Po-Hsun Cheng

HL7 middleware framework for healthcare information system

In this paper, a new middleware framework developed for the Health Information System (HIS) rightsizing project of National Taiwan University Hospital (NTUH) is proposed. The framework is basically a Service-Oriented Architecture (SOA). Challenges as formatting complex medical information as well as integrating heterogeneous systems in our hospital are addressed by introducing HL7 and Web services standard into our framework. Finally, the performance of a operating HIS based on our framework is analyzed and presented to evaluate the efficiency of our design. Keywords—HL7, Healthcare information system, web services, Service-oriented Architecture

Middleware based Inpatient Healthcare Information System

The paper presents a multi-tier, integrated, distributed, inpatient healthcare information system based on service oriented architecture (SOA) .NET environment in National Taiwan University Hospital (NTUH). The architecture and outcomes of the newly developed inpatient information system (IIS) platform are discussed in details. We also present mechanisms of integration as well as interoperability among the components and multi-database in IIS via health level seven (HL7) Middleware layer. The preliminary performance of the current operating IIS is evaluated and analyzed to verify the efficiency and effectiveness of the architecture we designed.

A Scalable Multi-tier Architecture for the National Taiwan University Hospital Information System based on HL7 Standard

This article describes the successful experiences of National Taiwan University Hospital (NTUH) in moving from IBM Mainframe to connected networking computer systems. We use multi-tier architecture and HL7 standard to implement our new outpatient hospital information system (HIS). The NTUH HIS is a complex environment with several operating systems, databases, and information systems. We adopt service-oriented architecture (SOA) to reduce the complex relations between systems and solve data consistency problems among databases. We also show that the distributed architecture can provide us stable and reasonable system performances. Our main contribution is proving that the distributed environment with HL7 standard and SOA can sustain in a highly demanding environment

Design and Implementation of Web-Based Mobile Electronic Medication Administration Record

Patients’ safety is the most essential, critical issue, however, errors can hardly prevent, especially for human faults. In order to reduce the errors caused by human, we construct Electronic Health Records (EHR) in the Health Information System (HIS) to facilitate patients’ safety and to improve the quality of medical care. During the medical care processing, all the tasks are based upon physicians’ orders. In National Taiwan University Hospital (NTUH), the Electronic Health Record committee proposed a standard of order flows. There are objectives of the standard: first, to enhance medical procedures and enforce hospital policies; secondly, to improve the quality of medical care; third, to collect sufficient, adequate data for EHR in the near future. Among the proposed procedures, NTUH decides to establish a web-based mobile electronic medication administration record (ME-MAR) system. The system, build based on the service-oriented architecture (SOA) as well as embedded the HL7/XML standard, is installed in the Mobile Nursing Carts. It also implement accompany with the advanced techniques like Asynchronous JavaScript and XML (Ajax) or Web services to enhance the system usability. According to researches, it indicates that medication errors are highly proportion to total medical faults. Therefore, we expect the ME-MAR system can reduce medication errors. In addition, we evaluate ME-MAR can assist nurses or healthcare practitioners to administer, manage medication properly. This successful experience of developing the NTUH ME-MAR system can be easily applied to other related system. Meanwhile, the SOA architecture of the system can also be seamless integrated to NTUH or other HIS system.

E-Health and Healthcare Enterprise Information System Leveraging Service-Oriented Architecture

OBJECTIVE To present the successful experiences of an integrated, collaborative, distributed, large-scale enterprise healthcare information system over a wired and wireless infrastructure in National Taiwan University Hospital (NTUH). In order to smoothly and sequentially transfer from the complex relations among the old (legacy) systems to the new-generation enterprise healthcare information system, we adopted the multitier framework based on service-oriented architecture to integrate the heterogeneous systems as well as to interoperate among many other components and multiple databases. We also present mechanisms of a logical layer reusability approach and data (message) exchange flow via Health Level 7 (HL7) middleware, DICOM standard, and the Integrating the Healthcare Enterprise workflow. The architecture and protocols of the NTUH enterprise healthcare information system, especially in the Inpatient Information System (IIS), are discussed in detail. IMPLEMENTATION The NTUH Inpatient Healthcare Information System is designed and deployed on service-oriented architecture middleware frameworks. The mechanisms of integration as well as interoperability among the components and the multiple databases apply the HL7 standards for data exchanges, which are embedded in XML formats, and Microsoft .NET Web services to integrate heterogeneous platforms. MEASUREMENTS The preliminary performance of the current operation IIS is evaluated and analyzed to verify the efficiency and effectiveness of the designed architecture; it shows reliability and robustness in the highly demanding traffic environment of NTUH. CONCLUSIONS The newly developed NTUH IIS provides an open and flexible environment not only to share medical information easily among other branch hospitals, but also to reduce the cost of maintenance. The HL7 message standard is widely adopted to cover all data exchanges in the system. All services are independent modules that enable the system to be deployed and configured to the highest degree of flexibility. Furthermore, we can conclude that the multitier Inpatient Healthcare Information System has been designed successfully and in a collaborative manner, based on the index of performance evaluations, central processing unit, and memory utilizations.

A service-oriented healthcare message alerting architecture in an Asia medical center: a case study.

This paper illustrates how our development team has used some information technologies to let physicians obtain an instant abnormal laboratory result report for critical patient care services. We have implemented a healthcare message alerting system (HMAS) on a healthcare short message service (HSMS) engine and the distributed healthcare-oriented service environment (DiHOSE) in the National Taiwan University Hospital (NTUH). The HSMS engine has a general interface for all applications which could easily send any kind of alerting messages. Fundamentally, the DiHOSE uses HL7 standard formats to process the information exchange behaviors and can be flexibly extended for reasonable user requirements. The disease surveillance subsystem is an integral part of NTUH new hospital information system which is based on DiHOSE and the disease surveillance subsystem would send alerting messages through the HSMS engine. The latest cell phone message alerting subsystem, a case study, in NTUH proved that the DiHOSE could integrate the user required functions without much work. We concluded that both HSMS and DiHOSE can generalize and extend application demands efficiently.

Design Ensemble Machine Learning Model for Breast Cancer Diagnosis

In this paper, we classify the breast cancer of medical diagnostic data. Information gain has been adapted for feature selections. Neural fuzzy (NF), k-nearest neighbor (KNN), quadratic classifier (QC), each single model scheme as well as their associated, ensemble ones have been developed for classifications. In addition, a combined ensemble model with these three schemes has been constructed for further validations. The experimental results indicate that the ensemble learning performs better than individual single ones. Moreover, the combined ensemble model illustrates the highest accuracy of classifications for the breast cancer among all models.

A Collaborative Knowledge Management Process for Implementing Healthcare Enterprise Information Systems

This paper illustrates a feasible health informatics domain knowledge management process which helps gather useful technology information and reduce many knowledge misunderstandings among engineers who have participated in the IBM mainframe rightsizing project at National Taiwan University (NTU) Hospital. We design an asynchronously sharing mechanism to facilitate the knowledge transfer and our health informatics domain knowledge management process can be used to publish and retrieve documents dynamically. It effectively creates an acceptable discussion environment and even lessens the traditional meeting burden among development engineers. An overall description on the current software development status is presented. Then, the knowledge management implementation of health information systems is proposed.

Multi-strengthening effects on the martensitic transformation temperatures of TiNi shape memory alloys

The multi-strengthening effects, introduced by combining cold rolling, aging and thermal cycling, on the martensitic transformation temperatures of Ti50Ni50 and Ti49Ni51 shape memory alloys have been studied by using DSC and microhardness measurements. Experimental results show that both pre-cold-rolling of Ti50Ni50 alloy and aging treatments of Ti49N51 alloy can impede the further introduction of dislocations during the thermal cycling and hence effectively reduce the effect of thermal cycling on transformation temperatures. For Ti49Ni51 alloy, whether the cold rolling is conducted before or after the aging treatment, the strengthening of cold rolling can significantly increase the specimen hardness but only slightly affect the following thermal cycling effect. The multi-strengthening effects on the martensitic transformation temperatures are also found to follow the equation of Ms = T0−KΔσy.

Temporal and Spatial Denoising of Depth Maps

This work presents a procedure for refining depth maps acquired using RGB-D (depth) cameras. With numerous new structured-light RGB-D cameras, acquiring high-resolution depth maps has become easy. However, there are problems such as undesired occlusion, inaccurate depth values, and temporal variation of pixel values when using these cameras. In this paper, a proposed method based on an exemplar-based inpainting method is proposed to remove artefacts in depth maps obtained using RGB-D cameras. Exemplar-based inpainting has been used to repair an object-removed image. The concept underlying this inpainting method is similar to that underlying the procedure for padding the occlusions in the depth data obtained using RGB-D cameras. Therefore, our proposed method enhances and modifies the inpainting method for application in and the refinement of RGB-D depth data image quality. For evaluating the experimental results of the proposed method, our proposed method was tested on the Tsukuba Stereo Dataset, which contains a 3D video with the ground truths of depth maps, occlusion maps, RGB images, the peak signal-to-noise ratio, and the computational time as the evaluation metrics. Moreover, a set of self-recorded RGB-D depth maps and their refined versions are presented to show the effectiveness of the proposed method.