The Conceptual Modeling of Interoperability Framework of Heart Sound Monitor in the Context of an Interoperable End-to-End Architecture

Background: Heart sound monitor (HSM), a device suitable for home-use, can be used to acquire heart sounds. It enables the telemonitoring of cardiac function, which has been largely evolved and widely used in recent years. Nevertheless, the designers paid little attention to the consistency of information model and data interaction of HSM, thus the data could not be shared and aggregated among healthcare systems. Consequently, the device's development and its application in person-centered telehealth are hindered. Objective: To solve this problem and to build interoperability for HSM, this article proposes a HSM interoperability framework that is constructed by using standardized modeling methods. Methods: The authors collected the common device-output information of HSM involved in telemonitoring, leveraged the standardized interoperability framework defined in ISO/IEEE 11073 Personal Health Device (11073-PHD) standards to model the static data structure and dynamic interaction behaviors of HSM. Results: Via a meta-analysis, the HSM device-output information includes collected data (heart sound measurement), and derived data (e.g., device status). Based on such information, an 11073-PHD-compliant domain information model has been successfully created. This enables the interoperability between HSM and aggregation device, allowing inter-device plug-and-play using the service model and communication model. A prototype of this design has been implemented and validated via Continua Enabling Software Library. Conclusions: The ISO/IEEE 11073-PHD standard framework has the potential to accommodate the HSM, which implicate HSM can be integrated into the interoperable ecosystem to achieve holistic health solution. Findings in this article may be taken as a reference for standard developing organizations to establish a standardized interoperability framework for HSM.