Autonomic care platform for optimizing query performance

Background: As the amount of information in electronic health care systems increases, data operations get more complicated and time-consuming. Intensive Care platforms require a timely processing of data retrievals to guarantee the continuous display of recent data of patients. Physicians and nurses rely on this data for their decision making. Manual optimization of query executions has become difficult to handle due to the increased amount of queries across multiple sources. Hence, a more automated management is necessary to increase the performance of database queries. The autonomic computing paradigm promises an approach in which the system adapts itself and acts as self-managing entity, thereby limiting human interventions and taking actions. Despite the usage of autonomic control loops in network and software systems, this approach has not been applied so far for health information systems. Methods: We extend the COSARA architecture, an infection surveillance and antibiotic management service platform for the Intensive Care Unit (ICU), with self-managed components to increase the performance of data retrievals. We used real-life ICU COSARA queries to analyse slow performance and measure the impact of optimizations. Each day more than 2 million COSARA queries are executed. Three control loops, which monitor the executions and take action, have been proposed: reactive, deliberative and reflective control loops. We focus on improvements of the execution time of microbiology queries directly related to the visual displays of patients' data on the bedside screens. Results: The results show that autonomic control loops are beneficial for the optimizations in the data executions in the ICU. The application of reactive control loop results in a reduction of 8.61% of the average execution time of microbiology results. The combined application of the reactive and deliberative control loop results in an average query time reduction of 10.92% and the combination of reactive, deliberative and reflective control loops provides a reduction of 13.04%. Conclusions: We found that by controlled reduction of queries' executions the performance for the end-user can be improved. The implementation of autonomic control loops in an existing health platform, COSARA, has a positive effect on the timely data visualization for the physician and nurse

A Priority-based Fair Queuing (PFQ) Model for Wireless Healthcare System

Healthcare is a very active research area, primarily due to the increase in the elderly population that leads to increasing number of emergency situations that require urgent actions. In recent years some of wireless networked medical devices were equipped with different sensors to measure and report on vital signs of patient remotely. The most important sensors are Heart Beat Rate (ECG), Pressure and Glucose sensors. However, the strict requirements and real-time nature of medical applications dictate the extreme importance and need for appropriate Quality of Service (QoS), fast and accurate delivery of a patient’s measurements in reliable e-Health ecosystem. As the elderly age and older adult population is increasing (65 years and above) due to the advancement in medicine and medical care in the last two decades; high QoS and reliable e-health ecosystem has become a major challenge in Healthcare especially for patients who require continuous monitoring and attention. Nevertheless, predictions have indicated that elderly population will be approximately 2 billion in developing countries by 2050 where availability of medical staff shall be unable to cope with this growth and emergency cases that need immediate intervention. On the other side, limitations in communication networks capacity, congestions and the humongous increase of devices, applications and IOT using the available communication networks add extra layer of challenges on E-health ecosystem such as time constraints, quality of measurements and signals reaching healthcare centres. Hence this research has tackled the delay and jitter parameters in E-health M2M wireless communication and succeeded in reducing them in comparison to current available models. The novelty of this research has succeeded in developing a new Priority Queuing model ‘’Priority Based-Fair Queuing’’ (PFQ) where a new priority level and concept of ‘’Patient’s Health Record’’ (PHR) has been developed and integrated with the Priority Parameters (PP) values of each sensor to add a second level of priority. The results and data analysis performed on the PFQ model under different scenarios simulating real M2M E-health environment have revealed that the PFQ has outperformed the results obtained from simulating the widely used current models such as First in First Out (FIFO) and Weight Fair Queuing (WFQ). PFQ model has improved transmission of ECG sensor data by decreasing delay and jitter in emergency cases by 83.32% and 75.88% respectively in comparison to FIFO and 46.65% and 60.13% with respect to WFQ model. Similarly, in pressure sensor the improvements were 82.41% and 71.5% and 68.43% and 73.36% in comparison to FIFO and WFQ respectively. Data transmission were also improved in the Glucose sensor by 80.85% and 64.7% and 92.1% and 83.17% in comparison to FIFO and WFQ respectively. However, non-emergency cases data transmission using PFQ model was negatively impacted and scored higher rates than FIFO and WFQ since PFQ tends to give higher priority to emergency cases. Thus, a derivative from the PFQ model has been developed to create a new version namely “Priority Based-Fair Queuing-Tolerated Delay” (PFQ-TD) to balance the data transmission between emergency and non-emergency cases where tolerated delay in emergency cases has been considered. PFQ-TD has succeeded in balancing fairly this issue and reducing the total average delay and jitter of emergency and non-emergency cases in all sensors and keep them within the acceptable allowable standards. PFQ-TD has improved the overall average delay and jitter in emergency and non-emergency cases among all sensors by 41% and 84% respectively in comparison to PFQ model

CONVIS: A tool enabling uninterrupted operation during refurbishments of complex buildings

Clash Detection refers to the identification of geometrical overlaps within a Building Information Model (BIM). This paper seeks to extend the notion of overlapping to activities: Given a construction site within a building, we seek to find clashes between construction activities and occupant routines. Such a situation is often encountered in the context of refurbishments of complex buildings operating 24/7 (e.g. airports, train stations, hospitals, prisons). By finding the influence radii of adverse effects resulting from construction - i.e. dust, noise and vibrations, functions may be temporarily relocated in order to guarantee uninterrupted operation. Our tool CONVIS implements these simulation and scheduling aspects and seeks to provide a digital project plan for refurbishments in the said context

Systemwide Clinical Ultrasound Program Development: An Expert Consensus Model.

Clinical ultrasound (CUS) is integral to the practice of an increasing number of medical specialties. Guidelines are needed to ensure effective CUS utilization across health systems. Such guidelines should address all aspects of CUS within a hospital or health system. These include leadership, training, competency, credentialing, quality assurance and improvement, documentation, archiving, workflow, equipment, and infrastructure issues relating to communication and information technology. To meet this need, a group of CUS subject matter experts, who have been involved in institution- and/or systemwide clinical ultrasound (SWCUS) program development convened. The purpose of this paper was to create a model for SWCUS development and implementation

A framework for deriving semantic web services

Web service-based development represents an emerging approach for the development of distributed information systems. Web services have been mainly applied by software practitioners as a means to modularize system functionality that can be offered across a network (e.g., intranet and/or the Internet). Although web services have been predominantly developed as a technical solution for integrating software systems, there is a more business-oriented aspect that developers and enterprises need to deal with in order to benefit from the full potential of web services in an electronic market. This ‘ignored’ aspect is the representation of the semantics underlying the services themselves as well as the ‘things’ that the services manage. Currently languages like the Web Services Description Language (WSDL) provide the syntactic means to describe web services, but lack in providing a semantic underpinning. In order to harvest all the benefits of web services technology, a framework has been developed for deriving business semantics from syntactic descriptions of web services. The benefits of such a framework are two-fold. Firstly, the framework provides a way to gradually construct domain ontologies from previously defined technical services. Secondly, the framework enables the migration of syntactically defined web services toward semantic web services. The study follows a design research approach which (1) identifies the problem area and its relevance from an industrial case study and previous research, (2) develops the framework as a design artifact and (3) evaluates the application of the framework through a relevant scenario

Maintenance and Modelling Strategies of Biomedical Equipment’s in Hospitals: A Review

This article analyzes recent developments in the derivation of bio-medical equipment’s maintenance management strategies, and proposes chary points to consider and affeer to perform during their operation. Medical technology is by now an integral part of health care according to consisting general accepted standards. Purchase and operation thereby represent an important economic position and both are subject of everyday optimization attempts. For this purpose by now exists a huge number of tools which conduce more likely to a complexness of the problem by a comprehensive implementation. In the future, we envision that new paradigms will be structured to overcome the present strategies, and in the longer term, provide an alternative source for maintenance and management of medical devices at hospitals. Keywords: Biomedical equipment’s, Hospitals, Maintenance, Medical Devices, Medical Technolog