While it is tempting to incorporate the maximum number of these technologies into our software, long experience has taught us that pragmatism is the best guide for their use. We leverage the mobile device technologies in our M-Stat software, only where it makes business sense to do so. We strongly resist the notion of simply implementing a solution that is in search of a problem.
Mobile Technology Capabilities Used by M-Stat:
M-Stat uses the audio microphone to record audio voice messages. This can be attached to a collaboration message which is exchanged between clinical practitioners.
M-Stat uses the audio speaker to allow clinical practitioners to listen audio voice messages. The speaker may also be used to provide an audible tone on the M-Stat user's mobile device to announce the arrival of a new notification.
M-Stat provides a fully responsive application user interface on multiple supported devices. This allows the user interface to automatically reconfigure and operate faithfully in either portrait or landscape mode.
Bar Code Scanning
M-Stat is able to scan 1D and 2D bar codes. A bar code on a patient wrist band may be scanned to instantly find the patient's information. A bar code assigned to a location in the hospital or clinic (e.g. a nurse station, ward, etc.) may be scanned to list out all of the patients who are currently at that location.
Full Motion Video
M-Stat is able to use the mobile device camera to record a full motion video (e.g. watching a patient walk) and attach it to a message. When the attachment is opened, M-Stat plays the video immediately.
NFC Tag Scanning
On supported Android mobile devices with a Near Field Communication (NFC) chip, M-Stat is able to scan encoded NFC tags. An NFC tag on a patient wrist band may be scanned to instantly find the patient's information. An NFC tag assigned to a location in the hospital or clinic (e.g. a nurse station, ward, etc.) may be scanned to list out all of the patients who are currently at that location.
On supported Android and Apple mobile devices, M-Stat notifies designated users about important events (e.g. the arrival of a clinical test result). The CMP leverages the Google Cloud Messaging (GCM) service and the Apple Push Notification Service (APNS) to send notifications to Android and iOS based devices that are running M-Stat. Both GCM and APNS notifications do not have guaranteed timeliness and delivery for 100% of messages. The providers make 'best efforts' to deliver the notification to the mobile device. As a consequence, M-Stat notifications are limited to the delivery capabilities of the GCM and APNS services.
M-Stat is able to use the mobile device camera to record a still photograph (e.g. a picture of a patient wound) and attach it to a message. When the attachment is opened, M-Stat displays the photographic image immediately.
The mobile device's vibration capability may also be used to announce the arrival of a new notification on the M-Stat user's mobile device.
The M-Stat mobile application does not use the traditional mobile provider's phone network. Rather it uses connection onto a local wireless network, thereby allowing connection of the M-Stat application onto the CMP.
- Organisations have large investments in important clinical back end systems. To unlock the information of these systems for mobility, mobile applications must be integrated with them.
- Legacy thick client (e.g. Win32) and simple web based applications do not translate well into mobility applications where mobile devices have limited form factors.
- The achievement of a good user experience (UX) for complex systems on mobile devices is very important and challenging to achieve.
- The successful integration of clinical information and business processes (workflow) across multiple systems is complex.
- Simplistic approaches to mobilising back end applications carry significant architectural risks (e.g. performance, stability, scalability, etc.).
To assist in understanding the mobility integration landscape, we offer a straight forward maturity model. The maturity model compresses a very complex collection of technologies and approaches down to a simple model, with five (5) levels of maturity.
Virtual Desktop Infrastructure (VDI)
VDI leverages the virtualization of centrally hosted desktop application in the data centre. Examples include: VMware, Citrix, etc. Users connect onto their virtual desktop from a mobile device. The user interface layout remains as it was with the desktop and there is little or no ability to access mobile device hardware / software features. Gartner calls this the 'tactical stopgap measure'.
Synthesised Mobility Application (SMA)
SMA extends the idea of virtualization of a centrally hosted desktop application in the data centre by generating and refactoring a more mobile friendly rendition of the desktop application on the mobile device. Examples include: PowWow, etc. Users connect onto their mobile friendly virtual desktop from a mobile device. There is an improved user experience for a single back end application.
Rapid Mobile Application Development (RMAD)
A number of vendors (e.g. Oracle, IBM) offer RMAD tool kits for the development of mobile applications. This allows the developer to create mobile apps that will execute on a number of different mobile platforms (e.g. iOS, Android, Windows, Blackberry, etc.) It provides the ability for the mobile app to access the back end system through a standard API (e.g. SAP), where these API's are available.
Aggregated Mobile Application
Aggregation technologies typically are vested in a mobile server, which enables the mobile application to obtain information from a number of back end applications through their exposed API's. Mobile application aggregation technologies are available from a number of vendors (e.g. Kony). Some vendors supplement this capability by offering some supporting services (e.g. database, file storage, mobile push notifications), which may be incorporated into the solution architecture. Examples include Mobile Back-end-As-A-Service (MBaaS) vendors (e.g. Microsft Azure), and Integration-As-A-Service (IaaS) vendors (e.g. Mulesoft). These offerings are frameworks with foundational services only. They require analysis, architecture, design, development and testing for them to deliver the final enterprise level mobility solution.
Enterprise Mobility Platform
The mobility application platform approach provides a coordinated approach to the creation of multiple mobile applications across the enterprise by providing a single middleware server which supports the integration of mobile applications and the integration with back end systems. It provides the capabilites of providers of SaaS, MBaaS, and IaaS in a single offering. An enterprise mobility platform augments these capabilities by offering extended business services (e.g. person, organisation) and technology services (e.g. subject-of-interest matching, master data management, etc.). It improves on aggregated mobile applications by offering:
- Full integration with back end systems is through API's and messages. A common set of business services for use by an entire suite of the mobility applications.
- A holistic single view of the information objects regardless of their source (i.e. semantic interoperability).
- Integrated user collaboration and business workflow is achieved through shared platform services. These are at the enterprise level as they service multiple back end applications or departments.
- A single high quality enterprise user experience (UX) that is focused on the business and not on any of the underlying systems.
The set M-Stat mobility applications form an integrated healthcare enterprise mobility suite which runs on a variety of mobile devices, laptops and workstations. The applications run on a variety of platforms (i.e. Android, iOS, Windows) and are fully responsive in both portrait and landscape orientation. They share a common workflow in-box, which collects any of the business events used by the applications (e.g. clinical test results, collaboration messages, system messages, etc.). They share a single view of key business information objects (e.g. patients, practitioners). It employs a CogentiX specific mobility software framework, ensuring radpid development and very high performance. They share a single high quality enterprise level user experience (UX) that is focused on the business and is agnostic of any back end systems.CogentiX Convergent Mobility Platform (CMP)
The Convergent Mobility Platform is a healthcare-specific Enterprise Mobility Platform. It mediates the flow of information between the apps on the mobile devices and the underlying back end systems. It provides the capabilites of SaaS, MBaaS, and IaaS offerings in a single server that is specifically focussed on healthcare mobility solutions. The CMP is a fully formed solution, and requires no development work by the client. It has a number of integration capabilities which are shared by all of the M-Stat mobility applications, including:
Mobile Device Integration
The CMP integrates with the M-Stat mobility applications running on a variety of different mobile devices (Android, iOS, Windows), laptops and workstations. The communication between the M-Stat mobility apps and the CMP secured with TLS / SSL. It also provides notification of key events (e.g. new clinical test result) to the mobile devices using push notification technologies.
Back End System Integration
It provides interconnection with multiple back end systems and technologies through standard API's (e.g. REST), queries (e.g. SQL, NoSQL), and event messages (e.g. HL7, HL7 FHIR). It also provides the ability to interconnect to external user directories (e.g. Microsoft Active Directory). It has a number of information processing capabilities which are shared by all of the M-Stat mobility applications, including:
It provides a service for each major business object (e.g. patient, practitioner, etc.). This provides a single view of each object for all mobility applications.
It provides an integrated security management service for managing user authentication and authorisation (RBAC) and security token management (aligned with OAuth2) for user session management. It manages an enterprise level collaboration and workflow service for the management of these capabilities across all of the M-Stat applications.
It provides searching, translational, transformational and reconciliation capabilities to provide the single view of business objects to the mobile apps (i.e. semantic interoperability). It provides subject-of-interest matching for cross system information translation. It provides transaction management and exception handling for all information access.
It stores structured business information (i.e. records) in a traditional database and stores multi-media business objects (e.g. images, documents, video, etc.) in an object store.
- Business Services
The answer is very simple. CogentiX combines its many years of real world architecture and implementation experience with a model driven architecture (MDA) approach to software development. Modern sophisticated software systems are complex to design, build and test. As with most engineering processes, the weakest link in the chain is the human being. Human beings slow down the manufacturing process and are prone to error. As such, they are also the main source of lower software quality.
Model Driven Architecture (MDA) is the software design approach for the development of software systems as proposed by the Object Management Group (OMG). It provides a set of guidelines for the structuring of specifications, which are graphical models expressed in the Unified Modelling Language (UML). The intent of the approach is to facilitate using the models to drive the development of computer software. MDA reduces the reliance on human beings to author all of the software components, by automating the manufacture of software components directly from UML models. This greatly increases the speed of the Software Development Life Cycle (SDLC) and greatly improves the level of quality.
CogentiX has a long history of using UML and Archimate models to specify software solutions. It extends this experience into MDA software manufacture through the use of a state-of-the-art MDA solution called 'Genome'. Genome reads and analyses UML and Archimate design models to generate a large proportion of the software used in its products. At the push of a single button, Genome generates in a few seconds what it would traditionally take a team of software programmers several months to write by hand.
This commercially proven methodology is based on the TOGAF enterprise architecture methodology and leverages the practical lessons learned from the entire CogentiX team. The CogentiX methodology is a repeatable series of carefully defined stages of work. The output of each stage is a collection of architecture products. Each product has a clearly defined product description. This ensures that all stakeholders understand the composition of the products before they are produced. Each product consists of a number of high quality artefacts that can be directly consumed by target stakeholders (such as design/build teams, configuration teams and testing teams). The implementation of the CogentiX methodology ensures that the client integration solution has passed through rigorous architectural analysis and design processes to ensure that no detail is left untouched. Risks and issues are addressed, and all required scenarios tested for feasibility. The result is a high quality solution that can be built, configured, tested and deployed. Since the methodology is focused on integration architecture, it produces a solution to satisfy business driven outcomes within reduced timeframes in comparison to other more generic methods.