Being familiar with all the benefits of e-Health and the strategic plan for the Slovenian health sector’s informatization, Telekom Slovenia and the Faculty of Medicine from the University of Maribor, along with other partners, have initiated an e-Health project. The project group is developing various e-Health services that are based on modern ICT (information and communications technology) solutions and will be available on several screens. In order to meet the users’ needs and expectations and, consequently, achieve the high acceptance of e-Health services, the user-centered design (UCD) approach was employed in the e-Health project. However, during the research it was found that conventional UCD methods are not completely appropriate for older adults: the target population of the e-Health services. That is why the selected UCD methods were modified and adapted for older adults. The modified UCD methods used in the research study are presented in this paper. Using the results of the adapted UCD methods, a prototype for a service named MedReminder was developed. The prototype was evaluated by a group of 12 study participants. The study participants evaluated the MedReminder service as acceptable with a good potential for a high adoption rate among its target population, i.e., older adults. Full article

In this article, key points are discussed concerning knowledge representation for clinical decision support systems in the domain of physical medicine and rehabilitation. Information models, classifications and terminologies, such as the “virtual medical record” (vMR), the “international classification of functioning, disability and health” (ICF), the “international classification of diseases” (ICD) and the “systematized nomenclature of medicine—clinical terms” (SNOMED CT), are used for knowledge integration and reasoning. A system is described that supports the measuring of functioning status, diversity, prognosis and similarity between patients in the post-acute stage, thus helping health professionals’ prescription of recommendations. Full article

In Norway, it is a national goal to provide more patients with thrombolytic treatment. A referring hospital and a specialist hospital have implemented videoconferencing (VC) equipment to share knowledge and discuss stroke patients, regarding thrombolytic treatment. VC has only been used four times within the 19 months that the service has been available. The objective in this article is to increase the understanding of the contradiction between the need for knowledge-sharing through VC technology, as well as the reasons for low frequency of use when discussing stroke patients. Semi-structured interviews were conducted with 13 professionals. The results illustrate how the technology per se is not the reason for the low frequency use. Health care is shaped by behavior, traditional rules, standards and division of labor. By using cultural historical activity theory (CHAT) as a framework, we illustrate the importance of understanding the historic way of performing an activity to be able to expand the treatment activity in the future. Full article

Smart homes are homes with technologically advanced systems to enable domestic task automation, easier communication, and higher security. As an enabler of health and well-being enhancement, smart homes have been geared to accommodate people with special needs, especially older people. This paper examines the concept of “smart home” in a technologically driven society and its multi-functional contribution to the enhancement of older people’s lives. Discussion then focuses on the challenges in the use of smart homes among older people such as accessibility and ethical issues. Finally, some implications and recommendations are provided. Full article

Little is known about the views of young patients themselves on interactive Web portal services provided by pediatric practitioners. We aimed to explore their perceptions of a real-world diabetes portal that offers facts and contact with peers and practitioners; e.g., discussion forums, blog tools, self-care and treatment information, research updates and news from local practitioners. Twelve young patients (ages 12–21, median 15 years), one boyfriend, 7 mothers and one father each wrote an essay on their experience from use of the portal. Their essays underwent qualitative content analysis. A major theme was “Helping and facilitating daily life with diabetes”, the portal was perceived as a place where contents are interesting, inspiring and may trigger users’ curiosity. There were three subthemes; “Ease of use in my everyday life,” which includes the perception that the portal was perceived as smooth and easy to enter and navigate whenever needed; that information was easy to understand for different groups of users. “Support via an exchange of experience,” includes the ability to contact peers being regarded advantageous. Some said that just reading others’ experiences can be helpful in terms of persevering; children could find peers in the same age group. “Evidence based information,” includes the perception of the portal being a useful and trustworthy source of facts on e.g., physical activity, blood glucose, medical devices, emotional wellbeing, food and nutrition, and other aspects that impact living with diabetes. Young users expressed positive perceptions towards the interactive web portal. Such services seem to have great potential for supporting young patients and significant others - intergrading for confidence. Full article

This article explores the ways in which collaboration between professionals using videoconferencing affects the e-health delivered to patients. In Norway, general practitioners (GPs) and specialists routinely hold videoconferences. Observations of 42 VC meetings, each lasting from 5 to 40 min, were analysed in terms of the interactions. In addition, five semi-structured, face-to-face interviews were conducted, each lasting from 20 to 70 minutes. Statements were selected to illustrate the content of the interactions and how collaborative work affects the delivery of healthcare. Successful collaborative work provides practitioners with a new way of thinking: exchanging information and knowledge between levels of care in order to provide the best treatment for patients locally. The regularity makes the collaborative work a two-way achievement. GPs receive decision support and second opinions, and specialists receive information and opportunities to follow up. How the professionals manage their work (i.e., collaborating) may benefit their patients. The regular use of videoconferencing will furnish professionals with enhanced resources for the meeting of patients’ demands in the future. Regularly informing one another and exchanging knowledge, benefits the professionals by providing increased certainty with regard to their medical decisions, and it benefits the patients because they will feel satisfied with the competence of the specialists where they live. Full article

As the costs of healthcare services rise and healthcare professionals are becoming scarce and hard to find, it is imminent that healthcare organizations consider adopting health information technology (HIT) systems. HIT allows health organizations to streamline many of their processes and provide services in a more efficient and cost-effective manner. The latest technological trends such as Cloud Computing (CC) provide a strong infrastructure and offer a true enabler for HIT services over the Internet. This can be achieved on a pay-as-you-use model of the “e-Health Cloud” to help the healthcare industry cope with current and future demands yet keeping their costs to a minimum. Despite its great potential, HIT as a CC model has not been addressed extensively in the literature. There are no apparent frameworks which clearly encompass all viable schemes and interrelationships between HIT and CC. Therefore, analyzing and comparing the effectiveness of such schemes is important. In this paper we introduce the concept of “e-Health Cloud” highlighting many of its constituents and proposing building an e-health environment and elucidating many of the challenges confronting the success of the e-Health Cloud. We will also discuss different possible solutions to address challenges such as security and privacy. Full article