Integration of hospital data using agent technologies - A case study

Data retrieval and its integration is one of the major problems that face large and complex health organizations. This is especially relevant when patient information is produced in heterogeneous environments. Implementing a Virtual Electronic Patient Record (VEPR) system may provide an adequate and cost-effective solution for most clinical information needs. In this paper, we describe and discuss the use of agent technologies for the retrieval and integration of clinical records in a VEPR, thus making patient information available at any point of care. Between May 2003 and May 2004, a VEPR was designed and implemented at Hospital S. Joao, a university hospital with over 1350 beds. An agent-based platform Multi-Agent System for Integration of Data (MAID ®) ensures the communication among various hospital information systems. Clinical reports are retrieved from clinical department information systems (DIS) and stored into a central repository in a browser friendly format. Documents are retrieved in HTML and PDF format and are digitally signed at storage. MAID is now running for the last 12 months, regularly scanning 7 DIS and collecting a mean of 2800 new reports each day. A visualization module for the VEPR was made available in October 2004 and the number of users and user sessions has been growing since. Currently, over 340 doctors are using the system on a daily basis. The total budget of the project was less than 400 000 euros. Around 30p of the costs were spent in software development and MAID accounted for only 13p of the total project budget. The use of agent technologies in the implementation of a VEPR enabled the successful integration of a large amount of heterogeneous data that could then be accessed from any workstation in the hospital Intranet. As few changes were required to be made in the existing DIS, the implementation has been done over a relatively short period of time and the stress in the organization was low. Optimization of the scheduling algorithm, automatic notification of health professionals, introspection of clinical reports, retrieval of XML report representations and extension of VEPR to health centres are priorities for future research and development. We strongly believe that agent technologies can and should be used to solve complex data integration and communication problems, which are crucial to the quality of patient care.