The Framework of a Real-time Patient Monitoring System Besnik Qehaja Supervisor: Dr. András Gábor CSc. Budapest, © Besnik Qehaja Content 1. INTRODUCTION ......................................................................................................... 1 1.1 Thesis outline ........................................................................................................... 3 1.2 Problem Statement ................................................................................................... 5 2. HEALTH STRATEGIES ............................................................................................. 8 2.1 World Health Organization (WHO)......................................................................... 8 2.2 World Health Organization and Europe .................................................................. 8 2.3 Health Strategy of Western Balkan Countries ......................................................... 9 2.4 Kosovo Health Strategy ......................................................................................... 12 2.5 Summary ................................................................................................................ 14 3. Organization of Healthcare ........................................................................................ 15 3.1 General Practitioner (Family Doctor) .................................................................... 15 3.2 Outpatient Care ...................................................................................................... 16 3.3 Tertiary Level Health Institutions .......................................................................... 16 3.4 Homecare - Family Care ........................................................................................ 16 3.5 Rehabilitation ......................................................................................................... 17 3.6 Prevention .............................................................................................................. 17 3.6.1 Awareness ....................................................................................................... 17 3.6.2 Fitness ............................................................................................................. 18 3.6.3 Sport ............................................................................................................... 18 3.6.4 Nutrition ......................................................................................................... 19 3.6.5 Lifestyle coaching........................................................................................... 19 3.7 Stakeholders ........................................................................................................... 19 3.7.1 Social policy-makers ...................................................................................... 20 3.7.2 Senior and junior medical staff ....................................................................... 21 3.7.3 Nurses ............................................................................................................. 22 3.7.4 Patients ........................................................................................................... 23 3.7.5 Family ............................................................................................................. 23 3.7.6 Civil organization ........................................................................................... 24 3.7.7 Health industry players ................................................................................... 26 3.8 Summary ................................................................................................................ 28 4. State of the Art – eHealth in the Literature .............................................................. 29 4.1 ICT Enter to Medical Sciences .............................................................................. 29 4.2 Digitalization in Healthcare ................................................................................... 30 4.3 Popularization of ICT in Medical Treatment ......................................................... 31 4.3.1 Digitalization in diagnosis and treatment ....................................................... 31 4.3.2 ICT Enter into the treatment of patients ......................................................... 32 4.4 Challenges of ICT in Medical Treatment .............................................................. 35 4.5 Cost Optimization .................................................................................................. 38 4.5.1 Prevention of disease and early detection through eHealth ............................ 40 4.6 ICT Infrastructure for eHealth Implementation ..................................................... 41 4.7 Data Standardization .............................................................................................. 43 4.8 Privacy and Security in eHealth ............................................................................. 44 4.9 Types of Hardware Used for eHealth Systems ...................................................... 46 4.10 Best Practice and Relevant Projects ....................................................................... 47 4.11 Summary ................................................................................................................ 51 5. Role of Monitoring in eHealth.................................................................................... 52 5.1 Health Indicators .................................................................................................... 52 5.1.1 Health status ................................................................................................... 52 5.1.2 Healthcare risk factors .................................................................................... 54 5.1.3 Effectiveness: quality of care and patient experience .................................... 54 5.1.4 Health costs and funding ................................................................................ 55 5.1.5 Use of services ................................................................................................ 56 5.1.6 ICT in healthcare ............................................................................................ 57 5.2 Tele-monitoring and eHealth ................................................................................. 58 5.2.1 Advantages of Tele-monitoring ..................................................................... 59 5.2.2 Challenges in tele-monitoring ........................................................................ 59 5.3 Implementation: best/good/bad practices .............................................................. 61 5.4 Summary ................................................................................................................ 64 6. Problem Definitions - Research Questions................................................................ 66 6.1 What Do We Want? ............................................................................................... 66 6.2 What Can We Do? Architecture Principles ........................................................... 68 6.3 Research Questions ................................................................................................ 70 7. e-Health Enterprise Architecture .............................................................................. 72 7.1 Why Enterprise Architecture Approach? ............................................................... 72 7.2 Current Situation of Healthcare Information Handling in Kosovo ........................ 74 7.3 Stakeholder Analysis ............................................................................................. 76 7.4 Application Architecture ........................................................................................ 82 7.4.1 Functional requirements ................................................................................. 82 7.4.2 Target groups .................................................................................................. 83 7.4.3 Applications .................................................................................................... 85 7.5 Data Architecture ................................................................................................... 90 7.5.1 Data analytics in the eHealth system .............................................................. 95 7.5.2 Disaster recovery - AllwaysOn ...................................................................... 97 7.5.3 Data security ................................................................................................. 100 7.6 Technology Architecture ..................................................................................... 101 7.7 Conclusion ........................................................................................................... 104 8. Roadmap .................................................................................................................... 106 8.1 Requirement phase ............................................................................................... 106 8.2 Development phase .............................................................................................. 107 8.3 Testing phase ....................................................................................................... 108