Streamlining Tangible 3D Printed and Intangible XR Content Creation and Evaluation: The ENTICE Experience.

ENTICE aimed to use co-creative methodologies in order to build a solid creation pipeline for medical experiential content. The project has developed and evaluated immersive learning resources and tools aiming to support well-defined learning objectives using tangible and intangible resources (AR/VR/MR, 3D printing) that are highly sought in the fields of anatomy and surgery. In this paper the preliminary results from the evaluation of the learning resources and tools in 3 countries as well as the lessons learnt are presented towards to the improvement of the medical education process.

A Prototype of the National EHR system for Cyprus.

The aim of this paper is to present Cyprus' initiative for the design and the implementation of the prototype of the integrated electronic health record at a national level that will establish the foundations of the country's broader eHealth ecosystem. The latter, requires an interdisciplinary approach and scientific collaboration among various fields, including medicine, information and communication technologies, management, and finance, among others. The objective, is to design the system architecture, specify the requirements in terms of clinical content as well as the hardware infrastructure, but also implement European and national legislation with respect to privacy and security that govern sensitive medical data manipulation. The present study summarizes the outcomes of the 1st phase of this initiative, which comprises of the healthcare as well as the administrative requirements, user stories, data-flows and associated functionality. Moreover, leveraging the HL7 Fast Healthcare Interoperability Resources (FHIR) standard we highlight the concluded interoperability framework that allows genuine cross-system communication and defines third-party systems connectivity.Clinical Relevance- This work is strongly correlated with medicine since it describes the system requirements and the architecture of a national integrated electronic health records system.

Virtual Reality Applications for Neurological Disease: A Review.

Recent advancements in Virtual Reality (VR) immersive technologies provide new tools for the development of novel and promising applications for neurological rehabilitation. The purpose of this paper is to review the emerging VR applications developed for the evaluation and treatment of patients with neurological diseases. We start by discussing the impact of novel VR tasks that encourage and facilitate the patient's empowerment and involvement in the rehabilitation process. Then, a systematic review was carried out on six well-known electronic libraries using the terms: "Virtual Reality AND Neurorehabilitation," or "Head Mounted Display AND Neurorehabilitation." This review focused on fully-immersive VR systems for which 12 relevant studies published in the time span of the last five years (from 2014 to 2019) were identified. Overall, this review paper examined the use of VR in certain neurological conditions such as dementia, stroke, spinal cord injury, Parkinson's, and multiple sclerosis. Most of the studies reveal positive results suggesting that VR is a feasible and effective tool in the treatment of neurological disorders. In addition, the finding of this systematic literature review suggested that low-cost, immersive VR technologies can prove to be effective for clinical rehabilitation in healthcare, and home-based setting with practical implications and uses. The development of VR technologies in recent years has resulted in more accessible and affordable solutions that can still provide promising results. Concluding, VR and interactive devices resulted in the development of holistic, portable, accessible, and usable systems for certain neurological disease interventions. It is expected that emerging VR technologies and tools will further facilitate the development of state of the art applications in the future, exerting a significant impact on the wellbeing of the patient.

Proposal for an eHealth Based Ecosystem Serving National Healthcare.

The European Union (EU)'s keen concern about citizens' health and well-being advancement has been expressed at all levels. It has been understood that at present, these can only be achieved through coordinated actions at the individual member states' level based on EU directives, as well as through promoting and funding R&D and expanding the use of eHealth technologies. Despite the diversities and particularities among member states, common values such as universal access to good quality healthcare, equity, and solidarity have been widely accepted across EU. That demanded the adoption of policies and follow directives, which streamlined actions to bridge healthcare gaps, and facilitate cross-border healthcare. This paper articulates a framework for deriving a national healthcare system, based on interoperable Electronic Health Record (EHR) with safeguarding healthcare quality, enabling quadruple helix (Public, Academia, Industry, NGOs) driven R&D and guided by a patient-centered approach. A methodology to develop an integrated EHR at National level is proposed as a prerequisite for eHealth and put into perspective. Recommendations are given for the steps needed, from the managerial, legal, technical, and financial concerns in developing an open access, patient-centered national healthcare system based on the context and constraints of a country. The example of a small country to apply the proposed methodology is demonstrated. Stakeholders, including citizens, healthcare professionals, academia, and the industry are mobilized, enabled, and incentivized for implementing the methodology. Experiences are aspired to be offered as lessons learned for other countries to adapt on their environment.

A patient centered electronic health: eHealth system development.

BACKGROUND: Medical practice and patient-doctor relationship will continue improving while technology is integrated in our everyday life. In recent years the term eHealth landmarked a new era with improved health provider's skills and knowledge, and increased patient participation in medical care activities. OBJECTIVE: To show why the design and implementation of a healthcare system needs to follow a specific philosophy dictated by the level of eHealth maturity of a country and its citizens. METHODS: Based on the maturity level, an adaptable framework for implementing an Electronic Health System at national level is derived, guided by the Patient Centered Philosophy as defined and introduced by the EU directives. Implementation prerequisites are analyzed together with guiding principles for identifying the maturity level of an organization or country. RESULTS: Cyprus being a small EU country, it can be used as pilot site for the whole Europe, was chosen for this study and its maturity level analysis is presented. Recommendations that determine general steps needed to prepare the ground for an adequate patient-centered national healthcare system are accompanied. CONCLUSION: The implementation of an integrated Electronic Health Record at National level, as a prerequisite for a patient-centered eHealth environment is evidently demonstrated.

eHealth Services for the European Reference Network on Rare Anaemias (eENERCA).

This paper presents an electronic registry system for the purposes of the eENERCA for rare congenital conditions that require lifelong follow up and treatment. The main objective of the eENERCA project focusses on the prevention of major rare anaemias (RAs) by facilitating the access, at a European level, to the best genetic counselling, diagnosis and clinical management of the patients with RA independently of their country of origin. This can be achieved by promoting an extension of the full Electronic Health Record system and specifically the electronic registries for RAs, across Europe for the purposes stated hence promoting service development for the benefit of patients. The proposed eRegistry will serve as an epidemiological tool to improve the management of patient services and ultimately improve patient care.

Integrated Electronic Health Record Database Management System: A Proposal.

eHealth has attained significant importance as a new mechanism for health management and medical practice. However, the technological growth of eHealth is still limited by technical expertise needed to develop appropriate products. Researchers are constantly in a process of developing and testing new software for building and handling Clinical Medical Records, being renamed to Electronic Health Record (EHR) systems; EHRs take full advantage of the technological developments and at the same time provide increased diagnostic and treatment capabilities to doctors. A step to be considered for facilitating this aim is to involve more actively the doctor in building the fundamental steps for creating the EHR system and database. A global clinical patient record database management system can be electronically created by simulating real life medical practice health record taking and utilizing, analyzing the recorded parameters. This proposed approach demonstrates the effective implementation of a universal classic medical record in electronic form, a procedure by which, clinicians are led to utilize algorithms and intelligent systems for their differential diagnosis, final diagnosis and treatment strategies.

A patient centered electronic health system: an example for cyprus.

The design and implementation of a healthcare system needs to follow a specific philosophy regarding its operational structure and must be adapted gradually with one step at a time, depending on the level of maturity of a country on certain key issues. The main goal of this paper is to present an overall recommendations framework for implementing an Electronic Health System at national level, guided by the Patient Centered Philosophy. Certain prerequisites for implementing such systems are analyzed together with guiding principles for identifying the maturity level of an organization or country. The maturity level analysis for Cyprus is presented and is accompanied by some recommendations that determine the steps needed to prepare the ground for a complete patient centered national healthcare system.