KSNet-Approach to Knowledge Fusion from Distributed Sources

The rapidity of the decision making process is an important factor in different branches of the human life (business, healthcare, industry, military applications etc.). Since responsible persons make decisions using available knowledge, it is important for knowledge management systems to deliver necessary and timely information. Knowledge logistics is a new direction in the knowledge management addressing this. Technology of knowledge fusion, based on the synergistic use of knowledge from multiple distributed sources, is a basis for these activities. The paper presents an overview of a Knowledge Source Network configuration approach (KSNet-approach) to knowledge fusion, multi-agent architecture and research prototype of the KSNet knowledge fusion system based on this approach

Managing healthcare workflows in a multi-agent system environment

Whilst Multi-Agent System (MAS) architectures appear to offer a more flexible model for designers and developers of complex, collaborative information systems, implementing real-world business processes that can be delegated to autonomous agents is still a relatively difficult task. Although a range of agent tools and toolkits exist, there still remains the need to move the creation of models nearer to code generation, in order that the development path be more rigorous and repeatable. In particular, it is essential that complex organisational process workflows are captured and expressed in a way that MAS can successfully interpret. Using a complex social care system as an exemplar, we describe a technique whereby a business process is captured, expressed, verified and specified in a suitable format for a healthcare MAS.</p

A survey of simulation techniques in commerce and defence

Despite the developments in Modelling and Simulation (M&S) tools and techniques over the past years, there has been a gap in the M&S research and practice in healthcare on developing a toolkit to assist the modellers and simulation practitioners with selecting an appropriate set of techniques. This study is a preliminary step towards this goal. This paper presents some results from a systematic literature survey on applications of M&S in the commerce and defence domains that could inspire some improvements in the healthcare. Interim results show that in the commercial sector Discrete-Event Simulation (DES) has been the most widely used technique with System Dynamics (SD) in second place. However in the defence sector, SD has gained relatively more attention. SD has been found quite useful for qualitative and soft factors analysis. From both the surveys it becomes clear that there is a growing trend towards using hybrid M&S approaches

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

Designing privacy for scalable electronic healthcare linkage

A unified electronic health record (EHR) has potentially immeasurable benefits to society, and the current healthcare industry drive to create a single EHR reflects this. However, adoption is slow due to two major factors: the disparate nature of data and storage facilities of current healthcare systems and the security ramifications of accessing and using that data and concerns about potential misuse of that data. To attempt to address these issues this paper presents the VANGUARD (Virtual ANonymisation Grid for Unified Access of Remote Data) system which supports adaptive security-oriented linkage of disparate clinical data-sets to support a variety of virtual EHRs avoiding the need for a single schematic standard and natural concerns of data owners and other stakeholders on data access and usage. VANGUARD has been designed explicit with security in mind and supports clear delineation of roles for data linkage and usage

A reasonable benchmarking frontier using DEA : an incentive scheme to improve efficiency in public hospitals

There exists research relating management concepts with productivity measurement methods that offers useful solutions for improving management control in the public sector. Within this sphere, we connect agency theory with efficiency analysis and describe how to define an incentives scheme that can be applied in the public sector to monitor the efficiency and productivity of managers. To fulfill the main objective of this research, we propose an iterative process for determining what we define as a ‘reasonable frontier’, a concept that provides the foundation required to establish the incentive scheme for the managers. Our ‘reasonable frontier’ has the following properties: i) it detects the presence of outliers, ii) it proposes a procedure to establish the influence introduced by extreme observations, and iii) it sorts out the problem of data masking. The proposed method is applied to a sample of hospitals taken from the public network of the Spanish health service. The results obtained confirm the applicability of the proposal made. Summing up, we define and apply a useful method, combining aspects of agency theory and efficiency analysis, which is of interest to those public authorities trying to design effective incentive schemes which influence the decision making of the public managers

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

Potential applications of simulation modelling techniques in healthcare: lessons learned from aerospace and military

The Aerospace and Military areas are to do with complex missions and situations. Modelling and Simulation (M&S) has been applied in many areas of defence ranging from space sciences, satellite engineering to multi-warfare (air warfare, undersea warfare), air & missile defence, acquisition, tactical military trainings & exercises, national security analysis and strategic decision making & planning, etc. The application of simulation modelling techniques in healthcare would improve the provision of healthcare services; however, their application has been much relatively feeble in the healthcare sector as compared to the defence sector. This paper presents results from a systematic literature survey on applications of modelling simulation techniques in the Aerospace & Military. The knowledge gained or lessons learned from the survey were finally used to analyze the potential applications of the simulation modelling techniques to the healthcare sector. Results show that in the defence sector, Distributed Simulation has now become a widely adopted technique. However, System Dynamics (SD) and Discrete Event Simulation (DSE) have also gained relative attention. From this survey it becomes clear that various simulation modelling techniques are useful for specific purposes and have potential applications in the healthcare sector

CoachAI: A Conversational Agent Assisted Health Coaching Platform

Poor lifestyle represents a health risk factor and is the leading cause of morbidity and chronic conditions. The impact of poor lifestyle can be significantly altered by individual behavior change. Although the current shift in healthcare towards a long lasting modifiable behavior, however, with increasing caregiver workload and individuals' continuous needs of care, there is a need to ease caregiver's work while ensuring continuous interaction with users. This paper describes the design and validation of CoachAI, a conversational agent assisted health coaching system to support health intervention delivery to individuals and groups. CoachAI instantiates a text based healthcare chatbot system that bridges the remote human coach and the users. This research provides three main contributions to the preventive healthcare and healthy lifestyle promotion: (1) it presents the conversational agent to aid the caregiver; (2) it aims to decrease caregiver's workload and enhance care given to users, by handling (automating) repetitive caregiver tasks; and (3) it presents a domain independent mobile health conversational agent for health intervention delivery. We will discuss our approach and analyze the results of a one month validation study on physical activity, healthy diet and stress management

Trust and Risk Relationship Analysis on a Workflow Basis: A Use Case

Trust and risk are often seen in proportion to each other; as such, high trust may induce low risk and vice versa. However, recent research argues that trust and risk relationship is implicit rather than proportional. Considering that trust and risk are implicit, this paper proposes for the first time a novel approach to view trust and risk on a basis of a W3C PROV provenance data model applied in a healthcare domain. We argue that high trust in healthcare domain can be placed in data despite of its high risk, and low trust data can have low risk depending on data quality attributes and its provenance. This is demonstrated by our trust and risk models applied to the BII case study data. The proposed theoretical approach first calculates risk values at each workflow step considering PROV concepts and second, aggregates the final risk score for the whole provenance chain. Different from risk model, trust of a workflow is derived by applying DS/AHP method. The results prove our assumption that trust and risk relationship is implicit