E-health Framework Research Articles

A therapy-driven gamification framework for hand rehabilitation

Rehabilitative therapy is usually very expensive and confined to specialized rehabilitation centers or hospitals, leading to slower recovery times for corresponding patients. Therefore, there is a high demand for the development of technology-based personalized solutions to guide and encourage patients towards performing online rehabilitation program that can help them live independently at home. This paper introduces an innovative e-health framework that develops adaptive serious games for people with hand disabilities. The aim of this work is to provide a patient-adaptive environment for the gamification of hand therapies in order to facilitate and encourage rehabilitation issues. Theoretical foundations (i.e., therapy and patient models) and algorithms to match therapy-based hand gestures to navigational movements in 3D space within the serious game environment have been developed. A novel game generation module is introduced, which translates those movements into a 3D therapy-driven route on a real-world map and with different levels of difficulty based on the patient profile and capabilities. In order to enrich the user navigation experience, a 3D spatio-temporal validation region is also generated, which tracks and adjusts the patient movements throughout the session. The gaming environment also creates and adds semantics to different types of attractive and repellent objects in space depending on the difficulty level of the game. Relevant benchmarks to assess the patient interaction with the environment along with a usability and performance testing of our framework are introduced to ensure quantitative as well as qualitative improvements. Trial tests in one disability center were conducted with a total number of five subjects, having hand motor controls problems, who used our gamified physiotherapy solution to help us in measuring the usability and users' satisfaction levels. The obtained results and feedback from therapists and patients are very encouraging.

Gamifying hand physical therapy with intelligent 3D navigation

As human-centered interactive technologies, serious games are getting popularity in a variety of fields such as training simulations, health, national defense, and education. To build the best learning experience when designing a serious game, a system requires the integration of accurate spatio-temporal information. Also, there is an increasing need for intelligent medical technologies, which enable patients to live independently at home. This paper introduces a novel e-Health framework that leverages GIS-based serious games for people with disabilities. This framework consists of a spatio-temporal map-browsing environment augmented with our newly introduced multi-sensory natural user interface. We propose a comprehensive architecture that includes a sensory data manager, a storage layer, an information processing and computational intelligence layer, and a user interface layer. Detailed mathematical modeling as well as mapping methodology to convert different therapy-based hand-gestures into navigational movements within the serious game environment are also presented. Moreover, an Intelligent Game Recommender has been developed for generating optimized navigational routes based on therapeutic gestures. Those routes are tailored to the patient preferences and capabilities. Motion data is stored in a repository throughout the different sessions for offline replaying and advanced analysis; and different indicators are displayed in a live manner. To the best of our knowledge, this is the first GIS-based game recommender framework for online physical therapy. The prototype has been deployed to a disability center. The obtained results and feedback from therapists and patients are encouraging.

Steerable pyramid transform and local binary pattern based robust face recognition for e-health secured login

This paper proposes a face recognition system based on a steerable pyramid transform (SPT) and local binary pattern (LBP) for e-Health secured login. In an e-Health framework, patients are sometimes unable to identify themselves by traditional login modalities such as username and password. Automatic face recognition can replace the conventional login modalities if the recognition system is robust. In the proposed system, SPT can decompose a face image into several subbands of different scales and orientations, and LBP can encode the subbands in binary texture pattern. Therefore, SPT-LBP scheme represents a face image in a robust way that includes multiple information sources from different scales and orientations. The proposed system is evaluated on the facial recognition technology (FERET) database. According to the results, the proposed system achieves 99.28% recognition in fb set, 80.17% in dup I set, and 79.54% in dup II set.

Cloud Computing Framework for E-Health in Ghana: Adoption Issues and Strategies: Case Study of Ghana Health Service

professionals do not always have all the information they require and at the time when it is most needed to make rapid patient-care decisions. Also healthcare services are still being provided using manual tools and technologies. The adoption of current technologies such as Cloud Computing provides an avenue to overcome these challenges. This paper therefore measures the ICT awareness of stakeholders in healthcare while also providing an evidence of the possibility of cloud implementation by Ghana Health Services (GHS) in relation to the ICT awareness of stakeholders. It also provides a framework for a cloud based E-Health adoption by the GHS.

New trends in biomedical engineering and bioinformatics applied to biomedicine - special issue of IWBBIO 2014.

New trends in biomedical engineering and bioinformatics applied to biomedicine - special issue of IWBBIO 2014.

A Systematic Literature Review of Cloud Computing in Ehealth

Cloud computing in eHealth is an emerging area for only few years. There needs to identify the state of the art and pinpoint challenges and possible directions for researchers and applications developers. Based on this need, we have conducted a systematic review of cloud computing in eHealth. We searched ACM Digital Library, IEEE Xplore, Inspec, ISI Web of Science and Springer as well as relevant open-access journals for relevant articles. A total of 237 studies were first searched, of which 44 papers met the Include Criteria. The studies identified three types of studied areas about cloud computing in eHealth, namely (1) cloud-based eHealth framework design (n=13); (2) applications of cloud computing (n=17); and (3) security or privacy control mechanisms of healthcare data in the cloud (n=14). Most of the studies in the review were about designs and concept-proof. Only very few studies have evaluated their research in the real world, which may indicate that the application of cloud computing in eHealth is still very immature. However, our presented review could pinpoint that a hybrid cloud platform with mixed access control and security protection mechanisms will be a main research area for developing citizen centred home-based healthcare applications.

The behavioral intervention technology model: an integrated conceptual and technological framework for eHealth and mHealth interventions.

A growing number of investigators have commented on the lack of models to inform the design of behavioral intervention technologies (BITs). BITs, which include a subset of mHealth and eHealth interventions, employ a broad range of technologies, such as mobile phones, the Web, and sensors, to support users in changing behaviors and cognitions related to health, mental health, and wellness. We propose a model that conceptually defines BITs, from the clinical aim to the technological delivery framework. The BIT model defines both the conceptual and technological architecture of a BIT. Conceptually, a BIT model should answer the questions why, what, how (conceptual and technical), and when. While BITs generally have a larger treatment goal, such goals generally consist of smaller intervention aims (the "why") such as promotion or reduction of specific behaviors, and behavior change strategies (the conceptual "how"), such as education, goal setting, and monitoring. Behavior change strategies are instantiated with specific intervention components or “elements” (the "what"). The characteristics of intervention elements may be further defined or modified (the technical "how") to meet the needs, capabilities, and preferences of a user. Finally, many BITs require specification of a workflow that defines when an intervention component will be delivered. The BIT model includes a technological framework (BIT-Tech) that can integrate and implement the intervention elements, characteristics, and workflow to deliver the entire BIT to users over time. This implementation may be either predefined or include adaptive systems that can tailor the intervention based on data from the user and the user’s environment. The BIT model provides a step towards formalizing the translation of developer aims into intervention components, larger treatments, and methods of delivery in a manner that supports research and communication between investigators on how to design, develop, and deploy BITs.

E-Health and Telemedicine: Current State and Future Steps

The article reviews the questions related to building the e-health systems. The key element of the system is electronic healthcare record to be formed according to the modular approach in the form of primary and satellite electronic medical records. Person-centred healthcare is proposed as a foundation for e-health. Such an approach provides a potential opportunity for all the medical doctors to obtain necessary information about their patients at any time via the teleconsultations in particular. Transition to e-health is associated with the creation of new opportunities for making diagnostic and therapeutic decisions based on the use of build-in decision support modules. The computer-assisted software design or hybrid systems are considered as the fourth generation medical information systems. It is reasonable to implement the entire information space of e-health, including the information systems of medical institutions and regional data repositories, based on cloud-optimized storage and computing solutions. This approach is expected to be implemented in Russia as a part of the unified state health information system. The authorized access to integrated databases for medical doctors of various specialties is required. In the framework of e-health, telemedicine is considered as an important component. Main elements comprise the real-time access of medical consultants to personified medical databases and remote follow-up of patients by the means of personal or home-based telemedicine. The use of personal portable devices for the control of vital signs of the organism is especially promising. Electronic stethoscopes and specialized video cameras for acquiring objective information should be increasingly used by remote consultants. Unfortunately, this trend is still underdeveloped in Russia. In perspective, e-health as unified medical space will provide a transition to the integrated analysis of population health by medical doctors of various specialties from different countries and will open new prospects for studying health based on the intelligent analysis of integrated data of patients.

Human factors considerations when developing eHealth solutions to support patients: comparison of Danish and Australian experiences

Single snapshot evaluations of eHealth projects often lack depth when explaining the impact of human factor influences at the conceptualisation stages of a project. This paper explores the conceptualisation and prototype building of two eHealth projects undertaken in Denmark and Australia and develops a human factors evaluation framework applicable for use during the initial phases of eHealth projects for patient use. Initially the projects were reviewed using a human factors lens to identify individual project phases. Project elements in each project were determined and analysed using thematic analysis. A conceptual framework was then developed and applied to the project phases resulting in the identification and exploration of five key themes. The developed framework can complement existing eHealth evaluation frameworks and enrich them with a human factors viewpoint and highlights the need for further research on cultural influences and the intersections between each framework component. Finally, the paper highlights the need for patients to be considered as end users of eHealth systems and engaged early and throughout the development of eHealth systems.

Novel Cloud and SOA-Based Framework for E-Health Monitoring Using Wireless Biosensors

Various and independent studies are showing that an exponential increase of chronic diseases (CDs) is exhausting governmental and private healthcare systems to an extent that some countries allocate half of their budget to healthcare systems. To benefit from the IT development, e-health monitoring and prevention approaches revealed to be among top promising solutions. In fact, well-implemented monitoring and prevention schemes have reported a decent reduction of CDs risk and have narrowed their effects, on both patients' health conditions and on government budget spent on healthcare. In this paper, we propose a framework to collect patients' data in real time, perform appropriate nonintrusive monitoring, and propose medical and/or life style engagements, whenever needed and appropriate. The framework, which relies on service-oriented architecture (SOA) and the Cloud, allows a seamless integration of different technologies, applications, and services. It also integrates mobile technologies to smoothly collect and communicate vital data from a patient's wearable biosensors while considering the mobile devices' limited capabilities and power drainage in addition to intermittent network disconnections. Then, data are stored in the Cloud and made available via SOA to allow easy access by physicians, paramedics, or any other authorized entity. A case study has been developed to evaluate the usability of the framework, and the preliminary results that have been analyzed are showing very promising results.

An Empirical Validation of the Patient-centered e-Health Framework in Patient-focused Websites

Although the Internet is in its second decade of wide-spread adoption, many patient-centered health websites are still in a phase of early adoption, scrambling to define and defend market segments in a shifting healthcare information landscape. Consequently, healthcare and health information providers are jockeying for position in a dynamic industry trying to serve different patients’ needs. To understand the situation, this article takes the approach of Patient-centered e-Health (PCEH) and makes three contributions. One, we empirically test the PCEH framework on patient-focused websites. Two, given the PCEH framework, we identify five categories of websites that serve different segments of the patient-centered health information market. Three, we analyze the five categories in terms of different features and derive a classification model. This article helps us better understand PCEH websites and guide the future development of online healthcare and health information services.

A mHealth Application for Chronic Wound Care: Findings of a User Trial

This paper reports on the findings of a user trial of a mHealth application for pressure ulcer (bedsore) documentation. Pressure ulcers are a leading iatrogenic cause of death in developed countries and significantly impact quality of life for those affected. Pressure ulcers will be an increasing public health concern as the population ages. Electronic information systems are being explored to improve consistency and accuracy of documentation, improve patient and caregiver experience and ultimately improve patient outcomes. A software application was developed for Android Smartphones and tablets and was trialed in a personal care home in Western Canada. The software application provides an electronic medical record for chronic wounds, replacing nurses’ paper-based charting and is positioned for integration with facility’s larger eHealth framework. The mHealth application offers three intended benefits over paper-based charting of chronic wounds, including: (1) the capacity for remote consultation (telehealth between facilities, practitioners, and/or remote communities), (2) data organization and analysis, including built-in alerts, automatically-generated text-based and graph-based wound histories including wound images, and (3) tutorial support for non-specialized caregivers. The user trial yielded insights regarding the software application’s design and functionality in the clinical setting, and highlighted the key role of wound photographs in enhancing patient and caregiver experiences, enhancing communication between multiple healthcare professionals, and leveraging the software’s telehealth capacities.

Der Nutzen der Schweizer Teilnahme im europäischen Projekt epSOS

epSOS (Smart Open Services for European Patients) was launched in July 2008 and is a European project, which is organised by representatives from different countries. The main objective of epSOS is the development and practical implementation of an eHealth framework and an information and communication technology infrastructure in Europe. Switzerland participates with the Canton of Geneva and the University Hospitals of Geneva with epSOS. Each participating country had to build a National Contact Point (NCP) as a national gateway for the transnational data exchange within epSOS. The secure connection between the various national NCPs forms the basis for the epSOS ‘circle of trust’. In epSOS at project start various legal, political, organisational and technical challenges arose based on the heterogeneity of the health systems in the EU countries, especially as health care is not part of the EU treaty. In this sense, the European situation at the beginning of the project is comparable with the Swiss one: firstly both don’t have a uniform legal basis, and secondly, the EU has a federal structure that is similar to the one in Switzerland. Both require a high coordination effort. The epSOS project has achieved the desired proof of concept. Since the second semester of 2012, the first countries are online with their use cases. This demonstrates that it is possible to find unified electronic processes even when starting from diverse situations. However, epSOS probably won’t be the solution for a homogeneous European solution for the transnational exchange of health data in the near future – as there are tremendous differences between the national eHealth infrastructures, policies and levels of development. The in epSOS implemented emergency data sets, electronic patient records and electronic prescriptions can make a major contribution to patient safety, by providing the medical personnel in emergency situations with lifesaving information to prevent treatment errors and to avoid the repetition of diagnostic procedures .

Context-aware multimedia services modeling: an e-Health perspective

In this paper we present an e-Health framework model that can dynamically provide context-aware multimedia services to a user. The framework collects live user context by analyzing sensory data obtained from a body sensor network and multimedia content available from live heterogeneous Internet-based services. Finally, we share the implementation details and test results.

A regulatory framework for pervasive e-health: A case study

To facilitate superior healthcare delivery and address current challenges faced by healthcare today, a plethora of pervasive e-health solutions are emerging. However, existing regulatory regimes are ill-equipped for dealing with them. This not only causes frustration to various stakeholders including patients, providers, healthcare organizations and payers, not to mention vendors but also means that the most appropriate solution cannot be accessed and used. Hence this exploratory study serves to investigate institutional regulatory factors that can impact the adoption of such pervasive e-health solutions. These factors are important as they can shape both the nature of these solutions and their diffusion trajectory. We argue that co-regulation, a mixture of direct monitoring and intervention of regulators through legislation and complete industry self-regulation, can be an effective approach especially in view of the complex and dynamic nature of this industry, co-regulation can minimize monitoring costs and enhance compliance. We illustrate with a case vignette.

A Holistic Framework to Improve the Uptake and Impact of eHealth Technologies

BackgroundMany eHealth technologies are not successful in realizing sustainable innovations in health care practices. One of the reasons for this is that the current development of eHealth technology often disregards the interdependencies between technology, human characteristics, and the socioeconomic environment, resulting in technology that has a low impact in health care practices. To overcome the hurdles with eHealth design and implementation, a new, holistic approach to the development of eHealth technologies is needed, one that takes into account the complexity of health care and the rituals and habits of patients and other stakeholders.ObjectiveThe aim of this viewpoint paper is to improve the uptake and impact of eHealth technologies by advocating a holistic approach toward their development and eventual integration in the health sector.MethodsTo identify the potential and limitations of current eHealth frameworks (1999–2009), we carried out a literature search in the following electronic databases: PubMed, ScienceDirect, Web of Knowledge, PiCarta, and Google Scholar. Of the 60 papers that were identified, 44 were selected for full review. We excluded those papers that did not describe hands-on guidelines or quality criteria for the design, implementation, and evaluation of eHealth technologies (28 papers). From the results retrieved, we identified 16 eHealth frameworks that matched the inclusion criteria. The outcomes were used to posit strategies and principles for a holistic approach toward the development of eHealth technologies; these principles underpin our holistic eHealth framework.ResultsA total of 16 frameworks qualified for a final analysis, based on their theoretical backgrounds and visions on eHealth, and the strategies and conditions for the research and development of eHealth technologies. Despite their potential, the relationship between the visions on eHealth, proposed strategies, and research methods is obscure, perhaps due to a rather conceptual approach that focuses on the rationale behind the frameworks rather than on practical guidelines. In addition, the Web 2.0 technologies that call for a more stakeholder-driven approach are beyond the scope of current frameworks. To overcome these limitations, we composed a holistic framework based on a participatory development approach, persuasive design techniques, and business modeling.ConclusionsTo demonstrate the impact of eHealth technologies more effectively, a fresh way of thinking is required about how technology can be used to innovate health care. It also requires new concepts and instruments to develop and implement technologies in practice. The proposed framework serves as an evidence-based roadmap.

New Trends in Biomedical Signal Processing: A Crossroads Between Smart Sensors in E-Health and Virtual Physiological Human Initiatives

New Trends in Biomedical Signal Processing: A Crossroads Between Smart Sensors in E-Health and Virtual Physiological Human Initiatives

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.

Introduction to CATCH-IT Reports: Critically Appraised Topics in Communication, Health Informatics, and Technology

EHealth has developed largely from an interdisciplinary framework and, as such, does not have a “home” discipline. The absence of this home discipline has allowed eHealth research to be published widely in journals ranging from the medical sciences, to engineering, to social science or to business and policy studies. The result of this fragmented, decentralized literature base is that researchers are not always aware of important papers published in other areas and journals. With this issue the Journal of Medical Internet Research is inaugurating a new article category which we call “CATCH-IT Reports” (Critically Appraised Topics in Communication, Health Informatics, and Technology). We hope these reports will draw attention to important work published in other (sometimes obscure) journals, provide a platform for discussion around results and methodological issues in eHealth research, and help to develop a framework for evidence-based eHealth. CATCH-IT Reports arise from “journal club” - like sessions founded in February 2003 at the Centre for Global eHealth Innovation. We invite other research institutions to create similar journal clubs and to write up and submit to this journal critiques in the form of CATCH-IT Reports.

E-Health: technologic revolution meets regulatory constraint.

Perspective Health AffairsVol. 19, No. 6 Perspective: E-Health: Technologic Revolution Meets Regulatory ConstraintBruce Merlin Fried, Gadi Weinreich, Gina M. Cavalier, and Kathleen J. Lester Affiliations Bruce Fried < [email protected] > and Gadi Weinreich are partners in the law firm Shaw Pittman, Washington, D.C. Gina Cavalier is an associate there. Kathleen Lester was with Shaw Pittman at the time of this writing; she is now a privacy consultant for the U.S. Department of Health and Human Services. Fried was director of the Center for Health Plans and Providers at the Health Care Financing Administration and is general counsel to the Internet Healthcare Coalition and the eHealthcare Association. PUBLISHED:November/December 2000No Accesshttps://doi.org/10.1377/hlthaff.19.6.124AboutSectionsView articleView Full TextView PDFPermissions ShareShare onFacebookTwitterLinked InRedditEmail ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions View articleTOPICSInternetRegulationEthicsMedicare savings programsSystems of careHealth information technologyHealth care providersQuality of careAccess to careMedicaid Loading Comments... Please enable JavaScript to view the comments powered by Disqus. DetailsExhibitsReferencesRelated Article MetricsCitations: Crossref 13 History Published online 1 November 2000 InformationCopyright © by Project HOPE: The People-to-People Health Foundation, Inc.PDF downloadCited ByENABLING THE UTILIZATION OF POTENTIALLY DISRUPTIVE DIGITAL INNOVATIONS BY INCUMBENTS: THE IMPACT OF CONTEXTUAL, ORGANISATIONAL, AND INDIVIDUAL FACTORS IN REGULATED CONTEXTS9 July 2020 | International Journal of Innovation Management, Vol. 25, No. 02The Origin and Impact of Ideals in eHealth Research: Experiences From the U-CARE Research Environment23 May 2014 | JMIR Research Protocols, Vol. 3, No. 2Regulating Pervasive e-Health Services6 November 2012A regulatory framework for pervasive e-health: A case studyHealth Policy and Technology, Vol. 1, No. 4Patient-Oriented Interactive E-health Tools on U.S. Hospital Web SitesHealth Marketing Quarterly, Vol. 29, No. 4The physician–patient relationship: the impact of patient-obtained medical information1 January 2006 | Health Economics, Vol. 15, No. 8Raising Awareness of On-line Cancer Information: Helping Providers Empower PatientsJournal of Health Communication, Vol. 10, No. sup1The nature of the Net: constructing reliability of health information on the WebInformation Technology & People, Vol. 17, No. 2Health Care Software Engineering: A Review of Selected LiteratureSSRN Electronic JournalWomen's health and the internet: understanding emerging trends and implicationsSocial Science & Medicine, Vol. 56, No. 1Chapter 10: Telehealth, Managed Care, and Patient-Physician Communication: Twenty-first Century InterfaceCommunication Yearbook, Vol. 26, No. 1The Internet, pharmaceuticals and the lawDrug Discovery Today, Vol. 6, No. 9Old Before Its Time: HIPAA And E-Health PolicyA law that predates the Internet explosion needs retrofitting to serve as a foundation for standardized data exchange.Rob Cunningham13 December 2018 | Health Affairs, Vol. 19, No. 6