SNA: The Optimal Nodes to Raise Nurses' Infosec Awareness.

Social Network Analysis (SNA) can promote Infosec awareness. A sample of 164 nurses selected the most trusted actors to get Infosec updates. UCINET 6 and NetDraw were used for mapping and PSPP 1.6.2 was used for data analysis. Nurses tend to trust managers, colleagues and IT professionals for retrieving Infosec updates.

InfoSec Practices - a Survey Conducted in Greek Hospitals.

Background: Langerhans The information technology is present in every aspect of private, social, and professional sphere and is constantly evolving whilst remaining vulnerable to security alerts and attacks. The healthcare sector contains sensitive information and can be compromised causing even fatal delays to healthcare delivery, loss of reputation of the organizations, and traumatic experiences for patients who might be stigmatized by the disclosure of their medical files. Infosec practices that are applied by nurses can make the difference in defending or compromising healthcare data. Objective: The aim of this research is to investigate the Infosec practices which are applied by nurses who work in Greek hospitals. Correlation between the Infosec practices, the knowledge on Infosec policies, and attitude towards Infosec policies will be further examined. Methods: The KAP model is applied and the HAIS-Q tool consisted of 45 items in five areas of interest was used. A sample of 277 nurses was collected. Confidentiality issues and consent were respected. IBM SPSS 25.0 was used for the statistical analysis. Descriptive analysis (mean, st. dev.) and inferential statistics, ANOVA, and Pearson Corerelations were conducted. The significance level was set up to 0.05. Results: A strong correlation between knowledge on Infosec policies and attitude towards Infosec policies, attitude towards Infosec policies and Infosec practices, and knowledge on Infosec policies and Infosec practices was established. Nurses apply good Infosec practices in three out of five areas of interest, while their practices concerning the report of security violations and their practices related to the Internet usage are average. Overall, nurses' Infosec awareness is good. Conclusion: The findings showed that nurses demonstrate average to good knowledge on Infosec policies, good attitude towards Infosec policies, good to average Infosec practices and good total Infosec awareness.The most vulnerable area is the Internet usage.

Assessing Internal Consistency of HAIS-Q: A Survey Conducted in Greek Hospitals.

Despite the prevailing perception that powerful software and hardware are adequate solutions to minimize information systems' security breaches, privacy remains at stake. Human factors play an important role in maintaining information security as it is evident that non secure practices applied by employees may increase the vulnerability of the systems and lead to privacy issues. Non secure practices found in literature are related to the use of Internet, the use of emails, password management, information handling and incidence reporting. For this purpose a survey was designed to be conducted in seven hospitals in Greece in order to record non secure practices applied by nursing staff and identify correlation factors. This paper presents the reliability test of the HAIS-Q tool which was applied in order to conduct the survey entitled: Examining the Nurses' non secure IT practices in Greek Hospitals as well as the preliminary results of the study.

The Transition to Distance Learning in the Era of Covid-19 Pandemic: The Perceptions and Experiences of Nursing Students.

During the first months of COVID-19 pandemic, authorities of many countries imposed to educational institutions of all educational levels, the online delivery of their courses to prevent the spread of SARS-CoV-2. We investigated the perceptions and first experiences of Nursing students that attended the synchronous distance learning undergraduate course of Health Informatics. Respondents' perceptions and experiences were positive regarding the design and material of the course and the discussions with their peers while the technical support was negatively rated. Students could not decide if distance learning is more difficult than traditional or whether distance learning is more time consuming than traditional learning. Nursing students prefer traditional learning as they stated that they learn more and feel more comfortable to participate in personal discussions. Distance learning can be ameliorated by careful design, more interaction initiatives, creative methods to enhance learning and availability of timely technical support. Future research should be conducted in a larger sample.

The Development and Evaluation of an Anti-Phishing E-Learning Intervention for Nurses.

Interactive games can be included in e-learning and train users to avoid web phishing. A multimodal educational intervention consisted of a serious game was developed in order to train nurses about phishing on Internet and was evaluated by experts and end users. The system was considered acceptable and can be used as an interesting learning resource for self-regulated learning. Future research will focus on evaluating the effectiveness of the educational intervention.

Health and Health Determinants.

This chapter aims at providing the student with a general overview of the Health and Health Determinantsbasic concepts. More precisely, this chapter provides a definition and explanation of health and health determinants and presents an overview of measures in epidemiology.

Greek Hospitals Web Accesibility.

Even though Internet is an exciting technological tool, it requires innovative design to be accessible to everyone, including people with disabilities.The purpose of the present work is to evaluate the accessibility of the web sites of the hospitals which are under the Greek Ministry of Health and belong in the first Health Regionusing afreeWCAG 2.0 and Section 508 Web Accessibility Checksoftware. An observation of the websitesalong with the software showed that no website meets the W3C criteria of accessibility.

Mission and Structure of Health Services.

This chapter aims at providing the student with a general overview of the appropriate structure and ethics healthcare organizations are based on, the concept of ethical leadership, the importance of having clear statements of mission, vision and value in healthcare organizations and the Health Promotion Charters implemented in a Globalized World.

Health Organization Development and Design.

This chapter aims at providing the student with a general overview of the Health Organization Development and Design basic concepts. More precisely, this chapter outlines the origins and the future of Health services planning and development and the structure of health organizations. The typology of different international healthcare systems implemented in United Kingdom, United States of America, Greece, Serbia and Germany is also presented.

The Dissemination and Communication Plan and Activities of the CrowdHEALTH Project: "Collective Wisdom Driving Public Health Policies".

Determining the dissemination and communication plans and activities of research projects is an important part for transferring research outputs to the target audience. This paper presents the dissemination and communication plans and activities of the CrowdHEALTH project. Towards this end, the methodology and results are presented in this paper.

Determining and Evaluating the Dissemination and Exploitation Plans and Activities for the CrowdHEALTH Project: The Role of the Impact Creation Board.

Determining and evaluating the dissemination and exploitation plans and activities of research projects can be a challenging task. This paper presents an overview of the role of the Impact Creation Board in the identification and assessment of the dissemination and exploitation plan and activities for the CrowdHEALTH project "Collective wisdom driving public health policies". Towards this end, a stepwise methodology was applied and the feedback from the Impact Creation Board members, and results of each step were analyzed and shared with the consortium.

Advanced Interoperability Techniques: Structure Mapping Service in CrowdHEALTH Project.

INTRODUCTION: Due to healthcare information systems interoperability issues, health-related events may be missed. Numerous techniques based on medical standards and technologies have been recommended to address this challenge. Nevertheless, these techniques do not follow a holistic approach. AIM: The purpose of the paper is to present the structure mapping service which is developed in the context of the initial design of the interoperability solution of the CrowdHEALTH project. METHODS: In the CrowdHEALTH project, subcomponents responsible for providing the appropriate interoperability solution have been created with first the rule engine for the implementation of the business logic. Another subcomponent responsible for creating and managing the knowledge related to the link that exists between information structures, or mappings between them, is the Structure Mapping Service. The envisioned approach for structure mapping is based on ontology alignment. Besides, the Terminology Service is responsible for providing a set of operations on medical terminologies used for the coding of medical knowledge, which fills the information structures. RESULTS: Within the development of the Structure Mapping component, the Ontology alignment process will be automated. Two phases exist when using the structure mapping service: the training phase and the run-time phase. In the training phase ontologies are created and are aligned, and data maps between the use case (source) data sets and the HHR Manager classes (target) are formed. Afterward, these data maps can be stored in the knowledge base. In the runtime phase, queries can be made to the structure mapping component by the data converter. The structure mapping controller can then access the Knowledge Base to retrieve the appropriate mapping and transformations and provide these as a response to the query. CONCLUSIONS: The initial design of the advanced interoperability techniques is described with emphasis put to Structural Mapping service which can be easily deployed and seamlessly integrated into healthcare settings. This design will be assessed and further enriched during the project life circle.

Modelling and Evaluation of Policies.

INTRODUCTION: NCDs (non-communicable diseases) are considered an important social issue and a financial burden to the health care systems in the EU which can be decreased if cost-effective policies are implemented, along with proactive interventions. The CrowdHEALTH project recognizes that NCD poses a burden for the healthcare sector and society and aims at focusing on NCDs' public health policies. AIM: The aim of this paper is to present the concept of Public Health Policy (PHP), elaborate on the state-of-the-art of PHPs development, and propose a first approach to the modeling and evaluation of PHPs used in a toolkit that is going to support decision making, the Policy Development Toolkit (PDT). METHODS: The policy creation module is a part of the PDT aiming to integrate the results of the rest of the health analytics and policy components. It is the module that selects, filters, and aggregates all relevant information to help policy-makers with the decision making process. The policies creation component is connected to the visualization component to provide the final users with data visualization on different PHPs, including outcomes from data-driven models, such as risk stratification, clinical pathways mining, forecasting or causal analysis models, outcomes from cost-benefit analysis, and suggestions and recommendations from the results of different measured KPIs, using data from the Holistic Health Records (HHRs). RESULTS: In the context of CrowdHEALTH project, PHP can be defined as the decisions taken for actions by those responsible in the public sector that covers a set of actions or inactions that affect a group of public and private actors of the health care system. In the CrowdHEALTH project, the Policy Development Toolkit works as the main interface between the final users and the whole system in the CrowdHEALTH platform. The three components related to policy creation are: (i) the policy modeling component, (ii) the population identification component and (iii) the policy evaluation component. In policy evaluation, KPIs are used as measurable indicators to help prevent ambiguity problems in the interpretation of the model and the structure. CONCLUSIONS: This initial Policy creation component design might be modified during the project life circle according to the concept complexity.

Disseminating Research Outputs: The CrowdHEALTH Project.

INTRODUCTION: Dissemination benefits come from the outputs integration and implementation by the key audience, who will also determine the relevance and usability of the disseminated content. AIM: One of the CrowdHEALTH project's objectives is the transition from patient health records towards the Holistic Health Records (HHRs) and Social HHR. The CrowdHEALTH project aims at integrating high volumes of health-related data collected from various sources to support policy-making decisions. METHODS: The European Federation for Medical Informatics (EFMI) supports the development of an effective Communication and Collaboration Plan identifying the messages, the tools and channels in disseminating the project and its outcomes to the target audience based on the McGuire approach. RESULTS: The process for defining the dissemination strategy is a cyclic one as shown in the following figure involving review of each step periodically The next step was to define the four dimension dissemination approach based on McGuire attributes of persuasive communication. The objectives, target groups, key messages, the tools and channels where defined at this stage. CONCLUSION: The CrowdHEALTH project and its outcomes were disseminated with a variety of tools and channels such as scientific journals, conferences, exhibitions and social media communication.

Generating and Knowledge Framework: Design and Open Specification.

INTRODUCTION: The Information Aggregation (IA) component manages streaming and batch data deriving from a multitude sources in a scalable, efficient and reliable way to create Holistic Health Records (HHRs).Within this context, the IA component combines a number of diverse data sources into a common format and stores information in an available form to be used for analytics, simulations and decision making. AIM: The purpose of this paper is to provide an overview of the CrowdHEALTH project and the technical architecture of the CrowdHEALTH platform in order to put the aforementioned IA mechanism in context. This is followed by the design details and initial specifications of the first prototype of the IA component as well as its relationship with other components. METHODS: The micro-service approach can be used to perform information aggregation and to update HHRs in the CrowdHEALTH platform. Micro-services are a variant of the service-oriented architecture (SOA) where applications are structured as a collection of loosely coupled services with defined interfaces. RESULTS: Within the CrowdHEALTH architecture, the Information Aggregation component is situated between the Interoperability Layer and the CrowdHEALTH Datastore. The Information Aggregation component processes and aggregates interoperable data, before data aggregation in the HHRs and storage in the big datastore of CrowdHEALTH platform. The aggregation functions use big data management techniques and enhance the state of the art in specific areas such as the use of micro-services to perform synchronous aggregation operations on heterogeneous datasets. CONCLUSIONS: Although an initial version of the IA component was presented, the specifications and implementation level details will be further updated during the project's course.

Disseminating Research Findings: The Crowdhealth Paradigm.

The CrowdHEALTH project intends to integrate high volumes of health-related heterogeneous data from multiple sources with the aim of supporting policy making decisions. The European Federation of Medical Informatics supports the development of an effective Communication and Collaboration Plan.A dissemination strategy has been applied for this purpose considering appropriate messages, target audience, tools, and channels to achieve the highest impact and the first results of social media dissemination are presented here.

The Integrated Holistic Security and Privacy Framework Deployed in CrowdHEALTH Project.

INTRODUCTION: Individuals and healthcare providers need to trust that the EHRs are protected and that the confidentiality of their personal information is not at stake. AIM: Within CrowdHEALTH project, a security and privacy framework that ensures confidentiality, integrity, and availability of the data was developed. METHODS: The CrowdHEALTH Security and Privacy framework includes Privacy Enhancing Technologies (PETs) in order to comply with the GDPR EU laws of data protection. CrowdHEALTH deploys OpenID Connect, an authentication protocol to provide flexibility, scalability, and lightweight user authentication as well as the attribute-base access control (ABAC) mechanism which supports creating efficient access control policies. RESULTS: CrowdHEALTH integrates ABAC with OpenID Connect to build an effective and scalable base for end-users' authorization. CrowdHEALTH's security and privacy framework interacts with other CrowdHEALTH's components, for instance the Big Data Platform, that depends on user authentication and authorization. CrowdHEALTH users are able to access the CrowdHEALTH's database based on the result of an ABAC request. Moreover, due to the fact that the CrowdHEALTH system requires proofs during the interactions with data producers of low trust or low reputation level, the requirements for the Trust and Reputation Model have been identified. CONCLUSION: The CrowdHEALTH Integrated Holistic Security and Privacy framework meets the security criteria for an e-health cross-border system, due to the adoption of security mechanisms, such as user authentication, user authorization, access control, data anonymization, trust management and reputation modelling. The implemented framework remains to be tested to ensure its robustness and to evaluate its performance. The holistic security and privacy framework might be adapted during the project's life circle according to new legislations.

Data Sources and Gateways: Design and Open Specification.

INTRODUCTION: With With the proliferation of available ICT services, several sensors and health applications have become ubiquitous, while many applications have been developed to detect certain health conditions and early signs of disease. Currently, all these services operate independently, and the available data is heterogeneous with limited value gained from its exploitation. AIM: The Data Sources and Gateways component aims at providing an abstracted and unified API to support the data accumulation from various sources including healthcare organisations, biosensors, laboratories and mobile applications. Meanwhile it tackles connectivity and communication issues with such information sources. METHODS: The CrowdHEALTH Data Sources and Gateways Service incorporates four main services: The Configuration Service, The DB Connection Handling Service, The File Parsing Service and The RESTful Client Service. RESULTS: The initial version of the component design has built upon the requirements collected from the use case participants acting also as data providers. CONCLUSION: These four services presented in this paper guide the implementation of the first version of the Data Sources and Gateways component software prototype. The Data Sources and Gateways component remains to be evaluated within the context of the project and be enriched in order to meet additional end user needs.

A Framework for Enhancing and Updating Study Programs in Public Health and Medical Informatics Fields in Montenegro.

Montenegro plans to enhance and modernize the curricula and programs in public health fields in line with EU standards and hence the Erasmus-Phelim project developed a framework to develop, implement, and evaluate the education process. A stepwise approach consisting of three dimensions per step was implemented for workshop development. For the evaluation, a train-the-trainer approach was developed and a self-regulation concept consisting of three phases was applied. Semi-structured interviews with the workshop participants were conducted and results suggested that self-regulation is an understandable concept and can be applied as a training and knowledge transfer method.

The CrowdHEALTH project and the Hollistic Health Records: Collective Wisdom Driving Public Health Policies.

INTRODUCTION: With the expansion of available Information and Communication Technology (ICT) services, a plethora of data sources provide structured and unstructured data used to detect certain health conditions or indicators of disease. Data is spread across various settings, stored and managed in different systems. Due to the lack of technology interoperability and the large amounts of health-related data, data exploitation has not reached its full potential yet. AIM: The aim of the CrowdHEALTH approach, is to introduce a new paradigm of Holistic Health Records (HHRs) that include all health determinants defining health status by using big data management mechanisms. METHODS: HHRs are transformed into HHRs clusters capturing the clinical, social and human context with the aim to benefit from the collective knowledge. The presented approach integrates big data technologies, providing Data as a Service (DaaS) to healthcare professionals and policy makers towards a "health in all policies" approach. A toolkit, on top of the DaaS, providing mechanisms for causal and risk analysis, and for the compilation of predictions is developed. RESULTS: CrowdHEALTH platform is based on three main pillars: Data & structures, Health analytics, and Policies. CONCLUSIONS: A holistic approach for capturing all health determinants in the proposed HHRs, while creating clusters of them to exploit collective knowledge with the aim of the provision of insight for different population segments according to different factors (e.g. location, occupation, medication status, emerging risks, etc) was presented. The aforementioned approach is under evaluation through different scenarios with heterogeneous data from multiple sources.