Risk analysis of a patient monitoring system using Bayesian Network modeling

In a modern technological environment where information systems are characterized by complexity, situations of non-effective operation should be anticipated. Often system failures are a result of insufficient planning or equipment malfunction, indicating that it is essential to develop techniques for predicting and addressing a system failure. Particularly for safety-critical applications such as the healthcare information systems, which are dealing with human health, risk analysis should be considered a necessity. This paper presents a new method for performing a risk analysis study of health information systems. Specifically, the CCTA Risk Analysis and Management Methodology (CRAMM) has been utilized for identifying and valuating the assets, threats, and vulnerabilities of the information system, followed by a graphical modeling of their interrelationships using Bayesian Networks. The proposed method exploits the results of the CRAMM-based risk analysis for developing a Bayesian Network model, which presents concisely all the interactions of the undesirable events for the system. Based on "what-if" studies of system operation, the Bayesian Network model identifies and prioritizes the most critical events. The proposed risk analysis framework has been applied to a vital signs monitoring information system for homecare telemedicine, namely the VITAL-Home System, developed and maintained for a private medical center (Medical Diagnosis and Treatment S.A.).

[1]  C. Weston,et al.  Guidelines for the early management of patients with myocardial infarction , 1994 .

[2]  Catherine A. Meadows,et al.  One Picture Is Worth a Dozen Connectives: A Fault-Tree Representation of NPATRL Security Requirements , 2007, IEEE Transactions on Dependable and Secure Computing.

[3]  Donald J. Reifer,et al.  Software Failure Modes and Effects Analysis , 1979, IEEE Transactions on Reliability.

[4]  Mohammad Modarres Reliability engineering and risk analysis , 1999 .

[5]  Lakhmi C. Jain,et al.  Introduction to Bayesian Networks , 2008 .

[6]  W E Vesely,et al.  Fault Tree Handbook , 1987 .

[7]  Vassilis Koutkias,et al.  Home care delivery through the mobile telecommunications platform: the Citizen Health System (CHS) perspective , 2002, Int. J. Medical Informatics.

[8]  Finn Verner Jensen,et al.  Introduction to Bayesian Networks , 2008, Innovations in Bayesian Networks.

[9]  Luigi Portinale,et al.  Improving the analysis of dependable systems by mapping fault trees into Bayesian networks , 2001, Reliab. Eng. Syst. Saf..

[10]  Eric Horvitz,et al.  MSBNx: A Component-Centric Toolkit for Modeling and Inference with Bayesian Networks , 2001 .

[11]  Alessandro Birolini Reliability Engineering: Theory and Practice , 1999 .

[12]  J. B. Bowles,et al.  Software failure modes and effects analysis for a small embedded control system , 2001, Annual Reliability and Maintainability Symposium. 2001 Proceedings. International Symposium on Product Quality and Integrity (Cat. No.01CH37179).

[13]  J. Dugan,et al.  Minimal cut set/sequence generation for dynamic fault trees , 2004, Annual Symposium Reliability and Maintainability, 2004 - RAMS.

[14]  H. Harry Asada,et al.  A twenty-four hour tele-nursing system using a ring sensor , 1998, Proceedings. 1998 IEEE International Conference on Robotics and Automation (Cat. No.98CH36146).

[15]  Manolis Tsiknakis,et al.  Risk assessment of a cardiology eHealth service in HYGEIAnet , 2003, Computers in Cardiology, 2003.

[16]  H. Schneider Failure mode and effect analysis : FMEA from theory to execution , 1996 .

[17]  A. Fard,et al.  Remote system for patient monitoring using Bluetooth/spl trade/ , 2002, Proceedings of IEEE Sensors.

[18]  William R. Dunn Practical Design of Safety-Critical Computer Systems , 2002 .

[19]  T. Evans,et al.  Cardiac arrests outside hospital , 1998, BMJ.

[20]  S. Barro,et al.  Intelligent telemonitoring of critical-care patients. , 1999, IEEE engineering in medicine and biology magazine : the quarterly magazine of the Engineering in Medicine & Biology Society.

[21]  Sotiris Pavlopoulos,et al.  A novel emergency telemedicine system based on wireless communication technology-AMBULANCE , 1998, IEEE Transactions on Information Technology in Biomedicine.

[22]  Nancy G. Leveson,et al.  An investigation of the Therac-25 accidents , 1993, Computer.

[23]  A Allen,et al.  Technical and clinical progress in telemedicine. , 1999, JAMA.

[24]  John Quigley,et al.  Bayesian belief nets for managing expert judgement and modelling reliability , 2001 .

[25]  Richard L. Craft,et al.  An open framework for risk management , 1998 .