The rapid development of information technology and the multiple usage of Information Systems make indisputable their appliance in all the sectors including the Nursing Service area. Information Systems that have been developed for the Nursing Service Administration are extremely useful in the processing and the categorisation of a large number of information, providing significant advantages such as information storage, information availability, information precision and reliability. In addition, the appliance of Information Systems provides important advantages in the administration of the nursing personnel’s data, contributing to the improvement of the operating effectiveness of the Nursing Service. This paper describes the development and the evaluation of an Information System for the Nursing Service Administration that classifies all the information related to the nursing personnel and helps the administration to handle the appropriate nursing data. The method of Life Cycle Model was decided as the most appropriate for the development of the System, because of the important advantages that it offers. For the evaluation of our own designed system we based on the standards, which are used for evaluating Information Systems in general. The evaluation of this Information System is carried out by a survey among the undergraduate and the postgraduate students of the Nursing Department of the University of Athens and the Nursing Personnel of a number of Hospitals. Useful conclusions have been derived concerning those characteristics, which should be fulfilled by the system. Important conclusions have been also drown out concerning the dependencies of the variables under study, the future readjustments of the system, and the general perception of the newcomers in health profession towards the application of the information technology.

Access to clinical reference information at the point-of-care is a goal that is difficult to achieve by lack of really portable reference material. Handheld computers have matured to the point where they are powerful enough to be used as clients of a distributed knowledge system serving reference information and decision-aid applications in a highly portable form factor. We describe a pilot project launched at the Geneva University Hospital studying the use of handhelds and associated clinical applications in two internal medicine clinics. Results garnered by this study will help answer the many questions raised by the use of handhelds in medical practice, in term of cost, benefits, risk and change in workflow.

Within public health, there is a tradition of co-operation between researchers and communities in planning and implementation of health promotion programs. As a consequence, public-health organizations are characterized by having complex multidisciplinary structure and dynamic organizational goals. In this paper, we discuss the economic impacts from the use of Participatory Design for development of public-health information systems. Creation of systems that have both utility and usability is suggested to be highlighted as the central goal. The identified prerequisites for a positive impact are that the new system should be of high quality, appropriate to the nature of the health promotion tasks, and to how activities are coordinated and integrated both between and within the stakeholder groups involved. We argue further that a method that minimizes the information asymmetry in the development process is necessary for avoiding market failures. The conclusion is that participatory design will diminish transaction costs, will help to avoid sunk costs, and will contribute to rich efficient use of human and economic resources in public-health organizations.

South Africa initiated a national District Health Information System rollout strategy in the latter half of 1999. Experience has demonstrated that the implementation of an information system as a vehicle for the delivery of accountability in the management of health services, demands organisational change within a framework of human resource development and technical support. The aim of training, to empower facility and district staff to use locally generated information to improve coverage and quality of primary health care services, can only be realized if training and innovation for change are appropriately marketed and supported.

The appeal of HISP software, a locally developed application system lies in its user acceptance. While computers form a vital tool in providing easily accessible information for decision-making, their use must not be seen as a panacea for all information problems in primary health care services.

Strategies for promoting sustainability of DHIS implementation lie in the social processes of human resource development, changing organisational infrastructure and the use of ongoing evaluation rather than those of technical infrastructure. South Africa has developed a variety of mechanisms to facilitate this process.

To control the heterogeneity inherent to hospital information systems the information management needs appropriate hospital information systems modeling methods or techniques. This paper shows that, for several reasons, available modeling approaches are not able to answer relevant questions of information management. To overcome this major deficiency we offer an UML-based ontology for describing hospital information systems architectures. This ontology views at three layers: the domain layer, the logical tool layer, and the physical tool layer, and defines the relevant components. The relations between these components, especially between components of different layers make the answering of our information management questions possible.

Technical mechanisms such as authentication and access controls and so on, are important subjects on protecting the security of hospital information system. The function of individual user authentication is essential and important requirement of secure system. Our discussion is focused on techniques of individual authentication using finger print system or IC card system based on the questionnaires answered by several vendors, from the point of effective daily clinical works.

In Japan, hospital information systems (HIS) introduced at national university hospitals, are already evolved into second to third generations. Recently, some university hospitals experienced many troubles. We made a questionnaire survey to analyze Chat the problems are. In most cases, the length of time from the signing of a contract to the beginning of using new system was too short. Some hospitals experienced their worst problems because of inadequate completion of the custom software, incompatibilities in data and so on. If ample preparation time is not available, the current contracting procedure must actively be reviewed.

Recently hospital information systems have come into wide use. It has become easier for healthcare providers to retrieve patient data. However they need to have the ability to analyze the patient data using the most reliable and upto- date medical knowledge. We think that the next generation of hospital information system (HIS) should not only provide patient data but also support interpretation of the data for the healthcare providers. In order to provide appropriate medical knowledge to them, we developed a system which dynamically creates linkage between an HIS and an electronic medical textbook (EMT).

Electronic patient records (EPR) have been introduced in large hospitals and its usefulness has been reported. However, there are few studies on how to deal with the large amount of documents that recorded before the introduction of EPR. Also, EPR has a problem with storage of pictures handwritten by medical experts. In order to solve these problems, we developed a system electronizing patient records handwritten by using image-scanners. This system contains a high-speed scanner (Kodak — Kodak Digital Science DS3500), which can read the 60 sheets per minute. When a chart is scanned, it is stored in the server of the hospital information system (HIS) with the identification codes. Medical staff members in the hospital can refer to the scanned chart and read it on the PCs in the HIS. It takes about 5-20 seconds to acquire the scanned chart from the server; this is much faster and easier than manual lending service. Another advantage of this system is that it also achieves the storage of the non-character information such as drawings or tables on the paper chart, which plays an important role in the record of some department, such as surgery. This poster reports the experience of the usage of this system in Shimane Medical University Hospital.

This paper discusses the issues related to use of Information Technology (IT) solutions in dialysis, and describes the implementation of some of them in a medium size dialysis center. First, starting from the analysis of the organization of public-health nephrology services, the potential role of IT is highlighted. Second, the main directions for IT exploitation in dialysis, namely telemedicine and automated monitoring of dialysis sessions are discussed. Third, the on-field implementation of these services is described, together with some preliminary results. The work here presented shows how IT may improve dialysis services by ameliorating quality and reducing costs.

We describe a five-month pilot project conducted in the dialysis unit at Boston's Children's Hospital. Pediatric patients with renal disease used the Zora therapeutic community program while undergoing hemodialysis. Zora is a 3D multi-user computer environment designed at the MIT Media Laboratory to help young people explore issues of identity, while engaging in a virtual community. Users build “virtual rooms” and populate them with objects and characters, program them with storytelling behaviors, and converse with other young people in real-time through a virtual character representing themselves. It was specifically designed to help young people explore issues of identity, while engaging in a participatory virtual community. This paper presents the experience and evaluates the feasibility and safety of using Zora in a hospital setting. It describes how Zora facilitated explorations of identity and mutual patient support and interaction. Finally it also presents design recommendations for future interventions of this kind. More generally, this paper explores the potential of technology specifically designed with therapeutic purposes to help patients cope with their illness.

A comprehensive computerized questionnaire was developed to obtain the anamnesis of patients seeking contact with a physician for any type of new problem. The purpose of this pilot study was to investigate if a structured questionnaire filled out by the patient and complementing an interview at the physician’s office would contribute to a better quality of the total anamnesis and/or lead to savings in time at the visit. The results encourage further developments in this direction. The potential uses proposed are, in addition to being used to improve a visit, the correct assessment of the history for prioritization and scheduling of visits and in some situations, the anamnesis obtained over the net may be the basis for medical advice without a visit. This study emphasizes the great improvement of information captured by this type of questionnaire based on medical knowledge about associated symptoms and relevant questions depending on the problem presented compared to the results obtained by a simple open question used in many e-health services today.

National Asthma Education and Prevention Program (NAEPP) suggests using asthma action plans for patient self-care. Recent studies reported that many asthma patients had difficulties in following action plans on a daily basis and had low compliance to medication regimens. The goal of our study was to design and evaluate the Home Asthma Telemonitoring (HAT) system aimed to help asthma patients to follow their self-care plans according to the NAEPP recommendations. Our study resulted in the development of the system which provided patients with continuous individualized help in the daily routine of asthma self-care and notified heath care providers if certain clinical conditions occurred. This allowed early recognition of potentially dangerous situations and timely intervention. The evaluation of the HAT system underwent several stages. First we showed, that the HAT system provides reliable reciprocal exchange of all relevant information between a physician and asthma patient in home settings. Further evaluation demonstrated that lung function test results collected during home asthma telemonitoring are comparable to those collected under the supervision of trained professionals, and Internet-based home asthma telemonitoring can be successfully implemented in a group of patients without previous computer experience. Preliminary results of an on-going HAT evaluation showed higher patient compliance to asthma action plans in comparison to the compliance reported for patients in standard care. The clinical impact of HAT on asthma outcomes is being currently evaluated in a randomized clinical trial funded by NIH. HAT has a potential for improving clinical outcomes and quality of life in the studied patient population and may be a model for monitoring and self-management of patients with other chronic health conditions.

Telemedicine offers the potential to alleviate the severe shortage of medical specialists in developing countries. However lack of equipment and poor network connections usually rule out video-conferencing systems. This paper describes a software application to facilitate store-andforward telemedicine by email of images from digital cameras. TeleMedMail is written in Java and allows structured text entry, image processing, image and data compression, and data encryption. The design, implementation, and initial evaluation are described.

This paper describes recent research that proposes virtual reality techniques as a therapy for patients with cognitive and psychological problems. Specifically this applies to victims of conditions such as traumatic brain injury, alzheimers and parkinsons. Additionally virtual reality therapy offers an alternative to current desensitization techniques for the treatment of phobias Some important issues are examined including means of user interaction, skills transfer to the real world, and side-effects of virtual reality exposure.

Disease management programs seek to improve the health of a population of patients with a disease through a multidisciplinary approach founded in the collection, analysis and feedback of disease-specific outcomes. Currently, the majority of disease management programs have been conducted by insurers or external vendors. Limitations of these programs derive from separation of care from primary care and the inability to rapidly and accurately obtain the necessary clinical data. The utility offered by an electronic medical record allows physician organizations to conduct disease management programs of higher quality at lower cost.

Home health care is an expanding area within the health care system. The idea of moving parts of the health care process from expensive specialised hospital care to primary health care and home health care might be attractive in a cost perspective. The introduction of home health care applications must be based on a rigorous analysis of necessary requirements to secure a safe and reliable health care. This article reports early experiences from the development of a home health care application based on emerging Java technologies such as the OSGi platform. A pilot application for follow-up of diabetes patients is presented and discussed in relation to a list of general requirements on home health care applications.

Health care delivery is changing drastically. In its current state it tends to use the home care model in order to increase quality of life, to rationalize costs and to achieve wellness. Pivotal to these purposes are contact centers, which act as mediators between the medical staff and the citizens seeking advice and/or therapy. Main platforms used for the development of such applications are the INTERNET and PCs, and the telecommunication networks, including mobile solutions. In this paper, a generic contact center model shall be presented, which is under development in the context of an IST European project in health telematics entitled ‘Distance Information Technologies for Home care. The Citizen Health System (CHS)’. After the description of this generic contact center, an application for health care delivery to diabetic patients shall be described. In this application we shall see the possible use of the Wireless Application Protocol (WAP) scheme. This application proves the usefulness of wireless technology in providing health care services all around the clock and everywhere the citizen is located, it shows the necessity for restructuring the medical knowledge for education delivery to the patient, and it shows the virtue of interactivity by means of using the limited, yet useful browsing capabilities of the WAP technology.

In this paper we examined a new joint motion monitoring method by use of accelerometers to monitor subjects’ detailed motion in daily activities. In this method two accelerometers are set at as near points of both sides around the joint as possible. The difference between these two sensors' outputs mainly depend on the joint angle because the centrifugal and the turning acceleration occurred by the rotation around the joint can be neglected. In the experiments we tried to monitor various subject's behaviors of his upper and lower extremities and whole body motion, and could show this method is useful for the ambulatory monitoring of behavior in daily life.