Middleware for Pervasive Healthcare-A White Pa-per

This white paper describes work-in-progress at the Center for Pervasive Computing (CfPC) at University of Aarhus. We describe our pervasive healthcare project, which is a collaboration between hospitals in the county of Aarhus, a Danish software company developing an electronic patient record solution, and CfPC. The aim of the paper is to present and discuss a vision of a middleware architecture for pervasive computing within clinical work settings. Our research is grounded in careful observations of clinical work within a hospital and we start by outlining recurring scenarios in the daily life of healthcare staff and sketch how pervasive middleware technologies may provide a strong foundation for pervasive and mobile solutions in this setting. INTRODUCTION Distributed computing has for a long time been dominated by the client-server paradigm. In this paradigm shared data and services are available on the server, and more or less complex clients draw upon the services of the server. The client-server paradigm is a strong paradigm and has proved its strength over time. Until recently, however, computational devices have been heavy, bulky, and thus immobile, and this fact has influenced our perception of what constitutes the client. Traditionally, the client is a single application running on a single computer with integrated inputand output devices. The growth of small portable devices like mobile phones and PDAs makes it apparent that we must rethink client-side computing. Small devices have their primary force in their mobility but have a number of inherent weaknesses: they have limited screenand interaction abilities, they are easily lost or stolen, and their access to the network varies greatly and rapidly. These constraints pose new and interesting challenges to middleware technologies: middleware must support application programmers in building clients that overcome these inherent weaknesses. The Center for Pervasive Computing at University of Aarhus is a multi-disciplinary cooperation between a wide range of research areas, like Programming Languages and Environments, Virtual Machine Design, Software Architecture, Colored Petri Nets, Computer Supported Cooperative Work (CSCW), Human-Computer Interaction (HCI), Ethnography, and Industrial Design [6]. The Computer Science Institute has a long-standing tradition in experimental systems development with user involvement as we believe in the power of end-user reality ‘fighting back’ upon our designs. One of the cornerstones in our experimental research is testing prototype systems in real environments. One of the projects in the Center for Pervasive Computing is Pervasive Healthcare where our center is collaborating with healthcare staff at hospitals in the county of Aarhus as well as a software company that is developing a next-generation electronic patient information system. This context is an ideal test-bed for pervasive middleware technologies. First, healthcare at modern hospitals is characterized by mobility taken to the extreme —nurses and doctors are on the move almost constantly. Second, the seemingly trivial task of just finding the physical space for an ordinary PC is difficult. Third, interruptions are frequent during everyday tasks, like giving medicine to the patients. Thus the activities and tasks are well suited for being supported by mobile and pervasive solutions. Collaborating with the healthcare staff is vital for ensuring the soundness of proposals and underlying middleware technologies. And finally, the collaboration with the supplier of the electronic patient record system allows us to tap into the real healthcare data making a truly realistic setting for experimenting with prototypes – and to some extent influence the infrastructure solutions adopted by the supplier.