One of the biggest challenges for IT in Healthcare sector in the upcoming years will be to gather, maintain and search into geographically dispersed and unstructured clinical information including but not limited to electronic health records, biomedical images, operational documentation. For years, many institutions have been trying to collect, standardize and centralize this information into common storage in order to provide consistent health data. BioAGE project presents a decentralized concept to link and build a virtual electronic medical record, stored onto one or more distributed computers or embedded devices, without any need of a central server, and single database or data cluster.

INTRODUCTION

Modern medicine is probably the widest and most dynamically developing science with applications in fundamental natural sciences, such as anatomy, biochemistry, genetics, cytology, physiology; specialized activities, such as surgery, neurology, cardiology, oncology, ophthalmology; with many general practitioners and health management activities.

Today, the Health Informatics provides automation in all these complex and heterogeneous activities by using variety of hardware and software solutions. As a result of the progress of these sectors, the volume of information dramatically arises together with the requirements for processing, standardization, security, reliability and sharing. Furthermore, a significant part of this information remains unstructured. It is clear that without specialised tools for searching, accessing and virtualizing of data, the medical information will become inconsistent and will be processed even more difficultly [1].

Variety of examples from different medical fields can be given about issues that arise from the presence of dispersed, heterogamous, and unstructured medical information. Such problems can also be found in EHR (Electronic Health Records), which should collect and present in consistent appearance the clinical information about the patients from different medical sources, such as centralised systems for clinical administration, content management systems (CMS), professional scanners, lab results, OCR data and more [2].

Information technologies, where a centralised database is used with computer connectivity in a local network, can automate and standardise particular medical activities in a single health facility. The technological boundaries of that type of solutions are quickly reached and exhausted, when the practise requires:

• Development of new medical activities performed on different storages and locations;
• Integration with multiple professional systems and existing devices, such as scanners, security systems and many more;
• Data virtualisation, including controlled data sharing;
• Searching in geographically dispersed unstructured medical and operational information;
• Processing of distributed medical data and results;
• Applying new business processes and work-flows.

These modern information technology solutions can overcome the limitations, can upgrade and connect the existing software and hardware infrastructure of one or more medical facilities in a grid or cloud.

These technologies can result number of benefits. Some of those are  mentioned below:

• To achieve cost-savings during the expansion of the existing IT infrastructure;
• To increase efficiency and better performance of current medical activities and workflows;
• To improve the quality of medical services;
• To standardize and normalize the data from and to different external systems;
• To perform additional processing of medical information, such as fully text search in unstructured data, documents attached to the EHR,  distributed medical image processing, and many more;
• To monitor and control the information access and the usage of systems by other system providers.

BIOAGE PROJECT

Goals and Objectives

BioAGE is a project for developing of hybrid conceptual platform for parallel computations, which provides tools for building and deploying computational data grid. This solution incorporates number of standards and technologies for communication, grid computing and capabilities to work with embedded devices, under ISO EN13606, OpenCV, and Erlang – a time-tested runtime system designed by Ericsson to support virtualized, distributed, fault-tolerant, soft-real-time, non-stop applications.

The platform is developed as a result of the execution of project BG161POO03-1.1.05-0152-COO01, co-sponsored by the European Union, Bulgarian Government and BINETIX LLC. 

The major goal of the project is to create collaborative environment where different business rules, systems, functions and data can bring measurable results to a particular application field, like health informatics.

BioAGE provides complete set of technology and programs for designing and deploying of computational and data grid. Tools for developing new functions, connectivity, workflows and number of options to integrate existing external systems into a common grid.

The scope of the project includes also few demonstrations of the capabilities of computational data grid through different applications in the medical practice.

Applications and Deployment

BioAGE finds particular application in the field of Healthcare for building virtual EHR to ensure their decentralized management and full-text search in structured and unstructured information, documents, databases and images associated with EHR.

The Grid is also used in medical imaging, in particular for the processing and analysis of images obtained by digital subtraction angiography by CT scans, MRI scanners, infrared cameras, apparatus for positron emission tomography, as well as different isotope studies [3].

Image processing and the provisioning of interim or final results, as part of the clinical information in an EHR, involves complex and time-consuming operations. Example of such operations is the amplification of the signal/noise ratio, contrast improving, contour and regional segmentations, bi-directional Fourier transformations, object recognition and comparative analysis of the results of regular surveys and observations of patients.

Users of the platform can be patients, doctors, and experts in hospitals, laboratories, pharmacies and other Healthcare institutions which are authenticated by computers and that can receive access to information related to health records [5].

The information is managed by decentralized computers which can be connected in a common virtual infrastructure through Internet Protocol [4]. Information can be locally created, deleted, altered,  or globally summarized, synchronized and searched from any connected computer.
The connectivity between computers is not mandatory.

Solution Architecture

The Grid has SaaS (Software as a Service) architecture and it is dynamically built by interconnected nodes (computers, servers, mobile and other embedded devices). The design of the nodes allows them to operate on different hardware platforms and operating systems, like Linux and Windows, and behave as a single entity. Due to the service nature of the entire solution, all resources in the grid, such as interfaces to external systems, unstructured files and documents, intersections and unions from data bases, extra developed functionality,  can be:

• categorized and represented in unified format;
• accessed, exchanged and ultimately used in a controlled way from all nodes in the grid;
• utilized and scheduled simultaneously, in accordance with particular business needs and practical scenarios.

The Node is managed by a special program called Agent. The Agents control the execution and the exchange of algorithms and data between the nodes in the grid and its users.

Fig. 1 depicts exemplary system architecture for decentralized management of electronic health records realized through BioAGE, which consists of nodes 1.1, 1.2, ..., 1.n-1, 1.n, which build virtual infrastructure and within it are the users of the system - patients at home or in public places, experts, doctors and specialists in hospitals, laboratories, pharmacies and other health-care institutions. The connectivity between nodes 1.1, ..., 1.n is not mandatory, but can be achieved by one or more connections by using appropriate transport Internet Protocol (TCP, UDP, SCTP), in local computer network as well as in the public Internet cyberspace 1-INET [4].

The Agents dynamically and asynchronously optimize the executed requests and their content, thus balancing the performance of complex parallel tasks in the grid, reducing the traffic between the nodes and ensuring timely delivery of interim and final results.

Due to its hybrid design, BioAGE technology enables the integration of existing applications and algorithms in a distributed, competitive and geographically distributed computing environment.

CONCLUSION

BioAGE project presents an innovative method for decentralized management of electronic health records by the existing software and hardware infrastructure with integrated tools for full text search in structured and unstructured information.

The advantages of such a solution are that it automatically builds electronic health record information distributed on one or more computers without requiring the presence of a central computer. As a result of this, data can be summarized on the visits to various doctors, from expertise conclusions and analyses made in geographically distant laboratories, conducted treatments in hospitals, for medicines nomenclatures stocks, knowledge bases, and to perform processing for the purposes of medical diagnostic imaging.

Additionally, the virtual infrastructure ensures the continuity of services provided for data management, comprehensive protection against data loss, autonomy of the medical records on individual users or institutions and to automatically include new computers, devises and resources by which to update and supplement the health records with new relevant information. Thus improving the quality and the flexibility of professional healthcare.

REFERENCES

[1] Robert M. Veatch, „Medical Ethics“, Jones & Bartlett Learning, 1997
[2] "Mobile Tech Contributions to Healthcare and Patient Experience". Top Mobile Trends. Retrieved 29 May 2014.
[3] A. Andreev, PhD, „Development of Parallel Computational Environment Applicable to Medical Image Diagnostics“, 2008.
[4] ITU-T Recommendation Q.1400, „Architecture framework for the development of signaling and OA&M protocols using OSI concepts“, 1993, pp 4, 7.
[5] BINETIX LLC, „System for Decentralized Management of Electronic Health Records“, 2014, patent pending