Towards an interoperable healthcare information infrastructure - working from the bottom up

Historically, the healthcare system has not made effective use of information technology. On the face of things, it would seem to provide a natural and richly varied domain in which to target benefit from IT solutions. But history shows that it is one of the most difficult domains in which to bring them to fruition. This paper provides an overview of the changing context and information requirements of healthcare that help to explain these characteristics.First and foremost, the disciplines and professions that healthcare encompasses have immense complexity and diversity to deal with, in structuring knowledge about what medicine and healthcare are, how they function, and what differentiates good practice and good performance. The need to maintain macro-economic stability of the health service, faced with this and many other uncertainties, means that management bottom lines predominate over choices and decisions that have to be made within everyday individual patient services. Individual practice and care, the bedrock of healthcare, is, for this and other reasons, more and more subject to professional and managerial control and regulation.One characteristic of organisations shown to be good at making effective use of IT is their capacity to devolve decisions within the organisation to where they can be best made, for the purpose of meeting their customers' needs. IT should, in this context, contribute as an enabler and not as an enforcer of good information services. The information infrastructure must work effectively, both top down and bottom up, to accommodate these countervailing pressures. This issue is explored in the context of infrastructure to support electronic health records.Because of the diverse and changing requirements of the huge healthcare sector, and the need to sustain health records over many decades, standardised systems must concentrate on doing the easier things well and as simply as possible, while accommodating immense diversity of requirements and practice. The manner in which the healthcare information infrastructure can be formulated and implemented to meet useful practical goals is explored, in the context of two case studies of research in CHIME at UCL and their user communities.Healthcare has severe problems both as a provider of information and as a purchaser of information systems. This has an impact on both its customer and its supplier relationships. Healthcare needs to become a better purchaser, more aware and realistic about what technology can and cannot do and where research is needed. Industry needs a greater awareness of the complexity of the healthcare domain, and the subtle ways in which information is part of the basic contract between healthcare professionals and patients, and the trust and understanding that must exist between them. It is an ideal domain for deeper collaboration between academic institutions and industry

Architecture and Implementation of a Trust Model for Pervasive Applications

Collaborative effort to share resources is a significant feature of pervasive computing environments. To achieve secure service discovery and sharing, and to distinguish between malevolent and benevolent entities, trust models must be defined. It is critical to estimate a device\u27s initial trust value because of the transient nature of pervasive smart space; however, most of the prior research work on trust models for pervasive applications used the notion of constant initial trust assignment. In this paper, we design and implement a trust model called DIRT. We categorize services in different security levels and depending on the service requester\u27s context information, we calculate the initial trust value. Our trust value is assigned for each device and for each service. Our overall trust estimation for a service depends on the recommendations of the neighbouring devices, inference from other service-trust values for that device, and direct trust experience. We provide an extensive survey of related work, and we demonstrate the distinguishing features of our proposed model with respect to the existing models. We implement a healthcare-monitoring application and a location-based service prototype over DIRT. We also provide a performance analysis of the model with respect to some of its important characteristics tested in various scenarios

How 5G wireless (and concomitant technologies) will revolutionize healthcare?

The need to have equitable access to quality healthcare is enshrined in the United Nations (UN) Sustainable Development Goals (SDGs), which defines the developmental agenda of the UN for the next 15 years. In particular, the third SDG focuses on the need to “ensure healthy lives and promote well-being for all at all ages”. In this paper, we build the case that 5G wireless technology, along with concomitant emerging technologies (such as IoT, big data, artificial intelligence and machine learning), will transform global healthcare systems in the near future. Our optimism around 5G-enabled healthcare stems from a confluence of significant technical pushes that are already at play: apart from the availability of high-throughput low-latency wireless connectivity, other significant factors include the democratization of computing through cloud computing; the democratization of Artificial Intelligence (AI) and cognitive computing (e.g., IBM Watson); and the commoditization of data through crowdsourcing and digital exhaust. These technologies together can finally crack a dysfunctional healthcare system that has largely been impervious to technological innovations. We highlight the persistent deficiencies of the current healthcare system and then demonstrate how the 5G-enabled healthcare revolution can fix these deficiencies. We also highlight open technical research challenges, and potential pitfalls, that may hinder the development of such a 5G-enabled health revolution

A Survey of Access Control Models in Wireless Sensor Networks

Copyright 2014 by the authors; licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution license (http://creativecommons.org/licenses/by/3.0/)Wireless sensor networks (WSNs) have attracted considerable interest in the research community, because of their wide range of applications. However, due to the distributed nature of WSNs and their deployment in remote areas, these networks are vulnerable to numerous security threats that can adversely affect their proper functioning. Resource constraints in sensor nodes mean that security mechanisms with a large overhead of computation and communication are impractical to use in WSNs; security in sensor networks is, therefore, a challenge. Access control is a critical security service that offers the appropriate access privileges to legitimate users and prevents illegitimate users from unauthorized access. However, access control has not received much attention in the context of WSNs. This paper provides an overview of security threats and attacks, outlines the security requirements and presents a state-of-the-art survey on access control models, including a comparison and evaluation based on their characteristics in WSNs. Potential challenging issues for access control schemes in WSNs are also discussed.Peer reviewe

A multi-agent system for pervasive healthcare

Wireless technology based pervasive healthcare has been proposed in many applications such as disease management and accident prevention for cost saving and promoting citizen’s wellbeing. However, the emphasis so far is on the artefacts with limited attentions to guiding the development of an effective and efficient solution for pervasive healthcare. Therefore, this paper aims to propose a framework of multi-agent systems design for pervasive healthcare by adopting the concept of pervasive informatics and using the methods of organisational semiotics. The proposed multi-agent system for pervasive healthcare utilises sensory information to support healthcare professionals for providing appropriate care. The key contributions contain theoretical aspect and practical aspect. In theory, this paper articulates the information interactions between the pervasive healthcare environment and stakeholders by using the methods of organisational semiotics; in practice, the proposed framework improves the healthcare quality by providing appropriate medical attentions when and as needed. In this paper, both systems and functional architecture of the multi-agent system are elaborated with the use of wireless technologies such as RFID and wireless sensor networks. The future study will focus on the implementation of the proposed framework

System Support for Managing Invalid Bindings

Context-aware adaptation is a central aspect of pervasive computing applications, enabling them to adapt and perform tasks based on contextual information. One of the aspects of context-aware adaptation is reconfiguration in which bindings are created between application component and remote services in order to realize new behaviour in response to contextual information. Various research efforts provide reconfiguration support and allow the development of adaptive context-aware applications from high-level specifications, but don't consider failure conditions that might arise during execution of such applications, making bindings between application and remote services invalid. To this end, we propose and implement our design approach to reconfiguration to manage invalid bindings. The development and modification of adaptive context-aware applications is a complex task, and an issue of an invalidity of bindings further complicates development efforts. To reduce the development efforts, our approach provides an application-transparent solution where the issue of the invalidity of bindings is handled by our system, Policy-Based Contextual Reconfiguration and Adaptation (PCRA), not by an application developer. In this paper, we present and describe our approach to managing invalid bindings and compare it with other approaches to this problem. We also provide performance evaluation of our approach