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Papers by Christian Lovis

Studies in health technology and informatics, 2017

Introduction: Patient centred care fosters a holistic approach of care switching the focus from a... more Introduction: Patient centred care fosters a holistic approach of care switching the focus from a disease perspective to a patient's experience perspective. Patient centred care is of particular importance in the context of paediatric emergency medicine. Indeed, parents entering a paediatric emergency department (PED) are usually under stress caused by their children's illness, the unfamiliar setting of the PED and delays of care. All these factors can deteriorate their experience as well as the relationships between healthcare providers, the patients and their parents.

Methods We explore potential areas to improve the patient experience during his journey into PED. The dimensions of the picker's patient centred care are used to guide observations, conduct interviews and focus groups. The areas of improvement are then operationalized through their translation into app functionalities.

Results Our novel application allows supporting users on 7 of the 8 dimensions of picker's patient centred care model. The app supports parents in their decision-making to consult a PED, it provides relevant medical information to avoid unrealistic expectations and accompany the family after discharge thanks to tailored information sheets about diagnostics.

Conclusion: Our mobile app allows to make a big step toward the improvement of the patient-caregiver relationship. The direct benefits will be shared by patients and caregivers, as well as the institution.

International journal of clinical pharmacy, Jan 10, 2016

Background While evidence on implementation of medication safety strategies is increasing, reason... more Background While evidence on implementation of medication safety strategies is increasing, reasons for selecting and relinquishing distinct strategies and details on implementation are typically not shared in published literature. Objective We aimed to collect and structure expert information resulting from implementing medication safety strategies to provide advice for decision-makers. Setting Medication safety experts with clinical expertise from thirteen hospitals throughout twelve European and North American countries shared their experience in workshop meetings, on-site-visits and remote structured interviews. Methods We performed an expert-based, in-depth assessment of implementation of best-practice strategies to improve drug prescribing and drug administration. Main outcome measures Workflow, variability and recommended medication safety strategies in drug prescribing and drug administration processes. Results According to the experts, institutions chose strategies that targ...

AMIA ... Annual Symposium proceedings / AMIA Symposium. AMIA Symposium, 2015

Shift-to-shift handoffs refer to the process of transferring role and responsibility for providin... more Shift-to-shift handoffs refer to the process of transferring role and responsibility for providing care from one person to another, thus insuring continuity of care. Through focus groups of residents and supervising physicians, we studied how physicians select patient cases to discuss during handoffs. We also compared the selection across level of experience. Understanding the patient selection criteria can give us insight into how to improve handoffs, in particular using supportive technologies that are integrated into the clinical information system. Studying the actual handoff process and note-taking also generated suggestions for handoff improvement.

Information and communication technologies have a role to play in improving a citizen's quali... more Information and communication technologies have a role to play in improving a citizen's quality of life. The ageing world population demonstrates the major challenge of as-sisting citizens in their various activities. ICTs could help them to have a healthier lifestyle, reduce physical efforts, reduce the risk of disease and prevent accidents or ill-nesses. PEACE aims to provide a system allowing the association of any type of sensors or data sources with any action within the user's environment. The generic ap-proach of this system allows it to be deployed in several backgrounds. Indeed, multiple purposes can concern home automation, clinical environment automation and progress in the Ambient Assisted Living field. Creating this system required focusing on multiple areas like user interaction paradigms, I/O management, security management systems and automatic services discovery. Developing this project has demonstrated significant future job possibilities. Indeed, the imple...

Informatique et Santé, 2009

Studies in health technology and informatics, 2009

Five generations of second year students at the Zagreb University School of Medicine were intervi... more Five generations of second year students at the Zagreb University School of Medicine were interviewed through an anonymous questionnaire on their use of personal computers, Internet, computer laboratories and computer-assisted education in general. Results show an advance in students' usage of information and communication technology during the period from 1998/99 to 2002/03. However, their positive opinion about computer laboratory depends on installed capacities: the better the computer laboratory technology, the better the students' acceptance and use of it.

Informatique et Santé, 2009

Abstract Background An observatory of ENT diseases in children was set up. It aimed at estimatin... more Abstract Background An observatory of ENT diseases in children was set up. It aimed at estimating the incidence of acute episodes of rhinopharyngitis, otitis media, tonsillitis, sinusitis and laryngitis and evaluating their time-space evolution in winter in France. In addition, this study evaluated the ability of our surveillance platform generator to implement and manage such an observatory. Methods A network of practitioners,

International Journal of Medical Informatics, 2007

Studies in Health Technology and Informatics, Feb 1, 2009

Studies in Health Technology and Informatics, Feb 1, 2009

Proceedings of Spie the International Society For Optical Engineering, Oct 22, 2007

This article describes the use of a medical image retrieval system on a database of 16'000 fractu... more This article describes the use of a medical image retrieval system on a database of 16'000 fractures, selected from surgical routine over several years. Image retrieval has been a very active domain of research for several years. It was frequently proposed for the medical domain, but only few running systems were ever tested in clinical routine. For the planning of surgical interventions after fractures, x-ray images play an important role. The fractures are classified according to exact fracture location, plus whether and to which degree the fracture is damaging articulations to see how complicated a reparation will be. Several classification systems for fractures exist and the classification plus the experience of the surgeon lead in the end to the choice of surgical technique (screw, metal plate, ...). This choice is strongly influenced by the experience and knowledge of the surgeons with respect to a certain technique. Goal of this article is to describe a prototype that supplies similar cases to an example to help treatment planning and find the most appropriate technique for a surgical intervention. Our database contains over 16'000 fracture images before and after a surgical intervention. We use an image retrieval system (GNU Image Finding Tool, GIFT) to find cases/images similar to an example case currently under observation. Problems encountered are varying illumination of images as well as strong anatomic differences between patients. Regions of interest are usually small and the retrieval system needs to focus on this region. Results show that GIFT is capable of supplying similar cases, particularly when using relevance feedback, on such a large database. Usual image retrieval is based on a single image as search target but for this application we have to select images by case as similar cases need to be found and not images. A few false positive cases often remain in the results but they can be sorted out quickly by the surgeons. Image retrieval can well be used for the planning of operations by supplying similar cases. A variety of challenges has been identified and partly solved (varying luminosity, small region of interested, case-based instead of image-based). This article mainly presents a case study to identify potential benefits and problems. Several steps for improving the system have been identified as well and will be described at the end of the paper.

The venue of telematics necessarily modifies the current design of the Electronic Patient Record ... more The venue of telematics necessarily modifies the current design of the Electronic Patient Record (EPR). A question is open : should the EPR be build on top of the web ? This solution does not provide the quality of a proprietary implementation, and the problems of confidentiality are not yet fully solved, although it brings many advantages. Therefore, in the

ABSTRACT Information technology and the information sciences have been part of our lives for some... more ABSTRACT Information technology and the information sciences have been part of our lives for some time now. They have revolutionized the healthcare system, changing the whole health landscape, as well as health culture. New devices, sources of data and roles

Renal Failure, 1994

The heat shock (HS) response is remarkably conserved during evolution and is evoked under many co... more The heat shock (HS) response is remarkably conserved during evolution and is evoked under many conditions of stress. There are a number of ways in which this ubiquitous response may be important for the understanding of renal pathophysiology. Ischemia, toxin exposure, and oxidative stress induce this response. Several models of hypertension are associated with increased susceptibility to environmental stress and increased accumulation of heat shock protein mRNA. HSP70 polymorphism has been demonstrated when comparing normotensive and hypertensive rats. Heat shock proteins may play a role in renal diseases through their important involvement in immunological processes. Several observations point to a role of the heat shock response in systemic lupus erythematosus (SLE). Autoantibodies against HSP70 and ubiquitin are found in many patients with this disease. Autoantibodies against ubiquitin and ubiquitinated histone H2A are localized to the kidney glomerular basement membrane of SLE patients with active disease. A better understanding of the HS response may thus provide important insight into renal pathophysiology and may suggest paradigms for therapeutic interventions.

Studies in health technology and informatics, 2017

Introduction: Patient centred care fosters a holistic approach of care switching the focus from a... more Introduction: Patient centred care fosters a holistic approach of care switching the focus from a disease perspective to a patient's experience perspective. Patient centred care is of particular importance in the context of paediatric emergency medicine. Indeed, parents entering a paediatric emergency department (PED) are usually under stress caused by their children's illness, the unfamiliar setting of the PED and delays of care. All these factors can deteriorate their experience as well as the relationships between healthcare providers, the patients and their parents.

Methods We explore potential areas to improve the patient experience during his journey into PED. The dimensions of the picker's patient centred care are used to guide observations, conduct interviews and focus groups. The areas of improvement are then operationalized through their translation into app functionalities.

Results Our novel application allows supporting users on 7 of the 8 dimensions of picker's patient centred care model. The app supports parents in their decision-making to consult a PED, it provides relevant medical information to avoid unrealistic expectations and accompany the family after discharge thanks to tailored information sheets about diagnostics.

Conclusion: Our mobile app allows to make a big step toward the improvement of the patient-caregiver relationship. The direct benefits will be shared by patients and caregivers, as well as the institution.

International journal of clinical pharmacy, Jan 10, 2016

Background While evidence on implementation of medication safety strategies is increasing, reason... more Background While evidence on implementation of medication safety strategies is increasing, reasons for selecting and relinquishing distinct strategies and details on implementation are typically not shared in published literature. Objective We aimed to collect and structure expert information resulting from implementing medication safety strategies to provide advice for decision-makers. Setting Medication safety experts with clinical expertise from thirteen hospitals throughout twelve European and North American countries shared their experience in workshop meetings, on-site-visits and remote structured interviews. Methods We performed an expert-based, in-depth assessment of implementation of best-practice strategies to improve drug prescribing and drug administration. Main outcome measures Workflow, variability and recommended medication safety strategies in drug prescribing and drug administration processes. Results According to the experts, institutions chose strategies that targ...

AMIA ... Annual Symposium proceedings / AMIA Symposium. AMIA Symposium, 2015

Shift-to-shift handoffs refer to the process of transferring role and responsibility for providin... more Shift-to-shift handoffs refer to the process of transferring role and responsibility for providing care from one person to another, thus insuring continuity of care. Through focus groups of residents and supervising physicians, we studied how physicians select patient cases to discuss during handoffs. We also compared the selection across level of experience. Understanding the patient selection criteria can give us insight into how to improve handoffs, in particular using supportive technologies that are integrated into the clinical information system. Studying the actual handoff process and note-taking also generated suggestions for handoff improvement.

Information and communication technologies have a role to play in improving a citizen's quali... more Information and communication technologies have a role to play in improving a citizen's quality of life. The ageing world population demonstrates the major challenge of as-sisting citizens in their various activities. ICTs could help them to have a healthier lifestyle, reduce physical efforts, reduce the risk of disease and prevent accidents or ill-nesses. PEACE aims to provide a system allowing the association of any type of sensors or data sources with any action within the user's environment. The generic ap-proach of this system allows it to be deployed in several backgrounds. Indeed, multiple purposes can concern home automation, clinical environment automation and progress in the Ambient Assisted Living field. Creating this system required focusing on multiple areas like user interaction paradigms, I/O management, security management systems and automatic services discovery. Developing this project has demonstrated significant future job possibilities. Indeed, the imple...

Informatique et Santé, 2009

Studies in health technology and informatics, 2009

Five generations of second year students at the Zagreb University School of Medicine were intervi... more Five generations of second year students at the Zagreb University School of Medicine were interviewed through an anonymous questionnaire on their use of personal computers, Internet, computer laboratories and computer-assisted education in general. Results show an advance in students' usage of information and communication technology during the period from 1998/99 to 2002/03. However, their positive opinion about computer laboratory depends on installed capacities: the better the computer laboratory technology, the better the students' acceptance and use of it.

Informatique et Santé, 2009

Abstract Background An observatory of ENT diseases in children was set up. It aimed at estimatin... more Abstract Background An observatory of ENT diseases in children was set up. It aimed at estimating the incidence of acute episodes of rhinopharyngitis, otitis media, tonsillitis, sinusitis and laryngitis and evaluating their time-space evolution in winter in France. In addition, this study evaluated the ability of our surveillance platform generator to implement and manage such an observatory. Methods A network of practitioners,

International Journal of Medical Informatics, 2007

Studies in Health Technology and Informatics, Feb 1, 2009

Studies in Health Technology and Informatics, Feb 1, 2009

Proceedings of Spie the International Society For Optical Engineering, Oct 22, 2007

This article describes the use of a medical image retrieval system on a database of 16'000 fractu... more This article describes the use of a medical image retrieval system on a database of 16'000 fractures, selected from surgical routine over several years. Image retrieval has been a very active domain of research for several years. It was frequently proposed for the medical domain, but only few running systems were ever tested in clinical routine. For the planning of surgical interventions after fractures, x-ray images play an important role. The fractures are classified according to exact fracture location, plus whether and to which degree the fracture is damaging articulations to see how complicated a reparation will be. Several classification systems for fractures exist and the classification plus the experience of the surgeon lead in the end to the choice of surgical technique (screw, metal plate, ...). This choice is strongly influenced by the experience and knowledge of the surgeons with respect to a certain technique. Goal of this article is to describe a prototype that supplies similar cases to an example to help treatment planning and find the most appropriate technique for a surgical intervention. Our database contains over 16'000 fracture images before and after a surgical intervention. We use an image retrieval system (GNU Image Finding Tool, GIFT) to find cases/images similar to an example case currently under observation. Problems encountered are varying illumination of images as well as strong anatomic differences between patients. Regions of interest are usually small and the retrieval system needs to focus on this region. Results show that GIFT is capable of supplying similar cases, particularly when using relevance feedback, on such a large database. Usual image retrieval is based on a single image as search target but for this application we have to select images by case as similar cases need to be found and not images. A few false positive cases often remain in the results but they can be sorted out quickly by the surgeons. Image retrieval can well be used for the planning of operations by supplying similar cases. A variety of challenges has been identified and partly solved (varying luminosity, small region of interested, case-based instead of image-based). This article mainly presents a case study to identify potential benefits and problems. Several steps for improving the system have been identified as well and will be described at the end of the paper.

The venue of telematics necessarily modifies the current design of the Electronic Patient Record ... more The venue of telematics necessarily modifies the current design of the Electronic Patient Record (EPR). A question is open : should the EPR be build on top of the web ? This solution does not provide the quality of a proprietary implementation, and the problems of confidentiality are not yet fully solved, although it brings many advantages. Therefore, in the

ABSTRACT Information technology and the information sciences have been part of our lives for some... more ABSTRACT Information technology and the information sciences have been part of our lives for some time now. They have revolutionized the healthcare system, changing the whole health landscape, as well as health culture. New devices, sources of data and roles

Renal Failure, 1994

The heat shock (HS) response is remarkably conserved during evolution and is evoked under many co... more The heat shock (HS) response is remarkably conserved during evolution and is evoked under many conditions of stress. There are a number of ways in which this ubiquitous response may be important for the understanding of renal pathophysiology. Ischemia, toxin exposure, and oxidative stress induce this response. Several models of hypertension are associated with increased susceptibility to environmental stress and increased accumulation of heat shock protein mRNA. HSP70 polymorphism has been demonstrated when comparing normotensive and hypertensive rats. Heat shock proteins may play a role in renal diseases through their important involvement in immunological processes. Several observations point to a role of the heat shock response in systemic lupus erythematosus (SLE). Autoantibodies against HSP70 and ubiquitin are found in many patients with this disease. Autoantibodies against ubiquitin and ubiquitinated histone H2A are localized to the kidney glomerular basement membrane of SLE patients with active disease. A better understanding of the HS response may thus provide important insight into renal pathophysiology and may suggest paradigms for therapeutic interventions.