Requirements

Four requirements really dictate the design and influence the architecture of a tether-less patient system. I have to present them to avoid questions about why this architecture versus other possible architectures. Without further ado and straight from my proposal draft:

Mobility Support

At its core, the tether-less patient paradigm amounts to the introduction of patient mobility to the traditional hospital monitoring scenario. The primary goal is to provide a similar level of monitoring while the patient goes about his or her normal routine.

Pervasive Operation

Patients too encumbered by the system's hardware will be unlikely to adopt it. As such, the system must be designed to fade into the background of their consciousness, alerting their attention as little as possible and adding a minimum of extra hardware to their person.

Management of Healthcare Professional's Time

Healthcare Professionals have limited time and oversee multiple patients. Where it may not be possible to in any way limit or discard the information delivered to a healthcare professional, the system should incorporate algorithms to intelligently monitor the patient’s situation such that the healthcare professional only be alerted to the important aspects of the situation.

HIPAA Compliance

The Health Insurance Portability and Accountability Act of 1996 stipulates that reasonable steps be taken to ensure an individual’s health information is kept confidential between a patient and his or her current healthcare professional, both through policy and technical means, except under several specific cases or unless the patient provides written authorization indicating otherwise. It defines four broad security requirements for Health Information Systems: Access Controls, Audit Controls, Integrity Controls, and Transmission Security. Access Controls must identify the system’s users (healthcare professionals) and grant access to patient information based on the role the user is currently fulfilling. Audit Controls require a system to log access grants and other activities for a period of six years. Integrity Controls require a system to put in place mechanisms ensuring health information is not altered or destroyed. Transmission Security requires steps to ensure data is not accessed in transit over a network.