Petar Rajkovic

A software solution for ambulatory healthcare facilities in the Republic of Serbia

During the last decade, the Ministry of Health of the Republic of Serbia, a developing country, funded several projects aiming to make the public healthcare system more efficient through the use of information technology (IT). This system development experience paper presents the first results of our project that develops software support for public ambulatory healthcare facilities, concentrating efforts on improving the work environment of general practice (GP) doctors. While earlier projects in Serbia centered on organizational and financial aspects of healthcare processes, our project focuses on medical aspects and results in a medical information system (MIS) based on a specially developed electronic health record (EHR). We also present a brief overview of our supporting tools for data modeling and application generation, developed for easier realization of MIS. Another goal of the project is to support interoperation and cooperation of ambulatory and clinical MIS within the University Clinical Center of Nis (there is no similar interoperation in any city in Serbia). The main contribution of this system development experience paper is to show how we have been applying and adapting modern MIS concepts in challenging circumstances of a developing country. These experiences could be relevant for other countries with similar challenges.

Software tools for rapid development and customization of medical information systems

We present data modeling and code generation tools for easier and faster development and customization of electronic health record (EHR) based medical information systems (MIS). In development of MIS, it is usually necessary to create a large number of different, but somewhat similar, graphical user interface (GUI) forms and database tables corresponding to different medical data. This process can be inefficient and time consuming. Our software tools enable power users to define meta data models, from which the tools automatically generate database tables, data object model classes and several common components (input forms, selection components, components for tracking measured values, reporting profiles, access control configurations) for EHR-based MIS. While we first developed these tools for clinical and ambulatory MIS in Serbia, they can be used in other countries, due to the built-in flexibility and multi-language support.

Using of Raspberry Pi for data acquisition from biochemical analyzers

A large number of analyses performed in a biochemical laboratory requires that results of these analyses are automatically acquired from analyzers which can be of different types and produced by various producers. Automatic data acquisition prevents errors which are possible if results are manually transcribed into reports for patients. Beside this, acquired results are saved in database from where they are available to be used in electronic health record (EHR). Above requirement resulted in development of a solution for data acquisition from heterogeneous laboratory analyzers. Here we present the solution which is based on minicomputer Raspberry Pi model B, Raspbian OS, Mono Framework and a .NET Framework 4.0 console application written in C# programming language. Proposed solution is tightly connected with medical information system MEDIS.NET and with laboratory information system LabIS. In order to test whole concept we developed a laboratory simulator which completely implements protocol for biochemical analyzers. The emphasis is on an inexpensive solution which connects a large number of heterogeneous analyzers at a biochemical laboratory.

Platform independent database replication solution applied to medical information system

Medical Information System (MIS), as any other information system (IS), can be based on centralized or distributed database management system. It is much easier to implement and to administer centralized system, but the benefits of distributed over centralized architecture in our case were crucial. However, database replication in distributed MIS represents a significant problem. All well-known database replications are platform-dependent, and when it comes to the possible platform migration, a huge problem of setting replication on different platforms is born. This paper describes one platform independent - information system dependent database replication solution, that can enable fast replication even in low-band/low-speed internet connections.

Custom made medical data reporting tool

Every organization needs to create clearly formatted reports using some reporting software. Created reports can be used within organization either as a base for further analysis and researches, or as set of data formatted as a document that can be delivered to employees, customers, and partners. Since reporting software usually is not used just by IT professionals, it ought to have simple and easily understandable user interface. A custom build medical data reporting tool is presented by this paper. The main aim of our tool is helping medical researchers and managers to extract and use information stored within medical information systems database. It can be used for creating medical data models, extracting and filtering data from medical information system, and generating reports. Generated reports can be viewed directly in application or can be exported as XML files, as well as MS Office and Open Office documents.

An e-health solution for ambulatory facilities

Ambulatory segment of the Serbian public health system has a complex organization and much operational inefficiency, so it needs significant information technology (IT) support to perform all its operational aspects better. Our main goal is to create software, suited to satisfy the needs of the Serbian public healthcare system. This system development experience paper presents the results of our project that aims to develop IT support for public ambulatory healthcare facilities, with special emphasis on the improvement of environment for the work of general practitioners. Architectural overview, as well as main usage scenario of proposed solution is presented by this paper in order to illustrate how we are including and adapting modern MIS concepts in challenging circumstances of a health care organization in our country. Another crucial requirement for our software, due to too low level of IT education of medical staff in Serbia, was that the medical information system (MIS) interface should resemble the actual paper documents as much as possible.

A software model of mobile notification system for medication misuse prevention

The one of the most common problems affecting older patients is the misuse of prescribed therapies. The patients, in many cases, forget to take their therapy, use it twice or even use the wrong medication. Since all of the mentioned cases can trigger further serious health problems, and since the majority of the population in Serbia already uses mobile phones, we decided to extend our existing medical information system with a prescription service that will allow the development of mobile-device based notification system. The notification system will then help patients with medication timing and dosing issues to take their therapies more accurate and to prevent possible health complications. In this paper we present the existing mobile services offered by the medical information system Medis.NET, as well as an architectural solution for the extension of the existing software with a prescription and notification service. The architectural solution is followed by the example of an initial implementation, description of the most important use-cases and related test results. In a near future, we plan to improve the proposed solution by offering new options to the patients, easing the connection with third party services and by developing a smartphone application that can improve the complete interaction with patients.

ON THE CHARACTERIZATION OF TASKS MODELED BY INTERVAL DESIGN STRUCTURE MATRIX ON DOMAIN-DRIVEN DESIGN SOFTWARE DEVELOPMENT

Development and design of new products of various kinds often contain a very complex set of relationships among many coupled tasks. Ranking, controlling and redesigning the features of these tasks can be usefully performed by a suitable model based on the design structure matrix in an iteration procedure. The proposed interval approach of design iteration controls and predicts the convergence speed of iteration work on tasks within a project. Interval method is based on Perron-Frobenius theorem and interval linear algebra where intervals and interval matrices are employed instead of real numbers and real matrices. In this way, a more relaxed quantitative estimation of tasks is achieved and the presence of undetermined quantities is allowed to a certain extent. The presented model is demonstrated in the example of simplified domain-driven design process, an approach to software development.

Adaption of medical information system's e-learning extension to a simple suggestion tool

Developing suggestion tools in the scope of health information systems can be a complex task, followed by a risk of not being accepted by the end users. Thus, we decide to start the implementation around the existing functionality. In this paper we present a case study showing the adaptation of e-learning medical information system extension to a set of simple suggestion tools. While some features of initial system had to be modified, the domain specific knowledge collected for the e-learning extension is used to suppress potential errors. Presented suggestion tool is based on highly configurable lists of pre-defined entities that can be easily selected, and after the verification from the medical practitioner, copied into an active visit. After four years of active use, and several iteration of update, described suggestion tools are mostly accepted among the general practitioners, especially within certain scenarios where faster medication prescription is a must.

Software module for registering provided health services and consumed medications in infirmary

In this paper, the software module for recording health services provided and consumed medications in the infirmary is shown. The presented software module provides software support for medical staff in the hospital, enabling the billing of health services provided to patients who are hospitalized in infirmary at the health center. Also, the software module allows monitoring and recording of consumed drugs and medical supplies (medicaments), generating e-invoices, as well as generating a larger number of fixed reports. The presented module can function as a standalone desktop application or in conjunction with medical information system (MIS) MEDIS.NET. In addition to possible horizontal integration with MIS MEDIS.NET and system for dynamically generating reports there is vertical integration with RFZO unit via electronic invoices, by checking patients insurance and loading codebooks for secondary care provided by RFZO. Presented software module currently is in used in several health care institutions and it is in closely associated with the MIS MEDIS.NET.