Aris Tzavaras - Academia.edu (original) (raw)
Papers by Aris Tzavaras
A comprehensive "users manual" for analyzing a medical imaging capital budget project. ... more A comprehensive "users manual" for analyzing a medical imaging capital budget project. The book utilizes a step by step approach based on a case scenario for introducing the concept of medical equipment capital budgeting assessment and evaluation. The case scenario is the acquisition of an MRI equipment by a for-profit hospital. The target audience is students and professionals involved into consulting, managing, planning and assessment of health care financial investments. Although traditionally health care finance books introduce the principles of capital budgeting methods and then advance to investment evaluation approaches, this book attempts a different approach. It utilizes as a vehicle a case base scenario for becoming the reader’s “user manual” in evaluating capital budgeting decisions. It is written in a format, that the reader could replicate for directly applying it to his/hers specific problem.
Studies in health technology and informatics
In this paper, a Web-based software platform appropriately designed to support the continuity of ... more In this paper, a Web-based software platform appropriately designed to support the continuity of health care information and management for both in and out of hospital care is presented. The system has some additional features as it is the formation of continuity of care records and the transmission of referral letters with a semantically annotated web service. The platform's Web-orientation provides significant advantages, allowing for easily accomplished remote access.
The Diagnosis-Related Groups (DRGs), is a method that identifies patients with similar resources ... more The Diagnosis-Related Groups (DRGs), is a method that identifies patients with similar resources use, based on statistical evaluation of hospital records. Statistics provide the Diagnosis related consumed resources and, thus, they enable the calculation of an average patient's case-cost. On the basis of the Hospital activity levels and case mix, the health authorities can allocate the annual hospital budgets, both, prospectively and retrospectively. The purpose of the present study is to determine whether the implementation of the DRGs as a refunding methodology is, both, welcomed and feasible in the Greek National Health System (NHS). The aim was to collect information on the attitude, the knowledge, the experience, and the acceptability of the DRGs, as well as, on the existence of the necessary infrastructure. Two methods were used: First, a questionnaire was designed and sent to the Departments of Administrative and Economic Affairs of 50 Hospitals, corresponding to the 38% o...
Clinical personnel experience and expertise, case mix, task complexity and medical errors in the ... more Clinical personnel experience and expertise, case mix, task complexity and medical errors in the ICU, are the main factors affecting ventilation management efficiency. There are increasing evidence to support the need of "automating " t he process of ventilation management, not only in terms of efficiency, but also in terms of health care cost containment. Patients with chronic obstructive pulmonary disease (COPD) are characterized by increased work of breathing (WOB) and ventilatory muscle dysfunction. Since patients' needs are not static, ventilator settings have to be adjusted regularly. The aim of the present study was the development and evaluation of a neural network driven fuzzy advisor that utilizes non-invasively acquired parameters for the determination of the appropriate tidal volume (VT ) a nd respiration frequency (RR) ventilator settings for COPD patients. Forty three (43) hours of non-invasively monitored physiology parameters and ventilator settings, fr...
This paper presents the implementation of a laboratory classroom simulation of radiology networki... more This paper presents the implementation of a laboratory classroom simulation of radiology networking technology. The simulation focuses on educating undergraduate students in various aspects of installing and applying radiology Picture Archiving and Communication Systems (PACS) in a networked environment, based on the Digital Image and Communication in Medicine (DICOM) standard, with particular emphasis placed on student- centered learning. Laboratory structure enables students to simulate the operation of radiology departments in terms of DICOM communication with imaging devices, storage and archiving of DICOM information and DICOM- compatible digitization of film-printed radiographs.
IFMBE Proceedings, 2007
ABSTRACT We have developed a home-computer based system, addressing important aspects of the deve... more ABSTRACT We have developed a home-computer based system, addressing important aspects of the development of contemporary home — care that comprises of first, the employment of low-cost commercially available components, supporting home-care patient’s well-being observation, including eventually vital-signs monitoring, and, second, software means for the processing, the evaluation and the targeted transmission of the acquired health-data, together with the home-care patient administration,. The hardware of the system comprises of, first, a custom-made ECG acquisition module, equipped with a RF link between amplifier and PC, second, a Nellcor finger pulse oximetry probe for typical plethysmography based Oxygen Saturation (SpO2) measurements and the estimation of Heart Rate (HR) and Respiration Rate (RR), and third, another custom-made Carotid Sounds (CS) acquisition module, for the extraction of Heart Rate (HR) and Respiration Rate (RR). The acquired row data and trends of SpO2, HR, RR, ECG waveforms, Oxygen Therapy advice etc. are appropriately processed to produce decision supportive data, while they can be easily stored in the home computer and / or transmitted to another location. The transmission can be achieved through wireless point-to-point links, modem and telephone lines on both, landlines and mobile cellular telephone lines, by a designated location through secured paths over the internet and, finally, through two satellite communication links. The pulse oximetry module is employed only if the patient is in need of Oxygen Therapy.
Optimization of Medical Supervision, Management, and Reimbursement of contemporary Home Care (978... more Optimization of Medical Supervision, Management, and Reimbursement of contemporary Home Care (9781599048895): B. Spyropoulos, M. Botsivaly, A. Tzavaras, K. Koutsourakis: Book Chapters.
Conference proceedings : ... Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. Annual Conference, 2013
The fusion of Biomedical Technology, Informatics and Medical Decision-making into the modern Clin... more The fusion of Biomedical Technology, Informatics and Medical Decision-making into the modern Clinical Decision Support Systems (CDSS), as well as the population ageing and the escalation of hospital costs are the driving forces for adopting decentralized systems of health care provision. One of the main problems arising with decentralized health care provision, such as Home Care, is the discontinuity of medical care. This discontinuity appears not only in medical data transfer, but also in the quality of medical supervision. In order to accommodate for the lack of sufficient medical supervision in Home-Care environment, we have developed low-cost prototype solution for monitoring basic physiological parameters. The implemented architecture is employing wearable biomedical signal acquisition modules, utilizing "off the shelf" technologies in order to minimize cost. These modules transmit the acquired vital signs through a wireless link to a laptop computer. A web applicatio...
The aim of the paper is to identify the key physiological variables and ventilator settings invol... more The aim of the paper is to identify the key physiological variables and ventilator settings involved in ventilation management, and required for an appropriate Clinical Decision Support System (CDSS). Based on the results of a questionnaire designed for the purpose of the research, 70 hours of physiological and ventilation data were recorded. Recorded data were classified by clinicians into three major lung pathologies and were further statistically analyzed for identifying strong relationships between monitored and controlled ventilator parameters. Correlation analysis was evaluated by Intensive Care Unit (ICU) clinicians. Based on the evaluators' majority voting the number and type of participating variables in a CDSS was drastically decreased. The number and type of monitored variables ranged from a single one to six, depending on the patient's lung pathology, and the controlled ventilator setting. Evaluation results were successfully applied to Neural Network models for providing suggestions on Tidal Volume and the Fraction of inspired Oxygen.
AMIA ... Annual Symposium proceedings / AMIA Symposium. AMIA Symposium, 2007
The purpose of the present study was the development of software supporting Planning, Quality Ass... more The purpose of the present study was the development of software supporting Planning, Quality Assurance, Accreditation, and Operation of interdisciplinary Healthcare Professional Education. The form of the tool-kit is that of a secure website including fourteen principal screens, corresponding to the main aspects of the course under evaluation.
The purpose of this paper is to review 20 years (1987-2007) of experience in training young Biome... more The purpose of this paper is to review 20 years (1987-2007) of experience in training young Biomedical Engineers in Biochemistry and in vitro Diagnostics (IVD) Technology. This encountering has resulted in the gradual formation of a comprehensive training package that includes lectures and laboratory practicals, supported by both, traditional and on-line digital means, such as lecture-notes, slides, videos, demos and equipment simulations. Further, this course is maintained up to date by several research and development activities that offer partially feed back to the course and enrich its contents with custom developed devices, methods and application software. In this paper are presented, first, the structure and the components of this course, and second, the most important custom developed novelties, which have been integrated in the IVD Technology laboratory- practicals.
Patients with chronic obstructive pulmonary disease (COPD) are characterized by increased work of... more Patients with chronic obstructive pulmonary disease (COPD) are characterized by increased work of breathing (WOB) and ventilatory muscle dysfunction. Mechanical ventilation is applied to unload the WOB; rest respiratory muscles decrease arterial partial pressure of carbon dioxide (PaCO2) and treat hypoxemia. Since patients' needs are not static, ventilator settings have to be adjusted regularly. The aim of the present study was the development and evaluation of a neuro-fuzzy controller, that utilizes non-invasively acquired parameters for the determination of the appropriate tidal volume (VT) and respiration frequency (RR) ventilator settings for COPD patients. Forty three (43) hours of non-invasively monitored physiology parameters and ventilator settings, from four (4) different COPD patients ventilated in control mode, were collected in two (2) General Hospitals in Greece. Recorded data were randomly allocated into two sets, namely training set (60%) and evaluation set (40%). A neuro-fuzzy controller was developed and trained, by employing the training set. The controller utilizes non-invasively measured parameters, namely oxygen saturation (SpO2), lung compliance (C) and resistance (R), Peak Inspiratory pressure (PIP) and Plateau pressure (Pplateau), for predicting appropriate VT and RR settings. The developed neuro-fuzzy controller was tested against evaluation set. The Mean Square Error of the tidal volume and the respiration rate was 0.222 ml/Kgr and 1.21 breaths per minute (bpm) respectively.
The purpose of this study is the presentation of a system appropriate to be used upon the transit... more The purpose of this study is the presentation of a system appropriate to be used upon the transition of a patient, from hospital to homecare. The developed system is based upon the creation of a structured subset of data, complying with the ASTM E2369-0 Standard Specification for Continuity of Care Record, concerning the most relevant facts about a patient's healthcare, organized and transportable, in order to be employed during the post-discharge homecare period. The system allows for the extension of the use of DRGs to estimate mean Home-Care cost, taking advantage of the planning and the optimal documentation of the provided homecare
AMIA ... Annual Symposium proceedings / AMIA Symposium. AMIA Symposium
The purpose of the present study was the development of a Medical Procedure Resources-Allocation ... more The purpose of the present study was the development of a Medical Procedure Resources-Allocation and Cost-Capturing Software for the Estimation of the Mean DRGs associated Treatment Cost and its initial implementation in the specific context of the Surgery Department.
A comprehensive "users manual" for analyzing a medical imaging capital budget project. ... more A comprehensive "users manual" for analyzing a medical imaging capital budget project. The book utilizes a step by step approach based on a case scenario for introducing the concept of medical equipment capital budgeting assessment and evaluation. The case scenario is the acquisition of an MRI equipment by a for-profit hospital. The target audience is students and professionals involved into consulting, managing, planning and assessment of health care financial investments. Although traditionally health care finance books introduce the principles of capital budgeting methods and then advance to investment evaluation approaches, this book attempts a different approach. It utilizes as a vehicle a case base scenario for becoming the reader’s “user manual” in evaluating capital budgeting decisions. It is written in a format, that the reader could replicate for directly applying it to his/hers specific problem.
Studies in health technology and informatics
In this paper, a Web-based software platform appropriately designed to support the continuity of ... more In this paper, a Web-based software platform appropriately designed to support the continuity of health care information and management for both in and out of hospital care is presented. The system has some additional features as it is the formation of continuity of care records and the transmission of referral letters with a semantically annotated web service. The platform's Web-orientation provides significant advantages, allowing for easily accomplished remote access.
The Diagnosis-Related Groups (DRGs), is a method that identifies patients with similar resources ... more The Diagnosis-Related Groups (DRGs), is a method that identifies patients with similar resources use, based on statistical evaluation of hospital records. Statistics provide the Diagnosis related consumed resources and, thus, they enable the calculation of an average patient's case-cost. On the basis of the Hospital activity levels and case mix, the health authorities can allocate the annual hospital budgets, both, prospectively and retrospectively. The purpose of the present study is to determine whether the implementation of the DRGs as a refunding methodology is, both, welcomed and feasible in the Greek National Health System (NHS). The aim was to collect information on the attitude, the knowledge, the experience, and the acceptability of the DRGs, as well as, on the existence of the necessary infrastructure. Two methods were used: First, a questionnaire was designed and sent to the Departments of Administrative and Economic Affairs of 50 Hospitals, corresponding to the 38% o...
Clinical personnel experience and expertise, case mix, task complexity and medical errors in the ... more Clinical personnel experience and expertise, case mix, task complexity and medical errors in the ICU, are the main factors affecting ventilation management efficiency. There are increasing evidence to support the need of "automating " t he process of ventilation management, not only in terms of efficiency, but also in terms of health care cost containment. Patients with chronic obstructive pulmonary disease (COPD) are characterized by increased work of breathing (WOB) and ventilatory muscle dysfunction. Since patients' needs are not static, ventilator settings have to be adjusted regularly. The aim of the present study was the development and evaluation of a neural network driven fuzzy advisor that utilizes non-invasively acquired parameters for the determination of the appropriate tidal volume (VT ) a nd respiration frequency (RR) ventilator settings for COPD patients. Forty three (43) hours of non-invasively monitored physiology parameters and ventilator settings, fr...
This paper presents the implementation of a laboratory classroom simulation of radiology networki... more This paper presents the implementation of a laboratory classroom simulation of radiology networking technology. The simulation focuses on educating undergraduate students in various aspects of installing and applying radiology Picture Archiving and Communication Systems (PACS) in a networked environment, based on the Digital Image and Communication in Medicine (DICOM) standard, with particular emphasis placed on student- centered learning. Laboratory structure enables students to simulate the operation of radiology departments in terms of DICOM communication with imaging devices, storage and archiving of DICOM information and DICOM- compatible digitization of film-printed radiographs.
IFMBE Proceedings, 2007
ABSTRACT We have developed a home-computer based system, addressing important aspects of the deve... more ABSTRACT We have developed a home-computer based system, addressing important aspects of the development of contemporary home — care that comprises of first, the employment of low-cost commercially available components, supporting home-care patient’s well-being observation, including eventually vital-signs monitoring, and, second, software means for the processing, the evaluation and the targeted transmission of the acquired health-data, together with the home-care patient administration,. The hardware of the system comprises of, first, a custom-made ECG acquisition module, equipped with a RF link between amplifier and PC, second, a Nellcor finger pulse oximetry probe for typical plethysmography based Oxygen Saturation (SpO2) measurements and the estimation of Heart Rate (HR) and Respiration Rate (RR), and third, another custom-made Carotid Sounds (CS) acquisition module, for the extraction of Heart Rate (HR) and Respiration Rate (RR). The acquired row data and trends of SpO2, HR, RR, ECG waveforms, Oxygen Therapy advice etc. are appropriately processed to produce decision supportive data, while they can be easily stored in the home computer and / or transmitted to another location. The transmission can be achieved through wireless point-to-point links, modem and telephone lines on both, landlines and mobile cellular telephone lines, by a designated location through secured paths over the internet and, finally, through two satellite communication links. The pulse oximetry module is employed only if the patient is in need of Oxygen Therapy.
Optimization of Medical Supervision, Management, and Reimbursement of contemporary Home Care (978... more Optimization of Medical Supervision, Management, and Reimbursement of contemporary Home Care (9781599048895): B. Spyropoulos, M. Botsivaly, A. Tzavaras, K. Koutsourakis: Book Chapters.
Conference proceedings : ... Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. Annual Conference, 2013
The fusion of Biomedical Technology, Informatics and Medical Decision-making into the modern Clin... more The fusion of Biomedical Technology, Informatics and Medical Decision-making into the modern Clinical Decision Support Systems (CDSS), as well as the population ageing and the escalation of hospital costs are the driving forces for adopting decentralized systems of health care provision. One of the main problems arising with decentralized health care provision, such as Home Care, is the discontinuity of medical care. This discontinuity appears not only in medical data transfer, but also in the quality of medical supervision. In order to accommodate for the lack of sufficient medical supervision in Home-Care environment, we have developed low-cost prototype solution for monitoring basic physiological parameters. The implemented architecture is employing wearable biomedical signal acquisition modules, utilizing "off the shelf" technologies in order to minimize cost. These modules transmit the acquired vital signs through a wireless link to a laptop computer. A web applicatio...
The aim of the paper is to identify the key physiological variables and ventilator settings invol... more The aim of the paper is to identify the key physiological variables and ventilator settings involved in ventilation management, and required for an appropriate Clinical Decision Support System (CDSS). Based on the results of a questionnaire designed for the purpose of the research, 70 hours of physiological and ventilation data were recorded. Recorded data were classified by clinicians into three major lung pathologies and were further statistically analyzed for identifying strong relationships between monitored and controlled ventilator parameters. Correlation analysis was evaluated by Intensive Care Unit (ICU) clinicians. Based on the evaluators' majority voting the number and type of participating variables in a CDSS was drastically decreased. The number and type of monitored variables ranged from a single one to six, depending on the patient's lung pathology, and the controlled ventilator setting. Evaluation results were successfully applied to Neural Network models for providing suggestions on Tidal Volume and the Fraction of inspired Oxygen.
AMIA ... Annual Symposium proceedings / AMIA Symposium. AMIA Symposium, 2007
The purpose of the present study was the development of software supporting Planning, Quality Ass... more The purpose of the present study was the development of software supporting Planning, Quality Assurance, Accreditation, and Operation of interdisciplinary Healthcare Professional Education. The form of the tool-kit is that of a secure website including fourteen principal screens, corresponding to the main aspects of the course under evaluation.
The purpose of this paper is to review 20 years (1987-2007) of experience in training young Biome... more The purpose of this paper is to review 20 years (1987-2007) of experience in training young Biomedical Engineers in Biochemistry and in vitro Diagnostics (IVD) Technology. This encountering has resulted in the gradual formation of a comprehensive training package that includes lectures and laboratory practicals, supported by both, traditional and on-line digital means, such as lecture-notes, slides, videos, demos and equipment simulations. Further, this course is maintained up to date by several research and development activities that offer partially feed back to the course and enrich its contents with custom developed devices, methods and application software. In this paper are presented, first, the structure and the components of this course, and second, the most important custom developed novelties, which have been integrated in the IVD Technology laboratory- practicals.
Patients with chronic obstructive pulmonary disease (COPD) are characterized by increased work of... more Patients with chronic obstructive pulmonary disease (COPD) are characterized by increased work of breathing (WOB) and ventilatory muscle dysfunction. Mechanical ventilation is applied to unload the WOB; rest respiratory muscles decrease arterial partial pressure of carbon dioxide (PaCO2) and treat hypoxemia. Since patients' needs are not static, ventilator settings have to be adjusted regularly. The aim of the present study was the development and evaluation of a neuro-fuzzy controller, that utilizes non-invasively acquired parameters for the determination of the appropriate tidal volume (VT) and respiration frequency (RR) ventilator settings for COPD patients. Forty three (43) hours of non-invasively monitored physiology parameters and ventilator settings, from four (4) different COPD patients ventilated in control mode, were collected in two (2) General Hospitals in Greece. Recorded data were randomly allocated into two sets, namely training set (60%) and evaluation set (40%). A neuro-fuzzy controller was developed and trained, by employing the training set. The controller utilizes non-invasively measured parameters, namely oxygen saturation (SpO2), lung compliance (C) and resistance (R), Peak Inspiratory pressure (PIP) and Plateau pressure (Pplateau), for predicting appropriate VT and RR settings. The developed neuro-fuzzy controller was tested against evaluation set. The Mean Square Error of the tidal volume and the respiration rate was 0.222 ml/Kgr and 1.21 breaths per minute (bpm) respectively.
The purpose of this study is the presentation of a system appropriate to be used upon the transit... more The purpose of this study is the presentation of a system appropriate to be used upon the transition of a patient, from hospital to homecare. The developed system is based upon the creation of a structured subset of data, complying with the ASTM E2369-0 Standard Specification for Continuity of Care Record, concerning the most relevant facts about a patient's healthcare, organized and transportable, in order to be employed during the post-discharge homecare period. The system allows for the extension of the use of DRGs to estimate mean Home-Care cost, taking advantage of the planning and the optimal documentation of the provided homecare
AMIA ... Annual Symposium proceedings / AMIA Symposium. AMIA Symposium
The purpose of the present study was the development of a Medical Procedure Resources-Allocation ... more The purpose of the present study was the development of a Medical Procedure Resources-Allocation and Cost-Capturing Software for the Estimation of the Mean DRGs associated Treatment Cost and its initial implementation in the specific context of the Surgery Department.