Surgery Management using Cloud Computing Services
The evolution of technology has many applications in various fields. In current digital technology, every organization has implemented information management systems for effective use of resources and improves business activities. One of the fields is Healthcare where a huge amount of data needs to be stored and processed.
The most complex and expensive resource in a hospital is the surgery room. The surgery has to be performed in a proper and timely manner in order to increase the success rate of patient recovery from medical problems. Surgical management is the method of the end to end surgical process handling. This management mainly helps in order to manage and schedule the difficult tasks in a clinic or hospital.
The operation theatres and their related activities are said to be the main functionality of the hospital and it is performed for saving the lives of several people. This surgery management has several modules namely, the OT surgeon module, OT configuration module, Nurse Module, CSSD module, and the Anaesthetist module.
These modules help for handling the critical surgeries and the integration of the post and the pre-operation care for the particular patient. This project Surgery management system using cloud computing services helps to manage the clinical data related to the surgeries in the operating room. This plans and schedules the surgeries based on the availability of specialized surgeons and anesthesiologists.
This will manage the technical assistants and operating room staff to prepare for the surgeries based on the schedule. This enables the hospital to efficiently use the resources and the medical equipment which are economically high and complex. This will improve the performance of the hospital increasing their business opportunities with spending proper expenditures for the surgical facilities. The objective of this project is to plan and manage the surgeries in the operation theatre. This will help to manage and schedule the surgeries with the surgeons in the hospital
Planning is one of the significant processes in the system development life cycle where it decides the success of the project. Planning includes scheduling the tasks, budgeting, setting goals and milestones.
The project management plan consists of project scope, project time and project cost plans. The project scope plan defines the objectives, constraints, assumptions and the responsibilities of the stakeholders. The project plan has to be prepared by the system analyst who coordinates all the activities of the project. The Milestones of this project are given below.
| Process | Time |
| Requirement Specification | 8 days |
| System Analysis and design | 6 days |
| System implementation | 8 days |
| System Testing | 8 days |
| System Maintenance (if required) | 2 days |
- Requirement Specification
This step involves the documenting all the requirements of the project. The requirements are gathered from the stakeholders. This is done by interviews, surveys and meetings.
- System analysis and design
In this step, the system requirements are analysed based on the functional and non-functional requirements of the project. Then the requirements are modelled into different forms of design of the project such as class diagram, context flow diagram, ER diagram and the physical architecture (A.Croxatto & G.Greub, 2017).
- System Implementation
In this step, the project is implemented using the front end and back end of the system. The technologies and programming languages are used for implementation. The user interface and database of the project will be implemented.
- System Testing
In this step, the system will be verified using various inputs. The system will be tested under different conditions whether it performs the intended operations.
3. Cloud Architecture Solution and Implementation
The process of obtaining the requirements from the stakeholders is said to be requirement gathering. In this project, the requirements are collected from the hospital staffs of the surgery department. The different requirements of each stakeholder are obtained. And the requirements are verified and added to the final project plan. Then the functional and non-functional requirements of the project are defined.
Functional and Non-functional requirements
The functional requirements of the project are set of tasks and activities likely to be performed by the system (OfniSystems, 2020).
Emergency Management
This function involves the managing of patient details who come during emergency conditions and the surgery are planned based on the schedule and the availability of the surgeon.
Admin module
This function involves the scheduling of surgeries based on the medical conditions and availability of the surgeons. It involves searching for free slots and surgeons.
Manager module
This function involves coordinating all the activities such as checking the schedules, preparing the operation theatre and producing the bills for surgeries.
Surgeon module
This function involves approval of requested surgery schedule by the surgeon. The surgeon can view the list of surgeries assigned to him with the time of schedule.
Operation theatre
This function involves the preparation of the operation theatre by viewing the schedule. The set of requirements and the equipment are prepared by the medical assistants.
The non-functional requirements of the project are set of attributes defining the system (SAFe Scaled Agile, 2020). These requirements act as constraints to the system. The non-functional requirements of the system are given as follows:
- Security – This defines the level of security the system will provide.
- Reliability – This defines how accurate the results or outputs the system provides.
- Performance –This defines the ability of the system perform intended operations.
- Scalability – This defines how well this system can handle more number of workloads.
- Usability- This defines the set of devices and platforms where this system will be used
3.2 Choice of type of cloud platform
As the next phase of the project, it is necessary to choose the cloud platform type. The most commonly used five cloud platforms are listed below:
- Amazon Web Services
AWS is the most well-known and powerful cloud service provided by Amazon. It provides services to most of the government agencies and leading organizations.
- Google Cloud Platform
Google offers public cloud services in the name of Google Cloud Platforms. It offers very robust data storage services. Google offers online development environment for the software developers.
- Microsoft Azure
This is the cloud computing service provided by Microsoft. This enables to deploy the services only on the Microsoft servers. It offers many security features for the web applications.
- IBM Blue mix
This is the cloud solution provided by IBM and it offers the PaaS and IaaS services. This enables to run and deploy applications that are scalable in nature.
- Alibaba Cloud
This is the cloud service provided by Alibaba a Chinese company. It offers all dominant cloud services (Anurag, 2017).
The project team decided to choose the Microsoft Azure for the implementation of the surgery management.
3.3 Choice of data centre and standards
The data centres are classified into four tiers of standards based on the level of service it offers. The Telecommunications Industry Association (TIA) formed these standards for the data centre. The tier1 data centre is more like a data warehouse. It is not very complex.
Tier 2 data centre are more complex than the Tier1 and it provides services by balancing between the cost and the performance. Tier 3 data centre provides high availability and fault recovery services. Tier 4 data centre provides fault-tolerant and sophisticated services (phoenix nap, 2018).
The data centre can be chosen based on the requirements of the system. Tier1 data centre can be chosen for this project. As the data handled by the hospital will be sufficient for this type of data centre.
AST standard is used for the surgery management in order to handle the specimens related to the surgery. AST is nothing but the association of surgery technical in which it fully manages the surgery management.
3.4 Cloud System Architecture developed to solve the problem
The project team decided to do the implementation process of the surgery management in the amazon cloud service platform and is saved in the Kubernetes database. The cloud services selected is the Microsoft Azure, in order to solve the issue in the surgery management project.
As the initial step the instance of the surgery is chosen. Database Kubernetes is selected in order to store the relevant informations regarding a surgery and a patient in a large number and it also helps to view it in future. In the below diagram, the architecture implementation based on Microsoft Azure is shown. For CPU monitoring, and for keeping the data safe the azure is implemented with the secret key vault.
The google app engine helps to check the process status and the number of instances that took place. In the database the patient detailed store and the patient’s history is created.
With the database information one can easily check the details of the particular patient whenever needed. In order to view the details of a patient-first, it is necessary to log in from the home page, and the outlook is shown below. Nearly 60% of the process is completed including the surgery initiation, staff salary, operation cost etc.
3.5 Implementation using any cloud platform
Using the cloud service Microsoft azure the surgery management is implemented as follows.
Google Cloud Platform
Instance
Kubernetes
Google app engine
Database
Surgery management system
Calculation
The calculation is showed for the activity duration, the cost drivers, the unit cost values and the doctors involved in a surgery cost. This calculations are done with the AWS calculator and the cost for each process in a surgery is mentioned in the below table.
| Process | Time duration
(Minutes) |
Unit cost | Total cost (Euros) |
| Set up | 36m | 4.83 | 177 |
| Patient position | 62m | 3.93 | 237 |
| Anaesthesia | 55m | 5.88 | 322 |
| Intervention | 283m | 7.00 | 2030 |
| Dressing the wound | 20 | 2.45 | 48 |
| Cleaning | 45 | 4.50 | 230 |
| Recovery | – | 88 | 260 |
The detailed analysis of the surgery management system which is implemented based on the cloud computing services is done and the requirements need for the project is gathered. The cloud provider and the consumer should have a service level agreement which documents the set of requirements of the resources with the preferred level of performance. This will help the consumer to pay based on the usage and the performance of the resources. The cloud provider should enable services like remote administration, resource management and SLA management.
The cloud provider and consumer should also follow the government regulations while availing of the cloud services. The cloud provider should ensure the following security issues. Authenticated user access for the data processed outside the hospital the regulatory standards provided by the international standards, the provider should ensure the location of data centre, the data should be segregated from other users, the backup and recovery of data (Khan, Li, & Khan, 2019).
Thus the Surgery Management System for a hospital has been designed using the cloud computing services and some of the modules of the system are implemented. We have also discussed how the google platform helps in order to implement the system in an effective manner.
This system will be helpful for the clinical staffs to manage and schedule the surgery events. This schedule will helpful for the surgeons and the operation theatre assistants to prepare for the surgeries. This will improve the performance based on time, cost and human power. The effective usage of resources will be enabled by the system.
References
1. A.Croxatto, & G.Greub.,2017. Project management: importance for diagnostic laboratories. Elsevier, 434-440.
- Anurag.,2017. Top 5 Cloud Platforms and Solutions to Choose From. https://www.newgenapps.com/blog/top-5-cloud-platforms-and-solutions-to-choose-from/ , 1-1.
- Khan, R. A., Li, T., & Khan, A.,2019. Cloud Migration: Standards and Regulatory Issues with Their Possible Solutions. Int. J. Advanced Networking and Applications, 4113-4118.
4.OfniSystems.,2020. Functional Requirements. http://www.ofnisystems.com/services/validation/functional-requirements/ , 1-1.
- pheonixNAP.,2018. Data Center Tier Classification Levels Explained (Tier 1, 2, 3, 4). https://phoenixnap.com/blog/data-center-tiers-classification , 1-1.
6.SAFe Scaled Agile. (2020). Nonfunctional Requirements. https://www.scaledagileframework.com/nonfunctional-requirements/ , 1-1.
