Download PDF
Methods Inf Med 2010; 49(02): 156-160
DOI: 10.3414/ME9305
Special Topic – Original Articles
Schattauer GmbH

Ensuring the Continuity of Care of Cardiorespiratory Diseases at Home

Monitoring Equipment and Medical Data Exchange over Semantically Annotated Web Services
B. Spyropoulos
1   Medical Instrumentation Technology Department, Faculty of Engineering, Technological Educational Institution (TEI) of Athens, Athens, Greece
,
A. Tzavaras
1   Medical Instrumentation Technology Department, Faculty of Engineering, Technological Educational Institution (TEI) of Athens, Athens, Greece
,
M. Botsivaly
1   Medical Instrumentation Technology Department, Faculty of Engineering, Technological Educational Institution (TEI) of Athens, Athens, Greece
,
K. Koutsourakis
1   Medical Instrumentation Technology Department, Faculty of Engineering, Technological Educational Institution (TEI) of Athens, Athens, Greece
› Author Affiliations
Further Information

Publication History



05 February 2010

Publication Date:
17 January 2018 (online)

    Permissions and Reprints

Summary

Objectives: A significant portion of care related to cardiorespiratory diseases is provided at home, usually but not exclusively, after the discharge of a patient from hospital. It is the purpose of the present study to present the technical means which we have developed, in order to support the adaptation of the continuity of care of cardiorespiratory diseases at home.

Methods: We have developed an integrated system that includes: first, a prototype laptop-based portable monitoring system that comprises low-cost commercially available components, which enable the periodical or continuous monitoring of vital signs at home; second, software supporting medical decision-making related to tachycardia and ventricular fibrillation, as well as fuzzy-rules-based software supporting home-ventilation optimization; third, a typical continuity of care record (CCR) adapted to support also the creation of a homecare plan; and finally, a prototype ontology, based upon the HL7 clinical document architecture (CDA), serving as basis for the development of semantically annotated web services that allow for the exchange and retrieval of homecare information.

Results: The flexible design and the adaptable data-exchange mechanism of the developed system result in a useful and standard-compliant tool, for cardiorespiratory disease-related homecare.

Conclusions: The ongoing laboratory testing of the system shows that it is able to contribute to an effective and low-cost package solution, supporting patient supervision and treatment. Furthermore, semantic web technologies prove to be the perfect solution for both the conceptualization of a continuity of care data exchange procedure and for the integration of the structured medical data.

Keywords

Homecare - cardiorespiratory diseases - continuity of care - semantically annotated web-services
 

  • References

  • 1 Meyer GS, Gibbons RV. House calls to the elderly – a vanishing practice among physicians. N Engl J Med 1997; 337: 1815-1820.
    CrossrefPubMedSearch in Google Scholar
  • 2 Frederiks CMA, te Wierik MJM, van Rossum HJL. et al. Why do Elderly People seek Professional Home Care?. Methodologies Compared, Journal of Community Health 1992; 17: 131-141.
    PubMedSearch in Google Scholar
  • 3 Gilman L. A Doctor in the House. Time. 2006 Sep 24.
    PubMedSearch in Google Scholar
  • 4 Spyropoulos B, Papagounos G. A theoretical approach to Artificial Intelligence Systems in Medicine. Artificial Intelligence in Medicine 1995; 7: 455-465.
    CrossrefPubMedSearch in Google Scholar
  • 5 Spyropoulos B. et al. Application Tools supporting Decision Making in the Modern Hospital. IJSR 2006; 16: 129-133.
    PubMedSearch in Google Scholar
  • 6 Editorial.. Can House Calls Survive?. N Engl J Med 1997; 337: 1840-1841.
    CrossrefPubMedSearch in Google Scholar
  • 7 Botsivaly M, Koutsourakis K, Spyropoulos B. A quasi real time Biosignal Acquisition processing and Transmission System. 4th European Symposium on Biomedical Engineering, Patras, Greece: 2004
    Search in Google Scholar
  • 8 Hillberg RE, Douglas CJ. Non Invasive Ventilation. N Engl J Med 1997; 337: 1746-1752.
    CrossrefPubMedSearch in Google Scholar
  • 9 Simonds AK. Home ventilation. Eur Respir J 2003; 22 (47) 38-46.
    CrossrefPubMedSearch in Google Scholar
  • 10 Kohorst J. Transitioning the Ventilator-Dependent Patient from the Hospital to Home. Medscape Pulmonary Medicine 2005 9: www.medscape.com (514735).
    PubMedSearch in Google Scholar
  • 11 Tzavaras A, Weller P, Spyropoulos B. A Neuro-Fuzzy Controller for the Estimation of Tidal Volume and Respiration Frequency Ventilator Settings for COPD Patients Ventilated in Control Mode. Proceedings of the 29th Annual International Conference of the IEEE Engineering in Medicine and Biology Society, August 23-26, 2007. Lyon, France.:
    Search in Google Scholar
  • 12 ASTM. www.astm.org E2369-05, Standard Specification for Continuity of Care Record.
    PubMed
  • 13 Tessier C. Continuity of Care Record. ASTM E31- WG on CCR, 21st TEPR 2004 (Towards an Electronic Patient Record), May 16-18, 2005. Salt Lake City, USA.:
    Search in Google Scholar
  • 14 ISO 13606-1:2008.. Health informatics – Electronic health record communication – Part 1: Reference model. http://www.iso.org.
    PubMed
  • 15 ASTM. www.astm.org ADJE2369 – Adjunct to E 2369 Continuity of Care Record (CCR).
    PubMed
  • 16 Saba VK. Home Health Care Classification of Nursing Diagnoses and Interventions. Washington, DC: Georgetown University; 1994
    Search in Google Scholar
  • 17 Dogac A, Laleci G, Kirbas S, Kabak Y, Sinir S, Yildiz A, Gurcan Y. Artemis: Deploying Semantically Enriched Web Services in the Healthcare Domain. Information Systems Journal 2006; 31 4–5 321-339.
    CrossrefPubMedSearch in Google Scholar
  • 18 Bicer V, Laleci G, Dogac A, Kabak Y. Providing Semantic Interoperability in the Healthcare Domain through Ontology Mapping. eChallenges. 2005. Ljubljana, Slovenia.:
    Search in Google Scholar
  • 19 Eccher C, Purin B, Pisanelli DM, Battaglia M, Apolloni I, Forti S. Ontologies supporting continuity of care: The case of heart failure. Comput Biol Med 2006; 36 7–8 789-801.
    CrossrefPubMedSearch in Google Scholar
  • 20 Health Level 7 (HL7). http://www.hl7.org.
    PubMed
  • 21 The openEHR Foundation.. Available from: http://www.openehr.org.
    PubMed
  • 22 Dolin RH. Clinical Document Architecture. HL7 International Affiliates Joint Meeting. August 2000. Dresden, Germany.:
    Search in Google Scholar
  • 23 Dolin RH, Alschuler L, Boyer S, Beebe C, Behlen FM, Biron PV, Shabo A. The HL7 Clinical Document Architecture. J Am Med Inform Assoc 2001; 8 (06) 552-561.
    CrossrefPubMedSearch in Google Scholar
  • 24 Müller M, Ückert F, Bürkle T, Prokosch H. Cross- institutional data exchange using the clinical document architecture (CDA). International Journal of Medical Informatics 2005; 74: 245-256.
    CrossrefPubMedSearch in Google Scholar
  • 25 Paterson GI, Shepherd M, Wang X, Watters C, Zitner D. Using the XML-based Clinical Document Architecture for Exchange of Structured Discharge Summaries. Proceedings of the 35th Hawaii International Conference on System Sciences, 2002
    PubMedSearch in Google Scholar
  • 26 Della Valle E, Corizza D, Bicer V, Kabak Y, Laleci GB, Lausen H. The Need for Semantic Web Service in the eHealth. W3C Workshop on Frameworks for Semantics in Web Services, 2005 Available from: http://www.w3.org/2005/04/FSWS/accepted-papers.html.
    PubMedSearch in Google Scholar
  • 27 Kamel Boulos MN, Roudsari AV, Carson ER. Towards a semantic medical Web: HealthCyberMap’s tool for building an RDF metadata base of health information resources based on the qualified Dublin Core Meta-data Set. Med Sci Monit 2002; 8 (07) 124-136.
    PubMedSearch in Google Scholar
  • 28 Botsivaly M, Malamateniou F, Vassilacopoulos G, Macris A. A semantic web-based system for information support to emergency healthcare delivery. Computers in Human Behavior. Elsevier; 2007. Accepted for publication.
    Search in Google Scholar
  • 29 HL7 Reference Information Model.. http://www.hl7.org/library/data-model/RIM/modelpage–mem.htm. 2006
    PubMed
  • 30 Dolin RH, Alschuler L, Boyer S, Beebe C, Behlen FM, Biron PV, Shabo A. HL7 Clinical Document Architecture, Release 2. J Am Med Inform Assoc 2006; 13: 30-39.
    CrossrefPubMedSearch in Google Scholar