| Abstract |
Medical collaboration has always been a common practice for healthcare professionals, mainly by means of oral consultation. Nowadays, the convergence of informatics and telecommunications technology has enabled the efficient support of medical collaboration, by utilizing modern technological media, thus achieving a more efficient integration of medical expertise with available infrastructure, while rescinding geographical and organizational borders. In the context of this work, an open, extensible, based on XML medical collaboration environment has been designed, implemented and evaluated. The proposed environment aims to the provision of all necessary technological means for the reliable communication among healthcare professionals and their effective collaboration over actual medical episodes. This environment is a distributed service that utilizes the World Wide Web, as the medium for information exchange. It is based on open technologies and international standards, in order to ensure openness, extensibility and interoperability with other applications that adopt such technologies. XML, an open and extensible international standard for the Internet, has been chosen in order to represent protocol messages, as well as digitally signed medical documents and examinations that are exchanged in a context of a medical collaboration session. An instant messaging and presence system has been adopted as the basic communication platform. This platform makes instantly available the ability of rapid communication among participants, as well as the presence awareness and availability of other users. The basic instant messaging and presence protocol has been extended, in order to cover the medical collaboration specific functional needs. Every actual medical episode is modeled as a virtual workspace, which maintains a collection of medical documents and examinations that are relative to the episode and enables the consequent sharing of these documents among the participants. The collaboration environment supports, among others, methods for authentication, storing and retrieval of digitally signed medical files, inviting other healthcare professionals and receiving notifications upon certain events or actions. Auditing and thorough future references are fully supported, due to full storage of all episode related information and history of actions, in a database. The environment’s user interface is also based on open technologies and international standards and it is accessible via the World Wide Web. The open architecture of the proposed environment has enabled the efficient reuse of existing infrastructure, for purposes of searching, locating and using human and technical resources, for global authentication and for ensuring security, authenticity and integrity of the exchanged data. Moreover, this environment is interoperable with other existing healthcare services, such as the integrated electronic healthcare record and the primary and pre-hospital emergency healthcare information systems. Finally, the proposed environment has been evaluated for its performance, by contacting proper experimental measurements. It is critical to know the actual limits of such an environment, because it concerns the transmission and manipulation of sensitive medical data. In many cases, it is necessary to know the actual response time of the service, because information such as notifications and presence awareness must be delivered in a reliable and instant manner, as possible delays may have serious consequences. This work has been experimentally evaluated and has been found adequately effective, in terms of scalability and robustness, while it was found that the addition of security mechanisms do not seriously affect the overall performance.
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Ανάπτυξη ενός περιβάλλοντος στήριξης της ιατρικής συνεργασίας, βασισμένο σε τεχνολογία XML
