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MiRo:MiRo:A Virtual Private Network For A Virtual Private Network For

Telehealth ServicesTelehealth Services

MiRo:MiRo:A Virtual Private Network For A Virtual Private Network For

Telehealth ServicesTelehealth Services

ROBERTO DI ROSA, MIRCO STURARI,ALDO FRANCO DRAGONI*, GIUSEPPE GIAMPIERI**

*DEIT, Dipartimento di Elettronica Intelligenza Artificiale e Telecomunicazioni – Università Politecnica delle Marche, Ancona

**ASUR Zona 7, Azienda Sanitaria Locale delle Marche Ancona

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MiRo ProjectMiRo ProjectMiRo ProjectMiRo Project

• CONTEXTsoftware-design to organize telemedicine services

• MOTIVATIONSnecessity to integrate health services in a wide and delocalized environment

• SCOPEto provide a flexible architecture for teleconsulting and telereporting

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TelemedicineTelemedicineTelemedicineTelemedicine

represents the erogation of health service at distances through informatics and telecommunications technologies

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TelemedicineTelemedicineTelemedicineTelemedicine

ensures high quality digital information even for complex health services

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TelemedicineTelemedicineTelemedicineTelemedicine

reaches better results if coordinated with the other applications

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MiRo -MiRo - ArchitectureArchitectureMiRo -MiRo - ArchitectureArchitecture

is configured as a substrate to integrate health systems

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MiRo -MiRo - FinalitiesFinalitiesMiRo -MiRo - FinalitiesFinalities

• provides a flexible software framework for teleconsulting and services development

• integrates with the existing health information system to facilitate and rationalize information interchange

• improves and facilitates TCP/IP-based teleconsulting services in Intra/Internet environment

• provides a report and “second opinion” service

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Abstract Data-StructureAbstract Data-StructureAbstract Data-StructureAbstract Data-Structure

• Exam-data: generic digital data produced by an examination

• Report: text-file and digital signature

• Event: database record containing– the date-time of the insertion in the database– the examination type– the laboratory who produced it

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DATA-STRUCTURE• Data: digital data produced

by an examination

• Event: database record that links to the exam

• Report: text-file containing report

SYSTEM-ENTITIES• Repository: archives event

• Laboratory: generates event

• Phisician: reports examination

MiRo -MiRo - ArchitectureArchitectureMiRo -MiRo - ArchitectureArchitecture

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• Allows laboratories to generate and manage events

• Allows phisicians to control and report examination

• Stores reports allowing teleconsultation

Acts as a sophisticated DBMS for event-records

RepositoryRepositoryRepositoryRepository

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• Generates clinical event

• Provides digital data of examination

• Monitors the workflow of reporting phase

• Terminates reporting phase

LaboratoryLaboratoryLaboratoryLaboratory

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• Consults published examination

• Consults reports written by other phisicians

• Compiles and signs report

• Send this report to a timestamp service and then to the repository

PhisicianPhisicianPhisicianPhisician

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1. Laboratory executes an examination that produces digital data

2. Laboratory pubblicates exam through the creation of an event

3. Phisician compiles and signs a report and sends it to the timestamp service

4. Timestamp service appends a certificated datetime to the report and forwards this back to the phisician

5. Phisician sends this composite-data to the Repository

6. The Laboratory decides when to terminate the refertation process

From Exam to ReportFrom Exam to ReportFrom Exam to ReportFrom Exam to Report

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1. Laboratory executes an examination that produces digital data

2. Laboratory pubblicates exam through the creation of an event

Event-Generation ProcessEvent-Generation ProcessEvent-Generation ProcessEvent-Generation Process

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3. Repository records event informations about exam

4. The exam is reachable through the MiRo Network from each authorized client

Event-Generation ProcessEvent-Generation ProcessEvent-Generation ProcessEvent-Generation Process

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1. Phisician, as client, connects to Repository and can see a list of events

2. Phisician chooses an event and retrieves linked examination data

Report-Generation ProcessReport-Generation ProcessReport-Generation ProcessReport-Generation Process

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3. Phisician sees reports written by other associates

4. Phisician compiles a report and sends it to the Repository

Report-Generation ProcessReport-Generation ProcessReport-Generation ProcessReport-Generation Process

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MiRo -MiRo - TechnologiesTechnologiesMiRo -MiRo - TechnologiesTechnologies

• Service-Oriented Architecture based on common standards widely applied in different health contexts

• implemented through Web Services (SOAP, XML, …), which are becoming a standard to distribute services inside an heterogeneous environment such as Internet

• Client can enter in any moment to consult and to insert event or report data using a common Web Browser

• transactions are encrypted through standard SSL X509.v3, using standard Digital Certificates

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MiRo – Development EnvironmentMiRo – Development EnvironmentMiRo – Development EnvironmentMiRo – Development Environment

• Java 2 Platform Standard Edition• development tools:

– Eclipse 3.1 – as development environment– Apache Axis and Java Servlet – to realize web services– Apache Struts and Java Sever Pages – to design web

interfaces

• Java web services technology– JDBC interface (in our case MySQL).

• Clients adopt just Web Browsers

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MiRo -MiRo - Security LayerSecurity LayerMiRo -MiRo - Security LayerSecurity Layer

• Secure Socket Layer(SSL)– Confidentiality achieved through cryptography,

guarantees that data can exclusively be read from the authorized user.

• Digital Sign– Integrity and no-repudiation, achieved through the

digital sign, guarantees that information are not modified during the transmission and that those who use the system assume the responsibilities of what they are doing.

– Authentication achieved through digital certificate, Username and Password, guarantees that the user is exactly the person he declares to be.

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Conclusions and future worksConclusions and future worksConclusions and future worksConclusions and future works

• MiRo is a software architecture for TCP/IP-based telereporting activities and “second opinion” services

• thanks to its flexibility, can be exploited in many different operational realities and is able to incorporate different Intra/Internet-based services.

• In future perspective, we foresee the possibility to implement and to provide new services and to reach citizens.

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GreetingsGreetingsGreetingsGreetings

• ALDO FRANCO DRAGONIDEIT, Dipartimento di Elettronica Intelligenza Artificiale e Telecomunicazioni – Università Politecnica delle Marche, Ancona

• GIUSEPPE GIAMPIERIASUR Zona 7, Azienda Sanitaria Locale delle Marche Ancona

THANK FOR YOUR ATTENTION