A Distributed eHealthcare System Based on the Service Oriented Architecture

1
A Distributed e-Healthcare System
Based on the
Service Oriented Architecture

• Firat Kart, G. Miao, L. E. Moser, P. M.
  Melliar-Smith
• University of California, Santa Barbara

SCC Contest Salt Lake City, July 2007
2
Outline

• Motivation
• Key Contribution
• e-Healthcare System Architecture
• Clinic Module
• Pharmacy Module
• Patient Module
• Related Work
• Conclusion
• Future Work

3
Motivation
Human beings, in all lines of work, make
errors. Errors can be prevented by designing
systems that make it hard for people to do the
wrong thing and easy for people to do the right
thing. (US Institute of Medicine)

• Healthcare is life-critical work
• 7,000 deaths per year in the USA are due to
  incorrect prescriptions
  (Colorado State Board of
  Pharmacy News)
• 5 of 3 billion prescriptions per year are
  incorrect (The Washington Post)

4
Status of Current Healthcare

• Difficulties
• Management of personal data
• Standardization of data formats
• Extraction / analysis of content-based knowledge
• Federation of different healthcare databases
• Security and privacy of healthcare information
• Needs
• Improve the quality of healthcare
• Ease access to healthcare and healthcare
  information
• Reduce the cost of delivery of healthcare

5
Common Healthcare Delivery Practice
6
Key Contribution

• Distributed e-healthcare system based on SOA that
  aims to
• Provide support for physicians,
  nurses, pharmacists, patients and
  medical monitoring devices
• Reduce human errors
• Maintain electronic healthcare records
• Ease access to healthcare and healthcare
  information
• For healthcare professionals and patients

7
e-Healthcare System Architecture

• Service Oriented Architecture (SOA)
• Provides abstraction, encapsulation,
  modularization and software reuse
• Underlying implementation is free to change
• SOA is particularly appropriate for healthcare

8
Security and Privacy

• Session-based authentication
• Web sites require login
• Session information is checked
• Content-based authorization
• Authorized users can access patients data
  records
• Authorization is requested for access to
  patients data

9
e-Healthcare System Architecture

• Clinic, Pharmacy and Patient Modules
• Separation of concerns
• Different modules require different expertise
• Different styles of user interfaces
• Diverse implementations
• Custom deployments with different policies
• Allow competition and innovation
• Interoperability
• Different hardware such as mobile devices
• Growth, evolution and innovation in the future

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Clinic Module

• Clinical Staff Services
• Add patient data / notes
• Monitor patient data
• Make referrals to other physicians
• Patient Services
• Make appointments
• Receive patient data from medical monitoring
  devices
• Deliver notifications

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Clinic Module
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Clinic Module

• Web Service interface for stand-alone
  applications
• Physician application
• Appointment calendar
• For each appointment
• Patient data (history)
• Prescription items, etc.
• Referrals to other physician
• Speech-enabled software for ease of use
• Patient monitoring devices
• Blood pressure monitor
• Web site for patients

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Multi-Modal User Interface

• Interactive communication for healthcare
  professionals
• High-quality display
• Better for lists
• Keyboard
• User input
• Speech recognition
• Ease input to devices
• Speech synthesis
• Provide feedback

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Multi-Modal User Interface

• Example application
• Preparation of prescriptions
• Select patient
• Select medication, dosage, frequency, etc
• Select pharmacy
• Submit prescription electronically to pharmacy

15
Synchronizing Information

• Mobile Device Clinic Web Service
• Consistent Data Replication Protocol
• Based on the Atom Syndication Technology

16
Pharmacy Module

• Pharmacy Services
• Integrate with current medical devices
• Receive / view / fill prescriptions
• Patient Services
• Enable renewals of prescriptions
• Provide notifications

17
Pharmacy Module
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Pharmacy Module

• Pharmacy applications
• Integrate with Web Services interface
• Read existing e-prescriptions sent by physicians
• Update status of e-prescriptions
• Notify physician and patient of status changes
• Web site for patients
• Check prescription status
• Request refills of medications

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Patient Module

• Access to Web sites
• Clinic Web site
• View / make appointment
• Register patient devices
• View patient data
• Pharmacy Web site
• View status of prescriptions
• Request refill
• Integration with patient monitoring devices
• Blood pressure monitor, weight scale, pill box etc

20
Patient Module
21
Medical Monitoring Devices

• AD blood pressure monitor
• Transmit readings using Bluetooth
• Client application receives data

22
Medical Monitoring Devices

• Blood pressure history

23
Implementation

• Web Servers and Web Services are deployed on 3
  GHz computers with 2 GB memory
• Client applications are deployed on
  2 GHz computers with 2 GB
  memory
• For the PDA we used the OQO device
• A full-featured 3 x 5 personal computer
• Powered by a 1 GHz Transmeta Crusoe processor
• Features a 800 x 480 resolution screen
• Uses WiFi to communicate with other computers

24
Performance Evaluation

• Latency of requests
• Different rates of new prescription arrivals
• 0.1, 0.2, 0.5, 1, 2 and 3 prescriptions per second

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Related Work

• Architectures
• Beyer, et al., Process-oriented architecture for
  healthcare network
• Taylor, et al., SOA for health research data
  network
• Omar and Talen-Bendiab, Sensor and actuator
  framework
• Workflow
• Song, et al., Computer-aided healthcare workflow
• Ardissono, et al., Healthcare workflow as a BPEL
  process
• Records and databases
• Bourke, Strategy and architecture of healthcare
  information systems
• Tsiknakis, et al., Health telematic services
  based on digital libraries
• Dick, et al., Computer-based patient records
• Commercial Web sites and products
• Web sites (Aurora, Medseek)
• Prescription software (Epocrates)
• Monitoring devices (AD, MedSignals)

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Conclusion

• SOA based e-healthcare system
• Supports healthcare professionals
• Fewer human errors
• Electronic healthcare history
• Facilitates communication between healthcare
  professionals and patients
• Improves presentation / delivery of healthcare

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Future Work

• Incorporation of other kinds of medical devices
  (e.g.,
  e-pillboxes, weight scales)
• Integration with applications provided by
  pharmaceutical companies
• Improved and accurate medical information
• Awareness of new medications and
  accurate
  information
• Collaboration with healthcare professionals

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Questions ?
Tesekkürler!
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