Research on Biomedical Engineering
https://rbejournal.org/article/doi/10.1590/2446-4740.18004
Research on Biomedical Engineering
Original article

SMART: a service-oriented architecture for monitoring and assessing Brazil’s Telehealth outcomes 

Jailton Carlos de Paiva, Túlio de Paiva Marques Carvalho, Allyson Bruno Campos Barros Vilela, Giovani Ângelo Silva da Nóbrega, Beatriz Soares de Souza, Ricardo Alexsandro de Medeiros Valentim

Downloads: 2
Views: 198

Abstract

Introduction: Brazilian Telehealth Program was instituted by the Ministry of Health in 2007. Its initial structure was composed of nine telehealth centers administered by public higher education institutions. No standards, processes, applications or quality indicators had been defined since its creation. All this, combined with the decentralization of the centers, led each one of them to develop their own system, with different programming languages and architectures. The lack of regulation and integration of the information with the Ministry of Health made it difficult to evaluate the program. In this context, this paper describes the specification, implementation, and validation of an architecture, entitled SMART, to integrate the various telehealth platforms developed by the centers. Such architecture aims to standardize information so that the Ministry of Health can monitor and evaluate the results of Telehealth actions. Methods: SMART’s architecture consists of four main components: a web tool for data manipulation; a web service to receive the center’s production data; a component responsible for converting the received data into decision support data; and a component that collects data from external sources to compose the data warehouse. Results: The architecture was validated with performance tests, which were executed under extreme workloads. The results of the experiments were summarized in order to attest SMART’s effectiveness. Conclusion: The analysis of the results obtained on real data shows that the project’s performance remained stable under the workloads and its high quality was proven due to the absence of errors during the experiments. 

Keywords

Telehealth, Evaluation, Standardization, SOA, Integration, Interoperability. 

References

Agboola S, Hale TM, Masters C, Kvedar J, Jethwani K. “Real-world” practical evaluation strategies: a review of telehealth evaluation. JMIR Res Protoc. 2014; 3(4):1-11. http://dx.doi.org/10.2196/resprot.3459. PMid:25524892.

AlDossary S, Martin-Khan MG, Bradford NK, Armfield NR, Smith AC. The development of a telemedicine planning framework based on needs assessment. J Med Syst. 2017; 41(5):171-94. http://dx.doi.org/10.1007/s10916-017-0709-4. PMid:28321589.

Arifin SMN, Madey GR, Vyushkov A, Raybaud B, Burkot TR, Collins FH. An online analytical processing multi-dimensional data warehouse for malaria data. Database (Oxford). 2017; 1(1):1-20. http://dx.doi.org/10.1093/database/bax073. PMid:29220463.

Asadollah AS, Chiew TK. Web service response time monitoring: architecture and validation. Adv Math Comput Methods. 2012; 2(3):58-63. http://dx.doi.org/10.1007/978-3-642-24999-0_39.

Brasil. Ministério da Saúde. Portaria nº 35 de 04 de janeiro de 2007. Institui, no âmbito do Ministério da Saúde, o Programa Nacional de Telessaúde. Diário Oficial da República Federativa do Brasil [Internet], Brasília, 2007 [cited 2017 June 10]. 

Available from: http://bvsms.saude.gov.br/bvs/saudelegis/gm/2007/prt0035_04_01_2007_comp.html

Brasil. Ministério da Saúde. Portaria nº 2.546, de 27 de outubro de 2011. Redefine e amplia o Programa Telessaúde Brasil, que passa a ser denominado Programa Nacional Telessaúde Brasil Redes. Diário Oficial da República Federativa do Brasil [Internet], Brasília, 2011 [cited 2017 June 10]. Available from: http://bvsms.saude.gov.br/bvs/saudelegis/gm/2011/prt2546_27_10_2011.html

Brasil. Ministério da Saúde. Nota Técnica n° 05/2014. Define diretrizes para o monitoramento e avaliação do Programa Nacional Telessaúde Brasil Redes, conforme Portaria n. 2.546, de 27 de outubro de 2011. Diário Oficial da República Federativa do Brasil [Internet], Brasília, 2014 [cited 2017 June 20]. Available from: http://smart.telessaude.ufrn.br/static/smart/nt_005_2014.pdf

Brasil. Ministério do Planejamento, Orçamento e Gestão. Padrões de interoperabilidade de governo eletrônico [Internet]. Brasília: Secretaria de Tecnologia da Informação; 2018 [cited 2018 Jan 10]. Documento de referência. Avaliable from: http://eping.governoeletronico.gov.br

Cannata M, Antonovic MP, Molinari ME. Load testing of HELIDEM geo-portal: an OGC open standards interoperability example integrating WMS, WFS, WCS and WPS. Int J Spat Data Infrastruct Res. 2014; 9(1):107-30. http://dx.doi.org/10.2902/1725-0463.2014.09.ART5.

Chang H. Evaluation framework for telemedicine using the logical framework approach and a fishbone diagram. Healthc Inform Res. 2015; 21(4):230-8. http://dx.doi.org/10.4258/hir.2015.21.4.230. PMid:26618028.

Changbin W, Xu Y. Web services integration method. Programme networks and distributed systems [thesis]. Gothenburg: Chalmers University of Technology; 2010.

Cito J, Gotowka D, Leitner P, Pelette R, Suljoti D, Dustdar S. Identifying web performance degradations through synthetic and real-user monitoring. J Web Eng. 2015; 14(5-6):414-42. http://dx.doi.org/10.5167/uzh-110955.

Haddad AE. Experiência Brasileira do Programa Nacional Telessaúde Brasil. GoldBook: Inovação Tecnológica em Educação e Saúde. [Internet]. 2012 [cited 2017 June 11]; 1(1):12-56. Available from: http://www.telessaude.uerj.br/resource/goldbook/pdf/2.pdf

Hsieh SH, Hsieh SL, Cheng PH, Lai F. E-health and healthcare enterprise information system leveraging service-oriented architecture. Telemed J E Health. 2012; 18(3):205-17. http://dx.doi.org/10.1089/tmj.2011.0100. PMid:22480301.

Jain PJ, Rajput B, Sayankar A. Implications for data analyses and higher education with SQL and data analysis. IJFEAT. 2015; 11(1):80-6.

Kimball R, Ross M. The data warehouse toolkit: the definitive guide to dimensional modeling. USA: John Wiley & Sons; 2013.

Kranch M, Bonneau J. Upgrading HTTPS in mid-air: an empirical study of strict transport security and key pinning. In: Proceedings of the NDSS Symposium; 2015 Feb; San Diego, CA, USA. USA: Internet Society; 2015. http://dx.doi.org/10.14722/ndss.2015.23162. 

Kundu S. Web testing: tool, challenges and methods. IJCSI Int J Comput Sci Issues. 2012; 9(2):481-5.

Lopes PRL, Gundim RS, Silva AB. Avaliação: um componente importante da telemedicina. In: Ribeiro JL Fo, Messina LA, Lopes PRL, editors. RUTE 100 - As 100 primeiras unidades de Telemedicina no Brasil e o impacto da Rede Universitária de Telemedicina (RUTE). Rio de Janeiro: E-papers; 2014. p. 78-87.

Maeder A, Poultney N. Evaluation strategies for telehealth implementations. In: IEEE International Conference on Healthcare Informatics (ICHI); 2016 Oct 4-7; Chicago. USA: IEEE; 2016. p. 363-6. http://doi.org/10.1109/ICHI.2016.65.

McLeod C. A framework for distributed deep learning layer design in python. arXiv preprint. 2015; 1(1):1-8.

Mendes EV. 25 anos do Sistema Único de Saúde: resultados e desafios. Estud Av. 2013; 27(78):27-34. http://dx.doi.org/10.1590/S0103-40142013000200003.

Millman KJ, Aivazis M. Python for scientists and engineers. Comput Sci Eng. 2011; 13(2):1-5. http://dx.doi.org/10.1109/MCSE.2011.36.

Nurseitov N, Paulson M, Reynolds R, Izurieta C. Comparison of JSON and XML data interchange formats. San Francisco: Caine; 2009. p. 157-62.

Obe R, Hsu L. PostGIS in action. 2th ed. Greenwich: Manning Publications Co; 2015.

Oliveira TC, Oliveira JG Jr, Tavares G, Rigato AFG, Pereira FW A, Carvalho FF B. The National Program Telehealth Brazil networks: a historic and situational perspective. Lat Am J Telehealth. 2017; 4(2):104-13.

Pautasso C. RESTful web services: principles, patterns, emerging technologies. InWeb Serv Found. New York: Springer; 2014. p. 31-51.

Rodrigues F, Pereira D, Nascimento JC, Ribeiro J, Barros P, Correia R, et al. Interoperabilidade na Saúde - Onde Estamos? APDSI. 2013; 1(1):1-167.

Sernadela P, González-Castro L, Oliveira JL. Scaleus: semantic web services integration for biomedical applications. J Med Syst. 2017; 41(4):54-64. http://dx.doi.org/10.1007/s10916-017-0705-8. PMid:28214993.

Sharmila S, Ramadevi E. Analysis of performance testing on web applications. Int J Adv Res Comput Commun Eng. 2014; 3(3):5228-60.

Silva AB, Carneiro ACMG, Sindico SRF. Regras do Governo Brasileiro sobre Serviços de Telessaúde: revisão integrativa. Planej Polít Públicas. 2015; 44(1):167-88.

Silva AB, Moraes IHS. O caso da Rede Universitária de Telemedicina: análise da entrada da telessaúde na agenda política brasileira. Physis. 2012; 22(3):1211-35. http://dx.doi.org/10.1590/S0103-73312012000300019.

Sistema de Monitoramento e Avaliação dos Resultados do Programa Telesaúde – SMART. Modelo Nacional de Interoperabilidade do BTBR [Internet]. Natal: LAIS/UFRN; 2018 [cited 2018 Jan 15]. Available from: http://smart.telessaude.ufrn.br/webapp/api_docs.html

van Dyk L. A review of telehealth service implementation frameworks. Int J Environ Res Public Health. 2014; 11(2):1279-98. http://dx.doi.org/10.3390/ijerph110201279. PMid:24464237.

Vargens JMC. Uma abordagem sociotécnica para design e desenvolvimento de sistemas de informação em saúde no âmbito do SUS [thesis]. Rio de Janeiro: Escola Nacional de Saúde Pública; 2014.

Waas F, Wrembel R, Freudenreich T, Thiele M, Koncilia C, Furtado P. On-demand ELT architecture for right-time BI: extending the vision. Int J Data Warehous Min. 2013; 9(2):21-38. http://dx.doi.org/10.4018/jdwm.2013040102.

Wen CL. Telemedicina e telessaúde - um panorama no Brasil. Rev Inform Públ. 2008; 10(2):7-15.

5c48debc0e8825c03675a621 rbejournal Articles
Links & Downloads

Res. Biomed. Eng.

Share this page
Page Sections