Developing quality heathcare software using quality function deployment: A case study based on Sultan Qaboos University Hospital

Development of software is one of the most expensive projects undertaken in practice. Traditionally, the rate of failure in software development projects is higher compared to other kinds of projects. This is partly due to the failure in determining software users’ requirements. By using Quality Function Deployment (QFD), this research focuses on identification and prioritization of users’ requirements in the context of developing quality health-care software system for Sultan Qaboos University Hospital (SQUH) in Oman. A total of 95 staff working at eight departments of SQUH were contacted and they were requested to provide their requirements in using hospital information systems. Analytic Hierarchy Process has been integrated with QFD for prioritizing those user requirements. Then, in consultation with a number of software engineers, a list consisting of 30 technical requirements was generated. These requirements are divided into seven categories and all of them are purported to satisfy the user needs. At the end of QFD exercise, continuous mirror backup from backup category, multi-level access from the security and confidentiality category, linkage to databases from application category emerge as technical requirements having higher weights. These technical requirements should receive considerable attention when designing the health-care software system for SQUH.Software quality; Quality function deployment; Healthcare software; Analytic Hierarchy Process

A case study in open source innovation: developing the Tidepool Platform for interoperability in type 1 diabetes management.

OBJECTIVE:Develop a device-agnostic cloud platform to host diabetes device data and catalyze an ecosystem of software innovation for type 1 diabetes (T1D) management. MATERIALS AND METHODS:An interdisciplinary team decided to establish a nonprofit company, Tidepool, and build open-source software. RESULTS:Through a user-centered design process, the authors created a software platform, the Tidepool Platform, to upload and host T1D device data in an integrated, device-agnostic fashion, as well as an application ("app"), Blip, to visualize the data. Tidepool's software utilizes the principles of modular components, modern web design including REST APIs and JavaScript, cloud computing, agile development methodology, and robust privacy and security. DISCUSSION:By consolidating the currently scattered and siloed T1D device data ecosystem into one open platform, Tidepool can improve access to the data and enable new possibilities and efficiencies in T1D clinical care and research. The Tidepool Platform decouples diabetes apps from diabetes devices, allowing software developers to build innovative apps without requiring them to design a unique back-end (e.g., database and security) or unique ways of ingesting device data. It allows people with T1D to choose to use any preferred app regardless of which device(s) they use. CONCLUSION:The authors believe that the Tidepool Platform can solve two current problems in the T1D device landscape: 1) limited access to T1D device data and 2) poor interoperability of data from different devices. If proven effective, Tidepool's open source, cloud model for health data interoperability is applicable to other healthcare use cases

An intelligent multi-agent memory assistant

World population is ageing and increasingly scarce resources are required to cover the needs of everyone adequately. Medical conditions, especially memory problems, restrict the daily life of a broad slice of the elderly population, affect their independence. To prevent this, providing the right care and assistance while having in mind the costs implicated is essential. One possible path is to work with resources that we already have today and create innovative solutions to achieve the required level of support. There are not many solution either technological or not to prevent memory loss. In this work we present a possible solution aimed at restoring or maintaining the independence of elderly people, through the use of so-called Memory Assistants. We thus present an Intelligent Multi-Agent Memory Assistant designed to help people with memory problems remember their events and activities. The implementation of an event manager, free time manger, medication remainder and a sensory system, to manage and monitor the user, we aim to improve their quality of life and increase their independence

Telehealth Case Management Nursing Process and Technology Enhancements: Reflecting Practice and Outcomes

Accurate reflection of care practices in telehealth care management is the fore runner to the delivery of reportable beneficiary outcomes. Success in delivering Geriatric Care Services (GCS) resides in a partnership between clinician practice and technology tools utilized in telehealth practice. Through in home technologies, telehealth can provide ongoing care needs to underserved populations, and it can support independent aging of beneficiaries who live with chronic care conditions. Tele-health care management, performed through a health plan, presents a unique opportunity to capitalize on the abundance of health data collected on a patient, and maximize the use of that information for clinical decision support. Nursing informatics is the facilitator of telenursing. It is the specialty that integrates and applies nursing science, and respective theoretical models, in identifying, collecting, processing, and managing data. It furthers seeks to process that data to formulate knowledge based decisions and informed care plan actions. Maximizing technology and available data are primary tools a telehealth clinician uses in care management practice. It is imperative that the technology system utilized in practice supports the telehealth interaction by accurately and effectively reflecting the clinician’s practice through data inputs, collection methods, and interpretation logic. This Doctorate of Nursing Practice (DNP) systems change project examined existing telehealth care practice and available technology tools. The project explored options for practice and process improvements in identification and formulation of cases and the development of new clinical technology tools to support the practice. Further, this project implemented practice change to support the organization’s strategic plan to provide efficient and effective GCS case management to our client. In summary, this project produced new clinical technology tools to reflect telehealth practice, gave a voice to telehealth case managers in the technology development cycle, and established a measurement framework for organizational reporting on case management outcomes

A Model-Based Approach to Comprehensive Risk Management for Medical Devices

The European medical technology industry consists of around 27,000 companies, more than 95% of them small and medium-sized enterprises (SMEs), with over 675,000 employees [MEDT17]. In the European Union (EU) alone, medical devices constituted by far the biggest part of the medical technology (MedTech) sector with a market of 95 billion euros in annual sales in 2015 [EURO15].The European medical technology industry consists of around 27,000 companies, more than 95% of them small and medium-sized enterprises (SMEs), with over 675,000 employees [MEDT17]. In the European Union (EU) alone, medical devices constituted by far the biggest part of the medical technology (MedTech) sector with a market of 95 billion euros in annual sales in 2015 [EURO15]

The Development of eServices in an Enlarged EU: eGovernment and eHealth in the Czech Republic

In 2005, IPTS launched a project which aimed to assess the developments in eGoverment, eHealth and eLearning in the 10 New Member States at national, and at cross-country level. At that time, the 10 New Member States were Cyprus, the Czech Republic, Estonia, Hungary, Latvia, Lithuania, Malta, Poland, and Slovakia. A report for each country was produced, describing its government and health systems and the role played by eGovernment and eHealth within these systems. Each report then analyzes, on the basis of desk research and expert interviews, the major achievements, shortcomings, drivers and barriers in the development of eGovernment and eHealth in one of the countries in question. This analysis provides the basis for the identification and discussion of national policy options to address the major challenges and to suggest R&D issues relevant to the needs of each country ¿ in this case, the Czech Republic. In addition to national monographs, the project has delivered a synthesis report, which offers an integrated view of the developments of each application domain in the New Member States. Furthermore, a prospective report looking across and beyond the development of the eGoverment, eHealth and eLearning areas has been developed to summarize policy challenges and options for the development of eServices and the Information Society towards the goals of Lisbon and i2010.JRC.J.4-Information Societ

Blockchain for Healthcare: Securing Patient Data and Enabling Trusted Artificial Intelligence

Advances in information technology are digitizing the healthcare domain with the aim of improved medical services, diagnostics, continuous monitoring using wearables, etc., at reduced costs. This digitization improves the ease of computation, storage and access of medical records which enables better treatment experiences for patients. However, it comes with a risk of cyber attacks and security and privacy concerns on this digital data. In this work, we propose a Blockchain based solution for healthcare records to address the security and privacy concerns which are currently not present in existing e-Health systems. This work also explores the potential of building trusted Artificial Intelligence models over Blockchain in e-Health, where a transparent platform for consent-based data sharing is designed. Provenance of the consent of individuals and traceability of data sources used for building and training the AI model is captured in an immutable distributed data store. The audit trail of the data access captured using Blockchain provides the data owner to understand the exposure of the data. It also helps the user to understand the revenue models that could be built on top of this framework for commercial data sharing to build trusted AI models

A go-to-market strategy for vertebral metrics

Dissertação para obtenção do Grau de Mestre em Engenharia Biomédica“A Go-to Market Strategy for Vertebral Metrics” is a project for commercialization of a technology capable of measuring the spatial coordinates of previously marked points. The device has been initially development for spine assessment even though it can be applied in different fields. The strategy for market penetration followed outlines some of these applications but will focus on the original purpose for which de device has been created. Market research analysis has resulted in different target segments ranging from small and medium sized healthcare providers to health club and wellness facilities. The project‟s timeline proposed for the next 6 years will be the following: Product development by NGNS, Innovative Solutions (Developer of Vertebral Metrics current prototype) to be finished in 2012. Sales initiation in Portugal (2013) followed by the product‟s entrance in Spain (2014) and Italy (2015). Commercialization will depend upon the creation of a new company called IHS – Innovative Healthcare Solutions which will manage sales, marketing and financial activities. Product assembly and early technical support will be performed by NGNS. Technical assistance will be, with time, incorporated in IHS and production outsourced, with NGNS maintaining its activity as an R&D partner. Marketing objectives will focus on attracting new customers and establishing partnership with both suppliers and distributors. IHS will have its own sales force in Portugal and depend upon partners for local distribution in other countries. The project depends upon an initial investment of 500 000€ with a payback period of 4 years and 3 months. The return is expected to be 6 times higher than the initial investment after 6 years

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

Prototyping Closed Loop Physiologic Control With the Medical Device Coordination Framework

Medical devices historically have been monolithic units – developed, validated, and approved by regulatory authorities as standalone entities. Despite the fact that modern medical devices increasingly incorporate connectivity mechanisms that enable device data to be streamed to electronic health records and displays that aggregate data from multiple devices, connectivity is not being leveraged to allow an integrated collection of devices to work together as a single system to automate clinical work flows. This is due, in part, to current regulatory policies which prohibit such interactions due to safety concerns. In previous work, we proposed an open source middleware framework and an accompanying model-based development environment that could be used to quickly implement medical device coordination applications – enabling a “systems of systems” paradigm for medical devices. Such a paradigm shows great promise for supporting many applications that increase both the safety and effectiveness of medical care as well as the efficiency of clinical workflows. In this paper, we report on our experience using our Medical Device Coordination Framework (MDCF) to carry out a rapid prototyping of one such application – a multi-device medical system that uses closed loop physiologic control to a affect better patient outcomes for Patient Controlled Anelgesic (PCA) pumps