A service oriented architecture to implement clinical guidelines for evidence-based medical practice

Health information technology (HIT) has been identified as the fundamental driver to streamline the healthcare delivery processes to improve care quality and reduce operational costs. Of the many facets of HIT is Clinical Decision Support (CDS) which provides the physician with patient-specific inferences, intelligently filtered and organized, at appropriate times. This research has been conducted to develop an agile solution to Clinical Decision Support at the point of care in a healthcare setting as a potential solution to the challenges of interoperability and the complexity of possible solutions. The capabilities of Business Process Management (BPM) and Workflow Management systems are leveraged to support a Service Oriented Architecture development approach for ensuring evidence based medical practice. The aim of this study is to present an architecture solution that is based on SOA principles and embeds clinical guidelines within a healthcare setting. Since the solution is designed to implement real life healthcare scenarios, it essentially supports evidence-based clinical guidelines that are liable to change over a period of time. The thesis is divided into four parts. The first part consists of an Introduction to the study and a background to existing approaches for development and integration of Clinical Decision Support Systems. The second part focuses on the development of a Clinical Decision Support Framework based on Service Oriented Architecture. The CDS Framework is composed of standards based open source technologies including JBoss SwitchYard (enterprise service bus), rule-based CDS enabled by JBoss Drools, process modelling using Business Process Modelling and Notation. To ensure interoperability among various components, healthcare standards by HL7 and OMG are implemented. The third part provides implementation of this CDS Framework in healthcare scenarios. Two scenarios are concerned with the medical practice for diagnosis and early intervention (Chronic Obstructive Pulmonary Disease and Lung Cancer), one case study for Genetic data enablement of CDS systems (New born screening for Cystic Fibrosis) and the last case study is about using BPM techniques for managing healthcare organizational perspectives including human interaction with automated clinical workflows. The last part concludes the research with contributions in design and architecture of CDS systems. This thesis has primarily adopted the Design Science Research Methodology for Information Systems. Additionally, Business Process Management Life Cycle, Agile Business Rules Development methodology and Pattern-Based Cycle for E-Workflow Design for individual case studies are used. Using evidence-based clinical guidelines published by UK’s National Institute of Health and Care Excellence, the integration of latest research in clinical practice has been employed in the automated workflows. The case studies implemented using the CDS Framework are evaluated against implementation requirements, conformance to SOA principles and response time using load testing strategy. For a healthcare organization to achieve its strategic goals in administrative and clinical practice, this research has provided a standards based integration solution in the field of clinical decision support. A SOA based CDS can serve as a potential solution to complexities in IT interventions as the core data and business logic functions are loosely coupled from the presentation. Additionally, the results of this this research can serve as an exemplar for other industrial domains requiring rapid response to evolving business processes

Terrain Database Correlation Assessment Using an Open Source Tool

Configuring networked simulators for training military teams in a distributed environment requires the usage of a set of terrain databases to represent the same training area. The results of simulation exercises can be degraded if the terrain databases are poorly correlated. A number of methodologies for determining the correlation between terrain databaHowever, there are few computational tools for this task and most of them were developed to address government needs, have limited availability, and handle specific digital formats. The goal of this paper is thus to present a novel open source tool developed as part of an academic research project.Comment: 12 pages, I/ITSEC 201

DESIGN AND EXPLORATION OF NEW MODELS FOR SECURITY AND PRIVACY-SENSITIVE COLLABORATION SYSTEMS

Collaboration has been an area of interest in many domains including education, research, healthcare supply chain, Internet of things, and music etc. It enhances problem solving through expertise sharing, ideas sharing, learning and resource sharing, and improved decision making. To address the limitations in the existing literature, this dissertation presents a design science artifact and a conceptual model for collaborative environment. The first artifact is a blockchain based collaborative information exchange system that utilizes blockchain technology and semi-automated ontology mappings to enable secure and interoperable health information exchange among different health care institutions. The conceptual model proposed in this dissertation explores the factors that influences professionals continued use of video- conferencing applications. The conceptual model investigates the role the perceived risks and benefits play in influencing professionals’ attitude towards VC apps and consequently its active and automatic use

Interoperable services based on activity monitoring in ambient assisted living environments

Ambient Assisted Living (AAL) is considered as the main technological solution that will enable the aged and people in recovery to maintain their independence and a consequent high quality of life for a longer period of time than would otherwise be the case. This goal is achieved by monitoring human’s activities and deploying the appropriate collection of services to set environmental features and satisfy user preferences in a given context. However, both human monitoring and services deployment are particularly hard to accomplish due to the uncertainty and ambiguity characterising human actions, and heterogeneity of hardware devices composed in an AAL system. This research addresses both the aforementioned challenges by introducing 1) an innovative system, based on Self Organising Feature Map (SOFM), for automatically classifying the resting location of a moving object in an indoor environment and 2) a strategy able to generate context-aware based Fuzzy Markup Language (FML) services in order to maximize the users’ comfort and hardware interoperability level. The overall system runs on a distributed embedded platform with a specialised ceiling- mounted video sensor for intelligent activity monitoring. The system has the ability to learn resting locations, to measure overall activity levels, to detect specific events such as potential falls and to deploy the right sequence of fuzzy services modelled through FML for supporting people in that particular context. Experimental results show less than 20% classification error in monitoring human activities and providing the right set of services, showing the robustness of our approach over others in literature with minimal power consumption

Transforming Healthcare Quality through Information Tehnology

Information and information exchange are crucial to the delivery of care on all levels of the health care delivery system—the patient, the care team, the health care organization, and the encompassing political-economic environment. To diagnose and treat individual patients effectively, individual care providers and care teams must have access to at least three major types of clinical information—the patient’s health record, the rapidly changing medical-evidence base, and provider orders guiding the process of patient care. In this frame, Information Technology can help healthcare organizations improve the quality of care that they provide, improve patient safety, improve cost-effectiveness, accelerate the translation of research findings into practice, improve care for the medically underserved, increase consumer involvement, improve accuracy and privacy, and increase their ability to monitor health nationally. Consequently, in the present article are presented some implementations of Information and Communication Technologies in the Health Care field.Healthcare; Quality; Information and Communication Technologies