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Journal of Medical Systems
Published in: Journal of Medical Systems 12/2014

01-12-2014 | Transactional Processing Systems

Service Oriented Architecture for Clinical Decision Support: A Systematic Review and Future Directions

Authors: Salvador Rodriguez Loya, Kensaku Kawamoto, Chris Chatwin, Vojtech Huser

Published in: Journal of Medical Systems | Issue 12/2014

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Abstract

The use of a service-oriented architecture (SOA) has been identified as a promising approach for improving health care by facilitating reliable clinical decision support (CDS). A review of the literature through October 2013 identified 44 articles on this topic. The review suggests that SOA related technologies such as Business Process Model and Notation (BPMN) and Service Component Architecture (SCA) have not been generally adopted to impact health IT systems’ performance for better care solutions. Additionally, technologies such as Enterprise Service Bus (ESB) and architectural approaches like Service Choreography have not been generally exploited among researchers and developers. Based on the experience of other industries and our observation of the evolution of SOA, we found that the greater use of these approaches have the potential to significantly impact SOA implementations for CDS
Appendix
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Literature
1.
Erl, T., Service-Oriented Architecture Concepts, Technology, and Design. PTR, Prentice Hall, 2005.
2.
Malinverno P, Plummer DC, Huizen G Van (2013) Magic Quadrant for Application Services Governance.
3.
Heffner, R., and Leganza, G., SOA Adoption 2010: Still Important. Still, Strong, 2011.
4.
5.
Dobrescu R, Purcarea V (2012) Impact of Information Technology on the Quality of Health Services. In: Borangiu T, Thomas A, Trentesaux D (eds) Serv. Orientat. Holonic Multi-Agent Manuf. Control SE - 23. Springer Berlin Heidelberg, pp 307–319
6.
7.
Kawamoto, K., Honey, A., and Rubin, K., The HL7-OMG Healthcare Services Specification Project: Motivation, Methodology, and Deliverables for Enabling a Semantically Interoperable Service-oriented Architecture for Healthcare. J. Am. Med. Inform. Assoc. 16:874–881, 2009. doi:10.​1197/​jamia.​M3123.CrossRef
8.
9.
10.
Canada Health Infoway Inc (2006) EHRS BluePrint an Interoperable EHR framework, Version 2
11.
12.
Kawamoto, K., Houlihan, C. A., Balas, E. A., and Lobach, D. F., Improving clinical practice using clinical decision support systems: a systematic review of trials to identify features critical to success. BMJ 330:765, 2005. doi:10.​1136/​bmj.​38398.​500764.​8F.CrossRef
13.
Sharma, B., Electronic Healthcare Maturity Model (eHMM): A White paper. Chennai, India, 2008.
14.
Garets D, Davis M (2006) Electronic Medical Records vs . Electronic Health Records : Yes, There Is a Difference. Policy white Pap. Chicago, HIMSS Anal.
15.
16.
Wainwright, D., and Waring, T., The information management and technology strategy of the UK National Health Service – Determining progress in the NHS acute hospital sector. Int. J. Public. Sect. Manag. 13:241–259, 2000. doi:10.​1108/​0951355001034615​2.CrossRef
17.
Graham, R., Mancher, M., Wolman, D. M., et al., Clinical Practice Guidelines We Can Trust. Press, National Academies, 2011.
18.
19.
Wu, S., Chaudhry, B., Wang, J., et al., Systematic review: impact of health information technology on quality, efficiency, and costs of medical care. Ann. Intern. Med. 144:742–752, 2006.CrossRef
20.
21.
Kawamoto K (2007) Integration of Knowledge Resources into Applications to Enable Clinical Decision Support: Architectural Considerations. In: Greenes RA (ed) Clin. Decis. Support Road Ahead. Elsevier Academic Press, Boston, pp 503–38
22.
Jahnke-Weber, J. H., Price, M., and McCallum, G., Making available Clinical Decision Support in Service-Oriented Architectures. J. Inf. Technol. Healthc. 6:42–54, 2008.
23.
24.
Kawamoto, K., Del Fiol, G., Orton, C., and Lobach, D. F., System-agnostic clinical decision support services: benefits and challenges for scalable decision support. Open Med. Inform. J. 4:245–254, 2010. doi:10.​2174/​1874431101004010​245.CrossRef
25.
Kawamoto, K., and Lobach, D. F., Proposal for Fulfilling Strategic Objectives of the U.S. Roadmap for National Action on Decision Support through a Service-oriented Architecture Leveraging HL7 Services. J. Am. Med. Inform. Assoc. 14:146–155, 2007. doi:10.​1197/​jamia.​M2298.CrossRef
26.
Kitchenham B (2004) Procedures for Performing Systematic Reviews. Technical Report TR/SE-0401 and NICTA Tecnical Report 0400011T1.
27.
Moher D, Liberati A, Tetzlaff J, Altman DG (2009) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. BMJ 339:
28.
Dyba T, Dingsoyr T, Hanssen GK (2007) Applying Systematic Reviews to Diverse Study Types: An Experience Report. Empir Softw Eng Meas 2007 ESEM 2007 First Int Symp 225–234. doi: 10.​1109/​ESEM.​2007.​59
29.
Kitchenham B, Charters S (2007) Guidelines for performing Systematic Literature Reviews in Software Engineering.
30.
31.
Arsanjani, A., Service-oriented modeling and architecture. IBM Dev. Work 1–15, 2004.
32.
Bianco P, Lewis GA, Merson P, Simanta S (2011) Architecting Service-Oriented Systems, TECHNICAL NOTE CMU/SEI-2011-TN-008 Research,.
33.
Charfi A, Mezini M (2004) Hybrid Web Service Composition: Business Processes Meet Business Rules. Proc. 2Nd Int. Conf. Serv. Oriented Comput. ACM, New York, NY, USA, pp 30–38
34.
Papazoglou, M. P., Traverso, P., Dustdar, S., and Leymann, F., Service-Oriented Computing: State of the Art and Research Challenges. Computer (Long Beach Calif.) 40:38–45, 2007. doi:10.​1109/​MC.​2007.​400.
35.
Baryannis G, Danylevych O, Karastoyanova D, et al. (2010) Service Composition. In: Papazoglou M, Pohl K, Parkin M, Metzger A (eds) Serv. Res. Challenges Solut. Futur. Internet SE - 3. Springer Berlin Heidelberg, pp 55–84
36.
Catley C, Petriu DC, Frize M (2004) Software performance engineering of a Web service-based clinical decision support infrastructure. Softw. Eng. Notes. USA, pp 130 – 8
37.
Ciccarese, P., Caffi, E., Boiocchi, L., et al., A Guideline Management System. Med. Inf. 28–32, 2004.
38.
39.
Ram, P., Berg, D., Tu, S., et al., Executing clinical practice guidelines using the SAGE execution engine. Stud. Health Technol. Inform. 251–5, 2004.
40.
Bicer, V., Kilic, O., Dogac, A., and Laleci, G. B., Archetype-Based Semantic Interoperability of Web Service Messages in the Health Care Domain. Int’l J. Semant. Web Inf. Syst. 1:1–22, 2005.CrossRef
41.
Heard KM, Huang C, Noirot L a, et al. (2006) Using BPEL to define an executable CDS rule process. AMIA Annu. Symp. Proc. American Medical Informatics Association, p 947
42.
Lobach DF, Kawamoto K, Anstrom KJ, et al. (2007) Development, Deployment and Usability of a Point-of-Care Decision Support System for Chronic Disease Management Using the Recently-Approved HL7 Decision Support Service Standard. In: Kuhn KA, Warren JR, Leong TY (eds) Medinfo 2007 Proc. 12th World Congr. Heal. pp 861–865
43.
Nakamura MM, Simons WW, Samuels R, et al. (2007) Service-oriented architecture for pediatric immunization decision support. AMIA 2007 Symp. Proc. p 1056
44.
45.
Huang, Y., Noirot, L. A., Heard, K. M., et al., Migrating toward a next-generation clinical decision support application: the BJC HealthCare experience AMIA. Annu. Symp. Proc. 344–8, 2007.
46.
Pires DF. F, Teixeira CAC. AC, Ruiz EES. ES d ES d, et al. (2008) A UMLS interoperable solution to support collaborative diagnosis decision making over the internet. Proc. ACM Symp. Appl. Comput. Fortaleza, Ceara, pp 1400–1404
47.
Jahnke-Weber, J. H., Design of decoupled clinical decision support for service-oriented architectures. Int. J. Softw. Eng. Knowl. Eng. 19:159–183, 2009.CrossRef
48.
Kashyap V (2009) From the Bench to the Bedside: The Role of Semantic Web and Translational Medicine for Enabling the Next Generation Healthcare Enterprise. In: Fred A, Filipe J, Gamboa H (eds) Biomed. Eng. Syst. Technol. SE - 3. Springer Berlin Heidelberg, pp 35–56
49.
Zhu, V. J., Grannis, S. J., Rosenman, M. B., and Downs, S. M., Implementing broad scale childhood immunization decision support as a web service AMIA. Annu. Symp. Proc. 745–9, 2009.
50.
Fdez-olivares, J., Juan, A. C., and Castillo, L., OncoTheraper : Clinical Decision Support for Oncology Therapy Planning Based on Temporal Hierarchical Tasks Networks. Knowl. Manag. Heal Care Proced. 25–41, 2009.
51.
Riposan A, Taylor IJ, Rana O, et al. (2009) The TRIACS analytical workflows platform for distributed clinical decision support. 2009 22nd IEEE Int. Symp. Comput. Med. Syst. Piscataway, NJ, USA, p 8 pp. –
52.
Laleci, G. B., and Dogac, A., A Semantically Enriched Clinical Guideline Model Enabling Deployment in Heterogeneous Healthcare Environments. Inf. Technol. Biomed. IEEE Trans. 13:263–273, 2009. doi:10.​1109/​TITB.​2008.​2010542.CrossRef
53.
Kameas A, Calemis I (2010) Pervasive Systems in Health Care. In: Nakashima H, Aghajan H, Augusto J (eds) Handb. Ambient Intell. Smart Environ. SE - 12. Springer US, pp 315–346
54.
Hatsek, A., Shahar, Y., Taieb-Maimon, M., et al., A scalable architecture for incremental specification and maintenance of procedural and declarative clinical decision-support knowledge. Open. Med. Inform. J. 4:255–277, 2010. doi:10.​2174/​1874431101004010​255.CrossRef
55.
Acosta DD., Patkar VV., Keshtgar MM., Fox J. J (2010) Challenges in delivering decision support systems: The MATE experience. Lect Notes Comput Sci (including Subser Lect Notes Artif Intell Lect Notes Bioinformatics) 5943 LNAI:124–140. doi: 10.​1007/​978-3-642-11808-1_​11
56.
Del Fiol, G., Kawamoto, K., Lapointe, N. M. A., et al., Improving Medication Adherence in a Regional Healthcare Information Exchange using a Scalable, Claims-Driven, and Service-Oriented Approach AMIA. Annu. Symp. Proc. 137–141, 2010.
57.
Kim JA, Shim, Kim S, et al. (2011) Implementation of Guideline-Based CDSS. Proc. 2011 Int. Conf. Ubiquitious Comput. Multimed. Appl. (UCMA 2011). Los Alamitos, CA, USA, pp 96 – 9
58.
Kim JA, Shim, Kim S, et al. (2011) Implementation of Guideline-Based CDSS. Proc. 2011 Int. Conf. Ubiquitious Comput. Multimed. Appl. (UCMA 2011). Los Alamitos, CA, USA, pp 96 – 9
59.
Fehre, K., and Adlassnig, K. P., Service-Oriented Arden-Sysntax-Based Clinical Decision Support. In: Schreier, G., Hayn, D., and Ammenwerth, E. (Eds.), Ehealth 2011 Heal. Informatics Meets Ehealth Von Der Wiss, Zur Anwendung Und Zurueck Grenzen Uberwinden. Contin. Care, pp. 123–128, 2011.
60.
Huser, V., Rasmussen, L. V., Oberg, R., and Starren, J. B., Implementation of workflow engine technology to deliver basic clinical decision support functionality. BMC Med. Res. Methodol. 11:43, 2011. doi:10.​1186/​1471-2288-11-43.CrossRef
61.
Kamaleswaran R, McGregor C (2012) CBPsp: Complex business processes for stream processing. 2012 25th IEEE Can. Conf. Electr. Comput. Eng. Vis. a Greener Futur. CCECE 2012
62.
Kawamoto, K., Jacobs, J., Welch, B. M., et al., Clinical information system services and capabilities desired for scalable, standards-based, service-oriented decision support: consensus assessment of the Health Level 7 clinical decision support Work Group AMIA. Annu. Symp. Proc. 446–55, 2012.
63.
64.
Cucino R, Eccher C (2012) Modeling Healthcare Processes in BPEL: A Colon Cancer Screening Case Study. In: Szomszor M, Kostkova P (eds) Electron. Healthc. SE - 10. Springer Berlin Heidelberg, pp 78–85
65.
Paterno, M. D., Goldberg, H. S., Simonaitis, L., et al., Using a service oriented architecture approach to clinical decision support: performance results from two CDS Consortium demonstrations AMIA. Annu. Symp. Proc. 690–698, 2012.
66.
67.
Papazoglou M (2007) What’s in a Service? In: Oquendo F (ed) Softw. Archit. SE - 3. Springer Berlin Heidelberg, pp 11–28
68.
Sartipi K, Yarmand MH, Down DG (2007) Mined-knowledge and decision support services in electronic health. Proc. - ICSE 2007 Work. Int. Work. Syst. Dev. SOA Environ. SDSOA’07
69.
Bossche B Van Den, Hoecke S Van, Danneels C, et al. (2008) Design of a {JAIN} SLEE/ESB-based platform for routing medical data in the {ICU}. Comput Methods Programs Biomed 91:265–277. doi: http://​dx.​doi.​org/​10.​1016/​j.​cmpb.​2008.​05.​003
70.
Bossche B Van Den, Hoecke S Van, Danneels C, et al. (2008) Design of a {JAIN} SLEE/ESB-based platform for routing medical data in the {ICU}. Comput Methods Programs Biomed 91:265–277. doi: http://​dx.​doi.​org/​10.​1016/​j.​cmpb.​2008.​05.​003
71.
Steurbaut, K., Colpaert, K., Gadeyne, B., et al., COSARA: Integrated Service Platform for Infection Surveillance and Antibiotic Management in the ICU. J. Med. Syst. 36:3765–3775, 2012. doi:10.​1007/​s10916-012-9849-8.CrossRef
72.
73.
Martínez-García A, Moreno-Conde A, Jódar-Sánchez F, et al. (2013) Sharing clinical decisions for multimorbidity case management using social network and open-source tools. J Biomed Inform -. doi: http://​dx.​doi.​org/​10.​1016/​j.​jbi.​2013.​06.​007
74.
Peleg, M., Tu, S., Bury, J., et al., Comparing Computer-interpretable Guideline Models: A Case-study Approach. J. Am. Med. Inform. Assoc. 10:52–68, 2003.CrossRef
75.
Boyer J, Mili H (2011) Agile Business Rule Development. Process, Architecture, and JRules Examples. 251–257. doi: 10.1007/978-3-642-19041-4
76.
Besana P, Patkar V, Glasspool D, Robertson D (2008) Distributed Workflows: The OpenKnowledge Experience. In: Meersman R, Tari Z, Herrero P (eds) Move to Meaningful Internet Syst. OTM 2008 Work. SE - 123. Springer Berlin Heidelberg, pp 965–975
77.
78.
79.
80.
De Clercq PA, Blom JA, Korsten HHM, Hasman A (2004) Approaches for creating computer-interpretable guidelines that facilitate decision support. Artif Intell Med 31:1–27. doi: http://​dx.​doi.​org/​10.​1016/​j.​artmed.​2004.​02.​003
81.
82.
83.
Pontes Guimaraes F, Kuroda EH, Batista DM (2012) Performance Evaluation of Choreographies and Orchestrations with a New Simulator for Service Compositions. Comput Aided Model Des Commun Links Networks (CAMAD), 2012 I.E. 17th Int Work 140–144. doi: 10.​1109/​CAMAD.​2012.​6335315
84.
85.
86.
87.
88.
89.
90.
91.
92.
93.
Safy FZ, El-Ramly M, Salah A (2013) Runtime Monitoring of SOA Applications: Importance, Implementations and Challenges. Serv Oriented Syst Eng (SOSE), 2013 I.E. 7th Int Symp 315–319. doi: 10.​1109/​SOSE.​2013.​61
Metadata
Title
Service Oriented Architecture for Clinical Decision Support: A Systematic Review and Future Directions
Authors
Salvador Rodriguez Loya
Kensaku Kawamoto
Chris Chatwin
Vojtech Huser
Publication date
01-12-2014
Publisher
Springer US
Published in
Journal of Medical Systems / Issue 12/2014
Print ISSN: 0148-5598
Electronic ISSN: 1573-689X
DOI
https://doi.org/10.1007/s10916-014-0140-z

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