• 11 APR 12
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    The technology behind Pathcare

    The technology behind Pathcare

    The technology behind Pathcare

    This article is for software developers who are interested in the technology behind Pathcare and may be interested in developing plugins of their own for the Pathcare platform.

    Introduction – what is Pathcare?

    Pathcare is a private social network for doctors, healthcare workers and their patients.

    Pathcare provides highly effective secure data sharing between doctors and patients. It allows patient-mediated input of data before visits to the office, making the clinical data more accurate and complete and boosting the trust between doctor/healthcare worker and patient.

    Pathcare has a private 1:N network topology of one doctor and her patients using social software applications such as file sharing, private messaging and groups to capture the physiological and emotional context of patients and ensure privacy of patient-doctor communications.

    The Pathcare private social network for healthcare provides powerful information exchange and search:

    • Captures critical events on a timeline (for example blood pressure, dizziness etc) that enables the doctor to respond in a timely fashion.
    • Reconciles differences between what the doctor ordered and what the patient did.
    • Granular access control for sharing of data between doctor, patient and referrals.
    • Tagging and free text searching subject to the access control rights
    • Private messaging without exposure to email-borne spam and malicious content.

    Pathcare also provides a distribution channel for scientific / evidence-based content

    • Healthcare search and information services for doctors, patients and families
    • Open access and pay-for-access scientific articles

    Pathcare is an outstanding tool for treatment that requires intensive involvement of family members and ongoing data updates, for example Parkinson, diabetes or ADHD:

    • Get the physiology, and the emotional context.
    • Interact with patients/caregivers independently of time and place.
    • Healthcare workers that support 100 homebound people per day instead of 5.
    • Have actual vital signs and medication from chronic patients instead of guessing.

    The making of Pathcare

    Pathcare is a private social network for healthcare built on top of the Elgg social networking engine.

    In 2009, we were called upon by the Schering-Plough Polska country manager to implement a project that would provide a private social network for the Remicade(TM)innovative biological product area connecting key opinion leaders, product management team and medical sales representatives with approximately 300 Polish specialists nation wide in the areas of dermatology and rheumatology.

    The motivation for the project was recent Polish regulation (similar regulation exists in Sweden) that forbids medical sales representatives from meeting with doctors during business hours. Schering-Plough Polska was looking for an edge in marketing Remicade(TM) that would give the sales and marketing team an edge and enable the product managers and key opinion leaders to communicate with large numbers of doctors without having to get into the car and drive from Warsaw to Gdynia.

    Since the project was experimental in nature, we searched for a platform that would help us get the project up and running with a minimum of custom software development. After considering a fair number of closed source and Open Source alternatives, we selected Elgg for the project.

    Elgg is a powerful social networking engine based on an Apache, PHP and MySQL stack, and is generally regarded as the premier Open Source project for social networking.

    We installed Elgg on a hosted server and implemented groups, private messaging, file sharing and a plugin we developed for video conferencing that hooked into a third-party service. Although the project died after the merger with MSD in 2010, the experience with Elgg was a learning experience for us. We decided to embark on the journey of taking the project to the next level.

    The result of that journey was Pathcare – a private social network for healthcare.

    Elgg – the good parts

    Elgg has a number of very good parts – plugins, data model, API and views. Hooks, notifications, language files and arbitrary overloading of CSS and views by plugins are the not so good parts.

    The combination of hooks and overloading can turn Elgg code maintenance into a nightmare making it difficult to discover what code is actually executing. Using Chrome developer tools to find a CSS identifier on the page and then grepping code for the CSS identifier just doesn’t feel right to us. Our Visual Studio colleagues laughed as we groped in the darkness of Elgg hooks and overloading with sticks and knives in our hands.

    Language support in Elgg is implemented with PHP source files that are included into the session. Since each plugin can (and generally does) have it’s own language files, uniformity and maintenance are very hard. Without a UI it’s also difficult to use translators and right to left support is unaddressed.

    Notifications are another problematic part of Elgg. Since a notification can be triggered by a user clck event and is processed online, sending large numbers of notifications can keep the user waiting.

    When we embarked on the Pathcare journey, we wanted to keep the good parts and wherever possible, ditch everything else and make the application run fast, real fast.  If you want to learn more about the underlying technology, feel free to contact us.

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