TSL Blog: Design Proposal on the Cyber-Healthcare System

Design Proposal on the Cyber-Healthcare System

by TSL

September 10, 2016

In general, a design proposal is a descriptive document of a certain product prepared by architect(s) or a design team to provide an overall guidance of the architecture in the project to the development team, and it is also a primary informative document of the design to an organizational management (IEEE, 2009). The product can be a hardware instrument, software package or a system. The design document may contain many sections and sub-sections that include a general overview, goals, flow chart, diagrams, specific specifications, assumptions, and limitations, etc. (CMS.gov, 2005). In this Unit 5 Individual Project (CS882 U5 IP), a newly hired big data analyst will present a design proposal using Hadoop ecosystem to analyze various large structured and unstructured datasets for the insights in a chain of the state-of-the-art hospitals and other health services in four states (Arizona, Colorado, New Mexico, and Utah) in the US. A Hadoop solution will address specific business problems in the healthcare field. The design proposal consists of eight sections as follows:

I. Introduction

II. Specific requirement design

III. Data flow diagrams

IV. Overall system diagrams

V. Communication Flow Chart

VI. Regulations, policies, and governance for the medical industry

VII. Assumptions and limitations

VIII. Justification

I. Introduction

This document provides a design proposal concerning a Hadoop solution that is applied to the business problem of analyzing various large data sets in a hospitals network system in four corners region, i.e., Arizona, New Mexico, Colorado, and Utah. The design proposal of the Cyber-Healthcare System gives corporate management a descriptive information and guidance of the architecture in the project that solves business problems of analyzing huge sets of scattered complex data in the healthcare system. The document is also provided the related readers an generic informative overview of the project.

With cloud computing, automation, Web technologies like artificial intelligence,

Internet of Things (IoT) in the competitive Internet-centric market and data-driven economy, big data at low storage cost, particularly complex data in the healthcare area, has exploded and become ubiquitous and available almost everywhere. Analyzing mostly unstructured data at a colossal volume such as personal health records, clinical health information, or public health data for insights usually poses many practical challenges and real business problems to many organizations such as hospitals, clinics, etc. in the area. For example, presentation of the analytical results from a real-time analysis is an issue in corporate management.

II. Specific requirement design

The design proposal of the Cyber-Healthcare System (The System) provides an overall description of the solution in data analytics to solve the challenges and business problems in healthcare field with the following requirements:

A. Large data sets

The broad and complex data sets processed in the Cyber-Healthcare System that include some structured and unstructured data will be stored in a reliable centralized on-line repository. Data sets can be replicated and shared among nodes in the scalable distributed clusters. A backup system will provide a safeguard and recovery if some disasters such as hacking or risks of the loss happen. Insightful information extracted by Hadoop system will be categorized into three categories (Schneiderman, Plaisant, & Hesse, 2013):

1. Personal health information:

Physicians and patients collect information about their practice and own health habits.

2. Clinical health information

Electronic health records systems can enhance a health care or cure to patients, and useful insights into pragmatic patterns of treatment.

3. Public health information

A large quantity of public health data is collected to assist policy makers in more reliable decisions.

Figure 1: Big data in healthcare area includes structured data and unstructured data in the 2/3 section of the data pie.

Source: Adapted from AllSight (2016).

B. Hadoop ecosystem

To extract and transform the complex, huge data sets of healthcare for insightful information, the Cyber-Healthcare System will implement and deploy the Hadoop ecosystem to hospitals in the area. As the de facto standard to manage big data, Apache Hadoop - an open source Java-based framework that uses parallel data processing across distributed clusters - is chosen for this project (Apache Software Foundation, 2014). A simplified Hadoop architecture includes four major components:

1. Hadoop Common

The component consists of Java libraries and utilities to support other components.

2. Hadoop YARN

The component does job schedules and manages cluster resources.

3. HDFS (Hadoop Distributed File System)

The HDFS provides high-throughput access to application data.

4. Hadoop Map/Reduce

It performs Map and Reduce functions on large data sets in parallel processing to retrieve insightful health information for patients, clinics, and hospitals.

Figure 2 shows a simplified Hadoop framework with four components: YARN Frameworks, Common Utilities, HDFS, and Map/Reduce Computation.

Source: Adapted from Hadoop Software Foundation, 2012.

Figure 3 displays a high-level HDFS architecture with name node and multiple data nodes in data processing.

Source: Adapted from Borthakur (Apache Hadoop Organization, 2012).

Healthcare tools in the Cyber-Healthcare System are designed to assist health authorities in long-term plans, business strategies, and healthcare policies. The healthcare tools include diagnostic tools for monitoring. evaluating, and assessing. Other tools are used to support priority scheduling, identify effective strategies, evaluate the cost, plan resource, calculate budget, and program and implement tasks (WHO, n.d.).

C. External interfaces

The Cyber-Healthcare System will allow related users such as nurses, physicians, to enter data or view and search health information in the Hadoop ecosystem. Patients can access and view their health records only. However, administrators and designers have privileges and authorization in options such as read/write/delete/save or change.

1. User interface

There is one unique graphic user interface (GUI) for three types of users.

- The GUI with basic privilege is provided to patients who can read, view, print out individual health records, information. They can schedule appointments, send emails for questions, etc.

- Nurses, physicians or data entry workers are provided more privileges such as to read, view health information, enter data, search or query for useful information, etc. on the GUI.

- Administrators and designers have full privileges such as read, write, delete, change, query, extract data, etc. with full privileges on the GUI.

2. Hardware interface and software interface

The Cyber-Healthcare System with a backbone of Hadoop environment supports NoSQL databases, aggregate data models, and key-value databases to perform the map-reduce computing and store the results of the mappers and the reducers in the materialized views with high fault-tolerance. Users can use industry standard formats like XML, JSON, texts on complex data.

The hardware interface comprises personal computers, desktops, laptops, Smartphones, iPhones, iPads, etc. (Natarajan, 2012).

Software interface includes:

a. Platforms:

- OS Windows 7, 8, 8.1, 10 (32-bit, 64-bit)

Windows Server 2008 (64-bit)

Windows Server 2012 (64-bit)

Windows Server 2012 R2 (64-bit)

Windows Vista SP1 and later (32-bit and 64-bit)

- Mac OS X hosts (64-bit)

Mavericks: 10.9

Yosemite: 10.10

EI Capitan: 10.11

- Linux hosts (32-bit or 64-bit)

Ubuntu 10.04 to 16.04

Debian GNU/Linux 6.0 (“Squeeze”) and 8.0 (“Jessie”)

Oracle Enterprise Linux 5, Oracle Linux 6 and 7

Redhat Enterprise Linux 5, 6 and 7

Fedora Core / Fedora 6 to 24

Gentoo Linux

openSUSE 11.4 to 13.2

- Solaris hosts (64-bit only)

Solaris 11

Solaris 10 (U10 and higher)

b. Emulated hardware

- Input devices: Standard PS/2 keyboards and mouse

- Graphics: Standard VGA devices

- Storage: Intel PIIX3/PIIX4 chips, the SATA (AHCI) interface, and two SCSI adapters (LSI Logic and BusLogic)

- Networking: Linux kernels version 2.6.25 or later

Windows 2000, XP and Vista, drivers

- USB: xHCI, EHCI, and OHCI

3. Nonfunctional requirements

a. Security:

General security principles are used securely

- Update software

- Safeguard Network Access to High Priority Services

- Obey the Least Privilege Principle

- Watchdog System Activity

- Maintain and upgrade on the Latest Security Information

b. Performance

- Poor performance caused by host power management

- Performance variation with frequency boosting

c. Policy

Cyber-Healthcare System works in harmony based on trained and motivated health workers’ inputs. It is designed in a well-logic infrastructure,
and a stable supply of technologies and medicines, supported by well funding, powerful health plans and make-sense policies (WHO, n.d.).

d. Business rules

Business rules explain the definitions, operations, and constraints that use in the Cyber-Healthcare System. The users who use the Cyber-Healthcare System are required to follow all the rules in the signed agreement when they sign up or join the System.

III. Data flow diagrams

Healthcare data is processed dually in traditional databases in data warehouse and Hadoop in ETL (Extract, Transform, and Load) process in parallelism as shown in Figures 4, and 5 below:

Figure 4: Process flow of the large healthcare data in Map/Reduce functions in Hadoop system.

Source: Adapted from Intel, 2016.

Figure 5: Data flow in both traditional data warehouse and Hadoop subsystem in parallelism in the Cyber-Healthcare System. Data science means data analytics that is a process of data analysis for retrieval of insights.

Source: Adapted from Intel, 2016.

In the Cyber-Healthcare System, a XML data flow document can be written in XML format. For example, a typical XML design document is programmed as follows:

<?xml verson=”1.0”?>

<!—File name: TheCyberHealthcareSystem.xml -->

<Group>

<Groupname>Arizona</Groupnames>

….

…..

……..

….

…..

……

<Groupname>Colorado</Groupnames>

….

…..

……..

….

…..

…..

</Group>

<Patientname>StevenConte</Patientname>

<PatientIllness>Vertigo</ PatientIllness>

…………

</Patient>

………..

IV. Overall system diagrams

The overall Cyber-Healthcare System based upon a Hadoop ecosystem consists of a Hadoop YARN, Common Utilities Unit, HDFS, and Hadoop Map/Reduce. Hadoop YARN is a communication and control unit that provides job scheduling and cluster resource management. Common Utilities Unit is a supportive unit to provide libraries and utilities. HDFS provides accessing to health data sets. Hadoop MapReduce applies parallel processing on the healthcare large data sets effectively. The large data sets in Tetra Bytes are broken into 64 or 128 MB and stored in multiple low- cost commodity nodes in HDFS for Map and Reduce functions to retrieve insightful information for end-users such as patients, frontline care providers (e.g., nurses, physicians, healthcare technologists, etc.).

Figure 6 shows the overall central Hadoop System with the control unit Hadoop YARN and supportive unit Common Utilities in the Cyber-Healthcare System.

Source: Created by TSL, 2016

V. Communication Flow Chart

In communication, the Cyber-Healthcare System consists of the central Hadoop ecosystem that connects to four groups, i.e., Arizona, Colorado, New Mexico and Utah in star configuration as shown in Figure 7 below. Each group is linked to local hospitals, outpatient clinics, nursing homes, and rehabilitation centers. Each organization has

many departments. Each department has its own care team or frontline care providers that include physicians, nurses, and family members who provide health care services to patients. Also, the environment group that comprises regulators, Medicare, Medicaid, insurance companies, healthcare purchasers, and research funders can communicate with institutions such as hospitals, clinics, nursing homes, rehabilitation centers, etc.

Figure 7 depicts a high-level communication flow chart among agencies in the Cyber-Healthcare System.

Source: Created by TSL, 2016

VI. Regulations, policies, and governance

The Cyber-Healthcare System complies with all regulations, policies, and governance for the medical industry in its design as follows:

1. Regulations

In practical view, market research and ethnics in healthcare data based on Internet technology are usually at odds with each other. Big Data Analytics (BDA) presents both technical and strategic capabilities to generate value from the data they store for the organizations. With the blossom of BI (Business Intelligence) and BDA, there will be more security violation and privacy issues (Quora, 2014). There is a prominent risk of violation of the personal privacy. For example, terrorists likely hack healthcare systems such as the Cyber-Healthcare System to sabotage the system, harm people, and take advantages for their own ideology, politics, or religion. The System considers the issues seriously and uses the latest antivirus software, firewall, etc. to protect the integrity of data and safeguard patients’ information. The System comply the government’s controversial in-depth regulations and obeys all medical rules. Notice that the Cyber-Healthcare System will work to obtain ISO 9001 Certification in the healthcare industry (Nolan, 2015).

2. Privacy Policies

Information about users’ uses of the website is collected by using a tracking cookie, and server access logs. The collected information includes the following:

a. The IP address from which user accesses the website.

b. The type of operating system (OS) and browser user uses to access the System site.

c. The date and time user accesses the Cyber-Healthcare System site.

d. The html pages users visit.

e. The pages addresses from where user followed a link to the System site.

Some of the information is gathered by using a tracking cookie set from the Hadoop Analytics or Google Analytics service in the privacy policy. Users may refer the browser documentation for instructions on how to disable the cookie if they do not want to share the data with Hadoop or Google.

The Cyber-Healthcare System gathers information to make the website more useful and friendly to visitors and better understanding how and when the website is surfed. The Cyber-Healthcare System does not collect or track personally identifiable information, or associate gathered data with any personally identifying information from the other sources.

By using this website, user consents to the collection of this data in the manner and for the purpose to solve the challenges and business problems in healthcare field (Hadoop.apache.org, n.d.).

3. Governance

HIPAA is the federal Health Insurance Portability and Accountability Act of 1996 in Tennessee. It was designed to safeguard healthcare information, assist people to retain health insurance, and facilitate administrative costs’ control in the healthcare industry (HIPAA, 1996). On the privacy issue, HIPAA emphasizes on protection and maintenance of personal health information in all health-related organizations. HIPAA requires (1) frontline providers (e.g., physicians, nurses, etc.), (2) medical producers (e.g., pharmaceutical, medical device companies, etc.), and (3) payers (e.g., insurance companies) must comply all the law and rules in governance.

The Cyber-Healthcare System comply all HIPAA governance rules.

VII. Assumptions and limitations

The Cyber-Healthcare System is developed and designed based on the following assumptions and limitations:

1. Assumptions (Flower, 1999):

- The System’s clients are patients.

- The System’s contact with patients is high intensity, low touch.

- Doctors are independent carriers of information and judgment.

- Healthcare is event-driven.

- Much of ill health will be predictable and preventable.

- Patients will be partners in managing their health.

- Data in the System’s centralized repository is assumed clean, reliable, and credible.

- All institutions such as hospitals, clinics, nursing homes, etc. use the same platform to access, view, query, and enter the large data sets in the centralized repository.

- All frontline care providers in the care team are trained to use the System properly and professionally.

- The System keeps all sources of time visible to the guest synchronized to a single time source, the monotonic host time.

2. Limitations (Hortonworks, 2016)

- Some experimental features are beta (labeled as experimental). Such beta features are provided but are not formally supported. However, users’ suggestions and feedback are welcome.

- Poor performance with 32-bit AMD CPUs may affect Windows and Solaris platforms.

- Poor performance with 3-bit Intel CPU model affects mainly on Windows, Solaris, and Linux kernel.

- NX (no excuse, data execution prevention) only works for 64-bit OS computers

- Windows XP has slower transmission rates because it supports segmentation offloading.

- Shared folders are not supported on the OS/2 computers.

VIII. Justification

The Cyber-Healthcare System is a modern state-of-the-art system in the contemporary network of hospitals, outpatient clinics, nursing homes, and rehabilitation centers in the 4-state region. The System is developed to eliminate isolation among hospitals, reduce inefficiency in care management, and prevent a loss of opportunities for advancing patient treatments. The Cyber-Healthcare System is designed with the following justifications:

1. Centralizing the scattered sources of colossal data sets from many agencies, various hospitals, and clinics.

2. Transforming unreliable huge data sets with duplication and redundancy in data and information to credible and reliable data sets.

3. Establishing a large healthcare network system in the region to allow users such as patients and frontline care providers (physicians, nurses, family members) with the different privilege to access, view, search information that is needed or required for patient treatments, and cures at low cost possible.

4. The Cyber-Healthcare System is implemented in Hadoop environment as described in Section II.B Hadoop Ecosystem above.

5. The System’s architecture is developed based on four target elements:

a. Patients.

b. Care team consists of physicians, nurses, family members.

c. Organization includes infrastructures, resources such as hospitals, clinics, nursing homes and rehabilitation centers.

d. The environment comprises regulation, policy, and market like regulators, Medicare, Medicaid, insurance companies, healthcare purchaser, research funders, etc.

6. The System is designed to tackle the huge data sets’ challenges in the healthcare industry. Some healthcare data challenges are:

a. Capturing data is difficult.

b. Curation is not easy.

c. Storage requires huge memory, disks.

d. Sharing data is complicated.

e. Transfer data take a lot of time because of huge size.

f. Analysis of data requires advanced analytical tools.

g. The presentation is sophisticated.

7. Organizations in the System can provide better and high-quality services based on historical data from previous medical records of patients.

8. The System has data visualization feature for users to access (Schneiderman, Plaisant, & Hesse, 2013):

- Personal health information

- Clinical health information

- Public health information

IX. Summary

This Unit 5 Individual Project document presented a design proposal of the Cyber-Healthcare System that used Hadoop environment to process and analyze huge data sets in healthcare in the four corners area like Arizona, Colorado, New Mexico, and Utah. The proposal included eight sections as follows:

I. Introduction

This section provides a quick overview of the Cyber-Healthcare System.

II. Specific requirement design

The section explains an overall description, external interface requirements such as user interface (GUI), hardware interface (computers, laptops, iPad, smartphone, etc.), software interface (OS, Platforms, etc.), and communication interface (if any of these apply, nonfunctional requirements such as security, performance, policy, business rules) at the high level. The large and complex data in specific healthcare, Hadoop ecosystem with various platforms, and other features are explained in details.

III. Data flow diagrams

This section describes a description of the data flow, flow of communication, and data processing in parallel MapReduce functions were displayed in several diagrams with labels and a typical XML programming code.

IV. Overall system diagrams

The section discusses an overall system design with the communication and control unit such as Hadoop YARN and HDFS modules.

V. Communication Flow Chart

The simplified communication flow chart used to connect the four geographical states is displayed in a star configuration with a high level description.

VI. Regulations, policies, and governance for the medical industry

This section provides regulations, policies, and governance in HIPAA for the medical industry considered in the Cyber-Healthcare System.

VII. Assumptions and limitations

Several assumptions and limitations applied in the design of the

Cyber-Healthcare System are described and mentioned with technical information of the typical operating systems.

VIII. Justification

Eight justification and rationales of the System’s design are summarized in this section.

In general, the Cyber-Healthcare System that is a huge project is implemented on Hadoop backbone to provide personal information, clinical health information and public health information to help hospitals, outpatient clinics, insurance companies, healthcare purchasers, etc. to provide the high-quality of effective healthcare services at the low cost to patients in this central region.

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Design Proposal on the Cyber-Healthcare System

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