A Context-Aware Framework for Health Care Governance Decision- Making Systems: A model based on the Brazilian Digital TV Mauro Oliveira & Odorico Andrade

Mauro Oliveira, Odorico Andrade, Regis Moura Claude Sicotte, J-L Denis, Stenio Fernandes José Bringel, Hervé Martin, Jérôme Gensel France Brazil Canada LARIISA Laboratoire Application Réseaux Intelligence Intégration Santé

1)MOTIVATION: Governance Model for Decision Making on Health Care Systems 2) OBJECTIVE: Context-aware System based on the Family Information 3) LARIISA: Riiso + Lara Projects - Prof Odorico: RIISO Project  Health Care APPLICATION - Prof Mauro: LARA Project  Communication INFRASTRUCTURE 4) CONCEPTS: Models for LARIISA Framework - Integration of Health care - Knowledge To Action - Unified Service Delivery Platform 5) PROPOSAL: Larissa Framework 6) APPLICATIONS: - DENGUE Study Case - Health Agent Scenario 7) CONCLUSIONS: - Taua Pilot Project - PNBL, High Bandwidth Brazilian Program LARIISA: Laboratoire Application Réseaux Intelligence Intégration Santé OUTLINE

Total of Houses: 70 millions –Coockle 97,7% –Television95,7% –Refrigerator 86,7% –Mobile phone 61,2% –Telephone54,0% –Microcomputador:16,91% Internet access15,08% Brazilian Digital Divide Problem 1. MOTIVATION

Analógico Today Interactive Digital TV Digital 1. MOTIVATION

(Passive) (Active) Interactive Digital TV (Active) 1. MOTIVATION

High Definition InteractivityMultiprogramming Mobility Interactive Digital TV 1. MOTIVATION

Network Audio Video Data Data Carrossel 1. MOTIVATION Interactive Digital TV

1. MOTIVATION Digital Belt Project

LARIISA: Laboratoire Application Réseaux Intelligence Intégration Santé 2. OBJECTIVE ITU-T J.200 Recommendation Brazilian Digital TV Model Digital Belt Project

(1) (2) (3,4) (5) Agent Personalized message Agent Personalized Information Context Detection IF-THEN RULE-BASED APPROACH (1) IF blood sugar exceeds a threshold, THEN should not take certain food. (2) IF the room is too dry, THEN turn on the humidity generator (3) IF the user is at lunch, THEN send the message later. (4) IF the user is not at office, THEN send the call to the mobile. (5) IF a PC is accessible, THEN present the message as video. Context-aware Services Context-Aware Health Agent APPLICATION Context-Aware Health Agent PERSONALIZATION Decision Making in Governance Decision MakingApplication 2. OBJECTIVE Two ways to capture the health data - Interactive Programs - Sensors

1)Real-time Information 2) Health Knowledge 3) Professional Experience 4) Decision-making "Once we realized the lack of a system able to provide reliable data and information in real time, offering correct information for making decisions, we have decided to transfer the Office of Health Secretary and his staff to the Control Center of Endemic Diseases and Zoonoses”. (Andrade, 2010)  Set-top-box and Digital Belt  Ontology Representation (OWL)  Context Reasoning Component  Decision-making Application Real SituationLARIISA: Context-Aware System 2. OBJECTIVE

Prof Mauro: LARA Project  Communication INFRASTRUCTURE 3. LARIISA Project Diga-Ginga (FINEP Project)

Prof Odorico: RIISO Project  Health Care APPLICATION (for governance model) 3. LARIISA Project

IF… and … IF… 3. LARIISA Project –Coockle 97,7% –Television95,7% –Refrigerator 86,7% –Mobile phone 61,2% –Telephone54,0% –Microcomputador:16,91% Internet access15,08% = How...

4) MODELS FOR LARIISA FRAMEWORK I.D.Graham, J.Logan, M.B. Harrison, S.E.Straus, J.Tetroe, W.Caswell, N.Robinson The Journal of Continuing Education in the Health Professions, Vol 26 N°1, 2006 – Wiley InterScience. Knowledege to Action for healthcare system

Knowledge Creation Knowledge to Action Process (KAP) Tailoring Knowledge Action Cycle (Application) Adaptation - Query Context Provider 1Context Provider 2Context Provider N … 5) PROPOSAL: LARISSA FRAMEWORK Ontology Base Service Adaptation Adaptation - Aggregation Context Reasoning Context-aware Service 1Context-aware Service 2Context-aware Service N … (Context-awareness) Container

… Ontology Base Service Adaptation Adaptation - Query Adaptation - Aggregation Context Provider 1Context Provider 2Context Provider N … Context Reasoning 5) PROPOSAL: LARISSA FRAMEWORK (Context-awareness) Knowledge to Action Process (KAP) Action Cycle (Application) Knowledge Creation LARISSA framework v2.1 Context-aware Services Decision MakingApplication Containers

7) PROPOSAL: LARISSA FRAMEWORK KNOWLEDGE TO ACTION (KTA) Knowledge Creation (Process) Decision Making in Governance LARISSA framework v2.1 (Information for the Knowledge Creation) Action Cycle (Application) 5) PROPOSAL: LARISSA FRAMEWORK … Ontology Base Service Adaptation Adaptation - Query Adaptation - Aggregation Context Provider 1Context Provider 2Context Provider N … Context Reasoning Context-aware Services Systemic Normative Clinical and Epidemiology Administration Share Management Knowledge Management Context-aware Services

5) PROPOSAL: LARISSA FRAMEWORK CONTEXT CATEGORIES (Zhang and all.): (1)Personal Health Context : physiological and mental context (2)Environment Contex: temperature, light, humidity, noise, etc. (3)Task Context: goals, task, actions, activities, events, etc. (4)Spatio-temporal Context: time and location (5)Terminal Context: terminal type, interface, media supported, etc. Agent Personalized message Agent Personalized Information Context Detection Decision Making in Governance

5) PROPOSAL: LARISSA FRAMEWORK

6) PROPOSAL: LARISSA FRAMEWORK Local health context model

6) PROPOSAL: LARISSA FRAMEWORK Global health context model

6) APPLICATIONS: Applying DENGUE Study Case to LARIISA Decision Making in Knowledge Management Decision Making in Systemic Normative Decision Making in Clinical and Epidemiology Decision Making in Share Management Decision Making in Administration Decision: Creating an Emergency for the clinical management of severe cases (ER-SC) Rule: IF the patient had Dengue more than once AND lives in an area with high infestation rate AND has symptoms A,B and C, THEN you must consult the ER-SC about this case Results: lower mortality due to a series of actions, in special the use of the rule above.

Applying DENGUE Study Case to LARIISA Administration Case Decision Making in Administration IF the patient had Dengue more than once AND lives in an area with high infestation indice AND has symptoms A,B and C, THEN you must consult the ER-SC about this case Results: lower mortality due to a series of actions, in special the use of the rule above Decision: Creating an Emergency (ER) for the clinical management of severe cases (ER-SC) 6) APPLICATIONS:

Taua Pilot Project Epidemiology Case Decision Making in Epidemiology High Level GLOBAL Decision: Reallocating Health Agents ! High Level LOCAL Decision: Updating the Agent’s Agenda ! 6) APPLICATIONS:

6) APPLICATIONS: Health Agent Scenario

LARIISA: Laboratoire Application Réseaux Intelligence Intégration Santé 7. CONCLUSION Tauá Pilot Project (Proof of Concept) PNBL

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