A pervasive approach to a real-time intelligent decision support system in intensive medicine

The decision on the most appropriate procedure to provide to the patients the best healthcare possible is a critical and complex task in Intensive Care Units (ICU). Clinical Decision Support Systems (CDSS) should deal with huge amounts of data and online monitoring, analyzing numerous parameters and providing outputs in a short real-time. Although the advances attained in this area of knowledge new challenges should be taken into account in future CDSS developments, principally in ICUs environments. The next generation of CDSS will be pervasive and ubiquitous providing the doctors with the appropriate services and information in order to support decisions regardless the time or the local where they are. Consequently new requirements arise namely the privacy of data and the security in data access. This paper will present a pervasive perspective of the decision making process in the context of INTCare system, an intelligent decision support system for intensive medicine. Three scenarios are explored using data mining models continuously assessed and optimized. Some preliminary results are depicted and discussed.Fundação para a Ciência e a Tecnologia (FCT

Distributed Object Medical Imaging Model

Abstract- Digital medical informatics and images are commonly used in hospitals today,. Because of the interrelatedness of the radiology department and other departments, especially the intensive care unit and emergency department, the transmission and sharing of medical images has become a critical issue. Our research group has developed a Java-based Distributed Object Medical Imaging Model(DOMIM) to facilitate the rapid development and deployment of medical imaging applications in a distributed environment that can be shared and used by related departments and mobile physiciansDOMIM is a unique suite of multimedia telemedicine applications developed for the use by medical related organizations. The applications support realtime patients’ data, image files, audio and video diagnosis annotation exchanges. The DOMIM enables joint collaboration between radiologists and physicians while they are at distant geographical locations. The DOMIM environment consists of heterogeneous, autonomous, and legacy resources. The Common Object Request Broker Architecture (CORBA), Java Database Connectivity (JDBC), and Java language provide the capability to combine the DOMIM resources into an integrated, interoperable, and scalable system. The underneath technology, including IDL ORB, Event Service, IIOP JDBC/ODBC, legacy system wrapping and Java implementation are explored. This paper explores a distributed collaborative CORBA/JDBC based framework that will enhance medical information management requirements and development. It encompasses a new paradigm for the delivery of health services that requires process reengineering, cultural changes, as well as organizational changes

Data mining predictive models for pervasive intelligent decision support in intensive care medicine

The introduction of an Intelligent Decision Support System (IDSS) in a critical area like the Intensive Medicine is a complex and difficult process. In this area, their professionals don’t have much time to document the cases, because the patient direct care is always first. With the objective to reduce significantly the manual records and, enabling, at the same time, the possibility of developing an IDSS which can help in the decision making process, all data acquisition process and knowledge discovery in database phases were automated. From the data acquisition to the knowledge discovering, the entire process is autonomous and executed in real-time. On-line induced data mining models were used to predict organ failure and outcome. Preliminary results obtained with a limited population of patients showed that this approach can be applied successfully.Fundação para a Ciência e a Tecnologia (FCT

Medical data processing and analysis for remote health and activities monitoring

Recent developments in sensor technology, wearable computing, Internet of Things (IoT), and wireless communication have given rise to research in ubiquitous healthcare and remote monitoring of human\u2019s health and activities. Health monitoring systems involve processing and analysis of data retrieved from smartphones, smart watches, smart bracelets, as well as various sensors and wearable devices. Such systems enable continuous monitoring of patients psychological and health conditions by sensing and transmitting measurements such as heart rate, electrocardiogram, body temperature, respiratory rate, chest sounds, or blood pressure. Pervasive healthcare, as a relevant application domain in this context, aims at revolutionizing the delivery of medical services through a medical assistive environment and facilitates the independent living of patients. In this chapter, we discuss (1) data collection, fusion, ownership and privacy issues; (2) models, technologies and solutions for medical data processing and analysis; (3) big medical data analytics for remote health monitoring; (4) research challenges and opportunities in medical data analytics; (5) examples of case studies and practical solutions

Intelligent decision support in Intensive Care : towards technology acceptance

Decision support technology acceptance is a critical factor in the success of the adoption this type of systems by the users. INTCARE is an intelligent decision support system for intensive care medicine. The main purpose of this system is to help the doctors and nurses making decisions more proactively based on the prediction of the organ failure and the outcome of the patients. To assure the adoption of INTCARE by the doctors and by the nurses, several requirements had taken into account: process dematerialization (information is now in electronic format); interoperability among the systems (the AIDA platform was used to interoperate with other information systems); on-line data acquisition and real-time processing (a set of software agents has been developed to accomplish these tasks). A technology acceptance methodology has been followed in the Intensive Care Unit (ICU) of Centro Hospitalar do Porto in order to assure the most perfect alignment between the functional and technical characteristics of INTCARE and the user expectations. Results showed that the ICU staff is permeable to the system. In general more than 90 % of the answers are scored with 4 or 5 points which gives a good motivation to continue the work.Fundação para a Ciência e a Tecnologia (FCT

Enabling ubiquitous data mining in intensive care: Features selection and data pre-processing

Ubiquitous Data Mining and Intelligent Decision Support Systems are gaining interest by both computer science researchers and intensive care doctors. Previous work contributed with Data Mining models to predict organ failure and outcome of patients in order to support and guide the clinical decision based on the notion of critical events and the data collected from monitors in real-time. This paper addresses the study of the impact of the Modified Early Warning Score, a simple physiological score that may allow improvements in the quality and safety of management provided to surgical ward patients, in the prediction sensibility. The feature selection and data pre-processing are also detailed. Results show that for some variables associated to this score the impact is minimal.Fundação para a Ciência e a Tecnologia (FCT

An intelligent information forwarder for healthcare big data systems with distributed wearable sensors

© 2016 IEEE. An increasing number of the elderly population wish to live an independent lifestyle, rather than rely on intrusive care programmes. A big data solution is presented using wearable sensors capable of carrying out continuous monitoring of the elderly, alerting the relevant caregivers when necessary and forwarding pertinent information to a big data system for analysis. A challenge for such a solution is the development of context-awareness through the multidimensional, dynamic and nonlinear sensor readings that have a weak correlation with observable human behaviours and health conditions. To address this challenge, a wearable sensor system with an intelligent data forwarder is discussed in this paper. The forwarder adopts a Hidden Markov Model for human behaviour recognition. Locality sensitive hashing is proposed as an efficient mechanism to learn sensor patterns. A prototype solution is implemented to monitor health conditions of dispersed users. It is shown that the intelligent forwarders can provide the remote sensors with context-awareness. They transmit only important information to the big data server for analytics when certain behaviours happen and avoid overwhelming communication and data storage. The system functions unobtrusively, whilst giving the users peace of mind in the knowledge that their safety is being monitored and analysed

Towards of a real-time Big Data architecture to intensive care

These days the exponential increase in the volume and variety of data stored by companies and organizations of various sectors of activity, has required to organizations the search for new solutions to improve their services and/or products, taking advantage of technological evolution. As a response to the inability of organizations to process large quantities and varieties of data, in the technological market, arise the Big Data. This emerging concept defined mainly by the volume, velocity and variety has evolved greatly in part by its ability to generate value for organizations in decision making. Currently, the health care sector is one of the five sectors of activity where the potential of Big Data growth most stands out. However, the way to go is still long and in fact there are few organizations, related to health care, that are taking advantage of the true potential of Big Data. The main target of this research is to produce a real-time Big Data architecture to the INTCare system, of the Centro Hospitalar do Porto, using the main open source big data solution, the Apache Hadoop. As a result of the first phase of this research we obtained a generic architecture who can be adopted by other Intensive Care Units."This work has been supported by COMPETE: POCI-01-0145-FEDER-007043 and FCT - Fundacao para a Ciencia e Tecnologia within the Project Scope: UID/CEC/00319/2013." This work is also supported by the Deus ex Machina (DEM): Symbiotic technology for societal efficiency gains - NORTE-01-0145-FEDER-00002

Step towards a patient timeline in intensive care units

In Intensive Medicine, the presentation of medical information is done in many ways, depending on the type of data collected and stored. The way in which the information is presented can make it difficult for intensivists to quickly understand the patient's condition. When there is the need to cross between several types of clinical data sources the situation is even worse. This research seeks to explore a new way of presenting information about patients, based on the timeframe in which events occur. By developing an interactive Patient Timeline, intensivists will have access to a new environment in real-time where they can consult the patient clinical history and the data collected until the moment. The medical history will be available from the moment in which patients is admitted in the ICU until discharge, allowing intensivist to examine data regarding vital signs, medication, exams, among others. This timeline also intends to, through the use of information and models produced by the INTCare system, combine several clinical data in order to help diagnose the future patients’ conditions. This platform will help intensivists to make more accurate decision. This paper presents the first approach of the solution designe