Designing interactive health care systems: Bridging the gap between patients and health care professionals

As patients become more proactive about their health and turn to technologies such as the Internet to acquire knowledge, the patient-health care professional relationship has been changing. Traditionally, information has flowed from health care professional to patient, but change to a two-way dialogue is taking place. In this study, we examine a high level design of a perceived medical system and determine the implications of adding patients as active contributors. The main challenge of modifying existing systems to incorporate patient interaction is preserving system integrity. We propose a systematic approach to support scaling health care systems while preserving system integrity. Distributed systems such as personal health records and eHealth systems provide two ways in which patients can become more involved with their own health care with or without the involvement of health care professionals. It is important that modifications to such systems do not compromise patient record integrity regardless of whether the patient is working alone or with their health care professional. The lack of central control in distributed systems added to the complexity of health systems poses challenges for design and modification. Of particular interest is the identification of emergent behavior (behavior not explicitly specified in the specifications) in distributed systems not explicitly defined in the requirements of its individual components. Use of the new emergent behavior detection (EBD) tool offers potentially considerable cost savings by proactively identifying such behaviors during the design rather than the deployment phase of a project. Based on high level message sequence charts, the EBD tool highlighted a data synchronization issue between the main database and the patient's interface to the system. This provides valuable feedback of the early health system design which benefits future design development.