A standards-based ICT framework to enable a service-oriented approach to clinical decision support

This research provides evidence that standards based Clinical Decision Support (CDS) at the point of care is an essential ingredient of electronic healthcare service delivery. A Service Oriented Architecture (SOA) based solution is explored, that serves as a task management system to coordinate complex distributed and disparate IT systems, processes and resources (human and computer) to provide standards based CDS. This research offers a solution to the challenges in implementing computerised CDS such as integration with heterogeneous legacy systems. Reuse of components and services to reduce costs and save time. The benefits of a sharable CDS service that can be reused by different healthcare practitioners to provide collaborative patient care is demonstrated. This solution provides orchestration among different services by extracting data from sources like patient databases, clinical knowledge bases and evidence-based clinical guidelines (CGs) in order to facilitate multiple CDS requests coming from different healthcare settings. This architecture aims to aid users at different levels of Healthcare Delivery Organizations (HCOs) to maintain a CDS repository, along with monitoring and managing services, thus enabling transparency. The research employs the Design Science research methodology (DSRM) combined with The Open Group Architecture Framework (TOGAF), an open source group initiative for Enterprise Architecture Framework (EAF). DSRM’s iterative capability addresses the rapidly evolving nature of workflows in healthcare. This SOA based solution uses standards-based open source technologies and platforms, the latest healthcare standards by HL7 and OMG, Decision Support Service (DSS) and Retrieve, Update Locate Service (RLUS) standard. Combining business process management (BPM) technologies, business rules with SOA ensures the HCO’s capability to manage its processes. This architectural solution is evaluated by successfully implementing evidence based CGs at the point of care in areas such as; a) Diagnostics (Chronic Obstructive Disease), b) Urgent Referral (Lung Cancer), c) Genome testing and integration with CDS in screening (Lynch’s syndrome). In addition to medical care, the CDS solution can benefit organizational processes for collaborative care delivery by connecting patients, physicians and other associated members. This framework facilitates integration of different types of CDS ideal for the different healthcare processes, enabling sharable CDS capabilities within and across organizations

Publish/subscribe scientific workflow interoperability framework (PS-SWIF)

Different or similar workflow systems, hosted anywhere on a network, written in any language and running on different operating systems, can easily use the full range of PS-SWIF tools to interoperate with each other. The PS-SWIF approach provides interoperability among a wide range of scientific workflow systems

The TRIACS analytical workflows platform for distributed clinical decision support

In this paper we discuss a flexible distributed workflow-based approach that enables researchers to study biomedical data for creating decision support pipelines. Specifically we describe the TRIACS platform, which has first been applied to supporting evidence-based decisions for optimum diabetic retinopathy screening intervals In the prioritization mechanism, pseudonymised case data is stratified for screening need by computation of outcome risk or by clustering of dasiaat-riskpsila cases with past cases of actual preventable outcomes. Workflows present a novel approach to this problem by providing an appropriate level of granularity for breaking the domain problem into a collection of reusable service-oriented components that can be applied in different ways. TRIACS is intended to make the creation of new application logic quicker and easier than bespoke development methods. Through the TRIACS workflow interface, modular code is portable and available to solve analogous domain problems including application to trial studies for mining and analysing clinical data