MYeHealthAppCY: A Healthcare Mobile Application in Cyprus.

This paper presents MYeHealthAppCY, an mHealth solution designed to provide patients and healthcare providers in Cyprus with access to medical data. The application includes features such as an at-a-glance view of patient summary, comprehensive prescription management, teleconsultation, and the ability to store and access European Digital COVID Certificates (EUDCC). The application is an integral part of the eHealth4U platform targeting to implement a prototype EHR platform for national use. The application developed is based on FHIR and follows a strict adherence to widely used coding standards. The application was evaluated receiving satisfactory scores; however, significant work is still needed to deploy the application in production.

eHealth4U: A DEMO of a Prototype National Electronic Health Record for Cyprus.

In this paper we present a demonstration of a prototype national Electronic Health Record platform for Cyprus. This prototype is developed using the HL7 FHIR interoperability standard in combination with terminologies widely adopted by the clinical community such as the SNOMED CT and the LOINC. The system is organized in such a way to be user-friendly for its users, being the doctors and the citizens. The health-related data of this EHR are separated into three main sections, being the "Medical History", the "Clinical Examination" and the "Laboratory results". Business requirements include the Patient Summary as defined by the guidelines of the eHealth network and the International Patient Summary which are used as the base for all the sections of our EHR, together with additional medical information and functionality such as the organization of medical teams or the history of medical visits and episodes of care. From the doctor's point of view, one can search for patients who have granted the doctor with a consent and read or add/edit their EHR data by initiating a new visit as defined in the Cyprus National Law for eHealth. At the same time, doctors can organize their medical teams by managing the locations of each team and the members that belong to each team.

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.

Operating an eHealth System for Prehospital and Emergency Health Care Support in Light of Covid-19.

Introduction: The support of prehospital and emergency call handling and the impact of Covid-19 is discussed throughout this study. The initial purpose was to create an electronic system (eEmergency system) in order to support, improve, and help the procedure of handling emergency calls. This system was expanded to facilitate needed operation changes for Covid-19. Materials and Methods: An effort to reform the procedures followed for emergency call handling and Ambulance dispatch started on the Island of Cyprus in 2016; along that direction, a central call centre was created. The electronic system presented in this work was designed for this call centre and the new organization of the ambulance services. The main features are the support for ambulance fleet handling, the support for emergency call evaluation and triage procedure, and the improvement of communication between the call centre and the ambulance vehicles. This system started regular operation at the end of 2018. One year later, when Covid-19 period started, we expanded it with the addition of several new features in order to support the handling of patients infected with the new virus. Results: This system has handled 112,414 cases during the last 25 months out of which 4,254 were Covid-19 cases. These cases include the transfer of patients from their house to the reference hospital, or the transfer of critical patients from the reference hospital to another hospital with an intensive care unit or transfer of patients from one hospital to another one for other reasons, like the number of admissions. Conclusion: The main purpose of this study was to create an electronic system (eEmergency system) in order to support, improve, and help the procedure of handling emergency calls. The main components and the architecture of this system are outlined in this paper. This system is being successfully used for 25 months and has been a useful tool from the beginning of the pandemic period of Covid-19.

Real-Time Adaptation to Time-Varying Constraints for Medical Video Communications.

The wider adoption of mobile Health video communication systems in standard clinical practice requires real-time control to provide for adequate levels of clinical video quality to support reliable diagnosis. The latter can only be achieved with real-time adaptation to time-varying wireless networks' state to guarantee clinically acceptable performance throughout the streaming session, while conforming to device capabilities for supporting real-time encoding. We propose an adaptive video encoding framework based on multi-objective optimization that jointly maximizes the encoded video's quality and encoding rate (in frames per second) while minimizing bitrate demands. For this purpose, we construct a dense encoding space and use linear regression to estimate forward prediction models for quality, bitrate, and computational complexity. The prediction models are then used in an adaptive control framework that can fine-tune video encoding based on real-time constraints. We validate the system using a leave-one-out algorithm applied to ten ultrasound videos of the common carotid artery. The prediction models can estimate structural similarity quality with a median accuracy error of less than 1%, bitrate demands with deviation error of 10% or less, and encoding frame rate within a 6% margin. Real-time adaptation at a group of pictures level is demonstrated using the high efficiency video coding standard. The effectiveness of the proposed framework compared to static, nonadaptive approaches is demonstrated for different modes of operation, achieving significant quality gains, bitrate demands reductions, and performance improvements, in real-life scenarios imposing time-varying constraints. Our approach is generic and should be applicable to other medical video modalities with different applications.

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.

LiSIs: An Online Scientific Workflow System for Virtual Screening.

Modern methods of drug discovery and development in recent years make a wide use of computational algorithms. These methods utilise Virtual Screening (VS), which is the computational counterpart of experimental screening. In this manner the in silico models and tools initial replace the wet lab methods saving time and resources. This paper presents the overall design and implementation of a web based scientific workflow system for virtual screening called, the Life Sciences Informatics (LiSIs) platform. The LiSIs platform consists of the following layers: the input layer covering the data file input; the pre-processing layer covering the descriptors calculation, and the docking preparation components; the processing layer covering the attribute filtering, compound similarity, substructure matching, docking prediction, predictive modelling and molecular clustering; post-processing layer covering the output reformatting and binary file merging components; output layer covering the storage component. The potential of LiSIs platform has been demonstrated through two case studies designed to illustrate the preparation of tools for the identification of promising chemical structures. The first case study involved the development of a Quantitative Structure Activity Relationship (QSAR) model on a literature dataset while the second case study implemented a docking-based virtual screening experiment. Our results show that VS workflows utilizing docking, predictive models and other in silico tools as implemented in the LiSIs platform can identify compounds in line with expert expectations. We anticipate that the deployment of LiSIs, as currently implemented and available for use, can enable drug discovery researchers to more easily use state of the art computational techniques in their search for promising chemical compounds. The LiSIs platform is freely accessible (i) under the GRANATUM platform at: http://www.granatum.org and (ii) directly at: http://lisis.cs.ucy.ac.cy.

High-resolution, low-delay, and error-resilient medical ultrasound video communication using H.264/AVC over mobile WiMAX networks.

In this study, we describe an effective video communication framework for the wireless transmission of H.264/AVC medical ultrasound video over mobile WiMAX networks. Medical ultrasound video is encoded using diagnostically-driven, error resilient encoding, where quantization levels are varied as a function of the diagnostic significance of each image region. We demonstrate how our proposed system allows for the transmission of high-resolution clinical video that is encoded at the clinical acquisition resolution and can then be decoded with low-delay. To validate performance, we perform OPNET simulations of mobile WiMAX Medium Access Control (MAC) and Physical (PHY) layers characteristics that include service prioritization classes, different modulation and coding schemes, fading channels conditions, and mobility. We encode the medical ultrasound videos at the 4CIF (704 × 576) resolution that can accommodate clinical acquisition that is typically performed at lower resolutions. Video quality assessment is based on both clinical (subjective) and objective evaluations.