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Citation Information : International Journal of Advanced Network, Monitoring and Controls. Volume 4, Issue 3, Pages 14-24, DOI: https://doi.org/10.21307/ijanmc-2019-055
License : (CC-BY-NC-ND 4.0)
Published Online: 11-November-2019
With the improvement of living standard and the change of life, people’s health awareness has been enhanced as a whole, and the health demand has changed from single medical service to multiple services such as disease prevention, health promotion, healthcare and rehabilitation. The wisdom medical system, Internet + medical service mode and digital hospital have become the direction of medical development. In order to build Tai’an healthy big data ecological domain, accelerate the traditional medical process informatization reform, and improve the application level of information service, we build a medical system with the support of new generation network IPV9 technology. The system is based on the medical institutions in Tai’an city, Shandong province, and has researched and implementation of the health ecosystem business structure, core technology, network architecture, system software and hardware, and system security. The system was put into trial operation in the medical institutions of the whole city and has achieved perfect results.
A new round of scientific and technological revolution and industrial changes are accelerating. Life science technologies continuously made new breakthroughs, and major technologies such as genetic engineering, molecular diagnostics, stem cell therapy, and 3D printing are accelerating applications. The new generation information biology and engineering technologies such as big data, cloud computing, Internet, artificial and intelligence are increasingly integrated into the medical and health fields. The rapid development of telemedicine, mobile medical care, precision medical care, smart medical care and other technologies have promoted the vigorous development of new formats and models of health industry, such as health management, health care, health tourism, leisure and health care, and “Internet + health”.
“13th Five-Year Plan for National Population Health Informatization Development” pointed out: We should strengthen population health informatization and health care big data service system construction, promote integration of government health care information system and public health medical data fusion, and eliminate information barriers, focus on improving the ability and level of population health information governance, vigorously promote the development of health care big data applications, and explore new models and new formats of innovative “Internet + health” services. We will build a unified, authoritative and interconnected platform for population health information, standardize and promote “Internet+ health care” services, and create new models of Internet health care services. Data collection, integration and sharing and business coordination of applied information systems such as public health, family planning, medical services, medical security, drug supply and comprehensive management are realized.
In recent years, the aging population in Shandong province is characterized by large base, rapid growth and empty nest. On the one hand, the needs of elder’s life care and medical health care are superimposed, and the consumption demand in the field of medical care, health care are strong, with huge space for the development of related industries. On the other hand, the health care industry in Shandong province is still in its infancy, with relatively insufficient supply-side capacity, structural contradictions and policy barriers, lack of high-quality resources, narrow coverage of medical care, and insufficient professional personnel, making it difficult to meet the needs of the elderly for different levels of health care services.
In 2016, Tai’an City proposed in the of “Tai’an City transformation and upgrading of medical and health service industry implementation plan” to accelerate the construction of “smart medical” system, explore the “Internet + medical” service mode, and build a digital hospital. We will build a sound healthy Tai’an big data ecological domain, accelerate the informatization reform of traditional medical treatment process, and improve the application level of informatization services. The government encourages medical and health institutions to make full use of the advantages of Internet development.
The design and research of this system is based on the medical informatization of Tai’an City, Shandong Province, which is led by Tai’an Central Hospital of Tai’an City, Tai’an Central Hospital and Tai’an City Hospital of Traditional Chinese Medicine. The district and county people’s hospitals are the main force, and the informatization development of the hospital is relatively perfect. However, some secondary hospitals, primary health care institutions, medical associations, medical communities, Internet hospitals, regional medical and health platforms and other information systems are not perfect, and they are unable to meet the growing needs of medical information development. Take the construction of medical and health information in Feicheng City as an example.
With the rapid development of IT technology, SOA technology, SaaS application, wireless network and other new technologies, the price of IT equipment is getting lower and lower, which makes the construction of smart city feasible technically and economically. Meanwhile, with the continuous application of cloud computing technology in the practice of medical informatization, the construction of regional medical informatization can achieve better results on this basis.
In August 2007, the Ministry of Information Industry Officially defined IPv9 as a new generation Internet to distinguish IPv6 next-generation Internet. The Internet based on TCP/IP protocol has been unable to meet the needs of future development by increasing bandwidth and gradual improvement. In order to break through the future network basic theory and support a new generation of Internet experiment. It is necessary to build test facilities include: original network equipment system, resource monitoring management system, covering cloud computing services, Internet of Things applications, spatial information network simulation, network information security.
On November 20, 2018, the General Staff Department of the People’s Liberation Army organized the IPv9 Technology Project Application Seminar at the No. 9 Dacheng Road in Beijing. They discussed and demonstrated the application of the healthy Tai’an Big Data Ecological Domain as an IPv9 technology application. It is required to speed up construction of the Tai’an big data ecological domain and rapidly increase the scale of the IPv9 network, and strive to build an IPv9 network technology demonstration zone through healthy Tai’an big data ecological domain.
Tai’an City “smart medicine” was achieved through the establishment of a unified data standard for health information in Tai’an City, public health information resources sharing, and electronic two-way referral and inspection results in the city mutual recognition and health card application in the city. With the healthy Tai’an big data ecological domain as the core, it realizes information interconnection and sharing, as well as comprehensive business collaboration. It promotes the development of a large health industry, achieves a more scientific management, smarter business, and benefits more residents, and promotes the openness of the health and family planning business in Tai’an City. Through the construction of this platform, the informatization construction of health and family planning in Tai’an City has reached the national first-class level.
Tai’an big data ecological domain can provide personalized health management and health care for residents, improve residents’ satisfaction. It can provide life-cycle health information for residents, and provide residents with network and information health services and health management. It enables residents to obtain continuous, comprehensive and high-quality health care services. It improves the efficiency of health services and reduces the waiting time of residents. We will support the rational use of high-quality regional health resources; effectively resolve the rational division of labor and allocation between primary and secondary large hospitals.
The health Tai’an big data ecosystem consists of five parts: business system layer, IT basic service layer, data layer (data warehouse), application layer and service layer (Internet + convenient service platform).
The business systems layer includes the business systems of medical institutions, health management centers, public health institutions, and other administrative agencies. Through the IPv9 service private network, network equipment, servers and storage equipment in the IT basic service layer, data such as electronic medical records, health files, population, and health resources are stored in the data layer. We divide the platform business system into three categories according to the different roles of data usage. The first category is the Internet + service platform for residents (including health Tai’an website, health Tai’an APP, Internet hospital, etc.). The second category is the medical collaborative service system for medical and health personnel (including hierarchical diagnosis and treatment platform, health identity card management system, telemedicine, health Tai’an imaging/ECG/inspection/pathology, etc.). The third category is the medical and health supervision system which serving the medical and health administrative institutions (including the medical and health supervision platform, medical reform monitoring system, third-party regional evaluation system, etc.). Meanwhile, business intelligence in data warehouse can be used to support the development of big data analysis and artificial intelligence.
The entire platform architecture conforms to the international and national information standard management system and information security protection framework to ensure the consistency and security of the exchange of data. Meanwhile, the remote disaster recovery and backup mode in line with international requirements is specially used to ensure the safe storage of data from natural or man-made disasters.
The health Tai’an big data ecological domain database uses relational databases such as MySQL, Oracle, SQL Server, and the development language uses JAVA and .net.
The platform service is built with ESB bus and SOA architecture, which provides perfect technical support for big data, and realizes rapid access to massive data. The flat platform provides complete functions such as collaborative support services and configuration management, and provides a comprehensive monitoring mechanism for the operating environment, which facilitates the rapid positioning and troubleshooting of problems. The overall technical framework of the platform conforms to the national standard and standard system, and adopts the data exchange standard of the industry standard, and adopts a variety of security mechanisms and security technologies to ensure the stable operation of the platform.
The platform adopts the Micro services architectural mode. Micro services are an updated version of the traditional SOA architectural pattern that supports for fine-grained control. Each system accessed in healthy Tai’an big data ecological domain is equivalent to micro services component, which dynamically realizes service scheduling and balance through registration and discovery mechanism. In addition, each service component can deploy multiple instances, effectively improving the overall stability of the platform.
A service component is a mineralized project with distributed deployment and invocation that provides a type of interface services. In terms of interface granularity division of service components, appropriate granularity should be adopted to split the interfaces to ensure the flexibility of top-level application calls and reduce the number of calls between different components to avoid complex business logic dependencies between components.
ESB (Enterprise Service Bus) is the combination of traditional middleware technology and XML, Web Service technology. The ESB provides the most basic connectivity hub in a network and is an essential element in building an enterprise nervous system. The enterprise service bus is the latest way to provide reliable, guaranteed messaging technology.ESB middleware products leverage Web services standards and interfaces with recognized reliable messaging protocols. Common features of ESB products include: connecting heterogeneous MOM, encapsulating the MOM protocol using the Web services description language interface, and the ability to transport Simple Object Application Protocol (SOAP) transport streams on the MOM transport layer.
The ESB uses the “bus” model to manage and simplify the integration topology between applications, based on open standards to support dynamic interconnectivity between applications at the level of messages, events, and services.
The platform adopts B/S architecture and SaaS deployment mode, which is different from traditional medical information platform manufacturers and the overall architecture design, is more advanced and efficient.
Following the unified standard, unified code, unified interface, under the principle of combing and standardized data through canonical business definition, strictly in accordance with established standards and technical route, so as to realize multiple departments, multiple system, information technology, as well as heterogeneous platform environment, interconnection, make sure that the maturity of the whole system, expansibility and adaptability, to evade the risk of system construction.
Under the principle of “unified specification, unified code, and unified interface”, the system strictly abides by established standards and technical routes, thereby achieving information interconnection in multi-sector, multi-system, multi-technology, and heterogeneous platform environments.
The platform security architecture refers to ISO-27001 and the third level of the national information security level protection system requirements. From the aspects of technology, operation and maintenance, management system and infrastructure, it is divided into security technology system, operation and maintenance security system, information security management system, security infrastructure and other parts.
The security technology system is mainly divided into application security, data security, network security and host security.
1) Application security. Application security mainly against common WEB security vulnerabilities published by OWASP. It mainly includes SQL injection, invalid authentication and authentication management, XSS attacks, invalid access control, sensitive information disclosure, CSRF, use of known vulnerability components, unprotected API, insufficient logging and monitoring and other WEB vulnerabilities.
2) Data security. Database security relies on various technologies and management measures to ensure data security, availability, integrity and confidentiality through data encryption, data desensitization, data storage backup, and access control.
3) Network security. Network security is mainly to ensure the integrity, confidentiality and non-repudiation of data in the process of network transmission. Through data transmission process encryption, intrusion prevention guarantees network security.
4) Host security. Host security solves the main security risks faced by the server, builds a server security protection system to prevent information leakage and risk by firewalls, white list isolation, security configuration, etc.
The system is divided into six areas, and the core area is two Huawei S2710 data center level switch clusters. The core area is connected to all other areas using dual gigabit connections. The network topology is shown in figure 5.
The access area is the area where all health cares institutions access. Two Huawei 10 Gigabit firewalls are used for isolation and aggregation. The business volume in the early stage is limited, and each of the two firewalls uses a 10 Gigabit connection, which can be expanded at any time with the business development in the future.
The internal network area is centered on two IPv9 backbone routers and Huawei 6650 data firewall. The data firewall isolates the internal network from the core switch 12710 to protect it. The establishment of virtual servers and storage devices in the internal network area is completed through optical fiber switches. The IPv9 router backbone router encrypts the address of the core data area of the internal network for higher security.
The external network deployment has the external network firewall. The anti-attack device is deployed to further increase the security protection of the external network. Platform logging, auditing, monitoring and IPv9 management are deployed in the management area. The security zone is used to deploy TOPSEC vulnerability scanning, network auditing, and flow control devices, which mainly provide security auditing and vulnerability scanning andother protection functions for the network.
The system is equipped with Huawei key business server minicomputer, which is mainly used in HIS system. It gives full play to the characteristics of strong processing capacity and high reliability of the minicomputer to ensure the normal operation of the hospital’s daily business for 24 hours. The system is equipped with Huawei high-performance data server, which serves as the city’s population health records database to ensure the security of these important data.
The high-performance generic server runs the LIS system, supply chain system, PACS system, medical business collaboration, Internet applications, and other applications. The cloud mode dynamically adjusts the computing resources of the server according to the running status of the service. Each virtual machine can be used as a backup. If a hardware server fails, the service will not be affected.
The hardware architecture of the system is shown in figure 6.
According to the outpatient volume of all levels of hospitals within Tai’an region, the available storage capacity of healthy Tai’an big data ecological domain is 202.5T, which can meet the business needs in the next 3 to 5 years. The storage portion consists of Huawei OceanStor6800 V3 and Huawei OceanStor5300 V3 virtualized Shared storage disk array.
The system plans HUAWEIRH2288HV3, (CPU E5-2620V4, 16G memory 600G hard disk) server, as a silver enterprise server, deploys two independent physical machine servers. System antivirus virus database upgrade server, and system antivirus virus database requires independent physical server.
Tai’an City health big data ecological domain designed in accordance with the above framework system, it has completed the overall planning of nearly 300 platforms and products in 8 categories, including basic platform, medical service, health service, healthy family, business system, benefit people service, business supervision, emerging technology since its construction in 2017. The system has completed the construction of all basic platforms, including platform standard management system, platform basic service, data exchange service, data resource service, information system integration platform, platform operation and maintenance system, platform security system. It has completed the construction of the information system of all primary medical institutions, including cloud HIS, cloud LIS, cloud PACS, cloud EMR and so on. Some health services have been completed, including basic public health services and family doctor services. It has completed the construction of some business collaboration systems, including medical group/medical association/medical community/specialist alliance system, health ID card management system, health record access system, two-way referral system, remote consultation system, imaging center system. It has completed the construction of some beneficial services, including health Tai’an website/app, Internet hospital, prescription sharing platform, pharmacy purchasing, sales and storage management system, online drug purchase management system, etc. It has completed the construction of some business supervision system, including medical and health supervision system, financial fund supervision system, medical insurance control system, etc. The detail is as follows:
In the above system, the financial capital clearing platform has been used in various medical and health unit in the whole city. The Fourth People’s Hospital of Tai’an City, Tai’an Traditional Chinese Medicine Hospital, and Wangzhuang Town Health Center of Feicheng City of medical informatization and Internet + application have been comprehensively. It has been fully launched and stable, and has been highly praised by visiting experts. The Fourth People’s Hospital of Tai’an City, the Wangzhuang Town Health Center of Feicheng City is applying for a typical case of the national universal medical health information platform. The overall platform has achieved good application results, and the operation based on IPV9 network platform is stable and reliable.