Skip to main content

Efficient consumption of the electronic health record in mHealth


With the advancement in mobile technology, there are lots of prospect for the health domain. Specifically, the accessibility of the electronic health record (EHR) can be extended to the mobile node to promote remote healthcare delivery; this is known as mobile Health or mHealth. However, supporting real-time access and services synchronization in highly distributed mobile environments can be challenging due to the fact that mobile devices rely on wireless communication mediums to exchange data. These mediums can be unstable due to bandwidth fluctuations and the mobility of the healthcare professionals. In this work, we examine how to provide real-time accessibility of the medical record in the mobile environment by overcoming the network-level limitations. Thus, we propose distributed cloud-hosted middleware platform that enables the mobile devices to receive updates. Since the middleware are distributed, a methodology called the “best-proximity” accessibility is enforced so that the healthcare professionals are able to connect to the middleware that offers the most optimal request–response time. The evaluation of the framework, called Med App, shows that: (1) medical data dissemination and accessibility can be achieved in a low-latency fashion, (2) data state can be managed efficiently through a policy-based consistency model, and (3) the resources of the mobile device can be efficiently utilized through services composition on the middleware.

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

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7
Fig. 8





  • Buyya R, Yeo CS, Venugopal S, Broberg J, Brandic I (2009) Cloud computing and emerging IT platforms: vision, hype, and reality for delivering computing as the 5th utility. Future Gener Comput Syst 25(6):599–616

    Article  Google Scholar 

  • Eysenbach G (2001) What is e-health? J Med Internet Res 3(2):e20. 2003 Regional Office for the Eastern Mediterranean—World Health Organization.

  • Jahns R-G mHealth apps: 8 reasons why it matters for Pharma. Accessed 30 Nov 2010

  • Lee W, Lee CM, Lee JW, Sohn J (2009) ROA Based Web Service Provisioning Methodology for Telco and its Implementation. In: Proceedings 12th Asia-Pacific Network Operations and Management Symposium, APNOMS, pp 511–14, 2009

  • Li H, Sedayao J, Hahn-Steichen J, Jimison E, Spence C, Chahal S (2009) Developing an Enterprise Cloud Computing Strategy, Intel White Paper, January 2009

  • Lomotey RK, Deters R (2013) Efficient Mobile Services Consumption in mHealth. In: Proceedings of the 2013 IEEE/ACM International Conference on Advances in Social Networks Analysis and Mining (ASONAM 2013), and the International Symposium on Network Enabled Health Informatics, Biomedicine and Bioinformatics (HI-BI-BI 2013), Niagara Falls, Canada, pp. 8 pages, 25–28 Aug 2013

  • Lomotey RK, Jamal S, and Deters R (2012) SOPHRA: A Mobile Web Services Hosting Infrastructure in mHealth, Mobile Services (MS), IEEE First International Conference. pp 88–95. doi: 10.1109/MobServ.2012.14, 24–29 June 2012

  • Overdick H (2007)The Resource-Oriented Architecture,” IEEE Congress on Services, pp 340–7

  • Ranck J (2010) The Rise of Mobile Health Apps,” In: GigaOM Pro, Oct 2010. Accessed 2 Nov 2013

  • Rusu M, Saplacan G, Sebestyen G, Todor N, Krucz L, Lelutiu C (2010) eHealth: towards a Healthcare Service-Oriented Boundary-Less Infrastructure. Orig Res Appl Med Inf 27(3/2010):1–14

    Google Scholar 

  • Saenz A, “Cardionet, Concept = Win, Strategy = Epic Fail. Accessed 15 June 2013

  • Schaffer HE (2009) X as a Service, Cloud Computing, and the Need for Good Judgment, IT Professional 11(5):4–5. doi: 10.1109/MITP.2009.112

  • Selonen P, Belimpasakis P, Yu Y (2010) Experiences in Building a RESTful Mixed Reality Web Service Platform, Web Engineering. In: Proceedings 10th International Conference, ICWE 2010, pp 400–14

  • Vital Wave Consulting (2009) mHealth for Development: The Opportunity of Mobile Technology for Healthcare in the Developing World. Accessed 2 Jan 2014

  • Wicks G, Van Aerschot E, Badreddin O, Kubein K, Lo K, Steele D (2009) Powering SOA Solutions with IMS,” Pg. 9 Publisher: IBM Redbooks Pub. Date: March 30, 2009 Part Number: SG24-7662-00 Pages in Print Edition: 410

  • Xu X, Zhu L, Liu Y, Staples M (2008) Resource-Oriented Architecture for Business Processes. In: 15th Asia-Pacific Software Engineering Conference, pp 395–402

  • Exforsys Inc. SOA Disadvantages. SOA Tutorial.


Download references


We are grateful to our medical research partners at the Geriatrics Ward at the City Hospital in Saskatoon, Canada for their commitment to the success of this project and funding.

We further thank Prof. Reda Alhajj (Faculty at the Department of Computer Science, University of Calgary, Calgary, Alberta, Canada), the Editorial Team of NetMAHIB, and the reviewers of this work for their invaluable critique.

We thank also the organizers of HI-BI-BI 2013 who awarded the initial version of this work as the best paper.

Author information

Authors and Affiliations


Corresponding author

Correspondence to Richard K. Lomotey.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Lomotey, R.K., Deters, R. Efficient consumption of the electronic health record in mHealth. Netw Model Anal Health Inform Bioinforma 3, 51 (2014).

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • DOI:


  • mHealth
  • REST
  • Middleware
  • WebSocket
  • Electronic health record
  • Publish/subscribe