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The demographic change with a rising proportion of very old people and diminishing resources leads to an intensification of the use of telemedicine and home care concepts. To provide individualized decision support, data from different sources, e.g. vital signs sensors and home environmental sensors, need to be combined and analyzed together. Furthermore, a standardized decision support approach is necessary. Objective: The aim of our research work is to present a laboratory prototype home care architecture that integrates data from different sources and uses a decision support system based on the HL7 standard Arden Syntax for Medical Logical Modules. Methods: Data from environmental sensors connected to a home bus system are stored in a data base along with data from wireless medical sensors. All data are analyzed using an Arden engine with the medical knowledge represented in Medical Logic Modules. Results: Multi-modal data from four different sensors in the home environment are stored in a single data base and are analyzed using an HL7 standard conformant decision support system. Conclusion: Individualized home care decision support must be based on all data available, including context data from smart home systems and medical data from electronic health records. Our prototype implementation shows the feasibility of using an Arden engine for decision support in a home setting. Our future work will include the utilization of medical background knowledge for individualized decision support, as there is no one-size-fits-all knowledge base in medicine. [ABSTRACT FROM AUTHOR]

Despite the abundance of past home care projects and the maturity of the technologies used, there is no widespread dissemination as yet. The absence of accepted standards and thus interoperability and the inadequate integration into transinstitutional health information systems (tHIS) are perceived as key factors. Based on the respective literature and previous experiences in home care projects we propose an architectural model for home care as part of a transinstitutional health information system using the HL7 clinical document architecture (CDA) as well as the HL7 Arden Syntax for Medical Logic Systems. In two short case studies we describe the practical realization of the architecture as well as first experiences. Our work can be regarded as a first step towards an interoperable – and in our view sustainable – home care architecture based on a prominent document standard from the health information system domain. [ABSTRACT FROM AUTHOR]

Unlabelled: The demographic change with a rising proportion of very old people and diminishing resources leads to an intensification of the use of telemedicine and home care concepts. To provide individualized decision support, data from different sources, e.g. vital signs sensors and home environmental sensors, need to be combined and analyzed together. Furthermore, a standardized decision support approach is necessary., Objective: The aim of our research work is to present a laboratory prototype home care architecture that integrates data from different sources and uses a decision support system based on the HL7 standard Arden Syntax for Medical Logical Modules., Methods: Data from environmental sensors connected to a home bus system are stored in a data base along with data from wireless medical sensors. All data are analyzed using an Arden engine with the medical knowledge represented in Medical Logic Modules., Results: Multi-modal data from four different sensors in the home environment are stored in a single data base and are analyzed using an HL7 standard conformant decision support system., Conclusion: Individualized home care decision support must be based on all data available, including context data from smart home systems and medical data from electronic health records. Our prototype implementation shows the feasibility of using an Arden engine for decision support in a home setting. Our future work will include the utilization of medical background knowledge for individualized decision support, as there is no one-size-fits-all knowledge base in medicine.

Despite the abundance of past home care projects and the maturity of the technologies used, there is no widespread dissemination as yet. The absence of accepted standards and thus interoperability and the inadequate integration into transinstitutional health information systems (tHIS) are perceived as key factors. Based on the respective literature and previous experiences in home care projects we propose an architectural model for home care as part of a transinstitutional health information system using the HL7 clinical document architecture (CDA) as well as the HL7 Arden Syntax for Medical Logic Systems. In two short case studies we describe the practical realization of the architecture as well as first experiences. Our work can be regarded as a first step towards an interoperable - and in our view sustainable - home care architecture based on a prominent document standard from the health information system domain.