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Background: Type 2 diabetes is an individual health challenge requiring ongoing self-management. Remote patient reporting of relevant health parameters and linked automated feedback via mobile telephone have potential to strengthen self-management and improve outcomes. This research involved development and evaluation of a mobile telephone-based remote patient reporting and automated telephone feedback system, guided by health behavior change theory, aimed at improving self-management and health status in individuals with type 2 diabetes. Subjects and Methods: This research comprised a randomized controlled trial. Inclusion criteria were diagnosis of type 2 diabetes, elevated glycosylated hemoglobin (HbA1c) levels (range, 6.5–11%) or use of oral diabetes medication, and 30–70 years of age. Intervention subjects (n=24) participated in remote patient reporting of health status parameters and linked health behavior change feedback. Control participants (n=24) received standard of care including diabetes education and healthcare provider counseling. Patients were followed for approximately 10 months. Results: Intervention participants achieved, compared with controls and controlling for baseline, a significantly greater mean reduction in HbA1c of −0.40% (95% confidence interval [CI] −0.67% to −0.14%) versus 0.036% (95% CI −0.23% to 0.30%) (P

DECIPHER is a pre-commercial procurement (PCP) project seeking mHealth solutions for cross border health services. The 4phase PCP process is meant to be a tool for procurers to develop together with SMEs solutions to their specific needs. SMEs may have excellent solutions as well as the flexibility and adoptability to react adequately to procurers needs. But with little access to competitions, information about their solutions is not always reaching procurers …

Personal Health Records (PHR's) and related services are emerging rapidly. Currently, most PHR's are isolated and do not communicate with other systems. Standards for interoperability exist, but they are oriented towards clinical applications. However, a substantial part of a typical PHR consists of non-clinical information such as a health diary. The present paper highlights the requirements related to exchanging non-clinical PHR information between services and shows how this information exchange can be accomplished. The approach utilizes a SOAP message for carrying the actual PHR content in a structure referred as Health Diary Entry (HDE) document. The HDE document provides mechanisms to bind the contents to external vocabularies and ontologies to achieve semantic interoperability. The approach was successfully tested in the context of an occupational health pilot, in which data contents from several health and wellness applications were merged into a common database.

Summary Objectives: There is an increasing need for userfriendly and interoperable mobile applications in health and wellness domain. The objective of this work has been to provide support for rapid and cost-effective development of such applications. Methods: We have introduced an application framework which provides a generic tool for mobile application designers. We have demonstrated the usage of the application framework by providing an example implementation and demonstrating its usage in a Tele-ECG use case. In order to support interoperability we propose a solution compatible with clinical document standards such as the HL7 CDA. Results: A new mobile platform applicable for a wide range of telemedicine and wellness applications is introduced. The platform provides connectivity between healthcare professionals, patients and measurement devices. It is based on an open application framework that provides interfaces for measurement, user interface, database and network connectivity implementations. Conclusions: Mobile application development based on the application framework was demonstrated successfully. The developed UPHIAC platform adopts a new technical approach using a local database solution for caching of information at the mobile terminal. The platform applies a document-based approach providing a versatile and reliable way of sharing and collabora - tively complementing of health information including standard information model documents (HL7/CDA), and integration with health information systems and personal storages. The implemented mobile tele-ECG case demonstrates the overall function of the platform. The platform can be used as a basis for developing new applications for specific purposes.

This paper describes a new approach for collecting and sharing personal health and wellness information. The approach is based on a personal health record (PHR) including both clinical and non-clinical data. The PHR is located on a network server referred as common server. The overall service architecture for providing anonymous and private access to the PHR is described. Semantic interoperability is based on an ontology collection and usage of OID (object identifier) codes. The formal (upper) ontology combines a set of domain ontologies representing different aspects of personal health and wellness. The ontology collection emphasizes wellness aspects while clinical data is modelled by using OID references to existing vocabularies. Modular ontology approach enables distributed management and expansion of the data model.

The paper presents fast two-dimensional (2-D) diffraction modelling in the horizontal plane for site-specific propagation prediction in urban micro-cellular environments. Comparison with measurements and simulation of published results validate the 2-D modelling that significantly reduces the computation time and overcomes the limitation and difficulty of existing techniques for multiple building diffraction. The modelling makes three contributions which are 1) extension of an expression for multiple building forward diffraction and use of the extended formulation, 2) equivalent source technique for parallel-street multiple diffraction and 3) inclusion of reflections from curved surfaces of street building corners. Additional comparisons of three-dimensional model prediction with measurements for an urban line-of-sight environment place the work in a more complete context The results show that an increase in the number of rays may not enhance the accuracy of ray-tracing model prediction.

The new work makes three UTD (uniforn geometrical theory of diffraction) based path-loss prediction models and their experimental validations for urban micro-cellular mobile radio communications. The three models apply to the base station and mobile antennas much lower than the surrounding buildings and can be written in explicit forms for both vertical-and horizontal-polarization transmission and reception. Comparisons of their predictions with measurements at 900.5 and 1800 MHz in shadow zones of urban areas confirm the three models experimentally. The results demonstrate that fast two-dimensional (2-D) models which do not require a building height database can provide acceptable accuracy for micro-cellular mobile radio propagation predictions in urban environments. The methodology of this work is to deternine in advance significant rays to use, from a particular geometry of the buildings in an urban area. It appears suitable here for 2-D modeling for parallel-street problem and irregular side-street problems. It has the potential to be used in practical design of micro-cellular mobile radio systems.

Radiowave propagation measurements at 1.7 GHz for indoor mobile systems are described. A coherent pulse measurement is used to measure path loss and complex power delay profile of the radio channel. The results show that path loss and delay spread are highly dependent on building architecture and materials. By introducing special attenuation factors for penetrated walls and floors a statistical path loss model is obtained which gives relatively good results in office environments with small rooms. For large rooms and open areas a conventional model with distance dependence works best. Delay spread is modelled by having the volume of the indoor environment as a model parameter.

Remote patient monitoring systems provide plenty of structured information about the monitored health variables. We propose a set of parameters that exploits the remotely monitored data to describe patient's monitoring adherence from different viewpoints. The parameters were applied in self-monitored weight and blood pressure data sets of 30 heart failure patients inherited from a clinical trial setting. With the help of the extracted adherence parameters the thirty heart failure patients were clustered into two subgroups with different monitoring profiles: a group of well-performing subjects (n=22) and a group of low-performing subjects (n=8). Beneficial effects of active monitoring were reflected as positive changes in clinical health outcomes and lowered burdening of health care providers among the group of well-performing subjects.

Telemedicine is gaining popularity due to its high potential for cost savings and increased efficiency in healthcare delivery. However, most telemedicine systems available in the markets are limited to particular applications and lack interoperability with other information systems and measurement devices. In this paper, we present a generic service platform, which is applicable in a wide range of telemedicine applications and in other areas involving the need for confidential information exchange. The platform particularly addresses the security challenges in the case when the information technology (IT) is outsourced to an external company. It also provides semantic interoperability by providing support to HL7 CDA R2 documents. The platform implementation, the PIR document service, is composed of software components for the health service provider, the IT service provider and the telemedicine customers. These include desktop, mobile and browser-based applications. The platform was tested in a tele-consultation trial where the Heart Centre of Pirkanmaa Hospital District offered cardiology consultation service for two remote health care units. The outcome of the test was positive. Both the Heart Centre cardiologists and the physicians of the remote units considered the benefits of the consultation service to be high. The consultation cases included refining cardiology diagnostics and medication as well as guidance for patient logistics. The physicians considered it feasible to use a commercial consultation service when available.

Biobanking and secondary use of healthcare data enable considerable improvement to healthcare through personalized medicine including innovative therapies, pharmaceuticals, medical technology, and healthcare processes tailored for the needs of individuals. The data-driven precision medicine ecosystem requires contributions from a large variety of stakeholders as well as public investments to boost ecosystem growth. This paper introduces a system dynamics model describing mechanisms for biobank data and biosample accumulation and the related impact to pharmaceutical R&D projects. The preliminary simulation results reflect the important role of public funding of the infrastructure needed for biobank and register data exploitation as well as setting up services to attract more donors. Large public-private precision medicine projects, such as the FinnGen project are in a key role. Further work is needed to improve the ecosystem model precision especially in taking into account the differences between pharmaceutical R&D projects and their data exploitation needs.