We are following the future, come along


iUZ is looking for international partnership to foster MESTRa platform for the European tele radiology markets.

MESTRa is an electronic market for the interpretation of radiological images, enabling a quicker and more agile matching process to overcome the shortage of specialized radiologists.

Interconnecting players using solutions already in place, MESTRa enables real time competition among imaging service providers whilst providing mechanisms to guarantee quality of service provided.

Based on a PhD thesis that identified this gap in the Portuguese radiology market, we expanded this concept by scaling the ICT solution to address European radiology markets. In fact, according to the European Commission, in 2020 an estimated shortage of 230.000 physicians, radiologists included, is expected. The implementation of an electronic market such as MESTRa will contribute to a positive change in this foreseeable future.


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iUZ has concluded the development and implementation of MESTRa, an R&D project financed by the Portuguese National Program QREN, to address the tele radiology market.

MESTRa_Logo logo_maiscentro_1 QREN_Logo(COR)UE FEDER

Starting from geographic availability disparity of health radiology expertise, MESTRA tele radiology platform empowers healthcare services providers with the ability to request and obtain clinical expert judgement and diagnoses on radiology images even when they are not locally available. Based on a flexible logic and rules engine, this business models allows customization and fine-tuning to match partners business procedures.

Starting from a PhD thesis awarded with the first prize in the research of practical utility category of Fraunhofer Challenge 2011, MESTRa project started with a deep analysis of teleradiology state-of-art, covering 4 areas of interest: organization, technology, quality and clinical aspects. An excerpt of the overall state-of-art report can be found Excert _MESTRa_M1-1_State-of-Art_Report (full version under request).

Having the European market in perspective, the alignment with eHealth interoperability international standards has soon been defined has a corner stone of MESTRa development. To accomplish this objective extensive research has been conducted on eHealth interoperability standards and technologies. An overview of eHealth interoperability platforms studied can be found MESTRa_M4-1_eHealth_Interoperability_Platforms_Standards (full information under request).

Based on these analysis and specifications, MESTRa implemented the following workflows:

  • User management
  • Entity and provider management
  • Image report request
  • Image report request management
  • Image report execution
  • Image report execution management

MESTRa management team is now planning the market approach to capitalize on project achievements.

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Speaker iUZ



EU eHealth in focus


In Europe, the eHealth Network established under article 14 of the cross-border directive endorsed in November 2013, the guideline for a minimum health data set to be used in emergency or unplanned care cross-border situations.

During a live demonstration in Boston (US), experts from the Trillium Bridge project proved that it is technically feasible to exchange Electronic Health Record (EHR) data between the European Union and the United States. This means that in theory it is possible for a local treating physician, provided the patient has given his or her consent, to request and access an EHR patient summary from the patient’s provider across the Atlantic. 

Following the success of this demonstration, the EC published an official post where the event is pointed out as an important step towards Digital Agenda for Europe.

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Marisa Branco


Transatlantic exchange of Patient summaries:

Live demonstration from Trillium Bridget Project.

Last month, October 22, at the State House of Massachusetts in Boston, during the 5th EU-US eHealth Marketplace and Conference, the Trillium Bridge, presented a live demonstration of provider-mediated exchange of patient summaries between EU and US, proving the technical feasibility of the exchange.

Gnomon Informatics SA supported by iUZ and the OpenNCP community worked with the Kaiser Permanent (KP) eHealth Exchange team (the major provider of healthcare services in the United States and the main partner in that country) to create a proof of concept reference implementation of the Trillium Bridge gateway as part of their eHealthPassTM project that is able to exchange clinical patient summaries with the eHealthWay.


Trillium Bridge Project

The Trillium Bridge project, co-funded by the European Commission, is a transatlantic clinical data exchange mission to establish the foundations of an interoperability bridge for the meaningful exchange of patient summary and electronic health records between the European Union (EU) and United Sates (US).


 According with Trillium organisation the project “support action extends the European Patient Summaries (epSOS) and Meaningful Use II, Transitions of Care in the United States to establish an interoperability bridge that will benefit EU and US citizens alike, advancing eHealth innovation and contributing to the triple win: quality care, sustainability and economic growth.”


The Trillium Bridge gateway, an adapted version of the national contact points in EU Member States for the epSOS large scale pilot, was used to search and retrieve in real time, the patient summary in CCD (Continuity of Care Document) of a United States citizen, enrolled in a Kaiser Permanente health plan. The demonstration involved:


  • a patient (Martha): who is from San Diego and had an accident during a trip to Italy where she was taken to the hospital

  • a fictional Italian doctor (played by Giorgio Cangioli Trillium Bridge project manager): Giorgio, deep in his role of the Italian physician, accessed the patient summary in Italian and wrote a note for patient’s physician back in the States.

  • Zachary Gillen (interoperability director at Kaiser Permanente) reviewed the information together with Martha once she was back home.



  • a patient (Paolo Cerutti): a European Citizen visiting the US, who suffers from chronic hypertension and lost his new medication while traveling to San Francisco and could not explain the symptoms he was experiencing

  • Zachary (as a KP Physician) showed that the same functionality can be available for Paolo Cerutti. In Boston, Zachary, successfully retrieved in CCD the patient summary of Paolo and identified his medication.


The demonstration proved that with effective transatlantic collaboration, the EU and the US can set the pace and tone for global standards development and eHealth innovation.

The experience gained and lessons learned will inform the work of IHE profiles XCPD (Cross-Comunity Patient discovery) and XCA (Cross-Comunity Access) and will be continued in pursuit of end-end integration for HIMSS 2015 in Chicago on April 2015.It is also expected to inform the efforts underway toward an international patient summary specification under the auspices of HL7 (Health Level 7), ISO (International Organization for Standardization) , and CEN.

We’ll give you the inroads of this project. Tell us what you think, bellow in the comments. 

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Ana Castilho

iUZ Blog | EDC


Wondering what EDC means?

And Clinical Studies?

Here at iUZ we’ve been working with our uEDC solution that focuses on Clinical and Observational Studies.


Electronic Data Capture

EDC, the acronym for Electronic Data Capture, is an electronic medical record system specialised in clinical research, with the main objective to collect clinical data in an electronic data.

With the increase of Information Technology (IT) in healthcare, is not new that there is a trend and a need to a simpler, effective and highly specialised electronic data capture systems that can be easily implemented and customisable, always thinking in the end-user.

EDC systems are web-based software platforms that are created to collect and store clinical data through electronic forms, and usually the user only needs a web browser.

Typically, electronic source data is used for health clinical investigations, where sponsors and CROs (Clinical Research Organisation) use this type of systems.


We tend to sort out these 3 EDC system types:

  • Clinical trials: Applied during the phase of a medicine with pre-market entry, with an advanced certification demanding;
  • Clinical studies: Applied during the entry phase of a medicine on the market;
  • Observational study: A non-interventional study, mostly applied during a medical treatment.

Usually EDC systems are designed to demonstrate the efficacy and/or safety of medical treatments or medicines.


Main features

At iUZ we’ve been upgrading our uEDC solution.

A platform targeted for clinical and observational studies offering advanced features, with an easy customised setup to specific study requirements. For activating a new Clinical Study it is required a CRF (Case Report Form) and a DVP (Data Validation Plan) along with the platform setup. The CRF is a paper or electronic questionnaire used in clinical research, which the study promotor develops containing all the questions that the study will have.

In this competitive healthcare market there are several Electronic Data Capture solutions, but obviously not all of them have the same features.

iUZ uEDC solution has the following main features (view also our Standard Feature List flyer):

  • Clinical Study Setup
  • Profile and user management
  • Data entry
  • Data validation
  • Data management
  • Calibration
  • Data export
  • Notifications
  • Audit Trail


The main benefits of Electronic Data Capture systems are:

  • Higher security
  • Faster and efficient, compared with paper-based systems
  • Reduces data entry errors, which are also detected earlier than with paper-based systems
  • Accelerates the clinical data management process
  • Decreases clinical development costs
  • Higher time-savings
  • Major tendency to the fulfilment with regulatory requirements
  • Data is centralised in a specific electronic database
  • Real-time view of the data collected



Want to see our solution? Ask us for a uEDC live demonstration. In the meantime, view our uEDC video.


Did we forget about some important aspect? Have some doubts? Please, let us know in the comments.

 (image from Flickr by Myfuture.com)

Opening the Future of Healthcare.
Contact iUZ today at +351 234 247 381 or visit iuz.pt

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Ana Castilho

Clinical Research

“… a branch of healthcare science that determines the safety and effectiveness of medications, devices, diagnostic products and treatment regimens intended for human use.” (Source: Wikipedia)


Clinical Trial Participation Equation

Understanding that clinical research is essential for public health has been rising over the past few years.

And what do you need for a successful clinical research?

Beyond a well-structured Information System platform and a Research Site, you need patients!


For that, Beth Harper, a Clinical Research Expert has created her Clinical Trial Participation Equation that Forte – Research Systems have shared.

The Clinical Trial Participation Equation is strictly directed to this type of studies and intends to be a formula for patient recruitment and retention success in clinical trials. Beth Harper explains that “is a formula for evaluating and understanding the factors that influence a subject’s willingness and ability to participate in a clinical trial”.

Have a look and tell us what you think, below in the comments.

(click in the image to view full-size)
iUZ Blog | The Clinical Trial Participation Equation [Infographic] 


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Ana Castilho

Interoperability Infographic | iUZ Blog

(Check our new infographic below)


We have been talking a lot about health interoperability lately, but what this mean exactly?

Well, have you watch Marcelo Fonseca iUZ.Talk back in July?


Back then, Marcelo explained iUZ point-of-view in the health interoperability field, and has referred important related aspects during his pitch. We have recorded it and you can still view it in our Youtube Channel.



Health Interoperability definition


According with HIMSS – Health Information and Management System Society, health interoperability is:

(…) the ability of different information technology systems and software applications to communicate, exchange data, and use the information that has been exchanged.

Data exchange schema and standards should permit data to be shared across clinicians, lab, hospital, pharmacy, and patient regardless of the application or application vendor. Health interoperability means the ability of information systems to work together within and across organisational boundaries in order to advance the effective delivery of healthcare for individuals and communities.

There are three levels of health information technology interoperability:

  1. Foundational (allows data exchange from one information technology system to be received by another)
  2. Structural (an intermediate level that defines the structure or format of data exchange)
  3. Semantic (provides interoperability at the highest level, which is the ability of two or more systems or elements to exchange information and to use the information that has been exchanged. Takes advantage of both the structuring of the data exchange and the codification of the data including vocabulary so that the receiving information technology systems can interpret the data)

(Source: HIMSS – Definition of Interoperability)



Cross-Border Interoperability and Challenges in the Interoperability field


At iUZ we have committed a lot of our time to cross-border interoperability in the healthcare field (check our epSOS case study (new) page), as cross-border interoperability “aiming to provide tools and common ways to exchange information between countries” (Source: Slideshare). According with epSOS, cross-border interoperability also means interoperability between neighbouring and non-neighbouring epSOS Member States and their entire territories.
In Marcelo pitch, he spoke about a few challenges in the interoperability field, being:

Legal and organisational interoperability challenges, such as:

  • Implementation of legal common grounds for information exchange
  • Establishment of circles of trust
  • Legal recognition of involved parties, such as HCPs (including their roles), patients and others
  • Set in place common authentication mechanisms (e.g. European e-Identification projects)
  • Etc.

interoperability challenges, such as:

  • Represent as much as possible the information using clinical code-systems
  • Define common and agreed value sets for information exchange (e.g. health sets of terminologies)
  • Establish formal mappings of existent information to the agreed value sets
  • Include the translations to allow multi-language capabilities (for cross-country scenarios)
  • Etc.

interoperability challenges, such as:

  • Implement common interfaces for services
  • Establish agreed format for information exchange
  • Prove and certify the compliance level of the involved systems
  • Define roadmaps for information integration
  • Etc.



Interoperability Benefits


Regarding the benefits for having information systems connected through cross-border health interoperability, are:

  • For citizens and patients:
    • Receive health care abroad (almost) seamlessly;
    • Receive medication in a foreign country on existing prescription;
    • Access to his own information in multiple languages and recognised formats;
  • For Health care providers:
    • Get quick and easy access to key patient data;
    • Improve health care cooperation across borders;
  • Health care quality:
    • Reduce medication errors by exchanging data;
    • Facilitate the occasional care of foreign patients


The answers to these issues are in these organisms:

  • IHE – Integrating the Healthcare Enterprise
  • HL7 – Health Level Seven International
  • DICOM – Digital Imaging and Communications in Medicine





We’ve already written about IHE, when we joined IHE international as a member organization and when we went to Connectathon 2014 in Vienna (Austria). IHE – Integrating Healthcare Enterprise, is an initiative by healthcare professionals and industry leaders that aims to improve the way computer systems in healthcare share information.

According with IHE, they intend to promote the coordinated use of established standards such as DICOM and HL7 to address specific clinical needs in support of optimal patient care. Systems developed in accordance with IHE communicate with one another better, are easier to implement, and enable care providers to use information more effectively. (Source: IHE)



Health Level Seven International (HL7) is a not-for-profit, ANSI-accredited standards developing organization. HL7 provides standards for interoperability that improve care delivery, optimize workflow, reduce ambiguity and enhance knowledge transfer among all stakeholders.

HL7 is dedicated to providing a comprehensive framework and related standards for the exchange, integration, sharing, and retrieval of electronic health information.



Digital Imaging and Communications in Medicine (DICOM) “is a standard for handling, storing, printing, and transmitting information in medical imaging.” (Source: Wikipedia)



See our new brand infographic about “What is Health Interoperability?”:


Click in the image to view full-size or see it on Slideshare. Don´t forget to share it.




There are much more to say about health interoperability. Share with us your thoughts, below in the comments.

Opening the Future of Healthcare.
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Ana Castilho


Healthcare IT is changing the medical industry


According with one of our latest’s blog post in the next 5-7 years, 50.000 healthcare informatics workers will be needed (U.S. data). However, you may think, what really needs to be done?

Five ways health care must improve


KevinMD.com, a social media influencer in healthcare wrote 5 ways health care must improve which lists five issues that must be upgrade in HIT (Health Information Technology):

  1. Make systems more efficient
  2. Integrate different EMRs together
  3. Make everything mobile
  4. Start using voice recognition
  5. Recognize the limitations of IT and understand that health care is a human experience



Technology is (really) changing the healthcare industry


Technology is (really) changing the healthcare industry, however hospitals/clinics are not communicating and IT systems tend to be hard to learn or far too complex. Therefore, there are much more to improve, although this is a good set to begin with.

We were inspired by KevinMD.com post and made this infographic where you can find a summarize version of the blog post.

Take a look and tell us what you think bellow in the comments.

Healthcare IT - 5 ways to improve - iUZ

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Ana Castilho


Healthcare Information and Management Systems Society


HIMSS (Healthcare Information and Management Systems Society) is a “not-for-profit organization dedicated to improving healthcare quality, safety, cost-effectiveness, and access, through the best use of information technology and management systems” (Source: wikipedia). Every year HIMSS produces a Leadership Survey according with U.S. senior IT executive’s responses, and for the 25th HIMSS Annual Leadership Survey there were 298 valid responses.
MuleSoft, a company that integrates platforms for connecting SaaS and enterprise applications in the cloud and on-premise, created an infographic regarding the collected information from the 25th Leadership Survey mentioned before.

Are you a connected hospital?


This infographic sums up HIMSS document, where we can see that in U.S.:

• 25% – Are leveraging the latest technology to provide better patient care

• 19% – Companies are integrating new technologies with installed systems

• Patients using telehealth services are expected to reach 7 million in 2018 up from 350.000 in 2013

• 37% – indicated that IT can positively impact patient care by improving clinical and quality outcomes

These statistics reinforces the need to health interoperable systems, for that data can flow freely across clinical and non-clinical devices/systems (Source: MuleSoft blog).

(Click in the image to view full-size)

Connected Healthcare Systems [Infographic]


Have something to add? Please, tell us below in the comments.

(image: Phalin Ooi)

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Ana Castilho

Health Conference at Aqualuz Resort & Conference Hotel.

Do you feel that there is much to talk about interoperability in healthcare, but you don’t really find opportunities to speak with experts about it?

HCist is for you!

The third edition of the HCist – International Conference of Health and Social Care Information Systems Technologies will occur in Tróia (Portugal), between the 15th and 17th of October at the lovely Aqualuz Resort & Conference Hotel.

ICT solutions are being tailored for specific service providers, which according with the HCist organization committee, reinforces the demand that Europe has to reduce market fragmentation, mainly to reduce the lack of a common EU interoperability, testing and certification framework.

HCist is aligned with the Digital Agenda for Europe and expects to leverage the eHealth Technical Interoperability discussions in Portugal with debates and workshops, establishing a “shared vision and architectural building block to approach the EU top priority use cases, building upon worldwide technical profiles and standards” (Source: HCist press release).


A workshop about interoperability

iUZ CEO as been invited to talk about our expertise in the interoperability field, mainly centred in the Portuguese integration with epSOS network, and the knowledge acquired with IHE Profiles adoption and implementation.
By the way, did you read our last post about us joining IHE?
The conference will also discuss about:

• Healthcare Interoperability
• HIE – Health Information Exchange Solutions
• Healthcare Information Systems
• HL7 Standards
• EHR – Electronic Health Records
• mHealth – Mobile Device Software for Healthcare
• etc.

During HCist, also will be held in the same place the ProjMAN 2014 (International Conference on Project Management) and CENTERIS 2014 (Conference on Enterprise Information Systems). These three conferences are organised by SciKA that aims to promote and disseminate scientific knowledge.

Feel free to share your thoughts below in the comments.

(images from HCist website)

Opening the Future of Healthcare.
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