Tampere University of Technology Information Technology

By:

Bikram Thapa Dela Aheto Ferdinand Muriyesu Tommi Uitti Alain Itangishaka

HEALTH NFORMATION SYSTEM COURSE WORK

VIRTUAL HOSPITAL

Contents 1. Introduction .......................................................................................................................................... 3

2. Motivation ............................................................................................................................................. 3

3. Stakeholders ......................................................................................................................................... 4

4. System Overview................................................................................................................................... 5

5. Use Cases: ............................................................................................................................................. 6

6. Diagrams of the system functionality ................................................................................................... 7

6.1. Class Diagram of the system .............................................................................................................. 7

6.2. Sequence Diagram of different activities ........................................................................................... 9

6.3. Separate Sequence diagram for individual functions ...................................................................... 10

7. Business Model ................................................................................................................................... 12

8. Challenges of the system .................................................................................................................... 13

8.1. Data Security .................................................................................................................................... 13

8.2. Coordination .................................................................................................................................... 13

8.3. Funds ................................................................................................................................................ 13

8.4. Usability ........................................................................................................................................... 13

9. Conclusion and recommendations ..................................................................................................... 14

1. Introduction Quality healthcare has become very important in our individual lives, and one shouldn’t

compromise on that. It is with this reason why healthcare should be easily accessible to

everyone.

Nowadays, the use of the Internet for medical purposes is increasing because of the advent

of technology; usage of smartphones, tablets and other mobile devices is enabling the

mobility of healthcare services consumers. People with chronic health diseases are surfing

the Internet for ways to manage their health condition, different people are using it for

wellness management activities. There is a litany of uses that can be sited for the use of the

Internet when it comes to healthcare.

It is with this reason why there is a need for a virtual hospital to be developed so that the

client/patient would not have to go to the hospital unless it is absolutely necessary to do so,

thereby saving cost and time in the process.

The virtual hospital provides a platform for different information systems to be integrated to

allow easy access to patient data, medical resources in a secure way over the Internet.

2. Motivation

There are a number of reasons why a virtual hospital is a community need to be developed;

To reduce the overall time spent at the real hospital in a queue waiting to see the doctor or to make an appointment

Availability of IT infrastructures

Because of the ubiquitous nature of the Internet, health care can easily be accessed

Those with especially chronic diseases need to form some sort of social network.

Online link between a person and healthcare providers and related stakeholders.

Minimizing costs for services that a person can do on own.

To involve citizen to be responsible of their health management and decisions.

Minimize the work performed in real hospitals while it can be executed online, like searching Personal Medical records.

Another opportunity of e-business.

3. Stakeholders

The virtual hospital has a number of stakeholders;

Patients/Clients: - these are the most important stakeholders because the virtual

hospital was designed purposely to help them acquire good quality healthcare at a

cost-effective rate.

Health Care professionals: - these are the people who are directly responsible for

effecting the quality health care that the patients’ needs and requires. They can be

doctors, nurses, lab technicians, dispensers, or any person who comes into the care

execution system

Suppliers: - these are the companies that supply items to the hospital. They can be

pharmaceutical companies who supply drugs and other consumables, or companies

who supply medical devices/equipment.

Health care policy makers: - they plan health insurance coverage, and initiate

wellness or advocacy programs that provide people with the best possible

information about different health care treatment options.

Insurance companies: - They are available to help reduce or cater for the cost a

patient/client has to pay for the healthcare service. These are usually private companies.

Government: - develop and evaluate health technologies and practices, and provides the

National Health Insurance so that the patients wouldn’t have to pay for the healthcare

delivery. Because it would cater for the cost.

4. System Overview

With the help of the virtual hospital, the client can be able to;

Make/cancel appointments: - The client can login using his/her credentials check the

available doctors/practitioners and make an appointment. The appointment can later be

cancelled or rescheduled if need be.

Monitor his/her health status: - The virtual has the functionality of allowing the

individual upload his/her personal health record (gathered from sensors or wearable

devices), so that he/she can be actively monitoring the health status.

View specialists from other hospitals: - since the virtual hospital brings about the

integration of other information systems, the patient can view specialist doctors from

other hospitals so that he/she can make an appointment directly to that specialist, not

having to see a general practitioner first before he/she is referred.

View of EHR: - the patient has the ability to view his/her electronic health record if

he/she desires.

Make payments: he/she can make payments directly or the insurance companies can

make the payments depending on the arrangements between both parties.

Order prescriptions: - this functionality helps the user order prescriptions (especially for

the chronic health diseases), but with the help of the doctor.

Manage chronic diseases : - an important function of our virtual hospital is the fact that

it enables patients with chronic diseases monitor and manage these diseases. The

management can be in the form of reminds, what food/drink to take or not to take, etc.

Join a social network : - the virtual system would definitely have people with chronic

diseases. So the system allows the patient(s) to join a social network of other people who

have similar diseases so that ideas can be shared about their respective experiences,

recommend a particular health care professional, just to mention a few

5. Use Cases: Use Case 1: Out- Patient routine visit

Use case 2: Diabetes management

6. Diagrams of the system functionality

6.1. Class Diagram of the system

The figure illustrates the class diagram of the system. The virtual information system provides services

via web API or json or xml request and fetch method. In the above Virtual Information system EHR, PHR,

EMR System does not exist inside virtual system but virtual system sends request and get information

from these system.

The functionalities provided by virtual system are

a. Authentication of patient

b. Uploading Self Monitored data

c. General appointment booking and hospital information

d. Getting feedback from Chronic care monitoring Clerks

e. Get basic summary for medication, drugs etc. from EMR, PHR, EHR

f. Communicate to other people via Community portal

g. Sending Drug reports to pharmacy

h. Send clinical, medication history to payer/insurance

i. Getting information about insurance companies

The communication between the virtual communication and external system takes via secure channel

and only by authentication. The communication in system takes in encrypted form over ssl. The general

+returned information are delivered to virtual hospital via encrypted messaging and session are handled

between request and response. Some of the classes and function of the system

Class Attributes Methods

User Userid, password, email,

Patient_profile Real_name, address, medication_type, membership_date, patient_type, age, phone

getUserDetails(); editContactDetails(); changePrivacy();

Chornic_case Medication_date, last_followup, monitoring_clerk_details, notification_sent,

getChoronicDiseasesTypes(); getClerkDetails(); getFollowupStatus(); getPatientInformation();

General_case Patient_id, appointment_date, patiet_information, hospital_details

getPatientInformation(); getSelectedHospital(); getAppointmentFormDetails(); sendRequesToHospitalSystem();

Community_Portal Channel_type, general_privacy_list, Protected_information, settingArrayList

getChannel(); post_articles(); commentOnPost(); view_posts();

6.2. Sequence Diagram of different activities

The above figure represents the sequence diagram of the virtual information system. In order to

use the system the patient has to register to the system which authenticates the user then allows

the available services. Only after successful authentication the user can choose the available

options. Sessions are maintained during the execution of the different functions.

6.3. Separate Sequence diagram for individual functions

Fig. Sequence Diagram for self-monitored Data upload process

This image illustrates the sequence diagram of self monitor data upload. After data is uploaded

then it is saved on the Virtual hospital information system database as archived and is accessible

to the clerk in so that the clerk can keep track of the patients progress or health status.

Fig. Sequence Diagram of Hospital Booking process via Virtual hospital

The figure represents the sequence diagram of hospital booking process. After successfully

authenticated and logged into the system the user can check lists of available hospitals, then fill

up forms and appointment date and sends requests to the hospital system owned by third party

via https request with client information as parameters. When response is received it updates the

virtual information system and alerts user or if error occurs then it shows error messages.

7. Business Model

The virtual hospital project is made for people, the first beneficiary is the citizen, but who want to invest in citizens? in this case the first investor is government and the government invests like other business world as it always think how to get back such funds invested in its people. The government is not alone, it has different partners and most of them may be interested in investing in that project, for example telecommunication companies, IT Companies, Insurance companies, pharmaceutical industries, private hospitals, laboratories, etc. The question is how to get the money back?

For the government if people are well, or if they don’t use much time to hospitals to renew the prescriptions, then they spend time in productive works and tax office do its work. In that case by saving time people spend to hospitals, citizen already save time and energy which is the purpose of most inventions along with Humanity history.

Telecommunication companies will provide their infrastructures for example as their business is to provide data networks, person will have another service and reason to use internet, and charges always goes to the customer (citizen) as long as the service is accessed. IT companies provide different services such as product development itself, storage, maintenance, backup, etc. Obviously internet community will pay this huge cloud consumption. IT companies will be at the heart of the system, in reality they are the one who own and run the virtual hospital system

Insurance companies will save time to wait for hospitals to send invoices by post or with carriers, they can just access all billing information from the virtual system, hospitals, pharmacies, laboratories also will benefit from the system by sending bills, accessing EMR of patients, communicating with patient, etc.

8. Challenges of the system

8.1. Data Security

In information technology, data security is a crucial issue. The citizen who is the main consumer of the system will wonder if his/her information is seen by the right person, right purpose and even in right place. The system should ensure the customers that their data are secured, but how? Who know how facebook or google are secured? Who decide the security level of the cloud?it is all those challenges which may affect the system implementation. It can be implemented, but what will happen if people don’t like it, very few customer register for it others don’t even though it will provides good services. And how professionals will trust data recorded by consumers themselves with mobile devices at home.

8.2. Coordination

The project development involve different stakeholders, all of them don’t have same interests, and each one always look only which part of the system will impact positively to their business, it might be a big challenge if stakeholders don’t arrive at the same consensus of how the system will work.

8.3. Funds

Who will fund the development of this project? Raising funds can harm the project implementation. Stakeholders are there but after signing consensus they may change they view or delay to give funds they committed to the project, and the project delay. If the project delays, complains raised from other partners.

8.4. Usability

The system is designed and implemented on computers and mobile devices, but how friendly the system is? How much real hospital will like to interact with their customers through the virtual hospital? How the interface does looks? How easy the customer can perform her task? The user should check her EMR in a secure and easy way. If the system works well but requires user to pass through different steps to check her laboratory results, she decide to call the laboratory technician than using the system.

9. Conclusion and recommendations

Virtual hospital as system will work as broker between real hospitals and patients; it will have different services for all users according to their categories. During this course work we have tried to think how this system will work. We included normal real hospital process, out-patient visits and all activities processed but in reality this virtual system will not provide virtual laboratories or such kind of infrastructures but it will connect all available services in real hospital with patient/customers. The business model is not yet clear, funds are always in our thought but we don’t know the reality. And how this system will benefit all investors financially? As National health information systems have been developed in different countries, this virtual hospital can support such projects by providing data. We have to think also about different standards during the system development especially those applied in health informatics such as HL7, etc. Cross-border health data communication also must be seen as the system will be really cloud, no restrictions. The system itself is wide, we started thinking as a real hospital system but this virtual one is bigger. It is a topic to go in deep with different collaborations and possible to be implemented as long as the idea is already on board.