Functional specifications of the Middleware

Biniaris C., Louloudakis S., Di Bona S., Martinelli M., Chiarugi F., Sakkalis V.

middleware 

The HEARTFAID (HF) project aims to devise, design, develop and deploy advanced and innovative computerized systems and services that, by collecting, integrating and processing all relevant biomedical data and information, are able to improve medical knowledge and make more effective and efficient all the processes related to diagnosis, prognosis, treatment and personalization of the Heart Failure care in elderly patients. This general goal will be achieved by: o developing an innovative technological platform for informative and decision support, which can make the procedures of diagnosis, prognosis and therapy more effective and reliable for the patient and optimal in the use of medical and clinical resources. This platform, by exploiting innovative results on computational modelling, knowledge discovery methodologies, visualization and imaging techniques, and using the medical knowledge of the relevant domain, is able to effectively integrate and process biomedical data and information at different levels of structure; o defining new health care delivery organization and management models for the relevant domain, which may result in more effective and efficient use of the needed total resources (health care operators, health care equipments, financial resources). A key work-package to achieve the first point is WP3 - MIDDLEWARE, INTEROPERABILITY AND INTEGRATION, which has the main goal to analyse, design and implement the core software architecture of the HEARTFAID platform, i.e. the Middleware. The Middleware is responsible to guarantee the integration and the interoperability among all the modules of the platform, as well as of the services provided to the end-users. As described in the Description of Work (DoW) of the project concerning the architectural design of the platform, the Middleware has been decomposed into two different, but integrated, levels: the Interoperability Middleware and the Integration Middleware. The first level has the main objective to guarantee the interoperability of the HEARTFAID system components and, using the approach of service-oriented integration, to integrate the functionalities the platform will provide to the end users, while the second level has the goal to design and develop a Data Management System that is responsible to guarantee the following features: all the data flowing within the entire platform are compliant with the standards identified in work-package WP3; management of the heterogeneous repository in order to allow the treatment of raw data, laboratory data, structured information (Electronic Patient Record (EPR), data entry services, and so on), multimedia and other data (reports, images, ultrasound signals, and so on). The first fundamental step for the attainment of these objectives, is to analyse the requirements of the final users, and hence of the platform, and to define the functional specifications of the platform itself. This deliverable has the main goal to analyse the problems that should be faced to achieve the Grand Vision of the project, and to define the functional specifications of the different components of the Interoperability and Integration Middleware. In more details, this document has been organised as follows. At first, an introduction will provide a general overview about the Health Information Systems. The main international initiatives to standardise protocols, roles, messaging procedures and data encoding procedures, will be described. Moreover, the vision that will drive the design and development of the HEARTFAID Electronic Health Records will be presented. Afterwards, we will analyse the state of the art and the methodological foundations that will support the "application integration". The issue of interoperability, including data access, exchange, and integration becomes more and more sophisticate especially for medical companies and healthcare structures, due to the heterogeneity of the informative systems available. Therefore, at this level it is nowadays very important to adopt adequate standards for data encoding and communication. These standards and the most common approaches, when they are considered suitable for the purposes of the HF project, will be adopted when defining the main infrastructure of the HF platform of services, i.e. the middleware. After a description of the state of the art on the most advanced solution able to support interoperability, we will analyse the requirements that the middleware should satisfy. These requirements are mainly concerned with interoperability issues of the healthcare structures. In fact, although health organizations are important users of the Information Technology, each of them and the system implemented typically use their own protocols and adopts different standards, principally because there is a lack of divulgation of information concerning standards. Furthermore, concerning data retention and exchange, information models in use are not always based on standards, and even when they are, such standards are not interoperable and even not enough spread within the stakeholders. Typically those solutions address the needs for local administration and management of services, that when available are not supported by its own ontology. Thus, health information is sparse, and with severe interoperability problems as people move across borders or even across health systems independently of the place. In the future, interoperability will enable the seamless integration of any Health heterogeneous systems. Thus, health data will be made available independently of the standards adopted for retrieving and exchanging information. A visionary future seeks a methodology to enhance organization's interoperability, keeping he same organization's technical and operational environment, improving its methods of work and the usability of the installed technology through ontological harmonization of the organization's models in use. Procedures will take complete care regarding ethics and privacy. This will allow secure and fast access to comparable public health data and to patient information located in different places over a wide variety of repositories and medical devices. After the requirements have been identified, we will analyse and define the functional specifications of the Interoperability and the Integration Middleware, as well as the issues related with the integration of the HF Decision Support System. In particular, the different components of the middleware layers will be described. The challenge of determining the functional specifications of each module lies in identifying the user needs and designing and implementing comprehensive and convenient interfaces, both with the final users and between the modules themselves. Since the Dow of the HEARTFAID project does not foresee a specific document on the design of the Middleware, we made a step forward with respect to the identification of the functional specifications and in Section 6 we will introduce some models that can be adopted in the subsequent implementation of the platform. Preliminary hardware specifications will also be identifies. Finally, due to the particular context in which the platform of services will operate and the sensibility of the data that will be handled, the security aspects related to safety, secrecy and privacy of data will examined.

Source: Research report, HEARTFAID, D11, pp.1–91, 2006