Search

[english] Today, many countries have succeeded in integrating telemedicine and advanced technologies into a broad-range of healthcare processes including diagnosis, treatment, disease prevention, and health education & research. Nevertheless, many developing countries are still unable to sustain meaningful telemedicine projects. Egypt has achieved significant progress in building the Information Society (IS), by providing an enabling legal and regulatory framework, and an adequate Information and Communications Technology (ICT) infrastructure. However, telemedicine projects in Egypt still face common problems and challenges that hinder the wide-scale adoption of eHealth systems. This study provides a comprehensive Strengths, Weaknesses, Opportunities, and Threats (SWOT) analysis of the current telemedicine applications in Egypt. Based on that, four future trends in Telemedicine in Egypt 2020 have been identified from governmental, financial, technological, and medical perspectives. Consequently, these future trends were aligned to the global trends in telemedicine. The main output of this study is that telemedicine should be part of a National eHealth Initiative.[german] Bis heute konnten in vielen Ländern erfolgreich Telemedizin und moderne Informationstechnik in vielen medizinischen Prozessen von der Diagnostik über Therapie und Vorsorge bis hin zur Medizinischen Ausbildung und Forschung integriert werden. Aber gerade in Entwicklungsländern ist es oft nicht gelungen, nützliche Telemedizin-Lösungen dauerhaft zu etablieren. Ägypten hat bereits erhebliche Fortschritte dabei gemacht, sich zu einer Informationsgesellschaft zu entwickeln. Es wurden rechtliche und regulatorische Rahmenbedingungen geschaffen, in deren Rahmen eine leistungsfähige Infrastruktur für Informations- und Kommunikationstechnik aufgebaut werden konnte. Dennoch sehen sich ägyptische Telemedizinprojekte immer noch mit erheblichen Problemen und Herausforderungen konfrontiert, wenn es darum geht, die Ergebnisse flächendeckend und in Routine anzuwenden. Diese Arbeit berichtet über eine umfassende SWOT-Analyse (Strengths, Weaknesses, Opportunities, and Threats) der Telemedizin in Ägypten. Mit Hilfe der SWOT-Analyse konnten vier Entwicklungstrends identifiziert werden, welche für die Entwicklung der ägyptischen Telemedizin bis 2020 bestimmend sein werden. Diese Trends beschreiben mögliche und notwendige Entwicklungen in den Bereichen der Regierungsverantwortung, der Finanzierung telemedizinischer Vorhaben, der Technik und der Medizin, die eng mit den entsprechenden globalen Trends zusammenhängen. Telemedizin wird in Ägypten aber nur dann erfolgreich sein, wenn sie Teil einer nationalen eHealth-Initiative ist.

We are creating a synergy among European Health Data Space projects (e.g., IDERHA, EUCAIM, ASCAPE, iHELP, Bigpicture, and HealthData@EU pilot project) via health standards usage thanks to the HSBOOSTER EU Project since they are involved or using standards, and/or designing health ontologies. We compare health-standardized models/ontologies/terminologies such as HL7 FHIR, DICOM, OMOP, ISO TC 215 Health Informatics, W3C DCAT, etc. used in those projects. [ABSTRACT FROM AUTHOR]

In recent years, the adoption of wearable gadgets such as Fitbit has revolutionized the way individuals track and monitor their personal activity data. These devices provide valuable in-sights into an individual's physical activity levels, sleep patterns, and overall health metrics. Integrating this data into healthcare informatics systems can offer significant benefits in terms of personalized healthcare delivery and improved patient outcomes. This paper explores the synergistic integration of Fitbit-generated personal activity data using the openEHR Reference Model in healthcare informatics as a practical case study in patientgenerated health data (PGHD) integration based on health informatics standards as a framework for the representation and exchange of Electronic Health Records (EHRs). The synergistic integration of Fitbit-generated personal activity data through openEHR and FHIR standards models also covers the way for advanced analytics and population health management. By linking and analyzing data from various sources, including sensors and wearable devices, healthcare organizations can identify trends, patterns, and insights that can guide population health strategies, preventive care initiatives, and personalized treatment plans, in addition to aiding physicians in follow-up care. [ABSTRACT FROM AUTHOR]

Health data collected by wearables and apps can be useful as part of patient-generated health data (PGHD) or personal health data for medical diagnosis or general health monitoring. Mobile health apps are more and more accepted, generate evidence and might be increasingly used in personal medicine. Data retrieved from wearables and apps are mostly not following a medical data standard and cannot be retrieved from the vendors in a straightforward way. The present work started the implementation of a Digital Health Convener and described the process to collect data from several wearables – starting with Fitbit data – and transforms this data to standardized JSON files following the Open mHealth (OmH) IEEE and the HL7 FHIR standard. The project achieved is provided as open source and can be extended and used in future projects to generate OmH and FHIR conform PGHD. [ABSTRACT FROM AUTHOR]

Patient-Generated Health Data (PGHD), such as data provided by wearable devices, hold promise to improve health outcomes. However, to improve clinical decision-making, PGHD should be integrated or linked with Electronic Health Records (EHRs). Typically, PGHD data are collected and stored as Personal Health Records (PHRs), outside EHR systems. To address this challenge, we created a conceptual framework for PGHD/EHR interoperability through the Master Patient Index (MPI) and DH-Convener platform. Then, we identified the corresponding Minimum Clinical Data Set (MCDS) of PGHD to be exchanged with EHR. This generic approach can be used as a blueprint in different countries. [ABSTRACT FROM AUTHOR]

With the numerous advances and broad applications of mobile health (mHealth), establishing concrete data sharing, privacy, and governance strategies at national (or regional) levels is essential to protect individual privacy and data usage. This article applies the recent Health Data Governance Principles to provide a guiding framework for low- and middle-income countries (LMICs) to create a comprehensive mHealth data governance strategy. We provide three objectives: (1) establish data rights and ownership to promote equitable benefits from health data, (2) protect people through building trust and addressing patients' concerns, and (3) promote health value by enhancing health systems and services. We also recommend actions for realizing each objective to guide LMICs based on their unique mHealth data ecosystems. These objectives require adopting a regulatory framework for data rights and protection, building trust for data sharing, and enhancing interoperability to use new datasets in advancing healthcare services and innovation. [ABSTRACT FROM AUTHOR]

Clinical data repositories often use entity-attribute-value (EAV) data models. To be valuable for secondary use, these health data can be transformed to the Observational Medical Outcomes Partnership (OMOP) Common Data Model (CDM). The present paper describes the lessons learned from such an endeavour based on the concept of registering transformation functions on source data elements. We further provide future work directions for follow-up projects. [ABSTRACT FROM AUTHOR]

This paper introduces the concept of the implementation of a FHIR server for bidirectional data exchange with the OMOP-CDM. Leveraging FHIR as a metamodel, the implementation aims to promote a more interconnected and patientcentric healthcare ecosystem. The methodology involves utilizing the Java HAPI FHIR API for server architecture and validating the solution through patient data exchange with a FHIR reference implementation server. This initiative signifies a significant advancement in healthcare data interoperability, promising improved patient care quality and clinical research vigor. [ABSTRACT FROM AUTHOR]

With the rapid proliferation of digital health technologies, the role of medical informatics in advancing personalized healthcare and wellbeing is emphasized. To examine the readiness of medical informatics for fostering digital health moving forward, a Strengths, Weaknesses, Opportunities, and Threats (SWOT) analysis was performed. As a result, actionable strategies have been identified to maximize the benefits of medical informatics and overcoming the faced challenges in the digital health era. [ABSTRACT FROM AUTHOR]

Introduction: To evaluate the impact of PSMA PET (prostate specific membrane antigen positron emission tomography) findings prior to salvage radiotherapy (SRT) in recurrent prostate cancer (PCa) after radical prostatectomy (RP) on metastasis-free survival (MFS).Patients and Methods: Between 01/2012 and 12/2018, 1,599 patients received SRT for biochemical recurrence after RP at our institution. Five-year MFS of "positive PSMA PET" (n = 49) vs. "negative PSMA PET" (n = 106) vs. "no PSMA PET" (n = 1,599) prior to SRT was determined. For all time to event analyses, uni- and multivariable Cox's proportional hazards models and univariable Kaplan-Meier analyses were applied, with a significance threshold of P < 0.05. Further 4:1 propensity score matching for patient, cancer and treatment characteristics was performed to account for residual differences between groups.Results: Of PSMA PET patients, 106 patients exhibited "negative PSMA PET" (68.4%) and 49 exhibited "positive PSMA PET" (31.6%). Median PSA at recurrence did not differ between groups (0.2 ng/ml; P= 0.4). After 4:1 propensity score matching, 5-year MFS between "no PSMA PET" and "negative PSMA PET" was 94.4 vs. 93.0%, respectively (P = 0.8). For "no PSMA PET" versus "positive PSMA PET", 5-year MFS was significantly lower in "positive PSMA PET" (92.3 vs. 48.5%, respectively P < 0.0001). Finally, "positive PSMA PET" was independently associated with worse MFS compared to "no PSMA PET" after multivariable adjustment in the overall cohort (HR 13.8, CI 7.5-25.2, P < 0.001).Conclusions: Locoregional positive PSMA PET findings in recurrent patients after RP are highly predictive of worse MFS in the setting of SRT. [ABSTRACT FROM AUTHOR]

Objective: The European Health Data Space (EHDS) shapes the digital transformation of healthcare in Europe. The EHDS regulation will also accelerate the use of health data for research, innovation, policy-making, and regulatory activities for secondary use of data (known as EHDS2). The Integration of heterogeneous Data and Evidence towards Regulatory and HTA Acceptance (IDERHA) project builds one of the first pan-European health data spaces in alignment with the EHDS2 requirements, addressing lung cancer as a pilot., Methods: In this study, we conducted a comprehensive review of the EHDS regulation, technical requirements for EHDS2, and related projects. We also explored the results of the Joint Action Towards the European Health Data Space (TEHDAS) to identify the framework of IDERHA's alignment with EHDS2. We also conducted an internal webinar and an external workshop with EHDS experts to share expertise on the EHDS requirements and challenges., Results: We identified the lessons learned from the existing projects and the minimum-set of requirements for aligning IDERHA infrastructure with EHDS2, including user journey, concepts, terminologies, and standards. The IDERHA framework (i.e., platform architecture, standardization approaches, documentation, etc.) is being developed accordingly., Discussion: The IDERHA's alignment plan with EHDS2 necessitates the implementation of three categories of standardization for: data discoverability: Data Catalog Vocabulary (DCAT-AP), enabling semantics interoperability: Observational Medical Outcomes Partnership (OMOP), and health data exchange (DICOM and FHIR). The main challenge is that some standards are still being refined, e.g., the extension of the DCAT-AP (HealthDCAT-AP). Additionally, extensions to the Observational Health Data Sciences and Informatics (OHDSI) OMOP Common Data Model (CDM) to represent the patient-generated health data are still needed. Finally, proper mapping between standards (FHIR/OMOP) is a prerequisite for proper data exchange., Conclusions: The IDERHA's plan and our collaboration with other EHDS initiatives/projects are critical in advancing the implementation of EHDS2., Competing Interests: No competing interests were disclosed., (Copyright: © 2024 Hussein R et al.)

Health data democratization requires a transparent, protected, and interoperable data-sharing environment. We conducted a co-creation workshop with patients living with chronic diseases and relevant stakeholders to explore their opinion on health data democratization, ownership, and sharing in Austria. Participants showed their willingness to share their health data for clinical and research purposes; provided that appropriate transparency and data protection measures are provided.

Wearable sensors and mHealth apps collect fitness and health data outside of clinical settings. These data are essential for precision medicine. This paper addresses and analyzes the available tools for extracting health and fitness data from wearables and mHealth apps. We focus on the most common tools used for research, namely, the Open mHealth-Shimmer application and Fitrockr research platform.

The Austrian national Electronic Health Record system ELGA is a population-based infrastructure for health data. However, to date, it does not include patient-reported outcomes. In this paper, we describe on-going work on extending ELGA with patient-reported outcome data. This will be done by linking ELGA with the infrastructure of the Health Outcomes Observatory (H2O) initiative. The focus will be on using ELGA's identifier registry for H2O patients and making H2O outcome data accessible in ELGA via an existing ELGA document type for telemonitoring.

With advances in Digital Health (DH) tools, it has become much easier to collect, use, and share patient-generated health data (PGHD). This wealth of data could be efficiently used in monitoring and controlling chronic illnesses as well as predicting health outcome. Although integrating PGHD into clinical practice is currently in a promising stage, there are several technical challenges and usage barriers that hinder the full utilization of the PGHD potential in clinical care and research. This paper aims to address PGHD opportunities and challenges while developing the DH-Convener project to integrate PGHD into the Electronic Health Record in Austria (ELGA). Accordingly, it provides an integrative technical-clinical-user approach for developing a fully functional health ecosystem for exchanging integrated data among patients, healthcare providers, and researchers.

Physical activity is a vital part of cardiac rehabilitation (CR). However, heart-healthy physical activity levels in people with cardiovascular disease drop significantly after CR. This exploratory study employs qualitative and survey methods within a co-creation approach. The aim is to understand the mechanisms of healthy behavior and habit formation in order to create a novel evidence-based (post-)rehabilitation approach that employs digital means to sustain long-term physical activity levels in people with cardiovascular disease.

Structured reporting (SR) was recently added to the Digital Imaging and Communications in Medicine (DICOM) standard to provide an efficient mechanism for the generation, distribution, and management of clinical reports. The main advantage of SR is the ability to link clinical documents with the referenced images for simultaneous retrieval and display. A generic SR toolkit that covers the different clinical reports used in today's healthcare enterprises was developed for picture archiving and communication system (PACS) workstations. The modules of the SR toolkit collaborate to automatically construct the DICOM SR files from the free-text input presented in hypertext markup language (HTML) by using the associated SR trees. The DICOM toolkit is reused for SR encoding and DICOM services. A setup module was required for creating both the standard and private SR templates used in different healthcare specialties. The SR manager transparently converts between the different SR document presentations, that is, DICOM SR files and HTML documents, to provide the end users with an easy-to-use toolkit. To evaluate and demonstrate the effectiveness of the SR toolkit in a pragmatic setting, the toolkit was integrated into PACS workstations., (Copyright RSNA, 2004)