Mobile eHealth MeH (PESOS 2012)

Business Goals and Domain Assumptions

In this page we briefly describe a case study, i.e. the Mobile eHealth (MeH), developed in the context of the IST PLASTIC project aimed at supporting self-adapting and context-aware services. The goal of the case study is to show how to model a service-based application and to demonstrate that model-based solutions are suitable to generate Quality of Service (QoS) models and adaptable code from service models.

In the following sections will be reported the Business Goals and the Domain Assumptions for the current case study.

Business Goals

Table BG1. Business Goal EH-BG-01

Field	Description
UniqueID	EH-BG-01
Short Name	Patient Data Retrìeval (PDR)
Type	Business Goals.
Description	By invoking the PDR service, the doctors retrieve mixed media information of their patients that combines text with or without different kinds of images referring to their personal data, their medical histories and patient-related diseases. The results can be displayed on the doctors’ handheld device. A more detailed description of this service is provided in [1].
Rationale	Provide the service that is tailored to a certain execution context.
Involved Stakeholders	Doctors, Patients, MeH System
Conflicts	None
Supporting Materials	[2]
Priority of accomplishment	Must have.

Table BG2. Business Goal EH-BG-02

Field	Description
UniqueID	EH-BG-02
Short Name	Remote Diagnosis
Type	Business Goals.
Description	By invoking the RD service, the patients update some vital parameters (e.g. heart rate) thus to provide the knowledge aimed at monitoring their health. On the basis of such data an alarm is sent in case of warning conditions that can be forwarded to his/her relatives, rural doctors and social workers. A more detailed description of this service is provided in [3].
Rationale	Improve the effectiveness and reliability of healthcare activities. Reduce costs of healthcare activities.
Involved Stakeholders	Doctors, Patients
Conflicts	None
Supporting Material	[4]
Priority of accomplishment	Must have.

Domain Assumptions

Table DA1. Assumption EH-DA-01

Field	Description
UniqueID	EH-DA-01
Short Name	Context/Resource Awareness
Type	Domain assumption
Description	The MeH system shall be a context-aware and adaptable service. Context is a set of heterogeneous information that can be sensed by and influence the system behavior. At design time, it results in artifacts (i.e., models) where structural and behavioral descriptions of the MeH System can be combined with a context model. At run time, it corresponds to the availability of an appropriate middleware that is capable to monitor the execution context and to adapt the system behavior accordingly.
Rationale	Provide the best QoS in an ubiquitous environment despite a continuosly evolving execution context.
Involved Stakeholders	Doctors, Patients
Conflicts	None
Supporting Material	[5]
Priority of accomplishment	Must have.

Domain Analysis

Strategic Dependency Model and Context Diagram

The SDD figure illustrates the strategic dependency diagram of the case study. The diagram puts in evidence the business goals shared among the related actors. For example, in the diagram we can note that the Doctor makes a remote diagnosis for the Patient. He/She can also retrieve multimedia data (text and images) about the assisted patients by accessing databases from the MeH System.

The following figure illustrates the context diagram of the current case study. In the context diagram, all the actors that appear in the business goals and scenarios are agents.

Domain Model

The figure below illustrates the domain model of the current case study. The model is represented using a UML notation. In particular the model shows the entities of the scenario, the actors and the relationship among them.

Scenarios

In this section the Business Goals, namely Remote Diagnosis and Patient Data Retrieval, are further detailed using UML Sequence Diagrams

Table S1: Scenario EHEALTH-S-01

Field	Description
UniqueID	EH-S-01
Short Name	Remote Diagnosis
Related To	EHEALTH-BG-01
Involved Actors	Doctor, Patient, MeH System
Detailed Operational Description	The behavioral description of the Remote Diagnosis service is illustrated in the above figure. A multi-radio networking service provided by a context-aware middleware (MRNAPI instances mrn-patient and mrn-doc), choose the best networks available (MRNAPI::activateBestNetworks()) before establishing either a multicast or a point-to-point communication among patients’ and doctors’ devices. In particular, the former communication protocol is used to send alarms from patients to any of their supervising doctors. In order to execute the sendAlarm() operation a networks with low bitrate and power consumptions is required. Indeed, the alarm message is usually very small (few bytes) and sent from a safety critical and possibly battery-powered device (e.g., a panic button). In this case a GPRS network satisfies the requirements as modeled by the QoSProfile01. On the doctor’s side, when the alarm is received, the visualcheck() service available on the patient’s side is invoked. A point-to-point communication needs to be established from the doctor to the patient: the adopted middleware is in charge of selecting the best network available according to certain quality profile. For example, a quality profile may require a free network with very high bitrate to transmit a video stream from the patient’s side. In this case the context-aware middleware (named ubiSOAP) ignores GPRS and switches to a WiFi network.
Problems and Challenges
Additional Material	[6]

Table S2: Scenario EHEALTH-S-02

Field	Description
UniqueID	EHEALTH-S-02
Short Name	Access current health data
Related To	EHEALTH-BG-01, EHEALTH-DA-02
Involved Actors	Doctor, Other Medical Staff
Detailed Operational Description	The doctor also needs access to the data recorded online during the consultation by either the doctor himself or his assistants. He may, in addition, need data that was recorded shortly before the consultation, or that was collected in the hospital or at home during a long-term monitoring with a mobile diagnostic device like, for instance, an ambulatory blood pressure unit. It is even conceivable that the doctor would use diagnostic data received from nanobots (that is, agent-like devices of nanometre-size brought into a human body for diagnosis or even for therapy). In addition, whatever kind of data he is using, the doctor should be supported in his analysis by expert systems and databases.
Problems and Challenges	The problems and challenges related to this scenario are the following: Integrate on demand data from various devices Store working sessions and allow to move sessions between devices Integration of distributed workflows, distributed transactions, federated identities Integration across domains Horizontal (enterprise information systems) and vertical integration (devices) Platform heterogeneity, interoperability HIPAA privacy and security compliance Use or disclosure of Protected Health information (PHI): Health Mitigation procedures to address unauthorized user Patient chart autorization access and protection Dependability, performance, security, and trust
Additional Material	Sub use case:

Table S3: Scenario EHEALTH-S-03

Field	Description
UniqueID	EHEALTH-S-03
Short Name	Access health data during examinations
Related To	EHEALTH-BG-01, EHEALTH-BG-04, EHEALTH-DA-02
Involved Actors	Doctor, Patient, Other Medical Staff
Detailed Operational Description	To reach a diagnosis during a complex examination, the doctor may need to use several devices in several locations. The devices could be a general-purpose handheld computer or a specific integrated device for medical diagnostics, for instance, an X-ray device. They are often located in the same hospital, but also their usage in a different place, e.g. the patient’s home, is conceivable. For the execution of patient checks a doctor could exploit different devices. In this case, their status has to be properly aligned.
Problems and Challenges	The problems and challenges related to this scenario are the following: Integrate on demand data from various devices Store working sessions and allow to move sessions between devices Integration of distributed workflows, distributed transactions, federated identities Integration across domains Horizontal (enterprise information systems) and vertical integration (devices) Platform heterogeneity, interoperability HIPAA privacy and security compliance Patient chart autorization access and protection Emergency access procedure for obtaining necessary electronic protected health information during an emergency Dependability, performance, security, and trust
Additional Material	Sub use-case:

Table S4: Scenario EHEALTH-S-04

Field	Description
UniqueID	EHEALTH-S-04
Short Name	Expert Consultation
Related To	EHEALTH-BG-02, EHEALTH-BG-05, EHEALTH-DA-02
Involved Actors	Doctor, Expert
Detailed Operational Description	The doctor might need to call a colleague for consultation or to evaluate a specific result. To this end, the doctor has access to directories and can place a phone call by one mouse-click from just the computer he uses at that moment. This feature may be taken a step further to collaborative environments and expert call centres.
Problems and Challenges	The problems and challenges related to this scenario are the following: Legal and technical issues with distributed and shared patient records Store working sessions and allow to move sessions between devices Integrate external applications (telephony, reservation, external patient records) Integration of distributed workflows, distributed transactions, federated identities Integration across domains Horizontal (enterprise information systems) and vertical integration (devices) Platform heterogeneity, interoperability Procedure that maintain electronic protected health information to allow access only to those persons or programs that have been granted access rights Emergency access procedure for obtaining necessary electronic protected health information during an emergency Dependability, performance, security, and trust
Additional Material	Sub use-case: