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\begin{document}

             \author[1]{Dr. M.  Lavanya}

             \author[2]{Dr.M.Usha  Rani}

             \affil[1]{  Sree Vidyanikethan Engineering College}

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\date{\small \em Received: 6 December 2011 Accepted: 1 January 2012 Published: 15 January 2012}

\maketitle


\begin{abstract}
        


Many of the current Indian medical information and emergency systems are still paper-based and stand alone systems that do not fully utilize the Internet, multimedia, wireless and real time technologies. This project work focuses on developing an integrated Emergency, Healthcare, and Medical Information System (IEHMS) that can overcome many of the problems in the current systems. The main aim of this work is to incorporate the real-time technologies with medical emergency systems. Our proposed system can offer: SMS, MMS, Phone call, Email. A prototype for the proposed system is implemented using open source tools. The system will revolutionize the delivery of emergency medical services, like ambulance, first aid etc,The call center of Emergency Management and Research Institute took up the case and identified the exact location where the patient had collapsed.When attending a call, the user check for the similar calls and search for the ambulance which is located to that area and ambulance is staffed by: ? One driver ? One helper ? One experienced paramedic ? One trained medical officer, if required For efficient medical monitoring of the patient's condition, the institute has qualified personnel with knowledge and skills sufficient to evaluate and stabilize patients with potentially lethal or disabling conditions.

\end{abstract}


\keywords{IEHMS, Emergency Service Manager (ESM), Helper.}

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\let\tabcellsep& 	 	 		 
\section[{Introduction}]{Introduction}\par
owadays, Intranet plays a significant role in connecting all the participants in the health community. It is used to control remote medical equipments, communication between parties such as patients and doctors, search for needed information, transferring text, graphics, audio and video files as well as supporting collaboration in real-time.\par
Many of the current Indian healthcare, medical information and emergency systems are still paperbased and stand alone systems that do not fully utilize the Internet, multimedia, wireless and real time technologies. The system will revolutionize the delivery of emergency medical services, like ambulance, first aid etc, the call center of Emergency Management and Research Institute took up the case and identified the exact location where the patient had collapsed.\par
When attending a call, the user check for the similar calls and search for the ambulance which is located to that area and ambulance is staffed by: ? One driver ? One helper ? One experienced paramedic ? One trained medical officer, if required For efficient medical monitoring of the patient's condition, the institute has qualified personnel with knowledge and skills sufficient to evaluate and stabilize patients with potentially lethal or disabling conditions. 
\section[{II.}]{II.} 
\section[{Existing medical related applications}]{Existing medical related applications}\par
Many of the current Indian healthcare, medical information and emergency systems are still paperbased and stand alone systems that do not fully utilize the Internet, multimedia, wireless and real time technologies.\par
We can summarize the drawbacks for such systems as: ? Lack of global shared system that is being used by all the emergency and healthcare centers ? Several of the medical centers that use electronic medical storage system for storing patients' information are window-based. ? Lack of utilizing open source software, which results in expensive to maintain systems. ? Lack of supporting multimedia environment, realtime and mobility technology ? Lack of integration between medical and emergency systems ? Lack of automatic generation for Plan of Care (the Plan of Care is a document created to finalize the treatment order) An emergency system reduces the risk of an emergency case to the health and safety of persons and valuables by providing an effective means of communication with relevant authorities, safety guidelines and measures to be taken in an emergency situation. Several of these systems are normally rely on the existing telephone and other communications infrastructure via operators and service personnel; therefore they suffer from several drawbacks: ? Require prior knowledge on how to behave under each situation.( D D D D )\par
? Require effective description for the emergency case and location to the emergency personnel on duty. ? The person reporting the emergency has to wait for a response before passing on the message. ? Lack of usage for advanced capabilities of multimedia technology such as video, graphs and pictures. ? Lack of integration with medical information systems.\par
Many hospitals' emergency centers are not efficient enough because the big number of emergency cases, which is not easy to be handled. In an emergency department, most likely a nurse will determine the severity of the wound and check patient's vital signs such as temperature, blood pressure and heart rate. Additional personal information and Medical history has to be obtained. In case patient's information is stored in another clinic or hospital they have to be obtained. Unless the patient has brought the personal file along, getting the required information will slow down the process. An emergency physician will have to examine the patient. In some cases, the patient needs great attention and sometimes the surgery room or other devices will be needed. All these will have to be arranged in timely manner, which in general is not the case. The lack or misunderstanding of ethical principles for people related to medical environment is another important problem that is reflected in the behavior of people as client or medical related staff, which affect the whole process. 
\section[{III.}]{III.} 
\section[{Integrated Emergency, Healthcare and Medical Information System (IEHMS)}]{Integrated Emergency, Healthcare and Medical Information System (IEHMS)}\par
To overcome the weakness of the current Indian medical related system; we propose this project, which is an Integrated Emergency, Healthcare and Medical Information System (IEHMS). It provides an easy to use, efficient and non-expensive web-based system while making use of real time and open source technologies. The main features of this system can be summarized as: It provides an easy to use, efficient and nonexpensive web-based system while making use of real time and open source technologies. The system provides an integrated medical database, which can provide stakeholders with related medical information. The registered users can log into the system to access or provide medical information based on their accessing privilege. The medical information can be stored in a variety of multimedia forms such as video, audio, pictures and text. For example, in addition to text description of patients' historical medical information, graphic images such as X-rays or video files of doctors' discussion about the disease can also be saved in patients' record.?\par
The system will have the capabilities for finding the patient location based (in case of an emergency call) and suggest the nearest emergency center, arrange all necessary related patient information to be ready for the physician when the patient arrives, assigning a doctor to the patient based on the availability of the doctors and list all necessary requirements (if any) such as special devices or surgery room.\par
The system is an open real-time client-server environment with highly available capabilities. The client system is loaded with multi-form interfaces, database access functionalities, and manipulation tools.\par
The scripting language used to build the system is Java and the database utilized is Oracle10g. Oracle10g is a true multiuser, multi-threaded SQL database server. JavaScript is an HTML-embedded scripting language. The goal of Java script is to allow web developers to write dynamically generated pages. By implementing Oracle and Java technologies together, one can design a functional web-based database quickly. IV. 
\section[{Iehms system design}]{Iehms system design}\par
Figure \hyperref[fig_0]{1} shows the architecture of the overall system that consists of the following components:( D D D D ) E 2012 
\section[{Year}]{Year}\par
Web Server: will listens for requests from Web browsers and upon receiving a request for a file sends it back to the browser. It will host the program and control information for the system.\par
In my project Apache Tomcat web server is used for this purpose.\par
Database: this is a fundamental part of the system. It stores all important and detailed information about the system stakeholder such as general users, emergency authorities, doctors, patients, hospitals and emergency centers, places or locations and events within the area of implementation. Beside that there is detail set of SMS, MMS, phone calls, and Emails which are suitable for different emergency and guidance cases. Hence it has both temporal validity and precise timing constraints, which allow it to store the most recent data and effect instant changes as soon as they occur.\par
Web Interface: The interface is simple, user friendly and requires little input from the user, mostly in the form of choices. It is based on Web 2.0 technology This system can be used as an application for the Medical service centers to manage the ambulance information as well as the immediate responses for needed people. The system also maintains the information of Patients. 
\section[{c) Functional Components}]{c) Functional Components} 
\section[{Community-Based}]{Community-Based}\par
Planning: Ambulance services must be represented in the planning processes at the local, state and federal level.\par
Personnel Protection \& Safety: All medics, including those who have the potential to respond in a mutual aid capacity, must have appropriate access to personal protective equipment, training, exercises and vaccines and antidotes.\par
The call center of Emergency Management and Research Institute took up the case and Geographical Information System (GIS) identified the exact location where the patient had collapsed.\par
When attending a call, the user check for the similar calls and search for the ambulance which is located to that area and ambulance is staffed by: ? One driver ? One helper ? One experienced paramedic ? One trained medical officer, if required In briefly the ambulance possesses all equipment standardized to enable a flawless transfer of patient during interruption of drug therapy or monitoring. 
\section[{User Interface Requirements Browser Based}]{User Interface Requirements Browser Based} 
\section[{Database Requirements Centralized}]{Database Requirements Centralized}\par
Integration Requirements Web/Pervasive enabled Preferred Technologies Solutions must be created using  
\section[{Other Details}]{Other Details}\par
The application should be highly secured and with different levels \& categories of access control.\par
V. 
\section[{Preliminary result analysis}]{Preliminary result analysis}\par
This research paper is work toward defining preliminary version of IEHMS system. A prototype as part of the suggested system has been build and some of the above mentioned features have been implemented. They include client application, administrator application, doctor application and mobility access system application. Client application is the interface between the user and the system. authenticated before they start using the system. The authorization function is global for all types of users, however the interface from where the users login is separated.\par
Figure  {\ref 2} : Client application architecture Emergency service manager application is responsible for managing the system configuration, management of the system users, medical information, patients, doctors, hospital staff, etc. Figure \hyperref[fig_2]{4} shows the interface for adding new doctor work schedule. Emergency service manager system is component based designed so that different components can be easily added at anytime to extend the functionality of the system.  After this the application is used to admit the patient after releasing the ambulance. Figure6 show how to allocate the Doctors, Helpers and particulars of the patient will be maintained.   This screen is used to release the ambulance which is sent by the helper to the location, where the patient has been collapsed. 
\section[{Year}]{Year}\par
After releasing the ambulance, the status of the ambulance will be available at particular location or the ambulance will be hospitalized.      The Servlet communicates with the database to obtain the required data. The request is forwarded to a Java Server Page, which then reads the data and forms the response HTML document. This document is sent to the client by the Servlet engine through the web server. Figure \hyperref[fig_5]{7} shows the architecture of the data access system.\par
Figure \hyperref[fig_14]{16} : Data access system architecture and JSP processing The system offers advance search capabilities for finding the geographical location of the patient where he/she collapsed. Figure \hyperref[fig_6]{8} shows the graphical user interface of the searching. Users can enter search criteria such as location of the patient collapsed. In this particular example, the user is searching for "Tirupati" as location. The search results will be shown in friendly interface. The paging capability allows the user to easily navigate between the returned results. The user will also be able to specify the number of records that is to be displayed at a time in the screen. Figure \hyperref[fig_6]{8} also shows some sample results returned from the system. The RDBMS used to host the data is Oracle which is open source software. The system database consists of a number of tables. A short list of tables and their description is included in the Table  {\ref 1}. Each of the tables consists of a certain number of related fields.  
\section[{Conclusion}]{Conclusion}\par
The study of the current Indian emergency, healthcare and medical information systems shows that they have several drawbacks such as lack of sharing between hospitals, no integration between emergency, healthcare and medical information systems, lack of utilizing real-time and open source technologies, still some parts are paper-based and stand alone systems. Thus, this paper is to develop an integrated Emergency, Healthcare, and Medical Information System (IEHMS) that can overcome many of the above problems. The proposed system contrast with the traditional approach in which, health professionals would need to gather information from many different devices or locations in the medical center to obtain a complete picture of a patient's status. \begin{figure}[htbp]
\noindent\textbf{1}\includegraphics[]{image-2.png}
\caption{\label{fig_0}Figure 1 :}\end{figure}
 \begin{figure}[htbp]
\noindent\textbf{}\includegraphics[]{image-3.png}
\caption{\label{fig_1}}\end{figure}
 \begin{figure}[htbp]
\noindent\textbf{4}\includegraphics[]{image-4.png}
\caption{\label{fig_2}Figure 4 :}\end{figure}
 \begin{figure}[htbp]
\noindent\textbf{5}\includegraphics[]{image-5.png}
\caption{\label{fig_3}Figure 5 :}\end{figure}
 \begin{figure}[htbp]
\noindent\textbf{6}\includegraphics[]{image-6.png}
\caption{\label{fig_4}Figure 6 :}\end{figure}
 \begin{figure}[htbp]
\noindent\textbf{7}\includegraphics[]{image-7.png}
\caption{\label{fig_5}Figure 7 :}\end{figure}
 \begin{figure}[htbp]
\noindent\textbf{8}\includegraphics[]{image-8.png}
\caption{\label{fig_6}Figure 8 :}\end{figure}
 \begin{figure}[htbp]
\noindent\textbf{9}\includegraphics[]{image-9.png}
\caption{\label{fig_7}Figure 9 :}\end{figure}
 \begin{figure}[htbp]
\noindent\textbf{10}\includegraphics[]{image-10.png}
\caption{\label{fig_8}Figure 10 :}\end{figure}
 \begin{figure}[htbp]
\noindent\textbf{11}\includegraphics[]{image-11.png}
\caption{\label{fig_9}Figure 11 :}\end{figure}
 \begin{figure}[htbp]
\noindent\textbf{12}\includegraphics[]{image-12.png}
\caption{\label{fig_10}Figure 12 :}\end{figure}
 \begin{figure}[htbp]
\noindent\textbf{13}\includegraphics[]{image-13.png}
\caption{\label{fig_11}Figure 13 :}\end{figure}
 \begin{figure}[htbp]
\noindent\textbf{15}\includegraphics[]{image-14.png}
\caption{\label{fig_12}Figure 15 :}\end{figure}
 \begin{figure}[htbp]
\noindent\textbf{17}\includegraphics[]{image-15.png}
\caption{\label{fig_13}Figure 17 :}\end{figure}
 \begin{figure}[htbp]
\noindent\textbf{1}\includegraphics[]{image-16.png}
\caption{\label{fig_14}T 1 :}\end{figure}
 \begin{figure}[htbp]
\noindent\textbf{} \par 
\begin{longtable}{}
\end{longtable} \par
  {\small\itshape [Note: ? Telephone Call ? SMS (Short Message Service) ? MMS (Multimedia Messaging Service) ? Email ? Developing a real time agent based medical emergency system by using latest technology ? Offering User friendly web interface application: ?]} 
\caption{\label{tab_0}}\end{figure}
 \begin{figure}[htbp]
\noindent\textbf{} \par 
\begin{longtable}{P{0.4115079365079365\textwidth}P{0.43849206349206354\textwidth}}
\tabcellsep Information of an\\
\tabcellsep ambulance\\
Patient\textunderscore Info\tabcellsep Patient information of\\
\tabcellsep ambulance\\
Patient\textunderscore Dischar\tabcellsep Patient discharge\\
ge\textunderscore info\tabcellsep information\\
Patient\textunderscore det\tabcellsep Patient personal\\
\tabcellsep information\\
Login\textunderscore audit\tabcellsep Audit details of logged\\
\tabcellsep user\\
Login\textunderscore det\tabcellsep For user\\
\tabcellsep Authentication\\
Login\textunderscore profile\tabcellsep To maintain the profile\\
\tabcellsep of the user\end{longtable} \par
 
\caption{\label{tab_2}Table name Description Ambulance\textunderscore Det Details of the Ambulance Ambulance\textunderscore Inf o}\end{figure}
 			\footnote{© 2012 Global Journals Inc. (US)} 		 		\backmatter  			  				\begin{bibitemlist}{1}
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