A self-learning nurse call system.

The complexity of continuous care settings has increased due to an ageing population, a dwindling number of caregivers and increasing costs. Electronic healthcare (eHealth) solutions are often introduced to deal with these issues. This technological equipment further increases the complexity of healthcare as the caregivers are responsible for integrating and configuring these solutions to their needs. Small differences in user requirements often occur between various environments where the services are deployed. It is difficult to capture these nuances at development time. Consequently, the services are not tuned towards the users' needs. This paper describes our experiences with extending an eHealth application with self-learning components such that it can automatically adjust its parameters at run-time to the users' needs and preferences. These components gather information about the usage of the application. This collected information is processed by data mining techniques to learn the parameter values for the application. Each discovered parameter is associated with a probability, which expresses its reliability. Unreliable values are filtered. The remaining parameters and their reliability are integrated into the application. The eHealth application is the ontology-based Nurse Call System (oNCS), which assesses the priority of a call based on the current context and assigns the most appropriate caregiver to a call. Decision trees and Bayesian networks are used to learn and adjust the parameters of the oNCS. For a realistic dataset of 1050 instances, correct parameter values are discovered very efficiently as the components require at most 100ms execution time and 20MB memory.

Towards computerizing intensive care sedation guidelines: design of a rule-based architecture for automated execution of clinical guidelines.

BACKGROUND: Computerized ICUs rely on software services to convey the medical condition of their patients as well as assisting the staff in taking treatment decisions. Such services are useful for following clinical guidelines quickly and accurately. However, the development of services is often time-consuming and error-prone. Consequently, many care-related activities are still conducted based on manually constructed guidelines. These are often ambiguous, which leads to unnecessary variations in treatments and costs.The goal of this paper is to present a semi-automatic verification and translation framework capable of turning manually constructed diagrams into ready-to-use programs. This framework combines the strengths of the manual and service-oriented approaches while decreasing their disadvantages. The aim is to close the gap in communication between the IT and the medical domain. This leads to a less time-consuming and error-prone development phase and a shorter clinical evaluation phase. METHODS: A framework is proposed that semi-automatically translates a clinical guideline, expressed as an XML-based flow chart, into a Drools Rule Flow by employing semantic technologies such as ontologies and SWRL. An overview of the architecture is given and all the technology choices are thoroughly motivated. Finally, it is shown how this framework can be integrated into a service-oriented architecture (SOA). RESULTS: The applicability of the Drools Rule language to express clinical guidelines is evaluated by translating an example guideline, namely the sedation protocol used for the anaesthetization of patients, to a Drools Rule Flow and executing and deploying this Rule-based application as a part of a SOA. The results show that the performance of Drools is comparable to other technologies such as Web Services and increases with the number of decision nodes present in the Rule Flow. Most delays are introduced by loading the Rule Flows. CONCLUSIONS: The framework is an effective solution for computerizing clinical guidelines as it allows for quick development, evaluation and human-readable visualization of the Rules and has a good performance. By monitoring the parameters of the patient to automatically detect exceptional situations and problems and by notifying the medical staff of tasks that need to be performed, the computerized sedation guideline improves the execution of the guideline.