Mobile Agents in Healthcare, a Distributed Intelligence Approach - Computational Intelligence in Healthcare: Advanced Methodologies - page 49

“dominated” by how well information is processed or reprocessed, retrieved, and com-
municated [2].
As more data on patients are now recorded than ever before [54] the economical
impact of their management is high. An estimated 35 to 39 percent of total hospi-
tal operating costs has been associated with patient and professional communication
activities. In a single healthcare institution, information technologies usually tend to
combine different modules or subsystems, resulting in a “best-of-breed” approach [24].
This leads to a great demand on creating efficient integrated electronic patient records
that would facilitate the communication process. Nevertheless, centralized solutions are
often infeasible and expensive. But, users will not agree on give up the legacy informa-
tion systems they have been using during years. Thus, integration with these systems
is a key issue in order to provide physicians with complete and reliable information. In
order to integrate clinical information systems in a way that improves communication
process and data use for healthcare delivery, research, and management, many different
issues must be handled, e.g., data availability, integrity, and validity. The combination
of data from heterogeneous sources takes a great deal of effort because the participating
systems usually differ in many respects, such as functionality, presentation, terminol-
ogy, data representation, and semantics [24]. Interfaces are needed in order to retrieve
useful information.
Taking into consideration the intra-institutional level, and departmental systems, Vir-
tual Electronic Patient Medical Records (VEPMR) systems approach can provide for
the necessary means for departmental systems integration, enabling, at the point of
care, a single integrated view of all patients' clinical information existing on the in-
stitution. We could say that at the institution level local information integration could
suffice to provide doctors with all the necessary information to deliver care to a given
visiting patient. However, patients are mobile entities, they visit multiple institutions
during their life time and leave a trail of information scattered around laboratories, pri-
mary care units and other hospitals. The patient clinical history available to the doctor
should not be resumed only to the information produced locally in the institution but
also to the external data. The lack of articulation observed at the institution level, in
what information systems integration is concerned, is also present when looking at the
inter-institution integration level. Usually data integration relies on patients carrying
their paper lab reports, x-rays, and other clinical documents themselves. In order to
provide consistent and complete clinical data availability, solutions must be provided
for bridging inter-institutional systems integration gap.
MedIGS is a gathering information system for securely integrating distributed med-
ical data using mobile agent technology.
3.1.1 Why Agents in MedIGS?
MedIGS provides new clinical data discovery mechanisms which allow each institution
to have access to external complementary patient clinical information. For the develop-
ment of an inter-institution Virtual Electronic Patients Record system several technolo-
gies could be used, such as peer-to-peer, Web services, or mobile agents.
- Peer-to-Peer is a good technology to efficiently search through a large network in
a decentralized way. Unfortunately this technology does not provide the privacy