Publications by authors named "Fabrizio L Ricci"

The paper describes a new metrics for measuring the structural complexity of clinical history (modelled by a HINe model) in order to compare different clinical histories and then assign it to the right types of learners.

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The main objective of this work is to define a common shared conceptual model that describes the health care environment using the ContSys standard, harmonizing it with the social care and assistive domotics concepts. The development of this model supports the integration of services, the interoperability among systems and the continuity of care across domains.Starting from the identification and extraction of the portion of the ContSys model suitable for the healthcare part, the article provides the methodology adopted to extend it with social and home automation concepts and to integrate them in a unique framework that supports the continuity of care.

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Scarce literature exists as to the use of Petri Nets (PN) to model the dynamic evolution of health issues in a deterministic way. Starting from the HIN (Health Issue Network) approach, the paper aims at describing the suitability of PN in supporting the Case-Based Learning method for improving an educational simulation environment in which students can manage realistic clinical data related to the evolution of a patient's health state over time.

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The increasing demand for territorial services requires the improvement of the coordination and cooperation among stakeholders in planning and delivery of integrated health and social services. In this scenario, to improve the communication among stakeholders there is a need of a formal conceptual model that facilitates the interoperability between organizations and professionals. This paper presents the methodology adopted by a UNINFO working group established in Italy to extend the ContSys standard with social care concepts to integrate health and social care contexts in a continuity of care perspective.

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HIN (Health Issue Network) is introduced as a peculiar approach to enhance Case-Based Learning (CBL) methodology for health sciences education, as well as innovative tool to query problem-oriented EHRs. In this paper HIN's Petri Nets-based formalism is described, and a first example of its twofold (lower and upper) representation level is proposed.

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There is an increasing social pressure to train medical students with a level of competency sufficient to face clinical practice already at the end of their curriculum. The case-based learning (CBL) is an efficient teaching method to prepare students for clinical practice through the use of real or realistic clinical cases. In this regard, the Electronic Healthcare Record (EHR) could be a good source of real patient stories that can be transformed into educative cases.

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This paper proposes a semi-automatic approach to extract clinical information structured in a HL7 Clinical Document Architecture (CDA) and transform it in a data warehouse dimensional model schema. It is based on a conceptual framework published in a previous work that maps the dimensional model primitives with CDA elements. Its feasibility is demonstrated providing a case study based on the analysis of vital signs gathered during laboratory tests.

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Aim of this paper is to propose a methodology to design Extract, Transform and Load (ETL) tools in a clinical data warehouse architecture based on the Electronic Healthcare Record (EHR). This approach takes advantages on the use of this infrastructure as one of the main source of information to feed the data warehouse, taking also into account that clinical documents produced by heterogeneous legacy systems are structured using the HL7 CDA standard. This paper describes the main activities to be performed to map the information collected in the different types of document with the dimensional model primitives.

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This paper proposes a conceptual framework to design a dimensional model based on the HL7 Clinical Document Architecture (CDA) standard. The adoption of this framework can represent a possible solution to facilitate the integration of heterogeneous information systems in a clinical data warehouse. This can simplify the Extract, Transform and Load (ETL) procedures that are considered the most time-consuming and expensive part of the data warehouse development process.

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The development of healthcare information systems is broadly considered a promising strategy to ensure, enhance and deliver of quality patient services, thus improving the healthcare economic sustainability [1]. However, their systematic evaluation needs to implement economic evaluation models that can help decision makers to determine a feasible and suitable analysis of the impact of an information system in the appropriate healthcare setting [2]. Aim of this paper is to define a mathematical model to provide an "ex-ante" measure of adequacy and significance in the adoption process of Electronic Healthcare Records (EHRs).

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In the paper an IT infrastructure for supporting the shift from organization-centric to patient-centric model of healthcare service delivery to facilitate collaborative, multidisciplinary and cross-organizational healthcare delivery processes is presented. The core of this infrastructure is an internet platform that provides e-services and promotes the interoperability by enabling not only inter-communication among authorized healthcare professionals, but also sharing the Virtual Healthcare Record, an authoritative, multi-dimensional view on the patient health state. The platform is implemented in the LuMiR project for Basilicata, an Italian region where integration of healthcare applications is required.

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The Lucania-Medici in Rete (LuMiR) project aims to support the shift from organization-centric to patient-centric healthcare in Basilicata, a region in the southern Italy. Main objective of the project is to foster collaborative, multidisciplinary and cross-organizational healthcare processes by developing and stimulating the adoption of a region-wide, software infrastructure, the LuMiR system. It is a suite of e-services that facilitates the sharing of patient related clinical data among authorized professionals, by enabling the interoperability among Electronic Medical.

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Clinical investigations (CIs) are carried out to demonstrate safety and efficacy of new Medical Devices (MDs). The presence of many stakeholders participating in CIs makes it necessary to develop a common standard language to achieve semantic interoperability among systems and organizations. In Italy the National Research Council is carrying out a project supported by Ministry of Health aiming to develop an information system (MEDIS) that manages MD clinical investigations.

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In order to estimate the cost of generic clinical guidelines based on telemedicine services for chronic patients, an economic model (E-DIMEM) has been defined. This model is designed to help health suppliers and managers to plan for the future. It is essentially a workflow composed by diagnosis and therapeutic activities.

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E-medicine covers the whole range of medical process and service. Multi-agent approach is suitable for the development of e-medicine systems. In this paper, firstly the requirements of e-medicine are analyzed and taxonomy is proposed for e-medicine systems.

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Computer systems and communication technologies are making a strong and influential presence in the different fields of medicine. The cornerstone of a functional medical information system represents the electronic health records management system. Due to a very sensitive nature of medical information, such systems are faced with a number of stringent requirements, like security and confidentiality of patients' related data, different media type's management, diversity of medical data that need to be processed etc.

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E-Health is producing a great impact in the field of information distribution of the health services to the intra-hospital and the public. Previous researches have addressed the development of system architectures in the aim of integrating the distributed and heterogeneous medical information systems. The easing of difficulties in the sharing and management of medical data and the timely accessibility to these data is a critical need for health care providers.

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The paper presents some results of the MobiDis project. MobiDis is an information system that includes healthcare consumers and providers in a unique, virtual organisation aimed at promoting a patient centric paradigm in healthcare. It allows logons from desktop or laptop computers, as well as wireless PDAs or tablet PCs connected to Internet.

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Management of many types of chronic diseases relies heavily on patients' self-monitoring of their disease conditions. In recent years, Internet-based home telemonitoring systems allowing transmission of patient data to a central database and offering immediate access to the data by the care providers have become available. The adoption of Extensible Mark-up Language (XML) as a W3C standard has generated considerable interest in the potential value of this language in health informatics.

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The management of clinical data is a complex task. Patient related information reported in patient folders is a set of heterogeneous and structured data accessed by different users having different goals (in local or geographical networks). XML language provides a mechanism for describing, manipulating, and visualising structured data in web-based applications.

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In recent years, internet-based home telemonitoring systems that allow transmission of patient data to a central database and offer immediate access to the data by the care providers have become available. The adoption of Extensible Mark-up Language (XML) as a W3C standard has generated a lot of interest in the potential value of this language in health informatics. However the telemonitoring systems often work with only one or a few types of medical devices and thus are limited in the types of diseases they can monitor.

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Increasing cooperation among health professionals--within and across organizations--require a suitable sharing of clinical information from heterogeneous (electronic) documentation. Information originates from healthcare activities and may be organized within record systems in relation to health issues, episodes of care, episodes of illness, etc. Implementation of record systems depends on tasks and attitudes within each particular healthcare environment, that determine (i) the balance among functions of the record system, e.

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The paper illustrates the system WITH (Write on Internet clinical Trials in Haematology) which supports the writing of a clinical trial (CT) document. The requirements of this system have been defined analysing the writing process of a CT and then modelling the content of its sections together with their logical and temporal relationships. The system WITH allows: a) editing the document text; b) re-using the text; and c) facilitating the cooperation and the collaborative writing.

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The Italian national telemedicine programme included a broad range of research projects, but they all served the common purpose of bringing about improvements in health-care management and performance. The programme consisted of seven projects, each of which had specific research and training objectives, and a three-year duration. The systems developed in the course of the programme were not experimental prototypes:they were intended to be pre-commercial systems.

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