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Distributed healthcare framework using patient-centric role-based security modelling and workflow

Symes, Mat


Mat Symes


Healthcare professionals are spending less time with patients and more time on administrative duties (Royal College of Nursing, 2008). This is due to a high bureaucratic demand (Brindley, 2007) on the caring process, patient population and longevity (Fougère and Mérette, 1999). A patient-centric system uses gathered information and includes the patient in its functional design (IBM, 2006). Patient-centric requirements have existed in UK healthcare IT since 2000 (Fairway, 2000). Some existing systems cannot be patient-centric. This is because the strategies that shape the requirements for IT systems have changed over time (Mackenzie, 2004); therefore, information technology solutions, built in different times, meet different healthcare requirements. The data created in these differing systems can become disparate and less useful (Singureanu, 2005). Patient information is sensitive; medical healthcare professional roles, such as doctors can only access a patient’s health record at appropriate times. Other healthcare professionals must ask for a patient’s permission to access their health record whilst other roles in the National Health Service (NHS) are only entitled to nonmedical information (Scottish Consumer Council, 2007). This implies that viewing patient data attributes are only permissible by role.
The aim of this project is to provide a patient-centric prototype distributed system that can demonstrate approaches to reducing complexity through data and interface integration; increasing visibility through relevant role based information targeting; and reducing administrative overhead through electronic workflow.
This report examines the history of IT strategies in the NHS, identifying some of the key aims from 1992 to 2008. It then discusses some of the standards defined to allow differing systems to communicate and highlights some of the existing IT systems in healthcare today.
The system design allows patients to interact with the in same way as healthcare professional, it provides access to personal space that displays tasks for the patient or healthcare professional to complete. Data integration is used to build a patient record from local and disparate data sources. Information targeting allows the patient or healthcare professional to visit an area that only displays information relevant to the person there. Finite State Machine methodologies are used to design an electronic workflow, which maps a business process of making a referral.
Using the Microsoft Office SharePoint Server information management framework, data integration is achieved through XML definition and the gathering of meta-data (Hoffman and Foster, 2007). Information targeting is achieved through personalised filtering and security permission modelling (Holiday et al., 2007); workflow is accomplished through the application of design; manipulation of the framework and dedicated workflow (Mann, 2007) code libraries built on top of popular ASP.NET web server technology (Walther, 2006).
This project finds that whilst it is possible to implement these approaches in theoretical context, more research is required into the application of such approaches in real world scenarios. In addition this report finds that software boundaries within the framework suggest the capacity for vast record user, security and management (Curry et al., 2008), however, research into the factors that affect these boundaries, such as concurrency and healthcare professional/ patient activity on such systems, is required in order extrapolate accurate scalability...

Thesis Type Dissertation
Deposit Date Dec 22, 2010
Publicly Available Date Dec 22, 2010
Peer Reviewed Not Peer Reviewed
Keywords Patient-centric system; healthcare professionals; IT solutions; health records; patient data; distributed system; information targeting; electronic workflow; security permission modelling; ASP.NET web server technology;
Public URL
Contract Date Dec 22, 2010
Award Date 2008-08


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