A three stage ontology-driven solution to provide personalized care to chronic patients at home

Purpose: The goal of this work is to contribute to personalized clinical management in home-based telemonitoring scenarios by developing an ontology-driven solution that enables a wide range of remote chronic patients to be monitored at home. Methods: Through three stages, the challenges of integration and management were met through the ontology development and evaluation. The first stage dealt with the ontology design and implementation. The second stage dealt with the ontology application study in order to specifically address personalization issues. For both stages, interviews and working sessions were planned with clinicians. Clinical guidelines and MDs (medical device) interoperability were taken into account as well during these stages. Finally the third stage dealt with a software prototype implementation. Results: An ontology was developed as an outcome of the first stage. The structure, based on the autonomic computing paradigm, provides a clear and simple manner to automate and integrate the data management procedure. During the second stage, the application of the ontology was studied to monitor patients with different and multiple morbidities. After this task, the ontology design was successfully adjusted to provide useful personalized medical care. In the third and final stage, a proof-of-concept on the software required to remote monitor patients by means of the ontology-based solution was developed and evaluated. Conclusions: Our proposed ontology provides an understandable and simple solution to address integration and personalized care challenges in home-based telemonitoring scenarios. Furthermore, our three-stage approach contributes to enhance the understanding, re-usability and transferability of our solution. (C) 2013 Elsevier Inc. All rights reserved.