Organization Meeting & Overview

Transcription

1 Organization Meeting & Overview CAS 757: Modern Software Technology for ehealth Instructor: Dr. Deptartment of Computing and Software McMaster University Canada January 12,

2 Instructor s Background 2 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

3 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 3 Modern Software Technology for ehealth Developing a prototype healthcare system using HTB

4 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. 4

5 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 5

6 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 6

7 Health Informatics 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. 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) 7

8 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. 8

9 COACH model for Health Informatics Involving Fields 9

10 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 10

11 Health Level Seven (HL7) 1/11/10 11

12 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. 12

13 HL7 Standard Versions 2.0 (1988) Prototype 2.1 (1990) First standard 2.2 (1994) Widely Adopted 2.3 (1997) In operation (1999) Current ANSI standard 2.4 (2000) In ballot 3.0 Balloting of Prototype in 2000, balloting of formal specifications in

14 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 14

15 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 15

16 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 16

17 What is HL7 17

18 Increased IS Complexity 18

19 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 19

20 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.) 20

21 Canada Health Infoway 1/11/10 21

22 Canada Health Infoway Canada Health Infoway (Infoway 2001) is an independent, notfor-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. 22

23 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. 23

24 Service Oriented Architecture 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." Interoperability 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) 24

25 Canada Health Infoway s iehr Infostructure JURISDICTIONAL INFOSTRUCTURE Registries Data & Services Client Registry Provider Registry Ancillary Data & Services Outbreak Management PHS Reporting Shared Health Record EHR Data & Services Drug Information Diagnostic Imaging Laboratory Data Warehous e Health Information Location Registry Business Rules EHR Index Message Structures Normalisation Rules Terminology Registry Longitudinal Record Services HIAL Security Management Data Common Services Communication Bus Privacy Data Configuration Public Health Services Pharmacy System Radiology Center PACS/RIS Lab System (LIS) Hospital, LTC, CCC, EPR Physician Office EMR EHR Viewer POINT OF SERVICE Public Health Provider Pharmacist Radiologist Lab Clinician Physician/ Provider 25 Physician/ Provider Physician/ Provider

26 Oracle Health Transaction Base (HTB) 1/11/10 26

27 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 27

28 Integration Overview 28

29 Organization Meeting & Overview CAS 757: Modern Software Technology for ehealth Instructor: Dr. Deptartment of Computing and Software McMaster University Canada January 12,