Supporting Prenatal Care in the Public Healthcare System in a Newly Industrialized Country

Transcription

1 Supporting Prenatal Care in the Public Healthcare System in a Newly Industrialized Country Ingrid Nunes Ingrid Nunes, Ricardo Choren, Camila Nunes, Bruno Fábri, Fernando Silva, Gustavo Carvalho, Carlos J. P. de Lucena

2 Agenda 1 Introduction 2 Problem Statement 3 SUAP 4 Challenges and Benefits 30/3/2010 Ingrid Nunes@LES/PUC-Rio 2/18

3 Introduction 600,000 women worldwide die each year from causes related to pregnancy, whereas almost all these deaths occur in NICs. Prenatal Care Unified System (SUAP) project MAS for supporting the prenatal care Use of the agent technology to manage healthcare records act as a clinical decision support system handle the logistics of high risk pregnancy cases 30/3/2010 Ingrid Nunes@LES/PUC-Rio 3/18

4 Problem Statement Problems in the prenatal care in the Brazilian Public Healthcare System Pregnant women data is still mostly stored manually Protocols established by the Government may not be appropriately followed Everything is ok. 30/3/2010 Ingrid 4/18

5 Problem Statement Problems in the prenatal care in the Brazilian Public Healthcare System It is not precisely known which is the most appropriate hospital to refer a high risk pregnant woman, based on her condition And some other requirements 30/3/2010 Ingrid Nunes@LES/PUC-Rio 5/18

6 SUAP SUAP Overview Development Team Development Team 1 project manager 3 analysts/designers 1 software architect 5 programmers 1 web designer 30/3/2010 Ingrid Nunes@LES/PUC-Rio 6/18

7 SUAP Development Approach Adoption of some agile practices Iterative development with continuous integration Intensive interaction with stakeholders Meetings, presentations, interviews and s Simplicity Pair programming 30/3/2010 Ingrid 7/18

8 SUAP Detailing the SUAP Agents Protocols agents <protocol, event, context, behavior> When an event is received if context matches then execute behavior Message alerts Medicine prescription Exam request Change preset schedule Referral process 30/3/2010 Ingrid 8/18

9 SUAP Results Alert in English: Subnutrition. Investigate food history, hyperemesis gravidarum, infections, parasites, anemia, debilitating diseases. 30/3/2010 Ingrid 9/18

10 Challenges and Benefits No previous knowledge about the domain Typical issue in complex domains In particular, prenatal care Domain experts do not know what they need Problem: Discover how we can improve the prenatal care, i.e. which tasks can be automated and delegated to our system. I think I can provide a solution to some of your problems, but I don t know how I can help you. Me neither 30/3/2010 Ingrid Nunes@LES/PUC-Rio 10/18

11 Challenges and Benefits Benefit: communication facility between analysts/developers and stakeholders Agent Role 30/3/2010 Ingrid 11/18

12 Challenges and Benefits In addition Having agents acting on behalf of users may bring the idea that automating everything that is possible is good But This is not true I simply don t want this. The protocol is not effective, I can detect it and change the protocol automatically. 30/3/2010 Ingrid Nunes@LES/PUC-Rio 12/18

13 Challenges and Benefits Human-agents interaction Stop telling me what to do! I have studied for several years to learn it. Protocols representation Our sources Governmental manuals Doctors (meetings, interviews, s) Explanations for humans, not computers Challenge: structure concepts in a generic way 30/3/2010 Ingrid Nunes@LES/PUC-Rio 13/18

14 Challenges and Benefits Benefit: reduced gap between analysis and design Agents Analysis Agents Design Development in a stepwise fashion Web-MAS architectural pattern Agents: loosely coupled components Adopted technologies Modular support to the construction of maintainable MAS JADE: thread control Seam/JBoss: view, persistence, security Scalability SUAP has a low number of agents Bottleneck: number of web requests 30/3/2010 Ingrid Nunes@LES/PUC-Rio 14/18

15 Challenges and Benefits Challenge: choosing the agent platform 1 BDI architecture does not add advantages to our agents 2 Adoption of complex platforms that provide several new abstractions would significantly increase training costs 3 Integration with object-oriented technologies 30/3/2010 Ingrid Nunes@LES/PUC-Rio 15/18

16 Challenges and Benefits Challenge: choosing the agent platform JADE Agent and Behavior abstractions are enough for our agents pure Java reduces the learning curve of programmers However JADE and Seam frameworks integration was not trivial Seam Seam JADE Agent It does not work Component Locator JADE Agent 30/3/2010 Ingrid 16/18

17 Conclusion Supports and monitors prenatal care Management of electronic healthcare records Advices on prenatal protocols Simple referencing protocol based on pregnancy risks Web-based integrated with a MAS Web-MAS architectural pattern Technologies Seam (and JSF, JSP/Faces, Hibernate ), JBoss, JADE Next steps Stage environment production environment HUAP Niterói state of Rio de Janeiro Hopefully 30/3/2010 Ingrid Nunes@LES/PUC-Rio 17/18

18 Questions Supporting Prenatal Care in the Public Healthcare System in a Newly Industrialized Country Ingrid Nunes ionunes@inf.puc-rio.br Ricardo Choren Camila Nunes Bruno Fábri Fernando Silva Gustavo Carvalho Carlos J.P. de Lucena 30/3/2010 Ingrid Nunes@LES/PUC-Rio 18/18