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roomagitatedInternet and Web Development

Dec 8, 2013 (3 years and 6 months ago)

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PhysioLog


Integrated Health Log/ Physiolog

Rogier Brussee,

ICME 2005

2005 7 7

Physiolog aka Multimedian N9 Media WP 7/8

Part of the MultimediaN media project

Partners:

IBM (Leon van den Oord, Erik Rongen, Jasper
Schroder, Ellis Zijlstra)

Roessingh Research and Development (RRD)
(Hans Bloo, Victorien Erren, Leendert Schaake)

TI (Paul Porskamp, Rogier Brussee)

In gesprek met : VL
-
e (virtual laboratory Amsterdam),
Univ. Delft.



Pilots PhysioLog: research tracks


Roessingh Research and Development (RRD)

Two scenarios


Diagnose trajectory (treatment of patient)


Objectify gait analysis with multimedia enrichment


Integrated Health care, health professionals working
together (Transmurale zorgnetwerken)


Video analysis as services operating on sensitive data

IBM

Physiolog goals

Infratructure for sharing patient data between a
network of physiotherapist

Infrastructure for media services that can handle
handle sensitive data

pilot with real patients and real therapists

Physiolog: content for Physiotherapists

The patients: an example

Scenario : before and after operation
(previous situation)

Patient may benefit from invasive operation

Surgeon requests opinion from movement analyst

Forms are filled in for Anamnese

Patient video is made for movement analysis on VHS

Movement analyst describes in structured language
what she sees

Forms + Report is printed and send to surgeon

Decision is made on operation in collaboration.

After recovery patient is sent back to movement
analysts



Scenario : before and after operation
(Physiolog situation)

Patient may benefit from invasive operation

Surgeon requests opinion from movement analyst

Forms are filled in for Anamnese
in physiolog

Patient video is made for movement analysis
video is
uploaded

Some Video analyse is done (in progress)

Movement analyst describes in structured language
what she sees
and can point to video


Forms + Report
+ Video

is made accessible to
surgeon

Decision
based on same data

is made on operation in
collaboration.

After recovery patient is sent back to movement
analysts


Gait analysis results: rich multimedia information set

Muscle analysis: EMGs

Ground Reaction Forces

Forms & documents

flexion

Degrees of

Motion

0

10

10

20

30

40

50

60

percentage of Gait Cycle

0

10

20

30

40

50

60

70

80

90

100

extension

Kinematics

Joint Motion Analysis

Image analysis / enrichment challenge

Physiotherapist at home of patient
flexion

Degrees of

Motion

0

10

10

20

30

40

50

60

percentage of Gait Cycle

0

10

20

30

40

50

60

70

80

90

100

extension

Access: Teleconsultation and casuistic

Communication between healthcare professionals

huisarts

Eerste

Lijn

logo

ergo

fysio

wijkverpl.

Pati
ent

maatsch.

werk

coörd. thuiszorg

logo

ergo

fysio

maatsch. werker

diëtist

neuroloog


internist

cardioloog


verpl.


Stroke


Unit


Zieken
-


huis


zorgcoörd.

psycholoog

SEH

reval. arts

verpleeghuisarts

Verpleeg
-

huis

Revalidatie

Centrum


logo

ergo

fysio

verpleegk.

diëtist

reval. arts

logo

verpleegkundige

ergo

fysio

activit. therap.

bewegingsag.

psycholoog

maatsch. w.

zorgcoörd.

diëtist

psycholoog

verpleeghuis
-

arts

maatsch. werker

Patient view

huisarts

Eerste

Lijn

logo

ergo

fysio

wijkverpl.

Pati
ent

maatsch.

werk

coörd. thuiszorg

logo

ergo

fysio

maatsch. werker

diëtist

neuroloog


internist

cardioloog


verpl.


Stroke


Unit


Zieken
-


huis

zorgcoörd.

psycholoog

SEH

reval. arts

verpleeghuisarts

Verpleeg
-

huis

Revalidatie

Centrum


logo

ergo

fysio

verpleegk.

diëtist

reval. arts

fysio

verpleegkundige

ergo

logo

activit. therap.

bewegingsag.

psycholoog

maatsch. w.

zorgcoörd.

diëtist

psycholoog

verpleeghuis
-

arts

maatsch. werker

Medics view.

huisarts

cardioloog

reval.
arts

Verpleeg
-

huis

maatsch.

werk

fysio

fysio

Revalidatie

Centrum

Physiotherapist

maatsch.

werk

fysio

fysio

Physiotherapist

District nurse

Patient

Surgeon

Patient

Patient

Patient

Patient

Patient

Patient

Patient

Patient

Patient

Patient

Patient

Patient

Sphere of influence ~ admintrative domain

Integrated healthcare

huisarts

Eerste

Lijn

logo

ergo

fysio

wijkverpl.

Pati
ent

maatsch.

werk

coörd. thuiszorg

logo

ergo

fysio

maatsch. werker

diëtist

neuroloog


internist

cardioloog


verpl.


Stroke


Unit


Zieken
-


huis

zorgcoörd.

psycholoog

SEH

reval. arts

verpleeghuisarts

Verpleeg
-

huis

Revalidatie

Centrum


logo

ergo

fysio

verpleegk.

diëtist

reval. arts

fysio

verpleegkundige

ergo

logo

activit. therap.

bewegingsag.

psycholoog

maatsch. w.

zorgcoörd.

diëtist

psycholoog

verpleeghuis
-

arts

maatsch. werker

Similar scenario in many

areas e.g. sport

Important characteristics of Integrated Health Log

Multimedia content in Content Management System

Role based access and personalization in content collections

e.g. clients, supervisors, viewers, physiotherapists

Groupware & collaborative services around content collections

Web browser based (Internet Explorer, Mozilla/FireFox etc)

Accessible from anywhere with multi
-
channeling

PC, laptop, PDA, cell
-
phone on GPRS/UMTS/WLAN/LAN

Multilingual support

e.g. English, Dutch, German, Spanish, Chinese

Quick prototyping around multimodal content

Scalable deployment possible from 1 upto 1000++ users

Secure deployment/access: SSL, PKI
-
infrastructure

Interacts with applications like windows
-
email, windows
-
office
through various protocols like http, webdav, ftp

Access to content enrichment services (MultimediaN)

(C)

Real organisations,

virtual administrative domains


Shift the administrative borders to fit organisation form


Here: create an virtual administrative domain (aka virtual
organisation) around a patient !.

Grid Model

Delegated access control

Standard

Compute

provider

Data


owner

Service

provider

Service

Service

provider

Service

data

Service

provider

Service

result

invocation

Trust domain

Access ticket

Access ticket’

Access ticket’’

Usable Virtual administrative domains

Create the illusion of a unified virtual

Administrative domain


Access rights


Access point to information and services

computing /storage facility

Goal is to reduce maintenance load,
not

to save cycles

Essential that
sensitive information

is not revealed

Patient data may legally not be revealed



Not revealing sensitive Information

Decouple service from service provider

IBM trusts EXCEL with finance data
not

Microsoft.

Medics trust hospital running PhD’s algorithm
not

PhD student + his computer system.

Many service providers hence



send information only to one (few) trusted
compute providers


Send services to compute providers as well.


Service providers can find a
standardised
environment

Future: Physiotherapist at home of patient

Ultimate image analysis challenge




Architectural overview PhysioLog

Connectivity Services

Content analysis
Services

Groupware /
Collaborative

Services

Content
Management
Services

Care Services

Security Infrastructure

Service Infrastructure (webservices, grid)

Connectivity Services

Content analysis
Services

Groupware /
Collaborative

Services

Content Management
Services

Care Services

Security
Infrastructure

Service Infrastructure (webservices, grid)

Architectural overview:
Simplified Services View

ADSL

GPRS

UMTS

WLAN

LAN

Kabel

etc.

TCP/IP

SSL/TLS/SSH

HTTP(s), FTP(s), SCP, WebDav,etc.

customized content
access

video conf./ application
sharing (netmeeting)

Chat services

discussion forums
boards

Poll module

Newsletters + subscrip.
infrastructure

Weblog
\
Wiki module

Workflow infrastructure

DBMS infrastructure
(OO/ relational/
hierarchisch)

Storage

Indexing/search

Commit
\
Rollback

Logging

Authentication

subscription infrastr.

Authorization
infrastructure

Portal infrastructure


(look and fee, portletsl)

Multi Channeling
(skinning) infrastructure

Internationalization
infrastructure

Application Server with
Session Management

Module Y

client
oriented
records with
multimedia
content

gait video
playlist
editing

clinical
forms
editing

gait video
step
length

detector

video
home
tracking
system

content
alignment
editor

patient
data
anonimi
-
sation

HL7v3
import
export

shot
dete
ctio
n

face
rem
over

feet
trac
ker

vide
o
tran
sco
ding

vide
o
con
vers
ion

vide
o
alig
nme
nt

video
analysis
services

audio
analysis
services

multimod
al
analysis
services

text
analysis
services

service Infrastructure (webservices, grid)

Mpeg7

import/
export/
editing
services

Content production line infrastructure (e.g. service composition)

Status, future work and a dream


Status

First pilot started at Roessingh: PhysioLog


RRD logs patient data (electronic patient file)

Content production line integration in IntegratedHealthLog
demonstration setting

BD activities


Several leads in medical domain (Bonaire)


NOC
-
NSF lead for Integrated Athletes Log (Bejing
-
China)

Near future

2005Q3


Open sourcing

2005Q4 Integrated health pilot


Fysiotherapists for children

Future 2007

Domain/sector independent service infrastructure within MultimediaN

Open source package for integrated health environments

Dream/goal

Open service infrastructure for multimedia enrichment services

in the Netherlands



Demo
-
site urls



Demo url

http://portals.telin.nl/ihl

http://portals.telin.nl/integratedhealthlog





Thanks to

MultimediaN, IBM, Roessingh, Telematica Instituut

Who made this possible

Paul Porskamp (OH)

Hans Kruse

Helped to find Plone

Martin Wibbels

SSL vraagbaak

Jaap Reitsma

scp tip

Arjan Peddemors

Advice as Open Source adapt

Maurice Markslag

Beautiful hand made pictures

Daan Velthausz

Pictures/ideas from his PhD
-
Thesis

A lot of open source communities