Simultaneous trend analysis for evaluating outcomes in patient-centred health monitoring services
Tóm tắt
The research aim underpinning the Healthcare@Home (HH) information system described here was to enable ‘near real time’ risk analysis for disease early detection and prevention. To this end, we are implementing a family of prototype web services to ‘push’ or ‘pull’ individual’s health-related data via an system of clinical hubs, mobile communication devices and/or dedicated home-based network computers. We are examining more efficient methods for ethical use of such data in timeline-based (i.e. ‘longitudinal’) data analysis systems. A consistent data collation infrastructure is being created for use along the ‘patient path’—accessible wherever patients happen to be. This ‘patient-centred’ infrastructure can be applied in the evaluation of disease progression risk (in the light of clinical understanding of disease processes). In this paper we describe the requirements for making multi-data trend management ‘scale-up’, together with some requirements of an ‘end-to-end’ functioning data collection system. A Service-Oriented Architecture (SOA) approach is used to maximise benefits from (1) clinical evidence and (2) computational models of disease progression that can be made available elsewhere on the SOA. We discuss the implications of this so-called ‘closed loop’ approach for improving healthcare intervention outcomes, patient safety, decision support, objective measurement of service quality and in providing inputs for quantitative healthcare (predictive) modelling.
Tài liệu tham khảo
Albert PS (1999) Longitudinal data analysis (repeated measures) in clinical trials. Stat Med 18:1707–1732
Baird J, Turisco F (2005) Service-oriented architecture: a critical technology component to support consumer-driven health care. AHIP Cover 46:74 76, 78 passim
Benson T (2007) Prevention of errors and user alienation in healthcare IT integration programmes. Inform Prim Care 15:1–7
Bescos C, Schmitt D, Kass J, Garcia-Barbero M, Kantchev P (2005) Interoperability and HealthGRID. Methods Inf Med 44:190–192
Breton V, Blanquer I, Hernandez V, Jacq N, Legre Y, Olive M, Solomonides T (2007) Roadmap for a European healthgrid. Stud Health Technol Inform 126:154–163
Bucur A, Kootstra R, van Leeuwen J, Obbink H (2006) Service-oriented architecture for grid-enabling medical applications. Stud Health Technol Inform 120:55–68
Dogac A, Laleci GB, Aden T, Eichelberg M (2007) Enhancing IHE XDS for federated clinical affinity domain support. IEEE Trans Inf Technol Biomed 11:213–221
Dolin RH, Alschuler L, Boyer S, Beebe C, Behlen FM, Biron PV, Shabo Shvo A (2006) HL7 clinical document architecture, release 2. J Am Med Inform Assoc 13:30–39
Donnelly K (2006) SNOMED-CT: the advanced terminology and coding system for eHealth. Stud Health Technol Inform 121:279–290
Estrella F, Hauer T, McClatchey R, Odeh M, Rogulin D, Solomonides T (2007) Experiences of engineering grid-based medical software. Int J Med Inform 76:621–632
Ferranti JM, Musser RC, Kawamoto K, Hammond WE (2006) The clinical document architecture and the continuity of care record: a critical analysis. J Am Med Inform Assoc 13:245–252
Hallett C (2006) Summarisation and visualisation of e-health data repositories. Part of Clinical e-Science Framework (CLEF) project. UK e-Science All-Hands Meeting 2006, available at: http://oro.open.ac.uk/5261/01/AHM06.pdf
Hartswood M, Jirotka M, Procter R, Slack R, Voss A, Lloyd S (2005) Working IT out in e-Science: experiences of requirements capture in a HealthGrid project. Stud Health Technol Inform 112:198–209
Hernandez V, Blanquer I (2005) The grid as a healthcare provision tool. Methods Inf Med 44:144–148
Herveg J (2007) Does healthgrid present specific risks with regard to data protection? Stud Health Technol Inform 126:219–228
Kawamoto K, Lobach DF (2007) Proposal for fulfilling strategic objectives of the U.S. Roadmap for national action on clinical decision support through a service-oriented architecture leveraging HL7 services. J Am Med Inform Assoc 14:146–155
Laszlo_Systems (2007) Source for OpenLaszlo, an open source platform for rich Ajax application development. http://www.laszlosystems.com/ last accessed: June 2007
Muller M, Frankewitsch T, Ganslandt T, Burkle T, Prokosch HU (2004) The Clinical Document Architecture (CDA) enables electronic medical records to wireless mobile computing. Medinfo 11:1448–1452
Nadkarni PM, Miller RA (2007) Service-oriented architecture in medical software: promises and perils. J Am Med Inform Assoc 14:244–246
Olive M, Rahmouni H, Solomonides T (2007) From healthgrid to SHARE: a selective review of projects. Stud Health Technol Inform 126:306–313
Rogers J, Puleston C, Rector A (2006) The CLEF chronicle: transforming patient records into an E-Science resource. Part of Clinical e-Science Framework (CLEF) project. UK e-Science All-Hands Meeting 2006, available at: http://www.allhands.org.uk/2006/proceedings/papers/688.pdf
Steinichen P, Turisco F (2006) Service oriented architecture: adding value to legacy IT systems. AHIP Cover 47:54 56, 58–59
Ure J, Procter R, Martone M, Porteous D et al (2007) Data integration in ehealth: a domain/disease specific roadmap. Stud Health Technol Inform 126:144–153
Various_authors (2007) Continua healthcare alliance; see http://www.continuaalliance.org Last accessed: June 2007
Various_authors (2005) Diabetes Continuing Care Reference dataset (DCCR); for details see http://www.ic.nhs.uk and http://www.ic.nhs.uk/our-services/improving-data-collection-and-use/datasets Last accessed: June 2007
Diabetes NSF (Wales) (2003) Standards http://www.wales.nhs.uk/sites3/home.cfm?orgid=440 Last accessed June 2007
Fifth IMA International Conference on Quantitative Modelling in the Management of Healthcare (2007) Institute of Mathematics and its Applications. http://www.ima.org.uk/Conferences last accessed June 2007
HealthGrid annual conferences, e.g. http://lyon2003.healthgrid.org, http://clermont2004.healthgrid.org http://oxford2005.healthgrid.org/, http://valencia2006.healthgrid.org/ http://geneva2007.healthgrid.org, URL's last accessed. May 2007
The NHS Common User Interface (CUI) Programme. Link accessed: https://www.cui.nhs.uk/Pages/NHSCommonUserInterface.aspx, 2007
OMII UK (2007) The OGSA-DAI Project—details at http://www.ogsadai.org.uk/. Last accessed: June 2007
Wozak F, Ammenwerth E, Breu M, Penz R, Schabetsberger T, Vogl R, Wurz M (2006) Medical data GRIDs as approach towards secure cross enterprise document sharing (based on IHE XDS). Stud Health Technol Inform 124:377–383
Evans E (2003) Domain-driven design: tackling complexity in the heart of software. Addison-Wesley