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Health Care

Submit a paper to Pervasive Healthcare
Contact: Prof Bill Buchanan
Overall, the healthcare industry is often seen as a chaotic structure, where it is difficult to map healthcare processes onto formal models. This special edition aims to identify and discuss useable models for new emerging patient care strategies within a changing healthcare environment, so that IT systems can be effectively designed around the patient, rather than, as in most cases, where healthcare systems are designed around the healthcare practitioners. This type of approach is key as it will allow a paradigm shift away from rigid centralised hospital dominated healthcare systems towards a more flexible distributed patient centred service. Upcoming ubiquitous and pervasive technologies will help to transform static on demand provider defined care patterns into need driven highly dynamic personalised interventions.... more information »

This research brings together knowledge from two important domains: medical care and information technology. Overall the health care industry is often seen as a chaotic model, where it is difficult to map health care processes onto formal models. This proof-of-concept aims to create a useable model for a patient within the health care environment, so that IT systems can be effectively designed around them, rather than, as in most cases, where health care systems are designed around the health care practitioners. This type of approach is key, as it will allow more efficient care systems, as well as focusing precious resources. An important factor is the identification of the health care roles around the patient, and the events, properties, procedures, and so on, which effectively define a patient’s environment. If this model can be accurately represented, it will then be applied within existing health care systems, with the data being used to populate the model from existing databases, and new methods will be applied to gain the other data. Unfortunately, most currently available systems have been designed around previously developed heath care systems which tend to be designed around technologies, rather than around health care expertise.

Concepts to be proven

This research has two main concepts to proven:

• Can a more effective patient data model be created, based on observation and practitioner expertise, which accurately takes into account as many of the different events, properties, functions, and so on, as possible, to create a model which is usable across a wide range of health environments?
• Can an integrated role-based security system be created, that is based on the protection of computer data for forensic investigations that can be applied to the data model so that it can be kept secure and that the data is only viewable by correctly authenticated roles?

Only when these concepts are proven, can we have a system which is both truly patient-focused, and also one which is credible and can be adopted by everyone involved in health care, from the patients themselves, to nurses, consultants, GP, and so on. There have been many scare stories of patient details being viewable by malicious parties, but the only way forward is to create electronic storage, processing and retrieval of digital information on records. In this way there can be complete audit trails, and the IT system can enhance the health workforce to work smarter, and make fewer mistakes.

Government focus

Many business leaders, and the UK Government, have identified that there needs to be a change in the way that health care is provided, in order to cope with the future requirements for health care. For example from Our Nation Health: A Plan for Action, A Plan for Change:
“To achieve these aims there has to be a culture change in the way the service interacts with the people it serves and the way services are delivered. It is no longer good enough to simply do things to people; a modern healthcare service must do things with the people it serves”.
The UK, though, is the best place to drive-through this new approach, as the HNS is one of the largest health care organisations in the world. Thus we have a great opportunity to use the expertise of practitioners across the UK, to build a more effective model of a patient. The UK thus has an opportunity to build an enhanced and security patient model, and also to implement it within the UK, in order to enhance patient care.

Current work

The research group and Dr Thuemmler have been working closely for sometime, and it is a perfect collaboration, as the research group can advise Dr Thuemmler on the IT issues, and how to take his ideas, and implement them in a secure and authenticated way. Recently they have extensively discussed their ideas within the NHS and with SMEs and larger companies, such as Siemens. All have been excited with the proposed work, and the future direction, but most will still identify that the two main concepts have still be been proven. A too simplistic model will not work in all situations and will not be scalable, and a too complex one might be too difficult to implement in a real-life environments, and within a workable platform, so it is important to define the model and its associated security carefully.

Up to the present the team have successfully implemented a passive RFID system within a hospital in order to effectively identify patients, and to link their tags to patient records. This concept has already been proven, but could be used to integrate with the data model in a hospital environment, and thus to correctly authenticate a patient, without obtrusive checks. For this the team have replaced the traditional written, or bar coded, wrist band with an RFID tag. An important part of the learning processes is that staff and patients must be part of the design, implementation and evaluation phases of the developments, otherwise they are unlikely to adopt the system. As the team has a respected medical consultant, it should help in providing medical knowledge to working practices, and also to the evaluation of the system.

Guiding light

Many government-led IT projects have failed, often due to their large nature and a general lack of overall focus. This PoC will succeed as Prof Buchanan and Dr Thuemmler have a long-term vision of how an effective health care system could effectively use IT, and the problems in the existing process. These have been through observation from both within and outside the health care environment. This will only work with both an effective patient-centric model, and with integrated role-based security. The PoC will start from a clean-slate, and not have any legacy in it, at all. In this way it will use the most up-to-date systems, and tools, and not be held back by existing methods, or by a committee-based design team. It is our vision to observe the patient within the health care environment and to map this exactly to a data model. This must be one which can scale to any size, and over global boundaries. The focus on health is one which is fundamental in our society, and it is only with a more integrative approach that future system can cope with the increasing demand. As our manufacturing industry is reducing, the new industries of knowledge and health will become the key growth areas, and wealth generation, along with enhanced patient care must be the focus for future enterprise and development. There is no way that we can outline the main thrust of this work, but hope to be able to fully justify the ideas, and how we could change the way that health care works in the future.

References

[1] Buchanan WJ, “Bill’s Home Page”, 2006, last accessed 11th January 2007, [online], http://www.soc.napier.ac.uk/~bill
[2] Buchanan WJ, “Handbook of Data Communications and Networks”, Kluwer, Jan. 1998, ISBN 0-412-84060-0. 2nd edition - August 2003.
[3] Buchanan WJ, Handbook of the Internet, Kluwer, June 2002, 2000 pages. ISBN 1-4020-7289-9.
[4] Buchanan WJ, Network Forensics and Security, CRC Press, USA (to be published February 2008).
[5] Buchanan WJ, “Network Emulators”, 2007, last accessed 11th January 2007, [online], http://network-emulators.com
[6] TCS with Canan. 2001-2003. Awarded Certificate of Excellence (Grade 1), Jan 2004.
[7] TCS with Seven Layer Communications Limited, South Queensferry. KTP Programming No. 2966. Development of high-speed configurable networking test equipment. Winning Programme, TCS/KTP Programme Awards 2003.
[8] TCS/KTP Programme Awards 2004.
[9] Patent application number GB0619694.3. Napier University and Dr. Thuemmler will share the IP for the technology arising from the cooperation.