Rationale and Architecture Principles for Medical Application Platforms

The concept of “system of systems” architecture is increasingly prevalent in many critical domains. Such systems allow information to be pulled from a variety of sources, analyzed to discover correlations and trends, stored to enable realtime and post-hoc assessment, mined to better inform decisionmaking, and leveraged to automate control of system units. In contrast, medical devices typically have been developed as monolithic stand-alone units. However, a vision is emerging of a notion of a medical application platform (MAP) that would provide device and health information systems (HIS) interoperability, safety critical network middleware, and an execution environment for clinical applications (“apps”) that offer numerous advantages for safety and effectiveness in health care delivery. In this paper, we present the clinical safety/effectiveness and economic motivations for MAPs, and describe key characteristics of MAPs that are guiding the search for appropriate technology, regulatory, and ecosystem solutions. We give an overview of the Integrated Clinical Environment (ICE) – one particular achitecture for MAPs, and the Medical Device Coordination Framework – a prototype implementation of the ICE architecture

mFish Alpha Pilot: Building a Roadmap for Effective Mobile Technology to Sustain Fisheries and Improve Fisher Livelihoods.

In June 2014 at the Our Ocean Conference in Washington, DC, United States Secretary of State John Kerry announced the ambitious goal of ending overfishing by 2020. To support that goal, the Secretary's Office of Global Partnerships launched mFish, a public-private partnership to harness the power of mobile technology to improve fisher livelihoods and increase the sustainability of fisheries around the world. The US Department of State provided a grant to 50in10 to create a pilot of mFish that would allow for the identification of behaviors and incentives that might drive more fishers to adopt novel technology. In May 2015 50in10 and Future of Fish designed a pilot to evaluate how to improve adoption of a new mobile technology platform aimed at improving fisheries data capture and fisher livelihoods. Full report

FUTURE-ORIENTED AND PATIENT-CENTRIC? A QUALITATIVE ANALYSIS OF DIGITAL THERAPEUTICS AND THEIR INTEROPERABILITY

This paper focuses on the integration of digital therapeutics (DTx) into future-oriented and patient-centric care pathways. Based on a workshop series and problem-centered interviews in Germany, the current state-of-the-art of regulatory and technical integration of DTx was mapped as a landscape of DTx interoperability. The results focus on key interfaces of DTx, namely with Electronic Health Records (EHRs), devices, and other digital health innovations such as telemedicine, and highlight current challenges and potentials for future development. On a broader level, the results point to unresolved issues of care coordination, the optional role of the EHRs as regulated platforms for care, and the importance of integrating DTx data into public data spaces for research

Logic-centred architecture for ubiquitous health monitoring

One of the key points to maintain and boost research and development in the area of smart wearable systems (SWS) is the development of integrated architectures for intelligent services, as well as wearable systems and devices for health and wellness management. This paper presents such a generic architecture for\ud multiparametric, intelligent and ubiquitous wireless sensing platforms. It is a transparent, smartphone-based sensing framework\ud with customizable wireless interfaces and plug‘n’play capability to easily interconnect third party sensor devices. It caters to wireless\ud body, personal, and near-me area networks. A pivotal part of the platform is the integrated inference engine/runtime environment\ud that allows the mobile device to serve as a user-adaptable personal health assistant. The novelty of this system lays in a rapid visual\ud development and remote deployment model. The complementary visual InferenceEngineEditor that comes with the package enables\ud artificial intelligence specialists, alongside with medical experts, to build data processing models by assembling different components\ud and instantly deploying them (remotely) on patient mobile devices. In this paper, the new logic-centered software architecture for ubiquitous health monitoring applications is described, followed by a\ud discussion as to how it helps to shift focus from software and hardware development, to medical and health process-centered design of new SWS applications

Medical Device Interoperability With Provable Safety Properties

Applications that can communicate with and control multiple medical devices have the potential to radically improve patient safety and the effectiveness of medical treatment. Medical device interoperability requires devices to have an open, standards-based interface that allows communication with any other device that implements the same interface. This will enable applications and functionality that can improve patient safety and outcomes. To build interoperable systems, we need to match up the capabilities of the medical devices with the needs of the application. An application that requires heart rate as an input and provides a control signal to an infusion pump requires a source of heart rate and a pump that will accept the control signal. We present means for devices to describe their capabilities and a methodology for automatically checking an application’s device requirements against the device capabilities. If such applications are going to be used for patient care, there needs to be convincing proof of their safety. The safety of a medical device is closely tied to its intended use and use environment. Medical device manufacturers create a hazard analysis of their device, where they explore the hazards associated with its intended use. We describe hazard analysis for interoperable devices and how to create system safety properties from these hazard analyses. The use environment of the application includes the application, connected devices, patient, and clinical workflow. The patient model is specific to each application and represents the patient’s response to treatment. We introduce Clinical Application Modeling Language (CAML), based on Extended Finite State Machines, and use model checking to test safety properties from the hazard analysis against the parallel composition of the application, patient model, clinical workflow, and the device models of connected devices

Integrating Wearable Devices and Recommendation System: Towards a Next Generation Healthcare Service Delivery

Researchers have identified lifestyle diseases as a major threat to human civilization. These diseases gradually progress without giving any warning and result in a sudden health aggravation that leads to a medical emergency. As such, individuals can only avoid the life-threatening condition if they regularly monitor their health status. Health recommendation systems allow users to continuously monitor their health and deliver proper health advice to them. Also, continuous health monitoring depends on the real-time data exchange between health solution providers and users. In this regard, healthcare providers have begun to use wearable devices and recommendation systems to collect data in real time and to manage health conditions based on the generated data. However, we lack literature that has examined how individuals use wearable devices, what type of data the devices collect, and how providers use the data for delivering solutions to users. Thus, we decided to explore the available literature in this domain to understand how wearable devices can provide solutions to consumers. We also extended our focus to cover current health service delivery frameworks with the help of recommender systems. Thus, this study reviews health-monitoring services by conglomerating both wearable device and recommendation system to come up with personalized health and fitness solutions. Additionally, the paper elucidates key components of an advanced-level real-time monitoring service framework to guide future research and practice in this domain

On Line Service Composition in the Integrated Clinical Environment for eHealth and Medical Systems

Medical and eHealth systems are progressively realized in the context of standardized architectures that support safety and ease the integration of the heterogeneous (and often proprietary) medical devices and sensors. The Integrated Clinical Environment (ICE) architecture appeared recently with the goal of becoming a common framework for defining the structure of the medical applications as concerns the safe integration of medical devices and sensors.This research was partly supported by iLand (EU ARTEMIS-1-00026) granted by the ARTEMIS JUand the Spanish Ministry of Industry, Commerce and Tourism. It has also been partly funded by the REM4VSS (TIN2011-28339) project grant of the Spanish Ministry of Economy and Competitiveness and by Universidad Carlos III de Madrid. The authors would also like to mention the large development team of the iLand reference implementation that performed an outstanding role to achieve a software proven also on commercial applications, and they thank them for their valuable efforts and work.Publicad

Inverted GUI Development for IoT with Applications in E-Health

In the context of Internet of Things (IoT), the research of this dissertation is concerned with the development of applications for end-user devices, i.e. devices through which the end-user directly interacts with systems. The complexity of such applications is partly due to network intricacies, and partly because GUI (Graphical User Interface) development is generally complicated and time consuming. We employ a middleware framework called PalCom to manage the former, and focus our research on the problems of the latter, by expanding the scope of PalCom to also enable GUI development. In particular, the research goal is a more efficient GUI development approach that does not require program code to be written.To enable end-users with little or no programming experience to participate in the GUI development process, we eliminate the need for programming by introducing a new development approach. We view this approach as “inverted” in that the development focus is on presenting functionality from an application model as graphical components in a GUI, rather than on retroactively attaching functionality to manually added graphical components. The inverted GUI development approach is supported in two steps. First, we design a language for describing GUIs, and implement interpreters that communicate with remotely hosted application models and render GUI descriptions as fully functional GUIs. Second, we implement a graphical editor for developing GUIs in order to make the language more accessible.The presented solution is evaluated by its application in a number of research projects in the domain of e-health. From the GUIs developed in those projects, we conclude that the GUI language is practically viable for building full-blown, professional grade GUIs. Furthermore, the presented graphical editor is evaluated by direct comparison to a market leading product in a controlled experiment. From this, we conclude that the editor is accessible to new users, and that it can be more efficient to use than the commercial alternative

An architecture for using commodity devices and smart phones in health systems

The potential of patient-centred care and a connected eHealth ecosystem can be developed through socially responsible innovative architectures. The purpose of this paper is to define key innovation needs. This is achieved through conceptual development of an architecture for common information spaces with emergent end-user applications by supporting intelligent processing of measurements, data and services at the Internet of Things (IoT) integration level. The scope is conceptual definition, and results include descriptions of social, legal and ethical requirements, an architecture, services and connectivity infrastructures for consumer-oriented healthcare systems linking co-existing healthcare systems and consumer devices. We conclude with recommendations based on an analysis of research challenges related to how to process the data securely and anonymously and how to interconnect participants and services with different standards and interaction protocols, and devices with heterogeneous hardware and software configurations

PediApp Finder: Creating a Pediatric Application Database

It is estimated that of the 85% of Americans that own cell phones, over half of these cell phone owners use apps on their phone (Fox & Duggan, 2012; Purcell, 2011). According to the U.S. Food and Drug Administration (2013), by 2015, 500 million mobile device users will be using mobile health, or “m-Health” apps. Healthcare professionals are increasingly adopting mobile technology as an innovative, cost-efficient, and timesaving tool that may promote patient wellness and disease prevention (Kumar, 2013; mHealth Bible, 2013). Although mobile technology is a natural fit to the field of occupational therapy, research demonstrates that few resources exist for finding apps for use in occupational therapy intervention with children (Hoesterey & Chappelle, 2012; Waite, 2012). The purpose of this project was to develop a free and open-source app that serves as a centralized database of apps beneficial to pediatric occupational therapy intervention. Dominican University of California Occupational Therapy graduate students partnered with Mr. Ruben Rivera of Northern New Mexico College (NNMC) in developing and implementing this project. As a result, an app titled PediApp Finder was created for mobile Android platforms and published on Google Play for free public download. The main goals of this project were to provide a resource tool for pediatric occupational therapists that would facilitate and streamline the process of searching for apps for use in pediatric intervention, as well as to provide a platform in which therapists can share the most up-to-date app technology in order to stay current and relevant in pediatric therapy. A pilot version of PediApp Finder was shared with four pediatric occupational therapists along with a Likert scale survey for evaluation of the app’s content, function, and design. Results of this survey guided the final refinement phase of the PediApp Finder development process. PediApp Finder is now currently available for free public download on Google Play