Nils Hellrung

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.

Strategic Information Management in Hospitals

Until now we have discussed how health information systems look like and how their quality can be described and measured. We will now examine how high quality health information systems can be achieved and how high quality can be maintained, especially in hospitals. High quality HIS can only by achieved and HIS failures can only be prevented if the HIS are systematically planned, monitored and directed. We summarize this triad by the term ‘information management’.

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 patients 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.

Quality of Health Information Systems

The International Organization for Standardization (ISO) defines quality in general as the ability to meet all the expectations of the purchaser of goods or services, or in other words, as the degree to which a set of inherent characteristics fulfills requirements, where “requirements” means need or expectation. Three major approaches to quality assessment are typically distinguished: Quality of structures, quality of processes, and quality of outcome. In the context of health care, the concept of quality of structures applies to the human, physical, and financial resources that are needed to provide medical care (e.g., educational level of staff, availability of medical equipment). Quality of processes describes the quality of activities carried out by care providers (e.g., adherence to professional standards, appropriateness of care). Finally, quality of outcome describes the effects of patient care, that is, the changes in the health status of the patient (e.g., mortality, morbidity, costs). While quality of structures influences quality of processes, quality of processes in turn influences quality of outcome.

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

Summary 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.

Einbettung assistierender Technologien in Gesundheitsnetzwerke – von der Wohnung zum Arzt

Die Bedeutung Informationstechnik(IT)-gestutzter Dienstleistungen fur die Sicherstellung bzw. Verbesserung von Qualitat und Effizienz der Gesundheitsversorgung ist langst weltweit erkannt. In ihrer eHealth-Resolution mahnt die World Health Organization bereits 2005 ihre Mitgliedsstaaten, entsprechende Programme systematisch umzusetzen (WHO Executive Board 2005). In reicheren Landern mit gut umfassender Versorgungsstruktur liegt das Potenzial in der Uberwindung okonomischer, wissenschaftlicher und, sozialer und operativer Barrieren. Im Fokus steht dabei die Unterstutzung eines „citizen-preventioneducation-home based“ (Healy 2007) Versorgungsparadigmas.

Health Institutions and Information Processing

Health information systems strongly influence quality and efficiency of health care, and technical progress offers advanced opportunities to support health care. In this chapter, we will discuss the interrelation between health information systems on one side and health care on the other side.

Modeling Health Information Systems

Modeling HIS is an important precondition for their management: What we cannot describe, we usually cannot manage adequately. After defining the concepts necessary for dealing with this chapter, we will present some types of information system models describing different aspects of HIS. We will then focus on the so-called “three-layer graph-based metamodel” (3LGM²), which has been developed for describing, evaluating and planning health information systems. 3LGM² models and their application for information management will play an important role throughout this book. Finally, we introduce reference models and a specific reference model that facilitates modeling information systems in hospitals.

Information System Basics

Every domain usually has its own terminology, which often differs from the ordinary understanding of concepts and terms. This chapter presents the terminology for information systems and their management, as used in this book. It is, therefore, essential to read this chapter carefully. All relevant concepts can also be found in the Thesaurus at the end of the book.

Specific Aspects for Architectures of Transinstitutional Health Information Systems

Although this book focuses on hospital information systems, it is important to understand that institutional information systems, in general, and hospital information systems, in particular, are parts of larger, cross-linked systems.