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
Ensuring the correct identification of the patient is key to matching the correct patients with the proper care (e.g. correct administration of medications and treatments), but it is also applied, for example, to monitoring the patient's movement in the hospital environment. This scoping review aims to find out what technologies based on unique patient identifiers are used to identify patients in healthcare facilities to increase patient safety and to identify future research trends. PRISMA-ScR guidelines were used, and the search focused on Web of Science and Scopus citation databases from 2000 to February 2024. Thirty-two papers dealing with patient identification methods from the point of view of person identification were found. The solutions found were built on the technologies (linear or 2D) of barcodes, RFID and NFC tags. None of the patient identification solutions found offer complete accuracy due to the human factor, and each solution targets a different problem context associated with a particular type of health facility. Future research can focus on the combination of multiple technologies, including biometric methods, to improve identification and tools to support decisions about the use of technology in a particular context and health facility (e.g. hospitals, medical nursing homes).
- MeSH
- Patient Safety MeSH
- Radio Frequency Identification Device MeSH
- Patient Identification Systems * MeSH
- Humans MeSH
- Check Tag
- Humans MeSH
- Publication type
- Review 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
- MeSH
- Medical Informatics * ethics methods trends MeSH
- Humans MeSH
- Personal Autonomy MeSH
- Risk MeSH
- Robotics ethics trends MeSH
- Mental Health Services ethics legislation & jurisprudence MeSH
- Privacy legislation & jurisprudence MeSH
- Artificial Intelligence * MeSH
- Medical Informatics Applications MeSH
- Check Tag
- Humans MeSH
- MeSH
- Diagnostic Errors legislation & jurisprudence MeSH
- Diagnostic Techniques and Procedures trends MeSH
- Medical Informatics * legislation & jurisprudence MeSH
- Humans MeSH
- Patient Harm legislation & jurisprudence MeSH
- Liability, Legal MeSH
- Artificial Intelligence * legislation & jurisprudence MeSH
- Check Tag
- Humans MeSH
Polygenetic Risk Scores are used to evaluate an individual's vulnerability to developing specific diseases or conditions based on their genetic composition, by taking into account numerous genetic variations. This article provides an overview of the concept of Polygenic Risk Scores (PRS). We elucidate the historical advancements of PRS, their advantages and shortcomings in comparison with other predictive methods, and discuss their conceptual limitations in light of the complexity of biological systems. Furthermore, we provide a survey of published tools for computing PRS and associated resources. The various tools and software packages are categorized based on their technical utility for users or prospective developers. Understanding the array of available tools and their limitations is crucial for accurately assessing and predicting disease risks, facilitating early interventions, and guiding personalized healthcare decisions. Additionally, we also identify potential new avenues for future bioinformatic analyzes and advancements related to PRS.
- MeSH
- Genome-Wide Association Study methods MeSH
- Genetic Predisposition to Disease * MeSH
- Genetic Risk Score MeSH
- Risk Assessment methods MeSH
- Humans MeSH
- Multifactorial Inheritance * MeSH
- Risk Factors MeSH
- Software * MeSH
- Computational Biology methods MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
- Review MeSH
Tromboembolická nemoc, zahrnující hlubokou žilní trombózu a plicní embolii, je spojena s vysokou morbiditou a mortalitou. Chirurgické výkony představují významný rizikový faktor pro vznik tromboembolické nemoci. Prevence tromboembolické nemoci musí být přizpůsobena každému pacientovi individuálně na základě jeho rizikových faktorů a specifik každého chirurgického oboru s ohledem na typy prováděných výkonů. Indikace farmakologické prevence tromboembolické nemoci v urologii u seniorů patří k nejčastějším. S narůstající problematikou stárnutí populace se stává stále důležitější ve stáří přizpůsobovat lékové režimy individuálně, aby byla zachována bezpečnost farmakoterapie. Tento článek představuje systém prevence tromboembolické nemoci na Urologické klinice 1. lékařské fakulty UK a Ústřední vojenské nemocnice Praha. Strategie byla pro snadné každodenní používání v klinické praxi převedena do aplikačního software. Zavedení tohoto jednoduchého a přehledného nástroje vedlo k racionalizaci antikoagulační farmakoterapie. Jde o příklad mezioborové spolupráce mezi lékaři a klinickými farmaceuty, která je klíčová pro zlepšení péče o pacienty.
Venous thromboembolism, which includes deep vein thrombosis and pulmonary embolism, is associated with high morbidity and mortality rates. Surgical procedures are a significant risk factor for the development of venous thromboembolism. Preventing venous thromboembolism must be personalized for each patient, based on their individual risk factors and the specific nature of the surgical procedure, considering the types of surgeries performed. In urology, elderly patients are the most frequent recipients of pharmacological venous thromboembolism prevention. With the growing challenge of an aging population, it is increasingly important to customize drug regimens in older adults to ensure safe pharmacotherapy. This article outlines the venous thromboembolism prevention system at the Urology Clinic of the First Faculty of Medicine, Charles University, and the Military University Hospital Prague. The strategy has been integrated into application software for ease of use in daily practice. The implementation of this system has led to more rational anticoagulant pharmacotherapy. It serves as an example of interdisciplinary collaboration between physicians and clinical pharmacists, which is key to improving patient care.
- MeSH
- Pharmacy methods MeSH
- Heparin, Low-Molecular-Weight administration & dosage MeSH
- Medical Informatics methods MeSH
- Humans MeSH
- Interdisciplinary Communication MeSH
- Perioperative Care methods MeSH
- Postoperative Complications prevention & control MeSH
- Risk Factors MeSH
- Practice Guidelines as Topic MeSH
- Software MeSH
- Thromboembolism * prevention & control MeSH
- Urologic Surgical Procedures * adverse effects MeSH
- Urology methods MeSH
- Check Tag
- Humans MeSH
- Publication type
- Research Support, Non-U.S. Gov't MeSH
The advancement of sciences and technologies, economic challenges, increasing expectations, and consumerism result in a radical transformation of health and social care around the globe, characterized by foundational organizational, methodological, and technological paradigm changes. The transformation of the health and social care ecosystems aims at ubiquitously providing personalized, preventive, predictive, participative precision (5P) medicine, considering and understanding the individual's health status in a comprehensive context from the elementary particle up to society. For designing and implementing such advanced ecosystems, an understanding and correct representation of the structure, function, and relations of their components is inevitable, thereby including the perspectives, principles, and methodologies of all included disciplines. To guarantee consistent and conformant processes and outcomes, the specifications and principles must be based on international standards. A core standard for representing transformed health ecosystems and managing the integration and interoperability of systems, components, specifications, and artifacts is ISO 23903:2021, therefore playing a central role in this publication. Consequently, ISO/TC 215 and CEN/TC 251, both representing the international standardization on health informatics, declared the deployment of ISO 23903:2021 mandatory for all their projects and standards addressing more than one domain. The paper summarizes and concludes the first author's leading engagement in the evolution of pHealth in Europe and beyond over the last 15 years, discussing the concepts, principles, and standards for designing, implementing, and managing 5P medicine ecosystems. It not only introduces the theoretical foundations of the approach but also exemplifies its deployment in practical projects and solutions regarding interoperability and integration in multi-domain ecosystems. The presented approach enables comprehensive and consistent integration of and interoperability between domains, systems, related actors, specifications, standards, and solutions. That way, it should help overcome the problems and limitations of data-centric approaches, which still dominate projects and products nowadays, and replace them with knowledge-centric, comprehensive, and consistent ones.
- Publication type
- Journal Article MeSH
