Transcript Applications of Advanced Network Infrastructure in Health

Generation of Context-Specific
ePCRs using Domain-Specific
Modeling
MOTHIS Workshop
Nashville, TN, Sept 30, 2007
Rohit Shenvi
([email protected])
Dept. of Computer and Information Sciences
AdvNet Project, HI, Dept. of HSA
University of Alabama at Birmingham
Acknowledgements

Advisors:



Collaborators:




Helmuth Orthner, PhD, Professor of Health Informatics, Department
of Health Services Administration, UAB
Jeff Gray, PhD, Associate Professor, Department of Computer and
Information Sciences, UAB
Giovanni Mazza, MSHI, MSCS, System Manager, AdvNet Project,
Health Informatics, Dept. of Health Services Admin., UAB
Devashish Saini, MD, MSHI, Resident Physician, University of
Missouri-Columbia
Marcie Battles, MSEE, AdvNet Project Manager, HI, Dept. HSA
Support:

This project has been funded by Federal funds from the National
Library of Medicine, NIH, under Contract No. N01-LM-3-3513 and
the National Science Foundation, under CAREER grant CCF0643725.
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Overview of Presentation
 EMS
Environment and Workflow
 Electronic
 ePCR
Development: Modular Approach
 CAB,
 ePCR
Patient Care Report (ePCR) Project
CSLA, WCF, WPF
Model Design: GME
 Domain-Specific
Modeling in EMS
 Summary
 Lessons
Learned
3
EMS Patient Flow
9-1-1 Dispatcher
Treatment
Ambulance dispatched
Patient Triage & Transport
EMT Assesses, Treats
& Transports Patient
Hospital ED
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Patient Care Report (PCR)
EMT Assesses, Treats &
Transports Patient
Issues and Problems
 Most
EMTs have moderate typing skills
 Little
or moderate experience with computers
 Concerned
 “Paper
 EMS
about extra work
+ Computer = Slower Work”
(paper) documentation is a problem
 Over
60% of required data elements are
missing (Mandar Gori's Thesis Project)
 Adherence
to clinical protocols is low
 Could be a documentation problem
 Contact is with Online Medical Control
is
avoided even when required (Dr. Devashish
Saini’s MSHI Thesis)
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ePCR Project
 Data
acquisition using ePCR

User Friendly Interfaces to Enter Data with
Minimum Actions
 Implementation of Security Mechanisms
such as Encryption and Authorized Access
to Patient Data
 Sharing
data collected in the field

Collect National EMS Information System
(NEMSIS)-compliant data
 Web Services to push/pull patient data
to/from ePCR terminal
 Transmitting Data to the Central Station
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Paper vs. Electronic
ePCR
PCR
Initial Prototype: Burns
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Initial Lessons Learned




Developing new User Interfaces is very
labor intensive
Maintenance and Scalability difficult
because business logic is intertwined
throughout the application
EMS agencies require customization of
the ePCR GUI and Business layer
Usability Study of ePCR UI requires
quick development of various design
alternatives
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2nd Prototype: Modular Approach
Initial
Approach
Modular
Approach
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2nd Prototype: Modular Approach
 Layered
Architecture
 Presentation
 User Interface
 Business Logic
 Data
Validation:
 Range Checking
 Data Manipulation
 Conversion from common
units to international units
 Data
Layer
 ADO.NET
 Data
Storage
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Domain-Specific Modeling

Identify entities in
the domain that
need to be modeled

Design the
metamodel

Build model
interpreter

Design the domainspecific model
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Domain-Specific Modeling
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Domain-Specific Modeling

Promises

Generation of
platform specific
systems
 Reduced
turnaround time
 Improves userdeveloper
interaction during
system
development
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Domain-Specific Modeling in EMS

Business layer
needs to adapt for
new requirements
Patient category
(pediatric, adult,
geriatric, etc.)
Medical devices (pulse
ox, EKG, etc.)


Drug-drug
interaction engine
integration with the
ePCR
UI automation
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Domain-Specific Modeling in EMS

Drug interactions



Needs to be integrated within
the ePCR
Domain-specific modeling to
generate wrapper code on
the drug interaction API for
the ePCR
Our focus

Generation of business and
data layer using domainspecific modeling
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ePCR Model Design: GME

ePCR

MandatoryBO

OptionalBO

PropertyOf_Mandatory

PropertyOf_Optional

MandatoryConn

OptCon
ePCR metamodel
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ePCR Model Design: GME

ePCR Context

Demographics

Vitals

Assessment

Treatment

Narrative

Attachments

Billing

Triage
ePCR domain-specific model
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Model to Code Transformation

Transformation logic
 Each object transforms
to a CSLA business
class

Each objects’ properties
are converted to C#
code
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Lessons Learned
 It
is difficult to implement new business
rules and modify existing ones without
affecting the modules where they are found
 Need
a mechanism to inject rules into
objects at run time
 The
specification of the rules should be
done in a simple unambiguous language
and translated later to executable code
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Limitations and Future Work
 Limitations
of Metamodel
 Initial
attempt at building the metamodel. It
does not contain the constructs for complex
business objects
 Limitations
of Interpreter Functionality
 Not
implemented to generate full fledged
CSLA business objects
 Experimental
 Formal
Validations
verification and validation not done
Conclusions
 We
discussed issues related to ePCR
development
 Deficiencies
 We
and improvements
introduced the modeling paradigm
 Areas
potentially benefiting by domainspecific modeling languages
A
partial implementation of the ePCR
business layer was illustrated
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Generation of Context-Specific
ePCRs using Domain-Specific
Modeling
Questions & Thank You
Rohit Shenvi
([email protected])
Dept. of Computer and Information Sciences
AdvNet Project, HI, Dept. of HSA
University of Alabama at Birmingham
Model to Code Transformation
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Initial Prototype: Vitals
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Methodology

UI design using WPF and CAB
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
Business and data layer using CSLA

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WPF: Windows Presentation Foundation
CAB: Composite UI Application Block
CSLA: Component-Based Scalable
Logical Architecture
Communication layer using WCF

WCF: Windows Communication
Foundation
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Domain-Specific Modeling in EMS
 Motivation
 Modeling
paradigm
 Promises
 Potential
areas of implementation
in the ePCR development cycle
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