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Perlich, A., Meinel, C.: Cooperative Note-Taking in Psychotherapy Sessions: An Evaluation of the Therapist’s User Experience with Tele-Board MED. Proceedings of the IEEE 20th International Conference on e-Health Networking, Applications and Services (Healthcom 2018) (2018).
In the course of patient treatments, psychotherapists aim to meet the challenges of being both a trusted, knowledgeable conversation partner and a diligent documentalist. We are developing the digital whiteboard system Tele-Board MED (TBM), which allows the therapist to take digital notes during the session together with the patient. This study investigates what therapists are experiencing when they document with TBM in patient sessions for the first time and whether this documentation saves them time when writing official clinical documents. As the core of this study, we conducted four anamnesis session dialogues with behavior psychotherapists and volunteers acting in the role of patients. Following a mixed-method approach, the data collection and analysis involved self-reported emotion samples, user experience curves and questionnaires. We found that even in the very first patient session with TBM, therapists come to feel comfortable, develop a positive feeling and can concentrate on the patient. Regarding administrative documentation tasks, we found with the TBM report generation feature the therapists save 60% of the time they normally spend on writing case reports to the health insurance.
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Perlich, A., Meinel, C., Zeis, D.: Evaluation of the Technology Acceptance of a Collaborative Documentation System for Addiction Therapists and Clients. Building Continents of Knowledge in Oceans of Data: The Future of Co-Created eHealth. pp. 695-699 (2018).
Addiction treatment outcomes are strongly determined by relational factors. We present the interactive documentation system Tele-Board MED (TBM) developed as an adjunct to therapy sessions aimed at enhancing the therapeutic alliance and patient empowerment. The objective of this work is to find factors that predict the acceptance of TBM in face-to-face addiction treatment sessions. We combined the methodologies of survey and focus group and based the data collection and analysis on the Unified Theory of Acceptance and Use of Technology. The studies, which involved therapists (n=13) and clients (n=33), were conducted in an addiction counselling center in Germany. Therapists see a flexible, contextdependent usage as a basic condition for TBM acceptance and its greatest benefit in providing a discussion framework and quick access to worksheets—in both individual and group sessions. Clients are inclined to use the system with the expectation of improved communication and better recall of the discussed topics based on a personal copy of the session notes.
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Perlich, A., Meinel, C.: Juggling Doctor and Patient Needs in Mental Health Record Design. Informatics Empowers Healthcare Transformation (2017).
Providing patients access to mental health records is a controversial topic that gains growing attention in research and practice. While it has great potential in increasing the patient engagement, skepticism is prevailing among therapists who fear detrimental effects and face a lack of feasibility when treatment notes are handwritten. We aim at empowering both therapists to new documentation approaches and patients to higher engagement, and develop the collaborative documentation system Tele-Board MED (TBM) as an adjunct to talk-based mental health interventions. We present an evaluation of TBM by comparing four prototypes and testing scenarios, reaching from early simulations to attempts of real-life implementations in clinical routines. This paper delivers a systematic need comparison of therapists as primary users and patients as secondary users, both during and beyond treatment sessions. While patient feedback is thoroughly positive, the therapist needs are only partially addressed; the benefits remain hidden behind the perceived effort.
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Shaabani, N., Meinel, C.: Incremental Discovery of Inclusion Dependencies. Proceedings of the 29th International Conference on Scientific and Statistical Database Management (SSDBM'17). p. 2:1--2:12. ACM (2017).
Inclusion dependencies form one of the most fundamental classes of integrity constraints. Their importance in classical data management is reinforced by modern applications such as data profiling, data cleaning, entity resolution and schema matching. Their discovery in an unknown dataset is at the core of any data analysis effort. Therefore, several research approaches have focused on their efficient discovery in a given, static dataset. However, none of these approaches are appropriate for applications on dynamic datasets, such as transactional datasets, scientific applications, and social network. In these cases, discovery techniques should be able to efficiently update the inclusion dependencies after an update in the dataset, without reprocessing the entire dataset. We present the first approach for incrementally updating the unary inclusion dependencies. In particular, our approach is based on the concept of attribute clustering from which the unary inclusion dependencies are efficiently derivable. We incrementally update the clusters after each update of the dataset. Updating the clusters does not need to access the dataset because of special data structures designed to efficiently support the updating process. We perform an exhaustive analysis of our approach by applying it to large datasets with several hundred attributes and more than 116,200,000 million tuples. The results show that the incremental discovery significantly reduces the runtime needed by the static discovery. This reduction in the runtime is up to 99.9996 % for both the insert and the delete.
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Perlich, A., Thienen, J. von, Meinel, C.: Establishing Therapeutic Alliance in Mental Health Care via Cooperative Documentation. Proceedings of the 16th World Congress on Medical and Health Informatics (MedInfo 2017) (2017).
In talk-based mental health interventions, treatment outcomes can be decisively improved by enhancing the relationship between patient and therapist. We developed the interactive documentation system Tele-Board MED (TBM) with the goal of supporting patients and doctors in their cooperative task of patient care. The system offers a whiteboard-inspired graphical user interface which allows them to take notes jointly during the treatment session. Two proxy studies were conducted whereby TBM was introduced in a role play that showcased the dialogue in a therapy session. The patient role was played by a volunteer. The audience of human-centered design as well as eHealth experts rated the therapist-patient relationship in a session with and without TBM. The data collected via questionnaires shows that TBM consistently receives a positive rating from study participants (N=36) in the areas of: collaboration, communication, patient-doctor relationship, as well as patient empowerment.
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Shaabani, N., Meinel, C.: Detecting Maximum Inclusion Dependencies without Candidate Generation. Database and Expert Systems Applications: 27th International Conference, DEXA 2016, Porto, Portugal, September 5-8, 2016, Proceedings, Part II. p. 118--133 (2016).
Inclusion dependencies (INDs) within and across databases are an important relationship for many applications in data integration, schema (re-)design, integrity checking, or query optimization. Existing techniques for detecting all INDs need to generate IND candidates and test their validity in the given data instance. However, the major disadvantage of this approach is the exponentially growing number of data accesses in terms of the number of SQL queries as well as I/O operations. We introduce Mind2, a new approach for detecting n-ary INDs (n > 1) without any candidate generation. Mind2 implements a new characterization of the maximum INDs we developed in this paper. This characterization is based on set operations defined on certain metadata that Mind2generates by accessing the database only 2 x the number of valid unary INDs. Thus, Mind2 eliminates the exponential number of data accesses needed by existing approaches. Furthermore, the experiments show that Mind2 is significantly more scalable than hypergraph-based approaches.
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Perlich, A., Meinel, C.: Patient-provider teamwork via cooperative note taking on Tele-Board MED. Exploring Complexity in Health: An Interdisciplinary Systems Approach (Proceedings of MIE2016 at HEC2016) (2016).
There is significant, unexploited potential to improve the patients’ engagement in psychotherapy treatment through technology use. We develop Tele-Board MED (TBM), a digital tool to support documentation and patient-provider collaboration in medical encounters. Our objective is the evaluation of TBM's practical effects on patient-provider relationships and patient empowerment in the domain of talk-based mental health interventions. We tested TBM in individual therapy sessions at a psychiatric ward using action research methods. The qualitative results in form of therapist observations and patient stories show an increased acceptance of diagnoses and patient-therapist bonding. We compare the observed effects to patient-provider relationship and patient empowerment models. We can conclude that the functions of TBM – namely that notes are shared and cooperatively taken with the patient, that diagnostics and treatment procedures are depicted via visuals and in plain language, and that patients get a copy of their file – lead to increased patient engagement and an improved collaboration, communication and integration in consultations.
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Shaabani, N., Meinel, C.: Scalable Inclusion Dependency Discovery. Proceedings of the 20th International Conference of Database Systems for Advanced Applications (DASFAA2015). pp. 425-440. Springer (2015).
Inclusion dependencies within and across databases are an important relationship for many applications in anomaly detection, schema (re-)design, query optimization or data integration. When such dependencies are not available as explicit metadata, scalable and efficient algorithms have to discover them from a given data instance. We introduce a new idea for clustering the attributes of database relations. Based on this idea we have developed S-indd, an efficient and scalable algorithm for discovering all unary inclusion dependencies in large datasets. S-indd is scalable both in the number of attributes and in the number of rows. We show that previous approaches reveal themselves as special cases of S-indd. We exhaustively evaluate S-indd's scalability using many datasets with several thousands attributes and rows up to one million. The experiments show that S-indd is up to 11x faster than previous approaches.
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Perlich, A., Meinel, C.: Automatic Treatment Session Summaries in Psychotherapy – a Step towards Therapist-Patient Cooperation. Proceedings of the International Conference on Current and Future Trends of Information and Communication Technologies in Healthcare (ICTH2015) (2015).
Therapeutic documentation is a crucial part in psychotherapy and should first and foremost support the patient’s therapy progress. Yet, the notes taken throughout a therapy, mainly serve the use of therapists. In line with the movement of patient empowerment, the calls for patients’ access to their records are growing louder and were incorporated into the German patients’ rights law. Hence, with Tele-Board MED, an interactive system for joint documentation of therapist and patient was developed. In this paper, we introduce one of its many features: the automatic creation of treatment session summaries. Our contribution also consists of the evaluation of its potential for practical use by psychotherapists. The aim of our work is twofold, namely the involvement of patients in the documentation, and the support of therapists with their documentation duties. The aspects of investigation include the therapists’ documentation habits (regarding time, amount, and method), their purposes to manually create session summaries and opinion about the automatically created summaries. It was discovered that the bigger part of the motivation for treatment session documentation lies in the therapists’ personal purposes, such as remembering a case right before the next session. Nevertheless therapists are willing to turn documentation in a cooperative activity if they had effective and efficient tools at hand. With the system presented, they can well imagine summarizing important issues together with the patient at the end of a session and also handing out printed summaries to them.
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Perlich, A., Sapegin, A., Meinel, C.: Implementation of Data Security Requirements in a Web-Based Application for Interactive Medical Documentation. Proceedings of the International Conference on Health Informatics (HealthInf 2015) (2015).
Keeping data confidential is a deeply rooted requirement in medical documentation. However, there are increasing calls for patient transparency in medical record documentation. With Tele-Board MED, an interactive system for joint documentation of doctor and patient is developed. This web-based application designed for digital whiteboards will be tested in treatment sessions with psychotherapy patients and therapists. In order to ensure the security of patient data, security measures were implemented and they are illustrated in this paper. We followed the major information security objectives: confidentiality, integrity, availability and accountability. Next to technical aspects, such as data encryption, access restriction through firewall and password, and measures for remote maintenance, we address issues at organizational and infrastructural levels as well (e.g., patients’ access to notes). With this paper we want to increase the awareness of information security, and promote a security conception from the beginning of health software research projects. The measures described in this paper can serve as an example for other health software applications dealing with sensitive patient data, from early user testing phases on.
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Meinel, C., Alnemr, R.: Security Issues and Aspects in Healthcare Pervasive Systems. XVI Winter Course CATAI, Tenerife, March 2008, pp. 4 - 9, ISBN: 978-84-612-1364-1. pp. 4 - 9. , Tenerife. Canary Islands. Spain (2008).
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Alnemr, R., Meinel, C.: A Discussion of Security Requirements and Issues in Healthcare Information Systems. Proceedings of the 10th International Conference on Healthcom (Healthcom 2008). pp. 345 - 350. IEEE Communications Press, Singapore (2008).
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Quasthoff, M., Meinel, C.: User Centricity in Healthcare Infrastructures. Proceedings of International Conference on Special Interest Group on Biometrics and Electronic Signatures (BIOSIG 2007). pp. 141 - 152. GI Press, Darmstadt, Germany (2007).
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Meinel, C., Quasthoff, M.: Identity Management in Telemedicine - The German Health Insurance Card. , Tenerife, Spain (2007).
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Jiang, C., Zhang, X., Meinel, C.: Medical Image Segmentation Using a Combined Approach. Proceedings of The 2005 International Conference on Computer Vision (VISION 2005). pp. 84-90. CSREA Press, Las Vegas, USA (2005).
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Jiang, C., Zhang, X., Meinel, C.: Hybrid Framework for Medical Image Segmentation. Proceedings of the 11th International Conference on Computer Analysis of Images and Patterns (CAIP 2005). pp. 264 - 271. Springer, Paris, France (2005).
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Jiang, C., Zhang, X., Gevantmakher, M., Meinel, C.: A New Practical Tool for 3D Medical Image Segmentation, Visualization and Measurement. Proceedings of the IEEE International Conference on Computing, Communications and Control Technologies (CCCT 2004). , Austin, USA (2004).
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Jiang, C., Zhang, X., Huang, W., Meinel, C.: Segmentation and Quantification of a Brain Tumor. Proceedings of 2004 IEEE Symposium on Virtual Environments, Human-Computer Interfaces and Measurement Systems (VECIMS 2004). pp. 61-66. IEEE Press, Boston/MA, USA (2004).
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Becker, T., Meinel, C.: Security in Telemedicine - Certificates and Digital Identity Cards. Presented at the , La Laguna, Teneriffa (2004).
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Vorwerk, L., Jiang, C., Meinel, C.: Secure Transfer of Digital Images and Related Data. Proceedings of the 11th International World Wide Web Conference (WWW 2002). W3C, Hawaii, USA (2002).
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Vorwerk, L., Meinel, C.: A Practical Approach to Store DICOM-conform Presentation of Radiological Images. Proceedings of SPIE Medical Imaging Conference (MedicalImaging 2002). pp. 299-306. SPIE Press, San Diego, USA (2002).
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Jiang, C., Vorwerk, L., Meinel, C.: Deformation and Construction of 3-D Medical Image. Proceedings of International Conference on Diagnostic Imaging and Analysis(ICDIA 2002). pp. 48-53. , Shanghai, China (2002).
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Vorwerk, L., Jiang, C., Meinel, C.: Application for Repairing and Presenting DICOM Objects. Proceedings of the 2002 International Conference on Application for Repairing and Presenting DICOM Objects (IMSA 2002). pp. 318-323. DBLP Press, Kauai, Hawaii, USA (2002).
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L., V., C., J., Ch, M.: Security Requirements for Telemedical Applications regarding DICOM-image-management in a PACS. Europacs 2002 , Oulu Finnland, Niinimäki J., Ilkko E., Reponen I., Oulu University Press (2002).
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Jiang, C., Vorwerk, L., Meinel, C.: Standardizing DICOM File and Rendering 3-D Medical Image. Proceedings of the 20th EuroPACS annual meeting (EuroPACS 2002). p. 225. Oulu University Press, Oulu, Finland (2002).
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Meinel, C., Vorwerk, L., Engel, T.: Trustcenter und Multifunktionskarten. Proc.ONLINE 2000, Düsseldorf (Germany), 2000. pp. C410.03 - C410.12.. , Duesseldorf, Germany (2000).
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Vorwerk, L., Meinel, C.: Security in Healthcare: An Overview. Proceedings of New Aspects of High Technology in Medicine (secinHealth 2000). pp. 455-458. , Hannover, Germany (2000).
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Vorwerk, L., Meinel, C.: A Multimedia-Editor for Making Findings in Radiology. Proc. CBMS 2000, Houston (Texas, USA), 2000. pp. 297-302. , USA (2000).
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Vorwerk, L., Hludov, S., Meinel, C.: Concept for Increased Security for Internet/Intranet-Based Administration of Patient Data. Proc. WSCG 2000, Plzen (Czech Republic), 2000 (2000).
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Vorwerk, L., Engel, T., Meinel, C.: A Proposal for a Combination of Compression and Encryption. Proc.SPIE Visual Communications and Image Processing, Perth (Australia). pp. 694-702 (2000).
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Vorwerk, L., Hludov, S., Meinel, C.: Constructing a Secure HIPACS with Structured Reporting. Proc. WSCG 2000, Plzen (Czech Republic), 2000. , San Diego (USA) (2000).
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Khludov, S., Vorwerk, L., Meinel, C.: Internet-Orientated Medical Information System for DICOM-Data Transfer, Visualization and Revision. Proc. CBMS 2000, Houston (Texas, USA), 2000. pp. 293-296 (2000).
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Vorwerk, L., Meinel, C.: Integration of TLS in an Intern/Intranet/based Application. Proc.MEDICOM 2000, Remagen, (Germany), 2000. pp. 143-149. , Perth, Australia (2000).
