Design of a flexible platform for execution of medical decision support agents in the intensive care unit.

This paper addresses the design of a generic and scalable platform for the execution of medical decision support agents in the intensive care unit (ICU). As will be motivated, medical decision support agents can impose high computational load and in practical setups a large amount of such agents are typically running in parallel. Future ICU systems will rely on extensive medical decision support. However, in current systems only one workstation is typically dedicated for the execution of medical decision support agents. Therefore, we propose an architecture based on middleware technology to allow for easy distribution of the agents along multiple workstations. The architecture allows for easy integration with a general ICU data flow management architecture.

Large-scale performance evaluation of e-homecare architectures using the WS-NS simulator.

BACKGROUND: E-homecare creates opportunities to provide care faster, at lower cost and higher levels of convenience for patients. As e-homecare services are time-critical, stringent requirements are imposed in terms of total response time and reliability, this way requiring a characterization of their network load and usage behavior. However, it is usually hard to build testbeds on a realistic scale in order to evaluate large-scale e-homecare applications. OBJECTIVE: This paper describes the design and evaluation of the Network Simulator for Web Services (WS-NS), an NS2-based simulator capable of accurately modeling service-oriented architectures that can be used to evaluate the performance of e-homecare architectures. METHODS: WS-NS is applied to the Coplintho e-homecare use case, based on the results of the field trial prototype which targeted diabetes and multiple sclerosis patients. Network-unaware and network-aware service selection algorithms are presented and their performance is tested. RESULTS: The results show that when selecting a service to execute the request, suboptimal decisions can be made when selection is solely based on the service's properties and status. Taking into account the network links interconnecting the services leads to better selection strategies. Based on the results, the e-homecare broker design is optimized from a centralized design to a hierarchical region-based design, resulting in an important decrease of average response times. CONCLUSIONS: The WS-NS simulator can be used to analyze the load and response times of large-scale e-homecare architectures. An optimization of the e-homecare architecture of the Coplintho project resulted in optimized network overhead and more than 45% lower response times.