An agent-based architecture for managing the provision of community care - the INCA (Intelligent Community Alarm) experience

Community Care is an area that requires extensive cooperation between independent agencies, each of which needs to meet its own objectives and targets. None are engaged solely in the delivery of community care, and need to integrate the service with their other responsibilities in a coherent and efficient manner. Agent technology provides the means by which effective cooperation can take place without compromising the essential security of both the client and the agencies involved as the appropriate set of responses can be generated through negotiation between the parties without the need for access to the main information repositories that would be necessary with conventional collaboration models. The autonomous nature of agents also means that a variety of agents can cooperate together with various local capabilities, so long as they conform to the relevant messaging requirements. This allows a variety of agents, with capabilities tailored to the carers to which they are attached to be developed so that cost-effective solutions can be provided. </p

Designing community care systems with AUML

This paper describes an approach to developing an appropriate agent environment appropriate for use in community care applications. Key to its success is that software designers collaborate with environment builders to provide the levels of cooperation and support required within an integrated agent–oriented community system. Agent-oriented Unified Modeling Language (AUML) is a practical approach to the analysis, design, implementation and management of such an agent-based system, whilst providing the power and expressiveness necessary to support the specification, design and organization of a health care service. The background of an agent-based community care application to support the elderly is described. Our approach to building agent–oriented software development solutions emphasizes the importance of AUML as a fundamental initial step in producing more general agent–based architectures. This approach aims to present an effective methodology for an agent software development process using a service oriented approach, by addressing the agent decomposition, abstraction, and organization characteristics, whilst reducing its complexity by exploiting AUML’s productivity potential. </p

CAMMD: Context Aware Mobile Medical Devices

Telemedicine applications on a medical practitioners mobile device should be context-aware. This can vastly improve the effectiveness of mobile applications and is a step towards realising the vision of a ubiquitous telemedicine environment. The nomadic nature of a medical practitioner emphasises location, activity and time as key context-aware elements. An intelligent middleware is needed to effectively interpret and exploit these contextual elements. This paper proposes an agent-based architectural solution called Context-Aware Mobile Medical Devices (CAMMD). This framework can proactively communicate patient records to a portable device based upon the active context of its medical practitioner. An expert system is utilised to cross-reference the context-aware data of location and time against a practitioners work schedule. This proactive distribution of medical data enhances the usability and portability of mobile medical devices. The proposed methodology alleviates constraints on memory storage and enhances user interaction with the handheld device. The framework also improves utilisation of network bandwidth resources. An experimental prototype is presented highlighting the potential of this approach

Intelligent multimedia communication for enhanced medical e-collaboration in back pain treatment

This is the post-print version of the Article. The official published version can be accessed from the link below - Copyright @ 2004 SAGE PublicationsRemote, multimedia-based, collaboration in back pain treatment is an option which only recently has come to the attention of clinicians and IT providers. The take-up of such applications will inevitably depend on their ability to produce an acceptable level of service over congested and unreliable public networks. However, although the problem of multimedia application-level performance is closely linked to both the user perspective of the experience as well as to the service provided by the underlying network, it is rarely studied from an integrated viewpoint. To alleviate this problem, we propose an intelligent mechanism that integrates user-related requirements with the more technical characterization of quality of service, obtaining a priority order of low-level quality of service parameters, which would ensure that user-centred quality of perception is maintained at an optimum level. We show how our framework is capable of suggesting appropriately tailored transmission protocols, by incorporating user requirements in the remote delivery of e-health solutions

Audit-based Compliance Control (AC2) for EHR Systems

Traditionally, medical data is stored and processed using paper-based files. Recently, medical facilities have started to store, access and exchange medical data in digital form. The drivers for this change are mainly demands for cost reduction, and higher quality of health care. The main concerns when dealing with medical data are availability and confidentiality. Unavailability (even temporary) of medical data is expensive. Physicians may not be able to diagnose patients correctly, or they may have to repeat exams, adding to the overall costs of health care. In extreme cases availability of medical data can even be a matter of life or death. On the other hand, confidentiality of medical data is also important. Legislation requires medical facilities to observe the privacy of the patients, and states that patients have a final say on whether or not their medical data can be processed or not. Moreover, if physicians, or their EHR systems, are not trusted by the patients, for instance because of frequent privacy breaches, then patients may refuse to submit (correct) information, complicating the work of the physicians greatly. \ud \ud In traditional data protection systems, confidentiality and availability are conflicting requirements. The more data protection methods are applied to shield data from outsiders the more likely it becomes that authorized persons will not get access to the data in time. Consider for example, a password verification service that is temporarily not available, an access pass that someone forgot to bring, and so on. In this report we discuss a novel approach to data protection, Audit-based Compliance Control (AC2), and we argue that it is particularly suited for application in EHR systems. In AC2, a-priori access control is minimized to the mere authentication of users and objects, and their basic authorizations. More complex security procedures, such as checking user compliance to policies, are performed a-posteriori by using a formal and automated auditing mechanism. To support our claim we discuss legislation concerning the processing of health records, and we formalize a scenario involving medical personnel and a basic EHR system to show how AC2 can be used in practice. \ud \ud This report is based on previous work (Dekker & Etalle 2006) where we assessed the applicability of a-posteriori access control in a health care scenario. A more technically detailed article about AC2 recently appeared in the IJIS journal, where we focussed however on collaborative work environments (Cederquist, Corin, Dekker, Etalle, & Hartog, 2007). In this report we first provide background and related work before explaining the principal components of the AC2 framework. Moreover we model a detailed EHR case study to show its operation in practice. We conclude by discussing how this framework meets current trends in healthcare and by highlighting the main advantages and drawbacks of using an a-posteriori access control mechanism as opposed to more traditional access control mechanisms

Electronic Report Generation Web Service evaluated within a Telemedicine System

This work presents a generic tool based on a client-server architecture that generates electronic reports helping the evaluation process of any information system. For the specific evaluation of telemedicine systems the defined reports cover four dimensions: auditory of the system; evolution of clinical protocols; results from the questionnaires for user acceptance and quality of life; and surveillance of clinical variables. The use of a Web Service approach allows multiplatform use of the developed electronic report service and the modularity followed in the implementation enables easy system evolution and scalability

Information architecture for a federated health record server

This paper describes the information models that have been used to implement a federated health record server and to deploy it in a live clinical setting. The authors, working at the Centre for Health Informatics and Multiprofessional Education (University College London), have built up over a decade of experience within Europe on the requirements and information models that are needed to underpin comprehensive multi-professional electronic health records. This work has involved collaboration with a wide range of health care and informatics organisations and partners in the healthcare computing industry across Europe though the EU Health Telematics projects GEHR, Synapses, EHCR-SupA, SynEx and Medicate. The resulting architecture models have fed into recent European standardisation work in this area, such as CEN TC/251 ENV 13606. UCL has implemented a federated health record server based on these models which is now running in the Department of Cardiovascular Medicine at the Whittington Hospital in North London. The information models described in this paper reflect a refinement based on this implementation experience