Ståle Walderhaug

Healthcare Systems and Other Applications

This paper presents healthcare systems and their applications namely helping people with dementia navigate their day, empowering the elderly and the cognitively disabled, context awareness in residence for elders, RFID-based nutritional assistance, a computer-based library for the blind, an NLP-based tool for assisting people with autism, making smart clothing smarter, PAS: a wireless-enabled personal assistance system for independent living

Experiences from Model-Driven Development of Homecare Services: UML Profiles and Domain Models

Model-driven development approaches such as Model Driven Architecture (MDA) have been proposed as the new paradigm for software development. The adoption of MDA is still low, partly because of the general-purpose modelling language being used. Domain specific modelling languages are being developed for technological and industrial domains to improve the expressiveness and effect of model-driven development techniques. The healthcare domain could benefit from these methodologies. In order to incorporate domain knowledge in a MDA process, information about workflows, artefacts and actors can be formalized in a UML profile and applied by MDA tools for design and development. This paper presents the work done on model-driven development of smart homecare services in the MPOWER project. Following an iterative approach, two UML profiles to support development of Service Oriented Architecture based homecare applications are proposed. Using homecare specific UML profiles indicate an improvement in the process for model-driven development of homecare services.

MAFIIA — An Architectural Description Framework: Experience from the Health Care Domain

Healthcare information systems are characterized by having many stakeholders, roles, complex and diverse information systems, high degree of formalized working practices and an intense focus on quality concerns like interoperability, security and reliability. There is an emerging need for a structured architectural tool for supporting system developers and architects working with this kind of critical infrastructure. This paper presents MAFIIA - an architectural description framework specialized for the health care domain. The framework has been used in the development of three different healthcare information systems: a system for individual care plans, a platform for image-guided surgery and a patient evacuation support system. The experience from the case studies shows that the framework is a useful and flexible tool for creating an architectural description, and assists in keeping the focus on selected quality concerns.

Reliable Data Replication in a Wireless Medical Emergency Network

Medical teams dealing with major accidents have an acute need to gather and share information about casualties. The paper describes how hand-held computers linked together in a wireless network can address this problem, discussing in particular how to achieve the high degree of reliability that is an essential pre-requisite for practical use in an emergency situation. The main focus is on the problem of how to achieve reliable data replication between nodes in a network that is established in a hurry, where radio links are likely to suffer intermittent failures and where the network topology can grow, shrink and change dynamically. The paper argues that off-the-shelf commercial database solutions are not suitable, and describes the design and operation of a novel approach we have implemented in a prototype.

Data Management in an Intelligent Environment for Cognitive Disabled and Elderly People

Recently intelligent and personalized medical systems tend to be one of the most important branches of the health-care domain, playing a great role in improving the quality of life of people that want to feel safe and to be assisted not regarding the place they are. This paper presents an innovative way of data management based on a middleware platform providing services for fast and easy creation of applications dealing with the problems of taking care of patients in their homes. The work was carried out as a part of the MPOWER project, funded by the EU 6th Framework Programme, and carried out by a multinational development team. The project focuses on supporting activities of daily living and provides services for elderly and cognitive disabled, e.g. people with dementia. The MPOWER platform is designed to facilitate rapid development of a variety of applications and adopt them to specific users’ needs. The paper introduces the whole platform, its functionality and principal goals along with the architectural background of data management, focusing on the different types of data that the system has to manage and analyze. The last section concludes the work done on the project.

Design and evaluation of the ModelHealth toolchain for continuity of care web services

Motivation: Systems interoperability is a key challenge in providing continuity of care to all patients. The challenge is addressed with information standards and new approaches to systems integration based on service-oriented architectures. Model-driven development promise utilities that are suitable for software service development in the healthcare domain, but development tools are still immature and their industry uptake is low. The knowledge about how model-driven development tools can become more useful to the healthcare software developers should be strengthened. Approach: This paper presents the ModelHealth toolchain that was created in four design/assess cycles, involving 28 students and 41 professional developers in the period 2007–2010. The toolchain provides design assistance for creating software services based on concepts from the CEN-13940 standard for continuity of care, which facilitates development of interoperable software services. Results: The CEN-13940 standard was successfully incorporated into the ModelHealth Toolchain assisting developers in creating software service design models that adhered to the standard. The developers expressed that improved understanding of the target system, documentation generation, and artifact traceability were essential utilities of the model-driven approach. Conclusion: The paper concludes healthcare domain knowledge can be successfully incorporated in a model-driven development toolchain, providing valuable input to the healthcare software service design process. A set of recommendations on how to incorporate domain specific concepts into model-driven development tools is provided. To our knowledge, no other scientific publications have reported from healthcare specific model-driven tool design and evaluations. Our recommendations extend and nuance existing knowledge on model-driven development tooling in general.

Towards precision fishery: standardized modelling of smart services in the fishery domain

Big data technologies can play an important role in improving fishery operations. This paper presents an investigation of how smart data-driven services for fisheries can be identified and designed using a model-driven approach with Archimate 3.0 and the big data reference model from BDVA. The combination of top-down and bottom-up modelling was successful in producing a model that can be used for further implementation and analysis. The work was therefore extended to include a total of 26 pilot systems, encompassing almost 450 design diagrams and 5700 modelling elements.

Telemedicine Services for the Arctic: A Systematic Review

Background Telemedicine services have been successfully used in areas where there are adequate infrastructures such as reliable power and communication lines. However, despite the increasing number of merchants and seafarers, maritime and Arctic telemedicine have had limited success. This might be linked with various factors such as lack of good infrastructure, lack of trained onboard personnel, lack of Arctic-enhanced telemedicine equipment, extreme weather conditions, remoteness, and other geographical challenges. Objective The purpose of this review was to assess and analyze the current status of telemedicine services in the context of maritime conditions, extreme weather (ie, Arctic weather), and remote accidents and emergencies. Moreover, the paper aimed to identify successfully implemented telemedicine services in the Arctic region and in maritime settings and remote emergency situations and present state of the art systems for these areas. Finally, we identified the status quo of telemedicine services in the context of search and rescue (SAR) scenarios in these extreme conditions. Methods A rigorous literature search was conducted between September 7 and October 28, 2015, through various online databases. Peer reviewed journals and articles were considered. Relevant articles were first identified by reviewing the title, keywords, and abstract for a preliminary filter with our selection criteria, and then we reviewed full-text articles that seemed relevant. Information from the selected literature was extracted based on some predefined categories, which were defined based on previous research and further elaborated upon via iterative brainstorming. Results The initial hits were vetted using the title, abstract, and keywords, and we retrieved a total of 471 papers. After removing duplicates from the list, 422 records remained. Then, we did an independent assessment of the articles and screening based on the inclusion and exclusion criteria, which eliminated another 219 papers, leaving 203 relevant papers. After a full-text assessment, 36 articles were left, which were critically analyzed. The inter-rater agreement was measured using Cohen Kappa test, and disagreements were resolved through discussion. Conclusions Despite the increasing number of fishermen and other seafarers, Arctic and maritime working conditions are mainly characterized by an absence of access to health care facilities. The condition is further aggravated for fishermen and seafarers who are working in the Arctic regions. In spite of the existing barriers and challenges, some telemedicine services have recently been successfully delivered in these areas. These services include teleconsultation (9/37, 24%), teleradiology (8/37, 22%), teledermatology and tele-education (3/37, 8%), telemonitoring and telecardiology (telesonography) (1/37, 3%), and others (10/37, 27%). However, the use of telemedicine in relation to search and rescue (SAR) services is not yet fully exploited. Therefore, we foresee that these implemented and evaluated telemedicine services will serve as underlying models for the successful implementation of future search and rescue (SAR) services.

Literatures Review of Telemedicine Services in Maritime and Extreme Weather

Purpose: The objective of this review is to asses and analyse the current status of tele-medicine services in the context of offshore, Arctic and extreme weather and its use within the search and rescue scenarios. Moreover, it presents state of the art systems for implementing successful telemedicine services in the Arctic (extreme weather and remote) regions and also indicates the extent of the challenge imposed by the existing geographical problems. Method: Literature search was conducted, between September 7 and October 28, 2015, through various databases, such as Google Scholar, PubMed/Medline, Science direct, ACM Digital Library, IEEE Xplore, Onepetro, Journal of American Medical Informatics Association (JAMIA), Journal of Telemedicine and Telecare and Journal of international maritime health. Furthermore, additional articles were also extracted from reference lists of the selected papers. Peer reviewed journals and articles were considered. The inclusion and exclusion criteria were setup through rigorous discussion and brainstorming among the authors. Several combination of the term “Arctic”, “oil and gas”, “shipping”, “telemedicine”, “search and rescue”, “maritime medicine”, “offshore”, “extreme weather”, and “telehealth” were used during the search. The search strings were combined using “AND” and “OR” for a better searching strategy. Relevant articles were first identified by reviewing the titles, keywords and abstract for a preliminary filter with our selection criteria, and then we reviewed full texts for articles that seemed relevant. Information was extracted based on some predefined categories, including Communication link, Telemedicine modalities and Telemedicine services, which were based on previous research and further elaborated upon via iterative brainstorming. Result: The first Author (AZW) vetted the first hit using the title, abstract and keywords, and retrieved a total of 471 papers. After removing duplicates, 422 records were remained. Then the authors did independent assessment of the articles based on the inclusion and exclusion criteria, which eliminated another 219 papers, leaving 203 relevant papers. After a full text assessment, 36 articles were left, which were critically analysed. The inter-rater agreement was measured using the Cohen’s Kappa test, and disagreements were resolved through discussion. According to the result, most of the studies have implemented various telemedicine services such as teleconsultation (24%), teleradiology (22%), telecardiology (5,5%), tele-ENT (5,5%), teledermatology (8,2%) and teleeducation (8,2%) and others (19%, incl. teleinterpretation, teleambulance, clinical decision making and others). Most of these studies also demonstrated the use of various means of communication links including satellite (29%), mobile (GSM, GPRS, CDMA, etc) (25%), radio, LAN & dialup (28%), ISDN (8%), broadband (6%) and VPN (5%). Moreover, all these studies have shown the use of various telemedicine modalities such as video (27%), still images (25%), audio (19%) and other medical data (18%). Discussion: Despite the increasing number of fishermen and other seafarers, maritime working conditions are mainly characterized by absence of access to health care facilities. The condition is further aggravated to fishermen and seafarers who are working in the Arctic regions. Even if onshore tele-medicine has been a success, its success on offshore is limited. This is due to various reasons such as the absence of good communication network, bad weather condition, long distances and longer time periods out of reach of search and rescue (SAR) helicopters, which reduces the possibility of medical evacuation (MEDEVAC). Technology adoption from onshore to offshore might seems a fast remedy for the case. However, this remains to be a challenge for various reasons. The main reason is the convergent and divergent nature of maritime and onshore telemedicine with respect to structural, practical and policy differences. Therefore, it requires to identify these differences and to carefully review them before the transfer of technology and research results to offshore situations. However, irrespective of these limitations, offshore and maritime telemedicine have recently been successful in delivering telemedicine services in the Arctic, Antarctica and other areas with extreme weather conditions. However, the use of telemedicine in relation to search and rescue (SAR) services is not yet fully exploited. Therefore, we foresee that these implemented and evaluated telemedicine services will serve as underlying models for successful implementation of future search and rescue (SAR) services.

Point-of-care devices for healthy consumers - a feasibility study.

Point of care (POC) devices are small, portable instruments that perform diagnostic testing at the site of patient care, e.g. at the bedside. They may be useful in telemedicine because they have the potential to provide a rapid assessment of health status for a non-expert user. We are interested in the possible value of POC devices for longterm personal health monitoring of subjects at home. Internationally recognized organizations control the quality of POC devices and validate them before their introduction into service. For example, the Food and Drug Administration in the USA reviews medical devices and decides to approve or reject them, based partly on clinical trial data submitted by the manufacturers. We have investigated users’ attitudes towards the use of certain POC devices and their perceptions about the usability of the equipment.