Mobile e-Health with HL7

Mobile e-Health with HL7

CAS 757 Modern Software Technology for eHealth

Term 2, Winter 2010

Dr. Kamran Sartipi

Jianhui (Jeffrey) Lei Yao (Aaron) Song

Agenda

•  Wireless Concepts and Technologies

•  Mobile e-Health Service

•  Mobile e-Health Technology and HL7 for Medical Information Management

•  Mobile e-Health System

•  Mobile e-Health with MacSeie

Wireless Concepts and Technologies

Wireless Technology Development

•  Wireless technology is already an integral part of everyday life.

•  Consumer demand is driving the development and evolution for wireless technology.

•  This phenomenon is similar to the evolution of PCs throughout the 1980s.

Wireless Devices

•  Cell Phone •  Personal Digital Assistant (PDA) •  Laptop •  Radio-Frequency Identification (RFID) •  Any other specific devices without wire,

i.e. medical sensors

OSI Reference Model

Communication of Networked Computers through OSI Model

Important Standards at Various OSI Layers

Issues To Be Considered

•  How far can a signal travel?

•  At what speed can information be transferred?

•  What are the known obstacles?

•  Potential security issues

Wireless Technology in Medical Environment

•  Wireless devices are widely used in health providers and patients.

•  WLAN (Wireless Local Area Network) deployment in medical environment is a cheap and effective way to provide high-speed, reliable connectivity.

Wireless Technology in Medical Environment

What wireless technology can bring for medical service?

•  Remote access and update Electronic Medical Record (EMR) system at the point of care, allow the health providers and patients to view, query and edit all information in real time.

•  Utilization of voice-over-WLAN that provide immediate voice communications.

Wireless Standards Change Fast

•  Meet customers’ desires

•  Remain consistent with newer technology designed to be compatible with prior generations.

•  Compatibility means less disadvantage of discovering a new technology’s shortcomings.

Two Wireless Communication Standards

•  IEEE (Institute of Electrical and Electronics Engineers) 802.11 family, also known by the brand name Wi-Fi for wireless computer networking

•  Global System for Mobile Communications (GSM) and 3rd Generation (3G) for cellular communications standard

Wi-Fi

•  A registered trademark, controlled and published by the Wi-Fi Alliance.

•  Permitted only on equipment which has passed testing.

•  The purpose of certification testing covers compatibility, security, quality of service, power save aspects.

Wireless Computer Local Area Network

Comparison of 802.11 a/b/g

Bluetooth

•  Bluetooth is a proprietary open wireless protocol for exchanging data over short distances (using short length radio waves) from fixed and mobile devices, creating Personal Area Networks (PANs).

•  Range: 1m – 100m

•  Data Rate: 1 Mbit/s (Version 1.2 ); 3 Mbit/s (Version 2.0 )

RFID

•  Radio-Frequency Identification (RFID) is a generic term for technologies that use radio waves to automatically identify objects.

•  Two components: a tag and a reader.

•  RFID bracelet, payment by mobile phones.

Cellular Network

TDMA •  Time Division Multiple Access (TDMA) is

the standard of Global System for Mobile Communications (GSM), Which is known as 2G.

•  TDMA is a channel access method for shared medium networks. It allows several users to share the same frequency channel by dividing the signal into different time slots.

CDMA •  Code Division Multiple Access is the

standard of 3rd Generation (3G).

•  CDMA allows several users to share a bandwidth of different frequencies.

•  CDMA employs spread-spectrum technology and a special coding scheme (where each transmitter is assigned a code) to allow multiple users to be multiplexed over the same physical channel.

FDMA •  Frequency Division Multiple Access

(FDMA) is a channel access method used in multiple-access protocols as a channelization protocol.

•  FDMA gives users an individual allocation of one or several frequency bands, or channels.

OFDMA

•  Orthogonal Frequency-Division Multiple Access (OFDMA) is a multi-user version of the popular orthogonal frequency division multiplexing digital modulation scheme.

•  Used in 802.16 standard, commonly referred to as Worldwide Interoperability for Microwave Access (WiMAX).

•  Higher sensitivity to frequency offsets and phase noise.

Overview of 3G Standards

Voice-over-WLAN

Review of Cellular and Computer Networks

Cellular Network

Computer Network

GSM: TDMA 3G: CDMA

Standard: 802.11 Family 802.11a/b/g

(802.11e/h, 802.1x, MAC, WEP, WPA are sub-protocols providing some specific features for 802.11a/b/g)

Mobile Communications

operator

•  Mapping between phone number and IP address •  Transforming message format •  Protocol: SIP

Mobile e-Health Service

Mobile e-Health Service

•  Apply software programming and computer network technologies to provide Electronic Healthcare Service  e-Health service

•  Apply mobile communication technologies to provide Mobile e-Health Service  m-Health service

Mobile e-Health Technology and HL7 for

Medical Information Management

Mobile e-Health Technology and HL7 for Medical Information Management

Background and Motivation •  Fragmentation of patient information increases

over a period of time

•  Managing medical information becomes more complicated

•  The need to access patient information grows with the need to consolidate the patient information across healthcare systems


•  Modern Medical Information Management

•  Ontology-based Multi-Agent System

•  Electronic Medical Agent System (eMAGS)


Modern Medical Information Management

•  Integrity •  Consolidates patient information across various

health management entities

•  Interoperability •  Provides public sharing mechanisms over

consolidated information across heterogeneous data sources


Goals •  Integrity •  Interoperability

Solutions •  Federated database approach •  XML-based integration •  CORBA •  Ontology-based Multi-Agent System


Ontology

•  In computer science and information science, an ontology is a formal representation of the knowledge by a set of concepts within a domain and the relationships between those concepts. (Wikipedia)


Mobile Agent

•  In computer science, a mobile agent is a composition of computer software and data which is able to migrate (move) from one computer to another autonomously and continue its execution on the destination computer. (Wikipedia)


What could Ontology and Mobile Agent provide us?

Ontology •  To provide interoperability among heterogeneous

data sources in medical information systems

Mobile Agent •  To access, decipher, learn and exploit medical

information on various health systems


Ontology

Mobile Agent

Ontology-based Multi-Agent System


Ontology-based Multi-Agent System •  Provides a framework for interactions in a distributed

medical systems environment (Integrity)

•  Allows access to patient information across multiple databases (Interoperability)

•  Without the limitations of the traditional client-server approach


Ontology-based Multi-Agent System

Client Workstation Database

Database Agent

Client Agent

Agent Broker

Served B

y

Served B

y

DB Query

DB Query Results


HL7 Ontology-based Multi-Agent System

Ontology Mobile Agent HL7

Electronic Medical Agent System (eMAGS)


Electronic Medical Agent System (eMAGS)

•  Multiple co-operating Mobile Agents

•  Ontology based on HL7 Reference Information Model (HL7-RIM)

•  Provides translations between local data and the HL7 format



eMAGS – Architecture

•  Agent Server

•  Database Application

•  HL7 Message and HL7 Agent

•  Agent Broker

•  Ontology Server


eMAGS – Architecture (Cont’d)

•  Ontology Server

•  HL7 Message Template Library (HL7MLib)

•  Ontology based on HL7-RIM (HL7RIMLib)

•  Data Mapping Library (DMLib)

•  Query Agent (Ontology Server Query Agent – OSQA)

•  User Interface Agent (Ontology Process Manager Agent – OPMA)




•  HL7MLib •  Facilitates the mapping resolution process

•  Populated with mappings created using commonly used healthcare applications

•  Mappings built manually over a period of time

•  Stored as a collection of XML documents



•  HL7RIMLib •  Facilitates the mapping resolution process

•  Stored in RDF/RDFS format

•  Relationships between concepts in HL7RIMLib ontology and fields in HL7MLib message template are established through the unique ID associated with each concept



•  DMLib •  Contains data mappings to resolve mappings between

local database application and HL7 message fields

•  Implemented as a collection of XML documents

•  Mapping information consists of database application ID, HL7 Message Field ID and database application field details


Conclusion

•  Modern Medical Information Management

•  Ontology-based Multi-Agent System

•  Electronic Medical Agent System (eMAGS)

Mobile e-Health System

Mobile e-Health System

•  Patient will not need to stay at hospitals

•  Patient’s health condition will be monitored by healthcare professionals while living normal life

•  Provides medical staff at a hospital or healthcare centre with real-time remote access to patient’s health data

Components of Mobile e-Health System

•  Sensor

•  Actuator

•  Front-End

•  Mobile Terminal

•  Body Area Network (BAN)

•  Mobile Communications Operator

•  e-Health Server (e-HS)

•  End-User Application (EUA)


•  Sensor •  Receives and responds to a signal or stimulus

•  Measures pulse, blood pressure, oxygen level, glucose level, etc.

•  Actuator •  Responsible for actuating a mechanical device

connected to a computer by a sensor link.


•  Front-End •  Hub for all sensors and actuators in the BAN

•  Records all data from sensors and actuators

•  Sends data to the mobile terminal

•  Mobile Terminal •  A mobile phone

•  A device with mobile communication capabilities, i.e. PDA



•  Sensors

•  Actuators

•  Front-End

•  Mobile Terminal



•  A specialization of Personal Area Network (PAN)

•  A network of sensors and/or actuators attached to a patient’s body

•  Interconnected to a hospital or healthcare centre through wires and/or wireless technologies


•  Mobile Communications Operator •  Network operator with wireless telephony access

to internet

•  Important component between BAN and Internet

•  e-Health Server (e-HS) •  Receives and distributes medical data

•  Installed in the mobile communications service provider, or at a hospital or healthcare centre


•  End-User Application (EUA)

•  Computers at a hospital or healthcare centre

•  Accesses information from sensors and actuators

•  Sends new configuration parameters to the BAN through the e-Health Server (e-HS)

Overview of Mobile e-Health System

Body Area Network (BAN)

e-Health Environment

Sensor

Actuator

Front-End

Cell Phone

P D A

SIP G

ateway

Base Station

Ethernet S

witch

Internet LAN

Access Pointer

Laptop

Laptop

e-Health Server

RFID

Desktop

Internet LAN


Operator

Mobile e-Health with MacSeie

Mobile e-Health with MacSeie

•  What can MacSeie provide with Mobile e-Health?

•  How to implement Mobile e-Health into MacSeie?

Overview of Mobile e-Health System (Revisited)



Sensor

Actuator

Front-End

Cell Phone

P D A


Operator

Base Station

Internet LAN

Access Pointer

Laptop

Laptop

e-Health Server

RFID

Desktop

Internet LAN

Overview of Mobile e-Health with MacSeie



Sensor

Actuator

Front-End

Cell Phone

P D A


Operator

Base Station

Internet LAN

Access Pointer

Laptop

Laptop

e-Health Server

RFID

Desktop

Internet LAN

MacSeie

MacSeie System with HL7 Middleware

MacSeie System

EMR Server

VT Server

EMR Database

Guideline Algorithm

Internet LAN

HL7 Middleware

SOAP

Implem

ent

Use

HL7

Middleware in Mobile e-Health

What is Middleware? •  Middleware is a computer software that connects software

components or applications

•  Middleware sits in the middle between application software that may be working on different operating systems.

•  Middleware consists of a set of services that allows multiple processes running on one or more machines to interact.

•  Middleware provides interoperability to support and simplify complex, distributed applications.

•  Middleware is integral to information technology based on XML, SOAP, Web Services, and SOA. (Wikipedia)

HL7 Middleware in Mobile e-Health

•  The HL7 middleware consists of two main components: converting and creating HL7 message.

•  The converting component receives either HL7-based or non-HL7-based message from sender and extracts data from it.

•  The creating component creates XML-based message following HL7 standard with given data.

MacSeie System with HL7 Middleware

MacSeie System

EMR Server

VT Server

EMR Database

Guideline Algorithm

Internet LAN

HL7 Middleware

SOAP

Implem

ent

Use

Cell Phone

HL7


Operator

Mobile Application

Mobile Application

•  Provides users a more user-friendly interface •  Form-based format

•  Extracts input data from user interface

•  Switches data to a form-based text message as output.

•  Adds extra text headers •  Next operator’s number •  Receiver’s number

Data Flow of Mobile Application

Patient Name Miller

Patient ID 12345

Blood Pressure 100

Blood sugar 8.0

OK Cancel

Cell Phone

[ MobileCommunicationsOperatorNumber [ CalleeNumber [ “MessageBody” ] ] ]

Mobile Application

Data Flow of Mobile Communications Operator

[MobileCommunicationsOperatorNumber [ CalleeNumber [ “MessageBody” ] ] ]


Operator

[ NextHopIPAddress [ CalleeIPAddress [ “MessageBody” ] ] ]

Data Flow Between HL7 Middleware & EMR

Middleware EMR

Query Info of EMR

CheckPatient

Patient Existed

Request PatIent’s info

Return Patient’s Info

Return Patient’s Info

Internet

Data Flow Between HL7 Middleware & EMR & VT

Middleware EMR

Update Info of VT

CheckPatient

Patient Existed

Send Update Info

Send Combined Update Info (Based On HL7 Standard)

Internet VT

OK

OK

OK

References

[1] W.D. Ankerstjerne, M. Rehman, Wireless Technologies [2] T, Tran, H. Kim, H. Cho, A Development of HL7

Middleware for Medical Device Communication [3] R. Martí, J. Delgado, X. Perramon, Security Specification

and Implementation for Mobile e-Health Services [4] B. Orguna, J.Vub, HL7 ontology and mobile agents for

interoperability in heterogeneous medical information systems in: Computers in Biology and Medicine 36 (2006) 817–836

[5] http://en.wikipedia.org/

Thank You

Q & A

Documents

Mobile e-Health with HL7