Design and implementation of a secure and user-friendly broker platform supporting the end-to-end provisioning of e-homecare services

We designed a broker platform for e-homecare services using web service technology. The broker allows efficient data communication and guarantees quality requirements such as security, availability and cost-efficiency by dynamic selection of services, minimizing user interactions and simplifying authentication through a single user sign-on. A prototype was implemented, with several e-homecare services (alarm, telemonitoring, audio diary and video-chat). It was evaluated by patients with diabetes and multiple sclerosis. The patients found that the start-up time and overhead imposed by the platform was satisfactory. Having all e-homecare services integrated into a single application, which required only one login, resulted in a high quality of experience for the patients

Use of web services for computerized medical decision support, including infection control and antibiotic management, in the intensive care unit

The increasing complexity of procedures in the intensive care unit (ICU) requires complex software services, to reduce improper use of antibiotics and inappropriate therapies, and to offer earlier and more accurate detection of infections and antibiotic resistance. We investigated whether web-based software can facilitate the computerization of complex medical processes in the ICU. The COSARA application contains the following modules: Infection overview, Thorax, Microbiology, Antibiotic therapy overview, Admission cause with comorbidity and admission diagnosis, infection linking and registration, and Feedback. After the implementation and test phase, the COSARA software was installed on a physician's off ice PC and then on the bedside PCs of the patients. Initial evaluation indicated that the services had been integrated easily into the daily clinical workflow of the medical staff. The use of a service oriented architecture with web service technology for the development of advanced decision support in the ICU offers several advantages over classical software design approaches

Service-oriented subscription management of medical decision data in the intensive care unit

Objectives: This paper addresses the design of a platform for the management of medical decision data in the ICU. Whenever new medical data from laboratories of monitors is available or at fixed times, the appropriate medical support services are activated and generate a medical alert or suggestion to the bedside terminal, the physician's PDA, smart phone or mailbox. Since future ICU systems will rely ever more on medical decision support, a generic and flexible subscription platform is of high importance. Methods: Our platform is designed based on the principles of service-oriented architectures, and is fundamental for service deployment since the medical support services only need to implement their algorithm and can rely on the platform for general functionalities. A secure communication and execution environment are also provided. Results: A prototype, where medical support services can be easily plugged in, has been implemented using Web service technology and is currently being evaluated by the Department of Intensive Cafe of the Ghent University Hospital. To illustrate the platform operation and performance, two prototype medical support services are used, showing that the extra response time introduced by the platform is less than 150 ms. Conclusions: The platform allows for easy integration with hospital information systems. The platform is generic and offers user-friendly patient/service subscription, transparent data and service resource management and priority-based filtering of messages. The performance has been evaluated and it was shown that the response time of platform components is negligible compared to the execution time of the medical support services

Dynamic selection of interactive eHomeCare services

Ehomecare services can save money and improve patient care due to increased feelings of well-being at home. However, since not all patients are technical experts and ehomecare services are developed by different vendors, using different languages and data definitions, acceptance of ehomecare might become difficult due to the complexity of managing all the different service locations and login information or due to unavailability of requested services. Therefore in this paper the authors present a patient centered application as a facade to the broker platform providing dynamic service selection. The client application is adjusted dynamically to fit the patient's profile, fulfilling the specific needs for each patient personally and presents only the ehomecare services that are of interest to the patient. In order to alleviate users from service localization, the broker platform provides transparent service selection and switching and guarantees that service requests are handled by dynamically selecting the best or least loaded service, this way also providing reliability

Design of software services for computer-based infection control and antibiotic management in the intensive care unit

The increase of nosocomial infections and antibiotic resistance at the Intensive Care Unit (ICU) requires new approaches for infection control and antibiotic management. Although large hospitals have already introduced database systems for automated collection of patients’ laboratory results and monitoring data, physicians and nurses are still confronted with time-consuming manual infection control. There is a lack of integrated computerized medical services that could aid physicians in making the most optimal decision in the antibiotic therapies and infection treatment for every patient. Today,current ICU platforms are not offering an infrastructure for infection surveillance, extended data mining and modeling of critical illness. Therefore, this paper describes the design of timeand data-driven software services to reduce improper use of antibiotics, prescriptions, inappropriate therapies and to offer an earlier and more accurate detection of infections and antibiotic resistance, contributing to increased efficiency of patient care