Healthcare for anyone, anywhere, anytime

Gli sviluppi in campo scientifico e nella medicina sono fortemente collegati. L'innovazione tecnologica ci aiuta a rendere più semplici le operazioni che potrebbero essere complesse, riuscendo a dare un grande aiuto in qualsiasi campo. In questo lavoro si approfondirà il contributo che può dare l'innovazione all'assistenza sanitaria, con lo scopo di riuscire a fornire un'assistenza sanitaria in qualsiasi luogo, in qualsiasi momento, a chiunque. Per fare questo ci si basa sull'mHealth e quindi sull'interazione tra la medicina e i dispositivi mobili. Si definirà una architettura che abbia le potenzialità di essere integrata con le procedure di assistenza sanitaria riuscendo a diminuire i costi aumentando i benefici percepiti da medici e pazienti. Lo strumento base utilizzato per fornire una assistenza sanitaria in mobilità saranno i sensori e gli attuatori impiantabili o indossabili.

Personal health data - Privacy policy harmonization and global enforcement

This workshop is jointly organized by EFMI Working Groups Security, Safety and Ethics and Personal Portable Devices in cooperation with IMIA Working Group "Security in Health Information Systems". In contemporary healthcare and personal health management the collection and use of personal health information takes place in different contexts and jurisdictions. Global use of health data is also expanding. The approach taken by different experts, health service providers, data subjects and secondary users in understanding privacy and the privacy expectations others may have is strongly context dependent. To make eHealth, global healthcare, mHealth and personal health management successful and to enable fair secondary use of personal health data, it is necessary to find a practical and functional balance between privacy expectations of stakeholder groups. The workshop will highlight these privacy concerns by presenting different cases and approaches. Workshop participants will analyse stakeholder privacy expectations that take place in different real-life contexts such as portable health devices and personal health records, and develop a mechanism to balance them in such a way that global protection of health data and its meaningful use is realized simultaneously. Based on the results of the workshop, initial requirements for a global healthcare information certification framework will be developed.

Mhealth entrepreneurship: an exploratory research for a managerial model for mhealth start ups in low and middle income countries

Since some years, mobile technologies in healthcare (mHealth) stand for the transformational force to improve health issues in low- and middle-income countries (LMICs). Although several studies have identified the prevailing issue of inconsistent evidence and new evaluation frameworks have been proposed, few have explored the role of entrepreneurship to create disruptive change in a traditionally conservative sector. I argue that improving the effectiveness of mHealth entrepreneurs might increase the adoption of mHealth solutions. Thus, this study aims at proposing a managerial model for the analysis of mHealth solutions from the entrepreneurial perspective in the context of LMICs. I identified the Khoja–Durrani–Scott (KDS) framework as theoretical basis for the managerial model, due to its explicit focus on the context of LMICs. In the subsequent exploratory research I, first, used semi-structured interviews with five specialists in mHealth, local healthcare systems and investment to identify necessary adaptations to the model. The findings of the interviews proposed that especially the economic theme had to be clarified and an additional entrepreneurial theme was necessary. Additionally, an evaluation questionnaire was proposed. In the second phase, I applied the questionnaire to five start-ups, operating in Brazil and Tanzania, and conducted semi-structured interviews with the entrepreneurs to gain practical insights for the theoretical development. Three of five entrepreneurs perceived that the results correlated with the entrepreneurs' expectations of the strengths and weaknesses of the start-ups. Main shortcomings of the model related to the ambiguity of some questions. In addition to the findings for the model, the results of the scores were analyzed. The analysis suggested that across the participating mHealth start-ups the ‘behavioral and socio-technical’ outcomes were the strongest and the ‘policy’ outcomes were the weakest themes. The managerial model integrates several perspectives, structured around the entrepreneur. In order to validate the model, future research may link the development of a start-up with the evolution of the scores in longitudinal case studies or large-scale tests.

Cyberhealth serving to support individual intake of medication.

The Internet and new communication technologies are deeply affecting healthcare systems and the provision of care. The purpose of this article is to evaluate the possibility that cyberhealth, via the development of widespread easy access to wireless personal computers, tablets and smartphones, can effectively influence intake of medication and long-term medication adherence, which is a complex, difficult and dynamic behaviour to adopt and to sustain over time. Because of its novelty, the impact of cyberhealth on drug intake has not yet been well explored. Initial results have provided some evidence, but more research is needed to determine the impact of cyberhealth resources on long-term adherence and health outcomes, its user-friendliness and its adequacy in meeting e-patient needs. The purpose of such Internet-based interventions, which provide different levels of customisation, is not to take over the roles of healthcare providers; on the contrary, cyberhealth platforms should reinforce the alliance between healthcare providers and patients by filling time-gaps between visits and allowing patients to upload and/or share feedback material to be used during the visits. This shift, however, is not easily endorsed by healthcare providers, who must master new eHealth skills, but healthcare systems have a unique opportunity to invest in the Internet and to use this powerful tool to design the future of integrated care. Before this can occur, however, important issues must be addressed and resolved, for example ethical considerations, the scientific quality of programmes, reimbursement of activity, data security and the ownership of uploaded data.

Middleware per Internet of Things: Java Embedded come caso di studio

Grazie al progresso dell'elettronica, ai giorni nostri, è possibile costruire dispositivi elettronici molto piccoli, che col passare del tempo lo sono sempre più. Questo ci permette di poter imboccare nuove strade nel mondo dell'informatica, sfruttando proprio questo fatto. Le dimensioni ridotte dei dispositivi in commercio, come sensori, attuatori, tag e tanto altro, sono particolarmente adatte a nuovi scenari applicativi. Internet of Things è una visione in cui Internet viene esteso alle cose. Facendo largo uso di dispositivi come sensori e tag è possibile realizzare sistemi intelligenti che possono avere riscontri positivi nella vita di tutti i giorni. Tracciare la posizione degli oggetti, monitorare pazienti da remoto, rilevare dati sull'ambiente per realizzare sistemi automatici (ad esempio regolare automaticamente la luce o la temperatura di una stanza) sono solo alcuni esempi. Internet of Things è la naturale evoluzione di Internet, ed è destinato a cambiare radicalmente la nostra vita futura, poichè la tecnologia sarà sempre più parte integrante della nostra vita, aumentando sempre più il nostro benessere e riducendo sempre più il numero delle azioni quotidiane da compiere. Sempre più sono middleware, le piattaforme e i sistemi operativi che nascono per cercare di eliminare o ridurre le problematiche relative allo sviluppo di sistemi di questo genere, e lo scopo di questa tesi è proprio sottolinearne l'importanza e di analizzare gli aspetti che questi middleware devono affrontare. La tesi è strutturata in questo modo: nel capitolo uno verrà fatta una introduzione a Internet of Things, analizzando alcuni degli innumerevoli scenari applicativi che ne derivano, insieme però alle inevitabili problematiche di tipo tecnologico e sociale. Nel secondo capitolo verranno illustrate le tecnologie abilitanti di Internet of Things, grazie alle quali è possibile realizzare sistemi intelligenti. Nel terzo capitolo verranno analizzati gli aspetti relativi ai middleware, sottolineandone l'importanza e prestando attenzione alle funzioni che devono svolgere, il tutto riportando anche degli esempi di middleware esistenti. Nel quarto capitolo verrà approfondito il middleware Java Embedded di Oracle.

Sistema Bluetooth-based di remarketing pervasivo

Il progetto si propone di dotare la realta fisica di un estensione digitale. Sensori, attuatori e tecnologie embedded hanno cambiato il nostro modo di lavorare, allenarci e seguire i nostri interessi. Il mondo del commercio non e rimasto a guardare ed ha dovuto adattarsi alla metamorfosi high-tech del settore dei servizi. Il sistema proposto costituisce un promotore per acquisti ed un raccoglitore intelligente di abitudini sullo shopping e si compone di applicazione mobile, microcontroller e web server. Caratteristica prima e principale del progetto e sicuramente la pervasivita. All'utente ed utilizzatore dell'app dello shopping center deve essere certamente resa nota la collaborazione al fine di raccogliere dati statistici sulle sue abitudini, tuttavia sono le modalita di tale operazione a dover rimanere velate, in modo da non appesantire il cliente con tediose operazioni di invio di feedback e valutazioni ed allo stesso tempo permettere una raccolta capillare delle informazioni. Parallelamente alla raccolta di dati funzionali al producer, sono state implementate features per il consumatore, come notifiche promozionali place-triggered e pubblicita mirata. Tra tutte le tecnologie adibite allo scambio di informazioni, si e scelto l'utilizzo del Bluetooth e del piu recente Bluetooth Low Energy (BLE) per permettere ai dispositivi di comunicare tra loro.

Adoption of accountable-eHealth systems by future healthcare professionals: An empirical research model based on the Australian context

This paper provides a first look at the acceptance of Accountable-eHealth systems, a new genre of eHealth systems, designed to manage information privacy concerns that hinder the proliferation of eHealth. The underlying concept of AeH systems is appropriate use of information through after-the-fact accountability for intentional misuse of information by healthcare professionals. An online questionnaire survey was utilised for data collection from three educational institutions in Queensland, Australia. A total of 23 hypothesis relating to 9 constructs were tested using a structural equation modelling technique. A total of 334 valid responses were received. The cohort consisted of medical, nursing and other health related students studying at various levels in both undergraduate and postgraduate courses. The hypothesis testing disproved 7 hypotheses. The empirical research model developed was capable of predicting 47.3% of healthcare professionals’ perceived intention to use AeH systems. A validation of the model with a wider survey cohort would be useful to confirm the current findings.

eHealth handbook for managers of healthcare services and systems

Prefacio de Alicia Bárcena y Luciano Sáez

Smart structures: sperimentazione mediante attuatori e sensori innovativi

L’idea di base della seguente tesi, finora mai applicata o descritta in letteratura scientifica in base alle ricerche effettuate, è stata quella di creare un sistema di monitoraggio strutturale intelligente (Structural Health Monitoring, SHM) mediante dei sensori di deformazione a reticolo di Bragg (Fiber Bragg Grating, FBG), incollati su fili a memoria di forma inseriti a loro volta, bloccati con opportuni ancoraggi esterni, in sei travi di betoncino cementizio armato. L’obbiettivo della sperimentazione è stato quindi quello di creare delle travi intelligenti che, in condizioni di carico eccezionali e critiche (monitorate dal sensore a fibra ottica), sapessero “autoripararsi” mediante gli attuatori a memoria di forma con un processo di riscaldamento appositamente progettato.

Perchè le imprese dovrebbero investire in mhealth? pro e contro della nuova frontiera del healthcare

La tesi si occupa della nuova frontiera del healthCare, la salute mobile o mHealth, analizzando al situazione di mercato, le previsioni future, quelli che possono essere i vantaggi di questo nuovo mercato e le barriere che ne possono limitare lo sviluppo. Integrando il lavoro con un analisi tramite le teorie strategiche imparate durante i corsi di studio

Accountable-eHealth systems : the next step forward for privacy

EHealth systems promise enviable benefits and capabilities for healthcare. But, the technologies that make these capabilities possible brings with them undesirable drawback such as information security related threats which need to be appropriately addressed. Lurking in these threats are patient privacy concerns. Fulfilling these privacy concerns have proven to be difficult since they often conflict with information requirements of care providers. It is important to achieve a proper balance between these requirements. We believe that information accountability can achieve this balance. In this paper we introduce accountable-eHealth systems. We will discuss how our designed protocols can successfully address the aforementioned requirement. We will also compare characteristics of AeH systems with Australia’s PCEHR system and identify similarities and highlight the differences and the impact those differences would have to the eHealth domain.

Legal issues related to Accountable-eHealth systems in Australia

Information privacy requirements of patients and information requirements of healthcare providers (HCP) are competing concerns. Reaching a balance between these requirements have proven difficult but is crucial for the success of eHealth systems. The traditional approaches to information management have been preventive measures which either allow or deny access to information. We believe that this approach is inappropriate for a domain such as healthcare. We contend that introducing information accountability (IA) to eHealth systems can reach the aforementioned balance without the need for rigid information control. IA is a fairly new concept to computer science, hence; there are no unambiguously accepted principles as yet. But the concept delivers promising advantages to information management in a robust manner. Accountable-eHealth (AeH) systems are eHealth systems which use IA principles as the measure for privacy and information management. AeH systems face three main impediments; technological, social and ethical and legal. In this paper, we present the AeH model and focus on the legal aspects of AeH systems in Australia. We investigate current legislation available in Australia regarding health information management and identify future legal requirements if AeH systems are to be implemented in Australia.

Designing an information accountability framework for eHealth

Information privacy is a crucial aspect of eHealth. Appropriate privacy management measures are therefore essential for its success. However, traditional measures for privacy preservation such as rigid access controls (i.e., preventive measures) are not suitable to eHealth because of the specialised and information - intensive nature of healthcare itself, and the nature of the information. Healthcare professionals (HCP) require easy, unrestricted access to as much information as possible towards making well - informed decisions. On the other end of the scale however, consumers (i.e., patients) demand control over their health information and raise concerns for privacy arising from internal activities (i.e., information use by HCPs). A proper balance of these competing concerns is vital for the implementation of successful eHealth systems. Towards reaching this balance, we propose an information accountability framework (IAF) for eHealth systems.

Identifying and using ehealth phobias to implement communication protocols and change cultural and social behaviours in ehealth

Standardisation of validated communication protocols that aid in the adoption of policies, methods and tools in a secure eHealth setting require a significant cultural shift among clinicians