London SynEx Demonstrator Site: Impact Assessment Report

The key ingredients of the SynEx-UCL software components are: 1. A comprehensive and federated electronic healthcare record that can be used to reference or to store all of the necessary healthcare information acquired from a diverse range of clinical databases and patient-held devices. 2. A directory service component to provide a core persons demographic database to search for and authenticate staff users of the system and to anchor patient identification and connection to their federated healthcare record. 3. A clinical record schema management tool (Object Dictionary Client) that enables clinicians or engineers to define and export the data sets mapping to individual feeder systems. 4. An expansible set of clinical management algorithms that provide prompts to the patient or clinician to assist in the management of patient care. CHIME has built up over a decade of experience within Europe on the requirements and information models that are needed to underpin comprehensive multiprofessional electronic healthcare records. The resulting architecture models have influenced new European standards in this area, and CHIME has designed and built prototype EHCR components based on these models. The demonstrator systems described here utilise a directory service and object-oriented engineering approach, and support the secure, mobile and distributed access to federated healthcare records via web-based services. The design and implementation of these software components has been founded on a thorough analysis of the clinical, technical and ethico-legal requirements for comprehensive EHCR systems, published through previous project deliverables and in future planned papers. The clinical demonstrator site described in this report has provided the solid basis from which to establish "proof of concept" verification of the design approach, and a valuable opportunity to install, test and evaluate the results of the component engineering undertaken during the EC funded project. Inevitably, a number of practical implementation and deployment obstacles have been overcome through this journey, each of those having contributed to the time taken to deliver the components but also to the richness of the end products. UCL is fortunate that the Whittington Hospital, and the department of cardiovascular medicine in particular, is committed to a long-term vision built around this work. That vision, outlined within this report, is shared by the Camden and Islington Health Authority and by many other purchaser and provider organisations in the area, and by a number of industrial parties. They are collectively determined to support the Demonstrator Site as an ongoing project well beyond the life of the EC SynEx Project. This report, although a final report as far as the EC project is concerned, is really a description of the first phase in establishing a centre of healthcare excellence. New EC Fifth Framework project funding has already been approved to enable new and innovative technology solutions to be added to the work already established in north London

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

Service oriented centered e-health solution for monitoring and preventing chronic diseases

The modern and continuously changing lifestyles in almost all parts of the world resulted in an increase in the incidence of chronic diseases (CDs). To reduce risks associated with chronic diseases, health professionals are studying various clinical solutions. As a result of recent advances in sensing technology, wireless communications, and distributed communication, the monitoring of patients\u27 health condition and the elaboration of prevention plans are considered the most promising solutions for the treatment of chronic diseases. In this paper, we propose a novel framework for monitoring chronic diseases and tracking their vital signs. The framework relies on the service orientation concepts and standards to integrate various subsystems. Monitoring of subjects\u27 health condition, using various sensors and wireless devices, aims to proactively detect any risk of chronic diseases. The system will allow generating and customizing preventive plans dynamically according to the subject\u27s health profile and context while considering many impelling parameters. As a proof of concept of our monitoring and tracking schemes, we have considered a case study for which we have collected and analyzed preliminary data

Using Radio Frequency Identification Technology In Healthcare

In the healthcare industry, medical treatment can be a matter of life and death, so that any mistakes may cause irreversible consequences. As hospitals have sought to reduce these types of errors, Radio Frequency Identification Technology (RFID) has become a solution in the healthcare industry to address these problems. Since 2005, RFID has generated a lot of interest in healthcare to make simpler the identification process for tracking and managing medical resources to improve their use and to reduce the need for future costs for purchasing duplicate equipment. There are rising concerns linked to the privacy and security issues, when RFID tags are used for tracking items carried by people. A tag by its design will respond to a reader\u27s query without the owner\u27s consent and without the owner even noticing it. When RFID tags contain patients\u27 personal data and medical history, they have to be protected to avoid any leaking of privacy-sensitive information. To address these concerns, we propose an Intelligent RFID System which is a RFID card system that embeds smart tags in insurance cards, medical charts, and medical bracelets to store medical information. Patient data is sent to the insurance providers by way of a clearinghouse that translates the information from the healthcare facility into a format that the insurance company can process. To ensure data protection, an additional security layer was added to secure the communication between the tags and the readers. This security layer will allow only authorized readers to poll tags for the patient\u27s medical tags and prevent unauthorized access to tag data. It will simplify the maintenance and transfer of patient data in a secure, feasible and cost effective way

RFID-based Hospital Real-time Patient Management System

In a health care context, the use RFID (Radio Frequency Identification) technology can be employed for not only bringing down health care costs but also facilitate automating and streamlining patient identification processes in hospitals and use of mobile devices like PDA, smart phones, for design a health care management systems. In this paper, we outline a RFID model for designing a system in the health care. An application of the architecture is described in the area of RFID-based Real-time Hospital Patien

IoT-based Asset Management System for Healthcare-related Industries

The healthcare industry has been focusing efforts on optimizing inventory management procedures through the incorporation of Information and Communication Technology, in the form of tracking devices and data mining, to establish ideal inventory models. In this paper, a roadmap is developed towards a technological assessment of the Internet of Things (IoT) in the healthcare industry, 2010–2020. According to the roadmap, an IoT-based healthcare asset management system (IoT-HAMS) is proposed and developed based on Artificial Neural Network (ANN) and Fuzzy Logic (FL), incorporating IoT technologies for asset management to optimize the supply of resources

The organisational and communication implications of electronic ordering systems for hospital pathology services

Computerised Provider Order Entry (CPOE) systems provide clinicians with the ability to electronically enter hospital orders for laboratory tests and services. CPOE is able to integrate with hospital information systems and provide point of care decision support to users thereby making a potentially significant contribution to the efficiency and effectiveness of care delivery. The evidence of the impact of CPOE systems on pathology services is not extensive and insufficient attention has been paid to their effect on organisational and communication processes. This thesis aimed to investigate the implications of CPOE systems for pathology laboratories, their work processes and relationships with other hospital departments, using comparative examinations to identify the tasks they are involved in and the particular needs the laboratories expect to be filled by the new system. This longitudinal study of a CPOE system was carried out over three years using multiple cases from a hospital pathology service based at a large Sydney teaching hospital. Multi-methods using quantitative and qualitative data were employed to achieve triangulation of data, theory and methods. The findings provide evidence of a significant 14.3% reduction of laboratory turnaround times from 42 to 36 minutes when laboratory data for two months were compared before and after CPOE implementation. The findings also reveal changes in the pattern and organisation of information communication, highlighting transformations in the way that work is planned, negotiated and synchronised. These findings are drawn together in a comprehensive organisational communication framework that is highly relevant for developing a contingent and situational understanding of the impact of CPOE on pathology services