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IT110Course Work # 3 (Revised)Bergantin, Nathan (IT-3)May 26, 2015Buenaventura, Arvin (IT-3)

mHealth Program Professor Mideth B. Abisado

General Purpose:To influence my readers the possible future of Medical Care.

Specific Purpose:The purpose of the study is to determine what are the impacts of digital Medicare and its distribution of public health care in thecountry.

Central Idea:Now is the time that we should focus more on improving our health. By doing such, we must not sacrifice data privacy by complying with the Health Insurance Portability and Accountability Act (HIPAA) and offer the best Quality of service (QoS).

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TABLE OF CONTENTSIntroduction....................................................................................................................................................2 Orienting Material.....................................................................................................................................3BODY............................................................................................................................................................3I. An Interactive Search System for Healthcare Services..............................................................................3 A. Electronic Medical Record retrieval systems........................................................................................4 B. Medical Retrieval System Design.........................................................................................................4 C. Medical Retrieval Model.......................................................................................................................6 D. Medical Retrieval Algorithm................................................................................................................7II. Doctors Search Engine based on ICD-10 (10th International Statistical Classification of Diseases and Related Health Problems)..............................................................................................................................8 A. Classification of the doctors specialty field..........................................................................................8 B. Construction of the specialist registration system..................................................................................8 C. Construction of Doctors Search Engine.................................................................................................8III. Data Processing....................................................................................................................................... 8 A. A Framework for Web-based Interactive Applications of High-Resolution 3D Medical Image Data................................................................................................................................................................8 B. Real-time monitoring of patients on remote sites................................................................................11 C. Using 3rd party services to provide a secure web-based medical environment...................................11References....................................................................................................................................................12

IntroductionHealth, an issue that has plagued doctors over the past centuries. In today's day and age, Information Technology has set the bar on healthcare even further, with the help of the World Wide Web, or more collectively known as the Internet has bridged the gap between patients and doctors alike. But the same can be said with all possibly new consequences that IT has brought along with it. With today's technology people have become ever increasingly lazy due to the fact that machines and computers do most of the work for us, thus, making them more vulnerable to certain diseases and illnesses. Doctors have made an attempt to remedy this situation, or rather, a quickfix so to speak by making them known and providing their services worldwide through the use of web-based healthcare systems.

Unfortunately, prior attempts have fallen short due to various complexities and overestimations, and some of them include lack of equipment, this is mostly only a problem for third-world countries who cannot afford to buy the latest equipment. Connectivity is a concern for every country, companies pay a royalty for the fastest internet connection possible, hospitals and emergency clinics who desires to help people globally through the use of the internet will have to pay for top-notch networking equipments to handle the massive surge internet packets coming from thousands, if not, millions of users worldwide who wants to avail for their medical services.

All the stated problems above involves cost, and most of the times, it wouldn't be a problem because equipments are mostly bought once and will be used for a long time. The problem arises when maintenance takes place. It takes both precious time and money to maintain the equipment needed for the information system to perform as expected, and to be on its maximum performance. And most of the time, the cost of maintain these equipment costs more than what the pay doctors and nurses for their professional fees. Developing countries would be in an even worse footing because of all theses stacking costs of equipment, maintenance, and subsequent fees.

Countries who are able on the other hand, such as the United States, were able to create a nationwide-scale healthcare system through the ever controversial Obamacare Website. The website was made as an attempt to consolidate most of the paperwork into digital form, making it easier for patients to acquire medical care on the go, and in the safety of their homes. The problem is that the attempt wasn't properly implemented, plagued with both hardware, software, and networking issues , such as, improper billing, wrong placement of medical records, slow order processing, and multiple congestions that slows the system down to a halt.

This paper is meant to inform readers about the attempts in making an actual, and realistically easy-to-use healthcare website by taking all of the positives from previous attempts, incorporate it into our healthcare system, all the while taking out all the negatives that plagued theirs.Attention Material

A. Healthcare and medical emergency in human life.1. Many countries work towards it.B. Difficulty with patient records1. Records are kept in file cabinets even today.2. Developing countries lack the necessary equipment.C. Advancement in mobile technology1. Faster, lighter, more convenient patient healthcare requires full computerization of records.Orienting Material

A. There have been prior attempts in creating an easier, more mobile friendly approach to medical healthcare.1. Momeda, Ambulance Project, Emergency-112, Multimedia Telemedicine System, Project E-vita, just to name a few. All of which are built around mobility, cost reduction, and reduced treatment times.B. Collection and sharing of medical data from a variety of medical sensors with low latency is a challenge for most developing countries.C. The Internet of Things1. Traditionally, Desktops and Laptops have acted as a gateway between medical sensors and back-end platforms(i.e transferring ECG readings to a database using a laptop)2. The problem with PCs and Laptops is that it is more suited for inhouse work, with the use of mobile phones and applications, solutions become more pervasive and portable.BODYI. An Interactive Search System for Healthcare Services.

A. Electronic Medical Record retrieval systems

1. Unified Medical Language System (UMLS) - consists of knowledge sources and databases of medical vocabularies that allows one to translate various terminologies found in the medical field. [1].1.1 askMEDLINE is a free-text, natural language query tool for clients who doesnt have background knowledge on medical terms used in the program.

*The picture above is a screenshot from askMEDLINE websiteaskMEDLINE provides patients with brief understanding of what their illnesses are and to potentially avoid another encoundter with the disease. Users who wants to know and understand different kinds disease terminologies and brief medical terms can visit their website for free with little to no cost. 1.2. MEDLINE and PubMed are Medical literature database systems.

* The picture above is a screenshot from askMEDLINE website (After searching for )Searched articles are provided with citations and references for patients to further understand and explore upon the topic if they so desire.Other practitioners on the same medical field will have access to more useful information. Such articles are stored within databases for easier retrieval of information.B. Medical Retrieval System Design1. Applying medical knowledge-bases facilitate in increasing productivity in a medical environment, support the making of diagnoses and other types of medical decisions, assist in the training of medical professionals, and can even handle some routine tasks in a medical environment. [13].

2. Knowing user queries Identifying the type of data inquiry depending on the user needs. [7].

*The picture above is based on the SAP Prototype in handling EMRsMobile devices have become powerful enough to process information and access databases like a laptop or a computer.T1.1 Common user queries The client user interface design

*The picture above is based on the SAP Prototype in handling EMRsSoftwares suitable for mobile gives an easier, faster, a more go-to approach in handling patient records, particulary useful for emergencies.This allows both doctors and their clients to access their respective data in keeping track of their health records. This eliminates most of the hassle from previous methods of retrieving data.1.2 Expert user queries The Doctors Electronic Medical Record for the patientC. Medical Retrieval Model

*The picture above is based on the Medical Retrieval Model [1] From the model, patients requests a query for available doctors, doctor's information and availability will be retrieved by the IRS from the medical database. From there the patient will be given out a list of available doctors and their specialized field for their choosing. Upon a successful treatment, patients and doctors can provide their feedback, and that feedback will be stored inside the medical database for future reference for the patient's previous disease and treatment, as well as the doctor's rating.1. Problem Statement. Problems encountered by existing systems [1]1.1 Systems searching accuracy1.2 Defining dynamic objective of users Identifying the Users secondary idea

2. Search Algorithms [1], [2]2.1 Goal based - a temporal difference algorithm to predict users information needs by incorporating both current and predicted knowledge into learning the user profile.2.2 Alternative based - The ANNs-based engine [5] was experimentally proven to be the most prominent one for handling data from alternative sources,2.3 Feedback based - The goal of the system is to maximize the total feedback submissions received by the end of the session.

3. Interactive Retrieval System Architecture [1], [14]

*The picture above is based on the Medical Retrieval System Architecture [1] From the image, the IRS handles and ranks articles based on user preference, history, subejct of interest to be searched for, and results will be given to the user from the medical database. 3.1 Document Scoring 3.2 User profiling

D. Medical Retrieval Algorithm [10] 1. Implementation Issues Issues encountered by existing systems 1.1 State space size The set of values that a single process can take. 1.2 Session Length Impact A sorting algorithm experiment based on the actual transaction time. 1.3 Feedback Size Impact A sorting algorithm experiment based on the users feedback.

2. Sarsa Algorithm for IIR - State-Action-Reward-State-Action [14]

*The picture above is based on the SARSA Algorithm for IIR [141] The algorithm used for querying and prioritizing user requests 2.1 Trained Value function used to select a set of places or countries which are ideal candidates for acquiring relevant informationII. Doctors Search Engine based on ICD-10 (10th International Statistical Classification of Diseases and Related Health Problems)

*The picture above is based on the proposed Doctor Search Engine [2] Search results are processed and gives out a list of available doctors and their specialized field and relational field depending on the user's input.A. Classification of the doctors specialty field [2]1. Doctors relational field2. Doctors specialty field

B. Construction of the specialist registration system1. Creating the databaseC. Construction of Doctors Search Engine1. Creating a suitable algorithm2. Testing and implementationIII. Data ProcessingA. A Framework for Web-based Interactive Applications of High-Resolution 3D Medical Image Data [4-8]1. Types of medical data that can be processed 1.1. Magnetic resonance imaging a test which produces detailed images of soft tissues, bones and other internal body structures1.2. Picture archiving and communication system - a medical imaging technology that provides convenient access to images from multiple systems.

2. Existing systems2.1. MACOSTAT

*The picture above is the user interface of MediTouch Medical Care System2.2. MediTouch

*The picture above is the user interface of prognoCIS running on Linux Operating SystemMeditouch is a web-based management system, it offers a powerful medical billing functionality. The system automatically checks patients' insurance eligibility for 72 hours hours before appointments.

2.3. prognoCIS

*The picture above is NueMD Medical Billing System Company Logo2.4. NueMD

*The picture above is the kareo Medical Database System Company Logo2.5. Kareo

3. Proposed Framework [4]3.1. Data Storage Algorithm [7]

3.1.1. Octree partitioning and labeling - are used for the correct representation of solid objects in a 3D environment, and are the basis for many modeling

3.1.2. Minimum Bounding Box (MBB) - The minimum bounding box of a point set is the same as the minimum bounding box of itsconvex hull

3.1.3. Hilbert Curve - a continuousfractalspace-filling curve

3.1.4. Huffman coding - a particular type of optimalprefix codethat is commonly used forlossless data compression.

3.1.5. LempelZivWelch - a universallossless data compression algorithm3.1.6. JPEG - method of lossy compressionfordigital images3.1.7. JPEG 2000 - is an image compression standard and coding system.

3.2. Data Access Optimization 3.3. 3.3.1. Incremental transmission3.3.2. Group Access

B. Real-time monitoring of patients on remote sites [8]1. Functional Requirements [9]1.1. Communication1.2. Data Access2. Existing monitoring systems2.1. Monitoring Information Service (MIS) - 2.2. Vital Sign Monitoring Service (VSMS) - 2.3. Multimedia Consulting Service (MCS) - 3. System Configuration

C. Using 3rd party services to provide a secure web-based medical environment1. Existing Trusted Third party Services (TTP). [12]

1.1. EUROMEDI+

1.2. EUDAMED

1.3. INFOSEC

2. Security Threats [9]2.1. Java Security Issues 2.1.1. Downloading or accessing the code in mobile apps. security threats while downloading or accessing codes2.1.2. Code Execution issues concerning the execution of an applet which includes the users local resources2.1.3. Network communication issues concerning back-end data privacy

3. Security Enhancements [8-12]3.1.1. Directory Services for Applet Certification ensures the authenticity and integrity of applets3.1.2. Source Code Certification validates the source code3.1.3. Vawing Levels of Trust overcomes execution issues under the users computer3.1.4. Secure Applet Communications secures communication between applets and servers3.1.5. Access Control Management allows privileged applets to access the server3.1.6. One-time keys for anonymous services secures the users account when accessed through a different device3.1.7. Other Communication services integrates to existing medical systems.

References:[1] Daltayanni, M., Wang, C., & Akella, R. (n.d.). A Fast Interactive Search System for Healthcare Services. 2012 Annual SRII Global Conference.[2] Doi, S., Kimura, T., Suzuki, T., & Takabayashi, K. (n.d.). Development of Doctors Search Engine based on ICD-10. The 6th International Conference on Soft Computing and Intelligent Systems, and The13th International Symposium on Advanced Intelligence Systems.[3] Sufi, F., Khalil, I., Fang, Q., & Cosic, I. (n.d.). A mobile web grid based physiological signal monitoring system. 2008 International Conference on Technology and Applications in Biomedicine.[4] Liu, D., Hua, K., & Sugaya, K. (n.d.). A Framework for Web-Based Interactive Applications of High-Resolution 3D Medical Image Data. 19th IEEE Symposium on Computer-Based Medical Systems (CBMS'06).[5] Economou, G., Lymberopoulos, D., Karavatselou, E., & Chassomeris, C. (n.d.). A new concept toward computer-aided medical diagnosis - a prototype implementation addressing pulmonary diseases. IEEE Transactions on Information Technology in Biomedicine IEEE Trans. Inform. Technol. Biomed., 55-65.[6] Ridder, M., Constantinescu, L., Bi, L., Jung, Y., Kumar, A., Kim, J., Fulham, M. (n.d.). A web-based medical multimedia visualisation interface for personal health records. Proceedings of the 26th IEEE International Symposium on Computer-Based Medical Systems.[7] Zhu, Y., Jia, P., Duan, H., & Lu, X. (n.d.). Integration of Medical Information Systems Based on Virtual Database and Web Services. 2009 3rd International Conference on Bioinformatics and Biomedical Engineering.[8] Park, S., Park, J., Ryu, S., Jeong, T., Lee, H., & Yim, C. (n.d.). Real-time monitoring of patients on remote sites. Proceedings of the 20th Annual International Conference of the IEEE Engineering in Medicine and Biology Society. Vol.20 Biomedical Engineering towards the Year 2000 and Beyond (Cat. No.98CH36286).[9] Liu, Q., Lu, S., Hong, Y., Wang, L., & Dssouli, R. (n.d.). Securing Telehealth Applications in a Web-Based e-Health Portal. 2008 Third International Conference on Availability, Reliability and Security.[10] Shepherd, M., Zitner, D., & Watters, C. (n.d.). Medical Portals: Web-based access to medical information. Proceedings of the 33rd Annual Hawaii International Conference on System Sciences.[11] Suapang, P., Dejhan, K., & Yimmun, S. (n.d.). Medical Image Archiving, Processing, Analysis and Communication System for Teleradiology. TENCON 2010 - 2010 IEEE Region 10 Conference.[12] Varvitsiotis, A., Polemi, D., & Marsh, A. (n.d.). Using trusted third party services to provide a secure Web-based medical environment. Proceedings of the 20th Annual International Conference of the IEEE Engineering in Medicine and Biology Society. Vol.20 Biomedical Engineering towards the Year 2000 and Beyond (Cat. No.98CH36286).[13] Doroszewski, J. (n.d.). Ethical and methodological aspects of medical computer data bases and knowledge bases. Theor Med Bioeth Theoretical Medicine, 117-128.[14] Taylor, M. (n.d.). Database retrieval techniques. Proceedings of Twentieth Euromicro Conference. System Architecture and Integration