Agile Patient Care with Distributed M-Health Applications

Agile Patient Care with Distributed M-Health Applications

Rafael Capilla (Universidad Rey Juan Carlos, Spain), Alfonso del Río (Universidad Rey Juan Carlos, Spain), Miguel Ángel Valero (Universidad Politécnica de Madrid, Spain) and José Antonio Sánchez (Universidad Politécnica de Madrid, Spain)
DOI: 10.4018/978-1-60566-002-8.ch020
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Abstract

This chapter deals with the conceptualization, design and implementation of an m-health solution to support ubiquitous, integrated and continuous health care in hospitals. As the life expectancy of population grows in modern societies, effective healthcare becomes more and more important as a key social priority. Medical technology and high quality, accessible and efficient healthcare is currently demanded by citizens. Existing technologies from the computer field are widely used to improve patient care but new challenges demand the use of new communication, hardware and software technologies as a way to provide the necessary quality, security and response time at the point of care need. In this scenario, mobile and distributed developments can clearly help to increase the quality of healthcare systems as well as reduce the time needed to react to emerging care demands. In this chapter we will discuss important issues related to m-health systems and we deeply describe a mobile application for hospital healthcare. This application offers a modern solution which makes more agile doctor and nurse rounds on behalf of an instant online access to patient records through wireless networks. We also provide a highly usable application that makes simple patient monitoring with handheld devices.
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Introduction

The origins of health telematics and telemedicine did mainly focus on the benefits of communicating and making available medical information from a patient to a remote medical expert instead of having to displace the injured person to a health centre (Bashur, R., 1997). Thus, telemedicine aimed to support people at the point of care wherever, for different reasons, neither the health professional nor the patient could easily travel to meet each other face to face. In this context, multiple new scenario were imagined taking into advantage Information and Communication technologies (ICT) to provide care to people in isolated regions, emergency situations or environments where a difficulty exists to displace a patient who cannot receive on site medical attention. At a parallel pace, medical informatics started to devote significant efforts to deploy health information systems that ensure medical data availability “at the point of care”. Both Hospital Information Systems (HIS) and Department Information Systems (DIS) aimed to provide health professionals with adequate tools that may integrate all the medical data required by health staff (medical doctors, nursery, administrative, health managers, etc.), to treat a patient (Winter A., 2003). Consequently, the concept of Electronic Health Record (EHR) raised and, with diverse levels of success at the market level, important standardization work have been active (CEN TC251, ISO215, HL7) making efforts to structure in a secure and efficient way the enormous amount of data that can be associated to a person´s health history (Dolin R., 2006). However, the traditional view of Medical Informatics focused more on those situations where the health professionals are, for instance, present at their hospital or care centre office providing a consultation service rather than those scenarios that oblige them to be displacing in order to assist in-bed patients in the hospital or elderly and disabled people at home.

A solution for the challenge of mobile care support came from the concept of m-health proposed in the ‘90s to exploit the potentiality of mobile communications to assist care professionals or patients “in movement” (Istepanian R.S.H, 2004). The original scenarios of health telematics were changing and technologies were no longer expected to only provide medical information at a fixed computer or medical device where the specialist is supposed to be located, but to “bring” valuable information to the professional wherever he or she is located, in movement, whichever mobile or wireless network is available. Mobile networks were initially used to transmit data from mobile patients; furthermore, the m-health concept started to think about mobile professionals or wirelessly connected citizens who are displaced from a fixed location. A typical example from the first ideas was the utilization of emerging GSM systems to transmit biomedical signals, like an ECG or blood pressure, in emergency situations where an injured patient is moved from a mobile ambulance unit to the hospital (Pavlopoulos S., 1999). Most advanced research on m-health has mainly treated with the unobtrusive and ubiquitous integration of e-care or telemedicine services with remote health information systems through GPRS/UMTS, WLAN or WPAN technologies as well as provision of context aware health care ad-hoc support including Quality of Service features (Oliver N., 2006) (Wac K., 2007).

Key Terms in this Chapter

M-Health (Mobile Health): It can be understood as mobile computing, medical sensor, and communications technologies for e-health (Istepanian R.S.H., Jovanov E. and Zhang Y.T., 2004)

Mobile Computing: Is a generic term describing your ability to use technology ‘untethered’, that is not physically connected, or in remote or mobile (non static) environments. The term is evolved in modern usage such that it requires that the mobile computing activity be connected wirelessly to and through the Internet or to and through a private network (Wikipedia).

Pervasive / Ubiquitous Computing: Mobile Computing: Pervasive computing is the trend towards increasingly ubiquitous (another name for the movement is ubiquitous computing), connected computing devices in the environment, a trend being brought about by a convergence of advanced electronic - and particularly, wireless - technologies and the Internet (SearchNetworking.com).

Web Service: A reusable component that can be registered, discovered, and invoked using standard internet protocols.

Hospital Information System (HIS): Central medical information system in hospitals where health care related data (e.g.: personnel, patients and their medical history etc.) is stored.

Lightweight Directory Access: Protocol (LDAP):. Is a software protocol for enabling anyone to locate organizations, individuals, and other resources such as files and devices in a network, whether on the public Internet or on a corporate intranet (SearchMobileComputing.com definitions).

Software: Architecture: Architecture is defined as the fundamental organization of a system, embodied in its components, their relationships to each other and the environment, and the principles governing its design and evolution (ANSI/IEEE Std. 1471-2000, 2000).

Telemedicine: The use of medical information exchanged from one site to another via electronic communications for the health and education of the patient or healthcare provider and for the purpose of improving patient care. Telemedicine includes consultative, diagnostic, and treatment services (Websters’s new world medical dictionary).

Medical Informatics: The rapidly developing scientific field that deals with biomedical information, data, and knowledge - their storage, retrieval, and optimal use for problem solving and decision making.

E-Health: Electronic Health. The term e-health encompasses all of the information and communication technologies (ICT) necessary to make the health system work (International Telecommunication Union – ITU, 2003)

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Editorial Advisory Board
Table of Contents
Preface
Athina A. Lazakidou
Acknowledgment
Athina A. Lazakidou
Chapter 1
Sanjay P. Sood, Sandhya Keeroo, Victor W.A. Mbarika, Nupur Prakash, Ankur Seth
It is claimed that seeds of ‘medical informatics’ were sown in 1960s.From this time until the 1990s experts have described the discipline as... Sample PDF
Medical Informatics: Thirty Six Peer-Reviewed Shades
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Chapter 2
D. John Doyle
E-health technology has started to become commonplace in the clinical world, with practitioners setting up their own Web sites to disseminate... Sample PDF
Medical Privacy and the Internet
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Chapter 3
Ana Ferreira, Ricardo Cruz-Correia, Luís Antunes, David Chadwick
This chapter reports the authors’ experiences regarding security of the electronic medical record (EMR). Although the EMR objectives are to support... Sample PDF
Security of Electronic Medical Records
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Chapter 4
György Surján
This chapter outlines the history of medical classifications in a general cultural context. Classification is a general phenomenon in science and... Sample PDF
The Cultural History of Medical Classifications
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Chapter 5
Spyros Kitsiou
A fundamental requirement for achieving continuity of care is commonly accepted to be the integration and interoperability of different clinical... Sample PDF
Overview and Analysis of Electronic Health Record Standards
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Chapter 6
Graham D. Bodie, Mohan J. Dutta, Ambar Basu
This chapter overviews an integrative model of e-health use that connects social disparities at the population level with individual characteristics... Sample PDF
The Integrative Model of E-Health Use
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Chapter 7
Firat Kart
In this chapter we describe a distributed e-healthcare system that uses service oriented architecture as a basis for designing, implementing... Sample PDF
A Distributed E-Healthcare System
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Chapter 8
Davor Mucic
In this chapter the author gives the short review over wide range of telepsychiatry applications. Furthermore, describes completely new and... Sample PDF
Telepsychiatry Within European E-Health
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Chapter 9
Azizah Omar
In this chapter the author discusses several marketing principles and issues related to pitfalls and successes of Telehealth application in the case... Sample PDF
Pitfalls and Successes of a Web-Based Wellness Program
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Chapter 10
Isabel de la Torre Díez
This chapter describes a Web -based application to store and exchange Electronic Health Records (EHR) and medical images in Ophthalmology... Sample PDF
A Web-Based Application to Exchange Electronic Health Records and Medical Images in Ophthalmology
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Chapter 11
Mario Ceresa
This chapter mainly focuses on biomedical knowledge representation and its use in biomedicine. It first illustrates the existent more relevant... Sample PDF
Clinical and Biomolecular Ontologies for E-Health
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Chapter 12
Roger Tait, Gerald Schaefer
The registration of corresponding patient volumes is often a pre-requisite for medical imaging tasks. Accurate alignment, however, usually results... Sample PDF
Distributed Medical Volume Registration
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Chapter 13
Bill Ag. Drougas
Internet today is one of the most useful tools for information, education and business or entertainment. It is one of the modern technology tools... Sample PDF
Electronic Commerce for Health Products Services-Problems- Quality and Future
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Chapter 14
Christos Bountis
This chapter introduces and reviews the concept of distributed knowledge management within the Healthcare environment and between Healthcare and... Sample PDF
Distributed Knowledge Management in Healthcare
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Chapter 15
Jelena Vucetic
This paper describes business and technological challenges and solutions for a successful emergency telemedicine venture called MediComm. Its... Sample PDF
An Analysis of a Successful Emergency Telemedicine Venture
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Chapter 16
Tammara Massey, Foad Dabiri, Roozbeh Jafari, Hyduke Noshadi, Philip Brisk, Majid Sarrafzadeh
This chapter introduces reconfigurable design techniques for light-weight medical systems. The research presented in this chapter demonstrates how... Sample PDF
Reconfigurable Embedded Medical Systems
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Chapter 17
Konstantinos Perakis
The evolutions in the field of telecommunications technologies, with the robustness and the fidelity these new systems provide, have significantly... Sample PDF
Third Generation (3G) Cellular Networks in Telemedicine: Technological Overview, Applications, and Limitations
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Chapter 18
Anton V. Vladzymyrskyy
This chapter introduces usage of telemedicine consultations in daily clinical practice. Author has describe process of teleconsultation, sample... Sample PDF
Telemedicine Consultations in Daily Clinical Practice: Systems, Organisation, Efficiency
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Chapter 19
Cheon-Pyo Lee, J. P. Shim
Ubiquitous healthcare has become possible with rapid advances in information and communication technologies. Ubiquitous healthcare will bring about... Sample PDF
Ubiquitous Healthcare: Radio Frequency Identification (RFID) in Hospitals
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Chapter 20
Rafael Capilla, Alfonso del Río, Miguel Ángel Valero, José Antonio Sánchez
This chapter deals with the conceptualization, design and implementation of an m-health solution to support ubiquitous, integrated and continuous... Sample PDF
Agile Patient Care with Distributed M-Health Applications
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Chapter 21
Žilbert Tafa
This chapter describes the very actual issues on mobile health (M-H) and home care (H-C) telecare systems, reviewing state of the art as well as... Sample PDF
Mobile Health Applications and New Home Care Telecare Systems: Critical Engineering Issues
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Chapter 22
José Antonio Seoane Fernández, Juan Luis Pérez Ordóñez, Noha Veiguela Blanco
This chapter presents an architecture for the integration of various algorithms for digital image processing (DIP) into web-based information... Sample PDF
A New System for the Integration of Medical Imaging Processing Algorithms into a Web Environment
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Chapter 23
Daniel Welfer
This chapter discusses the concept of open-source picture archiving and communication systems (i.e. PACS), which are low cost, and easy to... Sample PDF
PACS Based on Open-Source Software Components
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Chapter 24
Carolin Kaiser
This chapter introduces a case based reasoning (CBR) system for customizing treatment processes. The CBR system enables the generating of inpatient... Sample PDF
Case Based Reasoning for Customizing Treatment Processes
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Chapter 25
I. Apostolakis, A. Chryssanthou, I. Varlamis
A significant issue in health related applications is protecting a patient’s profile data from unauthorized access. In the case of telemedicine... Sample PDF
A Holistic Perspective of Security in Health Related Virtual Communities
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Chapter 26
Stamatia Ilioudi
This chapter aims to present various virtual learning environments for medical purposes in the world. More than ever, medical students and... Sample PDF
Virtual Learning Environments in Health
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Chapter 27
Jelena Vucetic
In the last decade, advances in medicine, telemedicine, computer technologies, information systems, Web applications, robotics and... Sample PDF
Multimedia Distance Learning Solutions for Surgery
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Chapter 28
Maria Andréia F. Rodrigues
This chapter shows how recent computing technologies such as collaborative virtual environments, high speed networks and mobile devices can be used... Sample PDF
Collaborative Virtual Environments and Multimedia Communication Technologies in Healthcare
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Chapter 29
Tiffany A. Koszalka, Bradley Olson
A major issue facing medical education training programs across the USA is the recent advent of universal mandatory duty hour limitations and the... Sample PDF
Transforming a Pediatrics Lecture Series to Online Instruction
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Chapter 30
Anastasia N. Kastania, Stelios Zimeras
In this chapter the authors investigate telehealth quality and reliability assurance. Various models and standards can be applied to assess software... Sample PDF
Quality and Reliability Aspects in Telehealth Systems
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Chapter 31
Kleopatra Alamantariotou
Recent statistics show that the World Wide Web has now grown to over 100 million sites: a phenomenal expansion in only 15 years (Mulligan 2007). It... Sample PDF
Quality of Health Information on the Internet
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Chapter 32
Kashif Hussain
This chapter provides a practical approach to computerized system validation (CSV) for the pharmaceutical organizations for the users dealing with... Sample PDF
A Practical Approach to Computerized System Validation
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Chapter 33
Bill Ag Drougas, Maria Sevdali
Ergophysiology as a division of the Physiology and helps us today to understand what happens in the human body and movement and how we are able to... Sample PDF
Organization and Evaluation of Experimental Measurements of Ergophysiological Data with the Method of SF12V2
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Chapter 34
Daniele Apiletti
Current advances in sensing devices and wireless technologies are providing a high opportunity for improving care quality and reducing the medical... Sample PDF
Ubiquitous Risk Analysis of Physiological Data
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Chapter 35
Manfred Doepp
In our energy diagnostic department we noticed more and more cases with irrational stimulus-reaction- patterns and with a chaotic regulation state... Sample PDF
Chaotization of Human Systems by Technical Electromagnetic Fields
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Chapter 36
Mary Schmeida, Ramona McNeal
This chapter is an analysis of demographic variables influencing policy outcomes with online health information searches in the general U.S. public.... Sample PDF
Demographic Differences in Telehealth Policy Outcomes
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About the Contributors