Information Engineering and Technology in Health

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  • Through this programme, the UNU International Institute for Software Technology (UNU-IIST) will help advance development of interoperable and collaborative networked health information systems and devices for safer, more effective, more patient-centred, and more equitable health services. The programme comprises research projects on the software engineering challenges in designing shared electronic health record systems and developing software tools to support healthcare applications. Since healthcare systems are subject to complex legal regulations and practice guidelines, the research and development projects will include modelling and validation of healthcare regulations and practice guidelines and their integration in the system architecture design. Software applications developed in close collaboration with healthcare professionals will drive the more theoretical work and provide a testing ground for its efficacy. Based on the research findings and development of tools and software applications, IETH will provide education, technology, and policy consultancy to assist states in their effort to tackle issues in global health.

    Twinning

    In this biennium, IETH will mainly contribute to the institutional effort in the implementation of the twinning concept led by the director, instead of seeking its own twinning initiatives.

    Focal Point

    Dr. Zhiming Liu, Senior Research Fellow, is the focal point for this programme.

    Purpose

    Developed and developing countries alike face mounting challenges in providing adequate healthcare to their populations. Developed countries are facing a moral and economic dilemma in dealing with the increasing prevalence of chronic diseases among their ageing populations. Developing countries face the challenge of providing quality healthcare to rapidly increasing populations without adequate infrastructure. At the same time factors like climate change are leading to new and re-emergent diseases, which are placing increased strain on healthcare systems worldwide.

    In an increasingly resource constrained world, traditional approaches are unlikely to lead to sustainable solutions to such problems, particularly at a time when other global challenges are likely to require significant investment to address. Information Communication Technology (ICT) has become one of the most important technologies in increasing quality and reducing cost of healthcare. UNU-IIST is working to help realize the potential of ICT by working closely with healthcare practitioners to find innovative solutions to practical pressing problems. Software systems can be developed for managing, controlling and monitoring policies, processes and workflows in medical systems, and are essential to the implementation of electronic health records. However, this reliance on software raises challenging issues related to safety, security and privacy. It is the purpose of this programme to address these issues.

    Approach

    In the past two decades there have been phenomenal advances in ICT, particularly in the areas of distributed and web-based computing, communication technologies of the Internet, wireless sensors and (wearable) smart objects, and mobile telecommunications. This offers the potential to achieve the ambition of the famous World Health Organization’s “Health for all in 2000” declaration — a safer, more effective, more patient-centered, more timely, more efficient and more equitable health system, through interoperable and collaborative networks of health information systems and devices.

    At the same time, there are many interrelated barriers in terms of governance, finance, education, social and professional culture and software engineering challenges that may hinder and obstruct the realization of the potential. The goals of IETH focus on the root causes of these barriers and contribute to their removal through effort in five areas: 1) foundational research and development of software engineering techniques and tools for design and validation of integrated health information systems for safe, effective and efficient sharing of health information and resources in collaborative healthcare; 2) development of prototypes of health application software systems; 3) development of courseware for training schools and for UNU-IIST’s postgraduate programs and projects for master’s and PhD students; 4) support to government health departments/bureaus and health care organizations in their strategic planning, policymaking, legislation and public education; 5) technology consultancy to government IT departments, health care organizations and institutions in their health information system development projects, in particular in requirements specification, analysis and validation, and system acceptance testing.

    These thematic areas are closely related, with research and development of software engineering techniques and tools as the foundation. At the same time, practice in software development, in collaboration with health care professionals, will be essential to develop domain expertise, as well as to experiment and test the research findings, techniques and tools. Research topics for master’s and PhD students will be developed through projects of the research component of IETH. The research findings, techniques and tools developed, as well experience gained in software development, will be taught at the training schools and in postgraduate courses. Finally, knowledge gained in the research, and the skills and experience developed through software development will provide a basis for effective policy support.

    Gender

    IETH is aware of the large number of female health care professionals and will make an effort to encourage and attract women to the area of ICT in health care in its education and training activities. IETH will seek to involve women in the leadership of research and development projects.

    Target Audience

    Primary beneficiaries of the programme’s activities will be academics, government and health organizations, health care providers and health information software companies.

    The research and development of software engineering methodologies and tools will contribute to advancing the state of the art of software engineering and its application in health informatics. Thus, it will be of interest to the international community of software engineering. The models, techniques and tools developed will help in improving and establishing international software standards for health care applications and thus will benefit the software industry.

    IETH emphasizes working with universities and health organizations in developing countries in order to contribute to their capacity building in research and software development, and in policy support and consultancy, such that they are in a strong position to determine the direction of development of their health care systems.

    Through close research collaboration with the University of Macau, Macau University of Science and Technology and Macau Polytechnic Institute, the research findings, technique and tool development of IETH will be used in undergraduate teaching and postgraduate supervision. IETH plans to develop further collaboration with the Macau Health Bureau, Macau Government Hospital and Kingwu Hospital, in the areas of software development, policy support and public education. Through these collaborations, IETH will contribute to the development of health care in Macau.

    IETH will investigate a wide range of dissemination efforts to deliver the benefits to the target audience, through publications in mainstream journals conferences, lectures at training school, and articles in various media. IETH will increase its international awareness through the conferences and associated training schools that UNU-IIST has founded: International Colloquium on Theoretical Aspects of Computing (ICTAC), Formal Aspects of Component Software (FACS) and Foundations of Software Engineering Health Informatics (FHIES).

    Intended Impact

    Impact: Furthering knowledge in an academic field
    Target: Advance software engineering foundations by 1) researching semantic theories of software models; 2) developing techniques for software model constructions, analysis, transformations and verification and validation; 3) building tools to support software design, verification and validation; 4) practical software development for health care applications — Electronic Health Record (EHR) and Electronic Medical Record (EMR) systems.
    How: IETH currently has three research projects funded by Macau Science and Technology Development Fund (and two joint projects, with Institute of Software and Tongji University respectively, funded by Chinese Natural Science Foundation (CNSF). Two joint grant applications, with the Lab of Parallel and Distributed Computing, have been subsisted to CNSF, and one joint grant application has been submitted to Tongji University (Shanghai). The impact of this will be mainly in “furthering knowledge” in the field of computer science and software engineering.

    Impact: Curriculum development
    Target: A coherent set of courses and PhD thesis topics on software engineering and health care will be developed for the UNU/Pisa PhD Programme of Computer Science, with the UNU-IIST emphasis in sustainability.
    How: Topics for PhD theses will be proposed through research projects; tools will be used in teaching the methods and techniques; and practical software development will be used as case studies, proof of concepts and demonstration of techniques and tools in the courses and in PhD students’ research.

    Impact: Teaching
    Target: IETH targets improvement in teaching, supervision and opportunities for students and young researchers from developing countries. In addition, it will contribute to teaching in the UNU-IIST Master’s degree and UNU/Pisa joint PhD degree of computer science.
    How: In addition to the teaching and supervision of students on the UNU-IIST postgraduate programmes, IETH uses its partners and contacts in Africa, Asia, (developing regions of) China and South America to organize courses and schools, with material presented by renowned educators. The programme also engages in joint supervision of dissertations and theses, acknowledging that guidance in writing and presentation is part of its duty.

    Impact: Capacity development in developed/developing countries
    Target: IETH collaborates with developing countries to strengthen their education and research in Software Engineering and its application in health care and their ability to produce and maintain complex health information systems.
    How: This will be achieved by developing joint research projects to work shoulder-to-shoulder with young researchers on appropriate research topics and joint software development projects. Further, courses tailored to the needs of developing countries will be developed and taught and consultancy on curriculum design and research grant applications will be provided.

    Impact: Supporting academic communities
    Target: IETH targets promotion of understanding between the professional communities of Computer Science, Software Engineering and ICT in developing countries and those of industrialized countries, contributing to enhancement of collaborations among developing countries and between developing countries and industrialized countries.
    How: In addition to schools and courses that involve teaching by acknowledged international educators, the IETH organizes international conferences and workshops in developing countries to locate there practitioners and researchers from academia, industry and government. IETH involves in the organization of the annual conferences ICTAC, FACS and FHIES that were founded by UNU-IIST. The programme contributes to the international academic community in its subject areas by publication of papers in journals, workshops and conferences, and by participation in joint research projects.

    Research Findings

    The expected research findings of IETH include: 1) rCOS Method of Model-Driven Development of Component Software, semantic theory of the rCOS modeling notations and composition, techniques of verification and refinement, model of component interface behavior, real-time, fault-tolerance and compensation; 2) development of tools to support the rCOS method; 3) application of model-driven and component-based techniques to integrated health information systems, models of EHR architecture, health care workflows and practice guidelines (modeling, analysis, validation, monitoring and management), models and techniques for privacy risks analysis followed up by design and verification of security mechanisms for privacy requirements; 4) and practical development of health care software systems and a Traditional Chinese Medicine Online Service System.

    Policy Bridging

    IETH will seek to bridge theoretical findings and apply tools to the support of policy and decisionmaking in the area, including 1) policies, regulations and guidelines for acquiring, communicating and using electronic health records; 2) liabilities of different stakeholders, such as vendors and users of health information systems, based on the studies of general performance and deficiencies of health information systems; 4) strategies to improve the overall quality of health care by leveraging existing EHR data to generate new and environmentally appropriate practice guidelines; 5) policy recommendations that reduce privacy risks and increase public trust; and 6) evaluation and validation of business models of health care providers that have an implementation of EMR.

    Value Added

    IETH will take the advantage of being part of UN and UNU to make a unique contribution to science and technology innovation and to global health in several ways. — As added value for the UN system, IETH promotes and contributes to the advancing the application of ICT to enable the goal of WHO’s “Health for all in 2000” declaration —  a safer, more effective, more patient-centered, more timely, more efficient and more equitable health system.  The value added for the UNU system is that IETH will maintain UNU’s established reputation in the international software engineering community in order to effectively serve the needs of developing countries in capacity building in education and research in computer science, software engineering and health informatics. The primary focus of UNU in its mission for developing countries will give IETH a key role in organizing and leading international collaborations in working with developing countries to solve the pressing problems there in ICT applications in health

    Additional value for government and policymakers, comes from the fact that IETH will provide evidence-based policy support and consultancy on strategic plans and business models. The capacity to do this will be based on research findings, experience of practical development of software methodology and software systems, and knowledge on the state of the art and the future trends in software engineering in health care. For IT departments of health care institutions, IETH will offer added value by providing technology consultancy on development projects of health information systems requirements document analysis, plan of system validation, testing, etc. Finally, another added value to the programme is that the research results, techniques, tools and health care software prototypes produced by IETH will play a part to advancing the state of the art of computer science and software engineering in health care, thus contributing to the international academic community and benefiting the software industry in the area of health care.

    Dissemination

    Results of the IETH’s research will be published in international journals, conferences and workshops, and as monographs and books, all available on the web (subject to copyright agreement), and in seminars and addresses. Course material will be freely available, though experience has shown that its users benefit most when they have first attended the course themselves and discussed it with us. Teaching of research and supervision will be achieved by working side-by-side with key representatives of our constituency. Tools and software systems will be disseminated through demonstrations in teaching, at training schools, and at conferences.

    Timeline/Programme Cycle

    IETH is to be an on-going programme but with a cyclic structure of research and development, knowledge transfer, teaching and supervision — leading back to research and so the cycle repeats. Its constituent projects typically span three years; PhD students take an average of between three and four years; postdoctoral and project staff are recruited for between one and three years (the latter tenure being necessary to compete internationally). It is planned that the programme be reviewed and revised every two years with the biennial budget cycle.

    Evaluation

    In the biennium of 2012-2013, IETH will focus on its own capacity building and the main indicators of its success will be establishment of its projects and collaboration partnerships in the health care application domain. To this end, initial research outputs and software system development will be essential to success. On the long-term, the program is evaluated in terms of publications of its research results in mainstream journals and conferences, the quality and practical usage of the software developed (including both tools and application systems), the influence of its policy support activities, the quality and number of students educated on the program, and the impact of capacity building events.

    Challenges

    Challenges facing the IETH programme include: securing sufficient funding to achieve stated goals; attracting quality staff and PhD students to Macao; working towards the next stage of commitment with potential twin institutes; and increasing engagement with other UN organizations.

    Expected Duration

    The programme is expected to run for a duration of 48 months, from 1 January 2010 through 31 December 2013.

  • Activities within the programme will involve cooperation between the UNU International Institute for Software Technology and the UNU International Institute for Global Health.

  • Prof. Peter F. Haddawy, Director
    United Nations University
    International Institute for Software Technology
    Casa Silva Mendes, Estrada do Engenheiro Trigo No. 4, Macau
    Mailing address: P.O. Box 3058, Macau

    T: +853 2871-2930
    F: +853 2871-2940
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