First International Conference for E-Medical Systems E-Medisys 2007 – October 24-26 FEZ Morocco 1

MOBIFLEX: A Generic Architecture for

Integrated M-Health Applications.
F. Bouchoul, and M. Mostefai

Abstract—Healthcare information systems (HCIS) are Today medical records are massively digitalized.
complex, heterogeneous, and spread out over multiple locations An electronic record may be created for each service a patient
making their management and exploitation very onerous and receives from a medical action, such as radiology, laboratory,
lacking efficiency. This paper proposes the design of MOBIFLEX
a generic architecture for healthcare systems. The architecture is
or pharmacy, or even administrative one. Numerous types of
a combination of mobile agents, stationary agents and agents- electronic records are used in healthcare environments. We
services. The aim of this combination is to ease flexible can cite the Automated Medical Record (AMR), the
integration and exploitation of healthcare sub-systems. Since Computerized Medical Record (CMR), the computer-based
mobility is inherent to healthcare environments, the architecture patient record (CPR), the Electronic Medical Record (EMR),
is managed by mobile workflows and empowered by fault- and the Electronic Patient Record (EPR). Although there are
tolerance mechanisms.
differences between these concepts, all these terms describe
Index Terms— Integrated M-health application, Fault tolerant
systems that provide a “structured, digitized and fully
mobile workflows, Mobile agents, Agentified web services. accessible patient record.” the reader can consult Ref. [1] for
differences. Today the term EHR has turned out to be the
I. INTRODUCTION favoured nomenclature for a sophisticated, generic term
covering all concepts encompassed in the terms given above.
Modern healthcare environments are built on distributed
The Health Information Management Systems Society’s
complex and heterogeneous resources at different places.
(HIMSS) [2] define Electronic Health Record (EHR) as “a
Since healthcare is information intensive, health systems have
longitudinal electronic record of patient health information
been developed over many years using various generations of
generated by one or more encounters in any care delivery
information and communication technologies (ICT).
setting. Included in this information are patient demographics,
Electronic tools of many types have been introduced [1], from
progress notes, problems, medications, vital signs, past
Hospital Information Systems (HIS) and related subsystems
medical history, immunizations, laboratory data, and
such as Laboratory Information System (LIS), Radiology
radiology reports.”
Information System (RIS) or Pharmacy Information System
Unfortunately, in a typical electronic healthcare system, all
(PIS) to newer tools such as Electronic Records. In fig. 1 we
these devices and systems interoperate only with the protocols
show in an abstract manner a typical architecture of such a
from the same vendor, and can’t interoperate with other
system. A HIS, also called Clinical Information System (CIS)
devices or systems running on different communication
is the main integrated information system designed to manage
protocols standards [3].
the administrative, financial and even clinical information in
a hospital. This encompasses paper-based information HIS
processing as well as data processing machines. The HIS is
often directly interfaced to other clinical systems, such as the
HL7
LIS, the RIS generally coupled with the (PACS) and the PIS.
A LIS is software for managing information generated by
Medical laboratory processes. A RIS is used by radiology LIS PIS RIS
departments to manage patient radiological data and imagery.
The Picture Archiving and Communication System (PACS) is
a system for the digital processing of radiological images. The DICOM
PIS manages requests for medication and may check for
potential medical interactions, patient allergies and dosage
errors. Other important components of health systems are PACS
electronic records. A medical record is a folder containing
from one to many patient health documents and reports. Fig. 1. A Typical architecture for a HCIS
 First International Conference for E-Medical Systems E-Medisys 2007 – October 24-26 FEZ Morocco 2

In particular, different electronic records are often captured

and remain in disparate and not integrated systems, e-Health
so that a typical HCIS consists of many independently
developed silos. A patient may have multiple medical records

Telemedicine

Telehealth
at each location with frequent redundancy. Each record may m-Health
contain partial information, and the process of retrieving data
and updating records is very hard. Clinical information of a
patient is spread out over a number of medical centers which
makes it difficult to get the exact state of a patient. In order to
improve the quality of care and to reduce costs, cooperation Medical-informatics
and information sharing among different health information
.
systems are strongly required. Integration of different
healthcare sub-systems and devices is one of the most active
Fig. 2. Terminologies in ICT based health systems
research areas and a suitable solution. The remainder of this
paper is organized as follows: section II presents the impact
The terms Telemedicine and e-Health are sometimes
and usage of ICT on healthcare domain, in section III we
confused [4] or used interchangeably. Telemedicine normally
study candidates technologies enabling the integration, in
refers to the provision of medical services from a distance,
section IV we propose MOBIFLEX an integrated architecture
while e-Health is a more generic term referring to the
for HCIS, in next section we show how we can manage
administration of health data electronically. M-Health
MOBIFLEX based systems by mobile workflows, last section
(mobile-health) is the application of e-health in the mobile
presents some applications examples of MOBIFLEX.
world; a mobile solution should fulfil what is called in [6] the
"5 ANYs":
II. ICT FOR HEALTHCARE
-- Any network (combining both mobile and wired) (e.g.
The impact of (ICT) in the healthcare domain is increasing GSM, GPRS, UMTS, Satellite, Wireless LAN, ADSL, etc.).
considerably in the last few years. Medical informatics [4] -- Any channel (e.g. Web, WAP, I-MODE, MIDLETS, etc.)
also called Health informatics has emerged as a new discipline or device (Mobile phone, PDA, HHT, Medical devices, PC,
in the intersection of information science, medicine and IDTV, etc.).
healthcare. It deals with the resources, devices and methods
-- Any user (any age, any culture, any expertise, etc.).
required to optimize the acquisition, storage, retrieval and use
-- Any place (local, regional, national, European; in a city,
of information in health and biomedicine. New terms like
countryside, road, etc.).
e-health, telehealth, telemedicine and m-health have appeared,
Fig. 2 adapted from [4] presents relationships between these -- Any service (i.e. a platform that can be tailored to any
new concepts. For the purpose of the paper we consider also specific vertical application).
m-health. E-health [5] is defined as “an emerging field in the The benefits of the wireless technology have been
intersection of medical informatics, public health and illustrated in a number of different applications [6]:
business, referring to health services and information -- Clinicians can have access to patient history, laboratory
delivered or enhanced through the Internet and related results, pharmaceutical data, insurance information, and
technologies.” In [6] the benefits of e-health are summarised medical resources from anywhere. They can prescribe
in three categories: medication, consult with colleagues and change treatment
regardless of their location.
--Improving the quality of care: ICT provide the clinician -- Inventory tracking can become instantaneous with a
with the patient’s entire health history or, even in some mobile staff finding what they need on the fly.
instances, the patient’s latest clinical encounter information.
-- A patient's vitals and location can be monitored with a
--Extending the reach of effective healthcare: The
simple handled device, providing better control with improved
implementation of e-health technologies such as telemedicine
flexibility over traditional methods.
can help Rural and low-income communities continue to have
facilities attracting and retaining healthcare professionals and
III. TOWARDS INTEGRATION OF HEALTHCARE INFORMATION
service facilities. SYSTEMS: ENABLING TECHNOLOGIES
--Reducing healthcare Costs: ICT give healthcare providers
the opportunity to reduce overall healthcare expenses by For the purpose of integrating HCIS, first efforts were
lowering the costs of administrative and clinical services. deployed in standardization; many solutions were proposed to
enable homogeneous interoperability between health systems
Telehealth, has become a more generic term to describe a and devices. Currently, for the storage and exchange of
wider definition of telemedicine. Telemedicine [7] is the use medical data, three standards have been established: DICOM
of electronic information and communications technologies to (Digital Imaging and Communications in Medicine) [8], HL7
provide healthcare when distance separates the participants. (Health Level Seven) [9] and CEN/TC251 [10].
 First International Conference for E-Medical Systems E-Medisys 2007 – October 24-26 FEZ Morocco 3

In practice the integration at the standards level is not -- Decision support systems: A distributed decision support
enough. Every day large volumes of data are generated from system based on the agent paradigm can monitor the status of
hospitals, primary care surgeries, clinics, and laboratories. a hospitalised patient and help to support co-operative medical
A new tendency for example is to build a regional EHR. Since decision-making.
information data is the key to digital HCIS and Rather than -- Education and simulation: Agents can help to improve
standardizing at the level of the vendor only, a new tendency medical training and education in distance-learning tutoring.
is to standardize at the level of the data. New standards in -- Planning and resource allocation: For example, an agent-
information technologies are adopted for this purpose. In this based coordination across a hospital could provide significant
section we shall try to make an adequate choice of improvements in the time required to pull together the
technologies enabling homogeneous and complete integration
resources required for tissue and organ transplant operation.
of HCIS. A convenient architecture must have in our sense
next characteristics: B. Web services for healthcare.
--Distribution: HCIS is distributed over disparate nodes If agents are the best solution for satisfying most of the
and built upon disparate technologies. requirements cited above, they are not sufficient to face
--Interoperability: interoperability between different interoperability issues, because of their coupled dependency to
medical systems has to be achieved easily through specific multi-agents platforms. In contrast web services, are
heterogeneous platforms among heterogeneous subsystems mainly designed to solve such interoperability problems.
and medical devices and via different mediums or different According to [12] web services bring to the healthcare domain
links (PDA, mobile phones, wired or wireless links…). many advantages:
--Mobility: healthcare workers are inherently mobile; thus -- It becomes possible to provide the interoperability of
the architecture must be implementable on stationary devices medical information systems through standardizing the access
as well as mobile ones. to data through WSDL and SOAP rather than standardizing
--Integrability: it must be possible to integrate sub-systems documentation of electronic health records.
in the same hospital or with other healthcare systems to realize -- Web services will extend the healthcare enterprises by
a regional EHR for example or to integrate legacy systems making their own services available to others.
such as old databases or old medical devices. -- Web services will extend the life of the existing software
--Flexibility and adaptability: the architecture must be by exposing previously proprietary functions as Web services.
flexible and adaptable enough to deal with frequent changes --Web services can be used to achieve interoperability not
and new circumstances inherent to health environment. only between heterogeneous platforms and standards but also
--Heterogeneity: the architecture has to bring together very between legacy databases and infrastructures such as old
disparate and heterogeneous components such as LIS/RIS RIS/LIS medical devices.
systems, medical monitoring devices, databases and so on.
--Complex coordination: there are several kinds of Furthermore web services are becoming the technology of
interactions to coordinate: human resource, resource-resource next generation of devices of different types and usage. The
and human-human. Devices Profile for Web Services (DPWS) [13] proposed by
--Intelligency: healthcare actions need intelligency to Microsoft in August 2004 defines a subset (profile) of Web
achieve flexibility and adaptability to frequent changing and Service protocols for its usage by devices. Today Internet
imprevisible circumstances of patients and the environment. technology can connect not only high level devices like
For all these constraints two technologies seem to be computers and PLCs but also devices of all kinds even at the
particularly convenient candidates for health domain: multi- lowest level of the device hierarchy, i.e. sensors and actuators.
agents systems and web services. Intelligent networked devices become able to collaborate with
each other to achieve their own individual goals. In medical
A. Multi-agents systems for healthcare. domain, Microsoft has already submitted three Web services
Healthcare is a promising research area where the agent specifications (WS-Addressing, WS-Security and WS-
paradigm is able to be applied. In Ref. [11], the authors gave a Reliable Messaging) as an update of the HL7 standard [14].
list of fields where researchers have already been applied
successfully the agent paradigm: IV. MOBIFLEX: AN INTEGRATED ARCHITECTURE FOR
--Information management: The increasing health M-HEALTH APPLICATIONS.
information available online (Internet and other electronic In this section, we propose MOBIFLEX an architecture
sources) has led to the development of information agents to combining agents and web services for the design of a
collect, filter and organise this information. platform enabling integration of HCIS and their management
--Community care: Agent-based systems have been applied with mobile workflows. Fig. 3 shows in an abstract manner
in the coordination of all the activities that have to be the building blocks of MOBIFLEX architecture. The key
performed for providing an efficient healthcare to citizens of a elements of our architecture presented in next sub-sections
community especially older or disabled citizens. have the next powerful characteristics:
 First International Conference for E-Medical Systems E-Medisys 2007 – October 24-26 FEZ Morocco 4

Legacy LIS/RIS BR-ws

Mobile agents

HL7 device NT-ws

Agents / Agents – HCIS
services
Desktop pc/ wireless Database DB-ws
devices/smart mobile phones
Fig. 4. In this example we have from top to bottom a brokering
DPWS / HL7 / HIS /LIS /PIS /RIS web-service(BR-ws), a native web-service(NT-ws) and a
Medical infrastructure database- web-service (DB-ws).

Hybrid wired/ wireless health computer Furthermore, when used together, web services and agent
networking technologies can generate a flexible, reconfigurable and
adaptive solution to achieve easily such integration objectives.
Fig. 3. Abstract building blocks for an intelligent and integrated
Finally, interoperability between agents and web-services is
architecture for M-health systems not obvious even though feasible because agents communicate
in ACL and web services interact with soap messages. In the
-- It combines static agents and mobile agents so that usage other hand if the agent is mobile and want to move to invoke
of agents is optimised. the web-service locally, it can not migrate only among sites of
-- It is fault tolerant since migration of agents can induce its platform or at most between identical platforms, an
real problems when altered agentification of the web-services seems appropriate to make
-- It is service oriented to achieve high interoperability for the architecture more homogeneous and facilitate the
healthcare systems. interactions.
-- It takes into account the characteristics of mobile devices Agents-services are proposed by the FIPA organization as
so that a minimal configuration is deployed on such devices an agentification standard of web services. In this architecture
when the core components of the systems are on the static web services are capabilities exposed by agents, these
platform. capabilities are not registered in UDDI (Fig. 5) but in special
-- Intelligent agents are used to handle complex functions yellow pages called Directory Facilitator (DF) that are
offering flexible and reconfigurable possibilities. managed by specific servers on agent platforms (Fig. 6). This
A. Web-services as integrating tools for HCIS. new vision presents the advantages to bring the gap between
agents and web services and to simplify their usage since they
Web-services can enable high degree of interoperability
interact uniformly by FIPA–ACL messages. For this purpose
between heterogeneous systems and devices. According to
we consider these two cases in MOBIFLEX (Fig. 7)
possibilities offered by service oriented technologies, we
--The web service implied in the HCIS is local to the
prefer differentiate between three classes of web services to be
enterprise or in a system directly linked to the hospital (e.g.
used in MOBIFLEX (see Fig. 4 as an example):
homecare): we use an agent-service.
-- Native web-services: we mean by native web-services
-- The web service implied in the HCIS is external and
those included originally in the device or the system such as
provided by some external enterprise: we create a broker
DPWS web services or HL7 ones.
agent-services which capabilities can vary from a simple
-- Brokering web services: they are web services created to
invocation of an external web service to a complex composite
interface the HCIS with legacy not service oriented devices
one combining local and external ones,
and systems.
For the case where the external system does not expose its
-- Data-Base web services: these web services enable
functionalities as web services, local agents-services can be
requesting and retrieving data from heterogeneous data-bases
created to interface the HCIS to external partner’s
systems.
functionalities.
B. Bringing the two technologies together: agentified web-
services. V. MANAGING THE INTEGRATED HEALTHCARE INFORMATION
Although the HCIS is local to the hospital business process, SYSTEM WITH MOBILE WORKFLOWS.
in some cases its scope goes beyond the hospital borders, e.g.
A. MOBIFLEX Workflow structure.
if implied in a virtual e-health system such as regional or
national HER or if extended to an external structure such as a The Workflow Management Coalition (WfMC) defines
homecare system managed from the hospital. In this case the workflow as [15]: “The automation of a business process, in
HCIS can be interfaced to the external partners by some whole or part, during which documents, information or tasks
brokering mechanism to ensure a secured interaction. By this are passed from one participant to another for action,
way the integrity of the HCIS is preserved. according to a set of procedural rules.
 First International Conference for E-Medical Systems E-Medisys 2007 – October 24-26 FEZ Morocco 5

Service External ws Broker agent-ws

registry
Publish services
Service discovery
Invoke web service
Service Service
provider Get service description requester
Local agent-ws
External agent-ws
Fig. 5. W3C based service oriented architecture
Fig. 7. Integration mechanism of MOBIFLEX
Directory
Facilitator B. Advantages of mobile agents in MOBIFLEX.
Publish services Service discovery
The WF-Manager can enact himself the workflow by a
centralized sequence of RPC. But the static agent interaction
Invoke web service model seems to be inadequate and very heavy in mobile
environment. Many works proved that mobile agents systems
Get service description can in most conditions outperform static agent systems, and
agent provider
agent requester that agent technology in general outperforms client-server
Fig. 6. FIPA based service oriented architecture
technology [18], [19]. for the special case where an interaction
is initiated from a mobile device to a sequence of fixed sites
we have shown in a previous work [20] that we have better
Especially, in healthcare domain [16], tasks can be results if the itinerary is executed by a mobile agent rather
diagnostic, therapeutic, administrative, or decision-making. than by a sequence of centralized RPC from a static agent
And are dependent of the actors (patients, practitioners, residing on the mobile device; because of the bottleneck due
administrators) and sometimes other resources (e.g. operating to the centralized architecture and of the number of low-
theatre availability, communication pathways) involved in a bandwidth links.
given care process. In the other hand, a mobile workflow [17]
is the system by which the business process flow can be C. Fault-tolerance model.
managed and made available to remote workers operating A first level of fault-tolerance of MOBIFLEX architecture is
over a wide geographical area through a wireless network. A obtained from the usage of mobile agents themselves;
mobile healthcare workflow can not only be a mean to build for example in the case of disconnections, the operation can
complex processes on different health sub-systems but also a resume without problems after its establishing.
flexible solution to integration. The architecture proposed for But this is not enough, if an M-Worker resides at site n and
managing workflows in MOBIFLEX is composed of three site n fails, all execution results that occurred between sites 1
types of agents (Fig. 11): and n are lost with the M-Worker and the execution must be
--A workflow manager (WF-Manager): the WF-Manager is performed again which is catastrophic in healthcare. We
the core component of the mobile workflow engine on the propose to resolve the problem at two levels
mobile device. The WF-Manager in this scenario takes full 1) By an adaptive itinerary at the M-Worker level.
responsibilities of a workflow management system, which At each step the M-Worker must have different alternatives
means that it has possibilities to enact and oversees its for destination to move, the best destination can be chosen
workflow according to specific parameters such as availability of the
--An agent planner (PL-Agent): It is an intelligent agent human user at the destination, the proximity or performances.
which resides on the main container. IA mechanisms and M-Worker has to contact directly the agent-services before
performances metrics can be used by the PL-Agent to choose moving, thus not only we have a QOS based workflow but
the most appropriate and most coherent sequences of web also a second level of fault-tolerance is obtained in the case
services composing the workflow to be enacted. When the where the destination is not available.
WF-Manager is initiated by the user by a specific request, it 2) By Checkpointing.
sends the request to the PL-Agent that returns details to the Checkpointing models for fault tolerance have been
workflow susceptible to achieve the goal. proposed to resolve similar problems [21], in MOBIFLEX,
--A mobile worker agent (M-Worker): the M-Worker is a prior to each M-Worker migration, an archival copy of the
mobile agent that enacts effectively the workflow. To enact agent is stored at the site from which it is migrating. One way
the workflow the WF-Manager sends an M-Worker to execute the WF-Manager can recognize the failure is based on
it. The agent carries with him an itinerary which offloads the expiration of the duration for the M-Worker to complete the
execution sequence for tasks. The WF-Manager can launch sequence or to send a notification when needed (i.e., a timeout
multiple mobile agents for a given workflow which are not occurs). The late can be caused either by a crash of the
dependent upon each other and can, therefore, be executed in M-Worker, the unavailability of any solvable destination or by
parallel. the human practitioner himself.
 First International Conference for E-Medical Systems E-Medisys 2007 – October 24-26 FEZ Morocco 6

When this occurs, the WF-Manager can recover the last Basic communication protocols like FIPA-Query, FIPA-
known copy of the M-Worker through a search across the Request and FIPA-Contract Net are enabled. Agents can move
sequence path as presented in [20] and then do suitable actions from one machine to another one, as and when required.
to resume the workflow by reactivating the copy of the M- The Lightweight Extensible Agent Platform (LEAP) [23] is
Worker, and eventually changing its itinerary or for the last an extension for JADE, which enables agents to use mobile
case alerting the human user as times as necessary until he devices as agent platforms. With LEAP it is possible to create
does its work (see the algorithm in the box below). a platform which is not only distributed over different servers
but can even be extended to devices which are connected by a
VI. IMPLEMENTATION ON JADE-LEAP/JADEX PLATFORM. wireless connection like PDAs or mobile phones.
Since a mobile workflow is enacted from a device with low JADEX is an other JADE extension which makes it possible
resources capacities typically a PDA or even a mobile phone, to use the BDI agents (Beliefs, Desires and Intentions) in
the architecture must be thought so that the only minimal JADE. Beliefs are informational attitudes of an agent, i.e.
configuration and capabilities are held by the mobile device. beliefs represent the information an agent has about the world
In this section we propose the design of such architecture. it inhabits. Desires represent the agent’s wishes and drive the
The choice of appropriate technologies is motivated by the course of its actions. Plans are the means by which agents
next requirements: achieve their goals and react to occurring events. JADEX
-- It can be deployed on both wired and wireless devices. supports four types of goals [24]: A perform goal specifies
-- Both static and mobile agents have to be enabled. some activities to be done, therefore the outcome of the goal
-- Provide possibilities to use intelligent agents. depends only on the fact if activities were performed or not.
-- Is portable on different platforms. An achieve goal represents a goal in the classical sense by
-- Provide services oriented management facilities. specifying a target state that shall be achieved, the agent has to
The platform JADE is perhaps the unique platform that perform specific activities for achieving the target state.
fulfils all these requirements together. JADE [22] is a FIPA A maintain goal has the purpose to observe some desired
compliant middleware implemented in Java for the world state and the agent actively tries to re-establish this state
development and execution of peer-to-peer multi-agents when it is violated. Query goals allow for an easy information
systems. Peer-to-peer systems are distributed ones where all retrieval from the beliefbase and when the result is not
nodes are peers in the sense that they are both clients and available the BDI mechanism will invoke plans for retrieving
servers in the same time. A peer could be a computer, the needed information. Fig. 10 shows the structure of a
a personal mobile terminal or some other device. JADEX agent.
A platform JADE is composed of one main container and Fault-tolerance Algorithm
many sub-containers. A JADE Main Container is used to host begin
- Send an M-workzer at time T0
the Agent Management System (AMS) and Directory while workflow not completed do
Facilitator (DF) agent in conformance to FIPA standards. -compute the approximative duration D to complete the
DF is an agent that offers Yellow Pages of the services that itinerary or receive notification
/* L: admissible Timeout percentage
can be offered by other JADE agents. (AMS) is an agent that -at time T > T0 +D(1+L)
offers a White Pages service to control the access and use of if the M-worker is back or notification received
the agents’ platform. Message Transport Service (MTS) is do nothing
used to communicate agents which are in different JADE else /*failure
-perform a binary search to locate the site K of the last
platforms. Agents communicate with each other directly via coherent checkpoint
messages through a FIPA-ACL–Communication protocol. - identify the cause of late
-if the M-worker
Reactivate the M-worker
SITE 1
Else /*insolvable next step
. -update M-Worker itinerary
-the M-worker resume its itinerary
WF-Manager FIG. 8.endifThe fault-tolerance algorithm
endif
end while
M-W orker copies

SITE 2
MIDP Pjava J2SE J2SE
SITE n container container container container

Fig. 8. Checkpointing mechanism Fig. 9. A typical Jade-Leap platform

 First International Conference for E-Medical Systems E-Medisys 2007 – October 24-26 FEZ Morocco 7

PDA
Adopted goals 4 WS
Wf Agent
Plan
Library manager
Adopt new goals Instantiate plans J2SE
Pjava
Selected for message
message Running
Reaction execution
Deliberation Plans
WS
Evaluate state Dispatch(sub-)goals/Events Agent
1 3
Handle events J2SE
5
Internal Agent
Beleif Beleifcondition events planner
base events
J DF
A
D
Query, Add, Remove Facts BB
E
WS
X J2SE
Agent
2
Fig. 10. Structure of a JADEX agent [24] J2SE

Fig. 11 shows the JADE based architecture of MOBIFLEX, Fig. 11. MOBIFLEX typical architecture
WF-Managers are JADE-LEAP agents residing in
personaljava containers on mobile devices, when the In [25] an elegant JADE solution is given to implement a
PL-Agent resides in the main-container of the JADE platform mobile agent itinerary, we can adapt this solution like this:
(J2SE). For the reasoning mechanism, JADEX does not
require any special kind of knowledge representation, but The WF-manager initially adds the behaviour
allows arbitrary Java objects to be stored as facts. The belief Itinerarybehaviour to the M-Worker, that sets the itinerary he
base (BB in Fig. 11) implementation also incorporates must follow, and then, this last starts the migration. The
concepts from the relational database world. A set oriented M-Worker execution is controlled by the methods beforeMove
declarative query language allows retrieving subsets of and afterMove that controls the migration and allows the
beliefs, or evaluating expressions over the belief base state. execution of the job, respectively. The agent job is
Each retrieved belief can generate an internal event that implemented in a behaviour called JobBehaviour.
initiates a new query goal for the next step in planning. Each For the checkpointing mechanism JADE offers sufficient
step can be generated according to QOS metrics or some methods to clone the agent (doclone()) deactivate it
applicability rules (resource availibility for example). When (deactivate()) and reactivate it (doactivate()).
the PL-Agent receives the FIPA-query message from the WF-
Manager (Step 1) the planning process is initiated (Step 2): a VII. TYPICAL APPLICATIONS OF MOBIFLEX
query goal is generated, and an information retrieval from the A. Medical data retrieval: a virtual EHR.
beleifbase is initiated, when the result is not available the BDI
Patient reports are usually stored in the electronic patient
mechanism will invoke plans for retrieving the needed
records spread over different and heterogeneous information
information. Flexibility in BDI plans is achieved by the
systems, such (RIS), (HIS) and LIS. Physicians frequently
dynamic selection of suitable plans for a certain goal which is
need to have an updated medical report for a given patient that
performed by a process called “meta-level reasoning”; this
combine information from his EPR and from RIS for some
process decides with respect to the actual situation which plan
specific imaging and some laboratory results from LIS. The
will get a chance to satisfy the goal. If a plan is not
objective is to have the complete medical information of a
successful, the meta-level reasoning can be done again
patient available in one consistent application rather than over
allowing a recovery from plan failures. The goal is to find a
several information systems. An M-Worker based workflow
suitable workflow to be done by the M-Worker including the
can be used as an intelligent agent-based information
sites to be visited and the tasks to be done (Step 3). The PL-
management system to access and retrieve information
Agent has eventually to consult the DF (Directory Facilitator)
homogenously from heterogeneous sources.
for best agent-servers candidates. Finally a plan is initiated
A virtual HER can thus be built on the fly with the newest
to return the result in a convenient form to the
and updated data without the need to create a true combined
M-Worker as a FIPA-inform message containing the itinerary
HER with very expensive maintenance tasks.
to be performed to achieve the goal. The WF-Manager
initiates the creation of an M-Worker (Step 4) to enact the B. Guidelines based careflows.
mobile workflow; this last performs its itinerary, and finally The standard definition of Clinical practice guidelines
comes back to its original location with the result (Step 5). (CPGs) is that of Field and Lohr [26]:
 First International Conference for E-Medical Systems E-Medisys 2007 – October 24-26 FEZ Morocco 8

[7] M. J. Field and J. Grigsby “Telemedicine and Remote Patient

Monitoring “ JAMA.2002; 288: 423-425.available at http://jama.ama-
"Systematically developed statements to assist practitioners assn.org/cgi/content/full/288/4/423#ACK#ACK
and patient decisions about appropriate healthcare for specific [8] Digital Imaging and Communications in Medicine (DICOM)
circumstances". The treatment for a specific patient is a path http://medical.nema.org/.
[9] Health Level-7 Standards home page. http://www.hl7. org
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