an efficient multi-agent system for e-health functionalities

7/28/2019 An Efficient Multi-agent System for E-health Functionalities

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International Journal of Software Engineering and Its Applications

Vol. 7, No. 3, May, 2013

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An Efficient Multi-agent System for E-health Functionalities

Mohammad Kalmarzi Moghaddam1, Mohammad Shojafar

2

Mohammad Reza Nami3

and Hassan Rashidi4

1Faculty of Electrical, IT and Computer Engineering, Qazvin Islamic Azad

University, Qazvin, Iran2Department of Information Engineering, Electronics Technology(DIET), Sapienza

University of Rome, Rome, Italy3Faculty of Electrical, IT and Computer Engineering, Qazvin Islamic Azad

University, Qazvin, Iran4Faculty of Electrical, IT and Computer Engineering, Qazvin Islamic Azad

University, Qazvin, [email protected],

[email protected]

[email protected],

[email protected]

Abstract

In recent years Agent technology has had a significant growth in all fields, especially inthe field of E-health. Agent-oriented software engineering based on agent-oriented

methodology is a novel phenomenon in the field of software engineering, which nowadays, isused in the production of distributed systems. The special features of agent such asintelligence and autonomy, cause reduction in running costs and performing automatic

functions in some systems like electronic health which have been implemented by Agenttechnology. Using New communication technologies, distributed systems and intelligent

Agents are also considered as a novel phenomenon in medicine. This paper aims to analyze

the Agent-oriented Software engineering, Agent Oriented Programming, Multi Agent Systemas well as providing agent-based system for the hospital by the utilization of agent

characteristics.

Keywords:Agent-oriented software engineering, Multi Agent System, Agent OrientedProgramming, E-health, hospital information system

1. Introduction

Agent-oriented software engineering was introduced quickly to respond to software

engineering basic needs and agent-based computing. Relying on agent-based computing,software engineering has been able to create secure applications in the field of E-health[1]. On the other hand the increasing need of software with complex operations, broadly

distributed, open source, dynamic and unpredictable with many interactions and

environmental programs have caused rapid growth of agent-oriented softwareengineering. Agent-Oriented Programming is a relatively new software paradigm that

brings concepts from the theories of artificial intelligence into the mainstream realm ofdistributed systems.

AOP essentially models an application as a collection of components called agents

that are characterized by, among other things, autonomy, proactively and an ability tocommunicate. Being autonomous they can independently carry out complex, and oftenlong-term, tasks while proactively make them able to perform a given task even without


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an explicit stimulus from a user. Finally being communicative they have the power tointeract with other entities to assist with achieving their own and others goals. Thearchitectural model of an agent-oriented application is intrinsically peer to peer, as any

agent is able to initiate communication with any other agent or be the subject of anincoming communication at any time [2].

In 2004 World Health Organization declared that E-health is one of the main pillarsfor improving public health in the entire world [3]. E -health has established connectionbetween medical science and engineering and in this way medical community is able touse engineering facilities Such as information technology infrastructure to improve the

level of public health. Some of the main reasons of creating electronic health seem tobe creating privacy and security for citizens, protection of various cultures andlanguages, Interaction ability between information systems, saving time and money andimproving access to the services. Among the systems using E-health, hospitalinformation system is noticeable. E-health is used for tasks such as: Updating hospitals,increasing proficiency, helping the hospital on admission, discharging, getting answers,

medical requests and referring to previous information. In addition to all factors abovewas increasing patient satisfaction and providing a better service. It is considered anelectronic health benefit that is used in the hospital information system. TeleNursing

and Telemedical, using telecommunications technology improve tasks like taking careof patients by nurses [4]. This technique uses communication channels for transferringdata, voice and image between human and computer. The idea of virtual organizations,

projects, necessities and their challenges, such as management, proficiency, security

and trust between members have played a key role in the presentation of a distributedhealth system. According to the characteristics of autonomy, the intelligence agent,value and great interest to the E-health, these two technologies can be combined todesign critical, intelligent and sensitive systems in order to help and improvecommunity health status.

Thus through this paper an agent-based System for hospitals is considered necessary

and crucial, in which agent correlative character is used to increase system flexibilityand security. Through the paper it is aimed to analyze the following factors: Section 2studies Agent oriented software engineering; Section 3 describes the agent oriented

platform. Section 4 focuses on Multi agent system in E-health. Section 5, describes theE-health and presents advantages of applying Information technology in E-health andfinally illustrates An Agent-based system for Hospital.

2. Agent Oriented Software Engineering

Agent-oriented software engineering is based on agent. The main goal of agent-

oriented software engineering is to create methodology, tools and facilities for Simplepreparation and maintenance of the agent -based software. Due to the fact that object-oriented software engineering is unable to response the requirement of the agent-based

software ,an urgent need of a new engineering coordinated to the view of agent, arose.

That caused agent-oriented software engineering development out of the object-orientedsoftware engineering. The appearance of agent technology caused a revolution in thesoftware industry and has had great advantages, such as autonomy, interaction,Knowledge base and intelligence. Thus Agent can be considered as an abstraction levelof software [5].

In general it can be assumed that Agent software engineering having thecharacteristics inherited from the Object software engineering is able to do thingsindependently to accomplish the task instead of its users. Agent can make the best


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decisions in the shortest time and the negative impact of environmental factors. Mainfeatures of agents include:

Autonomy: It improves the power of decision-making and performance

independently without supervisory and external Control of the agent. Mentalmechanisms: Realization of Goal Mechanisms in agent. Adaptability: Agents are

compatibles to the dynamic environmental changes to adjust their activities.Concurrency: multi tasking of an agent. Cooperation: There are some methods thatagents can cooperate with the other agents to achieve the goals. Reactive: this featuregives the early reactive abilities to agent against environmental changes .Benefit: It

gives the agent perseverance to get to the new goals .Communications: Protocols andmechanisms for identifying agent's mutual-reaction. Sociality: It gives the agent theability to interact with other agents. GAIA, MaSE methodologies are such standardagent-oriented methods in Production of Intelligent complex software systems inDistributed systems.

In Table 1, It shows compares the GAIA and MaSE methodologies based on the view

above [6-7].

Table 1. Comparison of Agent oriented Methodologies

Properties GAIA MaSE

Autonomy Good Good

Mental mechanism No Goal, Tasks

Adaptability Good No

Concurrency Good GoodCooperation Good Good

Communications Good Good

Reactive Good Good

Benefit Good Good

Sociality Middle Middle

3. Agent Oriented Programming

The Agent technology has been the subject of many extensive discussions andinvestigations within the scientific community for several years. However only recently

it has gained a significant degree of exploitation in commercial applications. Multi -agent systems are being used in an increasingly wide variety of applications, rangingfrom comparatively small systems for personal assistance to open, complex, mission-critical systems for industrial applications. Examples of industrial domains wheremulti-agent systems have been fruitfully employed include process control, systemdiagnostics, manufacturing, transportation logistics and network management [2].

When adopting an agent-oriented approach to solving a problem, there are a numberof domain independent issues that must always be solved, such as ways to allow agentsto communicate. Rather than expecting developers to develop this core infrastructurethemselves, it is convenient to build multi-agent systems on top of an agent-orientedmiddleware that provide the domain-independent infrastructure, allowing thedevelopers to focus on the production of the key business logic [2]. Building andimplement multi-agent environments, tools and applications are available. Following

describes Jade Technology for Agent oriented Programming.


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3.1. Jade Technology

Jade a distributed middleware is a flexible structure that is easily spread. Jadeframework makes agent oriented system design simple through implementing agent anda set of graphical tools.

Jade is completely Java based, having the same characteristics and book collections

programming. Thus designers are able to perform multi agents systems. Javatechnology can be added to a library in java language. Following we can see Jadecharacteristics more:

Multi-part application; Interoperability; Having open source; Diversity; Easy to use mobile software.

4. Multi Agent System

Author Multi-agent systems, is following a growing field of distributed artificialintelligence. The main goal of multi-agent systems is to provide structure principles ofcomplex systems involving several agents and Mechanisms to coordinate the behavior

of these agents. Coordination subject in multi agent systems is the fundamental issue,without which the benefits such as interaction and social behavior of agents fade [8, 9].Multi-agent systems in creating and developing vital systems, non-coherent, dynamic,complex, distributed and communication between remote users are useful to create E-health applications [8]. Agents are working together to achieve common goals in thesystem. Agent cooperation can increase processing speed and by its special

characteristics such as intelligence and knowledge base increase the quality andefficiency. An expert's important decision about a patient and finally the decision

better-running and operation is a typical example of these benefits. Nowadays, agentshave an important and basic role in many practical programs of E-health among whichthe disease diagnosis system, the ease and accelerate in treatment and prevention ofdynamic data distribution are noticeable. Thus E-health features, especially the

interaction and communication, have increased the need of agent.The best ideas for creating the practical programs of E-Health and supporting next

generation are practical programs and services of E-health multi-agent systems. In a

sense, the health systems will be implemented easily in suitable environments forintelligent multi-agent systems [9]. Important reasons for using multi-agent systems can

be mentioned as below [8]:

Necessity of some domain to multi -agent systems; To increase the speed with parallelism; Reliability; Extensibility; Programmer easier.


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5. E-health

The In recent decades, great advances have been done in development of E-healthtechnology as a way for tele-medical care which is supported by modern digital

communications media. E-Health covers a set of different concepts such as health,technology and trade. At first e-health was introduced by NASA to offer medical advice

to the astronauts and their treatment by telemedicine [10]. E-health uses networks,computers and information technology to manage, store and electronic retrieve of

patient's information instead of using paper and wardrobe full of confusion. E-Healthobjectives can be mentioned as enhancing the quality of health care, providing

integrated health care and access improvement to services. The features of electronichealth systems are considered protection of patient's information privacy and fairness inthe enjoyment of E-health independent of color, language, geography, culture andinteraction between information systems. The next sections will be focused on thedomains related to E-health and electronic health record [11].

5.1. Multi Agents in E-health

Multi-tasking systems are helpful in creating and developing vital, heterogeneous,

dynamic, complicated and distributed systems among agents to make e -health programspractical and possible.

Agents work together to meet the common goals of the system. This cooperation

enhances the system speed and through its unique features including intelligence andknowledge improves the quality and practicality. A specialists right decision on a

patient and eventually the success of the operation is a noticeable example of this point.

Nowadays Agents play essential roles in the practical programs of E-health, whichincludes the diagnosing system, facilitating and accelerating the treatment process andavoiding disorganized data system. Special features of E-health includingcommunication and interaction increases the need for agents. The best way to create E-health practical programs and to support the future generation is multi -tasking systems.In other words, E-health is easily practical in proper environments with multi-tasking

systems.The distributed artificial intelligence is used in creating soft wares based on

intelligent agents in E-health special parts. The controversial issues here are:Communicative protocols among electronic groups including, negotiation template,

virtual chat rooms , role definition, agents responsibilities, reorganizing the system in adynamic way when new members sign in , as agents or a creating a new multi-tasking

system with new objectives.Security relating to very agent, sources and the whole E -clinic systems. Determining

and conducting security rules and regulations.Determining Trust parameters for the members of multi-tasking systems. This means

that in case anything happens to each of the members who is actually known as anintelligent agent, they can figure the problem out and substitute a well qualified agent

for the former. Then the system will be automatically reconstructed and reorganized.

5.2. Benefits of using electronic health Technology

In this section benefits of using electronic health are analyzed which include [12]:

Efficiency - one of the objectives of E-health is to increase efficiency inhealth care, which leads to a decrease in costs. One possible way of


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decreasing costs would be by avoiding duplicative or unnecessary diagnosticor therapeutic interventions, through enhanced communication possibilities

between health care establishments, and patient involvement.

Enhancing quality of care - increasing efficiency not only reduces costs, butit also increases quality simultaneously. E-health may enhance the quality of

health care by allowing comparisons between different providers, involvingconsumers as additional power for quality assurance, and directing patient

streams to the best quality providers.

Evidence based - E-health interventions should be evidence-based in a sensethat their effectiveness and efficiency should not be assumed but proven byrigorous scientific evaluation. Much work still has to be done in this area.

Empowerment of consumers and patients - by making the basic knowledge ofmedicine and personal electronic records accessible to consumers over theInternet, E-health opens new ways for patient-centered medicine, and enablesevidence-based patient choice.

Encouragement of a new relationship between the patient and healthprofessional, towards a true partnership, where decisions are made in a sharedmanner.

Education of physicians through online sources (continuing medicaleducation) and consumers (health education, tailored preventive informationfor consumers).

Enabling information exchange and communication in a standardized waybetween health care establishments.

Extending the scope or the domain of health care beyond its conventionalboundaries. This is meant in both a geographical sense as well as aconceptual sense.E-health enables consumers to easily obtain health services

online from global providers. These services can range from simple advice to

more complex interventions or products such as pharmaceuticals.

Ethics - E-health involves new forms of patient-physician interaction andposes new challenges and threats to ethical issues such as online professional

practice, informed consent, privacy and equity issues.

Equity - One of the objectives of E-health is that to make health care moreequitable, but at the same time there is a considerable threat that E-healthmay deepen the gap between the "haves" and "have-nots".

People, who do not have the money, skills, and access to computers and networks,cannot use computers effectively. As a result, these groups of patients are those who arethe least likely to benefit from advances in information technology, unless political

measures ensure equitable access for all. The digital divide currently runs between ruralvs. urban populations, rich vs. poor, young vs. old, male vs. female , and between rarevs. common diseases.

In addition to these 10 essentials, E-health should also be

Easy-to-use; Entertaining; Exciting.


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5.3. Electronic Health Record

Electronic health record is a digital form of patients medical records. In this record,

personal information, medical records and issues related to patient health are stored.

Features of electronic health records are reducing errors, increasing security, saving

time, sharing, and giving authority to patient in his care and increasing health through

the use of medical records. Sharing resources are done according to international

security standards [13].

In Table 2, it shows compares the electronic health record with IT technologies

which can be created and filled. Patient records are manually filled which will be

discuss in the form.

Table 2. Comparison of electronic health records with the records manually

Area Electronics Manually

Location

Available

Always and

Available Always

but special place

Show All FormatsOnly One specific

Form

Purpose

And

Access to

information

Various and

unlimitedSpecific and

limited

Save

informationActive Inactive

Space Compact Non-Compact

Cost - Expensive

RetrievalQuick and

eas

Sometimes

im ossible

6.Proposed model for agent-based Hospital Information System

Creating agent-based systems can guarantee better service to patients. This section

provides an agent -based system. In Figure 1, the use case diagram of agent -based

hospital information system is displayed.


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Figure 1. The agent-based system use case diagram

In this system, health sector includes the following: critical and sensitive sectors

such as operating rooms and heart section. Patients have direct communication with

admission Section, discharge, operating health, nurse agent and doctor agent. Doctors

and nurses can update medical and nursing knowledge base of hospital. Agents relevant

to the database can be updated. Agent can make sensitive decisions away from the

tiredness and mistake, according to their features, and inform the doctor and the nurse.

Class diagram shows communication between the entities.In Figure 2, Agent-based hospital information system class diagram and their relation

that includes zero, one or infinity is displayed with an asterisk.


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Figure 2. The agent-based hospital information system class diagram

The agent-based hospital information system in addition to having the agent

characteristics is included the fo llowing benefits that will be in [8]:Using agent and paying attention to intelligence, autonomy, interaction and

knowledge base features. Reduce human error due to fatigue, stress, inexperience. If the

tasks are the same the factor can be shared and can b e used. Saves time and costs.

It must be noted that owing to the sensitivity of agent-based hospital information

system, the agent must be designed carefully. Design, implement and managing the

knowledge base for such a system is considered as one of software engineer skills. [14].

Agent-based self-management systems in various applications has been implemented

and proposed for distributed virtual environments [15]. Although object-oriented

software engineering is used in the implementation of current hospital information

systems, the major weakness of this technology, particularly in terms of intelligence

and autonomy has led to the future need of the agent idea. The complexity of the

proposed system can be managed by using self -computing ideas [16]. The combination

of self-management and agent technology results in improvement in efficiency and cost

reduction and management of non-homogeneous distributed systems.


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7. Conclusion

Consequently it was assumed that Agent oriented software engineering aided agent

oriented methodologies, and has facilitated Software development in agent-based

distributed systems. Main features of an agent in producing intelligent multi-agent

software systems including autonomy, intelligence and intelligent interaction have beenmet the requirement of advanced software in such environments. E-health is an

appropriate area to create agent-based systems. Agent technology using some features

causes services improvement and E-health communication challenges.

Finally this paper tried to analyze the agent-oriented software engineering and E-

health. Then, it has provided agent-based system for the hospital by using the agent

characteristics. It was seen that the combination of self-management and agent

technology caused improvement in efficiency and cost reduction and management of

non-homogeneous distributed systems.

References

[1] R. Annicchiarico, U. Corts and C. Urdiales, Agent Technology and e-Health, Springer, Birkhauser, Basel,(2008).

[2] F. L. Bellifemine, G. Caire and D. Greenwood, Developing Multi-Agent Systems with JADE, Wiley, WestSussex, (2007).

[3] B. E. Dixon, A Roadmap for the Adoption of e-Health, J. e-Service, vol. 5, no. 3, (2007), pp. 3-13.[4] L. M. Camarinha-Matos, Tele-Care and Collaborative Virtual Communities in Elderly Care, Proceedings of

1st International Workshop on Tele-Care and Collaborative Virtual Communities in Elderly Care, Porto,Portugal, (2004).

[5] J. C. Garcia-Ojeda, S.A. DeLoach and Robby, Agent-Tool Process Editor: Supporting the Design ofTailored Agent-based Processes, Proceedings of 24th Annual ACM Symposium on Applied Computing, ,

Hawaii, USA, (2009).

[6] L. Cernuzzi, T. Juan L. Sterling and F. Zambonelli, The GAIA Methodology: Concepts and Extensions,Proceedings of Methodologies and Software Engineering for Agent Systems, Springer, (2005).

[7] K. Hoa Dam and M. Winikoff, Comparing Agent-Oriented Methodologies, Proceedings of 5th InternationalBi-Conference Workshop, AOIS 2003, Springer, Melbourne, (2004).[8] S. A. DeLoach, Multi-agent Systems Engineering of Organization-based Multi-agent Systems, Proceedings

of 4th International Workshop on Software Engineering for Large-Scale Multi-Agent Systems, Springer, vol.3914, (2006), pp. 109-125.

[9] S. A. DeLoach, Moving Multi-agent Systems from Research to Practice, J. International Journal of Agent-Oriented Software Engineering, (2009).

[10] E. A. Miller, Solving the disjuncture between research and practice: Tele-health trends in the 21st century,

Health Policy, vol. 82, no. 2, (2007), pp. 133-141.[11] M. Marlene, M. Maheu, P. Whitten and A. Allen, E-Health, Tele-health, and telemedicine: a guide to start-

up and success, Wiley, Jossey-Bass, (2001).[12] National Center for Biotechnology Information, DOI: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC17618

94/.[13] N. Armstrong, H. Hearnshaw, J. Powell and J. Dale, Stakeholder perspectives on the development of

a virtual clinic for diabetes Care: qualitative study, J.Internet Medical Research, vol. 9, no. 3,

(2007).[14] M. Eichelberg, T. Aden and J. Riesmeier, A survey and analysis of Electronic Healthcare Record

standards, ACM, New York, vol. 37, no. 4, (2005), pp. 277-315.[15] B. Ghosh and J. E. Scott, Effective Knowledge Management Systems for a Clinical Nursing

Setting, vol. 24, pp. 73-84, Information Systems Management, (2007).

[16] F. Guidi-Polanco, C. Cubillos and G. Menga, The global automation platform: An agent-basedframework for virtual organizations, In: International Federation for Information Processing, vol.186, (2005), pp. 577-584.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC17618%2094/http://www.ncbi.nlm.nih.gov/pmc/articles/PMC17618%2094/http://www.ncbi.nlm.nih.gov/pmc/articles/PMC17618%2094/http://www.ncbi.nlm.nih.gov/pmc/articles/PMC17618%2094/


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Authors

Mohammad Kalmarzi Moghaddam received hid Bsc in Computer

Engineering-Software from Qazvin Islamic Azad University, Qazvin,Iran, 2011. He is Specialist in Network security and Artificial

intelligence. He is Presented papers in local conferences. Kalmarzisfocus of study is object and Agent Oriented Software Engineering andmulti agent systems, E-health, Network security and agent-based IDS.

Mohammad Shojafar is PhD Student in InformationCommunication Technology at Sapienza University of Roma from

November 2012. He Received his Msc in Software Engineering inQazvin Islamic Azad University, Qazvin, Iran in 2010.Also, he

Received His Bsc in Computer Engineering-Software major in IranUniversity Science and Technology, Tehran, Iran in 2006.

Mohammad is Specialist in Network Programming in Sensor fieldand Specialist in Distributed and cluster computing (Grid Computingand P2P Computing) and AI algorithms (PSO, LA, GA). He has

published more than 10 conference papers and 4 well -known

journals in his interests .

Mohammad Reza Nami received a PhD scholarship from the MSRT. He is currently aPhD Researcher. He started his PhD research at TU Delft University under the supervision ofProfessor Stamatis Vassiliadis, who passed away in 2007. He then pursued his PhD at IUST

and Amirkabir University in Iran. Nami has published more than ten papers in internationaljournals and conferences on his PhD thesis. His research interests are formal methods, E-

health, Software agent technology, autonomic computing, and virtual organizations.

Hassan Rashidi received the Ph.D. from Birmingham University,

London, England in 2006. He is an assistant professor in the Electrical,It, Computer Department of Qazvin Islamic Azad University, Qazvin,Iran and a faculty member in Department of Statistics, Mathematics, andComputer Science at Allameh Tabatabai University, Tehran, Iran. His

research interests are software engineering aspects and Multi agentsystems. He has published books in programming and softwaretrends. He has also published more than 30 papers in international

journals and conferences.


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an efficient multi-agent system for e-health functionalities

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