Studies in Health Technology and Informatics pptx

MEDINFO 2007
Studies in Health Technology and Informatics
This book series was started in 1990 to promote research conducted under the auspices of the EC programmes’
Advanced Informatics in Medicine (AIM) and Biomedical and Health Research (BHR) bioengineering branch.
A driving aspect of international health informatics is that telecommunication technology, rehabilitative technology,
intelligent home technology and many other components are moving together and form one integrated world of
information and communication media. The complete series has been accepted in Medline. Volumes from 2005
onwards are available online.
Series Editors:
Dr. J.P. Christensen, Prof. G. de Moor, Prof. A. Famili, Prof. A. Hasman, Prof. L. Hunter,
Dr. I. Iakovidis, Dr. Z. Kolitsi, Mr. O. Le Dour, Dr. A. Lymberis, Prof. P.F. Niederer,
Prof. A. Pedotti, Prof. O. Rienhoff, Prof. F.H. Roger France, Dr. N. Rossing,
Prof. N. Saranummi, Dr. E.R. Siegel, Dr. P. Wilson, Prof. E.J.S. Hovenga,
Prof. M.A. Musen and Prof. J. Mantas
Volume 129
Recently published in this series
Vol. 128. P.J. Murray, H A. Park, W.S. Erdley and J. Kim (Eds.), Nursing Informatics 2020: Towards Defining Our
Own Future – Proceedings of NI2006 Post Congress Conference
Vol. 127. L. Bos and B. Blobel (Eds.), Medical and Care Compunetics 4
Vol. 126. N. Jacq, H. Müller, I. Blanquer, Y. Legré, V. Breton, D. Hausser, V. Hernández, T. Solomonides and
M. Hofmann-Apitius (Eds.), From Genes to Personalized HealthCare: Grid Solutions for the Life Sciences –
Proceedings of HealthGrid 2007
Vol. 125. J.D. Westwood, R.S. Haluck, H.M. Hoffman, G.T. Mogel, R. Phillips, R.A. Robb and K.G. Vosburgh
(Eds.), Medicine Meets Virtual Reality 15 – in vivo, in vitro, in silico: Designing the Next in Medicine
Vol. 124. A. Hasman, R. Haux, J. van der Lei, E. De Clercq and F.H. Roger France (Eds.), Ubiquity: Technologies for
Better Health in Aging Societies – Proceedings of MIE2006
Vol. 123. D. Uyttendaele and P.H. Dangerfield (Eds.), Research into Spinal Deformities 5
Vol. 122. H A. Park, P. Murray and C. Delaney (Eds.), Consumer-Centered Computer-Supported Care for Healthy
People – Proceedings of NI2006 – The 9th International Congress on Nursing Informatics
Vol. 121. L. Bos, L. Roa, K. Yogesan, B. O’Connell, A. Marsh and B. Blobel (Eds.), Medical and Care Compunetics 3
Vol. 120. V. Hernández, I. Blanquer, T. Solomonides, V. Breton and Y. Legré (Eds.), Challenges and Opportunities of

HealthGrids – Proceedings of Healthgrid 2006
Vol. 119. J.D. Westwood, R.S. Haluck, H.M. Hoffman, G.T. Mogel, R. Phillips, R.A. Robb and K.G. Vosburgh
(Eds.), Medicine Meets Virtual Reality 14 – Accelerating Change in Healthcare: Next Medical Toolkit
Vol. 118. R.G. Bushko (Ed.), Future of Intelligent and Extelligent Health Environment
Vol. 117. C.D. Nugent, P.J. McCullagh, E.T. McAdams and A. Lymberis (Eds.), Personalised Health Management
Systems – The Integration of Innovative Sensing, Textile, Information and Communication Technologies
Vol. 116. R. Engelbrecht, A. Geissbuhler, C. Lovis and G. Mihalas (Eds.), Connecting Medical Informatics and Bio-
Informatics – Proceedings of MIE2005
Vol. 115. N. Saranummi, D. Piggott, D.G. Katehakis, M. Tsiknakis and K. Bernstein (Eds.), Regional Health
Economies and ICT Services
ISSN 0926-9630
MEDINFO 2007
Proceedings of the 12th World Congress on Health (Medical) Informatics
Building Sustainable Health Systems
Part 1
Edited by
Klaus A. Kuhn
University Medical Center, Technische Universität München, Germany
James R. Warren
Department of Computer Science, University of Auckland, New Zealand
and
Tze-Yun Leong
School of Computing, National University of Singapore, Singapore
Amsterdam • Berlin • Oxford • Tokyo • Washington, DC
© 2007 The authors.
All rights reserved. No part of this book may be reproduced, stored in a retrieval system, or transmitted, in any form or by
any means, without prior written permission from the publisher.
ISBN 978-1-58603-774-1
Publisher
IOS Press

Nieuwe Hemweg 6B
1013 BG Amsterdam
Netherlands
fax: +31 20 687 0019
e-mail:
Distributor in the UK and Ireland Distributor in the USA and Canada
Gazelle Books Services Ltd. IOS Press, Inc.
White Cross Mills 4502 Rachael Manor Drive
Hightown Fairfax, VA 22032
Lancaster LA1 4XS USA
United Kingdom fax: +1 703 323 3668
fax: +44 1524 63232 e-mail:
e-mail:
LEGAL NOTICE
The publisher is not responsible for the use which might be made of the following information.
PRINTED IN THE NETHERLANDS
Table of Contents
Editorial xxv
Preface from the Scientific Program Co-Chairs xxvii
Medinfo 2007 Scientific Program Committee xxviii
In Memory of Dr Branko Cesnik
Part 1
Chapter 1. eHealth 1
eHealth Solutions to the Continuity of Care
Linkcare – Enabling Continuity of Care for the Chronically Ill across Levels and Profession 3
Marius Mikalsen, Ståle Walderhaug, Per Håkon Meland and Ole Martin Winnem
Sustainable Ubiquitous Home Health Care – Architectural Considerations and First Practical Experiences 8
Michael Marschollek, Klaus-H. Wolf, Oliver-J. Bott, Mirko Geisler, Maik Plischke, Wolfram Ludwig,
Andreas Hornberger and Reinhold Haux
Do Physicians Take Action on High Risk Family History Information Provided by Patients Outside of a Clinic

Visit? 13
Lynn A. Volk, Maria Staroselsky, Lisa P. Newmark, Hannah Pham, Alexis Tumolo, Deborah H. Williams,
Ruslana Tsurikova, Jeffrey Schnipper, Jonathan Wald and David W. Bates
Sharing Electronic Laboratory Results in a Patient Portal – A Feasibility Pilot 18
Jonathan S. Wald, Karen Burk, Kate Gardner, Raisa Feygin, Elizabeth Nelson, Marianna Epstein,
Eric G. Poon and Blackford Middleton
eHealth Systems Modeling
An Evolving Systems-Based Methodology for Healthcare Planning 23
Jon Warwick and Gary Bell
Model-Centric Approaches for the Development of Health Information Systems 28
Mika Tuomainen, Juha Mykkänen, Heli Luostarinen, Assi Pöyhölä and Esa Paakkanen
Software Engineering Principles Applied to Large Healthcare Information Systems – A Case Report 33
Fabiane Bizinella Nardon and Lincoln de A. Moura Jr.
Towards Modeling and Simulation of Integrated Social and Health Care Services for Elderly 38
Alexander Horsch and Daryoush Khoshsima
Healthcare Delivery Systems: Designing Quality into Health Information Systems 43
Phil Joyce, Rosamund Green and Graham Winch
A Mobile Data Collection Tool for Workflow Analysis 48
Jacqueline Moss, Eta S. Berner and Kathy Savell
Towards Sustainable e-Health Networks: Does Modeling Support Efficient Management and Operation? 53
Martin Staemmler
The openEHR Java Reference Implementation Project 58
Rong Chen and Gunnar Klein
MEDINFO 2007
K. Kuhn et al. (Eds)
IOS Press, 2007
© 2007 The authors. All rights reserved.
v
A Conceptual Model of Computerised Hospital Information System (CHIS) use in South Africa 63
Lyn A. Hanmer, Sedick Isaacs and J. Dewald Roode

Are Problem-Oriented Medial Records (POMR) Suitable for Use in GPs’ Daily Practice? 68
Etienne De Clercq, Viviane Van Casteren, Pascale Jonckheer, Peter Burggraeve, Marie France Lafontaine,
Karen Degroote and Francis Roger France
Can an EPR Support the Concept of Family-Centred, Individualized Developmental Care of Premature
Infants and Newborns? 73
Christian D. Kohl, Claus Schott, Doris Verveur, Otwin Linderkamp and Petra Knaup-Gregori
Multiple Detection Modalities and Disease Natural History of Breast Cancer 78
Tony Hsiu-Hsi Chen, Amy Ming-Fang Yen, Grace Hui-Min Wu, Li-Sheng Chen and Yueh-Hsia Chiu
Care at a Distance
Challenges in Telemedicine and eHealth: Lessons Learned from 20 Years with Telemedicine in Tromsø 82
Gunnar Hartvigsen, Monika A. Johansen, Per Hasvold, Johan Gustav Bellika, Eirik Arsand, Eli Arild,
Deede Gammon, Sture Pettersen and Steinar Pedersen
A Satellite Infrastructure for Health Early Warning in Post-Disaster Health Management 87
C.E. Chronaki, A. Berthier, M.M. Lleo, L. Esterle, A. Lenglet, F. Simon, L. Josseran, M. Lafaye, Y. Matsakis,
A. Tabasco and L. Braak
Remote Support for Stroke Rehabilitation: MyHeart’s “Neurological Rehabilitation” Concept 92
Toni Giorgino, Paolo Tormene, Barbara Cattani, Caterina Pistarini and Silvana Quaglini
Effects of a Computerized Cardiac Teletriage Decision Support System on Nurse Performance: Results
of a Controlled Human Factors Experiment Using a Mid-Fidelity Prototype 97
Kirsten Carroll Somoza, Kathryn Momtahan and Gitte Lindgaard
Mobile Care
Opportunities and Barriers for Mobile Health in New Zealand 102
Farhaan Mirza and Tony Norris
Applying Mobile and Pervasive Computer Technology to Enhance Coordination of Work in a Surgical Ward 107
Thomas Riisgaard Hansen and Jakob E. Bardram
Feasibility and Usability of a Home Monitoring Concept based on Mobile Phones and Near Field
Communication (NFC) Technology 112
Jürgen Morak, Alexander Kollmann and Günter Schreier
Using Personal Digital Assistants and Patient Care Algorithms to Improve Access to Cardiac Care Best
Practices 117

Kathryn L. Momtahan, Catherine M. Burns, Heather Sherrard, Thierry Mesana and Marino Labinaz
Interoperability Issues in eHealth Information Systems
Improving Systems Interoperability with Model-Driven Software Development for HealthCare 122
Ståle Walderhaug, Marius Mikalsen, Gunnar Hartvigsen, Erlend Stav and Jan Aagedal
Conformance Testing of Interoperability in Health Information Systems in Finland 127
Tanja Toroi, Anne Eerola and Juha Mykkänen
Connecting Public Health and Clinical Information Systems by Using a Standardized Methodology 132
Diego M. Lopez and Bernd G.M.E. Blobel
Clinical and Translational Science Sustainability: Overcoming Integration Issues Between Electronic
Health Records (EHR) and Clinical Research Data Management Systems “Separate but Equal” 137
Robert P. DiLaura
Searching for Answers
The FA4CT Algorithm: A New Model and Tool for Consumers to Assess and Filter Health Information
on the Internet 142
Gunther Eysenbach and Maria Thomson
vi
WRAPIN: A Tool for Patient Empowerment Within EHR 147
Michel Joubert, Arnaud Gaudinat, Célia Boyer, Antoine Geissbuhler, Marius Fieschi,
HON Foundation Council members
How do Clinicians Search For and Access Biomedical Literature to Answer Clinical Questions? 152
Annie Y.S. Lau and Enrico Coiera
Emerging Technologies
Blogs, Wikis, and Discussion Forums: Attributes and Implications for Clinical Information Systems 157
Jacob B. Weiss and Thomas R. Campion Jr.
From Intermediation to Disintermediation and Apomediation: New Models for Consumers to Access and
Assess the Credibility of Health Information in the Age of Web2.0 162
Gunther Eysenbach
A Mobile Phone Based Remote Patient Monitoring System For Chronic Disease Management 167
Mathieu Trudel, Joseph A Cafazzo, Melinda Hamill, Walter Igharas, Kevin Tallevi, Peter Picton, Jack Lam,
Peter G. Rossos, Anthony C. Easty and Alexander Logan

Consumer Health Technologies
How to Enhance Integrated Care Towards the Personal Health Paradigm? 172
Bernd G.M.E. Blobel, Peter Pharow and Thomas Norgall
Developing Information Technology Attitude Scales for Health (ITASH) 177
Rod Ward, Katherine Pollard, Margaret Glogowska and Pam Moule
Development of Patient Centric Virtual Organizations (PCVOs) in Clinical Environment for Patient
Information Management 182
Mohyuddin, W.A. Gray, Hazel Bailey, Wendy Jones and David Morrey
SPIRS: A Framework for Content-Based Image Retrieval from Large Biomedical Databases 188
William Hsu, L. Rodney Long and Sameer Antani
The Impact of Clinical Information Systems
The Quality of Reporting of Health Informatics Evaluation Studies: A Pilot Study 193
Jan Talmon, Elske Ammenwerth and Thom Geven
Exploring the Unintended Consequences of Computerized Physician Order Entry 198
Joan S. Ash, Dean F. Sittig, Richard Dykstra, Emily Campbell and Kenneth Guappone
Impact of Health Care Information Technology on Hospital Productivity Growth: A Survey in 17 Acute
University Hospitals 203
Rodolphe Meyer, Patrice Degoulet and Louis Omnes
Risk Management and Measuring Productivity with POAS – Point of Act System 208
Masanori Akiyama and Tatsuya Kondo
eHealth at-Large
Connecting the Dots: Creation of an Electronic Regional Infection Control Network 213
Abel N. Kho, Paul Dexter, Larry Lemmon, Dauna Carey, Heather Woodward-Hagg, Steve Hare and
Brad Doebbeling
Dealing with Ecological Fallacy in Preparations for Influenza Pandemics: Use of a Flexible Environment
for Adaptation of Simulations to Household Structures in Local Contexts 218
Toomas Timpka, Magus Morin, Johan Jenvald, Elin Gursky and Henrik Eriksson
Effectiveness of a Chronic Disease Surveillance Systems for Blood Pressure Monitoring 223
Damian Borbolla, Diego Giunta, Silvana Figar, Mercedes Soriano, Adriana Dawidowski and
Fernan Gonzalez Bernaldo de Quiros

Nurses and Computers. An International Perspective on Nurses’ Requirements 228
Carol S. Bond
vii
Issues in Clinical Care and Research
The Need for Global Certification in the Field of Health Informatics: Some Ethical Issues 233
Eike-Henner W. Kluge
Using Fieldwork in Analyzing Ethical Issues Related to IT in Health Care 237
Ellen Balka, Christine Reidl and Ina Wagner
Handling Consent to Patient Data Access in a Hospital Setting 242
Gunnar René Øie, Herbjørn Andresen and Inger Anne Tøndel
A Day in the Life of a Clinical Research Coordinator: Observations from Community Practice Settings 247
Sharib A. Khan, Rita Kukafka, Philip R.O. Payne, J. Thomas Bigger and Stephen B. Johnson
eHealth System Adoption
A Survey of U.S.A. Acute Care Hospitals’ Computer-Based Provider Order Entry System Infusion Levels 252
Dean F. Sittig, Ken Guappone, Emily M. Campbell, Richard H. Dykstra and Joan S. Ash
E-Healthcare in India: Critical Success Factors for Sustainable Health Systems 257
Udita Taneja, Sushil
Health Information Systems Adoption: Findings from a Systematic Review 262
Maryati Mohd. Yusof, Lampros Stergioulas and Jasmina Zugic
Telemedicine Portal and Standardized Clinical Documents 267
Ivan V. Emelin and Radik A. Eltchiyan
eHealth and Risk Management
The Development of an Information System and Installation of an Internet Web Database for the Purposes
of the Occupational Health and Safety Management System 270
I. Mavrikakis, J. Mantas and M. Diomidous
Reliability Assessment of Home Health Care Services 275
Stergiani Spyrou, Panagiotis Bamidis, Vassilis Kilintzis, Irini Lekka, Nicos Maglaveras and Costas Pappas
From the Description of Activities to the Identification of Risks for Clinical Management: A Proposal of
Building, Merging and Sharing Knowledge Representations of Care Processes 280
Pascal Staccini, Michel Joubert, Rémy Collomp, Jean-François Quaranta and Marius Fieschi

Near-Miss and Hazard Reporting: Promoting Mindfulness in Patient Safety Education 285
Leanne M. Currie, Karen S. Desjardins, Patricia W. Stone, Tsai-ya Lai, Eric Schwartz, Rebecca Schnall and
Suzanne Bakken
Chapter 2. Data Repositories and Information Retrieval 291
Wide Electronic Health Records
A Territory-Wide Electronic Health Record – From Concept to Practicality: The Hong Kong Experience 293
Antonio C.H. Sek, N.T. Cheung, K.M. Choy, W.N. Wong, Anna Y.H. Tong, Vicky H. Fung, Michael Fung
and Eric Ho
Northern Territory HealthConnect: Shared Electronic Health Record Service Implementation Experiences
and Benefits Realised in Indigenous Health 297
Stephen Moo and John Fletcher
A Simulation-Based Performance Analysis of a National Electronic Health Record System 302
Leonidas Orfanidis, Panagiotis D. Bamidis and Barry Eaglestone
Principles-Based Medical Informatics for Success – How Hong Kong Built One of the World’s Largest
Integrated Longitudinal Electronic Patient Records 307
Ngai-Tseung Cheung, Vicky Fung, Wing Nam Wong, Anna Tong, Antonio Sek, Andre Greyling, Nancy Tse
and Hong Fung
viii
Healthcare and Research Data Repositories
Knowledge-Level Querying of Temporal Patterns in Clinical Research Systems 311
Martin J. O’Connor, Ravi D. Shankar, David B. Parrish and Amar K. Das
A Discussion About the Importance of Laws and Policies for Data Sharing for Public Health in the People’s
Republic of China 316
Xiue Fan and Ping Yu
Confidentiality Preserving Audits of Electronic Medical Record Access 320
Bradley Malin and Edoardo Airoldi
Design of a Decentralized Reusable Research Database Architecture to Support Data Acquisition in Large
Research Projects 325
Jimison Iavindrasana, Adrien Depeursinge, Patrick Ruch, Stéphane Spahni, Antoine Geissbuhler and
Henning Müller

Registers and Research
The Cancer Biomedical Informatics Grid (caBIG™): Infrastructure and Applications for a Worldwide
Research Community 330
The caBIG Strategic Planning Workspace
The Integration of Grid Resources into a Portal for Research Collaboratories 335
Yassene Mohammed, Sabine Rey, Fabian Rakebrandt and Ulrich Sax
Biomedical Data Mining in Clinical Routine: Expanding the Impact of Hospital Information Systems 340
Marcel Müller, Kornel Markó, Philipp Daumke, Jan Paetzold, Arnold Roesner and Rüdiger Klar
The Swedish National Pharmacy Register 345
Bengt Astrand, Bo Hovstadius, Karolina Antonov and Göran Petersson
Patient Record Documentation
The Use of Existing Low-Cost Technologies to Enhance the Medical Record Documentation Using a
Summary Patient Record [SPR] 350
S. Bart and T. Hannan
A New Approach in Nursing Documentation: Community Nursing Case 354
Uros Rajkovic, Olga Sustersic, Vladislav Rajkovic and Vesna Prijatelj
A Survey of the Effects of the full Computerized Nursing Records System on Sharing Nursing Records
Among Health Professionals 360
Yukio Kurihara, Naho Asai, Eri Ishimoto, Shigeyuki Kawamata and Satsuki Nakamura
New Method of Realization of Nursing Diagnosis Based on 3N in an Electronic Medical Record System 364
Young ah Kim, Mijung An, Jungyoen Park, Hyensun Jung, Yongoock Kim and Byungchul Chang
Integrated Health Records
Integration of Longitudinal Electronic Records in a Large Healthcare Enterprise: The U.S. Veterans
Health Administration Experience 367
Arthur C. Curtis, Joseph Gillon and Dale C. Malmrose
The AMPATH Medical Record System: Creating, Implementing, and Sustaining an Electronic Medical
Record System to Support HIV/AIDS Care in Western Kenya 372
William M. Tierney, Joseph K. Rotich, Terry J. Hannan, Abraham M. Siika, Paul G. Biondich, Burke W. Mamlin,
Winstone M. Nyandiko, Sylvester Kimaiyo, Kara Wools-Kaloustian, John E. Sidle, Chrispinus Simiyu,
Erika Kigotho, Beverly Musick, Joseph J. Mamlin and Robert M. Einterz

São Paulo City Health Information System – A Case Report 377
Cláudio G.A. Costa, Beatriz F. Leão and Lincoln A. Moura Jr.
Experience in Implementing the OpenMRS Medical Record System to Support HIV Treatment in Rwanda 382
Christian Allen, Darius Jazayeri, Justin Miranda, Paul G. Biondich, Burke W. Mamlin, Ben A. Wolfe,
Chris Seebregts, Neal Lesh, William M. Tierney and Hamish S.F. Fraser
ix
Information Retrieval
Multilingual Information Retrieval in Thoracic Radiology: Feasibility Study 387
Andrộ Coutinho Castilla, Sộrgio Shiguemi Furuie and Eneida A. Mendonỗa
Large-Scale Evaluation of a Medical Cross-Language Information Retrieval System 392
Kornộl Markú, Philipp Daumke, Stefan Schulz, Rỹdiger Klar and Udo Hahn
EHR Query Language (EQL) A Query Language for Archetype-Based Health Records 397
Chunlan Ma, Heath Frankel, Thomas Beale and Sam Heard
Design and Evaluation of a Temporal, Graph-Based Language for Querying Collections of Patient Histories 402
Ole Edsberg, Stein Jakob Nordbứ, Erik Vinnes and ỉystein Nytrứ
Evaluation of a Simple Method for the Automatic Assignment of MeSH Descriptors to Health Resources
in a French Online Catalogue 407
Aurộlie Nộvộol, Suzanne Pereira, Gaetan Kerdelhuộ, Badisse Dahamna, Michel Joubert and Stộfan J. Darmoni
Template-based Data Entry for General Description in Medical Records and Data Transfer to Data
Warehouse for Analysis 412
Yasushi Matsumura, Shigeki Kuwata, Yuichiro Yamamoto, Kazunori Izumi, Yasushi Okada, Michihiro Hazumi,
Sachiko Yoshimoto, Takahiro Mineno, Munetoshi Nagahama, Ayumi Fujii and Hiroshi Takeda
Challenges and Methodology for Indexing the Computerized Patient Record 417
Frộdộric Ehrler, Patrick Ruch, Antoine Geissbuhler and Christian Lovis
Experiments with Hierarchical Concept-Based Search 422
Robert Moskovitch, Roee Sa'adon, Eytan Behiri, Susana Martins, Aviram Weiss and Yuval Shahar
Chapter 3. Sharing Data 427
Data: Standards and Sharing
StructConsult: Structured Real-Time Wet Read Consultation Infrastructure to Support Patient Care 429
Craig Morioka, John David N. Dionisio, Alex Bui, Suzie El-Saden and Hooshang Kangarloo

Refining DICOM for Pathology Progress from the IHE and DICOM Pathology Working Groups 434
Christel Le Bozec, Dominique Henin, Bettina Fabiani, Thomas Schrader, Marcial Garcia-Rojo and Bruce Beckwith
A Generic, Web-Based Clinical Information System Architecture Using HL7 CDA: Successful Implementation
in Dermatological Routine Care 439
Thilo Schuler, Martin Boeker, Rỹdiger Klar and Marcel Mỹller
Analyzing the Key Variables in the Adoption Process of HL7 444
Alejandro E. Flores and Khin Than Win
An XML Model of an Enhanced Data Dictionary to Facilitate the Exchange of Pre-Existing Clinical Research
Data in International Studies 449
Stephany N. Duda, Clint Cushman and Daniel R. Masys
Framework for Clinical Data Standardization Based on Archetypes 454
Jose A. Maldonado, David Moner, Diego Tomỏs, Carlos ngulo, Montserrat Robles and Jesualdo T. Fernỏndez
Reaching Standards for Dissemination: A Case Study 459
Helen Christensen and Kathleen Griffiths
A Discrete Time-Space Geography for Epidemiology: From Mixing Groups to Pockets of Local Order in
Pandemic Simulations 464
Einar Holm and Toomas Timpka
Data: Transfer and Technical Standards
A National Study of eHealth Standardization in Finland Goals and Recommendations 469
Juha Mykkọnen, Maritta Korhonen, Jari Porrasmaa, Tuula Tuomainen and Antero Ensio
x
Building a Womb-to-Tomb Health Record in Hong Kong – An Application of Information Architecture 474
Vicky Fung, N.T. Cheung, Eric Ho, Clara Cheung, Hudson Chan, Kitty Tsang, Joycelyne Cheung, William Ho,
Maggie Lau, Veronica Hung, Austen Wong, Anna Tong, W.N. Wong and Antonio Sek
Another HISA – The New Standard: Health Informatics – Service Architecture 478
Gunnar O. Klein, Pier Angelo Sottile and Frederik Endsleff
Sharing Data
Protecting Privacy While Sharing Medical Data Between Regional Healthcare Entities 483
Tyrone Grandison, Srivatsava Ranjit Ganta, Uri Braun and James Kaufman
Pulling Back the Covers: Technical Lessons of a Real-World Health Information Exchange 488

Atif Zafar and Brian E. Dixon
Geographically Distributed Complementary Content-Based Image Retrieval Systems for Biomedical Image
Informatics 493
Sameer K. Antani, Thomas M. Deserno, L. Rodney Long and George R. Thoma
Utilizing SELinux to Mandate Ultra-Secure Access Control of Medical Records 498
Peter R. Croll, Matt Henricksen, Bill Caelli and Vicky Liu
Secure Data Transmission
Proposal of a French Health Identification Number Interoperable at the European Level 503
Catherine Quantin, François-André Allaert, Paul Avillach, Benoît Riandeye Marius Fieschi, Maniane Fassa
and Olivier Cohen
Clearinghouse: A Teleradiology Platform Emphasizing Security of Data and Communication 508
Michael Spitzer, Lars Brinkmann and Frank Ueckert
K-Box: Automatic Structuring and Exchange of Medical Documents Based on the Clinical Documentation
Architecture (CDA) 513
Minh H. Doan, Paul-Ludwig Lott, Marek Václavík and Frank Ueckert
Chapter 4. Medical Knowledge, Ontologies and Terminologies 517
Understanding Natural Language
Using Distributional Analysis to Semantically Classify UMLS Concepts 519
Jung-Wei Fan, Hua Xu and Carol Friedman
A Reappraisal of Sentence and Token Splitting for Life Sciences Documents 524
Katrin Tomanek, Joachim Wermter and Udo Hahn
Corpus-Based Error Detection in a Multilingual Medical Thesaurus 529
Roosewelt L. Andrade, Edson Pacheco, Pindaro S. Cancian, Percy Nohama and Stefan Schulz
Defining Medical Words: Transposing Morphosemantic Analysis from French to English 535
Louise Deléger, Fiammetta Namer and Pierre Zweigenbaum
Finding Malignant Findings from Radiological Reports Using Medical Attributes and Syntactic Information 540
Takeshi Imai, Eiji Aramaki, Masayuki Kajino, Kengo Miyo, Yuzo Onogi and Kazuhiko Ohe
A Normalized Lexical Lookup Approach to Identifying UMLS Concepts in Free Text 545
Vijayaraghavan Bashyam, Guy Divita, David B. Bennett, Allen C. Browne and Ricky K. Taira
Extracting Subject Demographic Information from Abstracts of Randomized Clinical Trial Reports 550

Rong Xu, Yael Garten, Kaustubh S. Supekar, Amar K. Das, Russ B. Altman and Alan M. Garber
Coupling Ontology Driven Semantic Representation with Multilingual Natural Language Generation for
Tuning International Terminologies 555
Anne-Marie Rassinoux, Robert H. Baud, Jean-Marie Rodrigues, Christian Lovis and Antoine Geissbühler
xi
Discovering New Biomedical Knowledge: Machine Learning and Data Mining
Biomedical Knowledge Discovery with Topological Constraints Modeling in Bayesian Networks:
A Preliminary Report 560
Guoliang Li and Tze-Yun Leong
Automatic Infection Detection System 566
Ove Granberg, Johan Gustav Bellika, Eirik Årsand and Gunnar Hartvigsen
Risk Stratification for LDL Cholesterol Using Induction Technique 571
Seung Hee Ho, Hyun Young Park, Yang Soo Jang and Sun Ha Jee
Results from Data Mining in a Radiology Department: The Relevance of Data Quality 576
Martin Lang, Nanda Kirpekar, Thomas Bürkle, Susanne Laumann and Hans-Ulrich Prokosch
Evaluating Learning Models with Transitions of Human Interests Based on Objective Rule Evaluation Indices 581
Hidenao Abe, Hideto Yokoi, Shusaku Tsumoto, Miho Ohsaki and Takahira Yamaguchi
An Automated Data Pattern Translation Process for Medical Data Mining 586
Anna Shillabeer
A Data Mining Approach to Analyze Non-Compliance with a Guideline for the Treatment of Breast Cancer 591
Amir R. Razavi, Hans Gill, Hans Åhlfeldt and Nosrat Shahsavar
Bayesian Networks for Multivariate Data Analysis and Prognostic Modelling in Cardiac Surgery 596
Niels Peek, Marion Verduijn, Peter M.J. Rosseel, Evert de Jonge and Bas A. de Mol
Role of Syndromic Management Using Dynamic Machine Learning in Future of e-Health in Pakistan 601
Aijaz Qadir Patoli
Classification Systems
Combining Lexical and Semantic Methods of Inter-Terminology Mapping Using the UMLS 605
Kin Wah Fung, Olivier Bodenreider, Alan R. Aronson, William T. Hole and Suresh Srinivasan
Biomedical Vocabularies – The Demand for Differentiation 610
Josef Ingenerf and Siegfried J. Pöppl

Development of a Taxonomy for Health Information Technology 616
Brian E. Dixon, Atif Zafar and Julie J. McGowan
A Practical Approach to Advanced Terminology Services in Health Information Systems 621
Maria Laura Gambarte, Alejandro Lopez Osornio, Marcela Martinez, Guillermo Reynoso, Daniel Luna and
Fernan Gonzalez Bernaldo de Quiros
SNOMED Terminology
Toward the Interoperability of HL7 v3 and SNOMED CT: A Case Study Modeling Mobile Clinical Treatment 626
Amanda Ryan, Peter Eklund and Brett Esler
A Web-Based SNOMED CT Browser: Distributed and Real-Time Use of SNOMED CT During the Clinical
Research Process 631
Rachel Richesson, Asif Syed, Heather Guillette, Mark S. Tuttle and Jeffrey Krischer
Using SNOMED CT
®
as a Reference Terminology to Cross Map Two Highly Pre-Coordinated Classification
Systems 636
Steven H. Brown, Casey S. Husser, Dietlind Wahner-Roedler, Sandra Bailey, Linda Nugent, Karla Porter,
Brent A. Bauer and Peter L. Elkin
Practical Issues in Using SNOMED CT as a Reference Terminology 640
Senthil K. Nachimuthu and Lee Min Lau
Issues in Terminology Management
Statistical Selector of the Best Multiple ICD-coding Method 645
Eiji Aramaki, Takeshi Imai, Masayuki Kajino, Kengo Miyo and Kazuhiko Ohe
xii
Creation and Evaluation of a Terminology Server for the Interactive Coding of Discharge Summaries 650
Hernán Navas, Alejandro Lopez Osornio, Analía Baum, Adrian Gomez, Daniel Luna and
Fernan Gonzalez Bernaldo de Quiros
Thesaurus Anomaly Detection by User Action Monitoring 655
Jeferson L. Bitencourt, Píndaro S. Cancian, Edson J. Pacheco, Percy Nohama and Stefan Schulz
Harmonizing Clinical Terminologies: Driving Interoperability in Healthcare 660
Russell A. Hamm, Sarah E. Knoop, Peter Schwarz, Aaron D. Block and Warren L. Davis IV

Semantic Issues in Healthdata Classification
A New Machine Learning Classifier for High Dimensional Healthcare Data 664
Rema Padman, Xue Bai and Edoardo M. Airoldi
Structuring of Free-Text Diagnostic Report 669
Hirofumi Fujii, Hiromasa Yamagishi, Yutaka Ando, Nobuhiro Tsukamoto, Osamu Kawaguchi,
Tomotaka Kasamatsu, Kaoru Kurosaki, Masakazu Osada, Hiroshi Kaneko and Atsushi Kubo
Semantic Issues in Integrating Data from Different Models to Achieve Data Interoperability 674
Rahil Qamar and Alan Rector
Medication Reconciliation Using Natural Language Processing and Controlled Terminologies 679
James J. Cimino, Tiffani J. Bright and Jianhua Li
Biomedical Text Mining and Standard Terminology
Comparing Medical Code Usage with the Compression-Based Dissimilarity Measure 684
Thomas Brox Røst, Ole Edsberg, Anders Grimsmo and Øystein Nytrø
A Scale-Free Network View of the UMLS to Learn Terminology Translations 689
Chintan O. Patel and James J. Cimino
Assigning Categorical Information to Japanese Medical Terms Using MeSH and MEDLINE 694
Yuzo Onogi
PharmARTS: Terminology Web Services for Drug Safety Data Coding and Retrieval 699
Iulian Alecu, Cédric Bousquet, Patrice Degoulet and Marie-Christine Jaulent
Machine Learning Approach for Automatic Quality Criteria Detection of Health Web Pages 705
Arnaud Gaudinat, Natalia Grabar and Célia Boyer
Using Discourse Analysis to Improve Text Categorization in MEDLINE 710
Patrick Ruch, Antoine Geissbühler, Julien Gobeill, Frederic Lisacek, Imad Tbahriti, Anne-Lise Veuthey and
Alan R. Aronson
A Comparison of Impact Factor, Clinical Query Filters, and Pattern Recognition Query Filters in Terms
of Sensitivity to Topic 716
Lawrence D. Fu, Lily Wang, Yindalon Aphinyanagphongs and Constantin F. Aliferis
A Method for Defining a Journal Subset for a Clinical Discipline Using the Bibliographies of Systematic
Reviews 721
Nancy L. Wilczynski, Amit X. Garg, R. Brian Haynes, for the Nephrology Hedges Team

Ontologies
Aequus Communis Sententia: Defining Levels of Interoperability 725
Peter L. Elkin, David Froehling, Brent A. Bauer, Dietlind Wahner-Roedler, S. Trent Rosenbloom, Kent Bailey
and Steven H. Brown
What’s in a code? Towards a Formal Account of the Relation of Ontologies and Coding Systems 730
Alan L. Rector
A Road from Health Care Classifications and Coding Systems to Biomedical Ontology: The CEN Categorial
Structure for Terminologies of Human Anatomy: Catanat 735
J.M. Rodrigues, C. Rosse, M. Fogelberg, A. Kumar and B. Trombert Paviot
xiii
The Nodes Focusing Tool for Clinical Course Data of Hypergraph Structure in the Ontological Framework
CSX Output from POMR-Based EMR system 741
Yasuyuki Hirose, Ryuichi Yamamoto and Shinichiro Ueda
Ontology Based Modeling
Integrating Descriptive, Functional and Cooperative Aspects in a Domain Ontology to Computerize Home
Care Charts 746
N. Bricon-Souf, S. Ngom and S. Hamek
The ICNP-BaT – A Multilingual Web-Based Tool to Support the Collaborative Translation of the
International Classification for Nursing Practice (ICNP) 751
Ulrich Schrader, Peter Tackenberg, Rudolf Widmer, Lucien Portenier and Peter König
Ontology Based Modeling of Pandemic Simulation Scenarios 755
Henrik Eriksson, Magnus Morin, Johan Jenvald, Elin Gursky, Einar Holm and Toomas Timpka
An Ontology-Based Model of Clinical Information 760
Thomas Beale and Sam Heard
Terminologies
Creation of a Local Interface Terminology to SNOMED CT 765
Alejandro Lopez Osornio, Daniel Luna, Maria Laura Gambarte, Adrian Gomez, Guillermo Reynoso and
Fernán González Bernaldo de Quirós
A Feasibility Study on Clinical Templates for the National Health Service in Scotland 770
Derek Hoy, Nicholas R. Hardiker, Ian T. McNicoll and Phil Westwell

Keeping Up with Changing Source System Terms in a Local Health Information Infrastructure: Running
to Stand Still 775
Daniel J. Vreeman
The Role of Local Terminologies in Electronic Health Records. The HEGP Experience 780
Christel Daniel-Le Bozec, Olivier Steichen, Thierry Dart and Marie-Christine Jaulent
Representing Biomedical Knowledge: Ontologies
Ontology-Based Knowledge Base Model Construction-OntoKBCF 785
Xia Jing, Stephen Kay, Nicholas Hardiker and Tom Marley
Integrating Biological Pathways in Disease Ontologies 791
Julie Chabalier, Jean Mosser and Anita Burgun
Reconciliation of Ontology and Terminology to Cope with Linguistics 796
Robert H. Baud, Werner Ceusters, Patrick Ruch, Anne-Marie Rassinoux, Christian Lovis and Antoine Geissbühler
SNOMED CT’s Problem List: Ontologists’ and Logicians’ Therapy Suggestions 802
Stefan Schulz, Boontawee Suntisrivaraporn and Franz Baader
Automatic Checking of the Correctness of Clinical Guidelines in GLARE 807
Paolo Terenziani, Luca Anselma, Alessio Bottrighi, Laura Giordano and Stefania Montani
Knowledge Zone: A Public Repository of Peer-Reviewed Biomedical Ontologies 812
Kaustubh Supekar, Daniel Rubin, Natasha Noy and Mark Musen
PICO Linguist and BabelMeSH: Development and Partial Evaluation of Evidence-Based Multilanguage
Search Tools for MEDLINE/PubMed 817
Paul Fontelo, Fang Liu, Sergio Leon, Abrahamane Anne and Michael Ackerman
Lessons Learned from Cross-Validating Alignments Between Large Anatomical Ontologies 822
Songmao Zhang and Olivier Bodenreider
Subject Index I
Author Index IX
xiv
Part 2
Chapter 5. Decision Support and Workflow 827
Decision Support at the Point of Care: Clinical Guidelines
How Updating Textual Clinical Practice Guidelines Impacts Clinical Decision Support Systems: A Case

Study with Bladder Cancer Management 829
Jacques Bouaud, Brigitte Séroussi, Ambre Brizon, Thibault Culty, France Mentré and Vincent Ravery
Improving Compliance to Guidelines Through Workflow Technology: Implementation and Results in a
Stroke Unit 834
Silvia Panzarasa, Silvana Quaglini, Giuseppe Micieli, Simona Marcheselli, Mauro Pessina, Corrado Pernice,
Anna Cavallini and Mario Stefanelli
Towards a Decision Support System for Optimising Clinical Pathways of Elderly Patients in an Emergency
Department 840
Marc Cuggia, Delphine Rossille, Aude Arnault, Jacques Bouget and Pierre Le Beux
Ontology-Based Modeling of Clinical Practice Guidelines: A Clinical Decision Support System for Breast
Cancer Follow-Up Interventions at Primary Care Settings 845
Samina R. Abidi, Syed S.R. Abidi, Sajjad Hussain and Mike Shepherd
Learning Causal and Predictive Clinical Practice Guidelines from Data 850
Subramani Mani, Constantin Aliferis, Shanthi Krishnaswami and Theodore Kotchen
Supporting Therapy Selection in Computerized Clinical Guidelines by Means of Decision Theory 855
Stefania Montani, Paolo Terenziani and Alessio Bottrighi
Development, Deployment and Usability of a Point-of-Care Decision Support System for Chronic Disease
Management Using the Recently-Approved HL7 Decision Support Service Standard 861
David F. Lobach, Kensaku Kawamoto, Kevin J. Anstrom, Michael L. Russell, Peter Woods and Dwight Smith
The TAR Model: Use of Therapeutic State Transitions for Quality Assurance Reporting in Chronic Disease
Management 866
R. Gaikwad, J. Warren and T. Kenealy
Decision Support in Health Information Systems
Development of Case-Based Medication Alerting and Recommender System: A New Approach to
Prevention for Medication Error 871
Kengo Miyo, Yuki S. Nittami, Yoichiro Kitagawa and Kazuhiko Ohe
Is the Future Evidence-Based? 875
Ben W.I. Sissons, W. Alex Gray, Tony Bater and Dave Morrey
Comparing Decision Support Methodologies for Identifying Asthma Exacerbations 880
Judith W. Dexheimer, Laura E Brown, Jeffrey Leegon and Dominik Aronsky

Decision Support at the Point of Care: Enhancing Patient Safety
Analysis and Redesign of a Knowledge Database for a Drug-Drug Interactions Alert System 885
Daniel Luna, Victoria Otero, Daniela Canosa, Sergio Montenegro, Paula Otero and
Fernan Gonzalez Bernaldo de Quirós
Closing the Loop: Bringing Decision Support Clinical Data at the Clinician Desktop 890
Claudine Bréant, Francois Borst, René Nkoulou, Olivier Irion and Antoine Geissbuhler
Are Clinicians’ Information Needs and Decision Support Affected by Different Models of Care?
Experimental Study 895
Vitali Sintchenko, Tim Usherwood and Enrico Coiera
Modeling and Acquisition of Drug-Drug Interaction Knowledge 900
Frédéric Mille, Patrice Degoulet and Marie-Christine Jaulent
xv
Activity Modeling
A Systems Development Life Cycle Approach to Patient Journey Modeling Projects 905
Joanne M. Curry, Carolyn McGregor and Sally Tracy
The Nurse—Patient Trajectory Framework 910
Gregory L. Alexander
System Analysis and Improvement in the Process of Transplant Patient Care 915
Catherine J. Staes, R. Scott Evans, Scott P. Narus, Stanley M. Huff and John B. Sorensen
St Elsewhere’s or St Everywhere’s: Improving Patient Throughput in the Private Hospital Sector 920
Jennifer A. Laffey and Moran Wasson
Clinical Guidelines and Protocols
A Meta Schema for Evidence Information in Clinical Practice Guidelines as a Basis for Decision-Making 925
Katharina Kaiser, Patrick Martini, Silvia Miksch and Alime Öztürk
Creating Interoperable Guidelines: Requirements of Vocabulary Standards in Immunization Decision Support 930
Karen M. Hrabak, James R. Campbell, Samson W. Tu, Robert McClure and Robert (Tony) Weida
Automatic Treatment of Temporal Issues in Clinical Guidelines in the GLARE System 935
Luca Anselma, Paolo Terenziani, Stefania Montani and Alessio Bottrighi
Chapter 6. Improving Quality 941
Optimal Order Entry

Information and Communication Processes in the Microbiology Laboratory – Implications for Computerised
Provider Order Entry 943
Andrew Georgiou, Joanne Callen, Johanna Westbrook, Mirela Prgomet and George Toouli
Using an Accident Model to Design Safe Electronic Medication Management Systems 948
Farah Magrabi, Geoff McDonnell, Johanna I. Westbrook and Enrico Coiera
Securing Chemotherapies: Fabrication, Prescription, Administration and Complete Traceability 953
Stéphane Spahni, Christian Lovis, Monique Ackermann, Nicolas Mach, Pascal Bonnabry and Antoine Geissbuhler
Multitasking by Clinicians in the Context of CPOE and CIS Use 958
Sarah Collins, Leanne Currie, Vimla Patel, Suzanne Bakken and James J. Cimino
Supporting the Care of Patients with Cancer
Diffusion of Electronic Health Records – Six Years of Empirical Data 963
Christian Nøhr, Stig Kjær Andersen, Knut Bernstein, Morten Bruun-Rasmussen and Søren Vingtoft
Text Categorization Models for Identifying Unproven Cancer Treatments on the Web 968
Yin Aphinyanaphongs and Constantin Aliferis
Currency of Online Breast Cancer Information 973
Funda Meric-Bernstam, Muhammad Walji, Smitha Sagaram, Deepak Sagaram and Elmer Bernstam
Children’s Contributions to Designing a Communication Tool for Children with Cancer 977
Cornelia M. Ruland, Laura Slaughter, Justin Starren, Torun M. Vatne and Elisabeth Y. Moe
Extending Care
“It’s Your Game”: An Innovative Multimedia Virtual World to Prevent HIV/STI and Pregnancy in Middle
School Youth 983
Ross Shegog, Christine Markham, Melissa Peskin, Monica Dancel, Charlie Coton and Susan Tortolero
HeartCareII: Home Care Support for Patients with Chronic Cardiac Disease 988
Patricia Flatley Brennan, Gail Casper, Susan Kossman and Laura Burke
xvi
A Web-Based Communities of Practice Support System for Caregivers 993
Shirley L. Fenton, H. Dominic Covvey, Douglas W. Mulholland, Donald D. Cowan, Judith Shamian and
Bonnie Schroeder
Core Features of a Parent-Controlled Pediatric Medical Home Record 997
Roberto A. Rocha, Alfred N. Romeo and Chuck Norlin

Improving Quality
Empowering Patients to Improve the Quality of Their Care: Design and Implementation of a Shared Health
Maintenance Module in a US Integrated Healthcare Delivery Network 1002
Eric G. Poon, Jonathan Wald, Jeffrey L. Schnipper, Richard Grant, Tejal K. Gandhi, Lynn A. Volk, Amy Bloom,
Deborah H. Williams, Kate Gardner, Marianna Epstein, Lisa Nelson, Alex Businger, Qi Li, David W. Bates and
Blackford Middleton
Clinical Communication Ontology for Medical Errors 1007
Yang Gong, Min Zhu, Jun Li, James P. Turley and Jiajie Zhang
u-SHARE: Web-Based Decision Support / Risk Communication Tool for Healthcare Consumers with
Unruptured Intracranial Aneurysms 1012
N. Aoki, M. Sakai, T. Nakayama, S. Fukuhara, S. Ohta, N. Kikuchi, M. Oishi, T. Kiuchi, K. Nozaki and
N. Hashimoto
Health On the Net Foundation: Assessing the Quality of Health Web Pages All Over the World 1017
Célia Boyer, Arnaud Gaudinat, Vincent Baujard and Antoine Geissbühler
Accurate Drug Prescribing
The Use of Electronic Medication Reconciliation to Establish the Predictors of Validity of Computerized
Medication Records 1022
Alexander Turchin, Tejal K. Gandhi, Christopher M. Coley, Maria Shubina and Carol Broverman
Evaluation of an Electronic Medication Reconciliation System in Inpatient Setting in an Acute Care Hospital 1027
Abha Agrawal, Winfred Wub and Israel Khachewatsky
Computerized Management of Chronic Anticoagulation: Three Years of Experience 1032
Beatriz H. Rocha, Laura H. Langford and Steven Towner
Physicians’ Response to Guided Geriatric Dosing: Initial Results from a Randomized Trial 1037
Josh F. Peterson, Benjamin P. Rosenbaum, Lemuel R. Waitman, Ralf Habermann, James Powers, Debbie Harrell
and Randolph A. Miller
Chapter 7. Usability 1041
Optimising User Interfaces
Graphical Overview and Navigation of Electronic Health Records in a Prototyping Environment Using
Google Earth and openEHR Archetypes 1043
Erik Sundvall, Mikael Nyström, Mattias Forss, Rong Chen, Håkan Petersson and Hans Åhlfeldt

Which Parts of a Clinical Process EPR Needs Special Configuration 1048
Anders Barlach and Jesper Simonsen
User Driven, Evidence Based Experimental Design: A New Method for Interface Design Used to Develop
an Interface for Clinical Overview of Patient Records 1053
Niels Boye, Frey Eberholst, Richard Farlie, Lene B. Sørensen and Karen Marie Lyng
User Interface Optimization for an Electronic Medical Record System 1058
Kai Zheng, Rema Padman and Michael P. Johnson
Cognitive Systems
AdaRTE: Adaptable Dialogue Architecture and Runtime Engine. A New Architecture for Health-Care
Dialogue Systems 1063
L.M. Rojas-Barahona and T. Giorgino
xvii
Multi-Channel Physiological Sensing of Human Emotion: Insights into Emotion-Aware Computing Using
Affective Protocols, Avatars and Emotion Specifications 1068
Panagiotis D. Bamidis, Andrej Luneski, Ana Vivas, Christos Papadelis, Nicos Maglaveras and Costas Pappas
A Framework for Cognitive Monitoring Using Computer Game Interactions 1073
Holly B. Jimison, Misha Pavel, Payton Bissell and James McKanna
Mobile Phone Computing for In-situ Cognitive Behavioral Therapy 1078
Magnus Bang, Toomas Timpka, Henrik Eriksson, Einar Holm and Conny Nordin
User Perception and Acceptance
Methods for Measuring the Impact of Health Information Technologies on Clinicians’ Patterns of Work
and Communication 1083
Johanna I. Westbrook, Amanda Ampt, Margaret Williamson, Ken Nguyen and Leanne Kearney
Enhancing User Acceptance of Mandated Mobile Health Information Systems: The ePOC
(electronic Point-Of-Care Project) Experience 1088
Lois Burgess and Jason Sargent
When Usage and User Satisfaction Differ: The Case of an Electronic Discharge Summary 1093
Thomas Bürkle and Philip A. Engel
Mapping Clinicians’ Perceptions About Computerized Protocol Use to an IT Implementation Framework 1098
Shobha Phansalkar, Katherine A. Sward, Charlene R. Weir and Alan H. Morris

Usability
e-Health in Scotland: Setting a Baseline for Stakeholder Alignment 1102
Sharon Levy, Anne Casey and Alison Wallis
Usability of Institutional Cancer Web Sites: An Italian Case Study 1106
M. Cristina Mazzoleni, Raffaella Butera, Franco Corbella, Vittoria Balcet and Enrico Masenga
Investigating Internet Use by Mental Health Service Users: Interview Study 1112
John Powell and Aileen Clarke
Text Characteristics of Clinical Reports and Their Implications for the Readability of Personal Health
Records 1117
Qing Zeng-Treitler, Hyeoneui Kim, Sergey Goryachev, Alla Keselman, Laura Slaughter and
Catherine Arnott Smith
Advances in User Interface
Generic Screen Representations for Future Proof Systems – Is It Possible? Two-Model Approach to a
Generic GUI 1122
Helma van der Linden, Thilo Schuler, Rong Chen and Jan Talmon
Speech Recognition in Dental Software Systems: Features and Functionality 1127
Jeannie Yuhaniak Irwin, Shawn Fernando, Titus Schleyer and Heiko Spallek
Assessing the Impact of Recording Quality Target Data on the GP Consultation Using Multi-Channel Video 1132
Maigaelle V. Moulene, Simon de Lusignan, George Freeman, Jeremy van Vlymen, Ian Sheeler,
Andrew Singleton and Pushpa Kumarapeli
Chapter 8. Sustainability 1137
Sustainability: Government Policy and Initiatives
Sustainable Health Systems: Addressing Three Key Areas 1139
Prajesh N. Chhanabhai, Alec Holt and George Benwell
Locating Nursing Classification Schemes Within Health Information Strategies for New Zealand 1144
Shona K. Wilson and Jan Duke
xviii
SHARE, from Vision to Road Map: Technical Steps 1149
Mark Olive, Hanene Rahmouni, Tony Solomonides, Vincent Breton, Yannick Legré, Ignacio Blanquer
and Vicente Hernandez

Penetration and Adoption of Health Information Technology (IT) in Thailand’ s Community Health
Centers (CHCs): A National Survey 1154
Boonchai Kijsanayotin, Supasit Pannarunothai and Stuart Speedie
Sustainability: Disaster Planning and Public Health
The Health Informatics Center of Acadiana – Informing Health Policymaking in Post-Katrina/Rita Louisiana 1159
L. Philip Caillouet
Informatics Solutions for Emergency Planning and Response 1164
Elizabeth E. Weiner and Patricia A. Trangenstein
A Multidiscipline Conceptual Framework for Consumer Health Informatics 1169
Robert A. Logan and Tony Tse
Sustainable Health Systems
A Japanese Model of Disease Management 1174
Naoki Nakashima, Kunihisa Kobayashi, Toyoshi Inoguchi, Daisuke Nishida, Naomi Tanaka,
Hiromi Nakazono, Akihiko Hoshino, Hidehisa Soejima, Ryoichi Takayanagi and Hajime Nawata
Towards Sustainability of Health Information Systems: How Can We Define, Measure and Achieve It? 1179
Sebastian Garde, Carola M. Hullin, Rong Chen, Thilo Schuler, Jana Gränz, Petra Knaup and Evelyn J.S. Hovenga
Bermuda Triangle or Three to Tango: Generation Y, e-Health and Knowledge Management 1184
Kwang Chien Yee
Health Service Organisations and Professionals: An Information Systems Model for Transforming the Nexus
Between Accreditation and Practice 1189
Jo-Anne Kelder
Health Informatics: An Intercultural Perspective 1194
Quynh Lê
Sustainable Systems: Design Success
Successful Systems Sustaining Change 1199
Sheila Bullas and John Bryant
MUST – A Participatory Method for Designing Sustainable Health IT 1204
Finn Kensing, Hrönn Sigurdardottir and Arjen Stoop
Change Management and the Sustainability of Health ICT Projects 1209
Karen Day and Tony Norris

A Sustainability View on the EPR System of N.N. Burdenko Neurosurgical Institute 1214
Michael A. Shifrin, Elena E. Kalinina and Eugene D. Kalinin
Chapter 9. Genomics 1217
Representing Biomedical Knowledge: Ontologies and Genomic Data Repositories
Predicting Coronary Artery Disease with Medical Profile and Gene Polymorphisms Data 1219
Qiongyu Chen, Guoliang Li, Tze-Yun Leong and Chew-Kiat Heng
Towards a Top-Domain Ontology for Linking Biomedical Ontologies 1225
Holger Stenzhorn, Elena Beißwanger and Stefan Schulz
The Molecular Medicine Informatics Model (MMIM) 1230
Marienne Hibbert, Peter Gibbs, Terence O’Brien, Peter Colman, Robert Merriel, Naomi Rafael and
Michael Georgeff
xix
Cancer Genomics Object Model: An Object Model for Multiple Functional Genomics Data for Cancer
Research 1235
Yu Rang Park, Hye Won Lee, Sung Bum Cho and Ju Han Kim
Algorithms for Genomic and Genetic Data Analysis
Automatic Pedigree Reconstruction for Genetic Studies in Isolated Populations 1240
C. Larizza, I. Buetti, G. Milani, A. Nuzzo, C. Sala, D. Toniolo and R. Bellazzi
Enhancing the Quality of Phylogenetic Analysis Using Fuzzy Hidden Markov Model Alignments 1245
Chrysa Collyda, Sotiris Diplaris, Pericles Mitkas, Nicos Maglaveras and Costas Pappas
Determining Transcription Factor Activity from Microarray Data Using Bayesian Markov Chain Monte
Carlo Sampling 1250
Andrew V. Kossenkov, Aidan J. Peterson and Michael F. Ochs
Ensemble Stump Classifiers and Gene Expression Signatures in Lung Cancer 1255
Lewis Frey, Mary Edgerton, Douglas Fisher and Shawn Levy
Algorithms and Research Frameworks for Genomics
From “Glycosyltransferase” to “Congenital Muscular Dystrophy”: Integrating Knowledge from NCBI
Entrez Gene and the Gene Ontology 1260
Satya S. Sahoo, Kelly Zeng, Olivier Bodenreider and Amit Sheth
Building a Research Model for Human Genetic Variation Knowledge Management 1265

Yulong Gu and James Warren
ECTracker – An Efficient Algorithm for Haplotype Analysis and Classification 1270
Li Lin, Limsoon Wong, Tze-Yun Leong and Pohsan Lai
A Dynamic Query System for Supporting Phenotype Mining in Genetic Studies 1275
Angelo Nuzzo, Daniele Segagni, Giuseppe Milani, Carla Rognoni and Riccardo Bellazzi
Chapter 10. Biomedical Image and Signal Processing 1281
Biomedical Signal Interpretation
Identifying QT Prolongation from ECG Impressions Using Natural Language Processing and Negation
Detection 1283
Joshua C. Denny and Josh F. Peterson
A Comparison of Supervised Classification Methods for Auditory Brainstem Response Determination 1289
Paul McCullagh, Haiying Wang, Huiru Zheng, Gaye Lightbody and Gerry McAllister
Non-Linear Analysis for the Sleepy Drivers Problem 1294
Ioanna Chouvarda, Christos Papadelis, Chrysoula Kourtidou-Papadeli, Panagiotis D. Bamidis,
Dimitris Koufogiannis, Evaggelos Bekiaris and Nikos Maglaveras
Identification and Genotype Related Classification of Children with Long QT-Syndrome Using 24h
Holter Recordings 1299
Matthias Bauch, Annamaria Siegler, Markus Khalil, Jörg Zehelein, Herbert E. Ulmer and Hartmut Dickhaus
Information Visualisation and Imaging Informatics
Temporal Abstraction and Data Mining with Visualization of Laboratory Data 1304
Katsuhiko Takabayashi, Tu Bao Ho, Hideto Yokoi, Trong Dung Nguyen, Saori Kawasaki, Si Quang Le,
Takahiro Suzuki and Osamu Yokosuka
Automated Interpretation of Optic Nerve Images: A Data Mining Framework for Glaucoma Diagnostic
Support 1309
Syed S.R. Abidi, Paul H. Artes, Sanjan Yun and Jin Yu
Intelligent Querying and Exploration of Multiple Time-Oriented Medical Records 1314
Denis Klimov and Yuval Shahar
xx
Analyzing Web Log Files of the Health On the Net HONmedia Search Engine to Define Typical Image
Search Tasks for Image Retrieval Evaluation 1319

Henning Müller, Célia Boyer, Arnaud Gaudinat, William Hersh and Antoine Geissbuhler
Biomedical Image Processing
Improving Computer Aided Disease Detection Using Knowledge of Disease Appearance 1324
Tatjana Zrimec and James S. Wong
MR Atlas for Articular Cartilage Morphology: Potential to Detect Shape Differences 1329
Hussain Z. Tameem and Usha S. Sinha
Automatic Image Modality Based Classification and Annotation to Improve Medical Image Retrieval 1334
Jayashree Kalpathy-Cramer and William Hersh
Quantification of Myocardial Perfusion for CAD Diagnosis 1339
Hartmut Dickhaus, Markus Erbacher and Helmut Kücherer
Chapter 11. Education and Training 1345
Health Informatics Education and Training
Enabling the Safe and Effective Implementation of Health Informatics Systems – Validating and Rolling
Out the ECDL/ICDL Health Supplement 1347
Michael J. Rigby, Carol Hulm, Don Detmer and Luca Buccoliero
A Multi-Method Approach to Assessing Health Information Systems End Users’ Training Needs 1352
Yiyu Qiu, Ping Yu and Peter Hyland
Making Health Informatics Competencies Useful: An Applied Health Informatics Competency
Self-Assessment System 1357
H.D. Covvey, S. Fenton, D. Mulholland and K. Young
eLearning and Distance Education
E-learning for Students in Their First Year: A French Experimentation at the Medical School of Grenoble 1362
Jean-Marie Renard, Daniel Pagonis, Jean-Philippe Vuillez, Jean-Paul Romanet and Bernard Sele
E-learning at Porto Faculty of Medicine. A Case Study for the Subject ‘Introduction to Medicine’ 1366
Cristina Costa-Santos, Ana Coutinho, Ricardo Cruz-Correia, Ana Ferreira and Altamiro Costa-Pereira
Designing m-Learning for Junior Registrars – Activation of a Theoretical Model of Clinical Knowledge 1372
Anne Marie Kanstrup, Niels Boye and Christian Nøhr
Evaluation and Assessment of the Online Postgraduate Critical Care Nursing Course 1377
Reena Patel
Professional Education – Nursing Informatics

Development and Evaluation of a PDA-Based Decision Support System for Pediatric Depression Screening 1382
Ritamarie John, Penélope Buschman, Mosely Chaszar, Judy Honig, Eneida Mendonca and Suzanne Bakken
Data Mining Results from an Electronic Clinical Log for Nurse Practitioner Students 1387
Patricia Trangenstein, Elizabeth Weiner, Jeffry Gordon and Ryan McNew
Phase I Implementation of an Academic Medical Record for Integrating Information Management
Competencies into a Nursing Curriculum 1392
Carole A. Gassert and Katherine A. Sward
ROC van Twente: Nursing Education in Care and Technology 1396
William T.F. Goossen, Anneke T.M. Goossen-Baremans, Laura Hofte and Bert de Krey
xxi
Professional Education – Research
Multiple Measures of Provider Participation in Internet Delivered Interventions 1401
Thomas K. Houston, Ellen Funkhouser, Jeroan J. Allison, Deborah A. Levine, O. Dale Williams and
Catarina I. Kiefe
Medical Students’ Knowledge and Perceptions of e-Health: Results of a Study in Sri Lanka 1406
Sisira Edirippulige, Rohana B. Marasinghe, Anthony C. Smith, Yoshikazu Fujisawa, Walisundara B. Herath,
M.T.M. Jiffry and Richard Wootton
Importance of Public Health Informatics: A Survey of Public Health Schools and Graduate Programs
in the United States 1410
Janise Richards
Educating Medical Students as Competent Users of Health Information Technologies: The MSOP Data 1414
Julie J. McGowan, Morgan Passiment and Helene M. Hoffman
Professional Education – Case Reports and Methods Studies
Establishing a National Resource: A Health Informatics Collection To Maintain the Legacy of Health
Informatics Development 1419
Beverley Ellis, Jean Roberts and Helen Cooper
The EIPEN Project: Promoting Interprofessional Education in Health Professions 1424
Joseph Liaskos, Antonis Frigas, Kostantinos Antypas, Dimitrios Zikos, Marianna Diomidous and John Mantas
Building ICT Capabilities for Clinical Work in a Sustainable Healthcare System: Approaches to Bridging
the Higher Education Learning and Teaching Gap 1428

Kathleen Gray and Jenny Sim
The Development of an Online Clinical Log for Advanced Practice Nursing Students: A Case Study 1432
Jeffry S. Gordon, Ryan McNew and Patricia Trangenstein
Computer-Assisted Medical Education
Personalized Case Driven Parental Education Informatics in the NICU 1437
John Chuo, Pavel Sherman, Claire Drain and Casimir Kulikowski
Conceptual Model of Health Information Ethics as a Basis for Computer-Based Instructions for Electronic
Patient Record Systems 1442
Mihoko Okada, Kazuko Yamamoto and Kayo Watanabe
PDA-Based Informatics Strategies for Tobacco Use Screening and Smoking Cessation Management:
A Case Study 1447
Suzanne Bakken, W. Dan Roberts, Elizabeth Chen, Joann Dilone, Nam-Ju Lee, Eneida Mendonca and
Marianthi Markatou
Chapter 12. Poster Contributions Selected for Best Poster Awards 2007 1453
Consumer Informatics
Needs Assessment for the Computer-Interpretable Hypertension Guideline at Public Health Centers in Korea 1455
EunJung Lee, SoYoung Kim, InSook Cho, JiHyun Kim, JaeHo Lee and Yoon Kim
Education
Development of a Personal Medical Recorder on a Cell Phone 1456
Akihiro Takeuchi, Katsura Kobayashi, Noritaka Mamorita and Noriaki Ikeda
Emerging Technologies
Implementing and Evaluating a Laboratory Information System to Optimize the Treatment of Tuberculosis
Patients in Peru 1457
Joaquin A. Blaya, Sonya S. Shin, Martin J.A. Yagui, Luis Asencios, Javier Vargas, Carmen Suares, Gloria Yale
and Hamish S.F. Fraser
xxii
Health Information Systems
Risk Analysis – A Tool for IT Development and Patient Safety A Comparative Study of Weaknesses Before
and After Implementation of a Health Care System in the County Council of Ostergotland, Sweden 1458
Annica Öhrn and Gunilla Eriksson

Multi-Label Text Classification of German Language Medical Documents 1460
Stephan Spat, Bruno Cadonna, Ivo Rakovac, Christian Gütl, Hubert Leitner, Günther Stark and Peter Beck
What Health Influences Are Caused by EMR Working? – In Case of Japanese Nursing Situation 1462
Yukie Majima and Yasuko Maekawa
Using PDA to Transform the Long MDS-HC Evaluation Form into a Favored System 1463
Chiao-Ling Hsu, Yu-Yin Kuo and Polun Chang
A Sustainable, Multi-Organizational Model for Decision Support During Public Health Emergencies 1465
Julie J. McGowan, Margaret W. Richwine and J. Marc Overhage
Customized Early Warning System Based on HTN for Home Healthcare Model 1467
Seung-Jin Jang, Jip-Min Jung, Sung-Oh Hwang and Young-Ro Yoon
Open Source Patient Data Management System for Intensive Care 1468
J. Massaut, P. Reper, L. Hooghe and P. Gottignies
Why Teach Computer Security to Medical Students? 1469
Ana M. Ferreira, Ricardo Cruz-Correia and Altamiro Costa-Pereira
Application of Wireless and Mobile Computing Technologies to Improve the Efficiency of Patient Care
and Education: The Role of Medical Engineering and Information Technology 1471
Lin Guo
Knowledge Management
Comparing Messages in an Online Communication Forum for Cancer Patients with Patients’ Messages
to a Clinical Nurse Specialist 1473
Annette Jeneson, Trine Andersen and Cornelia Ruland
Guideline-Based Visualization of Medication in Chronic Disease 1475
Ján Stanek and Michelle Joy Davy
Efficiency and Safety of New Radiofrequency Identification System in Japanese Hospital 1478
Yuichiro Saito, Takashi Hasegawa and Tetsuo Sakamaki
Development of Hypertension Management Ontology for Guideline-Based Clinical Decision Support System 1479
JiHyun Kim, InSook Cho, EunJung Lee, JaeHo Lee and Yoon Kim
Secure Remote Access for Web Based Clinical Information System Using Policy Control of PCs and
Healthcare PKI Authentication 1480
Katsuya Tanaka, Mayumi Yoshida and Ryuichi Yamamoto

Infobuttons: A Study of Usability 1481
Lily Gutnik, Sarah Collins, Leanne M. Currie, James J. Cimino and Vimla L. Patel
Organisations
The Application of a Clinical Data Warehouse to the Assessment of Drug-Warfarin Interactions 1482
Qiyan Zhang, Yasushi Matusmura and Hiroshi Takeda
Standards
Implementation of an Integrated Network for Health Research in Quebec 1483
Allen Huang, Jacques Lemieux, Jean-Claude Bouchard, Michel Bourque and Robyn Tamblyn
xxiii
OpenECG: Promoting Interoperability Through the Consistent Implementation of the SCP-ECG Standard
in Electrocardiography 1484
Catherine Chronaki, Franco Chiarugi and Ronald Fischer
Subject Index 1485
Author Index 1493
xxiv
EDITORIAL
Playing an active role in the 12th World Congress on Medical Informatics has been an honour and a
privilege for the Editorial Committee. We closely cooperated with our colleagues and friends of the
Scientific Program Committee (SPC) and the Organizing Committee (OC).
Out of 638 submissions, 292 high quality papers were selected for publication in these proceedings by
the SPC. Out of 218 poster submissions, 21 posters were nominated for a best poster award; they are
included as 1 page contributions in these proceedings. While high quality contributions have been
selected by the SPC, the Editorial Committee has focussed on providing proceedings with a high
quality of format and presentation which made additional editing necessary. The proceedings are also
appearing on CD-ROM. All accepted poster contributions are published on an additional CD-ROM.
The MEDINFO 2007 Proceedings present an excellent overview of a dynamic and quickly growing
field, demonstrating methodical and practical progress from around the world. Information science
and, specifically, (Bio-) Medical Informatics have become core pillars of foundational and clinical
research, of medical care, and of prevention. MEDINFO 2007 in Brisbane will be the leading
conference of the year, bringing a worldwide community together.

We have organized the proceedings into twelve chapters, covering topics such as eHealth, Decision
Support, Improving Quality, Usability, Sustainability, Genomics, Biomedical Image and Signal
Processing, and Education and Training. Within each chapter, the articles are organized according to
the conference sessions; the session titles are shown in the table of contents.
The assistance of HISA has been invaluable in all editorial steps, including communication with
authors, language editing, and formatting of manuscripts. We owe specific thanks to Joan Edgecumbe,
Dale Proposch and Tom Morgan.
The Editorial Committee
Klaus A. Kuhn, Germany
James R. Warren, New Zealand
Tze Yun Leong, Singapore
xxv