1. 1 MiRo: A Virtual Private Network For Telehealth Services ROBERTO DI ROSA, MIRCO STURARI, ALDO FRANCO DRAGONI*, GIUSEPPE GIAMPIERI** *DEIT, Dipartimento di Elettronica Intelligenza Artificiale e Telecomunicazioni – Università Politecnica delle Marche, Ancona **ASUR Zona 7, Azienda Sanitaria Locale delle Marche Ancona

2. 2 MiRo Project CONTEXT software-design to organize telemedicine services MOTIVATIONS necessity to integrate health services in a wide and delocalized environment SCOPE to provide a flexible architecture for teleconsulting and telereporting

3. 3 TelemedicineTelemedicine represents the erogation of health service at distances through informatics and telecommunications technologies

4. 4 TelemedicineTelemedicine ensures high quality digital information even for complex health services

5. 5 TelemedicineTelemedicine reaches better results if coordinated with the other applications

6. 6 MiRo - Architecture is configured as a substrate to integrate health systems

7. 7 MiRo - Finalities provides a flexible software framework for teleconsulting and services development integrates with the existing health information system to facilitate and rationalize information interchange improves and facilitates TCP/IP-based teleconsulting services in Intra/Internet environment provides a report and second opinion service

8. 8 Abstract Data-Structure Exam-data: generic digital data produced by an examination Report: text-file and digital signature Event: database record containing –the date-time of the insertion in the database –the examination type –the laboratory who produced it

9. 9 DATA-STRUCTURE Data: digital data produced by an examination Event: database record that links to the exam Report: text-file containing report SYSTEM-ENTITIES Repository: archives event Laboratory: generates event Phisician: reports examination MiRo - Architecture

10. 10 Allows laboratories to generate and manage events Allows phisicians to control and report examination Stores reports allowing teleconsultation Acts as a sophisticated DBMS for event-records RepositoryRepository

11. 11 Generates clinical event Provides digital data of examination Monitors the workflow of reporting phase Terminates reporting phase LaboratoryLaboratory

12. 12 Consults published examination Consults reports written by other phisicians Compiles and signs report Send this report to a timestamp service and then to the repository PhisicianPhisician

13. 13 1.Laboratory executes an examination that produces digital data 2.Laboratory pubblicates exam through the creation of an event 3.Phisician compiles and signs a report and sends it to the timestamp service 4.Timestamp service appends a certificated datetime to the report and forwards this back to the phisician 5.Phisician sends this composite-data to the Repository 6.The Laboratory decides when to terminate the refertation process From Exam to Report

14. 14 1.Laboratory executes an examination that produces digital data 2.Laboratory pubblicates exam through the creation of an event Event-Generation Process

15. 15 3.Repository records event informations about exam 4.The exam is reachable through the MiRo Network from each authorized client Event-Generation Process

16. 16 1.Phisician, as client, connects to Repository and can see a list of events 2.Phisician chooses an event and retrieves linked examination data Report-Generation Process

17. 17 3.Phisician sees reports written by other associates 4.Phisician compiles a report and sends it to the Repository Report-Generation Process

18. 18 MiRo - Technologies Service-Oriented Architecture based on common standards widely applied in different health contexts implemented through Web Services (SOAP, XML, …), which are becoming a standard to distribute services inside an heterogeneous environment such as Internet Client can enter in any moment to consult and to insert event or report data using a common Web Browser transactions are encrypted through standard SSL X509.v3, using standard Digital Certificates

19. 19 MiRo – Development Environment Java 2 Platform Standard Edition development tools: –Eclipse 3.1 – as development environment –Apache Axis and Java Servlet – to realize web services –Apache Struts and Java Sever Pages – to design web interfaces Java web services technology –JDBC interface (in our case MySQL). Clients adopt just Web Browsers

20. 20 MiRo - Security Layer Secure Socket Layer(SSL) –Confidentiality achieved through cryptography, guarantees that data can exclusively be read from the authorized user. Digital Sign –Integrity and no-repudiation, achieved through the digital sign, guarantees that information are not modified during the transmission and that those who use the system assume the responsibilities of what they are doing. –Authentication achieved through digital certificate, Username and Password, guarantees that the user is exactly the person he declares to be.

21. 21 Conclusions and future works MiRo is a software architecture for TCP/IP-based telereporting activities and second opinion services thanks to its flexibility, can be exploited in many different operational realities and is able to incorporate different Intra/Internet-based services. In future perspective, we foresee the possibility to implement and to provide new services and to reach citizens.

22. 22 GreetingsGreetings ALDO FRANCO DRAGONI DEIT, Dipartimento di Elettronica Intelligenza Artificiale e Telecomunicazioni – Università Politecnica delle Marche, Ancona GIUSEPPE GIAMPIERI ASUR Zona 7, Azienda Sanitaria Locale delle Marche Ancona THANK FOR YOUR ATTENTION