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

Contributions to the mixed-alkali effect in molecular dynamics simulations of alkali silicate glasses

The mixed-alkali effect on the cation dynamics in silicate glasses is analyzed via molecular dynamics simulations. Observations suggest a description of the dynamics in terms of stable sites mostly specific to one ionic species. As main contributions to the mixed--alkali slowdown longer residence times and an increased probability of correlated backjumps are identified. The slowdown is related to the limited accessibility of foreign sites. The mismatch experienced in a foreign site is stronger and more retarding for the larger ions, the smaller ions can be temporarily accommodated. Also correlations between unlike as well as like cations are demonstrated that support cooperative behavior.Comment: 10 pages, 12 figures, 1 table, revtex4, submitted to Phys. Rev.

Design and implementation of a federated health record server

This paper describes the practical implementation of a federated health record serverbased on a generic and comprehensive public domain architecture and deployed in alive clinical setting.The authors, working at the Centre for Health Informatics and MultiprofessionalEducation (University College London), have built up over a decade of experiencewithin Europe on the requirements and information models that are needed to underpincomprehensive multi-professional electronic health records. This work has involvedcollaboration with a wide range of healthcare and informatics organisations and partnersin the healthcare computing industry across Europe though the EU Health Telematicsprojects GEHR, Synapses, EHCR-SupA, SynEx and Medicate. The resultingarchitecture models have influenced recent European standards in this area, such asCEN TC/251 ENV 13606. UCL has now designed and built a federated health recordserver based on these models which is now running in the Department ofCardiovascular Medicine at the Whittington Hospital in north London. A new EC FifthFramework project, 6WINIT, is enabling new and innovative IPv6 and wirelesstechnology solutions to be added to this work.The north London clinical demonstrator site has provided the solid basis from which toestablish "proof of concept" verification of the design approach, and a valuableopportunity to install, test and evaluate the results of the component engineeringundertaken during the EC funded projects

The applicability and effectiveness of cluster analysis

An insight into the characteristics which determine the performance of a clustering algorithm is presented. In order for the techniques which are examined to accurately cluster data, two conditions must be simultaneously satisfied. First the data must have a particular structure, and second the parameters chosen for the clustering algorithm must be correct. By examining the structure of the data from the Cl flight line, it is clear that no single set of parameters can be used to accurately cluster all the different crops. The effectiveness of either a noniterative or iterative clustering algorithm to accurately cluster data representative of the Cl flight line is questionable. Thus extensive a prior knowledge is required in order to use cluster analysis in its present form for applications like assisting in the definition of field boundaries and evaluating the homogeneity of a field. New or modified techniques are necessary for clustering to be a reliable tool

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

Differential correction and preliminary orbit determination for lunar satellite orbits

Differential correction and preliminary orbit calculation for lunar satellite orbit

Security and confidentiality approach for the Clinical E-Science Framework (CLEF)

CLEF is an MRC sponsored project in the E-Science programme that aims to establish policies and infrastructure for the next generation of integrated clinical and bioscience research. One of the major goals of the project is to provide a pseudonymised repository of histories of cancer patients that can be accessed by researchers. Robust mechanisms and policies are needed to ensure that patient privacy and confidentiality are preserved while delivering a repository of such medically rich information for the purposes of scientific research. This paper summarises the overall approach adopted by CLEF to meet data protection requirements, including the data flows and pseudonymisation mechanisms that are currently being developed. Intended constraints and monitoring policies that will apply to research interrogation of the repository are also outlined. Once evaluated, it is hoped that the CLEF approach can serve as a model for other distributed electronic health record repositories to be accessed for research