Abstract
OBJECTIVE: One of the main problems in e-health environments for developing an accurate multiuser identification is in the large number of patients, especially with itinerant medical devices and elderly people. This paper aims to contribute with two approaches to be included in ISO/IEEE 11073 family of standards as a standardized procedure for multiuser identification that can be used for a large variety of medical devices, regardless of their brand or model. From this contribution and to validate it, this work proposes a standardized e-health solution, including multiuser identification, implementing it in real health environments for elderly people, and evaluating their usability, interoperability, and adoption in daily living. MATERIALS AND METHODS: This works implements the internationally recommended Personal Health Devices ISO/IEEE 11073 standards as a multiplatform environment (Windows/Linux/Mac OS) and fulfils the paradigms of scalability, modularity, portability, maintainability, and robustness. The standard e-health solution has been implemented in 26 health environments in several cities in Spain (Madrid, Barcelona, Sevilla, Zaragoza, etc.), consisting of 118 health professionals, 319 senior patients, and 18 technical professionals. RESULTS: The proposed multiuser identification reduces the human error rate (from 13.3% to less than 5%) with positive evaluation: almost 70% of users are satisfied, with usability and time savings that are more than 50% in all the groups (nursing, medicine, and caregiving) and environments (residences, health centres, and hospitals). DISCUSSION: The use of e-health solutions within multiuser identification, as it is proposed through two standard-compliant approaches, permits advanced services and data analysis for a large variety of medical devices, regardless of their brand or model. CONCLUSION: This paper contributes an open interoperable e-health solution as alternative to the closed and commercial solutions and enables third-party developers to work collaboratively and extend the already implemented features, owing to the design based on plugins, value-added services, and multiple transport technologies and protocols.