xAP as an open source communication protocol for health systems engineering : an application in the telemedicine environment

Andrag, Erich Paul (Stellenbosch : Stellenbosch University, 2011-12)

The objective of this project, with reference to the above, is dual fold. Firstly to evaluate the xAP protocol, as used in home automation as a suitable protocol for telemedicine diagnosis and data sharing. Secondly, network architecture capable of supporting telemedicine activities is suggested and tested based upon the xAP-protocol nature of the system.

Final year project, 2011

Technical Report

ENGLISH SUMMARY: Engineering initiatives to standardise the communication of health related systems are ineffective and uncoordinated. The extensive advantages of such standardisation could benefit both quality of service and patient turnaround time. Standardisation becomes critical once information and communication technologies (ICT) are implemented. ICT system interoperability is core to ensure the success of telemedicine. Current standardisation of telemedicine systems is led by two standardisation organisations. Health Level Seven (HL7) and the International Organisation for Standardisation (ISO) are both leading comprehensive standardisation initiatives. Access to documentation for development of systems according to these standards is restricted, inhibiting third party development and contribution. Telemedicine in Africa requires an open source development platform where privileged users can develop their own extension without the restrictions associated with current standards. Properties of the platform should address specific problems faced in an African context. Problems could include i) a lack of network infrastructure, ii) costly data transmission and iii) a lack of devices able to access the Internet. Recent widespread adoption of mobile devices compatible with cellular networks also provides an opportunity to develop standards supporting telemedicine use on cellular networks. Organisations are already capitalising on the benefits mobile phones offers. Applications for mobile phones, which provide medical related services, are popular. Services include general medical information as well as using the technology of the mobile phone to perform basic diagnoses. A simple heart rate monitoring is one such example. In Africa, a prime example for mobile initiatives is EPurse, capitalising on a successful implementation of mobile banking at the point of sale. This project investigates the application of the eXtensible Automation protocol (xAP) as a communication protocol suitable to the telemedicine environment. The properties of xAP prove favourable for application in the African context. Requirements of a system able to support xAP integrations are determined in relation to the protocol specifications. xAP is further integrated with the Internet Protocol Suite to facilitate Internet communication. A network configuration, representative of a real world operation, is tested in order to determine xAP suitability for telemedicine networks. The network configuration strives to represent telemedicine implementations, where data is communicated between a remote device and an interested party, over the Internet. Restrictions of the telemedicine systems communicating over the Internet were assessed. Internet Service Providers (ISPs) often restrict xAP applications based on the underlying Internet structure it utilises. It is thus suggested that a secondary method of communication, conforming to Hyper Text Transfer Protocol data transfer, is required if a successful communication session cannot be realised given the properties of xAP. Protocols are prescriptive on how communication should be done, as does xAP, whereas standards are an agreed way of operation. In order for telemedicine to be implemented sustainably, a standard for telemedicine networks should be created supporting the xAP framework. Simply put, xAP enabled network communication should be promoted as a standard and not just a protocol. This argument provides guidance to the execution of this project.

AFRIKAANSE OPSOMMING: Ingenieursinisiatiewe vir die standardisering van kommunikasie van gesondheidstelsels is oneffektief en ongekoördineerd. Die voordele wat sulke standardiseerings inisiatiewe kan inhou is uitgebreid beide vir kwaliteit van die dienslewering so wel as pasiënt omkeer tyd. Standardisasie raak selfs meer krities wanneer inligting en kommunikasie tegnologie in gebruik geneem word. Gemak van oorskakeling in inligting en kommunikasie tegnologie stelsels is kern tot die sukses van telemedisyne. Huidige standaardisasie van telemedisyne stelsels word gelei deur twee organisasies vir standaardisasie. Health Level Seven (HL7) en die International Organistion for Standardisation lei beide omvattende standaardiserings inisiatiewe. Toegang tot die dokumentasie vir die ontwikkeling van stelsels voldoende aan die standaarde is beperk, wat ontwikkeling en bydraes deur derde partye verhinder. Telemedisyne in Afrika vereis ‘n oop bron ontwikkelings platform waar voorkeur gebruikers hul eie uitbreidings kan ontwikkel sonder die beperkinge geassosier met huidige standaarde. Eienskappe van die platform moet spesifieke probleme wat Afrika in die gesig staar, aanspreek. Probleme kan opgesom word as i) die gebrek aan infrastruktuur, ii) die hoë koste van data oordrag en iii) gebrek aan toestelle met toegang to die Internet. Toename in die gebruik van selfone bied ‘n ook geleentheid vir die ontwikkeling van standaarde geskik vir telemedisyne gebruik op selfone. Organisasies kapitaliseer al reeds op die voordele gebied deur selfone. Sagteware, wat mediese dienste op selfone verskaf, is gewild. Dienste sluit in algemene mediese inligting sowel as toenemende gevorderde toepassings waar tegnologie van die selfoon gebruik word vir basiese diagnose. ‘n Voorbeel hiervan is ‘n eenvoudige hartklop monitor. In Afrika is a goeie voorbeel van selfoon verwante inisiatiewe, EPurse, ‘n toepassing van bank dienste by die verkoopspunt. Die projek ondersoek die eXtensible Automation protocol (xAP) as ‘n kommunikasie protokol vir geskiktheid in die telemedisyne omgewing. Die eienskappe van die protokol bleik gunstig te wees vir implementeering in ‘n Afrika konteks. Hierdie studie ondersoek ‘n stelsel ondersteunend vir die integrasie van xAP in die lig van die protokol spesifikasies. xAP word verder geïntegreer met die Internet Protocol Suite om kommunikasie oor die Internet te vergemaklik. ‘n Netwerk konfigurasie, verteenwoordigend van algemene gebruik, word getoets om xAP geskiktheid vir telemedisyne netwerke te bepaal. Die netwerk konfigurasie maak staat op die Internet as kommunikasie medium. Dit verteenwoordig telemedisyne kommunikasie tussen ‘n afgeleë toestel en ‘n ander geintereseerder toestel. Beperkinge op telemedisyne kommunikasie oor die Internet word ook geasseseer. Internetdiensverskaffers beperk gereeld xAP toepassings, as gevolg van die onderliggende Internet struktuur wat xAP gebruik. Dus word dit voorgestel dat ‘n sekondêre kommunikasie metode daargestel word, wat die Hyper Text Transfor Protocol gebruik, indien ‘n kommunikasie sessie nie realiseer gegewe die xAP eienskappe nie. Protokols dien as reëls vir kommunikasie, soos ook xAP, teenoor standaarde wat ‘n ooreengekomde manier van iets doen is. Vir die volhoubare implementering van ‘n xAP ondersteunende netwerk word dit voorgestel dat ‘n standaard rondom die xAP raamwerk ontwikkel word. Eenvoudig gestel, xAP netwerk kommunikasie moet as ‘n standaard bevorder word, nie net ‘n protokol nie. Die argument lei die uitvoering van hierdie projek.

Please refer to this item in SUNScholar by using the following persistent URL: http://hdl.handle.net/10019.1/18145
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