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Learn more: PMC Disclaimer | PMC Copyright Notice BMJ Health Care Inform . 2026 Apr 13;33(1):e102005. doi: 10.1136/bmjhci-2025-102005 Search in PMC Search in PubMed View in NLM Catalog Add to search Supporting street medicine through medical informatics: a manifesto on research needs Alfred Franz Winter Alfred Franz Winter 1 Institute of Medical Informatics, Statistics and Epidemiology, Leipzig University, Leipzig, Germany 2 Working Group “Inclusion Health Informatics (IncHI)”, European Federation for Medical Informatics, Le Mont-sur-Lausanne, Switzerland Find articles by Alfred Franz Winter 1, 2, ✉ , Andrea Alverà Andrea Alverà 3 Caritas Trieste, Trieste, Italy Find articles by Andrea Alverà 3 , Elske Ammenwerth Elske Ammenwerth 4 UMIT TIROL Private Universitat fur Gesundheitswissenschaften und -technologie GmbH, Hall in Tirol, Austria Find articles by Elske Ammenwerth 4 , Alina M Breaz Alina M Breaz 5 Aurel Vlaicu University of Arad, Arad, Romania Find articles by Alina M Breaz 5 , Catherine Chronaki Catherine Chronaki 6 HL7 Europe, Brussels, Belgium Find articles by Catherine Chronaki 6 , Mihaela Crişan-Vida Mihaela Crişan-Vida 7 Universitatea Politehnica Timisoara, Timișoara, Romania Find articles by Mihaela Crişan-Vida 7 , Jaime Delgado Jaime Delgado 8 Computer Architecture Department, Universitat Politècnica de Catalunya, Barcelona, Spain Find articles by Jaime Delgado 8 , Parisis Gallos Parisis Gallos 9 Department of Digital Systems, University of Piraeus, Pireas, Greece Find articles by Parisis Gallos 9 , Franziska Jahn Franziska Jahn 1 Institute of Medical Informatics, Statistics and Epidemiology, Leipzig University, Leipzig, Germany Find articles by Franziska Jahn 1 , Philipp Plicka Philipp Plicka 1 Institute of Medical Informatics, Statistics and Epidemiology, Leipzig University, Leipzig, Germany Find articles by Philipp Plicka 1 , Birgit Schneider Birgit Schneider 1 Institute of Medical Informatics, Statistics and Epidemiology, Leipzig University, Leipzig, Germany Find articles by Birgit Schneider 1 , Sven Speerforck Sven Speerforck 10 Department of Psychiatry and Psychotherapy, Leipzig University, Leipzig, Germany Find articles by Sven Speerforck 10 , Lăcrămioara Stoicu-Tivadar Lăcrămioara Stoicu-Tivadar 2 Working Group “Inclusion Health Informatics (IncHI)”, European Federation for Medical Informatics, Le Mont-sur-Lausanne, Switzerland 7 Universitatea Politehnica Timisoara, Timișoara, Romania Find articles by Lăcrămioara Stoicu-Tivadar 2, 7 Author information Article notes Copyright and License information 1 Institute of Medical Informatics, Statistics and Epidemiology, Leipzig University, Leipzig, Germany 2 Working Group “Inclusion Health Informatics (IncHI)”, European Federation for Medical Informatics, Le Mont-sur-Lausanne, Switzerland 3 Caritas Trieste, Trieste, Italy 4 UMIT TIROL Private Universitat fur Gesundheitswissenschaften und -technologie GmbH, Hall in Tirol, Austria 5 Aurel Vlaicu University of Arad, Arad, Romania 6 HL7 Europe, Brussels, Belgium 7 Universitatea Politehnica Timisoara, Timișoara, Romania 8 Computer Architecture Department, Universitat Politècnica de Catalunya, Barcelona, Spain 9 Department of Digital Systems, University of Piraeus, Pireas, Greece 10 Department of Psychiatry and Psychotherapy, Leipzig University, Leipzig, Germany ✉ Professor Alfred Franz Winter; [email protected] None declared. Received 2025 Dec 19; Accepted 2026 Mar 25; Collection date 2026. Copyright © Author(s) (or their employer(s)) 2026. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ Group. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: https://creativecommons.org/licenses/by-nc/4.0/ . PMC Copyright notice PMCID: PMC13084957 PMID: 41974479 Abstract Homeless individuals face major barriers in accessing regular healthcare, leading to the development of street medicine as a distinct humanitarian field. To enhance continuity and quality of care, consistent documentation is crucial. However, electronic health records are rarely used in European street medicine. An interdisciplinary European workshop identified four key research fields for medical informatics in street medicine: (1) Research ethics: The creation of ethical guidelines that promote co-creation and active communication with patients. (2) System development: Designing a secure, anonymous and European Health Data Space-compliant personal Electronic Health and Social Record (pEHSR), establishing standardised health and social care datasets, and implementing dynamic consent management methods. (3) Education and training: Developing targeted programmes to improve digital and health literacy among street medicine clients and training professionals in the effective use of the pEHSR system. (4) Management and evaluation: Creating management structures and evaluation frameworks suited to the unique challenges of street medicine. This manifesto calls for internationally coordinated scientific efforts to build effective, integrated digital health solutions for vulnerable populations. It encourages researchers and practitioners from medical informatics and related fields to engage with these priorities and support innovation that advances equitable healthcare access. Keywords: Medical Records; Medical Informatics Applications; Electronic Health Records; Decision Making, Computer-Assisted Introduction ‘Health for All’ by 2000 was the call made by the WHO in 1978, driven by global health inequalities. 1 This goal remains unmet, with inadequate healthcare persisting even in developed countries, for example, in the USA and the European Union. This is particularly apparent in the situation of homeless and other marginalised groups. In the USA, more than 650 000 sheltered and unsheltered homeless were counted in a single night in 2023. 2 In 2024, FEANTSA, the European Federation of National Organisations Working with the Homeless, estimated that there were around 1 287 000 ‘rough sleepers, people staying in night shelters and in temporary accommodation’ in Europe. 3 Especially homeless people face higher rates of morbidity and mortality than the general population, with high prevalence of cardiovascular, metabolic and infectious diseases. 4 Around 70% of homeless individuals also suffer from mental health issues, often linked to substance use. 4 Refugees and migrants among the homeless frequently present with skin, respiratory and viral infections. 5 Also, the WHO highlights the need to address these ‘vulnerable populations’ in its latest European action plan. 6 Despite significantly increased morbidity, these populations have extreme difficulty accessing the mainstream healthcare system as and if needed. Reasons are, for example, stigma and discrimination, negative experiences and missing health insurance in the country of residence. 7 8 Consequently, homeless people and other vulnerable groups must rely on low-threshold health services offered in shelters, on the streets or during special consultation hours by governmental or non-governmental organisations. 9 10 Particularly precarious in this regard is so-called street medicine. Street medicine refers to ‘the provision of health and social services care directly to people experiencing homelessness where they are, often via interprofessional teams’. 10 It is a subfield of humanitarian medicine, which upholds health as a human right, guided by ethical and humanitarian principles, including those of the WHO, UN and Red Cross. Its focus is on providing non-discriminatory, high-quality care without material gain. 11 Street medicine services are provided directly on the streets, in mobile bus clinics, or during consultation hours at shelters and other institutions that care for homeless people. 10 According to the Street Medicine Institute, there are ‘Street Medicine programmes in over 140 cities in 27 countries across 6 continents’. 9 The British National Institute for Health and Care Excellence considers providing medical care to homeless people on the streets to be an essential part of providing appropriate integrated healthcare for homeless people. 12 Street medicine teams include nurses, paramedics, doctors and trainees, often volunteering in their free time. They work closely with social workers to support clients, forming multidisciplinary teams. 10 However, cooperation and communication in the teams are hindered by limited resources, poor IT infrastructure and staff shortages. Many services rely on donations. Despite these obstacles, staff remain highly motivated but require specialised knowledge in street medicine, social work and informatics. Burnout is a major concern, and psychological support—potentially aided by digital interventions—is essential to sustain the well-being of these professionals and volunteers. 13 The specific circumstances of life on the streets, combined with the limited availability of street medicine services, usually lead to fragmented care. Fragmented care in general “is a major contributor to high healthcare spending and poor health outcomes […] [which is] particularly significant for individuals with behavioural health challenges”. 14 A longitudinal medical documentation in these settings would—as in conventional settings—support decision-making, planning of effective medical treatment, prevention of double examinations and adherence to proposed therapies, that is, coordinated and continuous care. 15 Street medicine clients are highly mobile and lack a fixed point of contact or safe storage for medical documents, making paper records unsuitable. 16 Electronic health records (EHRs) are a better option for maintaining consistent, long-term medical documentation, as confirmed by studies in the USA 16 and France. 15 Evidence, mainly from the USA, shows that longitudinal medical documentation and electronic medical record (EMR) use in street medicine is limited. 17 In Europe, this area is under-researched, with digitalisation and data exchange poorly developed. Only single, locally limited efforts to establish EMRs are known. 5 18 This lack of structured documentation hinders both primary care and the secondary use of data, which is essential for informing health institutions, policymakers and strategies aimed at improving care and supporting the reintegration of street medicine clients into mainstream health systems. Against this background, the aim of this paper is to identify the research needed to improve information processing in street medicine settings and, in particular, to make EHRs usable in these challenging settings. This will be done by answering the following questions: What are the main barriers and research needs to the implementation and use of electronic health records in street medicine? What must be done to integrate electronic health records into the processes of the sociotechnical settings of street medicine and what additional application systems are therefore needed? This paper aims to formulate a research agenda, rather than to provide a systematic review of existing solutions. The authors see this paper as a manifesto, a call for action to researchers from medical informatics, medicine, sociology and social work, ethics and other disciplines to address and answer the research questions raised. We want to mobilise dormant resources to improve the health of one of the most vulnerable groups in our societies and to save lives. Methods On 3 December 2024 to 4 December 2024, an international interdisciplinary workshop in Leipzig, Germany, gathered 20 experts from Austria, Belgium, Germany, Greece, Italy, Romania and Spain to identify research needs for improving longitudinal medical documentation and EHRs in street medicine. Participants were social work professionals and researchers from various fields, including sociology, research ethics, medicine including psychiatry and medical informatics. Keynote presentations provided insights into current challenges and solutions in medical documentation and information logistics in street medicine. An alternative city tour highlighted the situation of homeless individuals in Leipzig and demonstrated different aid services in practice. Research needs assessment regarding information processing in street medicine and social support for homeless individuals was done using ‘cardstorming’ 19 with predefined cards to identify open issues and a World Café 20 to support requirements and needs analysis especially regarding Empowerment and Education, Sociology and Social Work, Privacy and Security, and Piloting and Evaluation. Research needs were gathered during the workshop using posters and cards, then transcribed into keywords. These were categorised using Mayring’s inductive categorisation method. 21 Texts were partly generated from the keywords with ChatGPT4 (chatgpt.com) and reviewed by AFW, FJ, BS and PP for consistency. Subsequently, the statements about research needs that were identified in this way were complemented with references to publications that support these statements. All authors were involved in this process. A summary manuscript was created, revised and cross-checked by all authors, forming the basis for this paper. Results: research fields and needs On the street, medical care by health professionals and social counselling and care by street social workers go hand in hand. Both spheres of care are dependent on continuity of care, which requires integrated, electronic, personal, ubiquitously available health and social records (personal Electronic Health and Social Record, pEHSR). Four fields of research and development must be addressed to achieve pEHSR and to gain trust among street medicine clients for using it (see figure 1 ). Figure 1. Research needs for appropriate informatics support of street medicine. EHDS, European Health Data Space; EHR, electronic health record. Open in a new tab Research field 1: ethical principles for medical informatics research in street medicine In street medicine settings, research without strong ethical foundations risks reinforcing existing inequity and mistrust. To ensure that digital innovations serve the needs of street medicine clients respectfully and effectively, not only the fundamental ethical foundations for medicine like the Declaration of Helsinki must be observed. Moreover, the Belmont Report, calling for respect for persons, beneficence and justice, 22 must be precisely tailored to ethical guidelines for medical informatics research in street medicine. Research need 1.1: define ethical principles for medical informatics research in street medicine Successful research with street medicine clients relies on trust and fairness, posing complex ethical questions. 23 Ethical guidelines tailored to medical informatics research in street medicine are needed, ideally as a practical checklist. These should promote co-creation, 12 involving clients as co-researchers, not just subjects. Transparent communication about research goals and non-discriminatory aims is essential. A thorough requirements and risk analysis, especially concerning data privacy, must precede any IT solution design. Research field 2: pEHSR Many homeless persons already have access to digital services, for example, via smartphones, and facilities such as community shelters can create additional access opportunities. 24 However, secure systems for managing pEHSRs for street medicine clients, health professionals and social workers must be developed. These systems have to uphold rights granted by the European Health Data Space (EHDS) regulation 25 and follow international interoperability standards. To build trust, clients must always retain full control over their data. Research need 2.1: assess national EHR systems for street medicine suitability Many countries offer EHRs, like Germany’s ‘ePA’ and Austria’s ‘ELGA,’ designed for mainstream healthcare. However, their use in street medicine needs detailed investigation, as clients may lack ID, health cards or insurance, value anonymity and undergo different workflows. A systematic analysis is needed to assess the suitability of national EHR systems for street medicine and, in case of suitability, action plans to include medical data of street medicine clients. Research need 2.2: design an EHDS-compliant pEHSR architecture A pEHSR system architecture for street medicine clients, healthcare professionals (HCP) and social workers must be developed. It must comply with EHDS regulations for health data. Based on a generic model of the EHDS, 26 we propose the HD4U architecture (‘Health Data for You’), shown in figure 2 . It includes: Figure 2. Architectural sketch for a pEHR system in the setting of street medicine using 3LGM². 29 EPR, Electronic Patient Record; EHDS, European Health Data Space; HDAB, Health Data Access Body; HDAMS, Health Data Access Management System; HD4U, Health Data for You; HPAS, Health Professional Access Service; TCMS,Trust Center Management System. Open in a new tab HD4U-you: The personal EHR is stored here and managed by the client, removing the need for EHDS’s ‘electronic health data access service’. HD4U-HCP: Allows healthcare professionals to read, document and store treatments and results of care. HD4U-TCMS (Trust Center Management System): Implements EHDS’ Health Professional Access Services and authorises healthcare professionals’ access to the EHR. HD4U-HDAMS (Health Data Access Management System): Oversees secondary data access, aligning with EHDS’s Health Data Access Bodies. This model must evolve into an integrated pEHSR and consider compatibility with national EHR systems, as outlined in Research Need 2.1. Research need 2.3: create secure, anonymous identification solutions Methods and tools for ‘anonymous identification’ 27 are needed. This oxymoron describes the need to unambiguously identify street medicine clients to assign the correct health record, while allowing them to remain anonymous and not disclose personal details like name and date of birth. 15 These methods should be usable by health professionals and social workers in contact with clients, while also allowing clients to access their own health records or social files if they choose. Research need 2.4: ensure privacy and security by design Technical solutions for data protection in street medicine must address clients’ anonymity concerns, mobility and limited device access. Privacy and security must be ensured by design. Key elements include cloud architectures for broad access, mechanisms balancing security with emergency access and strong data provenance. International standards like ISO/TS 6201:2025, ISO/TC 215/WG 4 and HL7 FHIR. Consents should be adopted or adapted for this sensitive setting. Research need 2.5: standardise core datasets for health records A (minimum) basic dataset for street medicine EHRs must be defined, focusing on the typical morbidity profile of clients. It should follow European standards (eg, IPS (International Patient Summary), EHRXF (Electronic Health Record Exchange Format)) and use standard terminologies (eg, SNOMED (Systematized Nomenclature of Medicine), ICD10 (International Classification of Diseases, Version 10), ICPC-2 or ICPC-3 (International Classification of Primary Care)). The dataset must include demographic, medical history and encounter data. Data provenance is essential to assess the reliability of stored health information and for future reintegration into the mainstream healthcare system. Research need 2.6: standardise core datasets for social records A basic dataset for the social record 28 must be defined, using relevant European standards and terminologies. It should include social determinants of health like data on living situation, income (sources of support), mental health, family situation, special needs (eg, mobility, pets), addictions and key contact persons. Research need 2.7: develop dynamic consent mechanisms The consent of the users of the pEHSR to the processing of their data is necessary both for primary and secondary use (standard ISO/TS 6201:2025). However, the consent can change over time, both regarding the permitted type of data processing and regarding the scope of the data to be processed. Methods must be developed to represent and consider the dynamics of consent. Research need 2.8: enable multilingual and layperson-accessible content Users of the pEHSR have different native languages and are usually medical laypersons with little medical knowledge. Therefore, methods must be developed for storing the content of both the health and social files in a way that they can be translated into different foreign languages as well as into an understandable lay language. Standardised terminologies and vocabularies as well as AI-supported translation services are useful for this purpose (see Research Need 2.5 and 2.6). Research need 2.9: build interoperable pEHSR software solutions The pEHSR system must offer backend and frontend components for street medicine clients. The front-end priority is a kiosk solution for use in service facilities (eg, shelters). 15 Next, smartphone apps should be developed for clients. The system must be usable across Europe and worldwide, supporting integration with mainstream healthcare by providing interoperability with EHR systems per EHDS regulations. The results from previous Research Needs will feed into this research. Research need 2.10: provide secure communication tools for care teams Health professionals and social workers are often left to their own devices on the streets and need efficient and secure means of communication to collaborate. Since health and social records not only serve as a memory aid but also for communication within the treatment team, they should be supplemented by a trusted messenger service. Research field 3: education and training for clients and professionals Targeted education and training programmes must build trust and equip street medicine clients, health professionals and social workers with health and digital literacy they need. E-learning formats are particularly necessary in the situation of street medicine and street social work, as neither the clients nor the health professionals and social workers will be able to take part in traditional training classes. Research need 3.1: empower clients with health and digital literacy training Street medicine clients need education on basic healthcare, hygiene, health insurance, social assistance and their rights. 10 They also need support in using digital devices like smartphones. Motivating and familiarising them with the pEHSR is essential, requiring clear, trustworthy explanations tailored to the target group. Promising approaches include serious games and ‘training by peers’. Research need 3.2: train health professionals and social workers for street medicine care Health professionals and street social workers need training for their roles in street medicine, including tailored guidance on using the pEHSR. Platforms for providing relevant knowledge that can be used in this setting must be created. The professionals should also be supported by digital therapeutics to help prevent and manage mental health issues, such as burnout. Research Field 4: management and evaluation of the pEHSR system The pEHSR system will only benefit street medicine clients and staff if its operation is properly managed. 29 This includes defining responsible institutions and personnel as well as securing funding. Evaluation must demonstrate that the implemented procedures and IT solutions enhance client health and quality of life, as well as the work conditions of health professionals and social workers. Research need 4.1: establish a trusted managing institution To ensure secure operation of the pEHSR system, including data backup, maintenance, updates, user registration, access rights and data protection, an institution must be created. This institution must be trusted by street medicine clients. Whether a non-governmental organisation is suitable should be explored, and its specific responsibilities clearly defined. Research need 4.2: develop a sustainable business model The pEHSR system outlined in Research Field 2 requires funding for one or more development projects. However, permanent financial support for ongoing operation is also essential. A realistic business model must be created to calculate costs and outline how to generate necessary income within the low-resource context of street medicine. Research need 4.3: create an evaluation framework tailored to street medicine The impact of the pEHSR system on street medicine clients and professionals must be evaluated from the start, alongside software development. Given the complex context, a step-by-step piloting, agile approach to software development with continuous evaluation is essential. A tailored evaluation method must be developed, aligned with ethical research guidelines (Research Need 1.1) and drawing on sociology, public health and anthropology to suit the unique needs of street medicine. Discussion Medical informatics tools, such as personal EHRs and secure communication systems, offer promising solutions to improve healthcare for vulnerable populations in street medicine. However, providing software and hardware alone is insufficient; addressing numerous research questions across four key areas requires interdisciplinary collaboration from fields such as medical informatics, public health, medicine, nursing and sociology. Ideally, all areas would be tackled within one comprehensive project, but this would demand substantial funding, which is currently uncertain for street medicine initiatives. Alternatively, the sixteen identified research needs can be pursued through smaller, coordinated projects by various research groups. Effective coordination is essential to deliver timely and impactful solutions. Moreover, the approach should extend beyond street medicine to include other vulnerable groups in society. To support this mission, the European Federation for Medical Informatics (EFMI) has established the working group ‘Inclusion Health Informatics (IncHI)’. Scientists and practitioners from medical informatics, healthcare, sociology, ethics and related fields are encouraged to conduct research in the above-mentioned research areas and to use the IncHI working group with its website and the EFMI conferences to exchange findings, coordinate research projects and jointly acquire funding. Together, the goal is to move another step ‘towards health for all’. 30 Acknowledgements Footnotes Funding: Funded by the Deutsche Forschungsgemeinschaft (DFG, German Research Foundation) – 556059482. Supported by the Open Access Publishing Fund of Leipzig University. Patient consent for publication: Not applicable. Ethics approval: Not applicable. Provenance and peer review: Not commissioned; externally peer reviewed. Correction notice: This paper has been corrected since it was first published. The funding statement has been amended. References 1. WHO Declaration of Alma-Ata. 1978 2. de ST, Andrichik A, Prestera E, et al. The 2023 Annual Homelessness Assessment Report (AHAR) to Congress. 2023 https://www.huduser.gov/portal/sites/default/files/pdf/2023-AHAR-Part-1.pdf Available. 3. Fondation Abbé Pierre - FEANTSA SEVENTH overview of housing exclusion in Europe 2022. 2022 https://www.feantsa.org/public/user/Resources/reports/2022/Rapport_Europe_GB_2022_V3_Planches_Corrected.pdf Available. 4. Fazel S, Geddes JR, Kushel M. The health of homeless people in high-income countries: descriptive epidemiology, health consequences, and clinical and policy recommendations. Lancet. 2014;384:1529–40. doi: 10.1016/S0140-6736(14)61132-6. [ DOI ] [ PMC free article ] [ PubMed ] [ Google Scholar ] 5. Zenner D, Méndez AR, Schillinger S, et al. Health and illness in migrants and refugees arriving in Europe: analysis of the electronic Personal Health Record system. J Travel Med. 2022;29:taac035. doi: 10.1093/jtm/taac035. [ DOI ] [ PMC free article ] [ PubMed ] [ Google Scholar ] 6. WHO Regional digital health action plan for the WHO European Region 2023–2030. 2022 7. Canham SL, Weldrick R, Erisman M, et al. A Scoping Review of the Experiences and Outcomes of Stigma and Discrimination towards Persons Experiencing Homelessness. HSCC. 2024 doi: 10.1155/2024/2060619. [ DOI ] [ Google Scholar ] 8. Kaduszkiewicz H, Bochon B, van den Bussche H, et al. The Medical Treatment of Homeless People. Dtsch Arztebl Int. 2017;114:673–9. doi: 10.3238/arztebl.2017.0673. [ DOI ] [ PMC free article ] [ PubMed ] [ Google Scholar ] 9. Street medicine institute. 2023. https://stmi.memberclicks.net Available. 10. Enich M, Tiderington E, Ure A. Street Medicine: A Scoping Review of Program Elements. IJOH . 2021;3:295–343. doi: 10.5206/ijoh.2022.2.15134. [ DOI ] [ Google Scholar ] 11. Gunn SWA, Masellis M. Concepts and practice of humanitarian medicine. New York, NY: Springer; 2008. [ Google Scholar ] 12. National Institute for Health and Care Excellence Integrated health and social care for people experiencing homelessness: NICE guideline. 2022. https://www.nice.org.uk/guidance/ng214 Available. 13. Ng L, Adams E, Henderson D, et al. Interventions for burnout and well-being in homelessness staff: A systematic scoping review. PLoS One. 2025;20:e0309866. doi: 10.1371/journal.pone.0309866. [ DOI ] [ PMC free article ] [ PubMed ] [ Google Scholar ] 14. Matthews EB. The Impact of Delivery Reform on Health Information Exchange with Behavioral Health Providers: Results from a National Representative Survey of Ambulatory Physicians. Adm Policy Ment Health. 2024;51:818–25. doi: 10.1007/s10488-024-01367-1. [ DOI ] [ PubMed ] [ Google Scholar ] 15. Jego M, Gentile G, Giusiano B, et al. Prise en charge des personnes sans chez-soi: intérêt du dossier médical partagé? Sante Publique. 2018;Vol. 30:233–42. doi: 10.3917/spub.182.0233. [ DOI ] [ Google Scholar ] 16. Dang MT, Whitney KD, Virata MCD, et al. A web-based personal health information system for homeless youth and young adults. Public Health Nurs. 2012;29:313–9. doi: 10.1111/j.1525-1446.2011.00998.x. [ DOI ] [ PubMed ] [ Google Scholar ] 17. Eachus E, Schwartz K, Rasul T, et al. REDCap as a Platform for Cutaneous Disease Management in Street Medicine: Descriptive Study. JMIR Dermatol . 2024;7:e48940. doi: 10.2196/48940. [ DOI ] [ PMC free article ] [ PubMed ] [ Google Scholar ] 18. Safetynet . Safetynet; 2024. [23-Apr-2024]. SNPC medical record network. https://www.primarycaresafetynet.ie/services/safetynet-medical-record-network Available. Accessed. [ Google Scholar ] 19. creative facilitation Cardstorming. 2026. https://creativefacilitation.com/cardstorming-2 Available. 20. Monforte J, Netherway J, Smith B. The world café is an unmethod within co-produced research. Qual Res Psychol. 2023;20:398–419. doi: 10.1080/14780887.2023.2239728. [ DOI ] [ Google Scholar ] 21. Mayring P. Qualitative Content Analysis. Forum Qualitative Sozialforschung. 2000 doi: 10.17169/fqs-1.2.1089. [ DOI ] [ Google Scholar ] 22. National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research The belmont report: ethical principles and guidelines for the protection of human subjects of research. 1979 https://www.hhs.gov/ohrp/regulations-and-policy/belmont-report/index.html Available. 23. Wong G. Ethical and Legal Questions with Street Medicine. JHE . 2024;20:56–63. doi: 10.18785/jhe.2001.06. [ DOI ] [ Google Scholar ] 24. Radó N, Békási S, Győrffy Z. Health Technology Access and Peer Support Among Digitally Engaged People Experiencing Homelessness: Qualitative Study. JMIR Hum Factors. 2024;11:e55415. doi: 10.2196/55415. [ DOI ] [ PMC free article ] [ PubMed ] [ Google Scholar ] 25. European Parliament, European Council Regulation (EU) 2025/327 of the European Parliament and of the Council of 11 February 2025 on the European Health Data Space and amending Directive 2011/24/EU and Regulation (EU) 2024/2847: EHDS. 11.2.2025. 2025. http://data.europa.eu/eli/reg/2025/327/oj Available. 26. Winter A, Jahn F, Löbe M, et al. The European Health Data Space as 3LGM2-Based Enterprise Architecture Model. Stud Health Technol Inform. 2025;327:647–51. doi: 10.3233/SHTI250428. [ DOI ] [ PubMed ] [ Google Scholar ] 27. Dodis Y, Kiayias A, Nicolosi A, et al. In: Advances in cryptology - EUROCRYPT 2004. Kanade T, Kittler J, Kleinberg JM, et al., editors. Berlin, Heidelberg: Springer; 2004. Anonymous identification in Ad HOC groups; pp. 609–26. [ Google Scholar ] 28. Kagle JD, Kopels S. Social work records. 3rd. Long Grove, IL: Waveland Press; 2008. edn. [ Google Scholar ] 29. Winter A, Ammenwerth E, Haux R, et al. Health information systems. Cham: Springer International Publishing; 2023. [ Google Scholar ] 30. Geissbuhler A, Haux R, Kwankam SY. Towards health for all: WHO and IMIA intensify collaboration. Joint Communiqué during Medinfo 2007 in Brisbane. Methods Inf Med. 2007;46:503–5. doi: 10.1160/me5006. 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