CANDID PRIMER: Including Social Sciences and Humanities scholarship in the making and use of smart ICT technologies

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Opportunities And Challenges of E-Health and Telemedicine Via Satelite

The introduction of Information and Communication Technology (ICT) in the health scenario is instrumental for the development of sustainable services of direct benefit for the European citizen. The setting up of satellite based applications will enhance rapidly the decentralisation and the enrichment of the European territory driving it towards a homogenous environment for healthcare

Uma rede telemática para a prestação regional de cuidados de saúde

Doutoramento em Engenharia InformáticaAs tecnologias de informação e comunicação na área da saúde não são só um instrumento para a boa gestão de informação, mas antes um fator estratégico para uma prestação de cuidados mais eficiente e segura. As tecnologias de informação são um pilar para que os sistemas de saúde evoluam em direção a um modelo centrado no cidadão, no qual um conjunto abrangente de informação do doente deve estar automaticamente disponível para as equipas que lhe prestam cuidados, independentemente de onde foi gerada (local geográfico ou sistema). Este tipo de utilização segura e agregada da informação clínica é posta em causa pela fragmentação generalizada das implementações de sistemas de informação em saúde. Várias aproximações têm sido propostas para colmatar as limitações decorrentes das chamadas “ilhas de informação” na saúde, desde a centralização total (um sistema único), à utilização de redes descentralizadas de troca de mensagens clínicas. Neste trabalho, propomos a utilização de uma camada de unificação baseada em serviços, através da federação de fontes de informação heterogéneas. Este agregador de informação clínica fornece a base necessária para desenvolver aplicações com uma lógica regional, que demostrámos com a implementação de um sistema de registo de saúde eletrónico virtual. Ao contrário dos métodos baseados em mensagens clínicas ponto-a-ponto, populares na integração de sistemas em saúde, desenvolvemos um middleware segundo os padrões de arquitetura J2EE, no qual a informação federada é expressa como um modelo de objetos, acessível através de interfaces de programação. A arquitetura proposta foi instanciada na Rede Telemática de Saúde, uma plataforma instalada na região de Aveiro que liga oito instituições parceiras (dois hospitais e seis centros de saúde), cobrindo ~350.000 cidadãos, utilizada por ~350 profissionais registados e que permite acesso a mais de 19.000.000 de episódios. Para além da plataforma colaborativa regional para a saúde (RTSys), introduzimos uma segunda linha de investigação, procurando fazer a ponte entre as redes para a prestação de cuidados e as redes para a computação científica. Neste segundo cenário, propomos a utilização dos modelos de computação Grid para viabilizar a utilização e integração massiva de informação biomédica. A arquitetura proposta (não implementada) permite o acesso a infraestruturas de e-Ciência existentes para criar repositórios de informação clínica para aplicações em saúde.Modern health information technology is not just a supporting instrument to good information management but a strategic requirement to provide more efficient and safer health care. Health information technology is a cornerstone to build the future patient-centric health care systems in which a comprehensive set of patient data will be available to the relevant care teams, in spite of where (system or service point) it was generated. Such secure and efficient use of clinical data is challenged by the existing fragmentation of health information systems implementation. Several approaches have been proposed to address the limitations of the so called “information silos” in healthcare, ranging from full centralization (a single system) to full-decentralized clinical message exchange networks. In this work we advocate the use of a service-based unification layer, by federating distributed heterogeneous information sources. This clinical information hub provides the basis to build regional-level applications, which we have demonstrated by implementing a virtual Electronic Health Record system. Unlike the message-driven, point-to-point approaches popular in health care systems integration, we developed a middleware layer, using J2EE architectural patterns, in which the common information is represented as an object model, accessible through programming interfaces. The proposed architecture was instantiated in the Rede Telemática da Saúde network, a platform deployed in the region of Aveiro connecting eight partner institutions (two hospitals and six primary care units), covering ~ 350,000 citizens, indexing information on more than 19,000,000 episodes of care and used by ~350 registered professionals. In addition to the regional health information collaborative platform (RTSys), we introduce a second line of research towards bridging the care networks and the science networks. In the later scenario, we propose the use of Grid computing to enable the massive use and integration of biomedical information. The proposed architecture (not implemented) enables to access existing e-Science infrastructures to create clinical information repositories for health applications

Service-Oriented Architecture for Patient-Centric eHealth Solutions

The world is in shortage of about 7.2 million healthcare workers in 2013, and the figure is estimated to grow to 12.9 million by 2035, according to the World Health Organization (WHO). On the other hand, the median age of the world’s population was predicted to increase from 26.6 years in 2000 to 37.3 years in 2050, and then to 45.6 years in 2100. Thus further escalating the need for new and efficient healthcare solutions. Telehealth, telecare, and Ambient Assisted Living (AAL) solutions promise to make healthcare services more sustainable, and to enable patients to live more independently and with a higher quality of life at their homes. Smart homes will host intelligent, connected devices that integrate with the Internet of Things (IoT) to form the basis of new and advanced healthcare systems. However, a number of challenges needs to be addressed before this vision can be actualised. These challenges include flexible integration, rapid service development and deployment, mobility, unified abstraction, scalability and high availability, security and privacy. This thesis presents an integration architecture based on Service-Oriented Architecture (SOA) that enables novel healthcare services to be developed rapidly by utilising capabilities of various devices in the patients’ surroundings. Special attention is given to a service broker component, the Information Integration Platform (IIP), that has been developed to bridge communications between everyday objects and Internet-based services following the Enterprise Service Bus (ESB) principles. It exposes its functionalities through a set of RESTfulWeb services, and maintains a unified information model which enables various applications to access in a uniform way. The IIP breaks the traditional vertical “silo” approach of integration, and handles information dissemination task between information providers and consumers by adopting a publish/subscribe messaging pattern. The feasibility of the IIP solution is evaluated both through prototyping and testing the platform’s representative healthcare services, e.g., remote health monitoring and emergency alarms. Experiments conducted on the IIP reveal how performance aspects are affected by needs for security, privacy, high availability, and scalability

Securely sharing dynamic medical information in e-health

This thesis has introduced an infrastructure to share dynamic medical data between mixed health care providers in a secure way, which could benefit the health care system as a whole. The study results of the universally data sharing into a varied patient information system prototypes

Provision, discovery and development of ubiquitous services and applications

Ph.DDOCTOR OF PHILOSOPH