Day 2 :
Keynote Forum
Gunnar O Klein
Örebro University School of Business, Sweden
Keynote: Primary Care Physician Meeting the Cyberpatient
Time : 10:05-10:40
Biography:
Gunnar O Klein has spent 40 years on IT for health and medical research. He was for many years working for Karolinska Institute, the Medical University of Stockholm, Sweden both as a cancer researcher and for the development of health informatics research and education. He is now Professor of eHealth at the Centre for Empirical Research on Information Systems at the Örebro University School of Business. He has made many contributions to the development of security techniques for health and semantic interoperability. He was leading European Standardization of Health Informatics in CEN/TC 251 1997-2006 and was a Co-founder of the global standardization in ISO/TC 215. He is now involved in research on patient empowerment in interaction with healthcare using apps and other techniques and new innovative functions for managing elderly patients with multimorbidity. He is a member of the regional eHealth steering group and one day a week he works as a primary care physician.
Abstract:
This keynote lecture will present an overview of research and the personal experience of the author as a Primary Care Physician in Sweden, meeting the patient of the 21st century who uses the internet. The lecture will address topics like the new patient-physician role play when the world of knowledge is available a click away for both parties, the effects of patients having access to their health records online, new ways of interaction between patients/citizens and the health care providers with a special focus on patient reporting of outcome measures, the role of remote monitoring using medical devices in the home or on the go, the support of patients with chronic diseases like AIDS in lesser resourced countries using mHealth techniques with a special view at Mozambique and different technical and organizational approaches to communicate between patients and physicians.
Keynote Forum
Vivian Vimarlund
Jönköping University, Sweden
Keynote: Social innovations and e-health business models
Time : 10:40-11:15
Biography:
Vivian Vimarlund is Professor in e-health and in Informatics. She has a wide experience on management and leadership. Academic leadership is practiced as academic leader of the informatics research group, Director of the Research Center (CENIT/IS) at Jönköping International School (JIBS), as a Member of the American Medical Informatics (AMIA) Mentorship programme, and as the scientific leader of a series of research projects with focus on implementation, business models and social innovations. She is also the co-director of the master programme Software Engineering and Management at LiU, the coordinator of the national eHealth network and scientific secretary at SFMI. She has since 1989 conducted research within the area of Health Informatics with special focus on issues such as: a) Methods and models to evaluate the impact of the implementation and use of IT-based innovations in healthcare. b) Business models for Public Information Systems and Electronic Markets c) E-health services implementation.
Abstract:
Many countries in Europe develop strategies to foster the use of eHealth services and social innovations (European Commission, 2012). However, despite the fact that business models are perceived as an important part of the strategy used to achieve a sustainable implementation and use of social innovations as for instance eHealth services, there are no generic models that allow capturing the effects of a multi-side market. Further, business models are usually connected to an organization ability to focus on value- creation and to the ability to develop cost- effectiveness at the organizational level. In a multi-side market as e-health there are several challenges that have to be over-win to develop sustainable business models that increase market and penetration but that at the same time supported social innovations. In this presentation, issues such as: Challenges when developing business models for social innovation, pre-requisites a multi-side market demands and constrains the market for social innovations and e-health services has today will be discussed
- Track 5: Health care Communication Networks and Environment
Track 8: Clinical and Public Health Informatics
Chair
Eduardo J Simoes
University of Missouri School of Medicine, USA
Co-Chair
Vivian Vimarlund
Jönköping University, Sweden
Session Introduction
Julie M. Kapp
University of Missouri School of Medicine
USA
Title: A Hierarchical Framework for Population Health Surveillance: A Dashboard Approach
Time : 11:35-12:00
Biography:
Julie M. Kapp, MPH, PhD is an Associate Professor with a background in public health and evaluation. Her faculty appointments have included notable roles, such as: the Executive Director of the Health and Behavioral Risk Research Center, Margaret Proctor Mulligan Faculty Scholar, and Executive Director of the Partnership for Evaluation, Assessment, and Research. She has served as an NIH grant reviewer, an Associate Editor for BMC Cancer, and a journal reviewer for such notable titles as Cancer, International Journal of Cancer, and The Lancet. She recently completed a year-long Malcolm Baldrige Executive Fellows Program focused on aligning and integrating systems.
Abstract:
The Institute of Medicine (IOM) recently recommended a set of core metrics in an effort to improve data harmonization for the U.S. population health system and lay the foundation to measure performance improvement. Even with a set of common metrics, it is challenging to evaluate the effectiveness of population health initiatives dues to the many community-based organizations, and their complex interactions. The term ‘complex adaptive systems’ (CAS) acknowledges that health programs and activities are part of larger networks of stakeholders with histories and evolving dynamics. Systems engineering considers how components within the larger CAS structure operate and interact over the life cycle of the system; and how to optimize the design, implementation, and evaluation of that system. We propose a hierarchical systems framework, using a dashboard approach, in order to monitor U.S. population health progress with five system components: context, components, connections, infrastructure, and scale (Eoyang and Berkas, 1998). The framework aligns and integrates metrics across local (organization, hospital, city), regional, state, and national levels for data visualization and decision-making. Each metric may be computed in various ways to allow for noise, depending on the available data, and its result propagated and integrated at the higher level. Our pilot uses an obesity example. We compute obesity levels from various data sources at the local, regional (Boone County), and state levels in Missouri, USA. After data harmonization, metrics dynamics measures (decrease, rate of decrease, etc.) can be used to evaluate the impact of health programs implemented in Boone County.
Eduardo J Simoes
University of Missouri School of Medicine
USA
Title: Web-based applications for prioritizing health: A case study of 27 capital cities in Brazil 2006-2012
Time : 12:00-12:25
Biography:
Eduardo J Simoes, MD, is Chair and Alumni Distinguished Professor of the Department of Health Management and Informatics-University of Missouri School of Medicine (2011-current). He has a medical degree from Faculdade de Medicina, Universidade de Pernambuco in Brazil (1981), diploma and a Master of Sciences degree from University of London School of Hygiene Tropical Medicine (1987) and Master of Public Health degree from Emory University School of Public Health (1991). He is a fellow of the American College of Epidemiology. He has published 106 articles, eight book chapters and 18 reports, made 142 conference presentations, and reviewed/edited for 12 journals.
Abstract:
Introduction: Because public health funds are limited, programs need to be prioritized. We developed two indices to prioritize public health based on chronic disease risk factors (CDRF-PHI) and diseases (DZ-PHI). Methods: We used surveillance data from 27 capital cities in Brazil (2000-2012) about 12 risk factors and 32 diseases for CDRF-PHI and 51 diseases for DZ-PHI. We re-scaled and standardized indicators for risk factors and disease groups to create dimensionless scores. CDRF-PHI and DZ-PHI rank priorities using the sum of the rank of scores, the product or sum of scores across criteria: magnitude, severity, urgency, disparity, intervention effectiveness, intervention cost, and community preference. The current offline version of PHIs limits their use by public health practitioners. We developed a web application (PHP; MySQL-database) to help users upload surveillance data and calculate PHIs at any geographical level. We integrated the statistical R software within the application to conduct analysis. Results: For the combined 27 capital cities of Brazil, the six priority risk factors were physical inactivity, hypertension, hypercholesterolemia, smoking, heavy drinking and no hypertension screened in past 2 years; the 15 priority diseases were heart disease, pneumonia/influenza, other infectious diseases, assault/homicide, stroke/other cerebrovascular disease, diabetes, other diseases/disorders, health infant issues (<1 year), alcohol/related disorders, other mental diseases, HIV/AIDS, motor-vehicle accident, falls, zoonosis and colorectal cancer. Conclusions: Identified public health priorities varied across the 27 Brazilian capital cities. PHIs summarize and harmonize data from multiple indicators, health conditions and factors.
Dipankar Sengupta
Vrije Universiteit Brussel (VUB)
Belgium
Title: CliniPhenome: Clinical and phenotypic annotation database
Time : 12:25-12:50
Biography:
Dipankar Sengupta has completed his PhD in Bioinformatics from, Jaypee University of Information Technology, India. Currently, he is working as a Post doctoral researcher at COMO-Artificial Intelligence Lab, Vrije Universiteit Brussels, Belgium in BRiDGEIris project. Prior to this, he was working as Assistant Professor in Dept. of Bioinformatics & Biotechnology, Jaypee University of Information Technology, India. He aspires to unveil the intricacies of problem statements in life science and posses a passion to solve them with the aid of bioinformatics skills. His research interest broadly lies in the domain of Data mining, Database design & development, Algorithm design, Web interface development and Exploratory analysis. His primary research is focused on translational computing of clinical data with a considerable focus on temporal mining and auguring state of a disease for a patient. Currently, he is working on designing a Clinical-Phenomic Database and on development of machine learning approaches to connive comorbid patterns among the genomic variants with their associated clinical data.
Abstract:
As a part of the BRiDGEIris project, a clinical database CliniPhenome, has been developed that supports clinical and phenotypic annotation for patients. The project aims to develop a big data platform that can be used for sharing genomic and clinical data and support discovery studies in clinical genomics. A part of this goal was attained by the proposal of a generalized clinical schema design along with a merged ontology schema that provides cross-referencing possibilities. Also, introduction of the controlled vocabulary and data structure answers for the prevalent problem of plain text storage in the existing clinical databases, which causes impediment during data analysis. CliniPhenome not only supports the collection of patient data but also phenotypic and clinical annotation. Phenotypic annotation is supported by autogenously designed ontology that supports for Human Phenotype Ontology (HPO), Online Mendelian Inheritance in Man (OMIM) and Orphanet. Clinical annotation is currently supported by LOINC and SNOMED, with eventual assimilation of ICD-10 into it. It is a PHP based application with an easily operated interface that runs on a web browser and is facilitated by a MySQL database. A generalized schema design has been proposed, that ensures improved empathy among clinicians and researchers. Besides, it also features data migration utility that supports exchange of de-identified data in XML or JSON structure among the collaborators. In conclusion, CliniPhenome features streamlining of clinical workflow, efficient data entry and retrieval, improved diagnosis, cross-referencing of patient phenotype with clinical annotation, and sharing of de-identified patient data for research purposes.
Patrizia Colangeli
Istituto Zooprofilattico Experimental and Molise
Italy
Title: The integration of a laboratory information management system within a national livestock identification and traceability system in African countries
Time : 13:35-14:00
Biography:
Patrizia Colangeli has a degree in Engineering from the University “La Sapienza” of Rome, Italy. She worked at a private company in the applied mathematics and economy sector in Rome and after in a Bank in Teramo. Since 1991, she has worked at the Istituto Zooprofilattico Sperimentale dell’Abruzzo e del Molise (IZSAM) where she is the Head of “Information systems development and management” unit. She managed the analysis and implementation of many information systems at enterprise, regional, national and sovra-national level among which: The Animal Health National Information System (i.e. Brucellosis, Bluetongue, West Nile Disease), Laboratory Information Management System, Administrative and Staff information management system, the Datawarehouse enterprise, National information system for the notification of animal diseases; Zoonoses National System, Web-based application for the international surveillance of bluetongue in the European Union, OIE Bluetongue Reference Laboratories network, and the SILAB for Africa: A LIMS for African Labs currently used in Namibia, Botswana, Zimbabwe, Zambia, and Tanzania.
Abstract:
The control of animal diseases relies on rapid, accurate and reliable diagnoses, allowing early detection and response to disease outbreaks. Reduction in diseases, in particular zoonosis and greater safety of food have a direct effect on human health. In addition, the efficiency of a laboratory, and in particular accreditation according to ISO/IEC 17025 standards, is a pre-requisite for countries to access international trade.The LIMS called “SILAB for Africa” (SILABFA) is a web application developed by the Istituto Zooprofilattico Sperimentale dell’Abruzzo e del Molise (IZSAM), it is in routine use in five different National Veterinary Laboratories in Namibia, Botswana, Zimbabwe, Zambia and Tanzania. A LIMS system is an important element of the chain of the traceability system such as the Livestock Identification and Traceability System (LITS) (e.g. LITS in Botswana, NAMLITS in Namibia, TANLITS in Tanzania). The inter-linkage and inter-operability between SILABFA and a LITS system can therefore greatly improve the quality of the entire cycle of livestock production from the field to the laboratory, up to the export process. Such inter-operability can allow to insert data only once in one system and make data automatically available to other systems in use which enables rapid and fluid data transfer. It can then increase the effectiveness and efficiency of services involved in this whole chain, enhancing the exchange of information, promoting a better communication among operators, even across borders and allows a systematic ongoing collection of animal health information available and analyzed by the Epidemiological Unit.
Ingrid Hegger
National Institute for Public Health and the Environment
Netherlands
Title: Characterization of apps and other e-tools for medication use: Insights into possible benefits and risks
Time : 14:00-14:25
Biography:
I Hegger completed her PharmD at Utrecht University of Utrecht and is a Senior Researcher at the National Institute for Public Health and the Environment, The Netherlands. She is an expert on the regulation of medicinal products, with special interest in biologicals. Currently, her focus is on “close-to-policy” projects in the field of medical products, pharmaceutical care and health policy. She is project leader of project ‘e-Medication’ on the influence of internet on medicines use and involved in projects on the EU regulatory system for medicinal products and clinical trials. Furthermore, she is working on her PhD in a strategic research project on the utilization of knowledge within public health policy and healthcare supervision.
Abstract:
Little is still known regarding the use, possible effectiveness and risks of the enormous number of available health-related applications (apps). Many people use medicines and might benefit from tools that aid in the use of medicine, but could also have risks. Our aim was to gain more insight into the characteristics, possible risks and possible benefits of health apps and e-tools related to medication use.We investigateda selection of apps and other e-tools (n=116), including their characteristics. We found that a small subset of tools might involve relatively high risks (medical devices - class II and used by patients without involvement of health care professionals). On the other hand, a large majority of the tools (>80%) were assessed as relatively low risk tools (‘non-medical device’). However, the availability of these e-tools is enormous and poor functionality of these e-tools might have negative health effects for users. Since regulation of all the available health apps is impossible due to high numbers and constant changes, it is important for the general public to receive proper education concerning the possible risks associated with using apps and e-tools.
Maureen Lucy Schafer
George Mason University
USA
Title: Integrating Healthcare Informatics into Academia through application of the Systems Life Cycle model
Time : 14:25-14:50
Biography:
Maureen Lucy Schafer received her Ph.D in Health Care Systems and Informatics from the University of Arizona. An enterprise level clinical informaticist, Family Nurse Practitioner and military veteran, Dr. Schafer possesses a comprehensive background in advanced clinical care, health care systems, teaching and expert application of the Systems Life Cycle model. This training and accountability is derived from 25 years of experience in the United States Army, consulting, teaching and informatics work within and across academia and multiple health care organizations. Presently, she is a professor leading the growth of a robust Nursing informatics program at George Mason University within the College of Health & Human Services.
Abstract:
Routine reliance upon Information Technology (IT) and Informatics is now an essential standard for safe professional clinical practice. A challenge educators face is to incorporate the tenets of Informatics into the curriculum. To be prepared, the student clinician must not only understand the system but also the relationships between the technology, the information, and the processes and its impact on effective clinical practice. Over the past two years a 15 week graduate course was transformed to focus learning through a relevant team project from a health care system problem in an actual healthcare organization. The project stair-steps through the Systems Life Cycle model and is applied to healthcare systems and informatics in a clinical setting. Outcomes demonstrate that students successfully analyze the impact of data, information, and knowledge within the context of a model and learn to critically evaluate how information resources, if properly deployed, can address the challenges defined in an IT health care system problem. The real time System Life Cycle projects culminate in an executive summary with measured outcomes and is presented to the selected health care organization where the system issue was defined.
Daniele De Falco Alfano
University of Ferrara, Italy
Title: Texture Analysis of clear cell renal cell carcinoma
Time : 14:50-15:15
Biography:
Daniele De Falco Alfano began his experience in experimental radiology with the medical degree received in October 2009 at the University of Ferrara (Italy). In June 2011, he started the residency in radiology at the same University and over the last 3 years he has focused his scientific interests in Cancer Imaging and Texture Analysis. He has published more than 12 papers in reputed journals and has been serving as an Reviewer for European Radiology, La Radiologia Medica Journal, Tumori Journal and Journal of Radiology Case Report. He is the Member of: European Congress of Radiology (ECR), Radiological Society of North (RSNA), Italian Society of Radiology (SIRM).
Abstract:
Purpose: The main goal of this retrospective study in blind, was to evaluate the accuracy of Mean value of Positive Pixels (MPP) texture parameter in tomodensitometric evaluation of renal cell carcinoma. Materials & Methods: IRB approval was obtained for the study. All patients who underwent a surgical nephrectomy (radical or partial) between January and December of 2013 has been identified. The study sample consisted of 33 men and 16 women between the age of 37 and 91 years. The TCTA study was conducted using the commercial software Image J, National Institutes of Health, USA. Result: A statistically significant correlation between MPP values (rs=0.66; p<0.001) with Histologic Grading (Gold Standard) was documented. The average values of MPP were significantly lower in the non-tumor lesions (MPP 92.63±3.81) compared to well-differentiated lesions G1 (MPP=112.35±4.03), moderately differentiated lesions G2 (MPP = 142.41±13.83; ) and G3 (PP = 147.21±10.74) and to poorly differentiated lesions G4 (MPP =177.89±6.57). The intra-observer and interobserver accordande was excellent (respectively a=0.94 and 0.96). Conclusion: The CT Texture Analysis is a valid aid for the characterization of tumor lesions allowing a clear distinction of well differentiated carcinomas (G1), moderately differentiated (G2 and G3) and poorly differentiated (G4). The evaluation of MPP texture parameter represent an accurate and reproducible approach for tomodensitometric characterization of renal cell carcinomas.
Véronique Dubé
Université de Montréal
Canada
Title: Learning to become a family care-giver of a person recently diagnosed from Alzheimer’s disease: How a web-based intervention can help?
Time : 15:35-16:00
Biography:
Véronique Dubé was a scholarship recipient of the Hospital Foundation of the University of Montreal (CHUM) and a Doctoral fellowship from the accompanying National Researcher award from the FRSQ assigned. Francine Ducharme PhD, she is also a fellow of the Faculty of Nursing at the University of Montreal (purse Evelyn Adam-2007 scholarship Virginia Allaire 2010), the Interuniversity Research Group Nursing Intervention Quebec (GRISIIQ; 2007-2008 and 2008-2009) and the Ministry of Education, Leisure and Sport (MELS) in 2009-2010 and 2011-2012. She also earned a scholarship to support the dissemination of research results of the Quebec Network for Research on Aging (RQRV) and recently she received the fellowship of Health Research Institutes to Canada.
Abstract:
It has been known for several years that the support and care of a person diagnosed from Alzheimer’s disease are provided by family members, and often to the detriment of their own health and quality of life. The multiple responsibilities of care-givers are often perceived as stressors that require a repertoire of coping mechanisms. Over the last few years, a team from the Desjardins research chair in nursing care for seniors and their families has developed and evaluated a number of psychoeducational interventions striving to support family caregivers. Recently, the team explored an innovative approach by using information and communication technologies. A psycho-educational web-based intervention program promoting the adaptation to the care-givers’ role of a person recently diagnosed with Alzheimer's disease was designed. A pilot study assessed its implementation process and evaluated its effects on selected indicators of caregivers’ adaptation. The intervention program was offered to 20 care-givers who received an online training and tutoring by a healthcare professional over a period of seven weeks. Focused readings and exercises allowed family care-givers to acquire new supportive strategies based on their daily experiences as a care-giver. A brief description of the web sessions of this educational program will be presented as well as examples of the use of the web-based learning platform by family care-givers. This intervention approach, complementary to other types of interventions has several advantages, particularly for care-givers who are geographically distant from healthcare services and who have limited access to support groups or individual face to face interventions.
Harsha K Rajasimha
Strand Life Sciences, USA
Title: New generation health care delivery through smart labs capable of offering next-generation sequencing based multi-gene panels
Time : 16:00-16:25
Biography:
Harsha K Rajasimha is Vice President of Global Business Development at Strand Genomics Inc., a new generation healthcare company and a global leader in personalized medicine. He is affiliate faculty in systems biology at the George Mason University and is a co-founder of the Organization for Rare Diseases India. His career has spanned academia, non-profits, Government, Information Technology, and Biotechnology in highly interdisciplinary multinational environments. He is passionate about applying genomics to personalizing healthcare and increasing global food production. He holds a masters degree in computer science and doctoral degree in Genetics, Bioinformatics and Computational Biology from Virginia Tech, USA.
Abstract:
In the past decade, we have overcome the grand challenge of being able to sequence a human genome for $1000 within a week. This is already having tremendous implications on how health care is delivered to patients. For cancer care, it is critical to accurately classify the tumor at the molecular level and enable the oncologists to make the right clinical decisions through data integration, curation, mining and reporting by applying next-generation sequencing (NGS) technologies. The opportunity is real and applies to almost all human diseases – rare and common. It still takes about 7 years on an average to diagnose a rare disease in USA and the European Union. This is because of the large number of rare diseases (>7000), lack of genetic education among physicians and the lack of awareness among the general public. About 80% of these rare diseases are estimated to be caused by inherited mutations and many of them are treatable. There is a huge opportunity to improve our speed and accuracy of diagnosing rare diseases world-wide. Using real-world examples and use cases, I will present how recent advances in clinical genomics are enabling a new generation of diagnostic tests for clinical decision support. A comprehensive clinical genomics workflow and the Strand Smart Lab model for delivering personalized medicine tests at community hospitals will be discussed.
Sandra Milena Agudelo-Londono
Pontificia Universidad Javeriana
Colombia
Title: CODIFICO: Teaching game for health coding
Time : 16:25-16:50
Biography:
Sandra Milena Agudelo-Londono is a Health information system Manager and has a Master in Epidemiology from Universidad de Antioquia in Colombia. She is Professor of Health Information Systems and Managerial Epidemiology in Pontificia Universidad Javeriana, Bogotá. She has published several papers in reputed journals and has been serving as the Editorial Board Member of Health Management and Policy Journal in her country.
Abstract:
Directing health systems requires quality information. The basis for the management of health services are medical diagnostics. Proper and accurate coding is essential for the Colombian health system. In Colombia, whether the hospital has electronic or manual medical records, health professionals encode diagnoses without receiving training on how to do it, but by learning empirically and reproducing information biases where they learn. For this, we are working on the design and implementation of a mobile tool (app) called (CODIFICO) to develop skills in diagnoses coding by playful strategies (gamification). So students of health careers learn to codify diagnoses of diseases not by memory but by associations and pathological themed trees. So that, regardless of the type of medical records system, health professionals can, through learning and fun way, encode properly the diagnostics and this reflects in: Better use of time dedicated to care, better health risk management, and at the macro system, accurate diagnosis needed to provide efective health services. It has been identified that implementation of teaching strategies through technological tools such as m-health enhance learning; this is the technical assumption of this project. We will use a methodology before-after evaluation of the quality metrics in the register of medical diagnosis and analysis of usability of the app. It is expected that by their playful nature, the app can be offered free regardless of language, in the smartphones online stores.
Hayat Mushcab
University of Ulster
Northern Ireland
Title: The journey of a researcher in a diabetes clinic: Expectations vs. reality
Time : 16:50-17:15
Biography:
Hayat Mushcab has completed her BSc in Health Information Management & Technology at the age of 22 years from King Faisal University. She continued her education and achieved her MSc in Computing and Intelligent Systems at the age of 24 years from the University of Ulster. She is currently in her final year of her PhD studies in the field of Telehealth/Telemonitoring and Connected Health at the University of Ulster in the Faculty of Life and Health Sciences. She has 2 publications in International Journals.
Abstract:
In theory, conducting robust clinical research is a matter of developing a strong proposal and following it through. However, the reality of conducting a research is a complicated process involving many obstacles that challenge the researcher from start to finish. In this paper we aim to reflect on our experience conducting our study and describe the challenges we came across throughout the study and how we were able to manage them. We provided a brief overview of our study’s design and location and pragmatically discuss the challenges as they arose.