On the design of a generic and scalable multilayer software architecture for data flow management in the intensive care unit

Objectives: The current Intensive Care Information Systems (IC-ISs) collet and store monitoring data in an automated way and can replace all paper forms by an electronic equivalent, resulting in a paperless ICU. Future development of IC-ISs will now have to focus on bedside clinical decision support. The current IC-ISs are data-driven systems, with a two-layer software architecture. This software architecture is hardly maintainable and probably not the most optimal architecture to make the transition towards future systems with decision support. The aim of this research was to address the design of an alternative software architecture based on new paradigms. Methods: State-of-the art component middleware and agent technology were deployed to design and implement a software architecture for ICU data flow management. Results: An advanced multilayer architecture for efficient data flow management in the ICU has been designed. The architecture is both generic and scalable, which means that it neither depends on a particular ICU not on the deployed monitoring devices. Automatic device detection and Graphical User Interface generation are taken into account. Furthermore, a demonstrator has been developed as a proof that the proposed conceptual software architecture is feasible in practice. The core of the new architecture consists of Bed Decision Agents (BDAs). The introduction of BDAs, who perform specific dedicated tasks, improves the adaptability and maintainability of the future very complex IC-ISs. Conclusions: A software architecture, based on component, middleware and agent technology, is feasible and offers important advantages over the currently used two-layer software architecture.