RespDoc: a new clinical decision support system for childhood asthma management based on Fraction of Exhaled Nitric Oxide (FeNO) measurements.

The use of Fraction of Exhaled Nitric Oxide (FeNO) for measurement of inflammation in the respiratory system is a good way to assess the level of asthma in children. In this paper we present a new Clinical Decision Support System (CDSS) for Childhood Asthma Management based on FeNO, which is named RespDoc. The core of RespDoc is a decision making algorithm and a patient's monitoring process that are extensively analyzed in the paper. The performance of RespDoc is tested through the process and assessment of archived patients' data.

u-MCHC: a predictive framework for ubiquitous management of exacerbations in chronic diseases.

Exacerbations are crucial events in chronic diseases that require continuous management. Knowledge of the exacerbation risk enhances patient's quality of life and enables self-management and self-organizing of unscheduled doctor visits and/or hospitalization. This paper proposes a new framework for ubiquitous management of chronic diseases named u-MCHC. The proposed framework incorporates monitoring, decision-making, notification and management processes in order to deliver personalized therapeutical options and services. The delivery of services is realized by means of Next Generation Service Delivery Platform (NG-SDP). A prototype implementation of u-MCHC and its performance is demonstrated in a real world case for Chronic Obstructive Pulmonary Disease (COPD).

Application of Multiprotocol Medical Imaging Communications and an Extended DICOM WADO Service in a Teleradiology Architecture.

Multiprotocol medical imaging communication through the Internet is more flexible than the tight DICOM transfers. This paper introduces a modular multiprotocol teleradiology architecture that integrates DICOM and common Internet services (based on web, FTP, and E-mail) into a unique operational domain. The extended WADO service (a web extension of DICOM) and the other proposed services allow access to all levels of the DICOM information hierarchy as opposed to solely Object level. A lightweight client site is considered adequate, because the server site of the architecture provides clients with service interfaces through the web as well as invulnerable space for temporary storage, called as User Domains, so that users fulfill their applications' tasks. The proposed teleradiology architecture is pilot implemented using mainly Java-based technologies and is evaluated by engineers in collaboration with doctors. The new architecture ensures flexibility in access, user mobility, and enhanced data security.

A proposed Next Generation Service Delivery Platform (NG-SDP) for eHealth domain.

Nowadays, providing healthcare personalized services in user's intelligent space is an important issue for improving personal health, supporting predictive care and saving medical costs. In this paper, we propose an architecture for the Next Generation Service Delivery Platform (NG-SDP), suitable for composing and delivering personalized healthcare services. The core component of NG-SDP is a Context Decision Making Enabler (CDME) that assesses user contextual and bio information to yield personalized services. A prototype implementation of the proposed NG-SDP is also demonstrated. Finally a real case study demonstrates the CDME performance.

e-SCP-ECG Protocol: An Expansion on SCP-ECG Protocol for Health Telemonitoring-Pilot Implementation.

Standard Communication Protocol for Computer-assisted Electrocardiography (SCP-ECG) provides standardized communication among different ECG devices and medical information systems. This paper extends the use of this protocol in order to be included in health monitoring systems. It introduces new sections into SCP-ECG structure for transferring data for positioning, allergies, and five additional biosignals: noninvasive blood pressure (NiBP), body temperature (Temp), Carbon dioxide (CO(2)), blood oxygen saturation (SPO(2)), and pulse rate. It also introduces new tags in existing sections for transferring comprehensive demographic data. The proposed enhanced version is referred to as e-SCP-ECG(+) protocol. This paper also considers the pilot implementation of the new protocol as a software component in a Health Telemonitoring System.

A contextual data mining approach toward assisting the treatment of anxiety disorders.

Anxiety disorders are considered the most prevalent of mental disorders. Nevertheless, the exact reasons that provoke them to patients remain yet not clearly specified, while the literature concerning the environment for monitoring and treatment support is rather scarce warranting further investigation. Toward this direction, in this study a context-aware approach is proposed, aiming to provide medical supervisors with a series of applications and personalized services targeted to exploit the multiparameter contextual data collected through a long-term monitoring procedure. More specifically, an application that assists the archiving and retrieving of the patients' health records was developed, and four treatment supportive services were considered. The three of them focus on the discovery of possible associations between the patient's contextual data; the last service aims at predicting the stress level a patient might suffer from, in a given context. The proposed approach was experimentally evaluated quantitatively (in terms of computational efficiency and time requirements) and qualitatively by experts on the field of mental health domain. The feedback received was very encouraging and the proposed approach seems quite useful to the anxiety disorders' treatment.

Leveraging dynamic user profiles for the assistance of anxiety disorders' treatment using inferential rules.

While anxiety disorders exhibit an impressive spread especially in western societies, context-awareness seems a promising technology to provide assistance to physicians in psychotherapy sessions. In the present paper an approach addressing the assistance of the anxiety disorders' treatment is proposed. The suggested method employs the a priori association rule mining algorithm in order to achieve dynamic update of patient profiles according to generated rules describing the underlying relations between patients' main context conditions and their stress level. This method was evaluated by therapists specializing in the mental health domain and the feedback received was very encouraging with respect to the assistance dynamic patient profiles offer, during CBT sessions.

Establishing telemedicine system to support urgent incidents around the borderline of Greece: implemented architecture and evaluation.

An evaluation of a wide area Telemedicine System (TS) designed for a country with singular geomorphology like Greece is presented. It targets to improve the outcome in emergency cases, by means of an early and specialized pre-hospital treatment. The TS makes use of modern technologies leading to the cooperation of 30 mobile medical units, 3 Telemedicine Coordination Centers and 7 Regional Teleconference Rooms. An adaptive protocol is used to reduce the data transmission time and the resources required for archiving. An automated network switching keeps the communication live in most cases while a telemedicine service co-ordinates all the co-operating endpoints, providing call and connection management, remote healthcare assistance, teleconference capabilities and real-time vital signs' transmission.

WADA service: an extension of DICOM WADO service.

The Web Access to Digital Imaging and Communication in Medicine (DICOM) Persistent Objects (WADO) service is standardized as the Web extension to DICOM. This paper analyzes the operational specifications of the WADO service and extends its access capability to the whole DICOM hierarchy (patient, study, series, and object). The proposed Web Access to DICOM Archives (WADA) service, as opposed to WADO, also includes an extrainternal query mechanism and support of medical reports submission. A pilot implementation of WADA as software components and their integration into a three-tier architecture are also presented. Advanced security mechanisms are augmented to ensure communication encryption, user identification, and access restriction to data according to user roles. The proposed service is a simple approach, and can be embedded in any system managing medical images and reports. WADA can also be integrated into the Cross-Enterprise Document Sharing-Imaging (XDS-I) standard, which is considered to be the most likely future standard for medical imaging exchange.

Dynamic biosignal management and transmission during telemedicine incidents handled by Mobile Units over diverse network types.

Early and specialized pre-hospital patient treatment improves outcome in terms of mortality and morbidity, in emergency cases. This paper focuses on the design and implementation of a telemedicine system that supports diverse types of endpoints including moving transports (MT) (ambulances, ships, planes, etc.), handheld devices and fixed units, using diverse communication networks. Target of the above telemedicine system is the pre-hospital patient treatment. While vital sign transmission is prior to other services provided by the telemedicine system (videoconference, remote management, voice calls etc.), a predefined algorithm controls provision and quality of the other services. A distributed database system controlled by a central server, aims to manage patient attributes, exams and incidents handled by different Telemedicine Coordination Centers (TCC).