Catherine Chronaki

• Secretary General at HL7 Foundation

The objective of this study is to demonstrate the effective use of remote sensing and ground-based techniques in conjunction with geographic information systems (GIS) to achieve two important goals: (a) to conduct a rapid and comprehensive assessment of soil and water quality in urban streams and (b) to emphasise the critical importance of continuo...

This work aims to demonstrate the effective use of remote sensing and ground techniques integrated with geographic information systems (GIS) to a) provide a rapid assessment of soil and water characterization and b) highlight the importance of monitoring environmental indicators to ensure the health of urban streams, emphasizing their role in human...

The idea for establishing this kind of publication, named as “EFMI Inside” Newsletter was born in Lyon in August 2019, during “MEDINFO 2019” Conference and EFMI Council meeting, when Catherine Chronaki, Izet Masic, Arriel Benis, Paris Gallos, Lacramiora Stoicu-Tivadar, Alfred Winter and some other EFMI friends discussed and concluded to start with...

The Survivorship Passport (SurPass) for childhood cancer survivors provides a personalized treatment summary together with a care plan for long-term screening of possible late effects. HL7 FHIR connectivity of Electronic Health Record (EHR) systems with the SurPass has been proposed to reduce the burden of collecting and organizing the relevant inf...

Innovation in cancer therapy has increased childhood cancer survival rates. However, survivors are still at risk of developing late effects. In the digital transformation of the health sector, the Survivorship Passport (SurPass) can support long-term follow-up care plans. Gaps in seamless connectivity among hospital departments, primary care, combi...

Background To overcome knowledge gaps and optimize long-term follow-up (LTFU) care for childhood cancer survivors, the concept of the Survivorship Passport (SurPass) has been invented. Within the European PanCareSurPass project, the semiautomated and interoperable SurPass (version 2.0) will be optimized, implemented, and evaluated at 6 LTFU care ce...

The European Project GATEKEEPER aims to develop a platform and marketplace to ensure a healthier independent life for the aging population. In this platform the role of HL7 FHIR is to provide a shared logical data model to collect data in heterogeneous living, which can be used by AI Service and the Gatekeeper HL7 FHIR Implementation Guide was crea...

Telemedicine can provide benefits in patient affected by chronic diseases or elderly citizens as part of standard routine care supported by digital health. The GATEKEEPER (GK) Project was financed to create a vendor independent platform to be adopted in medical practice and to demonstrate its effect, benefit value, and scalability in 8 connected me...

The GATEKEEPER (GK) Project was financed by the European Commission to develop a platform and marketplace to share and match ideas, technologies, user needs and processes to ensure a healthier independent life for the aging population connecting all the actors involved in the care circle. In this paper, the GK platform architecture is presented foc...

BACKGROUND To overcome knowledge gaps and optimize long-term follow-up (LTFU) care for childhood cancer survivors, the concept of the Survivorship Passport (SurPass) has been invented. Within the European PanCareSurPass project, the semiautomated and interoperable SurPass (version 2.0) will be optimized, implemented, and evaluated at 6 LTFU care ce...

Purpose: Long-term follow-up (LTFU) care for childhood cancer survivors (CCSs) is essential to improve and maintain their quality of life. The Survivorship Passport (SurPass) is a digital tool which can aid in the delivery of adequate LTFU care. During the European PanCareSurPass (PCSP) project, the SurPass v2.0 will be implemented and evaluated a...

Medical data science aims to facilitate knowledge discovery assisting in data, algorithms, and results analysis. The FAIR principles aim to guide scientific data management and stewardship, and are relevant to all digital health ecosystem stakeholders. The FAIR4Health project aims to facilitate and encourage the health research community to reuse d...

Medication therapy adherence remains an important problem in health care, and information about medicines from electronic product information is large and untapped resource. The Gravitate-Health project is a large European Union Public Private Partnership that aims to elicit value for electronic product information, starting with information in a p...

This is the second volume of the official magazine of the European Federation for Medical Informatics (EFMI) named as “EFMI Inside”, which was established as Newspaper in Lyon in August 2019, during “MEDINFO 2019” Conference and EFMI Council meeting. Idea for founding EFMI Inside was born by Catherine Chronaki, current President of EFMI and Izet M...

This year marks the 45th anniversary of the European Federation for Medical Association (EFMI) and was recognized in MIE2021, run virtually along with the 200 years of the Hellenic revolution that led to the establishment of the Greek state. It has been a busy year for EFMI characterized by an ambitious workplan and launching of internal projects m...

Due to the nature of health data, its sharing and reuse for research are limited by ethical, legal and technical barriers. The FAIR4Health project facilitated and promoted the application of FAIR principles in health research data, derived from the publicly funded health research initiatives to make them Findable, Accessible, Interoperable, and Reu...

The Medical Product Information found in most medication boxes offer a wealth of information, including terms of active ingredients, excipients, indications, dosage, route of administration, risks, and safety information. Digital health services that help patients, their care givers, and health professionals to manage medication, can be improved wi...

Compared to the general population, childhood cancer survivors represent a vulnerable population as they are at increased risk of developing health problems, known as late effects, resulting in excess morbidity and mortality. The Survivorship Passport aims to capture key health data about the survivors and their treatment, as well as personalized r...

Due to the nature of health data, its sharing and reuse for research are limited by ethical, legal and technical barriers. The FAIR4Health project facilitated and promoted the application of FAIR principles in health research data, derived from the publicly funded health research initiatives to make them Findable, Accessible, Interoperable, and Reu...

This is the issue of third volume of EFMI Inside - the official magazine of the European Federation for Medical Informatics (EFMI), founded in Lyon, France in August 2019, during “MEDINFO 2019” Conference and EFMI Council meeting. In this issue readers can find important information about events organized during 2022 by EFMI Working Groups and nati...

Emergency preparedness is a continuous quality improvement process through which roles and responsibilities are defined to effectively anticipate, respond to, and recover from the impact of emergencies. This process results in documented plans that provide a backbone structure for developing the core capacities to address health threats. Neverthele...

Diversity, inclusion and interdisciplinary collaboration are drivers for healthcare innovation and adoption of new, technology-mediated services. The importance of diversity has been highlighted by the United Nations’ in SDG5 “Achieve gender equality and empower all women and girls”, to drive adoption of social and digital innovation. Women play an...

The European Commission published in 2019 the Recommendation on the European Electronic Health Record exchange format (EHRxF) to support citizens and healthcare providers in securely accessing and sharing EHRs. The European EHRxF is expected to contribute to the digital transformation of health and care in the digital single market empowering citiz...

Unstructured: One Digital Health (ODH) is proposed as a unified structure. The One Digital Health "Steering Wheel" conceptual framework is built around two keys (One Health and Digital Health), three perspectives (Individual Health and well-being, Population and Society, and Ecosystem), and five dimensions (Citizen's engagement, Education, Environ...

One Digital Health is a proposed unified structure. The conceptual framework of the One Digital Health Steering Wheel is built around two keys (ie, One Health and digital health), three perspectives (ie, individual health and well-being, population and society, and ecosystem), and five dimensions (ie, citizens’ engagement, education, environment, h...

One Digital Health is a proposed unified structure. The conceptual framework of the One Digital Health Steering Wheel is built around two keys (ie, One Health and digital health), three perspectives (ie, individual health and well-being, population and society, and ecosystem), and five dimensions (ie, citizens' engagement, education, environment, h...

This paper presents the early outcomes of the educational cooperation between two European academic associations, namely the European Federation of Medical Informatics (EFMI) and European Society of Emergency Medicine (EUSEM). Two webinars were organized in December 2019 and June 2020 to explore areas where mutual education would be beneficial for...

Evidence-based decision-making is central to public health. Implementing evidence-informed actions is most challenging during a public health emergency as in an epidemic, when time is limited, scientific uncertainties and political pressures tend to be high, and reliable data is typically lacking. The process of including data for preparedness and...

Background FAIR (findability, accessibility, interoperability, and reusability) guiding principles seek the reuse of data and other digital research input, output, and objects (algorithms, tools, and workflows that led to that data) making them findable, accessible, interoperable, and reusable. GO FAIR - a bottom-up, stakeholder driven and self-gov...

Background: Low childhood immunization rates in Europe are causing concern and have triggered several EU initiatives. However, these are counter-factual as they make immunization a stand-alone issue and cut across best practice in integrated child health services. They also focus unduly on 'anti-vax' pressures, generalize 'vaccine hesitancy' and o...

In higher education, programs in specialization in Health Informatics, Medical Informatics, Health Engineering are continuously growing. In this research, almost 1800 universities and colleges were checked in order to find related educational programs at all academic levels. Approximately 1000 academic leading degree programs in those domains have...

Immunisation is a key preventive health measure for children. E-health applications have been used for over 50 years, yet still there is no harmonization or standardization, while uncoordinated policy initiatives proliferate. Two EU research projects (Trillium II and MOCHA) have come together with experts and stakeholders, and used EU-wide situatio...

This paper provides a summary of the Privacy Management Analysis method followed for the analysis of the International Patient Summary exchange use cases of Trillium II Project. The objective is to recommend the required security and privacy measures by providing traceability from Regulations/Principles/Preferences to the recommended Security & Pri...

The eStandards methodology stressed the importance of trust and flow for health data as a key characteristic of well-functioning health systems. A digital health compass, leveraging perspectives of health systems, digital health markets, citizens, and workforce, drives a process of co-creation, governance and alignment in eStandards. A repository o...

Clinical data interoperability requires shared specifications of meaning. This is the rationale for clinical data standards. Up until now, the adoption of such standards has been varied, although they are increasingly advocated in an area where proprietary specifications prevail, and semantic resources are geared to specific purposes and limited by...

The International Patient Summary (IPS) standards aim to define the specifications for a minimal and non-exhaustive Patient Summary, which is specialty-agnostic and condition-independent, but still clinically relevant. Meanwhile, health systems are developing and implementing their own variation of a patient summary while, the eHealth Digital Servi...

Healthcare systems increasingly rely on digital technologies to sustain costs and improve access to quality care. Data drive a wave of automation aspiring to improve productivity by forging connections between health and wellness, medical research, and clinical decision support. Mobile apps and patient-generated data combined with provider recordin...

ASSESS CT is an EU funded project that aims at contributing to better semantic interoperability of eHealth services in Europe. Its main goal is the investigation of the fitness of the international clinical terminology SNOMED CT as a potential standard for EU-wide eHealth deployments. This panel will report on the current use of SNOMED CT's in Euro...

The European Patient Summary (PS) guideline specifies a minimal dataset of essential and important information for unplanned or emergency care initially defined in the epSOS project with aim to improve patients' safety and quality of Care. The eHealth Network of European Union (EU) Member State (MS) representatives established under Article 14 of t...

Large-scale eHealth deployment projects face a major challenge when called to select the right set of standards and tools to achieve sustainable interoperability in an ecosystem including both legacy systems and new systems reflecting technological trends and progress. There is not a single standard that would cover all needs of an eHealth project,...

The number of health-related mobile apps (mHealth apps) has increased dramatically over the last three years. Health professionals have started recommending apps to their patients, while healthcare systems, advocacy groups, and professional societies review or commission apps of relevance to their members. Still the issues surrounding mHealth apps...

The European Patient Summary (PS) guideline specifies a minimal dataset of essential and important information for unplanned or emergency care initially defined in the epSOS project with aim to improve patients' safety and quality of Care. The eHealth Network of European Union (EU) Member State (MS) representatives established under Article 14 of t...

The design of the patient cohort is an essential and fundamental part of any clinical patient study. Knowledge of the Electronic Health Records, underlying Database Management System, and the relevant clinical workflows are central to an effective cohort design. However, with technical, semantic, and organizational interoperability limitations, the...

In an increasingly mobile world, many citizens and professionals are frequent travellers. Access during unplanned care to their patient summary, their most essential health information in a form physicians in another country can understand can impact not only their safety, but also the quality and effectiveness of care. International health informa...

AimsTo provide a European perspective on reimbursement issues surrounding remote monitoring of cardiac implantable electronic devices in view of the anticipated costs and benefits.Methods and resultsReview of recent literature addressing clinical, economic, sociocultural, and technological factors associated with remote monitoring. When healthcare...

The effect of advanced age per se versus severity of chronic and acute diseases on the short- and long-term survival of older patients admitted to the intensive care unit (ICU) remains unclear. Intensive care unit admissions to the surgical ICU and medical ICU of patients older than 65 years were analyzed. Patients were divided into three age group...

e-Health is a broad term addressing the use of information and communication technologies in the support of health and health-related fields including healthcare provision, health surveillance, and education.1 e-Health can be divided into four areas: 1. telemedicine and telecare (including disease management services, remote patient monitoring, t...

This paper presents an overview and comparison of national efforts on ePrescribing in Finland and Greece focusing on aspects of interoperability and standards. Building on experience of HL7 affiliates in Finland and Greece, the role of HL7 Clinical Document Architecture (CDA) in assuring interoperability within the national and cross-border framewo...

Remote monitoring and follow-up of cardiac implantable electronic devices (CIEDs) introduces novel patient-focused and information-driven models of care. In this context, iCARDEA employs guideline-driven personalized care plans that use information from personal health records, hospital-based medical records, and CIED reports from remote follow-up...

Tsunamis are one of the most dangerous and destructive natural disasters: countries that experience a tsunami event are likely to undergo, after the immediate destruction of the regions nearby the coast, several secondary effects, for example epidemic outbreaks. Thus, early warning systems able to timely advise the authorities and the population of...

Accurate and timely information is critical for health early warning and effective emergency management. Health Information Technology (HIT) standards address the challenge of integrating information from disparate healthcare resources e.g. devices, people, and information systems to support not only the effective handling of emergencies, but also...

For patients with Cardiovascular Implantable Electronic Devices (CIEDs), telemonitoring promises improved quality of life and safety, since events recorded by the device or observed by the patient can alert a health professional. Taking into account the latest clinical guidelines when responding to such alerts, is a topic of active research address...

Cardiovascular Implantable Electronic Devices (CIED) are gaining popularity in treating patients with heart disease. Remote monitoring through care management systems enables continuous surveillance of such patients by checking device functions and clinical events. These care management systems include decision support capabilities based on clinica...

Purpose: Type 2 diabetes (T2D) is an important risk factor for heart failure. T2D is associated with the metabolic syndrome, encompassing cardiovascular risk factors such as obesity, insulin resistance and dyslipidemia, factors also associated with left ventricular diastolic dysfunction. Patients with T2D have elevated plasma levels of free fatty a...

The knowledge about the relationship between health-related activities on the Internet (i.e. informed citizens) and individuals' control over their own experiences of health or illness (i.e. empowered citizens) is valuable but scarce. In this paper, we investigate the correlation between four ways of using the Internet for information on health or...

In cardiology departments supporting implantation and follow-up of Cardiovascular Implantable Electronic Devices (CIED), relevant clinical data reside in autonomous healthcare information systems that support different health information technology (HIT) standards and proprietary data formats. Each organization chooses the Electronic Health Record...

Health quality measures can be used to improve the effective use of Electronic Health Record systems (EHRs) in health care delivery. The Health Quality Measures Format (HQMF) is a standard for representing a health quality measure as an electronic document. This presentation will present the standard, review the development process of quality measu...

The ISO/IEEE 11073 (x73) family of standards is a reference frame for medical device interoperability. A draft for an ECG device specialization (ISO/IEEE 11073-10406-d02) has already been presented to the Personal Health Device (PHD) Working Group, and the Standard Communications Protocol for Computer-Assisted ElectroCardioGraphy (SCP-ECG) Standard...

The ISO/IEEE 11073 (x73) family of standards is a reference frame for medical device interoperability. A draft for an ECG device specialization (ISO/IEEE 11073-10406-d02) has already been presented to the Personal Health Device (PHD) Working Group, and the Standard Communications Protocol for Computer-Assisted ElectroCardioGraphy (SCP-ECG) Standard...

Patient empowerment frameworks engage citizens in their healthcare. Heart patients undergo implantation of Cardiovascular Implantable Electronic Devices (CIEDs) that support remote monitoring hoping to live a longer healthier life. Electronic Health Records (EHR), remote device monitoring, and lifestyle data can supply patient context to computeriz...

Use of the Internet for health purposes is steadily increasing in Europe, while the eHealth market is still a niche. Online communication between doctor and patient is one aspect of eHealth with potentially great impact on the use of health systems, patient-doctor roles and relations and individuals' health. Monitoring and understanding practices,...

Accurate and timely information is critical for health early warning and effective emergency management. Health Information Technology (HIT) standards address the challenge of integrating information from disparate healthcare resources e.g. devices, people, systems to support not only the effective handling of emergencies, but also their analysis f...

The simulation of the extreme destructive historical earthquake of 365 AD in the Aegean Sea will help to draw a realistic disaster scenario to test EU member state collaboration in the frame of the European Civil Protection Mechanism.

The general decline in traffic accidents throughout Europe is not the case for Crete, a favorite holiday destination. The extent of problem and reflections on the significant impact of the interplay of organizational, educational, & technological interventions by the Emergency Coordination Center of Crete (ECC-Crete) are presented. 10-year data fro...

The storage and retrieval of digital ECGs in a standard-compliant way has been a key issue during the last decades. The SCP-ECG standard, one of the top efforts in this area, has been recently approved as part of the ISO/IEEE 11073 (x73) family of standards, a reference standard for medical device interoperability. For the Personal Health Device (P...

Resumen Hoy en día, en el diseño de los nuevos sistemas de información aplicados a la salud resultan aspectos clave los paradigmas de interoperabilidad y estandarización. Para los dispositivos médicos, esto puede conseguirse mediante los estándares internacionales de interoperabilidad. En ese campo, la familia de estándares ISO/IEEE 11073 (x73) es...

Resumen Durante las últimas décadas se han desarrollado y estandarizado una amplia variedad de protocolos de almacenamiento y transmisión de señales electrocardiográficas. El estándar SCP-ECG, que representa uno de los esfuerzos más importantes en este ámbito, ha sido incorporado recientemente a la familia de estándares ISO/IEEE 11073 (x73), estánd...

Ambient assisted living and integrated care in an aging society is based on the vision of the lifelong Electronic Health Record calling for HealthCare Information Systems and medical device interoperability. For medical devices this aim can be achieved by the consistent implementation of harmonized international interoperability standards. The ISO/...

I2Cnet (Image Indexing by Content network) aims to provide services related to the content-based management of images in healthcare over the World-Wide Web. Each I2Cnet server maintains an autonomous repository of medical images and related information. The annotation service of I2Cnet allows specialists to interact with the contents of the reposit...

Image indexing, storage, and retrieval based on pictorial content is a feature of image database systems which is becoming of increasing importance in many application domains. Medical image database systems, which support the retrieval of images generated by different modalities based on their pictorial content, will provide added value to future...

OBJECTIVE: To investigate the attitudes and perceptions of late adolescents and young adults (15-35 years) about the use of the Internet for health and illness (H&I information) in Greece. METHOD: Data were collected within the frame of the WHO eHealth Consumer Trends Survey, conducted in seven European countries in October 2005 and May 2007. Data...

The workshop is organized by HL7 and its affiliates to present and to discuss HL7's activities for providing international standards and specifications to enable advanced semantically interoperable eHealth and pHealth solutions, adaptable to national health systems through localization. The workshop especially focuses on the multi-disciplinary stru...

Despite progress in information and communication technologies (ICT), communication is still a bottleneck for health early warning and response systems. Satellite communications combined with a local WiFi network promise rapid deployment and facilitate coordinated response and optimal adjustment of resources for disaster management. In this paper,...

The risk of epidemics and emerging or re-emerging diseases is rising and it can only be contained with prevention, early warning, and prompt management. Readiness exercises are critical in improving readiness, testing means & methods, master plans & procedures, but above all in training civil protection personnel. However, despite progress in infor...

Background. E-Health is rapidly growing branch of medicine, and number of internet users seeking health information is increasing each year. E-Health services include electronic files, electronic health record (EHR), on-line health services, telemedicine services, internet portals offering health information and others. Objectives. The aim of the s...

This study aimed to explore relations between Internet use, socio-economic status (SES), social support and subjective health. Participants were from representative samples between 15 and 80 years of age from seven different European countries. Two different survey datasets were used: (i) eHealth trends (eHT; N = 7934) and (ii) the European social...

In the last decade, the number of Internet users worldwide has dramatically increased. People are using the Internet for various health-related purposes. It is important to monitor such use as it may have an impact on the individual's health and behavior, patient-practitioner roles, and on general health care provision. This study investigates tren...

This paper presents an effort launched in 2006 by the OpenECG network, led by the Graz University of Technology and supported by IEEE 1073, ISO 11073 and CEN TC251 to create a two-way converter in C++ between the SCP-ECG and the HL7 aECG standards. In the conversion, GDF, the BioSig internal data format, was used as an intermediate structure. This...

OBJECTIVE: The aim of this study was to investigate the perception and attitudes of people in Greece regarding the use of the internet for Health and Illness (H&I). It is the Creek part of a survey conducted concurrently in 7 European countries in 2005 and 2007, to establish eHealth consumer trends across Europe. METHOD: 1000 men and women aged bet...

This paper reflects on the role of open source in health information system interoperability. Open source is a driving force in computer science research and the development of information systems. It facilitates the sharing of information and ideas, enables evolutionary development and open collaborative testing of code, and broadens the adoption...

European citizens are increasingly being offered Internet health services. This study investigated patterns of health-related Internet use, its consequences, and citizens' expectations about their doctors' provision of e-health services. Representative samples were obtained from the general populations in Norway, Denmark, Germany, Greece, Poland, P...