It is evident that a patient empowerment approach based on self-management ICT tools is useful and accepted by patients and physicians. Further, there are clear indications that ICT frameworks such as the one presented in this paper support patients in behavioral changes and in better disease management. Finally, it was realized that self-management solutions should be built around the objective not only to educate and guide patients in disease self-management, but also to assist them in exploring the decision space and to provide insight and explanations about the impact of their own values on the decision.

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ObjectivesTo assess the current state of the art and the contribution of Free/Libre Open Source Software in health care (FLOSS-HC).MethodsThe review is based on a narrative review of the scientific literature as well as sources in the context of FLOSS-HC available through the Internet. All relevant available sources have been integrated into the MedFLOSS database and are freely available to the community.ResultsThe literature review reveals that publications about FLOSS-HC are scarce. The largest part of information about FLOSS-HC is available on dedicated websites and not in the academic literature. There are currently FLOSS alternatives available for nearly every specialty in health care. Maturity and quality varies considerably and there is little information available on the percentage of systems that are actually used in health care delivery.ConclusionsThe global impact of FLOSS-HC is still very limited and no figures on the penetration and usage of FLOSS-HC are available. However, there has been a considerable growth in the last 5 to 10 years. While there where only few systems available a decade ago, in the meantime many systems got available (e.g., more than 300 in the MedFLOSS database). While FLOSS concepts play an important role in most IT related sectors (e.g., telecommunications, embedded devices) the healthcare industry is lagging behind this trend.

BackgroundSmart Health is known as a concept that enhances networking, intelligent data processing and combining patient data with other parameters. Open data models can play an important role in creating a framework for providing interoperable data services that support the development of innovative Smart Health applications profiting from data fusion and sharing.MethodsThis article describes a model-driven engineering approach based on standardized clinical information models and explores its application for the development of interoperable electronic health record systems. The following possible model-driven procedures were considered: provision of data schemes for data exchange, automated generation of artefacts for application development and native platforms that directly execute the models. The applicability of the approach in practice was examined using the openEHR framework as an example.ResultsA comprehensive infrastructure for model-driven engineering of electronic health records is presented using the example of the openEHR framework. It is shown that data schema definitions to be used in common practice software development processes can be derived from domain models. The capabilities for automatic creation of implementation artefacts (e.g., data entry forms) are demonstrated. Complementary programming libraries and frameworks that foster the use of open data models are introduced. Several compatible health data platforms are listed. They provide standard based interfaces for interconnecting with further applications.ConclusionOpen data models help build a framework for interoperable data services that support the development of innovative Smart Health applications. Related tools for model-driven application development foster semantic interoperability and interconnected innovative applications.

Introduction: Diabetes requires a high level of disease management to be executed by the patient himself in order to succeed in treatment and for improving or at least preserving his health status. Aim: The main objective of the presented project is to design and implement a web technology based application framework. It shall provide sufficient means for selfmanagement and enable patient empowerment within the treatment process. Its underlying concept will be outlined in this work. Methods: Common techniques on requirements' engineering have been applied to derive an initial concept. It is based on a comprehensive state of the art analysis drawn from literature and web search.Results: A service-oriented architecture could be drafted that enables interoperability with existing eHealth systems on a technical and semantic level. Pilots will be deployed in Germany and Turkey. Pilot specific requirements can be address as well due to its modular architecture. Conclusion: The given concept gives a high level description of the envisaged approach. An initial prototype has been implemented. A second prototype is well on the way offering all major functionality and will be deployed within the pilot regions.