The care of chronic disease has become a main challenge for healthcare institutions around the world. As the incidence and prevalence of chronic diseases continue to increase, traditional hospital-based healthcare is less able to meet the needs of every patient. Treating chronic disease heavily depends on the patient’s daily behaviors, so patient-centered healthcare is encouraged. To improve patients’ quality of life, moving the base of healthcare from hospital to home is imperative. Home-based chronic disease care involves many different healthcare organizations and healthcare providers. Therefore, interoperability is a key approach to provide efficient and convenient home-based healthcare services. This thesis aims to reveal the interoperability issues in the current healthcare system and to point out an appropriate technical solution to overcome them. We start with collecting perspectives from both healthcare providers and healthcare recipients through interviews and online surveys to understand the situations and problems they face. In our research study, we mainly use two current techniques―peer-to-peer (P2P) networks and cloud computing―to design prototypes for sharing healthcare data, developing both a P2P-based solution and a cloud-based solution. Comparing these two techniques, we found the cloud-based solution covered most of the deficiencies in healthcare interoperability. Although there are different types of interoperability, such as pragmatic, semantic and syntactic, we explored alternative solutions specifically for syntactic interoperability. To identify the state of the art and pinpoint the challenges and possible future directions for applying a cloud-based solution, we reviewed the literature on cloud-based eHealth solutions. We suggest that a hybrid cloud model, which contains access controls and techniques for securing data, would be a feasible solution for developing a citizen-centered, home-based healthcare system. Patients’ healthcare records in hospitals and other healthcare centers could be kept in private clouds, while patients’ daily self-management data could be published in a trusted public cloud. Patients, as the owners of their health data, should then decide who can access their data and the conditions for sharing. Finally, we propose an online virtual community for home-based chronic disease healthcare―a cloud-based, home healthcare platform. The requirements of the platform were mainly determined from the responses to an online questionnaire delivered to a target group of people. This platform integrates healthcare providers and recipients within the same platform. Through this shared platform, interoperability among different healthcare providers, as well as with healthcare recipients’ self-management regimens, could be achieved.
Karlskrona: Blekinge Institute of Technology , 2014. , 112 p. p.