Patient Record Availability in Developing Regions

version 10 Feb 2014 /

• Problems:
  • A patient needs usually several healthcare professionals, typically a family doctor, one or more specialists, nurses, paramedical technicians, etc.. The actual "Care Team" of any individual patient depends on his/her health problems.
  • The members of the care team need to share information about the patient, but may be located in in different buildings, different cities or even different countries.
  • Such a patient centric record need to be available somewhere on an integrated server or network of servers.
  • The system must be available 24 hours a days, 7 days a week. This is particularly critical for the local medical staff near the patient.
  • In developing regions having poor internet access, the standard web architecture is not acceptable. Clients may not too much depend on a not reliable remote server.
• Objectives:
  • A prototype of architecture for a shared medical record in a telemedicine environment, in developing regions.
• Approaches:
  • Keep in mind that the availability of the workstations is the highest priority.
  • Consider strategies based on synchronizations, of course as soon as possible but which could be delayed a few hours, without interrupting local work on workstations.
  • All items should be versionized in an atomic way. If anything change, never update, but add a new version with a timestamps and a user ID. Normally by default only the latest version will be displayed. The motivations are:
    • Keep a trace for medico-legal reasons.
    • Make the synchronization less difficult.
  • Only the information having been added need to be transmitted. The expected ratio between read and write is relatively high.
  • Having somewhere a complete data base, local data base at small medical center level could be limited to the patients living nearby. In case a patient would occasionnally come from an other region, the record could be dowloaded from the central server.
  • Software tools to be considered should include among others, rsync, MongoDB, ZeroMQ, etc....
  • This project focus on the availability of shared information between the members of the Care Team, in the context of developing regions. The content of the medical record is assumed to have been defined elsewhere, as in the project "Patient Dashboard" and other projects.
  • The context is the Open Source working group of the ISfTeH, International Society for Telemedicine and eHealth, http://www.isfteh.org/working_groups/category/collaborative_care_team_in_open_source .
• Requirements:
  • In principle use exclusively Open Source software tools.
  • Python as the main programming language.
  • Since medical object to be archieved may be complex and very polymorphic, object data bbases are preferred.
  • Results to be published as Open Source in a repository like Gitlab.
  • In order to develop exchanges with partners of other countries in the ISfTeH community, all documentations need to be in English.
• Deliverables:
  • A working prototype of network making a shared patient record available as far as possible, and resilient to poor internet access and low bandith.width.