Digital transformation is widely understood as a process where technology is used to modify an organization's products and services and to create new ones. It is rapidly advancing in all sectors of society. Researchers have shown that it is a multidimensional process determined by human decisions based on ideologies, ideas, beliefs, goals, and the ways in which technology is used. In health care and health, the end result of digital transformation is digital health. In this study, a detailed literature review covering 560 research articles published in major journals was performed, followed by an analysis of ideas, beliefs, and goals guiding digital transformation and their possible consequences for privacy, human rights, dignity, and autonomy in health care and health. Results of literature analyses demonstrated that from the point of view of privacy, dignity, and human rights, the current laws, regulations, and system architectures have major weaknesses. One possible model of digital health is based on the dominant ideas and goals of the business world related to the digital economy and neoliberalism, including privatization of health care services, monetization and commodification of health data, and personal responsibility for health. These ideas represent meaningful risks to human rights, privacy, dignity, and autonomy. In this paper, we present an alternative solution for digital health called human-centric digital health (HCDH). Using system thinking and system modeling methods, we developed a system model for HCDH. It uses 5 views (ideas, health data, principles, regulation, and organizational and technical innovations) to align with human rights and values and support dignity, privacy, and autonomy. To make HCDH future proof, extensions to human rights, the adoption of the principle of restricted informational ownership of health data, and the development of new duties, responsibilities, and laws are needed. Finally, we developed a system-oriented, architecture-centric, ontology-based, and policy-driven approach to represent and manage HCDH ecosystems.
- MeSH
- Digital Technology MeSH
- Digital Health * MeSH
- Humans MeSH
- Human Rights MeSH
- Patient-Centered Care * MeSH
- Privacy MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
- Review MeSH
Background/Objectives: Health and social care systems around the globe are currently undergoing a transformation towards personalized, preventive, predictive, participative precision medicine (5PM), considering the individual health status, conditions, genetic and genomic dispositions, etc., in personal, social, occupational, environmental, and behavioral contexts. This transformation is strongly supported by technologies such as micro- and nanotechnologies, advanced computing, artificial intelligence, edge computing, etc. Methods: To enable communication and cooperation between actors from different domains using different methodologies, languages, and ontologies based on different education, experiences, etc., we have to understand the transformed health ecosystem and all its components in terms of structure, function and relationships in the necessary detail, ranging from elementary particles up to the universe. In this way, we advance design and management of the complex and highly dynamic ecosystem from data to knowledge level. The challenge is the consistent, correct, and formalized representation of the transformed health ecosystem from the perspectives of all domains involved, representing and managing them based on related ontologies. The resulting business viewpoint of the real-world ecosystem must be interrelated using the ISO/IEC 21838 Top Level Ontologies standard. Thereafter, the outcome can be transformed into implementable solutions using the ISO/IEC 10746 Open Distributed Processing Reference Model. Results: The model and framework for this system-oriented, architecture-centric, ontology-based, policy-driven approach have been developed by the first author and meanwhile standardized as ISO 23903 Interoperability and Integration Reference Architecture. The formal representation of any ecosystem and its development process including examples of practical deployment of the approach, are presented in detail. This includes correct systems and standards integration and interoperability solutions. A special issue newly addressed in the paper is the correct and consistent formal representation Conclusions: of all components in the development process, enabling interoperability between and integration of any existing representational artifacts such as models, work products, as well as used terminologies and ontologies. The provided solution is meanwhile mandatory at ISOTC215, CEN/TC251 and many other standards developing organization in health informatics for all projects covering more than just one domain.
- Publication type
- Journal Article MeSH
Health and social care systems around the globe currently undergo a transformation towards personalized, preventive, predictive, participative precision medicine (5PM), considering the individual health status, conditions, genetic and genomic dispositions, etc., in personal, social, occupational, environmental and behavioral context. This transformation is strongly supported by technologies such as micro- and nanotechnologies, advanced computing, artificial intelligence, edge computing, etc. For enabling communication and cooperation between actors from different domains using different methodologies, languages and ontologies based on different education, experiences, etc., we have to understand the transformed health ecosystems and all its components in structure, function and relationships in the necessary detail ranging from elementary particles up to the universe. That way, we advance design and management of the complex and highly dynamic ecosystem from data to knowledge level. The challenge is the consistent, correct and formalized representation of the transformed health ecosystem from the perspectives of all domains involved, representing and managing them based on related ontologies. The resulting business view of the real-world ecosystem must be interrelated using the ISO/IEC 21838 Top Level Ontologies standard. Thereafter, the outcome can be transformed into implementable solutions using the ISO/IEC 10746 Open Distributed Processing Reference Model. Model and framework for this system-oriented, architecture-centric, ontology-based, policy-driven approach have been developed by the first author and meanwhile standardized as ISO 23903 Interoperability and Integration Reference Architecture.
- MeSH
- Precision Medicine * MeSH
- Humans MeSH
- Artificial Intelligence MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
Technické riešenie realizácie procesov zameraných na preverovanie zdravotného stavu pri bežnej hraničnej kontrole pred vstupom do EÚ vykazuje značne kom- plexný charakter. Je nutné spoľahlivo a efektívne in- terpretovať odozvy na špecifické podnety v rámci rozličných podmienok prostredia a prípadného výsky- tu bezpečnostného rizika, zahŕňajúc špecifické náro- ky na vybavenie a personálne osadenie v rámci hra- ničného režimu. Komplexný charakter riadenia hraníc doplnený o problematiku zdravotných kontrol viedol k návrhu Mobilného, dátového, odberového a analy- tického centra (MDOAC). V rámci riešenia MDOAC je navrhnuté aktívne využívanie moderných rádiologických metód a techník podporených rýchlym spracovaním a vyhodnotením za pomoci systémov umelej inteligencie. Výhody, ktoré poskytuje synergia medzi oblasťou rádiológie a modernými technológia- mi zbierania a vyhodnocovania dát v reálnom čase, spolu s potrebami minimalizácie fyzického kontaktu medzi potenciálne rizikovým subjektom vyšetrenia a poverenými príslušníkmi Policajného zboru, resp. vyšetrujúcim personálom z radov rádiológov a rádiologických technikov, vykazujú optimálny pod- klad pre naplnenie podmienok a úloh zadefinova- ných v Európskej legislatíve a to predovšetkým v Novom pakte o migrácii a azyle. Realizovaná ana- lýza potrieb mobilného prevedenia navrhovaného centra a zároveň analýza jeho trvalého umiestnenia v stávajúcich priestoroch a areáloch hraničných prie- chodov poukazuje na možnosti zamerania výskumu aj smerom na stacionárne riešenie s orientáciou na využitie všetkých potenciálnych výhod
The technical solution for the implementation of pro- cesses aimed at checking the state of health during normal border control before entering the EU shows a considerably complex nature. It is necessary to in- terpret responses reliably and efficiently to specific stimuli within various environmental conditions and the eventual occurrence of a security risk, summari- zing the specific requirements for equipment and staffing within the border regime. The complex na- ture of border management, supplemented by the issue of health checks, led to proposal of the Mobile, Data, Collection and Analysis Center (MDOAC). As part of the MDOAC solution, the active use of mo- dern radiological methods and techniques supported by rapid processing and evaluation with the help of artificial intelligence systems is proposed. The advan- tages provided by the synergy between the field of radiology and modern technologies of data collec- tion and evaluation in real time, together with the need to minimize physical contact between the po- tentially risky subject of the examination and autho- rized members of the Police Force, resp. examining personnel from the ranks of radiologists and radio- graphers, they show the optimal basis for fulfilling the conditions and tasks defined in European legis- lation, especially in the New Pact on Migration and Asylum. The realized analysis of the needs of the mobile version of the proposed center and at the same time the analysis of its permanent location in the existing premises and areas of the border cros- sings point to the possibilities of focusing the rese- arch also in the direction of a stationary solution with an orientation the use of all potential advanta- ges.
Objective: For realizing pervasive and ubiquitous health and social care services in a safe and high quality as well as efficient and effective way, health and social care systems have to meet new organizational, methodological, and technological paradigms. The resulting ecosystems are highly complex, highly distributed, and highly dynamic, following inter-organizational and even international approaches. Even though based on international, but domain-specific models and standards, achieving interoperability between such systems integrating multiple domains managed by multiple disciplines and their individually skilled actors is cumbersome. Methods: Using the abstract presentation of any system by the universal type theory as well as universal logics and combining the resulting Barendregt Cube with parameters and the engineering approach of cognitive theories, systems theory, and good modeling best practices, this study argues for a generic reference architecture model moderating between the different perspectives and disciplines involved provide on that system. To represent architectural elements consistently, an aligned system of ontologies is used. Results: The system-oriented, architecture-centric, and ontology-based generic reference model allows for re-engineering the existing and emerging knowledge representations, models, and standards, also considering the real-world business processes and the related development process of supporting IT systems for the sake of comprehensive systems integration and interoperability. The solution enables the analysis, design, and implementation of dynamic, interoperable multi-domain systems without requesting continuous revision of existing specifications.
- Publication type
- Journal Article MeSH
Urban hydrology was created in order to improve methods of managing the runoff of precipitation in towns and protect them from flooding while also protecting public health and environment. The essence of a future solution consists in finding an acceptable compromise of an alternative solution for draining rainwater from a territory. The content of this work is a study focused on resolving the percolation of water from surface runoff and the confrontation between a field test, laboratory analysis, and numerical analysis. By confronting and subsequently proposing conditions for percolation, documents will be created for making urban drainage better and more efficient. The reason for the origin of the subject work follows from the insufficient information on infiltration systems in Slovak technical standards and, likewise, the lack of support for the percolation of water from surface runoff. This work points out the approaches, principles, and fundamentals of a proposal for percolation. The aim of the work is distribution of scientific knowledge in the field of research and solutions for the percolation of water from surface runoff, with emphasis placed on the retention capacity of the selected territory and the intensity of precipitation. A geological study (orientational, detailed or supplementary) must always be conducted with any decision on rainwater percolation in a certain locality. Its range is dependent on the difficulty and type of construction. The preliminary study of areal condition should be focused on detailed engineering-geological and hydrological information. After this work, it is concluded that the percolation of rainwater in urban areas with suitable hydrogeological condition is an effective rainwater management technology as well as protection to congestion of sewer systems.
- MeSH
- Rain * MeSH
- Hydrology MeSH
- Waste Disposal, Fluid MeSH
- Water Movements MeSH
- Cities MeSH
- Publication type
- Journal Article MeSH
- Geographicals
- Cities MeSH
For improving quality and safety of healthcare as well as efficiency and efficacy of care processes, health systems turn toward personalized, preventive, predictive, participative precision medicine. The related pHealth ecosystem combines different domains represented by a huge variety of different human and non-human actors belonging to different policy domains, coming from different disciplines. Those actors deploy different methodologies, terminologies, and ontologies, offering different levels of knowledge, skills, and experiences, acting in different scenarios and accommodating different business cases to meet the intended business objectives. Core challenge is the formal representation and management of multiple domains' knowledge. For correctly modeling such systems and their behavior, a system-oriented, architecture-centric, ontology-based, policy-driven approach is inevitable, thereby following established Good Modeling Best Practices. The ISO Interoperability Reference Architecture model and framework offers such approach. The paper describes and classifies the ongoing paradigm changes. It presents requirements and solutions for designing and implementing advanced pHealth ecosystems, thereby correctly adopting and integrating existing pHealth interoperability standards, specifications and projects.
- Publication type
- Journal Article MeSH
Background: Recently, the Austrian Patient Summary (APS) and Austrian Microbiology Report (AMR) document definitions were added to the Austrian national electronic health record repository. How to employ these standardized, structured patient data in clinical decision support (CDS) systems remains an interesting research subject. Objectives: To create a proof of concept for the emergency use of APS and AMR documents in a variety of CDS platforms and standards in an intensive care setting, in order to generate new insights by linking individual documents to different CDS approaches. Methods: APS and AMR definitions were stored using MongoDB, a document-oriented database system. For implementation of the clinical use case CDS, we selected the Drools business rule management system, as well as the ArdenSuite software for implementing the HL7 Arden Syntax for Medical Logic Systems standard. Results: Due to its manifold features, implementation of the CDS use case in Drools could be done quite efficiently without the need for additional coding of technical or algorithmic code, which results in smaller rules. In contrast, the use case implementations in Arden Syntax using the ArdenSuite required additional technical coding, distracting from the medical knowledge implementation. The Arden Syntax as a knowledge definition standard is, however, better understandable due to its resemblance to natural language compared to the Java-like definition language used in Drools. Conclusion: With the nation-wide availability of structured documents, the foundation for the implementation of clinical decision support systems has been laid. Commonly used open-source platforms offer extensive possibilities for the implementation of CDS systems. This evaluation of modern business rule management systems will advance the implementation of powerful clinical decision support solutions valuable to all stakeholders.
Německá společnost Evangelisches Jugend- und Fürsorgewerk se v průběhu své více než stodvacetileté historie vždy věnovala křesťanské pomoci potřebným lidem. Dnes je její činnost orientována zejména do oblasti inkludovaného mateřského školství, komplexní pomoci potřebným dětem a mladistvým, pomoci zdravotně postiženým dospělým osobám, bydlení a navazujících služeb pro seniory a poradenství pro různé cílové skupiny. V posledních letech se významně podílí i na řešení migrační krize v Německu, především v Berlíně. Teologickým a filozofickým základem veškeré její činnosti je láska k Bohu, projevovaná jako láska ke konkrétnímu trpícímu člověku. Činorodost společnosti pak vyplývá z vyznávané protestantské pracovní etiky. Prosazuje v německé společnosti postoj přiznávající legálním a v zákonnosti žijícím imigrantům právo na vlastní svobodné rozhodování o možnosti ponechat si nejrozmanitější vazby na svoji původní komunitu. Pro jednotlivé fáze začleňování imigrantů do svobodné demokratické společnosti rozvíjí prezentovaná společnost celou řadu projektů. Součástí studie je proto i stručná deskripce příkladů dobré praxe. Pro první, orientační fázi je vybrán projekt Georg-Kriedte-Haus, zajišťující ubytování a potřebnou stabilizaci imigrantů. Fáze orientační je reprezentována poradenským a edukačním zařízením Deutsch-Arabisches Zentrum für Bildung und Integration. Na širokou škálu činností charakteristických pro třetí, integrační fázi poukazuje nejlépe Familienzentrum Bisamkiez, nacházející se na panelovém sídlišti v Postupimi obývaném lidmi několika desítek různých národností. Cílem příspěvku je především motivovat zájem vysokoškolských studentů humanitních oborů o získávání osobních zahraničních zkušeností pro budoucí účinné řešení imigračních problémů v České republice.
During its more than a hundred and twenty-year history, the German organization “Evangelisches Jugend- und Fürsorgewerk” has always devoted its Christian support to people in need. Today, its activities focus mainly on the area of inclusive nursery education, comprehensive assistance to children and youth in need, assistance to adults with disabilities, housing and related services for the elderly, and counselling for different target groups. In recent years, it has been a major contributor to the migration crisis management in Germany, particularly in Berlin. The theological and philosophical basis of all its activities is the love for God, manifested as a love for a particular suffering person. The activeness of the organization derives from the wellknown Protestant work ethic. In German society, it advocates a position that grants legal and legally living immigrants the right to freely decide on the possibility of retaining the most diverse ties to their original communities. For the various phases of the integration of immigrants into a free democratic society, the organization is developing a number of diverse projects. Part of this paper is a brief description of good practice examples. The first, indicative phase, deals with the Georg-Kriedte- Haus project, which provides accommodation and the necessary stabilization for immigrants. The orientation phase is represented by the Deutsch-Arabisches Zentrum für Bildung und Integration a counselling and education facility. The Familienzentrum Bisamkiez, located in a panel housing estate in Potsdam, inhabited by several dozen people of different nationalities, best points out the wide range of activities characteristic of the third, integration phase. The aim of this contribution is to motivate university students in the humanity study programmes to gain personal experience from abroad for the future effective solution of immigration problems in the Czech Republic.
- MeSH
- Emigrants and Immigrants MeSH
- Humans MeSH
- Faith-Based Organizations utilization MeSH
- Social Facilitation MeSH
- Social Adjustment MeSH
- Refugees MeSH
- Social Participation MeSH
- Check Tag
- Humans MeSH
- Geographicals
- Germany MeSH
Background: Developed countries are planning the creation of national EHR (Electronic Health Record) systems to modernize the healthcare field and improve its quality, security and efficiency. Objectives: To support clinical data sharing, it is important that an EHR is designed to be integrated within an appropriate architectural context aimed to satisfy the needs of all actors involved in this information management by adding and integrating new functionalities to existing solutions. Methods: SOA (Service Oriented Architecture) provides a good approach to promote the easy integration and alignment of a new and existing solution into a cohesive architecture. The HSSP (Healthcare Service Specification Program) was formed to adopt the SOA approach to guarantee interoperability between applications and distributed and heterogeneous devices, by providing a set of standards to design and develop specific services. Results: The authors present a landscape architecture to support the collaboration between actors involved in the treatment of chronic diseases. The core of this architecture consists of services compliant to HSSP standards. Among these, the authors developed: Health Record Management Services, Health Terminology Services and Health Identity Services. The proposed architecture and these services have already been adopted in different systems: a telemonitoring system to support the continuity of care of CHF (Congestive Heart Failure) patients, two systems to share clinical data to manage clinical trials in both infectivology and ophthalmology. Conclusions: The main advantage of the proposed architecture is its flexibility that allows it to be adapted over time and to be adopted in all health care scenarios.
