e-baby Web services to support local and remote neonatal intensive care

This paper aims to test whether web services technology can be used to improve clinical management support for local and remote neonatal intensive care. Current NICU procedures provide limited remote access to patient information for patients and/or Neonatologists located outside the NICU. This scenario is further compounded by the fact that remote hospitals may be directed to any of the available NICUs, thus resulting in m (number of available NICUs) * n (number of remote hospitals) possible connections A recent survey of computing and IT research to support intensive care unit clinical management concludes that while recent research directions for computing and IT support within ICU has focused on the delivery of alarms/alerts to care providers these approaches do not enable mobility in healthcare and neither do they exploit the substantial benefits possible by proper application of mobility. In addition, while many other application domains are transforming web services excitement into reality, health care applications of web services are rare and currently quite limited. To address the research aims, web services were defined to support the areas of patient and care provider mobility, interoperability, alert delivery and improved data capture for later research and analysis. These web services form part of the e-Baby architecture. Within the e-Baby architecture web services were designed to interact with the Solution Manager Service (SMS) and the Neonatal Emergency Transport System (NETS) Contacts Database. Interaction with the SMS is via a set of define, log, monitor and analyse web services. The NETS Contacts Database establishes the connection between the remote hospital and the Neonatologist as assigned by NETS. This approach to the connection enables the establishment of dynamic links that exists for the duration of the required connection, eliminating the need to establish permanent point-to-point connections between all remote hospital and all NICUs. This paper further describes the application of that architecture to a specific pilot within the NICU at Nepean Hospital, Penrith Australia where several of the web services have been or are currently being tested and trialled. The set of web services described here have been found to enable mobility, interoperability, alert delivery and to improve data capture for later research and analysis. While the paradigm shift to using web services to support NICUs offers the potential to significantly improve the speed, efficiency and effectiveness of critical care within NICUs, there are currently several factors impacting its mainstream adoption. These include issues relating to the use of wireless networks in addition to security, privacy, cost and a lack of standards for physiological data capture and exchange and user interface design