Dimitris Koutsouris

Multiple Image Watermarking Applied to Health Information Management

Information technology advances have brought forth new challenges in healthcare information management, due to the vast amount of medical data that needs to be efficiently stored, retrieved, and distributed, and the increased security threats that explicitly have to be addressed. The paper discusses the perspectives of digital watermarking in a range of medical data management and distribution issues, and proposes a complementary and/or alternative tool that simultaneously addresses medical data protection, archiving, and retrieval, as well as source and data authentication. The scheme imperceptibly embeds in medical images multiple watermarks conveying patients personal and examination data, keywords for information retrieval, the physicians digital signature for authentication, and a reference message for data integrity control. Experimental results indicate the efficiency and transparency of the scheme, which conforms to the strict requirements that apply to regions of diagnostic significance

Secure and efficient health data management through multiple watermarking on medical images

The landscape of healthcare delivery and medical data management has significantly changed over the last years, as a result of the significant advancements in information and communication technologies. Complementary and/or alternative solutions are needed to meet the new challenges, especially regarding security of the widely distributed sensitive medical information. Digital watermarking is a recently established research area with many applications; nevertheless, the potential of this technology to contribute value-added services to medical information management systems has only recently started to be realized by the research community. The paper presents a review of research efforts in the area of medical-oriented watermarking and proposes a wavelet-based multiple watermarking scheme; this scheme aims to address critical health information management issues, including origin and data authentication, protection of sensitive data, and image archiving and retrieval. In accordance with the strict limitations applying to medical images, the scheme allows the definition of a region of interest (ROI) whose diagnostic value is protected, since the only additional information embedded therein aims at integrity control. The robustness of the method is enhanced through a form of hybrid coding, which includes repetitive embedding of BCH encoded watermarks. The experimental results on different medical imaging modalities demonstrate the efficiency and transparency of the watermarking scheme.

Computerised intrapartum diagnosis of fetal hypoxia based on fetal heart rate monitoring and fetal pulse oximetry recordings utilising wavelet analysis and neural networks

Objective To develop a computerised system that will assist the early diagnosis of fetal hypoxia and to investigate the relationship between the fetal heart rate variability and the fetal pulse oximetry recordings.

Energy-efficient MAC Protocol for Patient Personal Area Networks

The formulation of a personal area network (PAN), consisting of a wireless infrastructure of medical sensors, attached to patients body, and a supervising device carried by them, lays the path for continuous and real-time monitoring of vital signs without discomforting the person in question. This infrastructure enhances the context of remote healthcare services by supporting flexible acquisition of crucial vital signs, while at the same time it provides more convenience to the patient. Aiming at the exploitation of the inherent features and requirements of wireless medical sensor networks, in this paper we focus on the main design guidelines of a low power medium access control (MAC) protocol, designated to support a patient PAN. The proposed protocol intends to improve energy efficiency in such applications and thus is oriented towards the prevention of main energy wastage sources, such as collision, idle listening and power outspending

Mobile phone technologies and advanced data analysis towards the enhancement of diabetes self-management

Advances in the area of mobile and wireless communication for healthcare (m-Health) along with the improvements in information science allow the design and development of new patient-centric models for the provision of personalised healthcare services, increase of patient independence and improvement of patients self-control and self-management capabilities. This paper comprises a brief overview of the m-Health applications towards the self-management of individuals with diabetes mellitus and the enhancement of their quality of life. Furthermore, the design and development of a mobile phone application for Type 1 Diabetes Mellitus (T1DM) self-management is presented. The technical evaluation of the application, which permits the management of blood glucose measurements, blood pressure measurements, insulin dosage, food/drink intake and physical activity, has shown that the use of the mobile phone technologies along with data analysis methods might improve the self-management of T1DM.

Medical support system for continuation of care based on XML web technology

In this paper, the implementation of an Internet-based telematic service for medical support is presented, which was developed and operated in pilot form within the INTRANET HEALTH CLINIC project--a 2-year project supported by the European Commission under the Health Telematics Programme. The aim of the application is to offer high quality care to users of health services over inexpensive communication pathways, using Internet-based, interactive communication tools, like remote access to medical records and transmission of multimedia information. The XML technology was employed to achieve customised views on patient data, according to the access rights of different user profiles. Strict security and access control policy were implemented to ensure secure transmission of medical data through the Internet. The system was designed to collaborate with existing clinical patient record systems and to be adjustable to different medical applications. Current implementations include the fields of Oncology, Lupus Erythrematosis, Obstetrics and Chronic Obstructive Pulmonary disease. The results of the pilot operation with oncological patients in Greece were encouraging, so that the refining of the system and its expansion to a large number of patients is already in progress.

Using decision tree algorithms as a basis for a heart sound diagnosis decision support system

Decision trees algorithms were used with promising results in various critical problems, concerning heart sound diagnosis. In general this diagnostic problem can be divided in many sub problems, each one dealing either with one morphological characteristic of the heart sound or with difficult to distinguish heart diseases. The sub problems of the discrimination of aortic stenosis from mitral regurgitation and the discrimination between the second heart sound split, opening snap and third heart sound, are used as case studies. Using signal-processing methods, we extracted the heart sound feature vector. Relevance analysis was performed using the uncertainty coefficient. Then for each heart sound diagnosis sub problem, a specific decision tree (DT) was constructed. decision tree pruning was also investigated. Finally, a general decision support system architecture for the heart sound diagnosis problem, is proposed. The partial diagnosis, given by these DT, can be combined using arbitration rules to give the final diagnosis. These rules can be implemented by another DT, or can be based on different methods, algorithms, or even on expert knowledge. All these can lead to an integrated decision support system architecture for heart sound diagnosis.

A Multiple Watermarking Scheme Applied to Medical Image Management

Digital watermarking is a recently emerged research area, which has the potential of providing alternative/complementary solutions for a number of issues relating to medical data management and distribution. The present paper aims to reveal the perspectives of digital watermarking in health information systems, and proposes a wavelet-based multiple watermarking scheme that addresses the issues of medical data protection, archiving, and retrieval, as well as of origin and data authentication. The scheme applies multiple watermarking in medical images, and embeds in them the physicians digital signature, patients personal and examination data, keywords for image retrieval, and a reference watermark for the purpose of data integrity control. The experimental results demonstrate the efficiency and transparency of the watermarking scheme, which conforms to the strict limitations that apply to regions of diagnostic significance.

CT-based software for 3-D localization and reconstruction in stepping source brachytherapy

Describes innovative software for catheter localization and 3D reconstruction in stepping-source brachytherapy applications. The patient information is a set of computed tomography (CT) slices, scanned during the implantation of brachytherapy catheters. Catheter geometry and patient anatomy are exported for use with dose calculation software modules. The errors produced by the system are also encouragingly low. Time savings were achieved compared with other traditional reconstruction techniques. Various automated procedures, 3D graphics and a user-friendly GUI have contributed to providing a powerful, comprehensive software tool that is directly useable in clinical practice.

An indoor navigation system for visually impaired and elderly people based on Radio Frequency Identification (RFID)

One of the most challenging limitations for the elderly and/or the visually impaired people is the inability of self-navigation in unfamiliar indoor environments. Numerous existing indoor navigation systems have been proposed in order to solve such problems. However, these papers do not adequately examine the effectiveness of the systems in real time trials and are faced with a variety of technical and usability problems. In our paper we present a unique and elegant architecture of an indoor navigation system as an integrated and tested system in real time. This solution enables the localization of the user, as well as the navigation considering scenarios that the user might follow and suggests guidelines for self- navigation. To evaluate the feasibility of the proposed architecture we carried out experimental scenarios to prove that the system proposed is suitable enough to guide elderly people through an unknown built environment.