Integrating Safety Assessment into the Design of Healthcare Service-Oriented Architectures

Most healthcare organisations are service-oriented, fundamentally centred on critical services provided by medical and nursing staff. Increasingly, these human-centric services rely on software-intensive systems, i.e. medical devices and health informatics, for improving different aspects of healthcare, e.g. enhancing efficiency through automation and patient safety through smart alarm systems. However, many healthcare services are categorised as high risk and as such it is vital to analyse the ways in which the software-based systems can contribute to unintentional harm and potentially compromise patient safety. This paper proposes an approach to modelling and analysing Service-Oriented Architectures (SOAs) used in healthcare, with emphasis on identifying and classifying potential hazardous behaviour. The paper also considers how the safety case for these SOAs can be developed in a modular manner. The approach is illustrated through a case study based on three services: ambulance, electronic health records and childbirth services

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Dynamic real-time risk analytics of uncontrollable states in complex internet of things systems, cyber risk at the edge

The Internet of Things (IoT) triggers new types of cyber risks. Therefore, the integration of new IoT devices and services requires a self-assessment of IoT cyber security posture. By security posture this article refers to the cybersecurity strength of an organisation to predict, prevent and respond to cyberthreats. At present, there is a gap in the state of the art, because there are no self-assessment methods for quantifying IoT cyber risk posture. To address this gap, an empirical analysis is performed of 12 cyber risk assessment approaches. The results and the main findings from the analysis is presented as the current and a target risk state for IoT systems, followed by conclusions and recommendations on a transformation roadmap, describing how IoT systems can achieve the target state with a new goal-oriented dependency model. By target state, we refer to the cyber security target that matches the generic security requirements of an organisation. The research paper studies and adapts four alternatives for IoT risk assessment and identifies the goal-oriented dependency modelling as a dominant approach among the risk assessment models studied. The new goal-oriented dependency model in this article enables the assessment of uncontrollable risk states in complex IoT systems and can be used for a quantitative self-assessment of IoT cyber risk posture

Computerization of workflows, guidelines and care pathways: a review of implementation challenges for process-oriented health information systems

There is a need to integrate the various theoretical frameworks and formalisms for modeling clinical guidelines, workflows, and pathways, in order to move beyond providing support for individual clinical decisions and toward the provision of process-oriented, patient-centered, health information systems (HIS). In this review, we analyze the challenges in developing process-oriented HIS that formally model guidelines, workflows, and care pathways. A qualitative meta-synthesis was performed on studies published in English between 1995 and 2010 that addressed the modeling process and reported the exposition of a new methodology, model, system implementation, or system architecture. Thematic analysis, principal component analysis (PCA) and data visualisation techniques were used to identify and cluster the underlying implementation ‘challenge’ themes. One hundred and eight relevant studies were selected for review. Twenty-five underlying ‘challenge’ themes were identified. These were clustered into 10 distinct groups, from which a conceptual model of the implementation process was developed. We found that the development of systems supporting individual clinical decisions is evolving toward the implementation of adaptable care pathways on the semantic web, incorporating formal, clinical, and organizational ontologies, and the use of workflow management systems. These architectures now need to be implemented and evaluated on a wider scale within clinical settings

Internet of robotic things : converging sensing/actuating, hypoconnectivity, artificial intelligence and IoT Platforms

The Internet of Things (IoT) concept is evolving rapidly and influencing newdevelopments in various application domains, such as the Internet of MobileThings (IoMT), Autonomous Internet of Things (A-IoT), Autonomous Systemof Things (ASoT), Internet of Autonomous Things (IoAT), Internetof Things Clouds (IoT-C) and the Internet of Robotic Things (IoRT) etc.that are progressing/advancing by using IoT technology. The IoT influencerepresents new development and deployment challenges in different areassuch as seamless platform integration, context based cognitive network integration,new mobile sensor/actuator network paradigms, things identification(addressing, naming in IoT) and dynamic things discoverability and manyothers. The IoRT represents new convergence challenges and their need to be addressed, in one side the programmability and the communication ofmultiple heterogeneous mobile/autonomous/robotic things for cooperating,their coordination, configuration, exchange of information, security, safetyand protection. Developments in IoT heterogeneous parallel processing/communication and dynamic systems based on parallelism and concurrencyrequire new ideas for integrating the intelligent “devices”, collaborativerobots (COBOTS), into IoT applications. Dynamic maintainability, selfhealing,self-repair of resources, changing resource state, (re-) configurationand context based IoT systems for service implementation and integrationwith IoT network service composition are of paramount importance whennew “cognitive devices” are becoming active participants in IoT applications.This chapter aims to be an overview of the IoRT concept, technologies,architectures and applications and to provide a comprehensive coverage offuture challenges, developments and applications

Designing a gamified social platform for people living with dementia and their live-in family caregivers

In the current paper, a social gamified platform for people living with dementia and their live-in family caregivers, integrating a broader diagnostic approach and interactive interventions is presented. The CAREGIVERSPRO-MMD (C-MMD) platform constitutes a support tool for the patient and the informal caregiver - also referred to as the dyad - that strengthens self-care, and builds community capacity and engagement at the point of care. The platform is implemented to improve social collaboration, adherence to treatment guidelines through gamification, recognition of progress indicators and measures to guide management of patients with dementia, and strategies and tools to improve treatment interventions and medication adherence. Moreover, particular attention was provided on guidelines, considerations and user requirements for the design of a User-Centered Design (UCD) platform. The design of the platform has been based on a deep understanding of users, tasks and contexts in order to improve platform usability, and provide adaptive and intuitive User Interfaces with high accessibility. In this paper, the architecture and services of the C-MMD platform are presented, and specifically the gamification aspects. © 2018 Association for Computing Machinery.Peer ReviewedPostprint (author's final draft

A rapidly moving target: Conformance with e-health standards for mobile computing

The rapid adoption and evolution of mobile applications in health is posing significant challenges in terms of standards development, standards adoption, patient safety, and patient privacy. This is a complex continuum to navigate. There are many competing demands from the standards development process, to the use by clinicians and patients. In between there are compliance and conformance measures to be defined to ensure patient safety, effective use with integration into clinical workflow, and the protection of data and patient privacy involved in data collection and exchange. The result is a composite and intricate mixture of stakeholders, legislation, and policy together with national and individual perspectives. The challenges for standards development are numerous and include the cross over from traditional medical devices and mobile devices with apps, as well as harmonisation for consistent semantic terminology, and the diverse range of standards required in mobile health solutions. These issues affect the ability of conformance and compliance to be undertaken. Additionally, the need for interoperability in development of safe and secure mHealth software whilst being mindful of the implications for patient safety is vital. Conformance and compliance to established international standards is the first and, at present, the only step in meeting the mobile health challenges

A rapidly moving target: Conformance with e-health standards for mobile computing

The rapid adoption and evolution of mobile applications in health is posing significant challenges in terms of standards development, standards adoption, patient safety, and patient privacy. This is a complex continuum to navigate. There are many competing demands from the standards development process, to the use by clinicians and patients. In between there are compliance and conformance measures to be defined to ensure patient safety, effective use with integration into clinical workflow, and the protection of data and patient privacy involved in data collection and exchange. The result is a composite and intricate mixture of stakeholders, legislation, and policy together with national and individual perspectives. The challenges for standards development are numerous and include the cross over from traditional medical devices and mobile devices with apps, as well as harmonisation for consistent semantic terminology, and the diverse range of standards required in mobile health solutions. These issues affect the ability of conformance and compliance to be undertaken. Additionally, the need for interoperability in development of safe and secure mHealth software whilst being mindful of the implications for patient safety is vital. Conformance and compliance to established international standards is the first and, at present, the only step in meeting the mobile health challenges

Towards a Secure DevOps Approach for Cyber-Physical Systems: An Industrial Perspective

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