Medical Data Integration Research Articles

An Adaptive Enhanced Technique for Locked Target Detection and Data Transmission over Internet of Healthcare Things

The incredible advancements in data transmission technology have opened up more potentials for data security than ever before. Numerous methods for data protection have been developed during the previous decades, including steganography and cryptography. The security and integrity of medical data have emerged as major barriers for healthcare service systems as the Internet of Things has evolved dramatically in the healthcare business. Communication between two devices securely is a difficult problem. Numerous cryptographic algorithms are already available, including data encryption standard (DES), Rivest–Shamir–Adleman (RSA), and advanced encryption standard (AES). In this paper, we present a hybrid security model for the protection of diagnostic text data contained in medical photographs. The proposed model is built by combining a proposed hybrid encryption system with either a 2D Discrete Wavelet Transform 1 Level (2D-DWT-1L) or a 2D Discrete Wavelet Transform 2 Level (2D-DWT-2L) steganography technique. The suggested model encrypts secret data and hides them using 2D-DWT-3L. As text covers, color and grayscale images are employed. The suggested system’s performance was tested using PSNR, SSIM, MSE, and Correlation. Associated to state-of-the-art approaches, the proposed model masked personal patient data with high capacity, imperceptibility and minimum deterioration in the received stego-image. We use MATLAB to build the proposed mechanism, and measures such as throughput and execution time are used to assess performance.

Secure Multi-Party Computation Based Distributed Feasibility Queries - A HiGHmed Use Case.

The integration of routine medical care data into research endeavors promises great value. However, access to this extra-domain data is constrained by numerous technical and legal requirements. The German Medical Informatics Initiative (MII) - initiated by the Federal Ministry of Research and Education (BMBF) - is making progress in setting up Medical Data Integration Centers to consolidate data stored in clinical primary information systems. Unfortunately, for many research questions cross-organizational data sources are required, as one organization's data is insufficient, especially in rare disease research. A first step, for research projects exploring possible multi-centric study designs, is to perform a feasibility query, i.e., a cohort size calculation transcending organizational boundaries. Existing solutions for this problem, like the previously introduced feasibility process for the MII's HiGHmed consortium, perform well for most use cases. However, there exist use cases where neither centralized data repositories, nor Trusted Third Parties are acceptable for data aggregation. Based on open standards, such as BPMN 2.0 and HL7 FHIR R4, as well as the cryptographic techniques of secure Multi-Party Computation, we introduce a fully automated, decentral feasibility query process without any central component or Trusted Third Party. The open source implementation of the proposed solution is intended as a plugin process to the HiGHmed Data Sharing Framework. The process's concept and underlying algorithms can also be used independently.

COVID-19 Medical Data Integration Approach

The need to create automated methods for extracting knowledge from data arises from the accumulation of a large amount of data. This paper presents a conceptual model for integrating and processing medical data in three layers, comprising a total of six phases: a model for integrating, filtering, sorting and aggregating Covid-19 data. A medical data integration workflow was designed, including steps of data integration, filtering and sorting. The workflow for Covid-19 medical data from clinical records of 20400 potential patients was employed.

Medical Data Integration and Interoperability through Remote Monitoring of Healthcare Devices

In the age of intelligent gadgets and interconnected communities, the widespread surveillance and provision of healthcare to patients are made feasible through the Internet of Medical Things (IoMT). The number of implanted electronic devices that can be monitored remotely is increasing, leading to a rise in the amount and intricacy of biological data. The collected data can offer valuable diagnostic information that can be used to intervene and maintain implanted devices promptly, therefore enhancing the quality of treatment provided. Current remote monitoring processes are not fully using device diagnostics because of the lack of compatibility and data integration between exclusive applications and Digital Health Record (DHR) platforms. Establishing a technology framework that establishes information and enhances interoperability has the potential to strengthen remote monitoring. This article introduces the Medical Data Integration and Interoperability via Remote Monitoring of Healthcare Devices (MDII-RMHD) framework, which facilitates the collaboration of healthcare devices. MDII-RMHD enhances a cloud-based IoMT system using conversion resources at the network's boundary. This is achieved through the use of inquiring and conversion agents. The investigating devices keep track of a list of MDII-RMHD devices on the regional network and allow one device to seek information conversion from another gadget when the requesting device cannot do the task independently. The converting agent transforms the data into the necessary format and returns it to the original entity. These agents enable IoMT devices to utilize their surplus computational capabilities for data translations, reducing the need for cloud access. Conventional devices are compatible with fog resource managers that have MDII-RMHD support. We assess the MDII-RMHD framework by rigorous experimentation under different scenarios. The obtained results demonstrate that the proposed framework decreases the amount of uplink traffic and enhances the response time. This improvement in response time is significant for real-time healthcare applications.

Federated Multi-view Learning for Private Medical Data Integration and Analysis

Along with the rapid expansion of information technology and digitalization of health data, there is an increasing concern on maintaining data privacy while garnering the benefits in the medical field. Two critical challenges are identified: First, medical data is naturally distributed across multiple local sites, making it difficult to collectively train machine learning models without data leakage. Second, in medical applications, data are often collected from different sources and views, resulting in heterogeneity and complexity that requires reconciliation. In this article, we present a generic Federated Multi-view Learning (FedMV) framework for multi-view data leakage prevention. Specifically, we apply this framework to two types of problems based on local data availability: Vertical Federated Multi-view Learning (V-FedMV) and Horizontal Federated Multi-view Learning (H-FedMV). We experimented with real-world keyboard data collected from BiAffect study. Our results demonstrated that the proposed approach can make full use of multi-view data in a privacy-preserving way, and both V-FedMV and H-FedMV perform better than their single-view and pairwise counterparts. Besides, the framework can be easily adapted to deal with multi-view sequential data. We have developed a sequential model (S-FedMV) that takes sequence of multi-view data as input and demonstrated it experimentally. To the best of our knowledge, this framework is the first to consider both vertical and horizontal diversification in the multi-view setting, as well as their sequential federated learning.

Estimation and Monitoring of Operating Room Utilization by a Distributed Streaming and Analytics Architecture Deployed at Heidelberg University Hospital's Medical Data Integration Center.

Operating rooms are a major cost factor in a hospital's budget. Therefore, there is a need for process optimization related to the operating rooms (OR). However, the collection of key figures for process optimization is often done manually by medical staff. This can be erroneous, inaccurate, time consuming, and incomplete. Automated, data-driven approaches are intended to address these problems and help to get the most precise picture possible of what is happening within the OR. At Heidelberg University Hospital (UKHD), a distributed AI based streaming analytics architecture was set up and integrated into the Medical Data Integration Center (MeDIC). This architecture can process, store, and visualize heterogeneous data from different sources. Data from medical devices and the video stream of the wall mounted cameras of four integrated operating rooms are ingested into our system. Aggregated and analyzed in real-time computed key figures including OR state and utilization numbers are visualized in a dashboard for monitoring and decision support. Because of high data protection hurdles the proposed system, especially the video analytics, was trained and tested with statists and did not run during real procedures. Studies to evaluate and test the system during live surgeries are planned.

An Efficient Privacy-Preserving Public Auditing Protocol for Cloud-Based Medical Storage System.

The booming Internet of Things makes smart healthcare a reality, while cloud-based medical storage systems solve the problems of large-scale storage and real-time access of medical data. The integrity of medical data outsourced in cloud-based medical storage systems has become crucial since only complete data can make a correct diagnosis, and public auditing protocol is a key technique to solve this problem. To guarantee the integrity of medical data and reduce the burden of the data owner, we propose an efficient privacy-preserving public auditing protocol for the cloud-based medical storage systems, which supports the functions of batch auditing and dynamic update of data. Detailed security analysis shows that our protocol is secure under the defined security model. In addition, we have conducted extensive performance evaluations, and the results indicate that our protocol not only remarkably reduces the computational costs of both the data owner and the third-party auditor (TPA), but also significantly improves the communication efficiency between the TPA and the cloud server. Specifically, compared with other related work, the computational cost of the TPA in our protocol is negligible and the data owner saves more than 2/3 of computational cost. In addition, as the number of challenged blocks increases, our protocol saves nearly 90% of communication overhead between the TPA and the cloud server.

Guest Editorial Special Section on Learning With Multimodal Data for Biomedical Informatics

In this Special Section of the IEEE Transactions on Circuits and Systems for Video Technology, it is our honor to present emerging advanced machine learning and data analytics algorithms aiming at catalyzing synergies among image/video processing, text/speech understanding, and multimodal learning in biomedical informatics. Our goals are to 1) introduce novel data-driven models to accelerate knowledge discovery in biomedicine through the seamless integration of medical data collected from imaging systems, laboratory and wearable devices, as well as other related medical devices; 2) promote the development of new multi-modal learning systems to enhance the healthcare quality and patient safety; and 3) promote new applications in biomedical informatics that can leverage or benefits from the integration of multi-modal data and machine learning.

Research on Medical Waste Supervision Model and Implementation Method Based on Blockchain

The Internet of Things (IoT) has brought unprecedented changes to the society and permeated our daily life. However, it has not been successfully applied in the area of medical waste regulation, where the recycling and disposal of medical waste have significant loopholes in the management of classification, transportation, disposal, supervision, and other links. The source, authenticity, and integrity of medical waste data lack guarantees, and there is a risk of data tampering and forgery. Although there are currently some medical waste supervision applications combined with IoT-based blockchain domestically and internationally to facilitate information sharing and transfer, no verifiable method is provided for the information privacy leakage of medical waste operators. To address this problem, we propose a blockchain-based medical waste supervision model, which connects participants involved in the process, introduces digital credentials to achieve the protection of operator information privacy, and ensures that the entire data process is authentic and credible. By building a decentralized system architecture and setting intelligent contracts, we integrate and record the medical waste disposal regulatory information in different phases on the blockchain to form the supervision of medical waste chain. In addition, we digitize the physical credentials and certificates using digital credentials to achieve cryptography security and privacy protection. The regulatory model designed in this paper can provide digital certificates of disposal tracking information to the health, environmental protection, and other administrative departments in China. It can provide authoritative evidence for the supervision and accountability of medical waste disposal and support the construction of a new generation of medical waste regulatory information systems in China.

How the Utilization of Integrated Industry 4.0 Technologies will Radically Address Medical Data Integrity Concerns in Singapore

How the Utilization of Integrated Industry 4.0 Technologies will Radically Address Medical Data Integrity Concerns in Singapore

Development of Blockchain-Based Health Information Exchange Platform Using HL7 FHIR Standards: Usability Test

Health information exchange can improve health outcomes and reduce unnecessary medical expenses. An important task in health information exchange is to prove data integrity and strengthen the right to self-determination of individuals. This can be addressed using blockchain technology and dynamic consents. We aimed to develop a blockchain-based mobile platform called HealthPocket to exchange reliable health information with proven integrity through a dynamic consent system based on the HL7 FHIR standards. Through HealthPocket, subjects can selectively provide their consent to share specific medical and PHGD through proper authorization, and each response is converted into the JSON format with FHIR compatibility. We conducted a usability test to demonstrate health information exchange between primary and tertiary medical institutions. A total of 116 subjects used the HealthPocket mobile application to selectively share health information for at least one month, and conducted a questionnaire about their experience. In addition, medical staff of the institution could access the medical information shared by the participants and use it for treatment. The user surveys for patients examined the perceived usefulness, perceived ease of use, and overall service satisfaction. The mean overall satisfaction with the health information exchange service was the highest (4.67 out of 5 points). As security, personal information protection, and interoperability are main concerns related to health information exchange, blockchain technology can provide suitable solutions. For instance, when health information is exchanged using blockchain technology, it is impossible to alter data blocks. Therefore, by using a blockchain-based platform and dynamic consent system, we ensured the integrity of medical data.

Medical data integration using HL7 standards for patient's early identification.

Integration between information systems is critical, especially in the healthcare domain, since interoperability requirements are related to patients’ data confidentiality, safety, and satisfaction. The goal of this study is to propose a solution based on the integration between queue management solution (QMS) and the electronic medical records (EMR), using Health Level Seven (HL7) protocols and Extensible Markup Language (XML). The proposed solution facilitates the patient’s self-check-in within a healthcare organization in UAE. The solution aims to help in minimizing the waiting times within the outpatient department through early identification of patients who hold the Emirates national ID cards, i.e., whether an Emirati or expatriates. The integration components, solution design, and the custom-designed XML and HL7 messages were clarified in this paper. In addition, the study includes a simulation experiment through control and intervention weeks with 517 valid appointments. The experiment goal was to evaluate the patient’s total journey and each related clinical stage by comparing the “routine-based identification” with the “patient’s self-check-in” processes in case of booked appointments. As a key finding, the proposed solution is efficient and could reduce the “patient’s journey time” by more than 14 minutes and “time to identify” patients by 10 minutes. There was also a significant drop in the waiting time to triage and the time to finish the triage process. In conclusion, the proposed solution is considered innovative and can provide a positive added value for the patient’s whole journey.

Federated learning for computational pathology on gigapixel whole slide images.

Deep Learning-based computational pathology algorithms have demonstrated profound ability to excel in a wide array of tasks that range from characterization of well known morphological phenotypes to predicting non human-identifiable features from histology such as molecular alterations. However, the development of robust, adaptable and accurate deep learning-based models often rely on the collection and time-costly curation large high-quality annotated training data that should ideally come from diverse sources and patient populations to cater for the heterogeneity that exists in such datasets. Multi-centric and collaborative integration of medical data across multiple institutions can naturally help overcome this challenge and boost the model performance but is limited by privacy concerns among other difficulties that may arise in the complex data sharing process as models scale towards using hundreds of thousands of gigapixel whole slide images. In this paper, we introduce privacy-preserving federated learning for gigapixel whole slide images in computational pathology using weakly-supervised attention multiple instance learning and differential privacy. We evaluated our approach on two different diagnostic problems using thousands of histology whole slide images with only slide-level labels. Additionally, we present a weakly-supervised learning framework for survival prediction and patient stratification from whole slide images and demonstrate its effectiveness in a federated setting. Our results show that using federated learning, we can effectively develop accurate weakly-supervised deep learning models from distributed data silos without direct data sharing and its associated complexities, while also preserving differential privacy using randomized noise generation. We also make available an easy-to-use federated learning for computational pathology software package: http://github.com/mahmoodlab/HistoFL.

An Imperceptible Watermarking Scheme for Medical Image Tamper Detection

One of the important issues in telemedicine field refers to an advanced secure communication. Digital image watermarking is an ideal solution since it protects the electronic patient information’s from unauthorized access. This paper presents a novel blind fragile-based image watermarking scheme in spatial domain that merges Speed Up Robust Features (SURF) descriptor with the well-known Weber Descriptors (WDs) and Arnold algorithm. It provides a good way for enhancing the image quality and time complexity for medical data integrity. Firstly, the watermark image is shuffled using Arnold chaotic map. Secondly, the SURF technique is practiced to Region of Interest (ROI) of the medical image and then the blocks around the SURF points are selected to insert the watermark. Finally, the watermark is encrusted and extracted using WDs. Experimental results show good image fidelity with the shortest execution time to ensure medical images integrity.

Towards Data Integration for AI in Cancer Research.

Cancer research is increasing relying on data-driven methods and Artificial Intelligence (AI), to increase accuracy and efficiency in decision making. Such methods can solve a variety of clinically relevant problems in cancer diagnosis and treatment, provided that an adequate data availability is ensured. The generation of multicentric data repositories poses a series of integration and harmonization challenges. This work discusses the strategy, solutions and further issues identified along this procedure within the EU project INCISIVE that aims to generate an interoperable pan-European federated repository of medical images and an AI-based toolbox for medical imaging in cancer diagnosis and treatment.Clinical Relevance- Supporting the integration of medical imaging data and related clinical data into large interoperable repositories will enable the development, and validation, and wider adoption of AI-based methods in cancer diagnosis, prediction, treatment and follow-up.

Verifying the Feasibility of Implementing Semantic Interoperability in Different Countries Based on the OpenEHR Approach: Comparative Study of Acute Coronary Syndrome Registries.

BackgroundThe semantic interoperability of health care information has been a critical challenge in medical informatics and has influenced the integration, sharing, analysis, and use of medical big data. International standard organizations have developed standards, approaches, and models to improve and implement semantic interoperability. The openEHR approach—one of the standout semantic interoperability approaches—has been implemented worldwide to improve semantic interoperability based on reused archetypes.ObjectiveThis study aimed to verify the feasibility of implementing semantic interoperability in different countries by comparing the openEHR-based information models of 2 acute coronary syndrome (ACS) registries from China and New Zealand.MethodsA semantic archetype comparison method was proposed to determine the semantics reuse degree of reused archetypes in 2 ACS-related clinical registries from 2 countries. This method involved (1) determining the scope of reused archetypes; (2) identifying corresponding data items within corresponding archetypes; (3) comparing the semantics of corresponding data items; and (4) calculating the number of mappings in corresponding data items and analyzing results.ResultsAmong the related archetypes in the two ACS-related, openEHR-based clinical registries from China and New Zealand, there were 8 pairs of reusable archetypes, which included 89 pairs of corresponding data items and 120 noncorresponding data items. Of the 89 corresponding data item pairs, 87 pairs (98%) were mappable and therefore supported semantic interoperability, and 71 pairs (80%) were labeled as “direct mapping” data items. Of the 120 noncorresponding data items, 114 (95%) data items were generated via archetype evolution, and 6 (5%) data items were generated via archetype localization.ConclusionsThe results of the semantic comparison between the two ACS-related clinical registries prove the feasibility of establishing the semantic interoperability of health care data from different countries based on the openEHR approach. Archetype reuse provides data on the degree to which semantic interoperability exists when using the openEHR approach. Although the openEHR community has effectively promoted archetype reuse and semantic interoperability by providing archetype modeling methods, tools, model repositories, and archetype design patterns, the uncontrolled evolution of archetypes and inconsistent localization have resulted in major challenges for achieving higher levels of semantic interoperability.

CIPPPA: Conditional Identity Privacy-Preserving Public Auditing for Cloud-Based WBANs Against Malicious Auditors

Wireless body area networks (WBANs) rely on powerful cloud storage services to manage massive medical data. As precise medical diagnosis analysis is heavily based on these medical data, any altered medical data may cause severe consequences, the integrity of outsourced medical data has become the most concerning security issue. Up to date, most existing public auditing mechanisms have been proposed to check the data integrity, but they could not achieve conditional identity privacy, any patient would not like others to know his/her real identity corresponding to certain serious disease, and some malicious patients should be revoked timely due to misbehaviors. Additionally, they are vulnerable to malicious auditors, by colluding with the cloud server to cheat patients. In this paper, we propose a conditional identity privacy-preserving public auditing (CIPPPA) mechanism for cloud-based WBANs. CIPPPA is the first public auditing mechanism achieving conditional identity privacy of patients in WBANs, the real identity of a patient is unknown to anyone in cloud-based WBANs other than the private key generator (PKG). We attempt to integrate Ethereum blockchain into CIPPPA, which gives assistance to patients for validating malicious auditing behaviors. Formal security analysis and performance evaluation demonstrate that CIPPPA is practical for cloud-based WBANs.

Framework for Privacy-Preserving Wearable Health Data Analysis: Proof-of-Concept Study for Atrial Fibrillation Detection

Medical wearable devices monitor health data and, coupled with data analytics, cloud computing, and artificial intelligence (AI), enable early detection of disease. Privacy issues arise when personal health information is sent or processed outside the device. We propose a framework that ensures the privacy and integrity of personal medical data while performing AI-based homomorphically encrypted data analytics in the cloud. The main contributions are: (i) a privacy-preserving cloud-based machine learning framework for wearable devices, (ii) CipherML—a library for fast implementation and deployment of deep learning-based solutions on homomorphically encrypted data, and (iii) a proof-of-concept study for atrial fibrillation (AF) detection from electrocardiograms recorded on a wearable device. In the context of AF detection, two approaches are considered: a multi-layer perceptron (MLP) which receives as input the ECG features computed and encrypted on the wearable device, and an end-to-end deep convolutional neural network (1D-CNN), which receives as input the encrypted raw ECG data. The CNN model achieves a lower mean F1-score than the hand-crafted feature-based model. This illustrates the benefit of hand-crafted features over deep convolutional neural networks, especially in a setting with a small training data. Compared to state-of-the-art results, the two privacy-preserving approaches lead, with reasonable computational overhead, to slightly lower, but still similar results: the small performance drop is caused by limitations related to the use of homomorphically encrypted data instead of plaintext data. The findings highlight the potential of the proposed framework to enhance the functionality of wearables through privacy-preserving AI, by providing, within a reasonable amount of time, results equivalent to those achieved without privacy enhancing mechanisms. While the chosen homomorphic encryption scheme prioritizes performance and utility, certain security shortcomings remain open for future development.

Data Sharing in Distributed Architectures - Concept and Implementation in HiGHmed.

Medical routine data has the potential to benefit research. However, transferring this data into a research context is difficult. For this reason Medical Data Integration Centers are being established in German university hospitals to consolidate data from primary information systems in a single location. But, small data-sets from one organization can be insufficient to answer a research question adequately. In order to obtain larger data-sets, attempts to merge and provide data-sets across institutional boundaries are made. Therefore, this paper proposes a possible process that can extract, merge, pseudonymize and provide distributed data-sets from several organizations conforming to privacy regulations. This process is executed according to the open standard BPMN 2.0, the underlying process data model is based on HL7 FHIR R4. The proposed solution is currently being deployed at eight university hospitals and one Trusted Third Party in the HiGHmed consortium.

Management of medical and health big data based on integrated learning-based health care system: A review and comparative analysis

PurposeWe present a Health Care System (HCS) based on integrated learning to achieve high-efficiency and high-precision integration of medical and health big data, and compared it with an internet-based integrated system. MethodThe method proposed in this paper adopts the Bagging integrated learning method and the Extreme Learning Machine (ELM) prediction model to obtain a high-precision strong learning model. In order to verify the integration efficiency of the system, we compare it with the Internet-based health big data integration system in terms of integration volume, integration efficiency, and storage space capacity. ResultsThe HCS based on integrated learning relies on the Internet in terms of integration volume, integration efficiency, and storage space capacity. The amount of integration is proportional to the time and the integration time is between 170-450 ms, which is only half of the comparison system; whereby the storage space capacity reaches 8.3×28TB. ConclusionThe experimental results show that the integrated learning-based HCS integrates medical and health big data with high integration volume and integration efficiency, and has high space storage capacity and concurrent data processing performance.