LAR II SA Laboratoire Application Réseaux Intelligence Intégration Santé

LARIISALaboratoire Application Réseaux Intelligence Intégration Santé

LARIISA, a context-aware intelligent framework for a governance model supporting decision making in public health care system, based on the “Framework for the Analysis of Governance in Health Care Organizations”.

LARIISA encompasses and integrates family context in a New Intelligent Public Health Information System.

LARIISA is based on five intelligent management domains •knowledge, •normative, •clinical-epidemiological, •administrative and •shared

LARIISA framework uses three conceptual models: •The Integration of Health Care, •Knowledge To Action and •Unified Service Delivery Platform.

.


LARIISA Applayed to the Digital Belt / Brazilian Digital TV


1) APPROACH: Governance Model for Making Decision on Healt Care Systems- Denis: A Framework for the Analysis of Governance in

Health Care Organizations 2) OBJECTIVE: New Intelligent Public Health Information System

- Andrade: Intelligence & Context Reasoning to Health care Governance

3) CONCEPT 1: Conceptual models for LARIISA Framework- Contandrioulos, Denis and all: Integration of Health care

4) CONCEPT 2: Conceptual models for LARIISA Framework- Graham: Knowledge To Action

5) CONCEPT 3: Conceptual models for LARIISA Framework- karmouch: Unified Service Delivery Platform

6) CHALLENGE: Framework to LARIISA

- Oliveira & Andrade and Al.

7) APPLICATION: LARIISA to Digital Belt / Brazilian DTV

Governance Model for Making Decision on Healt Care Systems

Denis (2005): A Framework for the Analysis of Governance in Health Care Organizations

Andrade (2009): RIISO Project, Intelligence Governance for Decision Making

GOVERNANCE SETTINGOf INTEGRATED HEALTH SYSTEM

INTELLIGENCE & CONTEXT REASONINGTO HEALTCAREGOVERNANCE/DECISION MAKING

Knowledge Management

DECISION MAKING inINTEGRATED HEALTH SYSTEM

Decision Making inKnowledge Management

Decision Making inAdministration

New Intelligent Public Health Information System

Conceptual models for LARIISA Framework

Contandrioulos, Denis and all (2001): Integration of Health Care: Dimensions and implementations


Karmouch (2008): Unified Platform Service Delivery


I.D.Graham, J.Logan, M.B. Harrison, S.E.Straus, J.Tetroe, W.Caswell, N.RobinsonThe Journal of Continuing Education in the Health Professions, Vol 26 N°1, 2006 – Wiley InterScience.

Knowledege to Action for healthcare system

Knowledge Creation

Knowledge to Action Process (KAP)

TailoringKnowledge

Action Cycle (Application)

Context-aware Service 1 Context-aware Service 2 Context-aware Service N…

OntologyBase

Service Adaptation

Adaptation - Query

Adaptation - Aggregation

Context Provider 1 Context Provider 2 Context Provider N…

Context Reasoning

LARISSA FRAMEWORK

(Real-timeInformation)

(Context-awareness)

LARISSA FRAMEWORK

Context-Aware Health’s Users

Context-Aware Health Agent APPLICATION

Decision Making in Governance


SystemicNormative

Clinical Governance

AdministrationShared

Management

…

OntologyBase

Service Adaptation

Adaptation - Query



Context Reasoning

LARISSA FRAMEWORK

(Context-awareness)Knowledge to Action Process (KAP) Action Cycle (Application)

Knowledge Creation

LARISSA framework v2.1

Context-aware Services Context-aware Services Context-aware Services

Decision MakingApplication

7) PROPOSAL: LARISSA FRAMEWORKKNOWLEDGE TO ACTION (KTA)

Knowledge Creation(Process)


LARISSA framework v2.1

(Information for the Knowledge Creation)

Action Cycle (Application)

LARISSA FRAMEWORK

…

OntologyBase

Service Adaptation

Adaptation - Query



Context Reasoning

Context-aware Services Context-aware Services

Systemic Normative

Clinical and Epidemiology Administration Share

ManagementKnowledge

Management

Context-aware Services

LARIISA, a context-aware intelligent framework for a governance model supporting decision making in public health care system.

LARIISA encompasses and integrates family context in a New Intelligent Public Health Information System.

LARIISA uses the middleware (GINGA) developed for the Brazilian Digital TV, which full access will be country-wide in 2015.

LARISSA relies on a Digital Belt project, an Optical-WiMAX communication framework, which will reach 82% of urban population of Ceará State in Brazil.

The LARIISA framework uses three conceptual models: The Integration of Health Care, Knowledge To Action and Unified Service Delivery Platform.

LARIISAApplying on the Digital Belt and Brazilian DTV

LARISSA FRAMEWORK

Digital Belt Infrastructure

BST-OFDM

MPEG-2 System

H.264 [email protected] H.264 [email protected]

MPEG - 4 HE-AAC@L4 MPEG - 4 HE-AAC@L3

Ginga

APL1 APL2 APLn...

DemoduladorDecod. do Canal

Demux

.

Dec. Áudio

Dec. Vídeo

CPUMemória

VC

RF

IR CR

Video out

AudioSurround

Audio outRF out

RedeExterna

RF in

API SO

...

Context-Aware Health’s Users




SystemicNormative

Clinical Governance

AdministrationShared

Management

LARISSA FRAMEWORK

CONTEXT CATEGORIES (Zhang and all.):(1) Personal Health Context : physiological and mental context(2) Environment Contex: temperature, light, humidity, noise, etc.(3) Task Context: goals, task, actions, activities, events, etc.(4) Spatio-temporal Context: time and location(5) Terminal Context: terminal type, interface, media supported, etc.

AgentPersonalizedmessage

AgentPersonalizedInformation

Context Detection


LARISSA FRAMEWORK

CONTEXT CATEGORIES (Zhang and all.):

(1) Personal Health Context : physiological and mental context(2) Environment Contex: temperature, light, humidity, noise, etc.(3) Task Context: goals, task, actions, activities, events, etc.(4) Spatio-temporal Context: time and location(5) Terminal Context: terminal type, interface, media supported, etc.

(1)

(2)

(3,4)

(5)

AgentPersonalizedmessage

AgentPersonalizedInformation

Context Detection

IF-THEN RULE-BASED APPROACH

(1) IF blood sugar exceeds a threshold, THEN should not take certain food.(2) IF the room is too dry, THEN turn on the humidity generator(3) IF the user is at lunch, THEN send the message later.(4) IF the user is not at office, THEN send the call to the mobile.(5) IF a PC is accessible, THEN present the message as video.

Context-aware Services


Context-Aware Health Agent PERSONALIZATION


Decision MakingApplication

LARISSA FRAMEWORK

Applying DENGUE Study Case to LARIISA

Decision Making in Knowledge ManagementDecision: mapeamento de todos os profissionais da rede capacitados para o caso, reforçando a formação e adequando-a ao contexto.Rule: IF a quantidade de profissionais treinados < quantidade de estabelecimentos de saúde OR turnos de plantões em hospitais ou Clínicas THEN contratar K novos profissionais e capacitar L profissionais em competências X, Y, ZResults: Mobilização do Sistema Municipal de Saúde Escola e realocação de recursos então destinados a outros setores menos prioritários.

Decision Making in Systemic Normative

Decision: Reavaliar o valor e a aplicação das multas e sansões preconizadas na Lei 8966 de 14 de setembro de 2005.

Rule: IF o depósito de lixo não obedeceu art M da lei AND é reincidente THEN multar e fechar o estabelecimento

Results: Vários depósitos de lixo foram advertidos, alguns fechados e muitos melhoraram sensivelmente.

Decision Making in Clinical and Epidemiology

Decision: Implantação da Hidratação Venosa em todas as unidades de Saúde

Rule: IF há caso de reinfecção AND epidemia THEN criar no Posto de Saúde condições para Hidratação Venosa

Results: Melhoria do manejo de Casos Graves e descongestionamento dos Hospitais., invertendo o fluxo dos atendimento do Hospital para o Posto de Saúde.

Decision Making in Share Management

Decision: Mobilização da Sociedade Civil Organizada

Rule: IF canteiro de obras pertence a um construção com mais de X meses AND está localizado em uma área de infestação > 0,5% THEN esse canteiro deve ser incluído na relação de pontos estratégicos para monitoramento

Results: Diminuição em X% o índice de infestação e reforçou o envolvimento da sociedade civil.

Decision Making in Administration

Decision: Creating an Emergency for the clinical management of severe cases (ER-SC)

Rule: IF the patient had Dengue more than once AND lives in an area with high infestation indice AND has symptoms A,B and C, THEN you must consult the ER-SC about this caseResults: Fortaleza was one of the capitals with lower

mortality due to a series of actions, in special the use of the rule above.

LARISSA FRAMEWORK

Applying DENGUE Study Case to LARIISA

Administration Case

Decision Making in

Administration

IF the patient had Dengue more than once AND lives in an area with high infestation indice AND has symptoms A,B and C,

THEN you must consult the ER-SC about this case

Results: Fortaleza was one of the capitals with lower mortality due to a series of actions, in special the use of the rule above

Decision: Creating an Emergency (ER) for the clinical management of severe cases (ER-SC)


1) RECHERCHE: La création d’un axe de recherche multicentric.

- Actions: ?

2) COOPERATION: Formulation d’un projet de colaboration international entre les partenaires existents et d’outres.

- Actions: ?

3) PRODUIT: Business Plan pour la fabrication d’un produit Health Care.

- Actions: ?

LAR II SA Laboratoire Application Réseaux Intelligence Intégration Santé

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