Design and implementation of the standards-based personal intelligent self-management system (PICS).

Against the background of demographic change and a diminishing care workforce there is a growing need for personalized decision support. The aim of this paper is to describe the design and implementation of the standards-based personal intelligent care systems (PICS). PICS makes consistent use of internationally accepted standards such as the Health Level 7 (HL7) Arden syntax for the representation of the decision logic, HL7 Clinical Document Architecture for information representation and is based on a open-source service-oriented architecture framework and a business process management system.

GAL@Home: a feasibility study of sensor-based in-home fall detection.

Background: A considerable proportion of falls occur within the domestic environment. Sensor-based identification of falls in seniors' homes could help them to remain autonomous and self-sufficient in their own homes. The objective of this study was to evaluate fall detection systems within the home environment using optical and accelerometric sensor systems.

ARDEN2BYTECODE: a one-pass Arden Syntax compiler for service-oriented decision support systems based on the OSGi platform.

Patient empowerment might be one key to reduce the pressure on health care systems challenged by the expected demographic changes. Knowledge based systems can, in combination with automated sensor measurements, improve the patients' ability to review their state of health and make informed decisions. The Arden Syntax as a standardized language to represent medical knowledge can be used to express the corresponding decision rules.

A method to align the coordinate system of accelerometers to the axes of a human body: The depitch algorithm.

One of the key problems in accelerometry based gait analyses is that it may not be possible to attach an accelerometer to the lower trunk so that its axes are perfectly aligned to the axes of the subject. In this paper we will present an algorithm that was designed to virtually align the axes of the accelerometer to the axes of the subject during walking sections. This algorithm is based on a physically reasonable approach and built for measurements in unsupervised settings, where the test persons are applying the sensors by themselves.

Health-enabling technologies for the elderly--an overview of services based on a literature review.

Background: Services for the elderly based on health-enabling technologies promise to contribute significantly to the efficiency and effectiveness of future health care. Due to this promise, over the last years the scientific community has designed a complex variety of these valuable innovations. A systematic overview of the developed services would help to better understand their opportunities and limitations.

A Regional health care network: eHealth.Braunschweig. Domain fields and architectural challenges.

Background: Health care network eHealth.Braunschweig has been started in the South-East region of Lower Saxony in Germany in 2009. It composes major health care players, participants from research institutions and important local industry partners.

A nomenclature for the analysis of continuous sensor and other data in the context of health-enabling technologies.

Due to the progress in technology, it is possible to capture continuous sensor data pervasively and ubiquitously. In the area of health-enabling and ambient assisted technologies we are faced with the problem of analyzing these data in order to improve or at least maintain the health status of patients. But due to the interdisciplinarity of this field every discipline makes use of their own analyzing methods.

Increasing physical activity through health-enabling technologies: the project "being strong without violence".

Due to the increasing prevalence of adiposity in children numerous schools are introducing prevention programmes. Among these is "Gewaltlos Starksein" ("Being strong without violence"), a project of Hauptschule Sophienstraße Braunschweig, Germany (a general education secondary school for grades 5-10). This study aims to discover possible increases in activity through "Gewaltlos Starksein" where health-enabling technologies play a major role.

Methods in year 50: preserving the past and preparing for the future.

Background: Founded in 1962 and, therefore, the oldest international journal in medical informatics, Methods of Information in Medicine will publish its 50th volume in 2011. At the start of the journal's sixth decade, a discussion on the journal's profile seems appropriate.

Objectives: To report on the new opportunities for online access to Methods publications as well as on the recent strategic decisions regarding the journal's aims and editorial policies.

Health information systems for home telehealth services--a nomenclature for sensor-enhanced transinstitutional information system architectures.

Home telehealth services for elderly people promise to contribute to a more efficient health care in the future. Though isolated services at a patient's home might make sense for some applications, the full potential of home telehealth only arises through its integration into existing health information systems (HIS) and care processes. We know about traditional HIS architectures.

Supporting rehabilitation training of COPD patients through multivariate sensor-based monitoring and autonomous control using a Bayesian network: prototype and results of a feasibility study.

Repeated endurance training - supervised by an expert - is one of the most effective rehabilitation methods for patients with chronic obstructive pulmonary disease (COPD) to improve physical function. Monitoring of vital signs in combination with an automatic intelligent training control and emergency detection facilitates supervised training without the physical presence of an expert as well as training optimisation through individualisation. The aim of this study is the development of a suitable analysis and control method for this purpose.

The Lower Saxony research network design of environments for ageing: towards interdisciplinary research on information and communication technologies in ageing societies.

Worldwide, ageing societies are bringing challenges for independent living and healthcare. Health-enabling technologies for pervasive healthcare and sensor-enhanced health information systems offer new opportunities for care. In order to identify, implement and assess such new information and communication technologies (ICT) the 'Lower Saxony Research Network Design of Environments for Ageing' (GAL) has been launched in 2008 as interdisciplinary research project.

IMIA: the global informatics perspective for good health.

Objective: To report on IMIA, the International Medical Informatics Association, and on what has been achieved in the period 2007-2010.

Method: Summarizing IMIA's activities, discussions and decisions, in particular with respect to its Board and General Assembly meetings; looking at recent progress of biomedical and health informatics through IMIA's Yearbook.

Results: Over the last three years, decisions have been made and steps have been initiated which will lead to significant changes for IMIA.

An approach to simulate and visualize intraoperative scattered radiation exposure to improve radiation protection training.

Intraoperative radiography based on mobile image intensifier systems (C-arms) is widely used during the treatment of trauma and emergency patients. These devices produce scattered radiation, potential hazardous for surgeon and operation room personal (ORP). The propagation and intensity of scattered radiation is not intuitive, is not perceivable by human senses and depends on many variables.

Daily activities and fall risk--a follow-up study to identify relevant activities for sensor-based fall risk assessment.

The demographic change will lead to an increase in the incidence of falls in the elderly. Technological progress allows for unobtrusive physical activity measurement with miniature sensors, e.g.

A home-centered ICT architecture for health-enabling technologies.

Population ageing needs health-enabling technologies for delivering pervasive health care. Home care plays an import role in pervasive health care. In this paper, we aim to construct a home-centered health information system architecture which can efficiently manage multi sensors, actuators and decision support systems.

Medical informatics: past, present, future.

Objective: To reflect about medical informatics as a discipline. To suggest significant future research directions with the purpose of stimulating further discussion.

Methods: Exploring and discussing important developments in medical informatics from the past and in the present by way of examples.

On IMIA's International Activities in Health and Biomedical Informatics Education.

Background: Education has long been, and continues to be, one of the major thematic areas of the activities of IMIA, the International Medical Informatics Association.

Objective: To report on IMIA's past activities and to discuss possible future perspectives on IMIA's role on biomedical and health informatics education.

Methods: Summarizing past activities by searching in reports and publications.

Decision support for teletraining of COPD patients.

Background: Supervised physical training has been shown to promote rehabilitation of patients affected by chronic obstructive pulmonary disease (COPD). Currently, due to limited resources, not all COPD patients can be trained by an expert supervisor.

Objectives: The objective of our research is to construct a decision support system (DSS) which observes and controls physical ergometer training sessions of COPD patients.

Recent progress in sensor-enhanced health information systems - slowly but sustainably.

The use of health-enabling technologies is regarded as one important means to face some of the challenges which accompany the demographic change with an expected rise in multi-morbidity and an increased need of care. A precondition for the sensible use of these technologies is their integration in existing information system structures, and - preferably - the enhancement of these into sensor-enhanced health information systems (seHIS). The aim of this review is to report on recent progress in seHIS, and thus to identify relevant areas of research that have to be addressed to provide patient-centered services in a semantically interoperable environment.

A clinical study to assess fall risk using a single waist accelerometer.

Falls have various causes and are often associated with mobility impairments. Preventive steps to avoid falls may be initiated, if an increasing fall risk could be detected in time. The objective of this article is to identify an automated sensor-based method to determine fall risk of patients based on objectively measured gait parameters.

IMIA and its members: on balancing continuity and transition in biomedical and health informatics.

Objective: To report on major past (2008) and future (2009 and beyond) activities of IMIA, the International Medical Informatics Association.

Method: Summarizing discussions and planning activities within IMIA, in particular with respect to its Board and General Assembly meetings in 2008; looking at recent progress of biomedical and health informatics by commenting on IMIA Yearbook surveys and best paper selections.

Results: Major recent IMIA efforts include preparatory work for Medinfo 2010, global partnership activities in collaboration with WHO, planning activities for shifting to a biennial Medinfo cycle and setting up an IMIA office, all in accordance with IMIA's longterm strategic plan 'Towards IMIA 2015'.

An approach to calculate and visualize intraoperative scattered radiation exposure.

During the intraoperative radiograph generation process with mobile image intensifier systems (C-arm) most of the radiation exposure for patient, surgeon and operation room personal is caused by scattered radiation. The intensity and propagation of scattered radiation depend on different parameters, e.g.

Representing sensor data using the HL7 CDA personal healthcare monitoring report draft.

The recently published implementation guide for personal healthcare monitoring report (PHMR) defines a new format to represent measurements. The aim of the presented prototypical implementation is to check the ability of the defined format to represent health-related sensor data using a commercially available multi-sensor-device's measurements. An extensible stylesheet language (XSL) stylesheet has been developed to transform measured data from the multi-sensor device to a valid PHMR document.

Health-enabling technologies for pervasive health care: a pivotal field for future medical informatics research education?

Our societies are changing worldwide. Life expectancy has increased in many societies and this increase is often related to an increase in the relative amount of elderly persons. Health-enabling technologies are information and communication technologies for creating sustainable conditions for self-sufficient and self-determined lifestyles.