Dynamic trust negotiation for decentralised e-health collaborations

In the Internet-age, the geographical boundaries that have previously impinged upon inter-organisational collaborations have become decreasingly important. Of more importance for such collaborations is the notion and subsequent nature of security and trust - this is especially so in open collaborative environments like the Grid where resources can be both made available, subsequently accessed and used by remote users from a multitude of institutions with a variety of different privileges spanning across the collaboration. In this context, the ability to dynamically negotiate and subsequently enforce security policies driven by various levels of inter-organisational trust is essential. Numerous access control solutions exist today to address aspects of inter-organisational security. These include the use of centralised access control lists where all collaborating partners negotiate and agree on privileges required to access shared resources. Other solutions involve delegating aspects of access right management to trusted remote individuals in assigning privileges to their (remote) users. These solutions typically entail negotiations and delegations which are constrained by organisations, people and the static rules they impose. Such constraints often result in a lack of flexibility in what has been agreed; difficulties in reaching agreement, or once established, in subsequently maintaining these agreements. Furthermore, these solutions often reduce the autonomous capacity of collaborating organisations because of the need to satisfy collaborating partners demands. This can result in increased security risks or reducing the granularity of security policies. Underpinning this is the issue of trust. Specifically trust realisation between organisations, between individuals, and/or between entities or systems that are present in multi-domain authorities. Trust negotiation is one approach that allows and supports trust realisation. The thesis introduces a novel model called dynamic trust negotiation (DTN) that supports n-tier negotiation hops for trust realisation in multi-domain collaborative environments with specific focus on e-Health environments. DTN describes how trust pathways can be discovered and subsequently how remote security credentials can be mapped to local security credentials through trust contracts, thereby bridging the gap that makes decentralised security policies difficult to define and enforce. Furthermore, DTN shows how n-tier negotiation hops can limit the disclosure of access control policies and how semantic issues that exist with security attributes in decentralised environments can be reduced. The thesis presents the results from the application of DTN to various clinical trials and the implementation of DTN to Virtual Organisation for Trials of Epidemiological Studies (VOTES). The thesis concludes that DTN can address the issue of realising and establishing trust between systems or agents within the e-Health domain, such as the clinical trials domain

Computer-supported cooperative work in tele home care : architecture design, implementation and evaluation

With the development of healthcare service and computer networks, the healthcare providers are focusing on how to implant new technologies into health sections. These instant messaging techniques can lead healthcare service more efficienct than before. It is necessary to design and construct a cooperative work platform for patients and healthcare providers. They are able to communicate with each other, share information or documents and access into health records. This project will concentrate on the system design, implementation and evaluation to achieve a better performance platform. The underlying data repository will encompass distributed system aspects and data warehousing approach to promote the functions of this healthcare system. This platform will be deployed to the tele home care service and in-depth study on the healthcare services. Some of the innovations will be included in system design. The target of this project is to design the architecture of collaborative workspace for healthcare personnel and implement a prototype with useful functions. The evaluation will be conducted to validate the efficiency of proposed distributed database for patient records. In addition, it will be more flexible and less data redundant. Meanwhile, a demo system will be deployed in order to show and define the implemented functions

Designing object-oriented interfaces for medical data repositories

Thesis (S.B. and M.Eng.)--Massachusetts Institute of Technology, Dept. of Electrical Engineering and Computer Science, 1999.Includes bibliographical references (leaves 113-116).by Patrick J. McCormick.S.B.and M.Eng

Clinical foundations and information architecture for the implementation of a federated health record service

Clinical care increasingly requires healthcare professionals to access patient record information that may be distributed across multiple sites, held in a variety of paper and electronic formats, and represented as mixtures of narrative, structured, coded and multi-media entries. A longitudinal person-centred electronic health record (EHR) is a much-anticipated solution to this problem, but its realisation is proving to be a long and complex journey. This Thesis explores the history and evolution of clinical information systems, and establishes a set of clinical and ethico-legal requirements for a generic EHR server. A federation approach (FHR) to harmonising distributed heterogeneous electronic clinical databases is advocated as the basis for meeting these requirements. A set of information models and middleware services, needed to implement a Federated Health Record server, are then described, thereby supporting access by clinical applications to a distributed set of feeder systems holding patient record information. The overall information architecture thus defined provides a generic means of combining such feeder system data to create a virtual electronic health record. Active collaboration in a wide range of clinical contexts, across the whole of Europe, has been central to the evolution of the approach taken. A federated health record server based on this architecture has been implemented by the author and colleagues and deployed in a live clinical environment in the Department of Cardiovascular Medicine at the Whittington Hospital in North London. This implementation experience has fed back into the conceptual development of the approach and has provided "proof-of-concept" verification of its completeness and practical utility. This research has benefited from collaboration with a wide range of healthcare sites, informatics organisations and industry across Europe though several EU Health Telematics projects: GEHR, Synapses, EHCR-SupA, SynEx, Medicate and 6WINIT. The information models published here have been placed in the public domain and have substantially contributed to two generations of CEN health informatics standards, including CEN TC/251 ENV 13606

A FRAMEWORK FOR BIOPROFILE ANALYSIS OVER GRID

An important trend in modern medicine is towards individualisation of healthcare to tailor care to the needs of the individual. This makes it possible, for example, to personalise diagnosis and treatment to improve outcome. However, the benefits of this can only be fully realised if healthcare and ICT resources are exploited (e.g. to provide access to relevant data, analysis algorithms, knowledge and expertise). Potentially, grid can play an important role in this by allowing sharing of resources and expertise to improve the quality of care. The integration of grid and the new concept of bioprofile represents a new topic in the healthgrid for individualisation of healthcare. A bioprofile represents a personal dynamic "fingerprint" that fuses together a person's current and past bio-history, biopatterns and prognosis. It combines not just data, but also analysis and predictions of future or likely susceptibility to disease, such as brain diseases and cancer. The creation and use of bioprofile require the support of a number of healthcare and ICT technologies and techniques, such as medical imaging and electrophysiology and related facilities, analysis tools, data storage and computation clusters. The need to share clinical data, storage and computation resources between different bioprofile centres creates not only local problems, but also global problems. Existing ICT technologies are inappropriate for bioprofiling because of the difficulties in the use and management of heterogeneous IT resources at different bioprofile centres. Grid as an emerging resource sharing concept fulfils the needs of bioprofile in several aspects, including discovery, access, monitoring and allocation of distributed bioprofile databases, computation resoiuces, bioprofile knowledge bases, etc. However, the challenge of how to integrate the grid and bioprofile technologies together in order to offer an advanced distributed bioprofile environment to support individualized healthcare remains. The aim of this project is to develop a framework for one of the key meta-level bioprofile applications: bioprofile analysis over grid to support individualised healthcare. Bioprofile analysis is a critical part of bioprofiling (i.e. the creation, use and update of bioprofiles). Analysis makes it possible, for example, to extract markers from data for diagnosis and to assess individual's health status. The framework provides a basis for a "grid-based" solution to the challenge of "distributed bioprofile analysis" in bioprofiling. The main contributions of the thesis are fourfold: A. An architecture for bioprofile analysis over grid. The design of a suitable aichitecture is fundamental to the development of any ICT systems. The architecture creates a meaiis for categorisation, determination and organisation of core grid components to support the development and use of grid for bioprofile analysis; B. A service model for bioprofile analysis over grid. The service model proposes a service design principle, a service architecture for bioprofile analysis over grid, and a distributed EEG analysis service model. The service design principle addresses the main service design considerations behind the service model, in the aspects of usability, flexibility, extensibility, reusability, etc. The service architecture identifies the main categories of services and outlines an approach in organising services to realise certain functionalities required by distributed bioprofile analysis applications. The EEG analysis service model demonstrates the utilisation and development of services to enable bioprofile analysis over grid; C. Two grid test-beds and a practical implementation of EEG analysis over grid. The two grid test-beds: the BIOPATTERN grid and PlymGRID are built based on existing grid middleware tools. They provide essential experimental platforms for research in bioprofiling over grid. The work here demonstrates how resources, grid middleware and services can be utilised, organised and implemented to support distributed EEG analysis for early detection of dementia. The distributed Electroencephalography (EEG) analysis environment can be used to support a variety of research activities in EEG analysis; D. A scheme for organising multiple (heterogeneous) descriptions of individual grid entities for knowledge representation of grid. The scheme solves the compatibility and adaptability problems in managing heterogeneous descriptions (i.e. descriptions using different languages and schemas/ontologies) for collaborated representation of a grid environment in different scales. It underpins the concept of bioprofile analysis over grid in the aspect of knowledge-based global coordination between components of bioprofile analysis over grid

Cognitive assisted living ambient system: a survey

The demographic change towards an aging population is creating a significant impact and introducing drastic challenges to our society. We therefore need to find ways to assist older people to stay independently and prevent social isolation of these population. Information and Communication Technologies (ICT) provide various solutions to help older adults to improve their quality of life, stay healthier, and live independently for a time. Ambient Assisted Living (AAL) is a field to investigate innovative technologies to provide assistance as well as healthcare and rehabilitation to impaired seniors. The paper provides a review of research background and technologies of AAL