Tag Archives: Healthcare

Bringing an Efficient Home Care Solution to Life with WSO2 Technology

Senior citizens and disabled people—many in fragile health and requiring assistance—often have limited resources for managing their health and ensuring their security. Effective home care solutions allow such people to safely go about their day-to-day lives and enhances their quality of life. To aide home caregivers and patients, Raffaello Leschiera, a solution architect at Engineering Ingegneria Informatica, proposed a reference architecture for efficient home care using WSO2 technology at WSO2Con EU 2017.

Raffaello began by exploring the proposed reference architecture that connected and interfaced with all stakeholders, like the patient, his/her family and medical staff. Firstly, they need to collect data from medical devices in the patient’s home. Protocols like IEEE VU specifications are used and medical devices are mediated using Arduino and Raspberry Pi boards. Once collected, the data needs to be normalized and stored so it’s represented in the same way no matter which device it was collected from.

This data needs to run through analytics to monitor the patient’s health, process events and if needed, send notifications through various communication channels. Data integration channels using the HL7 standard protocol for health care is used to send this data to medical staff. The medical staff can then access it through web and mobile interfaces and an API gateway decouples all features from these user interfaces. And finally, the entire system needs to be synchronized and controlled by identity and access management to ensure security and privacy.

Reference architecture for a home care solution

Raffaello noted that WSO2’s comprehensive technology platform, particularly its integration and analytics capabilities, were the main reasons for picking WSO2 as their technology partner. The open source nature of the products was also a key deciding factor since Raffaello and his team work with many public administrators who prefer to adopt solutions that are completely open source. “WSO2 has a wide technology platform so you can find the right answer to every part of your problem,” said Rafaello. “And because all the products seamlessly integrate with each other it’s easy to focus on the domain problem rather than the technology problem,” he added.

To describe how WSO2 products were used for different tasks, Raffaello compared the home care solution to a football game:

  • Goalkeeper: WSO2 Microservices Framework for Java (WSO2 MSF4J) serves as the goalkeeper. This is the entire back-end of the system, which is based on lightweight microservices that are developed, deployed and monitored through MSF4J in a highly scalable and reliable manner with integrated security.
  • Defenders: WSO2 Data Analytics Server serves as one defender that receives data, analyzes it in real-time, and sends notifications. WSO2 Enterprise Integrator is the next defender who transforms disparate types of data into a normalized format and sends it to the hospital IT systems.
  • Forwards: WSO2 API Manager is one of the forwards, which faces the medical staff and is used to design, prototype and publish APIs and govern API usage. WSO2 IoT Server is another forward, which faces the medical devices for data collection, device management and protocol support.
  • Wings of the pitch: Here the WSO2 Identity Server takes care of all the strict security and privacy requirements.
  • Center of the pitch: Finally, WSO2 Governance Registry serves as the ‘Lionel Messi’ at the center of the pitch; in other words it governs the solution through surveillance just like how Messi would guide and lead his team to victory.
  • For this solution to work, Engineering Ingegneria Informatica needed a remote device that can track a patient’s movements within his/her home. Enter Joe Care (or the Joker pictured above). Joe Care is a remote presence device that is flexible and agile enough to move around the patient’s home. They used various technologies like Arduino boards, software that deals with movement and the sense of space as well handling (touch). It served as the medical eyes, ears, voice and fingers within the patient’s home.

    In the future Rafaello and his team aim to engage with users more, further analyze threat paths and include more technology like wearables that monitor movement and exercise. They would also like to create more intelligent early warning score models and move their entire solution to the cloud so more patients and operators can access it.

    Watch Rafaello’s presentation at WSO2Con EU 2017 below to learn more about their home care solution powered by WSO2.

WSO2 and MedVision360: Delivering Healthcare across Europe

Jan-Marc Verlinden is the founder and CEO of MedVision360. MedRecord, their flagship project, is an eHR (electronic Health Record) system: everything from patient data to digital health apps, devices, wearables, companies and hospital systems are wrapped together, providing a single platform on which healthcare providers can build medical applications and expose data and services via APIs. Currently, the MedVision platform is used in over 8 large EU projects, including hospitals from Hannover to Rome to Southampton.

At WSO2Con EU 2015, Jan-Marc took the stage to explain how MedVision360 achieved all this: using WSO2 products at the heart of their platform, with expertise from our partner, Yenlo.

Inside the medicine cabinet

MedRecord was born of a desire to do better. Europe, says Jan-Marc, is aging; by 2020, there will be 3 working people to every old person. In China, this problem is bound to be even more serious. This is a huge challenge for healthcare.

Given the severity of this situation, one would imagine this problem would have been tackled ages ago. Not so.

According to Jan-Marc, there are a few major problems in the way of change coming in with effective use of ICT; cost, concerns – or technical ignorance- about privacy and data security, a lack of communication between ICT systems, and the human capital it costs for data entry.

There’s also the lack of financial incentives to do better. There’s no real incentive for doctors to change the way they work and to reduce those long queues to something as simple as a mobile app, especially given the costs faced.

MedVision360 built two stacks: the first, which they subsequently open sourced, uses XML for storing data – and a second, enterprise version, with better performance using PostgreSQL. Both are based on the CEN/ISO EN 13606 standard, which requires the platform to use a dual-model architecture that maintains a clear separation between information and knowledge.

To convey the depth of modelling involved in this, Jan-Marc used the example of blood pressure, one of the many measurements involved in the process of treating a patient.

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This is the type of semantic model template developed by the NHS (the National Health Services, UK).  The idea is that this delivers both the data needed and the context that a medical specialist would need to frame the data in. As the system consumes these archetypes, it becomes instantly proficient.

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However, due to different workflows and standards, a doctor in a country other than the UK might require a different version of things, as seen above; not just a 1-1 translation of terms, either.

Working with Yenlo, MedVision360 utilized the open source WSO2 API Manager, WSO2 App Manager, and WSO2 Identity Server to solve this issue. WSO2 API Manager is a complete solution for designing and managing the API lifecycle after publishing. MedRecord’s architecture uses API manager to expose the data in the MedRecord platform from the PaaS layer, while managing access rights. WSO2 Identity Server enables login through third party identity providers (like Google and Netherland’s UZI-pass), handling role based access control and providing an audit trail.

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Everything else – applications, websites – is hosted on this layer. Swagger and JSON make it easier to build validated apps. Paired with a drag-and-drop HTML5 tooling interface, developers can easily build applications by accessing functionality from APIs with a few clicks. Hooks to portals like Drupal and Liferay allow better, device-independent presentation of content.

This opens up possibilities even for integration with Google Fit or Apple Health Kit. Google Fit, for example, collects data on the patient walking and so on; while that’s not relevant for a doctor, who’s more concerned with the patient not walking, parsing and analyzing the data would allow medical professionals to keep an eye on their customers’ health.

Healthcare is a very serious business, and at WSO2, we’re glad that providers like MedVision360 – and their clients- have chosen to trust our platform with the lives of others. To examine the full video of Jan-Marc Verlinden’s talk, click here.

At WSO2, we’re committed to making our platform better. To check out the components that MedVision used so successfully, visit the WSO2 API Manager, Identity Server and App Manager pages.

Zeomega: Building on WSO2 for a Comprehensive Healthcare Solution

The typical health management platform is a complex mechanism. This is, after all, an industry with zero tolerance for faults: even the slightest mistake could mean a life in danger.

Building healthcare solutions is what Zeomega specializes in. The Texas-based firm delivers integrated informatics and business process management solutions. Zeomega’s clients collectively service more than 30 million individuals across the United States.

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WSO2 is a part of their success: key to Zeomega is Jiva, Zeomega’s population health management platform. Delivering analytics, workflow, content and patient engagement capabilities, Jiva uses key WSO2 products and provides a deployable PHM infrastructure that both healthcare providers and clients can use. A strong track record of integration and acquisitions keep both Zeomega and Jiva on top of what they do.

Attending WSO2Con Asia 2016 to explain all of this were Praveen Doddamani and Harshavardhan Gadham Mohanraj, Technical Leads at Zeomega. Their speech, titled Building on WSO2 for a Comprehensive Healthcare Solution, detailed how Jiva works and why. Let’s dig in.

The State of the Art

Jiva has the capability to integrate with various data repositories and management systems. During the initial days of integration, they built an ETL tool and a framework – using Python – to integrate data into Jiva, generally in the form of a CSV. It could also export data.

As their customer base expanded, this integration challenge became even more integral; their requirements changed to needing to load millions of records. To pull this off, Zeomega used the pyramid framework to build a RESTful web service that would do the job. They ended up building a SOAP system as well to better interface with their clients, and using these three tools, they could address batch integrations effectively.

When it comes to a deployment, however, with multiple servers, having these multiple systems turned out to be a burden, especially when clients needed a single API to be able to manipulate data; multiple systems with different tech stacks became roadblocks to both support and development.

The Fix

“We don’t want to rewrite our existing logic; we want to leverage the existing business logic and provide a healthcare solution to external applications and well as third-party vendors,” said Harshavardhan Mohanraj, who was co-presenting with Doddamani.

At this point, they started evaluating WSO2 for a solution to this problem. WSO2 Enterprise Service Bus and WSO2 API Manager are built for this purpose. The WSO2 ESB would allow them to retain their legacy business platform and still connect whatever they needed to. WSO2 API Manager would handle the complete API management lifecycle, allowing them to push out secure APIs for their real-time web services.

To do this, said Mohanraj, they created a Jiva API framework. The core Jiva platform is exposed through RabbitMQ. Data is sent and received to this core platform through a module with the WSO2 ESB; this handles the integration, data transformation, turning flat files (CSV/XML)  or anything else into the JSON actually processed by Jiva.

image01This functionality is exposed via WSO2 API Manager, which enables Zeomega to publish, deploy and manage the necessary SOAP and REST APIs.

In the future, said Mohanraj, they intend to shift Jiva from a monolithic structure to a less tightly coupled SOA model, with reusable components and better standards support. And to do this, they intend to use WSO2 – not just WSO2 ESB and WSO2 API Manager, but also WSO2 Identity Server and WSO2 Governance Registry.

“WSO2 products provide us with high performance, high availability, and better configurability,” said Mohanraj. “We want SOA governance, DevOps and flexibility. As a whole, we’re able to achieve a robust solution by integrating WSO2 products. We’re now moving away from spending more of our efforts on business infrastructure and we’re able to speed up agility by creating healthcare solutions.”

To learn more about Jiva and the WSO2 collaboration, watch the Zeomega talk at WSO2Con Asia 2016 here.

 

Connected Health – Reinventing Healthcare with Technology

Demands for more personalized and convenient services from healthcare providers has steadily increased during the past decade. Increase in populations, life expectancy, and the advancement of technology are a few key contributors to this uptick in demand. These demands have resulted in creating a global eHealth market that is supposed to reach $308 billion by 2022, as predicted by Grand View Research INC.

The essence of a connected healthcare business is to deliver an efficient, effective service to its users by connecting disparate systems, devices, and stakeholders. It aims to automate most tasks and eliminate human error, trigger intelligent events for the hospitals and other stakeholders, and provide medical information via a range of devices at various locations. By becoming a connected ecosystem, hospitals have the opportunity to reduce costs, increase revenue, as well as offer a high-quality service to patients.

The success of a connected healthcare business though depends on how the enterprise will look to address key challenges via comprehensive solutions.

In the white paper “Connected Health Reference Architecture” Nuwan Bandara, a solutions architect at WSO2, discusses the significance of creating a connected healthcare system and explains how a middleware platform can be used to address each and every challenge faced at implementation.

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One of the key challenges he highlights is the ability to deliver aggregated information without  any latency issues between sources. In order to overcome this, you would need a centralized system that enables smooth integration of devices, services, and workflows. The use of multiple devices that take various measurements in different formats makes it a bit more difficult compared to other connected ecosystems; however, this can be addressed by consolidating the gathered data, and making it easily accessible to various services and applications from different locations.

Given that all this data is private information, it is vital to have fool proof security measures in place as well to restrict access only to authorized personnel, Nuwan notes.

Furthermore, it is important for hospitals to be geared to manage high capacities during crisis situations. If the system is unable to cope with high loads during these times, the system will crash and disrupt all workflows. Hospitals overcome this by equipping their systems with elastic scaling to handle high loads.

To learn more about the Connected Health reference architecture, download and read the white paper here .

WSO2Con Insights: South Carolina’s Department of Health and Human Services (SCDHHS) Focus on Open Platforms to Drive Innovation within Healthcare Services Industry

Spending in the healthcare industry continues to grow, reaching $2.8 trillion spent annually. However, excess costs from inefficient services and administrative waste prevent the industry from actually delivering the greatest health value for the investments citizens make. John Supra, Deputy Director for Operations and Information Management and CIO at South Carolina’s Department of Health and Human Services (SCDHHS) is tackling this challenge head on.

In his WSO2Con 2014 keynote, Supra discussed the efforts to modernize state Medicaid systems to reduce the per-capita cost of healthcare in South Carolina’s Medicaid program while improving the patient experience. He also discussed the critical role that open technologies and platforms play in driving innovation within the healthcare industry.

Vision: Automate the Basics to Increase Services

Through October 2013, SCDHHS’ Medicaid program relied 100% on paper-based applications. For state employees handling eligibility and enrollment, the work involved moving paper from one place to another, leaving no time to deliver value-added services that would improve the customer’s experience.John Supra2

Supra recalled that he and his team saw an opportunity to transform the process of connecting and sharing information and bring in new possibilities, such as services to support healthy living and improved scheduling experiences through software applications.

Supra explained, “Shouldn’t the experience be like, ‘Give me the data, allow me to check the data electronically, choose a plan because Medicaid has different plans, figure out who the providers are in your area because we know where you live, maybe schedule an initial appointment because we know that primary care matters for healthy outcomes. Then we connect to healthy living. This is why thinking from a platform perspective is so critical to our state’s Medicaid program and actually drives different behaviors in Medicaid and the government.”

Ending the Monolithic Era

A key aspect of realizing the SCDHHS vision for improved services is re-architecting the state’s Medicaid Management Information System (MMIS), Supra observed. The current system is a single, monolithic system with limited APIs and interfaces, closed systems, and flat file data exchanges, he explains. The system is also expensive to maintain, making it difficult to innovate.

Significantly, Supra noted, basic enterprise services, such as collaboration, communication, and shared document imaging systems don’t exist since the system operates from the perspective that everything is a silo. Additionally, the data the team has to run its programs typically comes back a month later, meaning the system can’t be adjusted dynamically.

“We need to destroy it and think about a modular MMIS,” Supra stated. “Breaking this up into components that are based on enterprise services and open source platforms will allow us to think about reporting analytics separately in nearly real time.”

Bringing Greater Transparency to Healthcare

Although the vision is to transform the platform, like many private enterprises SCDHHS has started with a focused project that offers clear benefits. The project, Supra explained, is the New South Carolina Health Data Transparency Site. Through the site, the team is working to provide hospital, nursing home and procedure data, as well as data about their federally qualified health centers (FQHC). Most of the data can be downloaded for personal use, and a user can view and sort within the application.

John Supra1Unlike other projects where it may take months to make a minor change, Supra and his team developed the website in a matter of months using open source technologies, taking publicly available data and existing data in the department’s network to build a system with a strong user experience.

The website has started the conversation of transforming healthcare and health delivery policy, Supra observes. “We’ve provided data that starts to ask ‘Why is the system like that? How does it relate to policy-making? How does it relate to decision making?” he explained. “It also takes a burden off our staff who used to chase this data around when people asked. We tell them it’s available on the site, and we support them by saying ‘click here.’ It’s an important start because often people are making policy decisions without good data.”

Supra noted that his team now aims to take some of the work going on in the private sector and employer-sponsored insurance, to drive information to consumers and help them understand the choices they make.

Open Source Spurs Innovation

As Supra and his team continue to drive innovation, he views open source as playing a central role.

“Like our health transparency site, open source gives myself as a CIO the opportunity to bring things into our environment, to test them, to set up an API, to show that value without some of the procurement challenges,” Supra explained. Open source also allows innovative companies to participate without having to navigate all the contractual language involved in government procurement, he added.

Among the open source technologies Supra and his team have been evaluating are WSO2 Application Server and WSO2 Enterprise Service Bus. Additionally, Supra noted that, as SCDHHS moves into a more DevOps-centric approach, the department is looking at WSO2 App Factory and WSO2 API Manager and how they can help to make the environment more interoperable and accessible.

“As open source tech on government procurement, it makes it easy for us to bring in the technology, to really experiment with it, and we’ve been working with the WSO2 team for eight to nine months on that experimentation.”

For more information about how to drive innovation within the healthcare services industry, see Supra’s WSO2Con US 2014 full presentation.

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