The Trajectory of IT in Healthcare at HICSS: A Literature Review, Analysis, and Future Directions

Research has extensively demonstrated that healthcare industry has rapidly implemented and adopted information technology in recent years. Research in health information technology (HIT), which represents a major component of the Hawaii International Conference on System Sciences, demonstrates similar findings. In this paper, review the literature to better understand the work on HIT that researchers have conducted in HICSS from 2008 to 2017. In doing so, we identify themes, methods, technology types, research populations, context, and emerged research gaps from the reviewed literature. With much change and development in the HIT field and varying levels of adoption, this review uncovers, catalogs, and analyzes the research in HIT at HICSS in this ten-year period and provides future directions for research in the field

An ontology-driven architecture for data integration and management in home-based telemonitoring scenarios

The shift from traditional medical care to the use of new technology and engineering innovations is nowadays an interesting and growing research area mainly motivated by a growing population with chronic conditions and disabilities. By means of information and communications technologies (ICTs), telemedicine systems offer a good solution for providing medical care at a distance to any person in any place at any time. Although significant contributions have been made in this field in recent decades, telemedicine and in e-health scenarios in general still pose numerous challenges that need to be addressed by researchers in order to take maximum advantage of the benefits that these systems provide and to support their long-term implementation. The goal of this research thesis is to make contributions in the field of home-based telemonitoring scenarios. By periodically collecting patients' clinical data and transferring them to physicians located in remote sites, patient health status supervision and feedback provision is possible. This type of telemedicine system guarantees patient supervision while reducing costs (enabling more autonomous patient care and avoiding hospital over flows). Furthermore, patients' quality of life and empowerment are improved. Specifically, this research investigates how a new architecture based on ontologies can be successfully used to address the main challenges presented in home-based telemonitoring scenarios. The challenges include data integration, personalized care, multi-chronic conditions, clinical and technical management. These are the principal issues presented and discussed in this thesis. The proposed new ontology-based architecture takes into account both practical and conceptual integration issues and the transference of data between the end points of the telemonitoring scenario (i.e, communication and message exchange). The architecture includes two layers: 1) a conceptual layer and 2) a data and communication layer. On the one hand, the conceptual layer based on ontologies is proposed to unify the management procedure and integrate incoming data from all the sources involved in the telemonitoring process. On the other hand, the data and communication layer based on web service technologies is proposed to provide practical back-up to the use of the ontology, to provide a real implementation of the tasks it describes and thus to provide a means of exchanging data. This architecture takes advantage of the combination of ontologies, rules, web services and the autonomic computing paradigm. All are well-known technologies and popular solutions applied in the semantic web domain and network management field. A review of these technologies and related works that have made use of them is presented in this thesis in order to understand how they can be combined successfully to provide a solution for telemonitoring scenarios. The design and development of the ontology used in the conceptual layer led to the study of the autonomic computing paradigm and its combination with ontologies. In addition, the OWL (Ontology Web Language) language was studied and selected to express the required knowledge in the ontology while the SPARQL language was examined for its effective use in defining rules. As an outcome of these research tasks, the HOTMES (Home Ontology for Integrated Management in Telemonitoring Scenarios) ontology, presented in this thesis, was developed. The combination of the HOTMES ontology with SPARQL rules to provide a flexible solution for personalising management tasks and adapting the methodology for different management purposes is also discussed. The use of Web Services (WSs) was investigated to support the exchange of information defined in the conceptual layer of the architecture. A generic ontology based solution was designed to integrate data and management procedures in the data and communication layer of the architecture. This is an innovative REST-inspired architecture that allows information contained in an ontology to be exchanged in a generic manner. This layer structure and its communication method provide the approach with scalability and re-usability features. The application of the HOTMES-based architecture has been studied for clinical purposes following three simple methodological stages described in this thesis. Data and management integration for context-aware and personalized monitoring services for patients with chronic conditions in the telemonitoring scenario are thus addressed. In particular, the extension of the HOTMES ontology defines a patient profile. These profiles in combination with individual rules provide clinical guidelines aiming to monitor and evaluate the evolution of the patient's health status evolution. This research implied a multi-disciplinary collaboration where clinicians had an essential role both in the ontology definition and in the validation of the proposed approach. Patient profiles were defined for 16 types of different diseases. Finally, two solutions were explored and compared in this thesis to address the remote technical management of all devices that comprise the telemonitoring scenario. The first solution was based on the HOTMES ontology-based architecture. The second solution was based on the most popular TCP/IP management architecture, SNMP (Simple Network Management Protocol). As a general conclusion, it has been demonstrated that the combination of ontologies, rules, WSs and the autonomic computing paradigm takes advantage of the main benefits that these technologies can offer in terms of knowledge representation, work flow organization, data transference, personalization of services and self-management capabilities. It has been proven that ontologies can be successfully used to provide clear descriptions of managed data (both clinical and technical) and ways of managing such information. This represents a further step towards the possibility of establishing more effective home-based telemonitoring systems and thus improving the remote care of patients with chronic diseases

Aide à la conception de workflows personnalisés : application à la prise en charge à domicile

Aujourd'hui, les TIC sont reconnues comme un élément inéluctable pour améliorer les pratiques et les usages du secteur de la santé et particulièrement celui de la PAD. Cependant, malgré tout l'engouement et les avancés accomplies dans ce domaine, un problème de coordination et de continuité des soins personnalisés aux patients subsiste toujours. Un système de gestion de workflow semble approprié pour assurer cette coordination de la PAD. Toutefois, les caractéristiques des processus de la PAD, que nous avons identifié, compliquent la conception de ce workflow. En effet, le processus de la PAD a la particularité d'être un processus, personnalisé pour chaque patient, collaboratif évoluant dans un environnement très dynamique et incertain avec une forte contrainte temporelle. Dans le but d'améliorer la coordination en tenant compte des caractéristiques des processus de la PAD, nous avons proposé une approche de conception d'un workflow personnalisé basé sur les modèles de connaissances et guidée par une approche dirigée par les modèles. Cette approche préconise l'utilisation d'ontologies du domaine de la PAD et du BPMN dans un processus de transformations qui aboutit à la conception d'un workflow personnalisé pour un patient donnée selon son profil. Les travaux développés dans ce mémoire présentent une partie de cette approche qui consiste à construire un processus BPMN personnalisé. Les contributions, que nous y exposons sont : premièrement, la conception d'une ontologie du domaine de la PAD. Cette ontologie inclut : le profil patient (pathologie, entourage, environnement,...), l'aspect organisationnel de la PAD (le rôle de chaque intervenant) et le traitement ou les interventions nécessaires pour chaque pathologie. Deuxièmement une proposition de règles de correspondances entre les termes du domaine de la PAD et du BPMN. Finalement des requêtes permettant la conception d'un processus BPMN personnalisé. Cette approche a été testée sur un cas d'étude de la PAD qui montre son bon fonctionnement.Today, ICT is recognized as a requirement to improve the practices of the health sector and particularly the home care area. However, despite all the advances accomplished in this field, a problem of coordination and continuity of personalized care remains. A workflow management system seems appropriate to ensure the coordination of home care. However, the characteristics of the home care processes complicate the design of the workflow. Indeed, the processes of home care need to be customized for each patient, collaborative, evolving in a very dynamic and uncertain environment with a strong time constraint. In order to improve the coordination taking into account the characteristics of the home care process, we propose an approach to design a custom workflow models based on knowledge and guided by a model driven approach. This approach advocates the use of ontologies in the field of home care and BPMN into a process of transformation that leads to the design of a custom workflow for a given patient according to his profile. The work developed in this thesis are part of this approach is to build a customized BPMN process. Contributions are: first, the design of an ontology for home care. This ontology includes: patient profile (pathology, environment, ...), the organizational aspect of the home care (the role of each actor) and the treatment or interventions necessary for each pathology. Secondly, a proposal of correspondence rules between the terms in the field of home care and BPMN. Finally queries are performed to design a customized BPMN process. This approach has been tested on a significative case study

Ubiquitous Robotics System for Knowledge-based Auto-configuration System for Service Delivery within Smart Home Environments

The future smart home will be enhanced and driven by the recent advance of the Internet of Things (IoT), which advocates the integration of computational devices within an Internet architecture on a global scale [1, 2]. In the IoT paradigm, the smart home will be developed by interconnecting a plethora of smart objects both inside and outside the home environment [3-5]. The recent take-up of these connected devices within home environments is slowly and surely transforming traditional home living environments. Such connected and integrated home environments lead to the concept of the smart home, which has attracted significant research efforts to enhance the functionality of home environments with a wide range of novel services. The wide availability of services and devices within contemporary smart home environments make their management a challenging and rewarding task. The trend whereby the development of smart home services is decoupled from that of smart home devices increases the complexity of this task. As such, it is desirable that smart home services are developed and deployed independently, rather than pre-bundled with specific devices, although it must be recognised that this is not always practical. Moreover, systems need to facilitate the deployment process and cope with any changes in the target environment after deployment. Maintaining complex smart home systems throughout their lifecycle entails considerable resources and effort. These challenges have stimulated the need for dynamic auto-configurable services amongst such distributed systems. Although significant research has been directed towards achieving auto-configuration, none of the existing solutions is sufficient to achieve auto-configuration within smart home environments. All such solutions are considered incomplete, as they lack the ability to meet all smart home requirements efficiently. These requirements include the ability to adapt flexibly to new and dynamic home environments without direct user intervention. Fulfilling these requirements would enhance the performance of smart home systems and help to address cost-effectiveness, considering the financial implications of the manual configuration of smart home environments. Current configuration approaches fail to meet one or more of the requirements of smart homes. If one of these approaches meets the flexibility criterion, the configuration is either not executed online without affecting the system or requires direct user intervention. In other words, there is no adequate solution to allow smart home systems to adapt dynamically to changing circumstances, hence to enable the correct interconnections among its components without direct user intervention and the interruption of the whole system. Therefore, it is necessary to develop an efficient, adaptive, agile and flexible system that adapts dynamically to each new requirement of the smart home environment. This research aims to devise methods to automate the activities associated with customised service delivery for dynamic home environments by exploiting recent advances in the field of ubiquitous robotics and Semantic Web technologies. It introduces a novel approach called the Knowledge-based Auto-configuration Software Robot (Sobot) for Smart Home Environments, which utilises the Sobot to achieve auto-configuration of the system. The research work was conducted under the Distributed Integrated Care Services and Systems (iCARE) project, which was designed to accomplish and deliver integrated distributed ecosystems with a homecare focus. The auto-configuration Sobot which is the focus of this thesis is a key component of the iCARE project. It will become one of the key enabling technologies for generic smart home environments. It has a profound impact on designing and implementing a high quality system. Its main role is to generate a feasible configuration that meets the given requirements using the knowledgebase of the smart home environment as a core component. The knowledgebase plays a pivotal role in helping the Sobot to automatically select the most appropriate resources in a given context-aware system via semantic searching and matching. Ontology as a technique of knowledgebase representation generally helps to design and develop a specific domain. It is also a key technology for the Semantic Web, which enables a common understanding amongst software agents and people, clarifies the domain assumptions and facilitates the reuse and analysis of its knowledge. The main advantages of the Sobot over traditional applications is its awareness of the changing digital and physical environments and its ability to interpret these changes, extract the relevant contextual data and merge any new information or knowledge. The Sobot is capable of creating new or alternative feasible configurations to meet the system’s goal by utilising inferred facts based on the smart home ontological model, so that the system can adapt to the changed environment. Furthermore, the Sobot has the capability to execute the generated reconfiguration plan without interrupting the running of the system. A proof-of-concept testbed has been designed and implemented. The case studies carried out have shown the potential of the proposed approach to achieve flexible and reliable auto-configuration of the smart home system, with promising directions for future research

Usability analysis of contending electronic health record systems

In this paper, we report measured usability of two leading EHR systems during procurement. A total of 18 users participated in paired-usability testing of three scenarios: ordering and managing medications by an outpatient physician, medicine administration by an inpatient nurse and scheduling of appointments by nursing staff. Data for audio, screen capture, satisfaction rating, task success and errors made was collected during testing. We found a clear difference between the systems for percentage of successfully completed tasks, two different satisfaction measures and perceived learnability when looking at the results over all scenarios. We conclude that usability should be evaluated during procurement and the difference in usability between systems could be revealed even with fewer measures than were used in our study. © 2019 American Psychological Association Inc. All rights reserved.Peer reviewe