, caused by the surrounding but unobtrusive character of this technology. Contributions from nearly all of the established sub-disciplines of medical informatics are demanded to turn the visions of this promising new research field into reality. [ABSTRACT FROM AUTHOR]

Objectives: To inform the medical and health informatics community on the rational, goals, and the achievements of the International Partnership for Health Informatics Education--IPHIE, (I phi E), that was established at six universities in 1999.Methods: We elaborate on the overall goals of I phi E and describe the current state of affairs: the activities undertaken and faculty and student experience related to these activities. In addition we outline the lessons we have learned over these past six years and our plans for the future.Results: I phi E members first started to collaborate by supporting and encouraging the exchange of talented students and faculty and by establishing joint master classes for honors students. Following the success of these activities, new initiatives were undertaken such as the organization of student workshops at medical informatics conferences and a joint course on strategic information management in hospitals in Europe.Conclusions: International partnerships such as I phi E take time to establish, and, if they are to be successful, maintaining leadership continuity is critically important. We are convinced that I phi E promotes professionalism of future medical informatics specialists. There will be a continuing growth of globalization in higher education. It will therefore become increasingly important to offer educational programs with international components. [ABSTRACT FROM AUTHOR]