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.

• Klíčová slova
• architecture, ecosystem, interoperability, knowledge management, knowledge representation, modeling, pHealth,
• Publikační typ
• časopisecké články MeSH

Multidisciplinary and highly dynamic pHealth ecosystems according to the 5P Medicine paradigm require careful consideration of systems integration and interoperability within the domains knowledge space. The paper addresses the different aspects or levels of knowledge representation (KR) and management (KM) from cognitive theories (theories of knowledge) and modeling processes through notation up to processing, tooling and implementation. Thereby, it discusses language and grammar challenges and constraints, but also development process aspects and solutions, so demonstrating the limitation of data level considerations. Finally, it presents the ISO 23903 Interoperability and Integration Reference Architecture to solve the addressed problems and to correctly deploy existing standards and work products at any representational level including data models as well as data model integration and interoperability.

• Klíčová slova
• 5P Medicine, architecture, integration, interoperability, knowledge management, knowledge representation, modeling, pHealth ecosystem,
• MeSH
• ekosystém * MeSH
• jazyk (prostředek komunikace) MeSH
• systémová integrace * MeSH
• Publikační typ
• časopisecké články MeSH

pHealth is a data (personal health information) driven approach that use communication networks and platforms as technical base. Often it' services take place in distributed multi-stakeholder environment. Typical pHealth services for the user are personalized information and recommendations how to manage specific health problems and how to behave healthy (prevention). The rapid development of micro- and nano-sensor technology and signal processing makes it possible for pHealth service provider to collect wide spectrum of personal health related information from vital signs to emotions and health behaviors. This development raises big privacy and trust challenges especially because in pHealth similarly to eCommerce and Internet shopping it is commonly expected that the user automatically trust in service provider and used information systems. Unfortunately, this is a wrong assumption because in pHealth's digital environment it almost impossible for the service user to know to whom to trust, and what the actual level of information privacy is. Therefore, the service user needs tools to evaluate privacy and trust of the service provider and information system used. In this paper, the authors propose a solution for privacy and trust as results of their antecedents, and for the use of computational privacy and trust. To answer the question, which antecedents to use, two literature reviews are performed and 27 privacy and 58 trust attributes suitable for pHealth are found. A proposal how to select a subset of antecedents for real life use is also provided.

• Klíčová slova
• antecedents, eCommerce, pHealth, privacy, trust,
• MeSH
• chorobopisy - počítačové systémy MeSH
• důvěra MeSH
• soukromí * MeSH
• zdravotní záznamy osobní * MeSH
• Publikační typ
• časopisecké články MeSH

From beginning to today, pHealth has been a data driven service that collects and uses personal health information (PHI) for personal health services and personalized healthcare. As a result, pHealth services use intensively ICT technology, sensors, computers and mathematical algorithms. In past, pHealth applications were focused to certain health or sickness related problem, but in today they use mobile devices, wireless networks, Web-technology and Cloud platforms. In future, pHealth uses information systems that are highly distributed, dynamic, increasingly autonomous, multi-stakeholder data driven eco-system having ability to monitor anywhere person's regular life, movements and health related behaviours. Because privacy and trust are pre-requirements for successful pHealth, this development raises huge privacy and trust challenges to be solved. Researchers have shown that current privacy approaches and solutions used in pHealth do not offer acceptable level of privacy, and trust is only an illusion. This indicates, that today's privacy models and technology shall not be moved to the future pHealth. The authors have analysed interesting new privacy and trust ideas published in journals, and found that they seem to be effective but offer only a partial solution. To solve this weakness, the authors used a holistic system view to aspects impacting privacy and trust in pHealth, and created a template that can be used in planning and development future pHealth services. The authors also propose a tentative solution for future trustworthy pHealth. It combines privacy as personal property and trust as legal binding fiducial duty approaches, and uses a Blockchain-based smart contract solution to store person's privacy and trust requirements and service providers' promises.

• Klíčová slova
• Fiducial Duty, Privacy, Privacy law, Smart Contract, System view, Trust,
• MeSH
• důvěra MeSH
• lidé MeSH
• počítače do ruky MeSH
• počítače MeSH
• soukromí * MeSH
• zdravotní záznamy osobní * MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

This Special Issue of the Journal of Personalized Medicine presents extended versions of selected contributions to pHealth 2022, the 19th International Conference on Wearable Micro and Nano Technologies for Personalized Health, held on 8-10 November 2022 in Oslo, Norway [...].

• Publikační typ
• úvodníky MeSH

This Special Issue of the Journal of Personalized Medicine presents extended versions of selected contributions to pHealth 2021, the 18th International Conference on Wearable Micro and Nano Technologies for Personalized Health, held on 8-10 November 2021 in Genoa, Italy [...].

• Publikační typ
• úvodníky MeSH

The paper introduces a structured approach to transforming healthcare towards personalized, preventive, predictive, participative precision (P5) medicine and the related organizational, methodological and technological requirements. Thereby, the deployment of autonomous systems and artificial intelligence is inevitably. The paper discusses opportunities and challenges of those technologies from a humanistic and ethical perspective. It shortly introduces the essential concepts and principles, and critically discusses some relevant projects. Finally, it offers ways for correctly representing, specifying, implementing and deploying autonomous and intelligent systems under an ethical perspective.

• Klíčová slova
• P5 medicine, artificial intelligence, autonomous systems, ethical principles, pHealth,
• MeSH
• lékařství * MeSH
• mravy MeSH
• poskytování zdravotní péče MeSH
• umělá inteligence * MeSH
• Publikační typ
• časopisecké články MeSH

For meeting the challenge of aging, multi-diseased societies, cost containment, workforce development and consumerism by improved care quality and patient safety as well as more effective and efficient care processes, health and social care systems around the globe undergo an organizational, methodological and technological transformation towards personalized, preventive, predictive, participative precision medicine (P5 medicine). This paper addresses chances, challenges and risks of specific disruptive methodologies and technologies for the transformation of health and social care systems, especially focusing on the deployment of intelligent and autonomous systems.

• Klíčová slova
• Artificial intelligence, Autonomous systems, Ethics, Healthcare transformation, Knowledge management, Knowledge representation, Learning, pHealth,
• MeSH
• individualizovaná medicína * MeSH
• lidé MeSH
• umělá inteligence * MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

Today's digital information systems and applications collect every day a huge amount of personal health information (PHI) from sensor and surveillance systems, and every time we use personal computers or mobile phones. Collected data is processed in clouds, platforms and ecosystems by digital algorithms and machine learning. Pervasive technology, insufficient and ineffective privacy legislation, strong ICT industry and low political will to protect data subject's privacy have together made it almost impossible for a user to know what PHI is collected, how it is used and to whom it is disclosed. Service providers' and organizations' privacy policy documents are cumbersome and they do not guarantee that PHI is not misused. Instead, service users are expected to blindly trust in privacy promises made. In spite of that, majority of individuals are concerned of their privacy, and governments' assurance that they meet the responsibility to protect citizens in real life privacy is actually dead. Because PHI is probably the most sensitive data we have, and the authors claim it cannot be a commodity or public good, they have studied novel privacy approaches to find a way out from the current unsatisfactory situation. Based on findings got, the authors have developed a promising solution for privacy-enabled use of PHI. It is a combination of the concept of information fiduciary duty, Privacy as Trust approach, and privacy by smart contract. This approach shifts the onus of privacy protection onto data collectors and service providers. A specific information fiduciary duty law is needed to harmonize privacy requirements and force the acceptance of proposed solutions. Furthermore, the authors have studied strengths and weaknesses of existing or emerging solutions.

• Klíčová slova
• Privacy, digital pHealth, fiduciary duty, personal health information, smart contract, trust,
• MeSH
• algoritmy MeSH
• důvěra MeSH
• ekosystém MeSH
• lidé MeSH
• soukromí * MeSH
• zdravotní záznamy osobní * MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

Health and social care ecosystems are currently a matter of foundational organizational, methodological and technological paradigm changes towards personalized, preventive, predictive, participative precision (5P) medicine. For designing and implementing such advanced ecosystems, an understanding and correct representation of structure, function and relations of their components is inevitable. To guarantee consistent and conformant processes and outcomes, the specifications and principles must be internationally standardized. Summarizing the first author's Keynotes over the last 15 years of pHealth conferences, the paper discusses concepts, standards and principles of 5P medicine ecosystems including their design and implementation. Furthermore, a guidance to find and to deploy corresponding international standards in practical projects is provided.

• Klíčová slova
• 5P medicine, System architecture, ecosystem, integration, interoperability, knowledge management, knowledge representation, modeling,
• MeSH
• ekosystém * MeSH
• individualizovaná medicína * MeSH
• Publikační typ
• časopisecké články MeSH