[Facing the challenges of ubiquitous computing in the health care sector]. / Herausforderungen durch ubiquitäres Computing im Gesundheitsbereich.

The steady progress of microelectronics, communications and information technology will enable the realisation of the vision for "ubiquitous computing" where the Internet extends into the real world embracing everyday objects. The necessary technical basis is already in place. Due to their diminishing size, constantly falling price and declining energy consumption, processors, communications modules and sensors are being increasingly integrated into everyday objects today. This development is opening up huge opportunities for both the economy and individuals. In the present paper we discuss possible applications, but also technical, social and economic barriers to a wide-spread use of ubiquitous computing in the health care sector.

Strategies for health data exchange for secondary, cross-institutional clinical research.

Secondary use of health data has a vital role in improving and advancing medical knowledge. While digital health records offer scope for facilitating the flow of data to secondary uses, it remains essential that steps are taken to respect wishes of the patient regarding secondary usage, and to ensure the privacy of the patient during secondary use scenarios. Consent, together with depersonalisation and its related concepts of anonymisation, pseudonymisation, and data minimisation are key methods used to provide this protection. This paper gives an overview of technical, practical, legal, and ethical aspects of secondary data use and discusses their implementation in the multi-institutional @neurIST research project.

The use of distributed displays of operating room video when real-time occupancy status was available.

INTRODUCTION: On the day of surgery, real-time information of both room occupancy and activities within the operating room (OR) is needed for management of staff, equipment, and unexpected events. METHODS: A status display system showed color OR video with controllable image quality and showed times that patients entered and exited each OR (obtained automatically). The system was installed and its use was studied in a 6-OR trauma suite and at four locations in a 19-OR tertiary suite. Trauma staff were surveyed for their perceptions of the system. RESULTS: Evidence of staff acceptance of distributed OR video included its operational use for >3 yr in the two suites, with no administrative complaints. Individuals of all job categories used the video. Anesthesiologists were the most frequent users for more than half of the days (95% confidence interval [CI] >50%) in the tertiary ORs. The OR charge nurses accessed the video mostly early in the day when the OR occupancy was high. In comparison (P < 0.001), anesthesiologists accessed it mostly at the end of the workday when occupancy was declining and few cases were starting. Of all 30-min periods during which the video was accessed in the trauma suite, many accesses (95% CI >42%) occurred in periods with no cases starting or ending (i.e., the video was used during the middle of cases). The three stated reasons for using video that had median surveyed responses of "very useful" were "to see if cases are finished," "to see if a room is ready," and "to see when cases are about to finish." CONCLUSIONS: Our nurses and physicians both accepted and used distributed OR video as it provided useful information, regardless of whether real-time display of milestones was available (e.g., through anesthesia information system data).