A home health monitoring system including intelligent reporting and alerts

We describe the design and implementation of an intelligent reporting and alerts system that has been designed with a specific goal to address the needs of managing chronic and complex disease through the use of home telecare technology. Our approach has been to develop these tools using as far as possible, open standards. Clinical measurement data gathered using home telecare and stored in a relational database in XML format is extracted and converted into a Clinical Document Architecture (CDA) as defined by the Health Level 7 (HL7) organization. Data trends are presented to the clinician as simple graphs and summary statistics (means, standard deviations) over time for an individual patient. Clinicians may receive this data by display through a Web-interface or by email or faxed reports. A Ripple Down Rules (RDR) knowledge base supports more complex decision-making provided in the Alerts module. The RDR output is incorporated into the output reports as a textual statement, and/or a graphical highlighting of key parameters in the trends images and tables. Rule development and validation is part of ongoing research.