Development and evaluation of SOA-based AAL services in real-life environments: a case study and lessons learned.

INTRO: The proper use of ICT services can support seniors in living independently longer. While such services are starting to emerge, current proprietary solutions are often expensive, covering only isolated parts of seniors' needs, and lack support for sharing information between services and between users. For developers, the challenge is that it is complex and time consuming to develop high quality, interoperable services, and new techniques are needed to simplify the development and reduce the development costs. This paper provides the complete view of the experiences gained in the MPOWER project with respect to using model-driven development (MDD) techniques for Service Oriented Architecture (SOA) system development in the Ambient Assisted Living (AAL) domain. METHOD: To address this challenge, the approach of the European research project MPOWER (2006-2009) was to investigate and record the user needs, define a set of reusable software services based on these needs, and then implement pilot systems using these services. Further, a model-driven toolchain covering key development phases was developed to support software developers through this process. Evaluations were conducted both on the technical artefacts (methodology and tools), and on end user experience from using the pilot systems in trial sites. RESULTS: The outcome of the work on the user needs is a knowledge base recorded as a Unified Modeling Language (UML) model. This comprehensive model describes actors, use cases, and features derived from these. The model further includes the design of a set of software services, including full trace information back to the features and use cases motivating their design. Based on the model, the services were implemented for use in Service Oriented Architecture (SOA) systems, and are publicly available as open source software. The services were successfully used in the realization of two pilot applications. There is therefore a direct and traceable link from the user needs of the elderly, through the service design knowledge base, to the service and pilot implementations. The evaluation of the SOA approach on the developers in the project revealed that SOA is useful with respect to job performance and quality. Furthermore, they think SOA is easy to use and support development of AAL applications. An important finding is that the developers clearly report that they intend to use SOA in the future, but not for all type of projects. With respect to using model-driven development in web services design and implementation, the developers reported that it was useful. However, it is important that the code generated from the models is correct if the full potential of MDD should be achieved. The pilots and their evaluation in the trial sites showed that the services of the platform are sufficient to create suitable systems for end users in the domain. CONCLUSIONS: A SOA platform with a set of reusable domain services is a suitable foundation for more rapid development and tailoring of assisted living systems covering reoccurring needs among elderly users. It is feasible to realize a tool-chain for model-driven development of SOA applications in the AAL domain, and such a tool-chain can be accepted and found useful by software developers.

Towards quality assurance of AAL services.

The Ambient Assisted Living domain is a fast growing area with many new technological artefacts and services developed. Most of the systems developed address end-users' needs. Yet, they have not achieved a large market penetration. The work presented here argues that this is primarily due to not sufficiently addressing the quality requirements posed by the health care organizations. Satisfying quality requirements requires a standardized and easily accessible framework for measuring quality. We present the initial steps towards such a framework by building on relevant ISO standards.

Interoperability services in the MPOWER Ambient Assisted Living platform.

Ambient Assisted Living systems for the ageing and cognitively disabled do not exist in isolation. What characterizes such systems is the cooperation of several different stakeholders in the care process and the service platforms need to address this. This paper reports on our work in the EU IST MPOWER project where we have designed and implemented interoperability services based on patterns, service-oriented architectures, web services and XSDL transformations. The services we present are freely available as open source under the MIT license.

An investigation of factors influencing healthcare workers' use and acceptance of e-learning in post-school healthcare education.

The objective of the study presented here was to perform an empirical investigation on factors affecting healthcare workers acceptance and utilisation of e-learning in post-school healthcare education. E-learning benefits are realised when key features of e-learning are not only applied, but deemed useful, compatible with the learning process and supportive in order to reach the overall goals of the learning process. We conducted a survey of 14 state-enrolled nurses and skilled-workers within the field of healthcare in Norway. The results show that perceived compatibility and subjective norm explain system usage of the e-learning tool amongst the students. We found that the fact that the students considered the e-learning to be compatible with the course in question had a positive effect on e-learning tool usage. We also found support for factors such as facilitating conditions and ease of use leads to the e-learning tool being considered useful.

Reusing models of actors and services in smart homecare to improve sustainability.

Industrial countries are faced with a growing elderly population. Homecare systems with assistive smart house technology enable elderly to live independently at home. Development of such smart home care systems is complex and expensive and there is no common reference model that can facilitate service reuse. This paper proposes reusable actor and service models based on a model-driven development process where end user organizations and domain healthcare experts from four European countries have been involved. The models, specified using UML can be reused actively as assets in the system design and development process and can reduce development costs, and improve interoperability and sustainability of systems. The models are being evaluated in the European IST project MPOWER.

Evacuation support system for improved medical documentation and information flow in the field.

PURPOSE: Documentation of medical treatment and observation of patients during evacuation from the point of injury to definitive treatment is important both for optimizing patient treatment and managing the evacuation process. The current practice in military medical field documentation uses paper forms and voice communication. There are many shortcomings associated with this approach, especially with respect to information capture and sharing processes. Current research addresses the use of new technology for civilian ambulance-to-hospital communication. The research work presented in this article addresses information capture and sharing in extreme military conditions by evaluating a targeted computerized information system called EvacSys during a military exercise in northern Norway in December 2003. METHODS AND MATERIALS: EvacSys was designed and implemented in close cooperation with military medical personnel in both Norway and the USA. The system was evaluated and compared to the traditional paper-based documentation method during a military exercise. The on-site evaluation was conducted in a military medical platoon in the Norwegian Armed Forces, using questionnaires, semi-structured interviews, observation and video recording to capture the users' system acceptance. RESULTS: A prototype software system running on a commercial off-the-shelf hardware platform was successfully developed. The evaluation of this system shows that the usability of digital information capturing and sharing are perceived to be at least as good as the traditional paper-based method. The medics found the new digital method to be more viable than the old one. No technical problems were encountered. CONCLUSIONS: Our research shows that it is feasible to utilize digital information systems for medical documentation in extreme outdoor environments. The usability concern is of utmost importance, and more research should be put into the design and alignment with existing workflow. Successful digitalization of information at the point of care will provide accurate and timely information for the management of resources during disaster response.

Linkcare--enabling continuity of care for the chronically ill across levels and profession.

Chronic diseases are increasing rapidly and this phenomenon is becoming a major burden to the health delivery system around the world. A new health care paradigm with focus on chronic treatment and care will actualize the need for interoperable standards based services due to the complexity of care where different health levels and professions are involved. Given the complexity of the domain, we argue the need for a systematic and formal approach to the development of interoperable information systems if there shall be any real support of the cooperating actors. We describe our work on technical interoperability done in the Linkcare project addressing new models of care and technology to support them in the domain of the chronically ill using concrete results from an architecture built using the MAFIIA architecture framework and the UML 2.0 profile for software services, and argue that building formal architectural descriptions on the basis of shared interface descriptions and profiles are an important part of achieving continuity of care based on sustainable health systems.

Improving systems interoperability with model-driven software development for healthcare.

An aging population and an increase in chronically ill patients demand teamwork treatment models. To support these with information systems, interoperability is a prerequisite. Model-driven software development (MDSD) with special healthcare extensions can enable reuse of components and improve conformance to international standards. In this paper, a MDSD HealthCare Framework is proposed and demonstrated for homecare services. Using the framework, information systems will improve their conformance to international standards and the interoperability with other systems.