Rodriguez Loya, Salvador (2015) A standards-based ICT framework to enable a service-oriented approach to clinical decision support. Doctoral thesis (PhD), University of Sussex.

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Abstract

This research provides evidence that standards based Clinical Decision Support (CDS)
at the point of care is an essential ingredient of electronic healthcare service delivery. A
Service Oriented Architecture (SOA) based solution is explored, that serves as a task
management system to coordinate complex distributed and disparate IT systems,
processes and resources (human and computer) to provide standards based CDS.

This research offers a solution to the challenges in implementing computerised CDS such
as integration with heterogeneous legacy systems. Reuse of components and services to
reduce costs and save time. The benefits of a sharable CDS service that can be reused by
different healthcare practitioners to provide collaborative patient care is demonstrated.
This solution provides orchestration among different services by extracting data from
sources like patient databases, clinical knowledge bases and evidence-based clinical
guidelines (CGs) in order to facilitate multiple CDS requests coming from different
healthcare settings. This architecture aims to aid users at different levels of Healthcare
Delivery Organizations (HCOs) to maintain a CDS repository, along with monitoring and
managing services, thus enabling transparency.

The research employs the Design Science research methodology (DSRM) combined with
The Open Group Architecture Framework (TOGAF), an open source group initiative for
Enterprise Architecture Framework (EAF). DSRM’s iterative capability addresses the
rapidly evolving nature of workflows in healthcare. This SOA based solution uses
standards-based open source technologies and platforms, the latest healthcare standards
by HL7 and OMG, Decision Support Service (DSS) and Retrieve, Update Locate Service
(RLUS) standard. Combining business process management (BPM) technologies,
business rules with SOA ensures the HCO’s capability to manage its processes. This
architectural solution is evaluated by successfully implementing evidence based CGs at
the point of care in areas such as; a) Diagnostics (Chronic Obstructive Disease), b) Urgent
Referral (Lung Cancer), c) Genome testing and integration with CDS in screening
(Lynch’s syndrome). In addition to medical care, the CDS solution can benefit
organizational processes for collaborative care delivery by connecting patients,
physicians and other associated members. This framework facilitates integration of
different types of CDS ideal for the different healthcare processes, enabling sharable CDS
capabilities within and across organizations.

Item Type:	Thesis (Doctoral)
Schools and Departments:	School of Engineering and Informatics > Engineering and Design
Subjects:	R Medicine > R Medicine (General) > R855 Medical technology R Medicine > R Medicine (General) > R858 Computer applications to medicine. Medical informatics
Depositing User:	Library Cataloguing
Date Deposited:	06 Mar 2015 07:56
Last Modified:	28 Sep 2015 13:31
URI:	http://srodev.sussex.ac.uk/id/eprint/53243

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