Thursday, October 31, 2013

1st Annual Netherlands eScience Symposium - eScience Center

1st Annual Netherlands eScience Symposium - eScience Center

Free symposium about big data at which the winners of the Enlighten Your Research 4 contest will be announced. Our project on LungCAVE, a european database on lungcancer screening is one of the finalists. More information about our and the other finalist projects on the contest BLOG.

HIMSS Europe 2013 Amsterdam - Plenary Session: “Patient Safety and IT”

Vesseur indicated that IT can be both beneficial to patient safety but also a hazard. Two of the top ten health technology hazards as reported by the ECRI are IT related (numbers 4 and 5). Patient safety is compromized when information in healthcare is not available, lacks integrity, or is not confidential. Information has to be safe and information exchange has to be safe. Important in these issues is compliance to standards like ISO/IEC 27001 or NEN 7510. 

Vesseur stated in his conclusion that IT will not automatically solve these problems but an approach is required that also involves the healthcare professional, the standards organisation, and hospital management.

Marinka de Jong-Fintelman presented on patient empowerment which, according to her is not possible without patient enabling. She showed that patients have to be an active partner in their own healthcare. Using an illustration by a personal experience story, she clearly demonstrated that currently the patient is not empowered and definitely not in control of their healthcare process resulting in many problems with respect to work and social activities and causing much stress and waiting. She recommends to make patients more aware of the possibilities of eHealth and have the ability to digitally access their records. Nictiz has a platform patient & eHealth to improve the patient empowerment. The platform provides a lot of information on how to develop and implement eHealth through their website (in Dutch). 

Plenary Session: “Patient Safety and IT”

Moderator: Michiel Sprenger
Jan Vesseur, Chief Inspector Patient Safety and Health IT, Dutch Health Care Inspectorate (IGZ), The Netherlands
Marinka de Jong-Fintelman, Program Manager Patient and Self Management, NICTIZ

The assumption is that IT contributes to the quality and the safety of health care. The delivery of care should have profits through the use of IT. The availability, the accuracy of information gains enormous with the help of IT. No one will ignore that. But there is another point of view. IT can also threat the quality and safety of health care. When information and the technology that handles information is not safe, it can harm the patient or even causes his death. The Dutch Health Care Inspectorate (IGZ) received several examples of failing information and failing IT with harm to the patient. For that reason IGZ started investigations in hospitals about the way they secure the patient information along the directives from the information security standards. Beside that they looked at the contribution of IT to information exchange. The conclusions were that IT does not contribute to the solving of the problems in information exchange as long as there will be different systems and different standards. IGZ asked for more standardization. New developments are the EU directive MEDDEV 2.1/6 about the software as a medical device and the way the IGZ will use this directive and the way electronic prescription of medication will be enforced. The aim of IGZ is that patient safety and IT are friends.

HIMSS Europe 2013 Amsterdam - SA4: Mobile Devices in Hospital Settings:Real World Strategies for Now and the Future

Session on mobile devices. Some remarks are that WIFI still poses a challenge in hospitals. There are no problems at the user side in terms of adaptation, but getting apps and mobile devices running in the supported environment of the hospital IT still is challenging.
Concrete examples were given in this session, e.g. Medimapp which provides the patient with an app that give all information about the medical traject including what was done and will be done based on a disease driven approach. This in contrary with traditional portals and information that are mostly specialty based and sometimes incomplete or contradictory.

SA4: Mobile Devices in Hospital Settings: Real World Strategies for Now and the Future

Maarten Winkelman, ICT Manager St. Jansdal Hospital Harderwijk, The Netherlands

mHealth for Nurses on the Ward of UMC Utrecht: A Pilot, Plans and Lessons Learned

Jan Christiaan Huysman, Program Manager ICT, CIO, University Medical Center Utrecht, The Netherlands

Mobile Health applications and platforms are being piloted at the academic medical centre in Utrecht. An example is the NurseMapp, a smartphone based application that enables nurses to register vital signs at the patient bed in realtime, integrated with the hospital information system. In another setup, a proof-of-concept mHealth app on a tablet is developed for patients in a diagnostic pathway for oncology. The patient can check all process information, interact with the physician and see the same information at home via a patient portal.

Operation iPad – a Mobile Strategy for the Years to Come

Werner Zuurbier, Head of Information Management, Antonius Zorggroep, The Netherlands

Recent years brought us a mobile IT-revolution with the iPad as one of its contributors. Healthcare is quickly embracing these innovations but many healthcare organizations struggle to define a useful and comprehensive strategy to fit this in the overall IT and business strategy. The opportunities are promising: Healthcare will be organized more and more outside of the hospital itself. This can be leveraged with a mobile and flexible infrastructure. But this also creates new problems and challenges. Are handheld devices the ultimate solution or is it just the beginning of a mobile health era? And what about sensor health or nano health?

HIMSS Europe 2013 Amsterdam - SB3: Clinical Decision Support: ChangeManagement and Protocol Maintenance

Process mining focuses in the data generated during the daily activities. Based on these data, processes are automatically constructed using process mining. The clinical paths of different patients are used to construct a general process. The results can be used to determine bottlenecks or to check on compliance to guidelines.

Process mining:
- unveils healthcare processes
- automates discovery of objective insights
- case: performance and guidelines adherence

The other presenter used a different approach that was based on the user knowledge to implement guidelines.

Below you will find the official information of the session including the abstracts

SB3: Clinical Decision Support: Change Management and Protocol Maintenance

Philippe Kolh, Professor and CIO at University of Liege, Belgium

Process Mining in Hospitals

Prof. Hajo Reijers, Full Professor, Eindhoven University of Technology, The Netherlands

Process mining is an analytical technique that can be used to exploit the vast amounts of data that become available through the use of information systems in contemporary organizations, such as hospitals. The technique provides a distinctive process perspective in comparison to other data analysis techniques. This is useful to unveil performance information that is of interest to management, medical specialists and patients. In this talk, the speaker will reflect on the experiences of using process mining in healthcare settings and present findings from these projects. The take-home message is: Process mining is available, applicable, and beneficial to healthcare.

100% Adherence to Guidelines: an Expert System for Preoperative Screening

Martijn Mertens, Anesthesiologist, Spaarne Ziekenhuis, The Netherlands

Smart configuration of the Anesthesia module of the EPIC® electronic medical record, resulted in an expert system that can guarantee 100% adherence to guidelines. Prior to a live demonstration of the system, its background, its objectives and its configuration will be discussed.

HIMSS Europe 2013 Amsterdam - SA2: Creating the Continuity of CareRecord (CCR) – An Interoperability Initiative of Eight UniversityMedical Centers Sharing EMRs

Although a country like Estonia is able to provide a full medical records to each healthcare provider and patient (Continuity of Care Record), the Netherlands is still not there with fragmented information and a lack of interoperability. A problem still is introduced by the lack of semantic ineroperability, requiring uniformity of language. Eight university hospitals in the Netherlands have started cooperation to introduce standardization and build the patient record. In this endeavour the patient is central. Getting to semantic interoperability is a long road with several problems on the way including standards, legislation, etc. Nictiz developed an interoperability model showing the different topics that need to be addressed to achieve interoperability.

Below you will find the official information and abstracts of the programme.

Jan Christiaan Huysman, Program Manager at UMC Utrecht, The Netherlands

A Core Data Set for Every Citizen

Jan Hazelzet, Pediatric Intensivist and CMIO, Erasmus Medical Center, The Netherlands

A patient when travelling through healthcare needs to pass his medical information to each caregiver over and over again. During this journey the caregivers store this information in different systems, using different terminology and in a different contextual perspective. This situation is a burden for patients and caregivers, can lead to incomplete information and is a risk for patient safety. It is time we change this situation from a caregiver focus to a patient centered focus. This means that caregivers all look at the same patient health information. For this concept to work we need one individual core dataset suitable in every healthcare situation. In the Dutch University Hospitals we have selected such an (international) dataset and the terminology to be used.

The Long and Winding Road to Interoperability

Sjaak Gondelach, Information Architect, University Medical Center Utrecht, The Netherlands

This presentation focuses on the more practical side of the exchange of patient records between hospitals, and the work of the eight UMC’s in the Netherlands to create a core dataset for semantical interoperability. We will look at the core dataset (the ‘Generieke Overdrachtsgegevens’) and the work that is done in the project, in some more detail. The presentation will also pay attention to other essential technical, organizational and legal aspects that must be addressed on the road to information exchange and semantical interoperabily between hospitals.

HIMSS Europe 2013 Amsterdam - SB1: Benchmarking eHealth and EMRAdoption in Europe

HIMSS started to develop EMR adoption models also for primary care (PC-EMRAM). It can be used to determine the interoperability of the General Practitioner. Two dutch GPs introduced an ICT ladder for the GP developed specifically for the Netherlands.

Krijgsman from Nictiz intriduced the eHealth monitor 2013. The report can be obtained by download from or where and infographic can also be obtained. The field consultation showed good progress but still a long way to go. The Netherlands is at the forefront when looking at a global scale. The use of self management of health information by patients is still very low and also the demand for it is very low. Four steps should be made to increase eHeatlh in the Netherlands:

Create greater awareness of options
Encourage electronic exchange of information
Provide access to medication records to patients
Increase eHealth awareness and enhance skills of professionals

Below this you will find the official session information and abstracts.

Rachelle Blake, PA (Physician Assistant), MHA, CEO and President of Omni Micro/Omni Med Solutions, Clinical Informatics, Data Analytics and Healthcare Technology Specialist

Establishing Benchmarks for EMR Adoption with the PC – EMRAM and ICT Ladder Models: The Only Way is Up!

Uwe Buddrus, Managing Director, HIMSS Analytics Europe, Germany
Bart van Pinxteren, General Practitioner, Huisartsen Oog in Al, The Netherlands
Hans Peucker, General Practitioner, SpinDok, Medisch Centrum Dorp, Houten, Netherlands

European healthcare delivery organizations are being pushed to do more with less and a major movement is brewing to push healthcare outside of the home. This session offers a unique opportunity to influence the standard for IT adoption in outpatient settings by engaging in a discussion on the PC-EMRAM. The PC-EMRAM is the next generation tool to drive IT adoption in primary care and out-patient settings. This new evaluation model creates a framework for building the healthcare settings of the future. The PC-EMRAM focuses on key IT systems and health information exchange (HIE) capabilities that need to be implemented for achieving higher levels of patient access, quality, efficiency and safety. Two General Practitioners and an IT specialist from The Netherlands have adapted and transformed the model to make it more comprehensive and promote its acceptance among the Dutch GPs. They advise their regional branch of the Dutch Association of General Practitioners to implement the so-called ‘ICT-ladder’. Presented by Uwe Buddrus, Hans Peucker and Bart van Pinxteren.

The Dutch National eHealth Monitor: Benchmarking eHealth in the Netherlands – by Nictiz and NIVEL

Johan Krijgsman, Senior Consultant, Nictiz, The Netherlands

Judith de Jong, Program Coordinator, NIVEL

The Netherlands, like other European countries, are confronted with rising costs of healthcare, an ageing population and rising prevalence of chronic illness. This creates challenges with regards to ensuring access to affordable, high quality health care in the future. There are high expectations of the possible contribution of eHealth to these issues. For instance, eHealth may support patient empowerment and self management, which eventually may lead to cost reductions. This is why it is important to monitor the adoption of eHealth by healthcare professionals and patients . Nictiz and NIVEL have started a yearly eHealth benchmark and present their first results.

HIMSS Europe 2013 Amsterdam - Opening Keynote

Opening remarks and keynote
Prof. Schrijvers presented on the fact that Dutch hospitals are still far from paperless. About 50% of Dutch hospitals are at stage 2 of the EMR adoption model. About 36% is at stage 5, and 9% at stage 6. No hospitals are in stage 7 yet. Although in Europe over 30% is still at level zero, in the Netherlands all hospitals are at level 1 or higher. Problems in theNetherland are still the nursing and clinical information, closed loop medication and intelligent pathways. In HIT science we should use routine outcome measurement since in other ways publications will come to late because of the delay in publication of one to two years.

The three main goals for HIT are Adoption, change management and interoperability

The opening keynote addressed reflective comments on US healthcare initiatives by Bert Reese, Kirk Heath and Betsy Rosenfield from Sentera Healthcare. Their institution has been EMRAM level 7 for five years. They described the US approach to interoperability, EMR adoption, the journey to analytics, the emergence of the mobile computing and the value proposition for technology investments. A main issue of interest is currently telemedicine.

Intelligent Health Agent
Aid to the patient to go through their complete treatment. Information about the intervention, the follow-up and revalidation. It really will allow the patient to be guided, to get information, and to provide information. The patient can be guided in what to do at what moment, when to do the excercises, etcetera.

Keys to succes
Keys to success for adopting an EMR are: Shared vision, avoid early skeppticism, realistic plans and goals, it is not an IT project, engage experienced help and support.

Wednesday, October 30, 2013

HIMSS Europe

Starting October 31, the first HIMSS Europe in Amsterdam. A two day event on advancing innovation and and best practice in European Health IT.

Visit the website at for more information.

Monday, October 28, 2013

Realview - Holographic Visualization in the OR during heart surgery

Check out this video from Realview. They developed a holographic visualization system that was actually used in the Operating Theatre.
This really looks like a breakthrough technology that could have major impact on the way three-dimensional imaging data of patients is used in the operating room. Their current hardware looks a bit bulky for the already crowded OR, but this might become smaller in the future to allow real integration. Big advantage is the ability to have touch-less interaction with the 3D holographic image which is a huge benefit in the OR.
Also check-out their website at

Friday, October 18, 2013

Hiding sensitive patient data in the information stream

RMIT University from Melbourne, Australia, has developed a method to hide sensitive information about patients inside the normal data stream using steganography, the practice of embedding secret information inside a larger bit of data without noticeably affecting the size or character of the larger data.

Check out the IEEE Spectrum coverage at:

Hiding Data in a Heartbeat

Tiny Wireless Pacemaker

New development by a start-up company called Nanostim that was recently acquired by st. Jude Medical of a pacemaker about the size of a AAA battery that can be inserted into the heart using a catheter and will last for 9 to 13 years without any leads or wires required.

Check out the coverage on: Teeny Tiny Pacemaker Fits Inside the Heart