The Cloud-Enabled Architecture of the Clinical Data Repository in Poland

Abstract

In this article, the authors, using information-systems modeling techniques, and considering current national legal regulations, present the cloud-enabled architecture of a clinical data repository. The patient’s medical record is an important carrier of information necessary for accurate diagnosis and selection of the correct treatment process. Therefore, it is not surprising that since the beginning of the development of computer technologies, databases have been built to enable the management of a patient’s medical records. These systems were most-often deployed locally at individual healthcare units, which carried certain limitations both in terms of the security and availability of the stored information, and the possibility of exchanging it with other clinics. However, recent developments in the standardization of medical information exchange in Poland, together with the revolution in cloud computing, have opened up completely new perspectives for clinical-data-repository implementations helping to make them far more sustainable. Although, the practical aspects of implementing clinical-documentation repositories are studied both in forums of European countries and also around the world; so far, no similar research was conducted with respect to Poland. This study tries to fill that gap by proposing a flexible multi-variant cloud-enabled architecture of the system providing the services of a clinical-data repository. The goal of the work was to propose such a system architecture that allows having a system that is either cloud-agnostic, that uses specifically selected cloud services, or that is even deployable locally. Thanks to the use of cloud computing services, the implemented system is characterized by high availability, scalability, and the possibility of exchanging data between medical institutions, which enables the improvement in the quality of medical processes for the whole Polish population.

Tuning a Kubernetes Horizontal Pod Autoscaler for Meeting Performance and Load Demands in Cloud Deployments

“…The subject of the case study was a medical system developed for the gathering and archiving of clinical data (Clinical Data Repository-CDR), which serves as a medical data store for many hospital information systems (HIS) deployed according to a multitenant approach. The architecture of this system has been previously outlined in the context of earlier proprietary studies [29].…”

“…The system was tested against the flood of critical requests. In the context of the considered cloud-enabled Kubernetes-based CDR system [29], there were requests to create a medical document-a so-called ITI-41 transaction according to the IHE and PIK-HL7 standard.…”

A systematic review and meta-data analysis of clinical data repositories in Africa and beyond: recent development, challenges, and future directions

“…A high throughput NLP architecture was developed in [29] using the clinical text analysis and knowledge extraction system where results obtained showed that the architecture processed 83,867,802 clinical documents in 13.33 days and produced 37,721,886,606 concept unique identifiers (CUIs) across 8 standardized medical vocabularies. A cloud-based architecture was proposed by Augustyn et al [30] and Sarwar et al [31] for Poland and Pakistan, respectively. Here, results showed that the proposed architectures met the set requirements and the criteria of the sustainable development paradigms and could result in the generation of a huge data repository that would help improve patient care, diagnostics and patient outcomes, disease prevention, and disease surveillance of possible outbreaks.…”

Enhancing Security of Medical Image Data in the Cloud Using Machine Learning Technique

“…In [29], developed a model that secures the access, storage and protection of using data in cloud-servers in the medical/ hospital sector. The study focused on private clouds and also the public clouds in the Poland based hospitals.…”