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PubMed2003

E-oncology and health portals: instructions and standards for the evaluation, production organisation and use.

In 2002 the Italian Ministry of Health promoted the institution of a network and a web portal, E-oncology (2), for the seven NHS research institutions specialising in oncology (Istituti di Ricovero e Cura a Carattere Scientifico-IRCCS). One of the aims was to gather and provide information on tumoral pathologies to operators and the public. For an optimum organisation of a health web site it is necessary to comply with the standards internationally used. The World Wide Web Consortium (W3C) has developed guidelines for accessibility and usability of the sites, implemented in Italy through governmental issues. Many international organisations adopt rules and codes of conduct to validate biomedical information and have organised quality portals such as NLM, OMNI, MEDCIRCLE, HON etc. Some terminological standards, such as the MESH thesaurus and UMLS, have been produced by the libraries for a correct management and an effective information retrieval, and are currently used by the most important biomedical web sites. The Dublin Core, metadata standard for the integration of information deriving from heterogeneous archives, has also been developed by the libraries. The easy access to information dims the complex architecture necessary for the construction of a web site. The contribution of different professionals is necessary to guarantee the production of quality medical/health web sites, among them librarians have always been involved with the management of knowledge and their skills are extremely valuable. Furthermore, the libraries' network is essential in order to guarantee universal access to health information, mostly still against payment, and to contribute to overcoming the 'digital divide' and 'second-level digital divide'.

Evaluation Studies as Topic↗
PubMed2003

Approaches in European health information systems architectures.

Information and Communication Technology (ICT) in healthcare represents a fundamental and highly qualifying pre-requisite for enabling the interoperability of information systems, the continuity of the caring process to the patient over the territory, the creation of an integrated electronic healthcare record, as well as the monitoring and optimisation of the organisational and economical aspects of healthcare enterprises. This paper presents a European architectural strategy for healthcare information systems, capable of facilitating the evolution of the existing procedures and their smooth integration into a homogeneous information and functional infrastructure, without requiring major modifications in already existing modules and protecting, therefore, previous investments.

Computer Systems↗
PubMed2004

Integrated advanced information management systems: a twenty-year history at the University of Cincinnati.

The University of Cincinnati (UC) has been active in the National Library of Medicine's Integrated Advanced Information Management Systems (IAIMS) program since IAIMS' inception in 1984. UC received IAIMS planning and modeling grants in the 1980s, spent the 1990s practicing its own form of "iaims" and refining its vision, and, in May 2003, received an IAIMS operations grant in the first round of awards under "the next generation" program. This paper discusses the history of IAIMS at UC and describes the goals, methods, and strategies of the current IAIMS program. The goals of UC's IAIMS program are to: improve teaching effectiveness by improving the assessment of health professional students and residents in laboratory and clinical teaching and learning environments; improve the ability of researchers, educators, and students to acquire and apply the knowledge required to be more productive in genomic research and education; and increase the productivity of researchers and administrators in the pre-award, post-award, and compliance phases of the research lifecycle.

Academic Medical Centers↗
PubMed2004

International efforts in implementing national health information infrastructure and electronic health records.

Many countries are developing national strategies using information and communication technologies (ICTs) to implement health information infrastructure and electronic health records (EHR), into their medical systems. Efficiency, quality of care and medical error along with new opportunities presented by the technologies themselves have driven this process internationally. Many countries have had spectacular failures costing billions of dollars alongside some amazing successes. There has been very little dialogue internationally about what works and what doesn't work despite the fact that many government and international agencies have placed this key priority on their agendas. The nature of the technologies used promotes cooperation and these innovations in healthcare lend themselves particularly to working together for collaboration and for communication in order to learn best practice from each other. In this paper, I look at some of the national initiatives for developing an information infrastructure for healthcare as well as some of the challenges presented by these very different approaches around the world. We also review briefly the many organizations looking at international standards relating to eHealth and to implementation of electronic health records.

Developed Countries↗
PubMed2004

A tool for abstracting relevant classes of concepts: the Common Ancestry Summarizer.

Controlled Medical Terminologies (CMTs) are indispensable tools for present medical information systems and medical informatics researches. Concept-oriented architecture and multiple-hierarchy have been accepted as two of the desiderata of contemporary CMTs. A common problem for informaticians working with class-based methods for terminologies is to find the Most Relevant Common Ancestor (MRCA) for a group of concepts, the common ancestor which has the closest semantic distance to all the given concepts. Finding an ancestor concept to summarize a group of concepts is required to map concepts from the knowledgebase to those of appropriate granularity in CMTs. However, manually exploring the hierarchical relationships and determining the MRCA are daunting tasks due to the massive size, the multiple hierarchies and in some case the cycles of the hierarchical networks of terminologies. In our study, we developed a web-based visualization tool, the Common Ancestry Summarizer (CAS), that graphically displays the hierarchical relations of multiple concepts within CMTs, and also assist users to identify the MRCA of these concepts by identifying the Lowest Common Ancestors (LCAs). The CAS has been shown useful in organizing classes for the controlled terms used in clinical guidelines (e.g. "the bottom-up method").

Algorithms↗
PubMed2002

e-health in eating disorders: Virtual Reality and telemedicine in assessment and treatment.

e-health, the integration of telehealth technologies with the Internet and shared virtual reality could become a significant enabler of consumer health initiatives. In fact, they provide an increasingly accessible communication channel for a growing part of the population. In the past decade medical applications of virtual reality (VR) and telemedicine have been rapidly developing, and the technology has changed from a research curiosity to a commercially and clinically important area of medical informatics technology. The chapter details the characteristics of the Experiential Cognitive Therapy (ECT), an integrated inpatient/outpatient (4 weeks) and telemedicine approach (24 weeks) that tries to enhance the classical cognitive-behavioral method used in the treatment of eating disorders, through VR sessions and telemedicine support in the follow-up stage. Particularly, using VR and telemedicine, ECT is able to address body experience disturbances, interpersonal relationships, self efficacy and motivation to change, key issues for the development and maintenance of eating disorders that are somehow neglected by actual clinical guidelines.

Cognitive Behavioral Therapy↗
PubMed2003

Telemedicine in extreme environments: analogs for space flight.

The integration of telecommunications and information systems into health care delivery in human space flight operations is not new. It has been an integral tool for over 45 years. During these past decades, numerous efforts have been conducted to further develop and promulgate telemedicine. The National Aeronautics and Space Administration (NASA) established a commercial space center in 1997, known as the Medical Informatics and Technology Applications Consortium (MITAC). MITAC has developed and conducted a variety of test beds in several international settings, including Russia, Ecuador and other extreme and remote environments. These test beds have been designed to evaluate and validate technologies and techniques that have application in the delivery and support of health care in unique environments. The characteristics of these test beds are analogous to what might be observed or experienced in low earth orbit or on space-based platform. These include intermittent communications, low bandwidth, level of competency of the front line health worker, etc. These test beds have led to new approaches for the delivery of health care as well as enhanced education. These experiences have been beneficial in the promulgation of telemedicine as an effective tool and have provided new ideals for space exploration as well terrestrial medicine. This paper will highlight MITAC's test beds and their relationship to space exploration.

Animals↗