Sarafidis Ma, Toumpaniaris Pa, Kouris Ia, Karanasiou Na, Moirogiorgou Kc, Kalla Ma, Matsopoulos Ga, Aisopou Vd, Fourlis Aa, Anousakis – Vlachochristou Nd, Chandrinou Ad, Psarros Fd, Costaridis Ne, Zervakis Mc, Koutsouris Da
aInstitute of Communications and Computer Systems - National Technical University of Athens
cTechnical University of Crete
dNaval Hospital of Athens
eDpt. for the Management of European & Developmental Projects – Ministry of Greek National Defence
*Corresponding author: Toumpaniaris P, School of Electrical and Computers Engineering, National Technical University of Athens, Athens, Greece
Submission: November 11, 2020Published: January 12, 2021
ISSN: 2576-8816Volume9 Issue2
In Greece, all men between the age of 18 and 45 with Greek citizenship are obliged to serve mandatory military service. The reserved training divisions are performed four to six times every year and the average number of recruits at each of them is around 400 to 1,000 . For each recruit a physical / clinical overall examination is performed, involving various medical specialties. Currently, this procedure takes place in the absence of any kind of digital tool. Hence, this shortage results in disrupting the efficient human resources, assets and time management.
eMass overall concept
The eMass project aims at creating a platform that will facilitate the military recruitment process and, more specifically, the medical examination procedure. The platform will integrate a recruits’ Electronic Health Record (EHR) which will be utilized to extract significant health indicators, which constitute a valuable key factor for actions towards recruits’ health prevention . In fact, for each recruit an EHR will be created by the staff of the classification unit, where his demographics along with his personal and family medical history will be stored. Additionally, a pre-screening test, through portable telemedicine equipment collecting ECG, blood pressure and oximetry signals, will be performed. The data will be automatically stored in the recruit’s EHR and will be deployed in assessing the individual’s cardiovascular risk function through dedicated digital tools and algorithms. The eMass digital health platform, with all the stored data, will be available to health scientists of local and central military medical units, for further evaluation and processing, giving them access to recruits’ EHRs and advanced health data processing solutions.
eMass Information flow description
The information flow in the context of the eMass platform is summarized in Figure 1. This figure describes the following steps of each recruit’s medical examination during his military recruitment process.
Figure 1:The information flow in the context of eMass platform.
A. Every prospective army recruit goes to a military entrance
B. The staff search his record with the conscription or social security number. Once the recruit has been identified, his basic data will be displayed (i.e., Name, Surname, Father’s and Mother’s name, conscription, and social security number).
C. The recruit’s status is changed to “PRESENTED”.
D. Α QR code is printed for the recruit. The recruit is then forwarded to a specially designed area where the medical staff is located, which is staffed with a doctors’ team from eight medical specialties (radiology, microbiology, pathology, cardiology, otorhinolaryngology, ophthalmology, surgery – orthopedics, and neurology – psychiatric). Each recruit passes through each medical specialty’s workplace, where the code given to him at the entrance station will be scanned and the data entry will be accomplished.
The pathologists and cardiologists will have the system of
portable telemedicine equipment, which will be connected with
the laptop that will be used to record the medical data of the
conscript in their EHR and by extension in the platform of e-Mass.
The data recorded by the medical staff are stored on the main
server of eMass. The team of each medical specialty is responsible
for choosing if everything is normal. In the incident of a disease
diagnosis, the appropriate finding is selected from a list of ICD-10
disease codes. Then, depending on the findings of each medical
specialty, a decision is made as to whether the new conscript will
receive a capacity crisis and join the ranking center to the military
camp or whether he should receive a medical referral to the Naval
Hospital of Athens (NHA) for further examinations.
An innovative feature of the project is that a possible cardiovascular medical incident will be clinically evaluated both by locally based medical staff and automatically though computational means, utilizing machine learning algorithms (e.g., classification, clustering, market basket analysis by using association rules and forecasting procedures) incorporated into eMass medical incidents management unit. If a critical incident arises, and needs special care, specialized clinicians at the NHA will be thoroughly informed and they will provide their advice accordingly. The summary report exporting from the recruit’s visit to the medical staff is recorded in the recruit’s EHR.
The major benefits deriving from the development and implementation of the eMass platform are be summarized consequently:
A. Supervision of overall health status and medical history of
each recruit, contributing to timely and accurate diagnosis of
B. Medical findings and diagnostic reports will be directly available to doctors.
C. More productive management of medical exam scheduling (e.g., in cases of referral to the NHA), as the procedures will be automated, recorded and will follow a predetermined flow, without deviations .
D. More efficient management and interpretation of medical data, avoiding repetition of unnecessary physical / medical examinations and, therefore, avoiding entailing errors .
E. Reduction of bureaucratic procedures and simplification of work processes (through e.g., scheduling, access to PACS-RIS and EHR, creation reporting, etc.).
F. Reduction of time and operational costs through utilization of ICT services (e.g., reduction of physical / clinical / imaging examinations for each recruit throughout the whole military recruitment process).
G. Facilitate and systematize the process of collection and recording of medical data .
H. Development and utilization of a recruiter’s Electronic Health Record. (i) The introduction and employment of automated machine-learning based cardiovascular risk assessment tool. This information is recorded in the individual’s EHR and supports medical staff in making decisions .
In overall, the Greek Ministry of Defense will be able to upgrade its recruitment facilities and procedures. The medical examination process will be supported at every stage by the developed EHR, thus helping administrators to guarantee an efficient way to assess and protect the health of new members of the Greek Army. The work performed in this project provides basis for future research in several areas.
This research has been co‐financed by the European Union and Greek national funds through the Operational Program Competitiveness, Entrepreneurship and Innovation, under the call RESEARCH – CREATE – INNOVATE (project code:T1EDK-03505)
© 2021 Toumpaniaris P. This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and build upon your work non-commercially.