Information architecture for a federated health record server

This paper describes the information models that have been used to implement a federated health record server and to deploy it in a live clinical setting. The authors, working at the Centre for Health Informatics and Multiprofessional Education (University College London), have built up over a decade of experience within Europe on the requirements and information models that are needed to underpin comprehensive multi-professional electronic health records. This work has involved collaboration with a wide range of health care and informatics organisations and partners in the healthcare computing industry across Europe though the EU Health Telematics projects GEHR, Synapses, EHCR-SupA, SynEx and Medicate. The resulting architecture models have fed into recent European standardisation work in this area, such as CEN TC/251 ENV 13606. UCL has implemented a federated health record server based on these models which is now running in the Department of Cardiovascular Medicine at the Whittington Hospital in North London. The information models described in this paper reflect a refinement based on this implementation experience

Design and implementation of a federated health record server

This paper describes the practical implementation of a federated health record serverbased on a generic and comprehensive public domain architecture and deployed in alive clinical setting.The authors, working at the Centre for Health Informatics and MultiprofessionalEducation (University College London), have built up over a decade of experiencewithin Europe on the requirements and information models that are needed to underpincomprehensive multi-professional electronic health records. This work has involvedcollaboration with a wide range of healthcare and informatics organisations and partnersin the healthcare computing industry across Europe though the EU Health Telematicsprojects GEHR, Synapses, EHCR-SupA, SynEx and Medicate. The resultingarchitecture models have influenced recent European standards in this area, such asCEN TC/251 ENV 13606. UCL has now designed and built a federated health recordserver based on these models which is now running in the Department ofCardiovascular Medicine at the Whittington Hospital in north London. A new EC FifthFramework project, 6WINIT, is enabling new and innovative IPv6 and wirelesstechnology solutions to be added to this work.The north London clinical demonstrator site has provided the solid basis from which toestablish "proof of concept" verification of the design approach, and a valuableopportunity to install, test and evaluate the results of the component engineeringundertaken during the EC funded projects

When intra-partum electronic fetal monitoring becomes court business

Sadly but inevitably, the clinical fruit of all scientific research, like the profile of the Roman god Janus, presents us with two faces - one is patient benefit while the other is medico-legal vulnerability. As part of defensive medicine, there are situations where malpractice risk is minimised by actual elimination of certain high-risk procedures e.g. in the case of some neurosurgical operations. Intra-partum electronic fetal monitoring (IPEFM) is the commonest obstetric procedure in the developed world, producing valuable information of fetal well being as co-related to maternal uterine activity with a scope of guarding fetal well-being in labour. It is a prime example of the therapeutic/ legal liability duality which haunts modern Medicine.peer-reviewe

TROUBLE 3: A fault diagnostic expert system for Space Station Freedom's power system

Designing Space Station Freedom has given NASA many opportunities to develop expert systems that automate onboard operations of space based systems. One such development, TROUBLE 3, an expert system that was designed to automate the fault diagnostics of Space Station Freedom's electric power system is described. TROUBLE 3's design is complicated by the fact that Space Station Freedom's power system is evolving and changing. TROUBLE 3 has to be made flexible enough to handle changes with minimal changes to the program. Three types of expert systems were studied: rule-based, set-covering, and model-based. A set-covering approach was selected for TROUBLE 3 because if offered the needed flexibility that was missing from the other approaches. With this flexibility, TROUBLE 3 is not limited to Space Station Freedom applications, it can easily be adapted to handle any diagnostic system

Inferring Argument Size Relationships with CLP(R)

Argument size relationships are useful in termination analysis which, in turn, is important in program synthesis and goal-replacement transformations. We show how a precise analysis for inter-argument size relationships, formulated in terms of abstract interpretation, can be implemented straightforwardly in a language with constraint support like CLP(R) or SICStus version 3. The analysis is based on polyhedral approximations and uses a simple relaxation technique to calculate least upper bounds and a delay method to improve the precision of widening. To the best of our knowledge, and despite its simplicity, the analysis derives relationships to an accuracy that is either comparable or better than any existing technique