BackgroundMedical personnel in hospitals often works under great physical and mental strain. In medical decision-making, errors can never be completely ruled out. Several studies have shown that between 50 and 60% of adverse events could have been avoided through better organization, more attention or more effective security procedures. Critical situations especially arise during interdisciplinary collaboration and the use of complex medical technology, for example during surgical interventions and in perioperative settings (the period of time before, during and after surgical intervention).MethodsIn this paper, we present an ontology and an ontology-based software system, which can identify risks across medical processes and supports the avoidance of errors in particular in the perioperative setting. We developed a practicable definition of the risk notion, which is easily understandable by the medical staff and is usable for the software tools. Based on this definition, we developed a Risk Identification Ontology (RIO) and used it for the specification and the identification of perioperative risks.ResultsAn agent system was developed, which gathers risk-relevant data during the whole perioperative treatment process from various sources and provides it for risk identification and analysis in a centralized fashion. The results of such an analysis are provided to the medical personnel in form of context-sensitive hints and alerts. For the identification of the ontologically specified risks, we developed an ontology-based software module, called Ontology-based Risk Detector (OntoRiDe).ConclusionsAbout 20 risks relating to cochlear implantation (CI) have already been implemented. Comprehensive testing has indicated the correctness of the data acquisition, risk identification and analysis components, as well as the web-based visualization of results.

The new IEEE 11073 service-oriented device connectivity (SDC) standard proposals for networked point-of-care and surgical devices constitutes the basis for improved interoperability due to its independence of vendors. To accelerate the distribution of the standard a reference implementation is indispensable. However, the implementation of such a framework has to overcome several non-trivial challenges. First, the high level of complexity of the underlying standard must be reflected in the software design. An efficient implementation has to consider the limited resources of the underlying hardware. Moreover, the frameworks purpose of realizing a distributed system demands a high degree of reliability of the framework itself and its internal mechanisms. Additionally, a framework must provide an easy-to-use and fail-safe application programming interface (API). In this work, we address these challenges by discussing suitable software engineering principles and practical coding guidelines. A descriptive model is developed that identifies key strategies. General feasibility is shown by outlining environments in which our implementation has been utilized.

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The long overdue IEEE 11073 Service-oriented Device Connectivity (SDC) standard proposals for networked and surgical devices provide vendor-independent interoperability and therefore room for improved workflow and new functionality in the operating room. Research and development in this domain remain also highly topical in orthopaedic surgery. Due to the novelty and complexity of the SDC standard family, there is currently a lack of open source public implementations. Such implementations have to overcome several non-trivial challenges, mainly because the complexity of the standards has to be reflected in the software design and implementation. The SDC standard family comes in three different parts and all three standard proposals must be considered when designing and implementing standard conform device communication.In this work, we address these challenges and discuss and compare two design approaches for different programming languages (C++ and Java). Suitable software engineering principles are used to ensure a clean design approach. Practical guidelines are given on how to integrate existing third party components and tools in the framework and the development process, respectively. General feasibility is demonstrated by outlining interoperability between two software frameworks developed using different design concepts.