Health Care Management Science

, Volume 11, Issue 2, pp 152–166 | Cite as

Simultaneous trend analysis for evaluating outcomes in patient-centred health monitoring services

  • Edward C. Conley
  • David R. Owens
  • Stephen L. Luzio
  • Mahesh Subramanian
  • Ali Shaikh Ali
  • Alex Hardisty
  • Omer Rana
Article

Abstract

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.

Keywords

Web services Time series analysis routines Scalability Chronic disease management Portal technologies Risk monitoring Service-oriented architecture 

References

  1. 1.
    Albert PS (1999) Longitudinal data analysis (repeated measures) in clinical trials. Stat Med 18:1707–1732CrossRefGoogle Scholar
  2. 2.
    Baird J, Turisco F (2005) Service-oriented architecture: a critical technology component to support consumer-driven health care. AHIP Cover 46:74 76, 78 passimGoogle Scholar
  3. 3.
    Benson T (2007) Prevention of errors and user alienation in healthcare IT integration programmes. Inform Prim Care 15:1–7Google Scholar
  4. 4.
    Bescos C, Schmitt D, Kass J, Garcia-Barbero M, Kantchev P (2005) Interoperability and HealthGRID. Methods Inf Med 44:190–192Google Scholar
  5. 5.
    Breton V, Blanquer I, Hernandez V, Jacq N, Legre Y, Olive M, Solomonides T (2007) Roadmap for a European healthgrid. Stud Health Technol Inform 126:154–163Google Scholar
  6. 6.
    Bucur A, Kootstra R, van Leeuwen J, Obbink H (2006) Service-oriented architecture for grid-enabling medical applications. Stud Health Technol Inform 120:55–68Google Scholar
  7. 7.
    Dogac A, Laleci GB, Aden T, Eichelberg M (2007) Enhancing IHE XDS for federated clinical affinity domain support. IEEE Trans Inf Technol Biomed 11:213–221CrossRefGoogle Scholar
  8. 8.
    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 13:30–39CrossRefGoogle Scholar
  9. 9.
    Donnelly K (2006) SNOMED-CT: the advanced terminology and coding system for eHealth. Stud Health Technol Inform 121:279–290Google Scholar
  10. 10.
    Estrella F, Hauer T, McClatchey R, Odeh M, Rogulin D, Solomonides T (2007) Experiences of engineering grid-based medical software. Int J Med Inform 76:621–632CrossRefGoogle Scholar
  11. 11.
    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 13:245–252CrossRefGoogle Scholar
  12. 12.
    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
  13. 13.
    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 112:198–209Google Scholar
  14. 14.
    Hernandez V, Blanquer I (2005) The grid as a healthcare provision tool. Methods Inf Med 44:144–148Google Scholar
  15. 15.
    Herveg J (2007) Does healthgrid present specific risks with regard to data protection? Stud Health Technol Inform 126:219–228Google Scholar
  16. 16.
    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 14:146–155CrossRefGoogle Scholar
  17. 17.
    Laszlo_Systems (2007) Source for OpenLaszlo, an open source platform for rich Ajax application development. http://www.laszlosystems.com/ last accessed: June 2007
  18. 18.
    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 11:1448–1452Google Scholar
  19. 19.
    Nadkarni PM, Miller RA (2007) Service-oriented architecture in medical software: promises and perils. J Am Med Inform Assoc 14:244–246CrossRefGoogle Scholar
  20. 20.
    Olive M, Rahmouni H, Solomonides T (2007) From healthgrid to SHARE: a selective review of projects. Stud Health Technol Inform 126:306–313Google Scholar
  21. 21.
    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
  22. 22.
    Steinichen P, Turisco F (2006) Service oriented architecture: adding value to legacy IT systems. AHIP Cover 47:54 56, 58–59Google Scholar
  23. 23.
    Ure J, Procter R, Martone M, Porteous D et al (2007) Data integration in ehealth: a domain/disease specific roadmap. Stud Health Technol Inform 126:144–153Google Scholar
  24. 24.
    Various_authors (2007) Continua healthcare alliance; see http://www.continuaalliance.org Last accessed: June 2007
  25. 25.
    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
  26. 26.
    Diabetes NSF (Wales) (2003) Standards http://www.wales.nhs.uk/sites3/home.cfm?orgid=440 Last accessed June 2007
  27. 27.
    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
  28. 28.
  29. 29.
    The NHS Common User Interface (CUI) Programme. Link accessed: https://www.cui.nhs.uk/Pages/NHSCommonUserInterface.aspx, 2007
  30. 30.
    OMII UK (2007) The OGSA-DAI Project—details at http://www.ogsadai.org.uk/. Last accessed: June 2007
  31. 31.
    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 124:377–383Google Scholar
  32. 32.
    Evans E (2003) Domain-driven design: tackling complexity in the heart of software. Addison-WesleyGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2008

Authors and Affiliations

  • Edward C. Conley
    • 1
    • 2
  • David R. Owens
    • 1
  • Stephen L. Luzio
    • 1
  • Mahesh Subramanian
    • 2
  • Ali Shaikh Ali
    • 2
  • Alex Hardisty
    • 2
  • Omer Rana
    • 2
  1. 1.Diabetes Research Unit, School of MedicineCardiff UniversityCardiffUK
  2. 2.The Welsh e-Science CentreCardiff University School of Computer ScienceCardiffUK

Personalised recommendations