CASEPLUS-SimPat: An Intersectoral Web-Based Case Management System for Multimorbid Dementia Patients.

One main challenge of health care systems in future will be the care and treatment of dementia patients. To their advanced age, dementia patients do not only have limitations in cognition, perception, and articulation, but also suffer from several other diseases (multimorbidity). These patients have sophisticated needs for assistance, care, and treatment relying on different health care sectors. Well-known communication and coordination deficits between sectors are intensified in the case of dementia, to the above described limitations. Coordination processes concerning the transition of patients from hospitals to inpatient or outpatient aftercare pose particularly difficult. To show a possible future direction for improving intersectoral care of dementia patients, we developed the web-based case management system CASEPLUS-SimPat as part of the project SimPat "Securing Integrated Care for Multi-morbid Patients with Dementia using an IT-based Service Concept". CASEPLUS-SimPat allows health care professionals, hospital employees and general practitioners, to jointly access patient data and exchange information about the treatment of patients. The case management system was implemented in a three-tier architecture with a role-based authorization concept. A portal for relatives complements the system. By providing precise information and e-learning services, caring relatives are integrated into the care process. In a pilot test, CASEPLUS-SimPat shows a good usability. Adapting aspects, such as keywords used to structure entries will make it easier to find required information, and thus will increase usability. Next steps comprise integration of further health care professionals and care facilities as well as real-life testing in terms of feasibility and effectiveness.

On Teaching International Courses on Health Information Systems. Lessons Learned during 16 Years of Frank - van Swieten Lectures on Strategic Information Management in Health Information Systems.

BACKGROUND: Health information systems (HIS) are one of the most important areas for biomedical and health informatics. In order to professionally deal with HIS well-educated informaticians are needed. Because of these reasons, in 2001 an international course has been established: The Frank - van Swieten Lectures on Strategic Information Management of Health Information Systems. OBJECTIVES: Reporting about the Frank - van Swieten Lectures and about our students' feedback on this course during the last 16 years. Summarizing our lessons learned and making recommendations for such international courses on HIS. METHODS: The basic concept of the Frank - van Swieten lectures is to teach the theoretical background in local lectures, to organize practical exercises on modelling sub-information systems of the respective local HIS and finally to conduct Joint Three Days as an international meeting were the resulting models are introduced and compared. RESULTS: During the last 16 years, the Universities of Amsterdam, Braunschweig, Heidelberg/Heilbronn, Leipzig as well as UMIT were involved in running this course. Overall, 517 students from these universities participated. Our students' feedback was clearly positive. The Joint Three Days of the Frank - van Swieten Lectures, where at the end of the course all students can meet, turned out to be an important component of this course. Based on the last 16 years, we recommend common teaching materials, agreement on equivalent clinical areas for the exercises, support of group building of international student groups, motivation of using a collaboration platform, ensuring quality management of the course, addressing different levels of knowledge of the students, and ensuring sufficient funding for joint activities. CONCLUSIONS: Although associated with considerable additional efforts, we can clearly recommend establishing such international courses on HIS, such as the Frank - van Swieten Lectures.

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.

eHealth vision towards cooperative patient care--domain fields and architectural challenges of regional health care networks.

Numerous eHealth projects and efforts to establish inter-organizational communication and to build up regional health care networks could be observed in the last ten years. Nevertheless the success of such efforts is profoundly different. The aim of this paper is to introduce the lately started regional initiative eHealth.Braunschweig compounding of the major health care players (hospitals, physician offices, nursing services and nursing homes) in the region of Braunschweig, participants from research institutions and industry. We propose in this paper the main goals of the regional initiative eHealth.Braunschweig, its constitution and major approaches. Based on respective literature and our former projects as well as experiences in this field we discuss our vision of a patient-oriented cooperative health care by depicting regional distinctions, identifying the major domain fields in this context and discussing the architectural challenges for the regional health care network eHealth.Braunschweig. In our view this work can be considered as a systematical approach to the establishment of regional health care networks with lasting and sustainable effects on patient-centered health care in a region.

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.

Health-enabling technologies for pervasive health care: a pivotal field for future medical informatics research education?

Our societies are changing worldwide. Life expectancy has increased in many societies and this increase is often related to an increase in the relative amount of elderly persons. Health-enabling technologies are information and communication technologies for creating sustainable conditions for self-sufficient and self-determined lifestyles. Sensor-enhanced health information systems play a major role in this context. The question is discussed, whether health-enabling technologies for pervasive health care can be regarded as a pivotal field for future medical informatics research and education.

IT-based information management in health care networks: the MedoCom approach.

Transinstitutional information systems support collaboration beyond the borders of single health care institutions. Information management in health care networks aims at establishing systematic information processing in order to contribute to the network's strategic goals. Health care networks can be characterized by complex and even conflicting goal systems. Our objective is to propose a framework, which describes organizational characteristics of health care networks. The framework is used to deduce effects of network characteristics on information management. Concluding, we present an architectural approach of a management platform for health care networks. The framework as well as the management platform are parts of our MedoCom approach.