On-site customer analytics and reporting (OSCAR):a portable clinical data warehouse for the in-house linking of hospital and telehealth data

This document conveys the results of the On-Site Customer Analytics and Reporting (OSCAR) project. This nine-month project started on January 2014 and was conducted at Philips Research in the Chronic Disease Management group as part of the H2H Analytics Project. Philips has access to telehealth data from their Philips Motiva tele-monitoring and other services. Previous projects within Philips Re-search provided a data warehouse for Motiva data and a proof-of-concept (DACTyL) solution that demonstrated the linking of hospital and Motiva data and subsequent reporting. Severe limitations with the DACTyL solution resulted in the initiation of OSCAR. A very important one was the unwillingness of hospitals to share personal patient data outside their premises due to stringent privacy policies, while at the same time patient personal data is required in order to link the hospital data with the Motiva data. Equally important is the fact that DACTyL considered the use of only Motiva as a telehealth source and only a single input interface for the hospitals. OSCAR was initiated to propose a suitable architecture and develop a prototype solution, in contrast to the proof-of-concept DACTyL, with the twofold aim to overcome the limitations of DACTyL in order to be deployed in a real-life hospital environment and to expand the scope to an extensible solution that can be used in the future for multiple telehealth services and multiple hospital environments. In the course of the project, a software solution was designed and consequently deployed in the form of a virtual machine. The solution implements a data warehouse that links and hosts the collected hospital and telehealth data. Hospital data are collected with the use of a modular service oriented data collection component by exposing web services described in WSDL that accept configurable XML data messages. ETL processes propagate the data, link, and load it on the OS-CAR data warehouse. Automated reporting is achieved using dash-boards that provide insight into the data stored in the data warehouse. Furthermore, the linked data is available for export to Philips Re-search in de-identified format

Evaluation of international standards for ECG-recording and storage for use in tele-medical services

This report is written to clarify which of the international standards for ECG recordings that can be used in tele-medical services, where the recordings should be transmitted by wireless telecommunication facilities and finally stored as information integrated into the patients Electronic Health Record (EHR). Some principals for recording, transmission and storage of digital vital signs parameters are highlighted and important aspects of wireless communication of recorded signals from biomedical sensors are described, in order to understand the significance and differences in the storing formats to be used. Even if most of the relevant standards are not yet ratified (the last meeting in ISO TC 251 WH6 was held in October 2005), the actual international standards SCP-ECG, MFER, FDAXML and DICIOM are defined and already widely adopted. In this report, these standards are briefly described and evaluated with respect to possible use in tele-medical services, and recommendations are given in order to obtain a reliable and secure communication solution. Requirements for integration of the ECG file formats into the EHR are briefly described, and it is given some recommendations for actual standards to be used in future solutions

A Cloud Telemedicine Platform Based on Workflow Management System: A Review of an Italian Case Study

The paper aims to describe a new technological and organizational approach in order to manage teleconsultation and telemonitoring processes involving a Physician, who remotely interacts with one or more Specialists, in order to evaluate and discuss the specific clinical conditions of a patient, based primarily on the sharing of digital clinical data, reports and diagnostic images. In the HINT project (Healthcare INtegration in Telemedicine), a teleconsultation and telemonitoring cloud platform has been developed using a Hub and Spoke architecture, based on a Business Process Management System (BPMS). The specialized clinical centres (Hubs) operate in connection with the territorial hospital centres (Spokes), which receive specific diagnostic consultations and telemonitoring data from the appropriate Specialist, supported by advanced AI systems. The developed platform overcomes the concepts of a traditional and fragmented teleconsultation and consequently the static organization of Hubs and Spokes, evolving towards an integrated clinical workflow management. The project platform adopts international healthcare standards, such as HL7 FHIR, IHE (XDS and XDW) and DICOM for the acquisition and management of healthcare data and diagnostic images. A Workflow Management System implemented in the platform allows to manage multiple and contemporaneous processes through a single platform, correctly associating the tasks to the Physicians responsible for their execution, monitoring the status of the health activities and managing possible clinical issues

An Interoperable eHealth Reference Architecture for Primary Care

eHealth is still not widely used in primary care, because barriers still exist around integrated and interoperable technological infrastructures for eHealth. This paper describes the design of an interoperable eHealth reference architecture for primary care and its evaluation with experts. This reference architecture aims to facilitate IT specialists in setting up interoperable eHealth infrastructures within primary healthcare organizations. The design of the reference architecture was based on the results of 14 working sessions with 10 eHealth Small and Medium sized Enterprises (SMEs) and the theory behind the Refined eHealth European Interoperability Framework (ReEIF). The evaluation with experts revealed additional conditions that – next to the reference architecture – are needed before interoperable eHealth in primary care can actually be achieved

Implementing Medical Business Processes Integrating Server Technologies

In this paper we describe a BPM solution implemented by integrating server technologies in a SOA manner. Our solution empowers healthcare workers to more efficiently and effectively create clinical forms and contribute in clinical business processes. The clinical forms are XML documents created either using a special editor or web forms. Shared access and document management facilities are supported via the SharePoint services while business processes management is driven by the BizTalk server. The integration between servers and components is realized via Web Services, adapters, and event handlers. The core logic behind business processes is implemented via BEPL constructs that obtain clinical forms, perform the requested data transformations, store data into the database, and push forms further into business processes. Event handlers receive forms from processes and, according to the routing information, deliver them to recipients. Web services provide SOA glue and lookups

Computer-supported cooperative work in tele home care : architecture design, implementation and evaluation

With the development of healthcare service and computer networks, the healthcare providers are focusing on how to implant new technologies into health sections. These instant messaging techniques can lead healthcare service more efficienct than before. It is necessary to design and construct a cooperative work platform for patients and healthcare providers. They are able to communicate with each other, share information or documents and access into health records. This project will concentrate on the system design, implementation and evaluation to achieve a better performance platform. The underlying data repository will encompass distributed system aspects and data warehousing approach to promote the functions of this healthcare system. This platform will be deployed to the tele home care service and in-depth study on the healthcare services. Some of the innovations will be included in system design. The target of this project is to design the architecture of collaborative workspace for healthcare personnel and implement a prototype with useful functions. The evaluation will be conducted to validate the efficiency of proposed distributed database for patient records. In addition, it will be more flexible and less data redundant. Meanwhile, a demo system will be deployed in order to show and define the implemented functions

A Home E-Health System for Dependent People Based on OSGI

This chapter presents a e-health system for dependent people installed in a home environment. After reviewing the state of art in e-health applications and technologies several limitations have been detected because many solutions are proprietary and lack interoperability. The developed home e-health system provides an architecture capable to integrate different telecare services in a smart home gateway hardware independent from the application layer. We propose a rule system to define users’ behavior and monitor relevant events. Two example systems have been implemented to monitor patients. A data model for the e-health platform is described as well.Ministerio de Educación y Ciencia TSI2006-13390-C02-0