Health-enabling technologies for the elderly--an overview of services based on a literature review.

BACKGROUND: Services for the elderly based on health-enabling technologies promise to contribute significantly to the efficiency and effectiveness of future health care. Due to this promise, over the last years the scientific community has designed a complex variety of these valuable innovations. A systematic overview of the developed services would help to better understand their opportunities and limitations. OBJECTIVE: To obtain a systematic overview of services for the elderly based on health-enabling technologies and to identify archetypical service categories. METHODS: We conducted a literature review using PubMed and retrieved 1447 publications. We stepwise reduced this list to 27 key publications that describe typical service archetypes. RESULTS: We present six archetypical service categories, namely handling adverse conditions, assessing state of health, consultation and education, motivation and feedback, service ordering and social inclusion and describe their implementation in current research projects.

Health information systems for home telehealth services--a nomenclature for sensor-enhanced transinstitutional information system architectures.

Home telehealth services for elderly people promise to contribute to a more efficient health care in the future. Though isolated services at a patient's home might make sense for some applications, the full potential of home telehealth only arises through its integration into existing health information systems (HIS) and care processes. We know about traditional HIS architectures. However, so far no models exist, helping us to understand and describe the upcoming sensor-enhanced transinstitutional information system architectures for home telehealth services. To develop a nomenclature for sensor-enhanced transinstitutional health information system architectures. We conducted two systematic literature reviews, assessing typical services and users of home telehealth and key characteristics of transinstitutional health information system architectures. The information retrieved from both reviews was integrated to build the nomenclature sought after. We present a nomenclature of information and communication technology (ICT) architectures for home telehealth services. The developed dimensions provide an overview on typical users, services, operating organisations, information flow, geographical reach and architectural paradigms of sensor-enhanced transinstitutional health information systems. The developed nomenclature helps us to better understand the upcoming ICT architectures. However, we are still in need of further experiences with their application.

An approach to simulate and visualize intraoperative scattered radiation exposure to improve radiation protection training.

Intraoperative radiography based on mobile image intensifier systems (C-arms) is widely used during the treatment of trauma and emergency patients. These devices produce scattered radiation, potential hazardous for surgeon and operation room personal (ORP). The propagation and intensity of scattered radiation is not intuitive, is not perceivable by human senses and depends on many variables. At courses on radiation protection the knowledge of the behavior of scattered radiation and the modus operandi to minimize the radiation exposure should be taught to ORP and surgeons. Currently this can only be done theoretically using fixed pictures and precalculated videos. This paper presents an approach to interactively simulate and visualize scattered radiation with a computer based training system for mobile image intensifier systems. The simulation depicts radiation propagation and intensity for arbitrary C-arm adjustments and different irradiated materials. This teaching component focuses on improving the current radiation protection training with interactive visual and practical aspects.

Improving education on C-arm operation and radiation protection with a computer-based training and simulation system.

PURPOSE: To discuss an approach to improve education in C-arm operation and reduction of radiation hazards based on a computer based training and simulation system called virtX. METHODS: virtX is equipped with a visualization of scattered radiation and means to include patient positioning changes in radiograph simulation. virtX was integrated in a course for ORP and evaluated based on questionnaires. RESULTS: Response rate was 73 (n = 77), mean age 35.4 (+/-9.2) and professional experience 11.2+/- 10.4 years. 91% use a C-arm regularly, 8% casually and 1% not. 78% agree that the translation of patient dummy positioning changes to simulated X-ray images is sufficiently realistic, 1% disagree (neutral 17%). 79% state that they acquired new knowledge concerning avoiding unnecessary radiation exposure, 10% do not (neutral 11%). CONCLUSIONS: The virtX-approach of simulating radiograph generation including patient positioning and scattered radiation was evaluated positively concerning its suitability for imparting knowledge regarding radiation protection and C-arm operation.

An approach to calculate and visualize intraoperative scattered radiation exposure.

During the intraoperative radiograph generation process with mobile image intensifier systems (C-arm) most of the radiation exposure for patient, surgeon and operation room personal is caused by scattered radiation. The intensity and propagation of scattered radiation depend on different parameters, e.g. the intensity of the primary radiation, and the positioning of the mobile image intensifier. Exposure through scattered radiation can be minimized when all these parameters are adjusted correctly. Because radiation is potentially dangerous and could not be perceived by any human sense the current education on correct adjustment of a C-arm is designed very theoretical. This paper presents an approach of scattered radiation calculation and visualization embedded in a computer based training system for mobile image intensifier systems called virtX. With the help of this extension the virtX training system should enrich the current radiation protection training with visual and practical training aspects.