Design and implementation of a federated health record server

This paper describes the practical implementation of a federated health record serverbased on a generic and comprehensive public domain architecture and deployed in alive clinical setting.The authors, working at the Centre for Health Informatics and MultiprofessionalEducation (University College London), have built up over a decade of experiencewithin Europe on the requirements and information models that are needed to underpincomprehensive multi-professional electronic health records. This work has involvedcollaboration with a wide range of healthcare and informatics organisations and partnersin the healthcare computing industry across Europe though the EU Health Telematicsprojects GEHR, Synapses, EHCR-SupA, SynEx and Medicate. The resultingarchitecture models have influenced recent European standards in this area, such asCEN TC/251 ENV 13606. UCL has now designed and built a federated health recordserver based on these models which is now running in the Department ofCardiovascular Medicine at the Whittington Hospital in north London. A new EC FifthFramework project, 6WINIT, is enabling new and innovative IPv6 and wirelesstechnology solutions to be added to this work.The north London clinical demonstrator site has provided the solid basis from which toestablish "proof of concept" verification of the design approach, and a valuableopportunity to install, test and evaluate the results of the component engineeringundertaken during the EC funded projects

London SynEx Demonstrator Site: Impact Assessment Report

The key ingredients of the SynEx-UCL software components are: 1. A comprehensive and federated electronic healthcare record that can be used to reference or to store all of the necessary healthcare information acquired from a diverse range of clinical databases and patient-held devices. 2. A directory service component to provide a core persons demographic database to search for and authenticate staff users of the system and to anchor patient identification and connection to their federated healthcare record. 3. A clinical record schema management tool (Object Dictionary Client) that enables clinicians or engineers to define and export the data sets mapping to individual feeder systems. 4. An expansible set of clinical management algorithms that provide prompts to the patient or clinician to assist in the management of patient care. CHIME has built up over a decade of experience within Europe on the requirements and information models that are needed to underpin comprehensive multiprofessional electronic healthcare records. The resulting architecture models have influenced new European standards in this area, and CHIME has designed and built prototype EHCR components based on these models. The demonstrator systems described here utilise a directory service and object-oriented engineering approach, and support the secure, mobile and distributed access to federated healthcare records via web-based services. The design and implementation of these software components has been founded on a thorough analysis of the clinical, technical and ethico-legal requirements for comprehensive EHCR systems, published through previous project deliverables and in future planned papers. The clinical demonstrator site described in this report has provided the solid basis from which to establish "proof of concept" verification of the design approach, and a valuable opportunity to install, test and evaluate the results of the component engineering undertaken during the EC funded project. Inevitably, a number of practical implementation and deployment obstacles have been overcome through this journey, each of those having contributed to the time taken to deliver the components but also to the richness of the end products. UCL is fortunate that the Whittington Hospital, and the department of cardiovascular medicine in particular, is committed to a long-term vision built around this work. That vision, outlined within this report, is shared by the Camden and Islington Health Authority and by many other purchaser and provider organisations in the area, and by a number of industrial parties. They are collectively determined to support the Demonstrator Site as an ongoing project well beyond the life of the EC SynEx Project. This report, although a final report as far as the EC project is concerned, is really a description of the first phase in establishing a centre of healthcare excellence. New EC Fifth Framework project funding has already been approved to enable new and innovative technology solutions to be added to the work already established in north London

Information architecture for a federated health record server

This paper describes the information models that have been used to implement a federated health record server and to deploy it in a live clinical setting. The authors, working at the Centre for Health Informatics and Multiprofessional Education (University College London), have built up over a decade of experience within Europe on the requirements and information models that are needed to underpin comprehensive multi-professional electronic health records. This work has involved collaboration with a wide range of health care and informatics organisations and partners in the healthcare computing industry across Europe though the EU Health Telematics projects GEHR, Synapses, EHCR-SupA, SynEx and Medicate. The resulting architecture models have fed into recent European standardisation work in this area, such as CEN TC/251 ENV 13606. UCL has implemented a federated health record server based on these models which is now running in the Department of Cardiovascular Medicine at the Whittington Hospital in North London. The information models described in this paper reflect a refinement based on this implementation experience

Immersive Composition for Sensory Rehabilitation: 3D Visualisation, Surround Sound, and Synthesised Music to Provoke Catharsis and Healing

There is a wide range of sensory therapies using sound, music and visual stimuli. Some focus on soothing or distracting stimuli such as natural sounds or classical music as analgesic, while other approaches emphasize the active performance of producing music as therapy. This paper proposes an immersive multi-sensory Exposure Therapy for people suffering from anxiety disorders, based on a rich, detailed surround-soundscape. This soundscape is composed to include the users’ own idiosyncratic anxiety triggers as a form of habituation, and to provoke psychological catharsis, as a non-verbal, visceral and enveloping exposure. To accurately pinpoint the most effective sounds and to optimally compose the soundscape we will monitor the participants’ physiological responses such as electroencephalography, respiration, electromyography, and heart rate during exposure. We hypothesize that such physiologically optimized sensory landscapes will aid the development of future immersive therapies for various psychological conditions, Sound is a major trigger of anxiety, and auditory hypersensitivity is an extremely problematic symptom. Exposure to stress-inducing sounds can free anxiety sufferers from entrenched avoidance behaviors, teaching physiological coping strategies and encouraging resolution of the psychological issues agitated by the sound

Enabling Entry Technologies for Ice Giant Missions

The highest priority science goals for Ice Giant missions are: 1) Interior structure of the Planet, and 2) Bulk composition that includes isotopes and noble gases. The interaction between the planetary interior and the atmosphere requires sustained global measurements. Noble gas and Isotope measurements require in situ measurement. Drag modulated aerocapture utilizing ADEPT offers more mass delivered to the Ice Giants than with propulsive orbit insertion. The Galileo Probe entered at a hot spot which created interpretation challenges. Juno is providing valuable orbital measurements, but without in situ measurements the story is incomplete. Planetary scientists interested in Ice Giant missions should perform mission design studies with these new Entry System technologies to assess the feasibility within the context of the international collaboration framework. A mission architecture that includes probe(s) along with an orbiting spacecraft can deploy the probes at the desired location while taking simultaneous measurements from orbit to provide invaluable data that can correlate both global and local measurements. Entry System Technologies currently being developed by NASA are poised to enable missions that position the Orbiter & Probes through drag modulated aerocapture (ADEPT), and HEEET enables the Probes to survive the extreme environments encountered for entry into the atmospheric interior