I.

Multi-Agent Based Healthcare Interface Manager: Related to Interface Engine(2.4) Project

Kambiz Houshiaryan, Il Kon Kim Ph.D, Yun Sik Kwak M.D, Nguyen Woang PhuongPh.D

Intelligent Health Information Sharing System Development Center, KyungPook National University Department of Computer Science, Daegu South Korea .kambiz@hanmail.net

Abstract: Many systems and software are designed to support specific work tasks in clinical work. Many steps in the right direction have been made to help the promotion of healthcare. However, the lack of agreement among physicians to use the same medical record have made problem for integrating information systems within healthcare. This complication is seldom supported by the technology. This paper introduces a Computer Based Healthcare Interface Manager (which is a part of Interface Engine Version (2.4) project) to work as a middleware software. This interface allows medical staff to request data from the hospital information system database's using forms displayed on a web browser and enables the web server to return updated and dynamic web pages based on the user's requests and profile. Each return includes the total Medical record for a patient within HL7 Message that can be cut down by developers for different use.

Keyword: hospital information system, multi agent platform, HL7 message.

Introduction

The characteristics of health care domains, agent-based solutions and the research and development challenges inherent in employing agents to solve problems in healthcare.

Agents have the potential to assist in a wide range of activities in health care environments. They can maintain the autonomy of the collaborating participants, integrated disparate operating environments, coordinate distributed data, such as patient records held in different hospital in a city or in several hospitals, clinics and other organizations involved in healthcare such as insurance companies. Also, in the last few years there has been a shift in health care practice towards healthcare promotion, shared patient-provider decision-making and managed care, creating an increased demand for information and online services[2], [3]. The shared decisions and actions of all concerned need to be coordinated to make sure that the care is efficient and effective. To facilitate this, software system are needed to reduce error in diagnosis and treatment, deliver healthcare to remote locations, improve medical training and education, and make healthcare information more accessible to patients. In this concern we intend to develop a middleware interface manager software and share the patient care medical record information through web service and agent platform to be used in a different department of a hospital or different hospital in a city or a remote area for a better treatment and health care.

II. Methods

Interface Engine Version 2.4 project has proposed by a team consist of students studding at Intelligent Information Laboratory Department of Computer Science, KyungPook national University. This project has divided into 3 parts. Validation, Message Composer and Interface.

Health care Interface manager is the third part of Interface Engine ver 2.4 Project. The task is to make a communication channel between different department of a hospital or among different health care systems (Figure 1). Each department or clinical center is suppose to add a specific message with HL7 format for requested test or treatment of a specific patient to the original medical record and save it to the Local Clinical Database. After all and at last, one medical record according to HL7 messaging format will be made and will transform from Local Database to the hospitals original Database.

This Middleware consist of an Original and Local database managed by Cache software. Original Database will be built as a Web Service. Each time a patient intend to move to the other healthcare system or when doctor agrees to discharge a patient, medical record of the same patient will updated and saved to the Original Database of the hospital. A technical method has been implemented to let the original database have more time responding requests from other Clinical or Healthcare systems with a faster operation. This implementation requires to save patient's medical record into a local Database with frequent update for saving changes. Local Database also have option to be used as a Web Service or different communication protocol in the case of using Multi-Agent platform (Agents are not yet been supported by web service). In the first stage, when a patient has arrived at the hospital for treatment, he or she must be registered in information department. After Patient registration (ADT Administration of Patient) one event handler will be made for two purpose: One is to invoke the related department in which registered patient should be treated at and the other is to either send message to the internet (1) (or other clinical health care or hospital on the web as an agent)

to get patient's personal history record or make a new medical record for that patient. This request for information occurs while a patient is transporting to related department for treatments (time is save now). A Referral System has been implemented [4] to link the history of patient's medical record together if past history of medication and treatments have occurred in one or several different health cares. This link will help tracking system to refer to the past history of medical record of a patient.

Figure 1. Healthcare Interface Design

After treatments if law of the hospital does not permit to transform the medical record of a patient to the current patient's living area, the medical record will save in the medical center which patient has been treated there but a reference will be linked to the old medical history for back tracking.

Communication between each department and the local DB will occurs as following: We mentioned that at first stage when a patient registered an event will made to invoke a department for starting treatment, test or care. This event has an ID and when it invokes by a department, the event will be recognizable for Local DB to return the medical record of a specific patient.

Dealing with medical information stored in a medical center is clearly a very sensitive issue.

One solution to this matter is to add a XML digital signature capability called B2B system[5]. It is obvious that the research on secure access to data such as authentication of users, delivery and use of certificates, cryptographic methods or security in communications, [1] will be the fundamental to ensure that agents may safely deal with medical data and only authorized users may access or update this kind of information.

III. Result

Advantage of this Middleware is that it can be adopted with any kind of software and platform that uses the same ontology according to standards of FIPA and HL7. The result message will be a web page (Figure 3) consists of total medical record within a HL7 message with XML format.

Each department, hospital or clinical care even different organization like Insurance companies can cut down the unnecessary parts and use it with their convenient method (Figure 2.). At last we have an integrated medical record useful for both health care system and patients.

Figure 2. A specific department can parse out some necessary information for a patient out of his or her total XML record (figure 3). Some filtered medical Record has shown in this picture.

Figure 3. A small part of Patient records in XML format.

(1) Messages are asynchronised in a web page. These messages are formed in standard envelops. A specific agent or software that can understand the language according to standards of FIPA (Foundation for Intelligent Physical Agents), ACL (Agent Communication Language) FIPA SL Content Language, standards of HL7 (Health Level 7) and knows the answer, can participate and respond to the original message. This ontology gives us advantage that we can integrate medical health care with the same standard language.

IV. Conclusions

Lack of agreement among physicians to use the same medical record have made variety of expensive software to be made individually which are not acceptable by other physicians or Health Care Systems. In the other way lack of integrating information systems within healthcare has a direct influence on patient care and has not completely reduce the possible risk of mistreatments or mistakes made by healthcare personals. This paper introduces a middleware software using a combination of Multi-Agent-Platform and Web-Service as a communication protocol for sharing medical record within clinics or hospitals of a city or a remote healthcare. Significant conclusions are as follows:

1. This middleware can be integrated with existing

applications. It has a composer that generates HL7 message.

2. Agents may access a database to obtain the information about the patients of a certain hospital[6]. Medical record can be accessible from a remote healthcare system independent of platforms and operating system.

3. Integration among information system within healthcare will be available in near future.

4. Information system may help both citizens and healthcare professionals to obtain up-to-date and relevant healthcare information.

References

[1]. John L Nealon, Antonio Moreno; The Application Of Agent Technology To Health Care. AgentCities Working Group On Health Care.

[2]. Silverman, B. G., Andonyadis, C. and Morales, A. Web based healthcare agents; the case of reminders and todos, too(R2Do2), Artificial Intelligent in Medicine, 14(3) (1998)

[3]. Shankararaman, V., Ambrosiadou, V. and Robinson, B.Agents in Medical Informatics, in Proc. Of IASTED International Conference on Applied Informatics, (Austria, 2000).

[4]. Jang Hyuk Jin; Referral System, Kyungpook National University; Intelligent Information Laboratory. April 2003.

[5]. Toshiro Takase and Naohiko Uramoto IBM Research, "XML Digital Signature System Independent Of Existing Applications." Tokyo Research Laboratory 1623-14, Shimotosuruma,Yamato-shi, Kanagawa, Japan.

[6]. Moreno A and Isern D. Accessing distributed health-care services through smart agents, to be preseted at the 4th IEEE Int. Workshop on Enterprise Networking and Computing in te Health Care Industry-HealtCom 2002(Nancy, France, 2002)(CAP), http://www.snomed.org/