Skip to main content

Distributed Agent Based Interoperable Virtual EMR System for Healthcare System Integration

Abstract

One of the major problems in health care system integration is the formidable cost of mediating between myriad vendors and policy makers for updating existing heterogeneous systems to support a great variety of standards or interfaces. To provide cost-effective healthcare system integration solution, this paper presents a Graphical User Interface state model (GUISM) for automatically exchanging information with existing healthcare software through their GUIs with no modifications needed to them. This can save the huge cost of upgrading, testing and redeploying the existing systems. By using the GUISM model, distributed agents are deployed to the client computers interacting with the local electronic medical system (EMR) for communicating with other EMR systems. The whole system is called virtual EMR system and each client in this system can request needed patient healthcare information without knowing the actual location of the data.

This is a preview of subscription content, access via your institution.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6

References

  1. Institute of Medicine, To err is human: Building a safer health system. In: Cohn, L. T., Corrigan, J. M., and Donaldson, M. S. (Eds.), Committee on the Quality of Health Care in America National Academies, 1999, Washington.

    Google Scholar 

  2. Dalsgaard, E., Kjelstrom, K., and Riis, J., A federation of web services for Danish health care id trust ’08, March 4–6, 2008, Gaithersburg, MD.

  3. Walker, J., Pan, E.;Johnston, D.;Adler-Milstein, J.;Bates, D. W., and Middleton, B., The value of health care information exchange and interoperability. Health Aff. (Millwood) Suppl Web Exclusives:W5-10–W5-18, 2005.

  4. Goldschmidt, P., HIT and MIS: Implications of health information technology and medical information systems. Communications of the ACM October 2005, Vol. 48, No. 10, pp 69–74.

  5. van der Linden, H., Kalra, D., Hasman, A., and Talmon, J., Inter-organizational future proof EHR systems: A review of the security and privacy related issues. Int. J. Med. Inform. 78:141–160, 2009.

    Article  Google Scholar 

  6. Wang, W., Wang, M., and Zhu, S., Healthcare information system integration: A service oriented approach. Services Systems and Services Management, 2005. Proc. ICSSSM ’05. 2:1475–1480, 2005.

    Google Scholar 

  7. Goroll, A. H., Simon, S. R., Tripathi, M., Ascenzo, C., and Bates, D. W., Community-wide implementation of health information technology: The Massachusetts eHealth collaborative experience. J. Am. Med. Inform. Assoc. 16:132–139, 2009. doi:10.1197/jamia.M2899.

    Article  Google Scholar 

  8. Jha, A. K., Doolan, D., Grandt, D., Scott, T., and Bates, D. W., The use of health information technology in seven nations. Int. J. Med. Inform. 77:848–854, 2008.

    Article  Google Scholar 

  9. Kane, M. D., Brewer, J. L. et al., Integrating bioinformatics, clinical informatics, and information technology in supporting or interdisciplinary curriculum development. ISGITE’06, October 19–21, Minneapolis, Minnesota, USA, 2006.

  10. Canada Infoway., Available at: http://www.inforway-inforoute.ca/en/Home/home.aspx. Accessed on March 15, 2009.

  11. NeHTA (Australia): National e-Health Transition Authority. Available at: http://www.nehta.gov.au/content/view/1/103/. Accessed on March 15, 2009.

  12. HIMSS, RSNA. Integrating the Healthcare Enterprise—IHE Technical Framework Volume I—Integration Profiles, Revision 5.3. HIMSS/RSNA; 2002

  13. CORBAmed Roadmap. OMG Document CORBAmed/2000-05-01 Version 2.0(draft). CORBAmed, 2000.

  14. Bruun-Rasmussen, M., Bernstein, K., and Chronaki, C., Collaboration—A new IT-service in the next generation of regional healthcare networks. Int. J. Med. Inform. 70 (2–3)205–214, 2003.

    Article  Google Scholar 

  15. Wright, A., and Sittig, D. F., SANDS: A service-oriented architecture for clinical decision support in a National Health Information Network. J. Biomed. Inform. 41:962–981, 2008.

    Article  Google Scholar 

  16. Mykkänen, J., Porrasmaa, J., and Korpela, M., et al. Integration models in health information systems: Experiences from the PlugIT project. Medinfo. 11 (Pt 2)1219–1222, 2004.

    Google Scholar 

  17. Medicare Australia. Public Key Infrastructure, Available at: http://www.medicareaustralia.gov.au/provider/vendors/pki/index.jsp. Accessed on April 2, 2009.

  18. Musiani, D., Lin, K., et al., Active sensing platform for wireless structural health monitoring. Proceedings of the 6th international conference on Information processing in sensor networks, Cambridge, Massachusetts, USA. pp. 390–399, 2007.

  19. Herman, T., Sriram, V., et al., Wireless applications for hospital epidemiology. WiMD ’09: Proceedings of the 1st ACM international workshop on Medical-grade wireless networks, New Orleans, Louisiana, USA. pp. 45–50, 2009.

  20. Massaguer, D., Fok, C. L., et al., Exploring sensor networks using mobile agents. AAMAS’06: Proceedings of the fifth international joint conference on Autonomous agents and multiagent systems, Hakodate, Japan. pp. 323–325, 2006.

  21. Memon, A. M., and Soffa M. L., Regression Testing of GUIs. ESEC/FSE’03, September 1–5, pp. 118–127, Helsinki, Finland, 2003. Copyright 2003 ACM.

  22. Yuan, X., Memon, A. M., Using GUI run-time state as feedback to generate test cases. icse, pp. 396–405, 29th International Conference on Software Engineering (ICSE’07), 2007.

  23. El-Fakih, K., Kolomeez, A., Prokopenko, S., and Yevtushenko, N., Extended finite state machine based test derivation driven by user defined faults. icst, pp.308–317, 2008 International Conference on Software Testing, Verification, and Validation, 2008.

  24. Xie, Q., Developing cost-effective effective model-based based techniques for GUI testing. The Doctoral Symposium, 28th International Conference on Software Engineering (ICSE’06). pp. 997–1000, May 20–28, Shanghai, China, 2006.

  25. Xie, Q., and Memon, A. M., Using a pilot study to derive a GUI model for automated testing. ACM Trans. Softw. Engin. Methodol. 18(2), 2008.

  26. Miao, Y., Tao, X. H., Shen, Z. Q., Liu, Z. Q., and Miao, C. Y. The equivalence of cognitive map, fuzzy cognitive and multi value fuzzy cognitive map. Proceedings of the 2006 IEEE International Conference on Fuzzy Systems, pp. 1872–1878.

  27. Miao, Y., The transformation between fuzzy cognitive maps and a class of simplified dynamical cognitive networks. Lect. Notes Comput. Sci. 4683:575–582, 2007.

    Article  Google Scholar 

  28. Yang, X., Miao Y., and Zhang, Y., GP eConnect: Extends e-referrals exchange to healthcare providers’ collaborations. IADIS eHealth 2009. Algarve, Portugal, 21–23 June 2009.

  29. Montreuil, B., and Garon, R., Toward patient centric and distributed healthcare delivery networks. Clin. Invest. Med. 28 (6)351–352, 2005.

    Google Scholar 

  30. Breen, G. M., Thomas, T. H., Wan, N., Zhang, J., Marathe, S. S., Seblega, B. K., and Paek, S. C., Improving doctor–patient communication: Examining innovative modalities vis-à-vis effective patient-centric care management technology. J. Med. Syst. 33:155–162, 2009.

    Article  Google Scholar 

  31. Miao, Y., Goal Oriented Interest Based Negotiation. Presented at the 7th IEEE International Conference on Cybernetic Intelligent Systems, 2008.

Download references

Acknowledgement

The authors would like to thank to Dr. Corinne Siebel, Dr. Simon Leslie and Mr. Manfred Queteschiner for their cooperation during our study. Thanks to all the staffs in Westgate General Practice Network for providing support to the study of usability and knowledge of healthcare information.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Xuebing Yang.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Yang, X., Miao, Y. Distributed Agent Based Interoperable Virtual EMR System for Healthcare System Integration. J Med Syst 35, 309–319 (2011). https://doi.org/10.1007/s10916-009-9367-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10916-009-9367-5

Keywords

  • Healthcare system integration
  • Virtual EMR
  • Software agent
  • Graphic user interface