Organization Meeting & Overvie3 CAS 757: Modern SW Tech for eHealth Kamran Sartipi Theme of my...
Transcript of Organization Meeting & Overvie3 CAS 757: Modern SW Tech for eHealth Kamran Sartipi Theme of my...
1 CAS 757: Modern SW Tech for eHealth Kamran Sartipi
Deptartment of Computing and Software McMaster University
Canada [email protected]
http://www.cas.mcmaster.ca/~sartipi
Dr. Kamran Sartipi
January 12, 2010
CAS 757: Modern Software Technology for eHealth
Instructor:
Organization Meeting & Overview
2 CAS 757: Modern SW Tech for eHealth Kamran Sartipi
Inst
ruct
or’s
Bac
kgro
und
Education: Electrical Engineering (B.Sc. & M.Sc.) Computer Science (MMath & PhD)
Research: Software Engineering (my expertise)
Forward Engineering – View-based (scenarios to design diagrams); – Tool development; – HW/SW co-design
Reverse Engineering – Software Architecture Recovery
• Pattern matching (Static Alborz Tool) • Dynamic analysis (Dynamic Alborz Tool) • Clustering; Concept lattice analysis; • Data mining techniques in SW Eng.
– Software Architecture Evaluation Health Informatics (new research)
Data and mined-knowledge interoperability (CDA, PMML) Healthcare system integration (HL7, SNOMED, SOA) Clinical Decision Support Systems (CDSS) Security and privacy
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Theme of my Courses Theory and Practice (Course project: design & development)
Operating Systems (CS 3SH3)
Simplified Unix file system using C
Software Development for CE/EE (SE 3KO4 / SE 3MO4) Automatic Banking Machine (ABM) using Java/C
Software Design (CAS 703) Fast-food restaurant system using UML and technologies
Software Architecture & Reverse Engineering (CAS 747) Reverse engineering of software systems using RE tools
Formal Specification Techniques (CAS 707) Specifying and verifying ABM/Restaurant system using FM tools
Modern Software Technology for eHealth Developing a prototype healthcare system using HTB
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CAS 757 Course Objectives Due to the importance of the quality of health services a major portion
of governmental spending in many countries has been allocated to these services.
Recently, healthcare organizations have been embracing new technologies to improve the quality of health services and to reduce the error rate in patient treatment. On the other hand, several modern technologies are emerging that can perfectly address the issues in the current state of growing network of healthcare systems.
This course exposes the graduate students with CS/SE background to the challenges in the field of Electronic Health (eHealth). The course introduces a collection of modern architectures and technologies that are recommended by standardization organizations to build the infrastructure that meets the emerging demands in the growing network
of healthcare systems.
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Healthcare��������� Costs as Main Drivers
Healthcare consumes a large portion of the government’s spending in many countries Total healthcare spending in Canada in 2005 was $140
billion Ontario invested $28.1 billions for health services in 2003/04 Vascular disease (#1 cost driver in healthcare) estimated at
$18 billions each year
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IT in Healthcare
Healthcare system is characterized by a large number of relatively independent entities: Hospitals; Physicians; Governmental agencies (OHIP),
Pharmacies, Laboratories, Long-term Care Facilities; Community Care Access Centres; Homecare Agencies.
Healthcare investment in IT is about 2.5% of its total revenue, much lower than most other Canadian industries (finance, business, insurance,..)
Healthcare and governmental organizations invest a lot to prevent duplication of information, adverse drug event, diagnosis, disease outbreaks,..
Low IT investment leads to higher operating costs, delays in
processing patients, and errors
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Health Informatics
Health Informatics Professionals develop and deploy information and systems solutions, drawing on expert knowledge from fields such as computer science, information management, cognitive science, communications, epidemiology, management sciences and health sciences.
Examples of health informatics applications include the design, development, implementation, maintenance and evaluation of:
Communication protocols for the secure transmission of healthcare data Electronic patient record systems (regionally, provincially, territorially or
nationally) Evidence-based clinical decision support systems Classification systems using standardized terminology and coding Case management systems (e.g., for community, home and long-term care)
Definition by Canada’s Health Informatics Association (COACH) Health informatics (HI) is the intersection of clinical,
IM/IT and management practices to achieve better health.
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Health Informatics … Examples of health informatics applications include the design,
development, implementation,maintenance and evaluation of:
Access and referrals systems for healthcare services Patient monitoring systems (e.g., computer controlled bedside monitors and
patient home monitoring devices) Digital imaging and image processing systems Tele-health technologies to facilitate and support remote diagnosis and
treatment Internet technology for engaging patients in their own care Public health surveillance and protection systems Methodologies and applications for data analysis, management and mining Clinical information data warehouses and reporting systems Business, financial, support and logistics systems ePrescription involving: management, distribution, communication,
monitoring, and control of all transactions for drug prescription. Mobile eHealth including: clinical data acquisition, representation,
distribution, and usage by mobile agents. Medical geomatics which lies in the interface of health informatics and
techniques such as GIS, GPS, RFID, and Sensor Networks.
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COACH model for Health Informatics Involving Fields
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World of Healthcare is Changing
The Old World Provider-focused Illness Site-of-care Episode Management Supply Management Solitary decision making
Efficiency De-centralized, generalized
care
The New World Patient & family-focused Wellness Continuum of care Disease Management Demand Management Collaborative, evidence-based
decisions Effectiveness Centralized, specialized care
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Health Level Seven (HL7)
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History of HL7 The HL7 organization was founded in 1987 In June 1994 HL7 was designated as an ANSI
accredited standards development organization (SDO)
–
HL7 Mission Statement: Provide standards for the exchange, management and
integration of data that supports clinical patient care and the management, delivery and evaluation of healthcare services.
Provide complete life cycle for standards specification, development, adoption, market recognition, utilization and adherence.
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HL7 Standard Versions
2.0 (1988) Prototype 2.1 (1990) First standard 2.2 (1994) Widely Adopted 2.3 (1997) In operation 2.3.1 (1999) Current ANSI standard 2.4 (2000) In ballot 3.0 Balloting of Prototype in 2000,
balloting of formal specifications in 2001
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Limitations of HL7 Version 2
Implicit information model, not explicit Events not tightly coupled to profiles Need for controlled vocabularies Limited to a single encoding syntax No explicit support for object technologies No explicit support for security functions Optionality is everywhere and troublesome
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Benefits of HL7 V3 Benefits to Providers
Deals with complexity of the HC environment Increases choices of innovative best-of-breed solutions Provides support for legacy systems Allows reliable verification of vendors’ conformance claims
Benefits to Vendors Reduces installation effort Reduces site-specific negotiations Simplifies interface programming Promotes vendor specialization by allowing segmentation
of product lines into niche market spaces Provides improved protocol for interconnecting
heterogeneous systems
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Version 3 is a change to the HL7 Architecture Version
The HL7 2.x specifications have: Segments that imply information entities Events that indicate implied behaviors Descriptive content that suggests use cases But never formally documents these
Version 3 seeks to formalize this by applying object analytic methods and style to improve the internal consistency of HL7 to provide sound semantic definitions to enable future architectures to produce an evolution not a revolution
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What is HL7
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Increased IS Complexity
Involved Technologies Modeling and designing information systems
UML diagrams (class diagram, sequence diagram, collaboration diagram, statechart, component diagram, activity chart), Message development views (separating message selection from its contents)
Web applications Client side programming: XHTML, JavaScript, CSS Server side programming: Servers, Databases, Java technology
(JSP, Servlets) Microsoft technology (ASP.NET), PHP, …
Web Services and Service Oriented Architecture (SOA): XML/XSL, SOAP, WSDL, UDDI. Abstract services
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Data Mining as Source of Knowledge
Classification: mapping data into predefined classes. (e.g., whether a patient has a specific disease or not)
Regression: mapping a data item to a prediction variable. (e.g., Estimating the probability that a patient will survive given the results of a set of diagnostic tests.)
Clustering: To identify clusters of data items. (e.g., to identify different groups of patients and their characteristics.)
Association Rule Mining: to find associated data based on shared attributes within database transactions. (e.g., how different patient data are related based on shared relations such as: “specific diseases”, “patients habits”, or “family disease history”.)
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Canada Health Infoway
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Canada Health Infoway Canada Health Infoway (Infoway 2001) is an independent, not-
for-profit organization whose members are Canada's 14 federal, provincial and territorial Deputy Ministers of Health.
Infoway’s mission is to accelerate the use of electronic health information systems and electronic health record (EHRs) across Canada.
These systems are increasingly providing health care professionals with rapid access to accurate and complete patient information, enabling better decisions about treatment and diagnosis.
The result will be a modernized and sustainable health care system offering improved accessibility, quality and productivity.
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Canada Health Infoway … The goal is to integrate information systems from different health
providers and administrations (e.g., hospitals, laboratories, pharmacies, physicians, and government agencies) within each province
These systems then will be connected to form a nationwide healthcare network with standard data formats, communication protocols, and a unique health history file for each patient.
The health information will be accessible everywhere and anytime, using common services according to different access privileges for patients and providers.
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Service Oriented Architecture
Service consumers Uses business processes and services within the system (in
Infoway infostructure: physicians, pharmacy, patient, EHR viewer)
Service registries Service interface and protocols, functionality and constraints
specification (registries for client, provider, location, terminology)
Service providers EHR data and services, and ancillary services.
Service bus Connects consumers to the services (Health Information Access Layer,
HIAL)
An architecture that relies on service orientation as its fundamental" design principal: based on loosely coupled and independent "
networked services; no knowledge of platform is required."
Inte
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Canada Health Infoway’s iEHR Infostructure JURISDICTIONAL INFOSTRUCTURE
Pharmacy System
EHR Data & Services
Pharmacist
EHR Viewer
Radiology Center
PACS/RIS Lab
System (LIS)
Hospital, LTC, CCC,
EPR
Physician/ Provider Lab Clinician Radiologist
Physician Office EMR
Physician/ Provider
Physician/ Provider
Public Health
Services
Public Health
Provider
Ancillary Data & Services
Outbreak Management
PHS Reporting
POINT OF SERVICE
Registries Data & Services
Client Registry
Provider Registry
Location Registry
Terminology Registry
Drug Information
Diagnostic Imaging
Laboratory Shared Health Record
Security Management Data
Privacy Data Configuration
HIAL Communication Bus Common Services
Data Warehous
e
Health Information
Longitudinal Record Services
Message Structures
EHR Index
Business Rules
Normalisation Rules
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Oracle Health Transaction Base (HTB)
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Oracle’s Healthcare Transaction Base (HTB)
Oracle’s Healthcare Transaction Base (HTB) is a Service Oriented Architecture that supports the integration, development, and operation of a full spectrum of healthcare applications.
The platform couples a comprehensive, standards-based data repository with a robust set of integrated services for data normalization, customer-defined security and auditing, and business process/workflow.
HTB functionality includes: • Administrative and Clinical Business Services • Core Application Services • Domain-specific Architecture • Business Intelligence
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Integration Overview
29 CAS 757: Modern SW Tech for eHealth Kamran Sartipi
Deptartment of Computing and Software McMaster University
Canada [email protected]
http://www.cas.mcmaster.ca/~sartipi
Dr. Kamran Sartipi
January 12, 2010
CAS 757: Modern Software Technology for eHealth
Instructor:
Organization Meeting & Overview