A health analytics semantic ETL service for obesity surveillance.

The increasingly large amount of data produced in healthcare (e.g. collected through health information systems such as electronic medical records - EMRs or collected through novel data sources such as personal health records - PHRs, social media, web resources) enable the creation of detailed records about people's health, sentiments and activities (e.g. physical activity, diet, sleep quality) that can be used in the public health area among others. However, despite the transformative potential of big data in public health surveillance there are several challenges in integrating big data. In this paper, the interoperability challenge is tackled and a semantic Extract Transform Load (ETL) service is proposed that seeks to semantically annotate big data to result into valuable data for analysis. This service is considered as part of a health analytics engine on the cloud that interacts with existing healthcare information exchange networks, like the Integrating the Healthcare Enterprise (IHE), PHRs, sensors, mobile applications, and other web resources to retrieve patient health, behavioral and daily activity data. The semantic ETL service aims at semantically integrating big data for use by analytic mechanisms. An illustrative implementation of the service on big data which is potentially relevant to human obesity, enables using appropriate analytic techniques (e.g. machine learning, text mining) that are expected to assist in identifying patterns and contributing factors (e.g. genetic background, social, environmental) for this social phenomenon and, hence, drive health policy changes and promote healthy behaviors where residents live, work, learn, shop and play.

Adaptive healthcare processes for personalized emergency clinical pathways.

Pre-hospital and in-hospital emergency healthcare delivery involves a variety of activities and people that should be coordinated in order effectively to create an emergency care plan. Emergency care provided by emergency healthcare professionals can be improved by personalized emergency clinical pathways that are instances of relevant emergency clinical guidelines based on emergency case needs as well as on ambulance and hospital resource availability, while also enabling better resource use. Business Process Management Systems (BPMSs) in conjunction with semantic technologies can be used to support personalized emergency clinical pathways by incorporating clinical guidelines logic into the emergency healthcare processes at run-time according to emergency care context information (current emergency case and resource information). On these grounds, a framework is proposed that uses ontology to model knowledge on emergency case medical history, on healthcare resource availability, on relevant clinical guidelines and on process logic; this is inferred to result in the most suitable process model for the case, in line with relevant clinical guidelines.

Specifying process requirements for holistic care.

Holistic (health and social) care aims at providing comprehensive care to the community, especially to elderly people and people with multiple illnesses. In turn, this requires using health and social care resources more efficiently through enhanced collaboration and coordination among the corresponding organizations and delivering care closer to patient needs and preferences. This paper takes a patient-centered, process view of holistic care delivery and focuses on requirements elicitation for supporting holistic care processes and enabling authorized users to access integrated patient information at the point of care when needed. To this end, an approach to holistic care process-support requirements elicitation is presented which is based on business process modeling and places particular emphasis on empowering collaboration, coordination and information sharing among health and social care organizations by actively involving users and by providing insights for alternative process designs. The approach provides a means for integrating diverse legacy applications in a process-oriented environment using a service-oriented architecture as an appropriate solution for supporting and automating holistic care processes. The approach is applied in the context of emergency medical care aiming at streamlining and providing support technology to cross-organizational health and social care processes to address global patient needs.

Emergency healthcare process automation using mobile computing and cloud services.

Emergency care is basically concerned with the provision of pre-hospital and in-hospital medical and/or paramedical services and it typically involves a wide variety of interdependent and distributed activities that can be interconnected to form emergency care processes within and between Emergency Medical Service (EMS) agencies and hospitals. Hence, in developing an information system for emergency care processes, it is essential to support individual process activities and to satisfy collaboration and coordination needs by providing readily access to patient and operational information regardless of location and time. Filling this information gap by enabling the provision of the right information, to the right people, at the right time fosters new challenges, including the specification of a common information format, the interoperability among heterogeneous institutional information systems or the development of new, ubiquitous trans-institutional systems. This paper is concerned with the development of an integrated computer support to emergency care processes by evolving and cross-linking institutional healthcare systems. To this end, an integrated EMS cloud-based architecture has been developed that allows authorized users to access emergency case information in standardized document form, as proposed by the Integrating the Healthcare Enterprise (IHE) profile, uses the Organization for the Advancement of Structured Information Standards (OASIS) standard Emergency Data Exchange Language (EDXL) Hospital Availability Exchange (HAVE) for exchanging operational data with hospitals and incorporates an intelligent module that supports triaging and selecting the most appropriate ambulances and hospitals for each case.

A cloud-based semantic wiki for user training in healthcare process management.

Successful healthcare process design requires active participation of users who are familiar with the cooperative and collaborative nature of healthcare delivery, expressed in terms of healthcare processes. Hence, a reusable, flexible, agile and adaptable training material is needed with the objective to enable users instill their knowledge and expertise in healthcare process management and (re)configuration activities. To this end, social software, such as a wiki, could be used as it supports cooperation and collaboration anytime, anywhere and combined with semantic web technology that enables structuring pieces of information for easy retrieval, reuse and exchange between different systems and tools. In this paper a semantic wiki is presented as a means for developing training material for healthcare providers regarding healthcare process management. The semantic wiki should act as a collective online memory containing training material that is accessible to authorized users, thus enhancing the training process with collaboration and cooperation capabilities. It is proposed that the wiki is stored in a secure virtual private cloud that is accessible from anywhere, be it an excessively open environment, while meeting the requirements of redundancy, high performance and autoscaling.

An electronic patient record implementation using clinical document architecture.

Electronic patient records (EPRs) provide the means for integrated access to patient information that may be scattered across dispersed healthcare organizations that, in general, use heterogeneous systems in order to support their internal functions. XML language and Clinical Document Architecture (CDA) provides a mechanism for defining, structuring, manipulating and visualizing patient medical data using the same semantics through web. In this paper, a prototype implementation of a web-based electronic patient record (EPR) system using XML for data format and CDA for defining and structuring patient clinical documents is presented.

Enabling virtual emergency healthcare enterprises using Web services.

Emergency healthcare delivery involves a variety of activities performed from the time of a call to the ambulance service till the time of patient's disposal from the emergency department of a hospital. As these activities are performed in at least two organizations (i.e. ambulance service and hospital) and they are interrelated to form inter-organizational healthcare processes, collaboration and coordination become a vital issue for patients and for emergency healthcare service performance. Web-based workflow systems in conjunction with web services present a new way for service-oriented integration (SOI) of disparate systems and for developing distributed applications within and between organizations. Thus, through process automation and the use of web services ambulance service and hospital emergency departments can automate their operations by making information available where and when needed and by providing an infrastructure for the integration of pre-hospital and in-hospital emergency healthcare. A prototype implementation of this approach is presented in this paper.

Emergency healthcare process automation using workflow technology and web services.

Emergency healthcare delivery involves a variety of interrelated activities performed from the time of a call to the ambulance service until the time of patient's exit from the emergency department of a hospital. As these activities can be viewed as parts of inter-organizational healthcare processes that involve at least two organizations (e.g. an ambulance service and a hospital), there is a need to provide the appropriate technological infrastructure for automating and managing these processes even in cases where the organizations involved use heterogeneous systems to support their internal services. Web-based workflow systems in conjunction with web services present a new way for service-oriented integration (SOI) of disparate systems and for developing distributed applications within and between organizations. Thus, process automation with the use of web services can provide an appropriate infrastructure for the integration of pre-hospital and in-hospital emergency healthcare. A prototype development of such a system is presented in this paper.

Specifying workflow process requirements for an emergency medical service.

Recent trends in healthcare delivery have led to a gradual shift in the conceptualisation of healthcare information systems towards supporting healthcare processes in a more direct way. The move towards integrated and managed care, which requires designing healthcare processes around patient needs and incorporating efficiency considerations has led to an increased interest in process-oriented healthcare information systems based on workflow technology. This means to actively deliver the tasks to be performed to the right persons at the right time with the necessary information and the application functions needed. Moreover, workflow technology promotes a component-oriented development whereby the process logic is separated from application logic. This paper presents an approach to capturing process logic requirements for healthcare workflow systems with a view to design a system that is easily adjustable to process changes and to evolving organizational structures at a reasonable cost.

A web-based workflow system for emergency healthcare.

Emergency healthcare delivery involves a variety of activities performed from the time of a call to the ambulance service till the time of patient's disposal from the emergency department of a hospital. Workflow systems have recently received considerable attention in the healthcare field since they overcome organizational structures and support collaboration and coordination requirements by automatically routing relevant information where and when needed. In particular, healthcare workflow systems implemented over the Web can form the basis for a collaborative environment by bringing together healthcare professionals who are geographically dispersed and, hence, creating virtual healthcare workgroups organized around patient care. In this paper, a web-based workflow system is presented that was developed to support emergency healthcare processes and to provide an infrastructure for the integration of pre-hospital and in-hospital emergency healthcare.