The results obtained show that the KDPI makes it possible to relate the donor's characteristics with the greater or lesser survival of the graft and the patient in the Spanish population. However, due to certain limitations, a new index for Spain based on Spanish or European data should be created. In this study, some predictive factors of graft survival are identified that may serve as a first step in this path.
Frailty syndrome is an independent risk factor for serious health episodes, disability, hospitalization, falls, loss of mobility, and cardiovascular disease. Its high reversibility demands personalized interventions among which exercise programs are highly efficient to contribute to its delay. Information technology-based solutions to support frailty have been recently approached, but most of them are focused on assessment and not on intervention. This paper describes a sensor-based mHealth platform integrated in a service-based architecture inside the FRAIL project towards the remote monitoring and intervention of pre-frail and frail patients at home. The aim of this platform is constituting an efficient and scalable system for reducing both the impact of aging and the advance of frailty syndrome. Among the results of this work are: (1) the development of elderly-focused sensors and platform; (2) a technical validation process of the sensor devices and the mHealth platform with young adults; and (3) an assessment of usability and acceptability of the devices with a set of pre-frail and frail patients. After the promising results obtained, future steps of this work involve performing a clinical validation in order to quantify the impact of the platform on health outcomes of frail patients.
Continuity of care requires the exchange of health information among organizations and care teams. The EU General Data Protection Regulation (GDPR) establishes that subject of care should give explicit consent to the treatment of her personal data, and organizations must obey the individual's will. Nevertheless, few solutions focus on guaranteeing the proper execution of consents. We propose a serviceoriented architecture, backed by blockchain technology, that enables: (1) tamper-proof and immutable storage of subject of care consents; (2) a fine-grained access control for protecting health data according to consents; and (3) auditing tasks for supervisory authorities (or subjects of care themselves) to assess that healthcare organizations comply with GDPR and granted consents. Standards for health information exchange and access control are adopted to guarantee interoperability. Access control events and the subject of care consents are maintained on a blockchain, providing a trusted collaboration between organizations, supervisory authorities, and individuals. A prototype of the architecture has been implemented as a proof of concept to evaluate the performance of critical components. The application of subject of care consent to control the treatment of personal health data in federated and distributed environments is a pressing concern. The experimental results show that blockchain can effectively support sharing consent and audit events among healthcare organizations, supervisory authorities, and individuals.INDEX TERMS Blockchain, consent management, fast healthcare information resources (FHIR), general data protection regulation (GDPR), service-oriented architecture (SOA), business process management (BPM).
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