 | | | E-Health - Akogrimo eH |
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 | (See also: video eHealth scenario, eHealth prototype workflow, eHealth prototype software, video eHealth prototype, eHealth prototype network)
The Akogrimo eHealth testbed explores Grid technology and the mobility paradigm in the healthcare domain. It builds on previous successful results from a 6-year German priority research program. Target users of a Grid based healthcare information system are European citizens, demanding mobile ad hoc or pervasive healthcare services (e.g. due to emergencies or chronic diseases), and healthcare service suppliers/institutions (stationary or mobile professionals, including healthcare advisors, pharmacies, nursing services, hospitals, emergency service devices and emergency stations). It is expected that a successful implementation and dissemination of the Grid based Akogrimo healthcare testbed will significantly impact the current reorganisation processes of the European healthcare system and will provide new business models for Grid based healthcare services.
The Scenario
Nurse Maria Dippon wakes up early in the morning. At breakfast she talks to her APA – her Akogrimo Personal Assistant – to acquire her day’s visit schedule. The APA is conneted to the larger Stuttgart Mobile Virtual Healthcare District. Maria’s personal affiliation is with the Weinstadt “Sozial and Diakonie Station”. Today, Maria’s schedule includes a number of visits. For each patient to visit, Mary has already on her APA the needed information – pertinent exactly to her and her patients of today – the medicamentation plan, special issues of today etc. She also finds her route – oh, yes, the Waiblinger Strasse is obviously still barred. At first she visits Mr. Häberle., a nice sweet old man who while enjoying the comfort and love of his home he regularly requires attention due to the seriousness of his situation. Arriving at his house and examining Mr H., Nurse Maria realises an extreme change in his condition – i.e. it is her APA talking to both the small patient monitor she brought and applied - and one of the KBoDs – Knowledge Base on Duty - as Maria learned to call the real or virtual expert of the Stuttgart Mobile Virtual Healthcare District. Only a few minutes later it becomes obvious that now a real person is involved in the case: On Mr. Häberle’s large flat wall screen, a doctor not known to Maria and Mr. H. introduces himself, and addressing the old man he says: Hullo, Mr. Häberle, I am Dr. Rall from Tübingen Universitätsklinikum which is admittedly not Stuttgart. You may wonder to see me, but you and Nurse Maria managed to magically get me in. Firstly, to explain it to you – all your vital data – horrible expression I know – were fed few minutes ago into some huge calculation system – and the result was, you would better stay for some time in a hospital, do not worry. Nurse Maria – hullo by the way as well – will help you to prepare your luggage. Secondly, isn’t it that you said some time ago: If the hospital, then Tübingen!? And, to admit it – we like to have you here – says our financial department – the Krankenkasse stuff is already o.k. I can see. By the way, the ambulance is on its way – here it is. “Hallo, ambulance!” “Yes, here we are, it’s me, Karl – ten more minutes, I am in Aichschiess”. “Hm”, Maria thinks, “a good start today”. Driver Karl has still to start the on-board patient monitor after Mr. H. is safely placed into the Ambulance. It takes almost an hour to go from Weinstadt to Tübingen. The drive is quiet – none of the automatic KBoDs in the background disturbes driver and trained paramedic Karl. Mr. Häberle is peacefully snoring. | | | Requirements and Solutions
Grid technologies are of particular relevance to healthcare services because each of their instances typically requires the establishment of a Virtual Organisation VO, and because of their dynamically ability to create and process a personalized complex workflow, which often cross the healthcare institutions boundaries. The complex workflows of the healthcare results: firstly from widespread inter- and intra-workflow interactions, secondly from the need to access distributed knowledge sources, and finally from the availability and quality of the resources involved changes over time. Further challenges arise from unexpected events, and in lots of such cases time is an extremely important factor for the final result of healthcare services.
Today, these challenges are solely addressed by organizational rules and procedures at the enterprise level, which do not provide sufficient transparency to all local situations involved. Responding to this issue, currently under development is a variety of IT-based coordination supporting tools, e.g. for distributed service discovery based on personalized and location-based criteria. Also enhanced by methods from the semantic web, distributed planning (varying degrees of local autonomy, access to distributed data and knowledge bases, evolving structures of VO), and negotiation protocols (task allocation, hand-over).
In addition, the knowledge intensive tasks in healthcare processes require spontaneous usability of the underlying communication technology infrastructure. This involves the ability to dynamically create, modify and dissolve MDVO’s, to access already available Grid services like OGSA-DAI, service lifecycle management, service communication, policy services, among others. Additional issues are the availability of user profiles (e.g. doctor, nurse, patient, family) and of the respective services, like single sign-on, the integration of recently developed mobile devices (smart cards for patients and healthcare professionals, obligatory in Germany from January 2006), and services to establish seamless information flows. Patient card and healthcare professional do already involve a dedicated security model. Part of developing the eHealth testbed application is to intertwine this security model with the security services of the underlying mobile Grid infrastructure.
Akogrimo with its strong Grid business process, internet and telecom orientation will leverage:
- Intra-/inter organizational process management and process optimization by Grid supported mobile applications (e.g. planning and control of emergency related processes)
- Coordination services of intra/inter-process interactions provide persons (physicians, nurses, patients) with individual and current information anytime anywhere
- Application of mobile devices to establish a medical sensor network to capture and examine patient health status (e.g. ECG, blood pressure, pulse etc.)
- Allocation planning and control of operating theatres, mobile intensive care units (MICU), diagnostic departments for dynamically evolving patient processes
- MICU requests for a second opinion or tele-consultation e.g. of a remote radiologist and requires access to distributed knowledge sources and the application of distributed calculations (e.g. pattern analysis of radiological images)
- MICU adapts itself to the healthcare institutions in an operational area unknown to it (e.g. catastrophe scenario)
Universität Hohenheim has gained vast experience from previous work projects and also is well equipped with several hundreds very detailed formalized and empirically validated process models concerning the treatment of different types of chronic/non-chronic diseases, and typical emergency scenarios (e.g. car accident). These process models do already include detailed knowledge about information on demands, management requirements, and their flows within and between healthcare institutions. Further, the Universität Hohenheim has also developed elaborated performance measurement indicators (e.g. quality of healthcare services, cost/benefit analysis, best practice studies, case bases).
Within Akogrimo, the process models will be used to conceptualize and to implement Grid-based healthcare applications very close to reality (relevance), and later-on the performance measurement indicators will be applied to early validate the practical results being achieved through Grid-based eHealth solutions (of appropriateness, quality).
For validation, evaluation and demonstration of its mission, Akogrimo eHealth will leverage its well established cooperation with more than six German hospitals/cities and will be extended by an Aveiro/Portugal component, by co-operations with Barcelona/Spain and London/UK to proof its mobility and applicability at international level. |
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