Pragmatic oriented data interoperability for smart healthcare information systems

Smart healthcare is a complex domain for systems integration due to human and technical factors and heterogeneous data sources involved. As a part of smart city, it is such a complex area where clinical functions require smartness of multi-systems collaborations for effective communications among departments, and radiology is one of the areas highly relies on intelligent information integration and communication. Therefore, it faces many challenges regarding integration and its interoperability such as information collision, heterogeneous data sources, policy obstacles, and procedure mismanagement. The purpose of this study is to conduct an analysis of data, semantic, and pragmatic interoperability of systems integration in radiology department, and to develop a pragmatic interoperability framework for guiding the integration. We select an on-going project at a local hospital for undertaking our case study. The project is to achieve data sharing and interoperability among Radiology Information Systems (RIS), Electronic Patient Record (EPR), and Picture Archiving and Communication Systems (PACS). Qualitative data collection and analysis methods are used. The data sources consisted of documentation including publications and internal working papers, one year of non-participant observations and 37 interviews with radiologists, clinicians, directors of IT services, referring clinicians, radiographers, receptionists and secretary. We identified four primary phases of data analysis process for the case study: requirements and barriers identification, integration approach, interoperability measurements, and knowledge foundations. Each phase is discussed and supported by qualitative data. Through the analysis we also develop a pragmatic interoperability framework that summaries the empirical findings and proposes recommendations for guiding the integration in the radiology context

Systems Interoperability Types: A Tertiary Study

Interoperability has been a focus of attention over at least four decades, with the emergence of several interoperability types (or levels), diverse models, frameworks, and solutions, also as a result of a continuous effort from different domains. The current heterogeneity in technologies such as blockchain, IoT and new application domains such as Industry 4.0 brings not only new interaction possibilities but also challenges for interoperability. Moreover, confusion and ambiguity in the current understanding of interoperability types exist, hampering stakeholders' communication and decision making. This work presents an updated panorama of software-intensive systems interoperability with particular attention to its types. For this, we conducted a tertiary study that scrutinized 37 secondary studies published from 2012 to 2023, from which we found 36 interoperability types associated with 117 different definitions, besides 13 interoperability models and six frameworks in various domains. This panorama reveals that the concern with interoperability has migrated from technical to social-technical issues going beyond the software systems' boundary and still requiring solving many open issues. We also address the urgent actions and also potential research opportunities to leverage interoperability as a multidisciplinary research field to achieve low-coupled, cost-effective, and interoperable systems.Comment: 33 page

Interoperating networked embedded systems to compose the web of things

Improvements in science and technology have enhanced our quality of life with better healthcare services, comfortable living and transportation among others. Human beings are now able to travel faster, communicate across the globe in fraction of seconds, understand nature better than ever before and generate and consume huge amount of information. The Internet played a central role in this development by providing a vast network of networks. Leveraging this global infrastructure, the World Wide Web is providing a shared information space for such unprecedented amount of knowledge that is mostly contributed and used by human beings. It has played such a critical role in the adoption of the Internet, it is common to find people referring specific web sites as Internet. This adoption coupled with advances in manufacturing of computing elements that led to the reduction in size and price has introduced a new wave of technology, called the Internet of Things. A rudimentary description of the Internet of Things (IoT) is an Internet that connects, not only traditional computing devices (with higher capacity and provide user interface) but also everyday physical objects or ’Things’ around us. These objects are augmented by small networked embedded computing elements that interact with the host via sensors and actuators. It is estimated that there will be Billions of such devices and Trillions of dollars of market value distributed in multiple aspects of our lives; such as healthcare, smart home, smart industries and smart cities. However, there are many challenges that are hindering the wide adoption of IoT. One of these challenges is heterogeneity of network interfaces, platforms, data formats and many standards that led to vertical islands of systems that are not interoperable at various levels. To address the lack of interoperability, this thesis presents the author’s contributions in three categories. The first part is a lightweight middleware called LISA that address variations in protocols and platforms. It is designed to work within the constrained resources of the networked embedded devices. The overhead of the middleware is evaluated and compared with other related frameworks. The second set of contributions focus on higher level of system integration and related challenges. It includes a domain specific IoT language (DoS-IL) and a server implementation to support the proposed code on demand approach. The scripting language enables re-configuration of the behaviour of systems during integration or functional changes. The related server provides abstraction of the physical object and its embedded device to provide mobility services in addition to hosting the scripts. The last set of contributions are focused on either generalized architectural style design or a specific healthcare use case. In summary, the overall thesis presents a highlevel architectural style that provides ease of understanding and communication of IoT systems, serves as a means for system level integration and provides the desired quality attributes for IoT systems. The other contributions fit in the architectural style to facilitate the adoption of the style or showcase specific instances of the architecture’s use. The performance of the middleware, the scripting language and the server including their resource utilization and overhead have been analyzed and presented. In general, the combination of the contributions enable inter-operation of networked embedded systems that serve as building blocks for the Web of Things - a global system of IoT systems

A Service-oriented Architecture for Ambient-Assisted Living

Ambient-Assisted Living (AAL) is currently an important research and development area, mainly due to the rapidly aging society, the increasing cost of health care, and the growing importance that individuals place on living independently. The general goal of AAL solutions is to apply ambient-assisted intelligence to enable people with specific demands (e.g. handicapped or elderly) to live in their preferred environment longer by tools (i.e. smart objects, mobile and wearable sensors, intelligent devices) being sensitive and responsive to the presence of people and their actions. The research describes the design and development of a novel service-oriented system architecture where different smart objects and sensors are combined to offer ambient-assisted living intelligence to older people. The design stage is driven by a user-centred approach to define an interoperable architecture and human-oriented principles to create usable products and well-accepted services. Such architecture has been realized in the context of an Italian research project funded by the Marche Region and promoted by INRCA (National Institute on Health and Science of Aging) in the framework of smart home for active ageing and ambient assisted living. The result is an interoperable and flexible platform that allows creating user-centred services for independent living

spotlight no. 5, 2018 - #SmartHealthSystems Digitalization requires an effective strategy, compelling political leadership and a coordinating institution with a national mandate

In terms of digitalizing its healthcare sector, Germany trails far behind several other countries as the potential for quality and efficiency in German healthcare remains untapped ●● Countries that are succeeding in digitalizing their healthcare systems feature an effective strategy, political leadership and a coordinating institution with a national mandate ●● Taking pragmatic steps that are driven by the expected benefits for patients and the healthcare stem alike is key to shaping digital transformation positively ●● Promoting acceptance through strategies such as co-design measures is essential to success ●● German health politics must take on a stronger pro-active role and strengthen its leadership in this are

Ontology engineering for simulation component reuse

Commercial-off-the-shelf (COTS) simulation packages (CSPs) are widely used in industry, although they have yet to operate across organizational boundaries. Reuse across organizations is restricted by the same semantic issues that restrict the inter-organizational use of web services. The current representations of web components are predominantly syntactic in nature lacking the fundamental semantic underpinning required to support discovery on the emerging semantic web. Semantic models, in the form of ontology, utilized by web service discovery and deployment architectures provide one approach to support simulation model reuse. Semantic interoperation is achieved through the use of simulation component ontologies to identify required components at varying levels of granularity (including both abstract and specialized components). Selected simulation components are loaded into a CSP, modified according to the requirements of the new model and executed. The paper presents the development of an ontology, connector software and web service discovery architecture. The ontology is extracted from simulation scenarios involving airport, restaurant and kitchen service suppliers. The ontology engineering framework and discovery architecture provide a novel approach to inter-organizational simulation, adopting a less intrusive interface between participants. Although specific to CSPs the work has wider implications for the simulation community

Mapping the Path to a Health Data Marketplace in Norway: An Exploratory Case Study

This Master's thesis explores the complex dynamics of health data in the digital age, focusing on its secure and efficient management and ethical considerations. It investigates the potential of implementing a Health Data Marketplace (HDM) in the Norwegian e-health sector, aiming to construct a seamless health data exchange platform. This study proposes the integration of an existing health data gateway, the Egde Health Gateway (EHG), with the HDM. The research offers an in-depth analysis of existing limitations in health data exchange systems in Norway. It addresses current research gaps in Data Marketplace, Business Models, Gateways, and the Norwegian e-health context. Guided by two central research questions, this thesis delves into identifying essential components required to successfully implement an HDM in Norway and how this marketplace could be established using an existing data platform. Significantly, the thesis underscores the pivotal role of primary stakeholders in the HDM - Platform Operators, Platform Users, and Legal Authorities. The exploration reveals that Platform Operators are vital influencers, fostering collaboration and innovation within the ecosystem, while Platform Users and Legal Authorities ensure the marketplace's innovative and compliance aspects. Additionally, this study identifies essential components for successfully integrating an HDM into an existing health data platform, including Data Standardization, Interoperability, Integration, Security, Trust, and Legal Frameworks, among others. The thesis marks a significant step towards realizing an HDM in the Norwegian e-health sector. It invites future research to broaden stakeholder perspectives, examine economic aspects of the HDM, and delve into ethical considerations and technological innovations. The findings from this exploration serve as a catalyst for leveraging health data effectively, securely, and ethically, contributing to improved healthcare outcomes, research, and innovation in Norway and beyon

Mapping the Path to a Health Data Marketplace in Norway: An Exploratory Case Study

This Master's thesis explores the complex dynamics of health data in the digital age, focusing on its secure and efficient management and ethical considerations. It investigates the potential of implementing a Health Data Marketplace (HDM) in the Norwegian e-health sector, aiming to construct a seamless health data exchange platform. This study proposes the integration of an existing health data gateway, the Egde Health Gateway (EHG), with the HDM. The research offers an in-depth analysis of existing limitations in health data exchange systems in Norway. It addresses current research gaps in Data Marketplace, Business Models, Gateways, and the Norwegian e-health context. Guided by two central research questions, this thesis delves into identifying essential components required to successfully implement an HDM in Norway and how this marketplace could be established using an existing data platform. Significantly, the thesis underscores the pivotal role of primary stakeholders in the HDM - Platform Operators, Platform Users, and Legal Authorities. The exploration reveals that Platform Operators are vital influencers, fostering collaboration and innovation within the ecosystem, while Platform Users and Legal Authorities ensure the marketplace's innovative and compliance aspects. Additionally, this study identifies essential components for successfully integrating an HDM into an existing health data platform, including Data Standardization, Interoperability, Integration, Security, Trust, and Legal Frameworks, among others. The thesis marks a significant step towards realizing an HDM in the Norwegian e-health sector. It invites future research to broaden stakeholder perspectives, examine economic aspects of the HDM, and delve into ethical considerations and technological innovations. The findings from this exploration serve as a catalyst for leveraging health data effectively, securely, and ethically, contributing to improved healthcare outcomes, research, and innovation in Norway and beyond

FUTURE-ORIENTED AND PATIENT-CENTRIC? A QUALITATIVE ANALYSIS OF DIGITAL THERAPEUTICS AND THEIR INTEROPERABILITY

This paper focuses on the integration of digital therapeutics (DTx) into future-oriented and patient-centric care pathways. Based on a workshop series and problem-centered interviews in Germany, the current state-of-the-art of regulatory and technical integration of DTx was mapped as a landscape of DTx interoperability. The results focus on key interfaces of DTx, namely with Electronic Health Records (EHRs), devices, and other digital health innovations such as telemedicine, and highlight current challenges and potentials for future development. On a broader level, the results point to unresolved issues of care coordination, the optional role of the EHRs as regulated platforms for care, and the importance of integrating DTx data into public data spaces for research