Healthy Living Combining Cloud Computing, Client-Server Together With New Pub/Sub Mesh Node Network Architectures (Part I Of 2)

There are at to the lowest degree iii key architectures for deploying wellness information technology software programs together with exchanging patient information:

1. Cloud computing
   
2. Client server
   
3. Publish/subscribe mesh node networks.
   

Each of these architectures has its ain work cases and, every bit I hash out below, I've concluded that using all iii provides the best solution for operating a national wellness information network (NHIN).

Cloud Computing Architecture Described

Here's a Definition of the cloud computing architecture that I believe captures its essence: Cloud computing architectures shop software programs together with information inwards servers that are accessed over the Internet via services (e.g., software every bit a service, SaaS); spider web browsers supply halt users an online interface to those services. The servers—along amongst the software together with centralized databases they contain—may live on owned together with managed yesteryear third-party vendors (public cloud), yesteryear the halt user's organisation (private cloud), or yesteryear both (hybrid cloud). In other words, typical cloud computing enables applications to live on accessed online from a Web browser, piece the software together with information are stored on remote servers. See this link for a depiction of how CPS nodes supply a simple, low-cost, secure way to commutation wellness data.

In add-on to their asynchronous pub/sub functionality (described above), CPS nodes have got other critical capabilities including:

• Data transformation
  
• Universal translation
  
• Composite reporting.
  

These capabilities, which are described below, enable CPS node networks to commutation patient information easily no affair what information structures together with terminology standards are used, together with where the master copy information are stored. This way that information transformation together with universal translation supply a way for modifying (transforming, translating) information every bit they overstep betwixt the nodes, so that all subscriber nodes have from their publisher nodes the correct data, inwards the correct format (structure) together with language, together with amongst the correct damage (semantics). This way the nodes suit all information standards, every bit good every bit whatever non-standardized (local or domain/discipline specific) data. It every bit good way that composite reporting combines information multiple sent publisher nodes to a unmarried subscriber node inwards gild to generate composite reports containing information from multiple sources.

Data Transformation Capabilities

CPS nodes work their extensive information transformation capabilities when information structures have got to live on modified to allow disparate databases to commutation their data. This happens when, for example, the databases have got (a) dissimilar table together with field names, (e.g., i database may work the champaign "birth_date" together with around other "dob" or (b) dissimilar information formats/syntax, e.g., whether the nascence information is month/day/year (as inwards U.S.) or day/month/year (as inwards Europe), every bit good every bit how many digits or characters are used inwards the date.

One way to bargain amongst the number of exchanging information betwixt incompatible databases is forcing everyone to work the same information standard. One such method is transforming all information to As I discussed at this link, ii advantages of the CPS information files over XML are: (1) they are easily 1000% to 2000% (10 to xx times) smaller than XML files containing the same information together with (2) they are much simpler together with to a greater extent than efficient to procedure (i.e., parse together with render) than XML.

As the information are beingness sent to the CPS information file, the publishing node transforms them depending on the information format needed yesteryear each subscribing node. The publisher so ships the transformed information to the subscribing node. The transformation procedure requires that the publisher node live on notified inwards advance every bit to the information transformations required yesteryear each subscribing node. This notification procedure tin direct house during when a subscribing node registers amongst a publishing node, or upon a subscribing node's asking for information from the publishing node.

Universal Translation Capabilities

CPS nodes work their universal translation capabilities when publishers work a dissimilar linguistic communication or damage than their subscribers. This is most probable to direct house when people inwards loosely-coupled professional person together with social networks portion information; that is, when various groups of individuals commutation information from various information sources. One such illustration is the vast multifariousness of people who volition commutation a smashing variety of information across a national wellness information network. Sometimes linguistic communication translation is necessary (e.g., English linguistic communication to Spanish), which is fairly straightforward. Other times dissimilar people work dissimilar damage (their local terminology standards) to refer to the same concept (thing or idea), which tin live on a complex problem.

One mutual strategy used to bargain amongst complex terminology problems is to discard local terminology standards yesteryear forcing everyone to adopt the same global terminology standards. This is done yesteryear agreeing on i fix of damage (semantics) for a exceptional thing. While such global standards for health-related damage tin foster widespread communications betwixt people from dissimilar regions, organizations together with disciplines, at that topographic point is a serious downside to eliminating the local standards people rely upon; the job is the loss of of import information due to reduced semantic precision together with nuance.

Take, for example, the term "high blood pressure;" at that topographic point are 126 dissimilar damage referring to this concept of elevated blood pressure level levels. These damage include "malignant hypertension," which refers to rattling high blood pressure level amongst swelling of the optic nervus behind the eye; it's a status unremarkably accompanied yesteryear other organ impairment such every bit middle failure, kidney failure, together with hypertensive encephalopathy. "Pregnancy-induced hypertension," on the other hand, is when blood pressure level rises during pregnancy (also called toxemia or preeclampsia). These are rattling dissimilar types of hypertension. So, piece referring to a person's status using a global standard term such every bit "hypertension" clearly conveys that the someone has high blood pressure, the standardized term loses of import details establish inwards the to a greater extent than detailed local standard terms. These lost details, inwards turn, could rattling good comport upon handling decisions together with outcomes. So, at that topographic point is a skilful ground to have got multiple damage that refer to the same health-related concept.

An payoff of the nodes' universal translation capabilities, therefore, is that they enable end-users to perish along existing local standards, back upward the development of those standards, together with work the information translation described higher upward to ensure everyone gets the information needed using the damage they ask together with understand. In a node network, this tin live on accomplished inwards a way similar to information transformation. But instead of having the publishing node transform the data, it replaces specific damage amongst the alternate damage required yesteryear the subscribing nodes.

Composite Reports

The nodes tin every bit good generate composite reports that are comprised of information sent from multiple publisher nodes to a unmarried subscriber node. The subscriber node takes all that information from multiple sources together with combines it into a unmarried integrated patient wellness written report that is tailored to the needs of the individual.

For example, let's order a primary attention Dr. (PCP) wants to perish along rails of the handling a patient is receiving from several provider specialists. The PCP's node, which serves every bit the subscriber, would transportation a asking for sure enough information from all the patient's specialists. Upon receipt of the information request, the specialists' nodes, which serve every bit the publishers, hollo upward the requested information from their dissimilar electronic wellness tape databases, transform together with interpret the information every bit necessary, together with so transportation the information automatically to the PCP's node. The PCP's node so incorporates the information into a composite written report tailored to the PCP's needs together with preferences, together with presents the written report on covert for the PCP to view. The PCP's subscriber node could every bit good live on instructed to asking information from the patient's node connected to his/her personal wellness tape and, upon receipt, add together the information into the same report. Likewise, a patient node could practise composite reports inwards a similar trend from information sent yesteryear multiple provider nodes.

So, which architecture is best—cloud, client-server, the new pub/sub node network, or a combined solution that embraces all three? I ground that it's the latter, whereby the benefits of each architecture are realized inwards dissimilar work cases.

In my side yesteryear side post, I will share my thoughts virtually this multifaceted solution yesteryear presenting possible work cases.

Related posts:

• Combining Cloud Computing, Client-Server together with Novel Pub/Sub Mesh Node Network Architectures (Part 2 of 2)
• The force for ‘push’ technology for the NHIN
• A Novel Way for Everyone inwards the Nation to Exchange Health Data Simply, Inexpensively together with Securely
• Simple, Low-Cost, Secure Health Data Exchange
• Who should Own a Patient’s Health Data, Where should they live on Stored, together with How should they live on Exchanged (Part 1 of 2)
• Who should Own a Patient’s Health Data, Where should they live on Stored, together with How should they live on Exchanged (Part 2 of 2)
• Health IT: Comparing Cloud Computing together with Desktop Applications (Part 1)
• Health IT: Comparing Cloud Computing together with Desktop Applications (Part 2)
• Health IT: Comparing Cloud Computing together with Desktop Applications (Part 3)
• Dueling Data Formats
• Knowledge, Standards together with the Healthcare Crisis: Part 6  
• Introducing our disruptive CP Split technology

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