João Luís Cardoso de Moraes

A methodology based on openEHR archetypes and software agents for developing e-health applications reusing legacy systems

BACKGROUND AND OBJECTIVE In Pervasive Healthcare, novel information and communication technologies are applied to support the provision of health services anywhere, at anytime and to anyone. Since health systems may offer their health records in different electronic formats, the openEHR Foundation prescribes the use of archetypes for describing clinical knowledge in order to achieve semantic interoperability between these systems. Software agents have been applied to simulate human skills in some healthcare procedures. This paper presents a methodology, based on the use of openEHR archetypes and agent technology, which aims to overcome the weaknesses typically found in legacy healthcare systems, thereby adding value to the systems. METHODS This methodology was applied in the design of an agent-based system, which was used in a realistic healthcare scenario in which a medical staff meeting to prepare a cardiac surgery has been supported. We conducted experiments with this system in a distributed environment composed by three cardiology clinics and a center of cardiac surgery, all located in the city of Marília (São Paulo, Brazil). We evaluated this system according to the Technology Acceptance Model. RESULTS The case study confirmed the acceptance of our agent-based system by healthcare professionals and patients, who reacted positively with respect to the usefulness of this system in particular, and with respect to task delegation to software agents in general. The case study also showed that a software agent-based interface and a tools-based alternative must be provided to the end users, which should allow them to perform the tasks themselves or to delegate these tasks to other people. CONCLUSIONS A Pervasive Healthcare model requires efficient and secure information exchange between healthcare providers. The proposed methodology allows designers to build communication systems for the message exchange among heterogeneous healthcare systems, and to shift from systems that rely on informal communication of actors to a more automated and less error-prone agent-based system. Our methodology preserves significant investment of many years in the legacy systems and allows developers to extend them adding new features to these systems, by providing proactive assistance to the end-users and increasing the user mobility with an appropriate support.

Using archetypes and Domain Specific Languages on development of ubiquitous applications to pervasive healthcare

Pervasive healthcare focuses on the use of new technologies, tools, and services, in order to help patients to play a more active role in the treatment of their diseases. Since pervasive healthcare environments demand a huge amount of information exchange, the use of technologies like Health Level Seven (HL7) and archetypes has been proposed to provide interoperability between applications for these environments. However, the complexity of such technologies difficults their full adoption as well as the migration from centralized healthcare environments into pervasive ones. Aiming at collaborating to bridge this gap, this paper proposes an approach to integrate archetypes into HL7 v3 messages for the development of pervasive healthcare applications. The approach suggests the use of Domain Specific Languages (DSLs), which simplify the HL7 messages modeling and allow to automate most of the messages schema codification.

A novel architecture for message exchange in Pervasive Healthcare based on the use of Intelligent Agents

In Pervasive Healthcare, novel information and communication technologies are applied to support the provision of health services anywhere, at anytime, and to anyone. Ubiquitous Computing technologies allow efficient and safe information exchange amongst caregivers and their patients in communities, homes and hospitals. Since health systems may offer their health records in various electronic formats, the openEHR foundation has proposed a dual model to achieve semantic interoperability between such systems. Intelligent Agents is a technology that has been applied to simulate human skills in healthcare procedures. In this paper, we propose an architecture for the exchange of context-aware messages in Pervasive Healthcare environments. This architecture is based on technologies from Ubiquitous Computing and Intelligent Agents, and complies with the openEHR dual model.

A Novel Approach to Developing Applications in the Pervasive Healthcare Environment through the Use of Archetypes

Pervasive Healthcare focuses on the use of new technologies, tools, and services, to help patients to play a more active role in the treatment of their conditions. Pervasive Healthcare environments demand a huge amount of information exchange, and specific technologies has been proposed to provide interoperability between the systems that comprise such environments. However, the complexity of these technologies makes it difficult to fully adopt them and to migrate Centered Healthcare Environments to Pervasive Healthcare Environments. Therefore, this paper proposes an approach to develop applications in the Pervasive Healthcare environment, through the use of Archetypes. This approach was demonstrated and evaluated in a controlled experiment that we conducted in the cardiology department of a hospital located in the city of Marilia (Sao Paulo, Brazil). An application was developed to evaluate this approach, and the results showed that the approach is suitable for facilitating the development of healthcare systems by offering generic and powerful approach capabilities.

Automatic ObjectPascal Code Generation from Catalysis Specifications

This paper presents a Component -based Framework Development Process, of the Cardiology Domain. The Framework, called FrameCardio, was developed in 4 steps: 1 Problem Domain Definition, 2-Components Specifications, 3-Components Internal Design and 4 -Components Implementation. In the first step the framework requirements were identified, based on experiences in the development of a cardiology system with 320 classes. The main models specified in this step are the Use Cases, Actions and Collaborations Models. In the Component Specification step component external behaviors were defined with their responsibilities, operations and interfaces. The main models are the Types Model, that describes an object external behavior, regardless of implementation decisions, and the Component Interactions that details the behavior of each case used in the Sequence Diagrams. Right after, in the third step, the Specified Components are refined, considering the implementation technologies. Among the models of this step, the components Classes Diagram, Components and the Component Packages stand out. The modeling was supported by a CASE tool. Finally, in the Components Implementation step the components code was generated in the ObjectPascal language, using a Transformation System. FrameCardio was structured in layers and organized in components packages, available in the CASE tool, to be reused by the applications. In the same way as in the development of FrameCardio, the Transformation System is used to generate the ObjectPascal code of the applications. A Cardiology domain Application is presented to show Framework components reuse.