Sensed Data Sharing in Cloud Federation for Advances in Health Information Exchange

Sensed Data Sharing in Cloud Federation for Advances in Health Information Exchange

Antonio Celesti, Maria Fazio, Antonio Puliafito, Massimo Villari
DOI: 10.4018/ijmtie.2013100104
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In this paper the authors focus on sensing systems supporting data exchange among several healthcare administrative domains. The challenge in this area is twofold: efficient management of a huge amount of data produced by medical devices, bio-sensors and information systems, sharing sensed data for scientific and clinical purposes. The authors present a new information system that exploits Cloud computing capabilities to overcome such issues, also guaranteeing patients' privacy. Their proposal integrates different healthcare institutions into a federated environment, thus establishing a trust context among the institutions themselves. The storage service is designed according to a fully distributed approach and it is based on the wide-used Open Source framework Hadoop, which is enriched to establish a compelling federated system. They adopt the XRI technology to formalize an XML-based data model which allows to simplify the classification, searching and retrieval of medical data.
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In the healthcare context, we observe a new trend leading different public and private institutions to share clinical and medical information by exchanging electronic documents (e-documents) through the Internet, with the goal of improving services quality and pushing down costs. More specifically, Health Information Exchange (HIE) strategies mobilize healthcare data electronically across organizations within a region, community or hospital system. Although HIE activities have were strongly fueled over the last years, effective advances in this field have mixed success. To understand why, let consider the Santa Barbara County Care Data Exchange experience. It was considered as one of the most ambitious and best-publicized HIE program in the United States for connecting hospitals and doctors’ offices in the California region. After nine years of works and $10 million grant ran out, on December 31, 2006, the Santa Barbara County Care Data Exchange was stopped and the medical community was not able to keep the healthcare service operative. This example proves how real healthcare systems are strongly dependent on fundings, private investments and political arrangement (Miller & Miller, 2007) and are slowly moving toward an effective electronic health networks. Despite several years of efforts, just 10% of doctors’ offices in U.S. use e-health documents. Hospitals are expanding their use, but the exchange of data among healthcare providers, especially with rivals, has barely begun. The technology itself has caused problems, such as on June/July 2012, when the medical records network run by the Kaiser Permanente company stuck due to power outage.

Nevertheless, providing shared and secure access to patient information is a clear success for healthcare, as proved by new ambitious projects for HIE, such as the The Connecting GTA program (Zeidenberg, 2011), which aims to share patient health information in the Greater Toronto Area (GTA).

In our view, to reduce the barriers toward HIE, future healthcare services should adopt steady, widely-used and versatile ICT (Information and Communications Technology) solutions, thus avoiding strong dependencies on grant, political conflicts and so on for electronic system deployment and management. Along this line, a very challenging and practical solution is the exploitation of Cloud services. Cloud Computing is an emerging technology that has been quickly employed in many different application fields (Jegundo, Martins, & Landeck, 2012; Krishnappa, Lyons, Irwin, & Zink, 2012; Fazio, Paone, Puliafito, & Villari, 2012), thanks to its inherent attitude to integrate heterogeneous infrastructures, complex information systems and different types of resources over a world wide distributed system.

We believe that healthcare can benefit from Cloud technology to manage huge amount of data originated from medical devices (e.g., EMG and EEG instrumentation, electrical stimulator, etc) and sensing equipments for patient monitoring (e.g., accelerometers, biosensors, EKG readings, etc). It allows to reduce costs leveraging external ICT resources available on Public Clouds. In addition, it is particularly helpful for sharing medical data (e.g., pathologies, research results, drugs testing, etc.) among several healthcare centers and medical institutions for scientific evaluations and research activities. The massive production of HIE data among hospitals and healthcare providers might represent an opportunity for studying pathologies and move forward the development of new therapies.

In this paper, we present a Cloud based HIE architecture, that offers advanced services for electronic health data management generated in clinical analysis and sensing activities of patients physiological parameters, their habits and the surrounding environment. Our architecture intends to provide:

  • Cloud Federation among different healthcare institutions;

  • Distributed Storage for low-level data retrieval data management;

  • Data Indexing for high-level data retrieval and data correlation.

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