Seamless Access to Healthcare Folders with Strong Privacy Guarantees

During the past decade, many countries launched ambitious Electronic Health Record (EHR) programs with the objective to increase the quality of care while decreasing its cost. Pervasive healthcare aims itself at making healthcare information securely available anywhere and anytime, even in disconnected environments (e.g., at patient home). Current server-based EHR solutions badly tackle disconnected situations and fail in providing ultimate security guarantees for the patients. The solution proposed in this paper capitalizes on a new hardware device combining a secure microcontroller (similar to a smart card chip) with a large external Flash memory on a USB key form factor. Embedding the patient folder as well as a database system and a web server in such a device gives the opportunity to manage securely a healthcare folder in complete autonomy. This paper proposes also a new way of personalizing access control policies to meet patient’s privacy concerns with minimal assistance of practitioners. While both proposals are orthogonal, their integration in the same infrastructure allows building trustworthy pervasive healthcare folders.

A Review of Wireless Sensor Networks for Wellness Monitoring in Residential Aged Care

With the increasing shift in the population profile to the older demographic and rising healthcare costs, it is more critical for developed countries to deliver long-term and financially sustainable healthcare services, especially in the area of residential aged care. A consensus exists that innovations in the area of Wireless Sensor Networks (WSNs) are key enabling technologies for reaching this goal. The major focus of this article is WSN design considerations for ubiquitous wellness monitoring systems in residential aged care facilities. Major enabling technologies for building a pervasive WSN will be detailed, including descriptions on sensor design, wireless communication protocols and network topologies. Also examined are data processing methods and knowledge management tools to support the collection of sensor data and their subsequent analysis for health assessment. To introduce future healthcare reform in residential aged care, two aspects of wellness monitoring, vital signs and activities of daily living (ADL) monitoring, will be discussed.

SMART

Patient monitoring is important in many contexts: at mass-casualty disaster sites, in improvised emergency wards, and in emergency room waiting areas. Given the positive history of use of monitoring systems in the hospital during surgery, in the recovery room, or in an intensive care unit, the authors sought to use recent technological advances to enable patient monitoring in more diverse circumstances: at home, while traveling, and in some less well-monitored areas of a hospital. This paper presents the authors’ experiences designing, implementing and deploying a wireless disaster management system prototype in a real hospital environment. In addition to a review of related systems, the sensors, algorithms and infrastructure used in our implementation are presented. Finally, general guidelines for ubiquitous methodologies and tools are shared based on the lessons learned from the actual implementation.

Information Completeness

Medical information is readily online to patients, family’s doctors and others in search of enhanced or supplementary information arising from healthcare concerns. To a large extent, this information varies greatly in terms of information quality and depending on the healthcare information source, is often incomplete. This study used an indirect qualitative analysis of the information completeness of 31 Indoor Air Quality (IAQ) checklists using CATPAC and found that these sources differed in both the depth and breathe of information provided. We suggest that users of healthcare information may be underserved and that healthcare information providers might act in a more collaborative way to better balance the presentation of their information in terms of depth and breathe of presented content. [Article copies are available for purchase from InfoSci-on-Demand.com]

Medical Data Visualization via a Pervasive Multi-Agent Platform

Pervasive healthcare is the field of application emerging from the combination of healthcare with pervasive computing, which is the computing paradigm that provides users with access to services in a transparent way, wherever they are and whichever their interacting device is. In this paper, a software infrastructure for pervasive healthcare is presented. Such an infrastructure aims at supporting medical practitioners with advanced pervasive access to medical data, which is also context-aware in the sense that the modality to fruit data depends on the device used by the operator and on his or her physical position within the environment. The paper also describes a service for high quality 3D rendering of medical volume data, which takes advantage of the software infrastructure to distribute the computational load upon the devices available in the environment in a completely transparent way to users.

Nursing Homes and E-Health

A nursing home provides skilled nursing care and rehabilitation services to people with illnesses, injuries or functional disabilities, but most facilities serve the elderly. Nursing homes provide various services for different residents’ needs, including daily care, assistance for the mentally disabled, and drug rehabilitation. The levels of care and quality of care provided by nursing homes have increased significantly over the past decade. The trend is toward continuous quality development and resident satisfaction; therefore, healthcare technology plays a significant role in nursing home operations. This article discusses general information about current nursing home conditions and systems in the United States and explores how technology and e-health help improve the nursing home development based on the present needs and trends. The authors also report on Thomasville Nursing Home, discussing current trends in nursing home technologies.

Multi-Dimensional Criteria for the Evaluation of E-Health Services

E-health is an emerging field in the intersection of information systems, healthcare and business, referring mainly to healthcare services delivered and enhanced through the use of information and communication technologies (ICT). An important area of research is the evaluation of e-health services. A holistic e-health evaluation framework should address the aspects that are hampering healthcare services from embracing the full potential of ICT towards successful e-health initiatives. In order to build a holistic evaluation framework for e-health services, this article suggests framework characteristics for the appropriate evaluation for e-health services. The article argues that e-health services evaluation framework should be criteria based. The criteria have to be multi-dimensional that grounded in, or derived from, one or more specific perspectives or theories. The proposed evaluation criteria in this article can serve as part of an e-health evaluation framework, improve our understanding of the role of information systems in health care, and develop our ability to deliver high quality services. [Article copies are available for purchase from InfoSci-on-Demand.com]

A Transaction Cost Economics Assessment of a Diabetes Self-Management Solution

Diabetes is one of the leading chronic diseases affecting Australians and is increasingly becoming a serious challenge and threat for both the quality of healthcare while increasing cost pressures on the Australian healthcare system. The goal of this study is to provide a transaction cost economics framework which can be used as a tool for high-level assessments of the economic viability of a pervasive technology solution developed by INET in the form of a wireless enabled mobile solution to facilitate superior diabetes self-management. In doing so, we prepare the inroads for proposing an approach for refined quantifiable assessments of a pervasive IT-enabled healthcare solution.

Telepractice

Telehealth is viewed as the removal of time and distance barriers in the provision of health care and patient education to underserved populations. Examined is a twenty first century clinical consultation model of healthcare. Offered are specific applications within a broad spectrum of services utilizing telehealth technology. Important technology shifts for administrative paradigms, clinical models, and educational information technology for healthcare services through telehealth technology are examined. The future of telehealth and its interface with various critical components of society needs to examine the potential benefits over risks in providing healthcare consultations and services through the educational settings available. Addressed is a technology model, which demonstrates the capability of reducing time and distance barriers in the provision of health care and education through telehealth technology. The use of telehealth technology in rural settings is seen as a viable medium for providing needed diagnostic and clinical consultation for underserved and rural.

Mobile Solutions for Managing Health Care

Wirhe project is an international collaborative study that focused on the future of healthcare needs, technology requirements and solutions for effective use of wireless platform for health care delivery. In this chapter, the authors present results of a Wirhe survey of 85 experts and individual interviews with 35 experts. The authors asked their opinions on the current status of adopting wireless equipment in health care, unmet needs in serving hospital in-patients and outpatients, and their views on the incorporation of wireless platform for future health care delivery and personal health management. Key findings are that 1) both remarkable quality improvements and process enhancements can be expected from thoroughly utilizing the wireless technologies and mobile solutions, 2) integration of personal health monitoring and professional health management is a key issue to be addressed and 3) health promotion and illness prevention will grow by utilizing mobile solutions. As a result of this study, they propose a framework that can be used in developing wireless health care solutions for managing diseases and related health problems. It can also be used to structure and stratify the needs by importance and utility, to anticipate which technologies and solutions are needed next, and to estimate how large the market size may be for industries.