Intelligent Personal Health Record: Experience and Open Issues

Web-based personal health records (PHRs) are under massive deployment. To improve PHR’s capability and usability, we previously proposed the concept of intelligent PHR (iPHR). By introducing and extending expert system technology and Web search technology into the PHR domain, iPHR can automatically provide users with personalized healthcare information to facilitate their daily activities of living. Our iPHR system currently provides three functions: guided search for disease information, recommendation of home nursing activities, and recommendation of home medical products. This paper discusses our experience with iPHR as well as the open issues, including both enhancements to the existing functions and potential new functions. We outline some preliminary solutions, whereas a main purpose of this paper is to stimulate future research work in the area of consumer health informatics.     

Automatic Home Medical Product Recommendation

Web-based personal health records (PHRs) are being widely deployed. To improve PHR’s capability and usability, we proposed the concept of intelligent PHR (iPHR). In this paper, we use automatic home medical product recommendation as a concrete application to demonstrate the benefits of introducing intelligence into PHRs. In this new application domain, we develop several techniques to address the emerging challenges. Our approach uses treatment knowledge and nursing knowledge, and extends the language modeling method to (1) construct a topic-selection input interface for recommending home medical products, (2) produce a global ranking of Web pages retrieved by multiple queries, and (3) provide diverse search results. We demonstrate the effectiveness of our techniques using USMLE medical exam cases.     

Secure Dynamic Access Control Scheme of PHR in Cloud Computing

With the development of information technology and medical technology, medical information has been developed from traditional paper records into electronic medical records, which have now been widely applied. The new-style medical information exchange system "personal health records (PHR)" is gradually developed. PHR is a kind of health records maintained and recorded by individuals. An ideal personal health record could integrate personal medical information from different sources and provide complete and correct personal health and medical summary through the Internet or portable media under the requirements of security and privacy. A lot of personal health records are being utilized. The patient-centered PHR information exchange system allows the public autonomously maintain and manage personal health records. Such management is convenient for storing, accessing, and sharing personal medical records. With the emergence of Cloud computing, PHR service has been transferred to storing data into Cloud servers that the resources could be flexibly utilized and the operation cost can be reduced. Nevertheless, patients would face privacy problem when storing PHR data into Cloud. Besides, it requires a secure protection scheme to encrypt the medical records of each patient for storing PHR into Cloud server. In the encryption process, it would be a challenge to achieve accurately accessing to medical records and corresponding to flexibility and efficiency. A new PHR access control scheme under Cloud computing environments is proposed in this study. With Lagrange interpolation polynomial to establish a secure and effective PHR information access scheme, it allows to accurately access to PHR with security and is suitable for enormous multi-users. Moreover, this scheme also dynamically supports multi-users in Cloud computing environments with personal privacy and offers legal authorities to access to PHR. From security and effectiveness analyses, the proposed PHR access scheme in Cloud computing environments is proven flexible and secure and could effectively correspond to real-time appending and deleting user access authorization and appending and revising PHR records.     

Navigation Interface for Recommending Home Medical Products

Based on users’ health issues, an intelligent personal health record (iPHR) system can automatically recommend home medical products (HMPs) and display them in a sequential order. However, the sequential output interface does not categorize search results and is not easy for users to quickly navigate to their desired HMPs. To address this problem, we developed a navigation interface for retrieved HMPs. Our idea is to use medical knowledge and nursing knowledge to construct a navigation hierarchy based on product categories. This hierarchy is added to the left side of each search result Web page to help users move through retrieved HMPs. We demonstrate the effectiveness of our techniques using USMLE medical exam cases.     

MIRASS: Medical Informatics Research Activity Support System Using Information Mashup Network

The advancement of information technology has facilitated the automation and feasibility of online information sharing. The second generation of the World Wide Web (Web 2.0) enables the collaboration and sharing of online information through Web-serving applications. Data mashup, which is considered a Web 2.0 platform, plays an important role in information and communication technology applications. However, few ideas have been transformed into education and research domains, particularly in medical informatics. The creation of a friendly environment for medical informatics research requires the removal of certain obstacles in terms of search time, resource credibility, and search result accuracy. This paper considers three glitches that researchers encounter in medical informatics research; these glitches include the quality of papers obtained from scientific search engines (particularly, Web of Science and Science Direct), the quality of articles from the indices of these search engines, and the customizability and flexibility of these search engines. A customizable search engine for trusted resources of medical informatics was developed and implemented through data mashup. Results show that the proposed search engine improves the usability of scientific search engines for medical informatics. Pipe search engine was found to be more efficient than other engines.     

Clinical bioinformatics

Clinical bioinformatics provides biological and medical information to allow for individualized healthcare. In this review, we describe the uses of clinical bioinformatics. After the analysis of the complete human genome sequences, clinical bioinformatics enables researchers to search online biological databases and use the biological information in their medical practices. The data obtained from using microarray is extremely complicated. In clinical bioinformatics, selecting appropriate software to analyze the microarray data for medical decision making is crucial. Proteomics strategy tools usually focus on similarity searches, structure prediction, and protein modeling. In clinical bioinformatics, the proteomic data only have meaning if they are integrated with clinical data. In pharmacogenomics, clinical bioinformatics includes elaborate studies of bioinformatics tools and various facets of proteomics related to drug target identification and clinical validation. Using clinical bioinformatics, researchers apply computational and high-throughput experimental techniques to cancer research and systems biology. Meanwhile, researchers of bioinformatics and medical information have incorporated clinical bioinformatics to improve health care, using biological and medical information. Using the high volume of biological information from clinical bioinformatics will contribute to changes in practice standards in the healthcare system. We believe that clinical bioinformatics provides benefits of improving healthcare, disease prevention and health maintenance as we move toward the era of personalized medicine.     

面向公民健康素养的信息技术应用研究

公民的健康素养不仅是指个人的医学知识和能力,也和医疗系统、教育系统、社会文化等健康环境因素有关。探讨信息技术在提高公民健康素养方面的一些应用,重点分析有关健康信息的互联网应用、医院的信息系统针对病人的功能配套、个人健康档案的开发和美国政府的有关支持措施,并对中国公民健康素养问题提出相关建议。     

Body Area Networks for Ubiquitous Healthcare Applications: Opportunities and Challenges

Body Area Networks integrated into mHealth systems are becoming a mature technology with unprecedented opportunities for personalized health monitoring and management. Potential applications include early detection of abnormal conditions, supervised rehabilitation, and wellness management. Such integrated mHealth systems can provide patients with increased confidence and a better quality of life, and promote healthy behavior and health awareness. Automatic integration of collected information and user’s inputs into research databases can provide medical community with opportunity to search for personalized trends and group patterns, allowing insights into disease evolution, the rehabilitation process, and the effects of drug therapy. A new generation of personalized monitoring systems will allow users to customize their systems and user interfaces and to interact with their social networks. With emergence of first commercial body area network systems, a number of system design issues are still to be resolved, such as seamless integration of information and ad-hoc interaction with ambient sensors and other networks, to enable their wider acceptance. In this paper we present state of technology, discuss promising new trends, opportunities and challenges of body area networks for ubiquitous health monitoring applications.     

面向医学信息互操作的SOA架构设计

随着IT技术在医疗行业的应用,医院内每天产生的信息呈爆发性增长。如何充分利用这些信息以提高医疗服务质量。已成为备受关注且亟需解决的问题。在区域医疗网络的整体框架下,结合面向服务的架构（SOA）以及Web2．0理念,提出一种医学信息互操作系统的设计方案,该系统可实现不同医疗机构之间医学信息的在线调阅及动态播放。加上SOA技术的使用,使该系统层次分明,具有良好的通用性和可维护性。     

基于语义的区域医疗信息集成方法研究

区域医疗信息共享能有效促进区域内医学信息平台之间数据的有效互通,提高医护人员的工作效率,提升医疗质量。但由于区域医疗的业务内容繁多,标准和规范复杂,同时涉及的运行机构多,严重限制了区域医疗信息系统之间的信息共享。针对这一问题,引入语义网技术,提出基于物理层、语义层和应用层三层架构模型的区域医疗信息集成框架,采用混合本体方法将分散的数据源发布成关联数据,构建一张计算机能理解的语义数据网络。通过局部本体和上层本体的建立,在不改变原有数据结构的条件下实现区域异构系统之间的无缝连接,进而达到为医护人员、患者等随时随地提供个性化的医疗保健服务目的。     

Assessing Domains of Uncertainty in Critical Web-Based Healthcare Communities

Search engines and Web-based directories play a central role in facilitating access to online health information. In this environment consumers often find and act upon health information of variable quality, with little input from health professionals. As an added concern, when consumers access health information on the Web via a search engine they often fail to discuss the information with a healthcare provider, especially in areas of perceived medical uncertainty. For many health consumers, the Internet may be the primary (or even sole) source of health information, especially where consumers lack access to, or trust in, trained providers. To date the corresponding role of search engine technology use and efficacy has received relatively little attention, however. This study serves as an exploratory technology assessment that explains the application of keyword effectiveness indexing (KEI) analysis in estimating the ability of commercial search engines to return relevant results for healthcare consumers. Findings suggest that KEI can serve as a useful health search profiling tool, though its applicability may vary across domains. This study was provided support from the Center for Technology Assessment, State College, PA.     

Creation of a RFID Based Real Time Tracking (R-RTT) System for Small Healthcare Clinics

A well-managed healthcare system improves the quality of the patient experience. However, many small healthcare clinics have suboptimal systems for scheduling and locating patients and medical staff, delaying the relay of information and creating poor resource and room utilization. This paper proposes a Radio Frequency Identification (RFID)-based Real-Time Tracking (R-RTT) System for optimizing small healthcare facility operations, enabling further optimization of throughput time, room utilization, and patient flow. In the proposed scenario, RFID readers were equipped in strategic locations throughout the facility. Patients and medical staff were issued personalized RFID tags. When they pass through the reader's interrogation zone, it reads their RFID tag and sends the information to a central computer equipped with software capable of filtering the RFID data into useable information. A Visual Basic Application (VBA) program uses the information received from the ID tags to display the location of the patients and staff as they move throughout the facility. This increases their visibility within the facility by allowing medical staff to determine where their colleagues and patients are at all times. The VBA program was also able to record the data in order to track the time each stage of the appointment process takes to complete. The recorded time data can be broken into processes, making it easier to determine if it adds value. This data can then be transformed into a value stream map for further analysis and improvement.     

基于SOA架构的医学图书馆个性化信息服务设计

随着互联网技术的快速发展,个性化信息服务已成为当前医学图书馆界研究的一个重要方向。通过分析医学图书馆个性化信息服务的内容及特点,提出了一套基于SOA架构的医学图书馆个性化信息服务系统架构。该架构具有标准化、松耦合、支持低成本改造和运维的特点,在确保个性化信息服务全面开展的同时又不影响医学图书馆各项日常业务的正常开展。     

基于CiteSpace的医学大数据国际发展研究现状分析

目的：使用CiteSpace探讨医学大数据研究热点与研究前沿。方法：以WoS核心核集收录的医学大数据领域相关文献作为数据来源,利用文献计量方法结合信息分析可视化工具CiteSpace对其进行分析。结果：自2012年以来,相关研究成果数量迅速攀升;big data、system、care、medicine、personalized medicine等节点较大;quality、children和mapreduce等Burst值较高。结论：当前医学大数据领域对医学大数据技术、精准医疗、医学健康大数据管理、医学大数据隐私及发展研究较多,mapreduce、ontology、hadoop等是研究前沿与发展趋势。     

Personal health records: a scoping review

Electronic personal health record systems (PHRs) support patient centered healthcare by making medical records and other relevant information accessible to patients, thus assisting patients in health self-management. We reviewed the literature on PHRs including design, functionality, implementation, applications, outcomes, and benefits. We found that, because primary care physicians play a key role in patient health, PHRs are likely to be linked to physician electronic medical record systems, so PHR adoption is dependent on growth in electronic medical record adoption. Many PHR systems are physician-oriented, and do not include patient-oriented functionalities. These must be provided to support self-management and disease prevention if improvements in health outcomes are to be expected. Differences in patient motivation to use PHRs exist, but an overall low adoption rate is to be expected, except for the disabled, chronically ill, or caregivers for the elderly. Finally, trials of PHR effectiveness and sustainability for patient self-management are needed.     

病人可视化索引系统的设计与实现

为了全面完整地了解一位病人的医疗状况,医生需要从不同的医学信息系统（如PACS,RIS,HIS,USIS）中搜寻病人医疗报告,作为对病人进行诊断和治疗的决策参考,但是这部分工作非常耗时与冗长乏味。为此开发了一套病人可视化索引系统,利用可视化技术在3D人体模型上显示病人全面的健康状况,为保存在各个系统中的病人检查信息提供检索功能。     

Combining Ontologies and Open Standards to Derive a Middle Layer Information Model for Interoperability of Personal and Electronic Health Records

The aim of our study was to enable better interoperability between Personal Health Record (PHR) and Electronic Health Record (EHR) systems and vice versa. A multi-layer architectural model that resides between a PHR and EHR system has been developed. The model consists of an ontology-driven information model and a set of transformation rules that work in conjunction to process data exported from a PHR or EHR system and prepare it accordingly for the receiving system. The model was evaluated by executing a set of case study scenarios containing data from both a PHR and an EHR system. This allowed various challenges to emerge and revealed gaps in current standards in use. The proposed information model offers a number of advantages. Altering only the information model can incorporate modifications to either a PHR or EHR system. The model uses classes and attributes to define how data is captured which allows greater flexibility in how data can be manipulated by receiving systems.     

Bat-Inspired Algorithm Based Query Expansion for Medical Web Information Retrieval

With the increasing amount of medical data available on the Web, looking for health information has become one of the most widely searched topics on the Internet. Patients and people of several backgrounds are now using Web search engines to acquire medical information, including information about a specific disease, medical treatment or professional advice. Nonetheless, due to a lack of medical knowledge, many laypeople have difficulties in forming appropriate queries to articulate their inquiries, which deem their search queries to be imprecise due the use of unclear keywords. The use of these ambiguous and vague queries to describe the patients’ needs has resulted in a failure of Web search engines to retrieve accurate and relevant information. One of the most natural and promising method to overcome this drawback is Query Expansion. In this paper, an original approach based on Bat Algorithm is proposed to improve the retrieval effectiveness of query expansion in medical field. In contrast to the existing literature, the proposed approach uses Bat Algorithm to find the best expanded query among a set of expanded query candidates, while maintaining low computational complexity. Moreover, this new approach allows the determination of the length of the expanded query empirically. Numerical results on MEDLINE, the on-line medical information database, show that the proposed approach is more effective and efficient compared to the baseline.     

面向医学信息交换的语义查询系统设计

医疗信息工作者通过制定医学数据交换标准，实现各种纷杂独立的异构医疗信息系统间的数据共享。但由于现实医疗环境的复杂性，存在如HIs、PACS、LIS和OS等异构系统，在这些异构系统中对相同含义的对象可能存在各种不同的语言表达方式，如何识别利用这些信息以提高医疗服务质量，成为备受关注且亟需解决的问题。提出面向医学信息交换的语义查询系统，引入本体的方法来解决语义信息缺乏问题，以更好地实现医疗系统的信息交换和共享。