82 research outputs found
Comparative study of healthcare messaging standards for interoperability in ehealth systems
Advances in the information and communication technology have created the field of "health informatics," which amalgamates healthcare, information technology and business. The use of information systems in healthcare organisations dates back to 1960s, however the use of technology for healthcare records, referred to as Electronic Medical Records (EMR), management has surged since 1990’s (Net-Health, 2017) due to advancements the internet and web technologies. Electronic Medical Records (EMR) and sometimes referred to as Personal Health Record (PHR) contains the patient’s medical history, allergy information, immunisation status, medication, radiology images and other medically related billing information that is relevant. There are a number of benefits for healthcare industry when sharing these data recorded in EMR and PHR systems between medical institutions (AbuKhousa et al., 2012). These benefits include convenience for patients and clinicians, cost-effective healthcare solutions, high quality of care, resolving the resource shortage and collecting a large volume of data for research and educational needs. My Health Record (MyHR) is a major project funded by the Australian government, which aims to have all data relating to health of the Australian population stored in digital format, allowing clinicians to have access to patient data at the point of care. Prior to 2015, MyHR was known as Personally Controlled Electronic Health Record (PCEHR). Though the Australian government took consistent initiatives there is a significant delay (Pearce and Haikerwal, 2010) in implementing eHealth projects and related services. While this delay is caused by many factors, interoperability is identified as the main problem (Benson and Grieve, 2016c) which is resisting this project delivery. To discover the current interoperability challenges in the Australian healthcare industry, this comparative study is conducted on Health Level 7 (HL7) messaging models such as HL7 V2, V3 and FHIR (Fast Healthcare Interoperability Resources). In this study, interoperability, security and privacy are main elements compared. In addition, a case study conducted in the NSW Hospitals to understand the popularity in usage of health messaging standards was utilised to understand the extent of use of messaging standards in healthcare sector. Predominantly, the project used the comparative study method on different HL7 (Health Level Seven) messages and derived the right messaging standard which is suitable to cover the interoperability, security and privacy requirements of electronic health record. The issues related to practical implementations, change over and training requirements for healthcare professionals are also discussed
Emerging and Established Trends to Support Secure Health Information Exchange
This work aims to provide information, guidelines, established practices and standards,
and an extensive evaluation on new and promising technologies for the implementation
of a secure information sharing platform for health-related data. We focus strictly on
the technical aspects and specifically on the sharing of health information, studying
innovative techniques for secure information sharing within the health-care domain,
and we describe our solution and evaluate the use of blockchain methodologically for
integrating within our implementation. To do so, we analyze health information sharing
within the concept of the PANACEA project that facilitates the design, implementation,
and deployment of a relevant platform. The research presented in this paper provides
evidence and argumentation toward advanced and novel implementation strategies
for a state-of-the-art information sharing environment; a description of high-level
requirements for the transfer of data between different health-care organizations or
cross-border; technologies to support the secure interconnectivity and trust between
information technology (IT) systems participating in a sharing-data “community”;
standards, guidelines, and interoperability specifications for implementing a common
understanding and integration in the sharing of clinical information; and the use of cloud
computing and prospectively more advanced technologies such as blockchain. The
technologies described and the possible implementation approaches are presented in
the design of an innovative secure information sharing platform in the health-care domain
Performance Evaluation of Smart Decision Support Systems on Healthcare
Medical activity requires responsibility not only from clinical knowledge and skill but
also on the management of an enormous amount of information related to patient care. It is
through proper treatment of information that experts can consistently build a healthy wellness
policy. The primary objective for the development of decision support systems (DSSs) is
to provide information to specialists when and where they are needed. These systems provide
information, models, and data manipulation tools to help experts make better decisions in a
variety of situations.
Most of the challenges that smart DSSs face come from the great difficulty of dealing
with large volumes of information, which is continuously generated by the most diverse types
of devices and equipment, requiring high computational resources. This situation makes this
type of system susceptible to not recovering information quickly for the decision making. As a
result of this adversity, the information quality and the provision of an infrastructure capable
of promoting the integration and articulation among different health information systems (HIS)
become promising research topics in the field of electronic health (e-health) and that, for this
same reason, are addressed in this research. The work described in this thesis is motivated
by the need to propose novel approaches to deal with problems inherent to the acquisition,
cleaning, integration, and aggregation of data obtained from different sources in e-health environments,
as well as their analysis.
To ensure the success of data integration and analysis in e-health environments, it
is essential that machine-learning (ML) algorithms ensure system reliability. However, in this
type of environment, it is not possible to guarantee a reliable scenario. This scenario makes
intelligent SAD susceptible to predictive failures, which severely compromise overall system
performance. On the other hand, systems can have their performance compromised due to the
overload of information they can support.
To solve some of these problems, this thesis presents several proposals and studies
on the impact of ML algorithms in the monitoring and management of hypertensive disorders
related to pregnancy of risk. The primary goals of the proposals presented in this thesis are
to improve the overall performance of health information systems. In particular, ML-based
methods are exploited to improve the prediction accuracy and optimize the use of monitoring
device resources. It was demonstrated that the use of this type of strategy and methodology
contributes to a significant increase in the performance of smart DSSs, not only concerning precision
but also in the computational cost reduction used in the classification process.
The observed results seek to contribute to the advance of state of the art in methods
and strategies based on AI that aim to surpass some challenges that emerge from the integration
and performance of the smart DSSs. With the use of algorithms based on AI, it is possible to
quickly and automatically analyze a larger volume of complex data and focus on more accurate
results, providing high-value predictions for a better decision making in real time and without
human intervention.A atividade médica requer responsabilidade não apenas com base no conhecimento
e na habilidade clínica, mas também na gestão de uma enorme quantidade de informações
relacionadas ao atendimento ao paciente. É através do tratamento adequado das informações
que os especialistas podem consistentemente construir uma política saudável de bem-estar. O
principal objetivo para o desenvolvimento de sistemas de apoio à decisão (SAD) é fornecer informações
aos especialistas onde e quando são necessárias. Esses sistemas fornecem informações,
modelos e ferramentas de manipulação de dados para ajudar os especialistas a tomar melhores
decisões em diversas situações.
A maioria dos desafios que os SAD inteligentes enfrentam advêm da grande dificuldade
de lidar com grandes volumes de dados, que é gerada constantemente pelos mais diversos
tipos de dispositivos e equipamentos, exigindo elevados recursos computacionais. Essa situação
torna este tipo de sistemas suscetível a não recuperar a informação rapidamente para a
tomada de decisão. Como resultado dessa adversidade, a qualidade da informação e a provisão
de uma infraestrutura capaz de promover a integração e a articulação entre diferentes sistemas
de informação em saúde (SIS) tornam-se promissores tópicos de pesquisa no campo da saúde
eletrônica (e-saúde) e que, por essa mesma razão, são abordadas nesta investigação. O trabalho
descrito nesta tese é motivado pela necessidade de propor novas abordagens para lidar
com os problemas inerentes à aquisição, limpeza, integração e agregação de dados obtidos de
diferentes fontes em ambientes de e-saúde, bem como sua análise.
Para garantir o sucesso da integração e análise de dados em ambientes e-saúde é
importante que os algoritmos baseados em aprendizagem de máquina (AM) garantam a confiabilidade
do sistema. No entanto, neste tipo de ambiente, não é possível garantir um cenário
totalmente confiável. Esse cenário torna os SAD inteligentes suscetíveis à presença de falhas
de predição que comprometem seriamente o desempenho geral do sistema. Por outro lado, os
sistemas podem ter seu desempenho comprometido devido à sobrecarga de informações que
podem suportar.
Para tentar resolver alguns destes problemas, esta tese apresenta várias propostas e
estudos sobre o impacto de algoritmos de AM na monitoria e gestão de transtornos hipertensivos
relacionados com a gravidez (gestação) de risco. O objetivo das propostas apresentadas nesta
tese é melhorar o desempenho global de sistemas de informação em saúde. Em particular, os
métodos baseados em AM são explorados para melhorar a precisão da predição e otimizar o
uso dos recursos dos dispositivos de monitorização. Ficou demonstrado que o uso deste tipo
de estratégia e metodologia contribui para um aumento significativo do desempenho dos SAD
inteligentes, não só em termos de precisão, mas também na diminuição do custo computacional
utilizado no processo de classificação.
Os resultados observados buscam contribuir para o avanço do estado da arte em métodos
e estratégias baseadas em inteligência artificial que visam ultrapassar alguns desafios que
advêm da integração e desempenho dos SAD inteligentes. Como o uso de algoritmos baseados
em inteligência artificial é possível analisar de forma rápida e automática um volume maior de
dados complexos e focar em resultados mais precisos, fornecendo previsões de alto valor para uma melhor tomada de decisão em tempo real e sem intervenção humana
Towards a Blockchain Assisted Patient Owned System for Electronic Health Records
Security and privacy of patients’ data is a major concern in the healthcare industry. In this paper, we propose a system that activates robust security and privacy of patients’ medical records as well as enables interoperability and data exchange between the different healthcare providers. The work proposes the shift from patient’s electronic health records being managed and controlled by the healthcare industry to a patient-centric application where patients are in control of their data. The aim of this research is to build an Electronic Healthcare Record (EHR) system that is layered on the Ethereum blockchain platform and smart contract in order to eliminate the need for third-party systems. With this system, the healthcare provider can search for patient’s data and request the patients’ consent to access it. Patients manage their data which enables an expedited data exchange across EHR systems. Each patient’s data are stored on the peer-to-peer node ledger. The proposed patient-centric EHR platform is cross-platform compliant, as it can be accessed via personal computers and mobile devices and facilitates interoperability across healthcare providers as patients’ medical records are gathered from different healthcare providers and stored in a unified format. The proposed framework is tested on a private Ethereum network using Ganache. The results show the effectiveness of the system with respect to security, privacy, performance and interoperability
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