Study: Psychiatric online evaluation system
Industry : HealthCare
Products and Technologies used:
Borland Delphi, MIDAS, Infopower controls, MP3 Technology, Compression
(Zlib), Encryption (Blowfish). Custom built distribution technology,
Error reporting over the internet, Multi language functionality.
Implemented By: Agni Software Private Limited.
Psychiatrists all over the world need to collaborate in order
to get the best diagnosis for their patients, because patterns
that appear in one set of patients can be matched and applied
elsewhere, after a reasonable comparison of symptoms. Today,
many hospitals are linked together with an intuitive solution
provided by Agni Software – the solution takes care
of consolidation of voice and data, collation of patient history
and prognosis support from an automated intelligent data analyzer.
The solution is built using Borland Delphi, and allows doctors
all over the world to interact using a standard PC and Internet
In the field of psychiatry, correct diagnosis depends on
correctly assessing a patient, his/her history and current
symptoms. There are standard question sets that are designed
by organizations such as the UN to allow for an inference-based
methodology. Evaluation can also be collated and a better
understanding of subjects reached, by automating the process
of questioning and rating. But there are hurdles to this approach:
- Costs of consolidation
- Time consumed by transcribing voice interviews into
- Collation of documents across hospitals, cities and
- Language differences in different countries
The proposed solution would need to:
- Reduce cost of consolidation among hospitals and doctors,
by using the internet for data transfer.
- Allow interview data and voice to be transportable in
a compressed form.
- Collate data automatically and build a diagnostic tree
for each new patient, based on certain rules and on earlier
- Allow users to change the language when they need to.
Apart from this, the need to train users to use the system
was important, especially to the students.
- Students would use the system to rate a subject
- A professional doctor would re-rate the subject, playing
back the interview (order of questions and voice) exactly
as it happened.
- The ratings would be compared and collated for decision-making.
Agni Software built a scalable, integrated solution that
allows doctors or students to connect to a federalized resource
over the Internet or an Intranet. The “rater”
conducts an interview, being led through the process by the
software, which configures the path of the questions according
to the rating given. In addition, the interview is “recorded”
in both voice (from a microphone) and ratings, and are transferred
to the server in chunks. As the rater proceeds, he gets a
current diagnostic tree which displays the potential diagnosis
of the current subject, including eliminated parts and inferences.
The solution uses Borland’s Datasnap technology (formerly
MIDAS), was written in Borland Delphi 5, and was built with
close co-ordination with the customer.
Datasnap as a technology was very sound, allowing users
to connect to the servers using a number of protocols, including
TCP/IP. Agni Software enhanced the Datasnap technology by
adding custom built components to allow interaction with multiple
databases. The product was built using a spiral model, with
base features implemented first and additional modules added
on with time. The VCL framework architecture was used extensively
throughout the project, and in addition, third party tools
such as Infopower and ReportBuilder were used to enhance user
The architecture was designed to run over the Internet, collating
data. The team built custom solutions to compress the data
effectively before transmission. Transmission of voice was
done in the MP3 format, a revolutionary way to transfer recorded
voice. Apart from compression data transfer was multithreaded
and done in the background, so that the users would notice
no drop in performance.
As the data was very sensitive, many encryption methodologies
were used to ensure data safety. Borland Delphi provides direct
access to DLLs, which were custom written for the level of
encryption that the customer required.
There was the necessity to work “offline” –
without any of the data being transferred to another machine.
Primarily meant for users who were on the move, or did not
have access to an Internet connection, it was also meant as
a means for doctors to have private information stores. The
Datasnap (MIDAS) technology allowed the use of a briefcase
model, where data was stored on the client machine. When the
user linked back to a network, the user could synchronize
with the network and transfer his stored data if he chose
Users in different countries and cultures could “switch”
languages without leaving the application – all language
specific data is stored at the server and downloaded to the
client machine whenever necessary.
Diagnostic support was provided at the server, constantly
collating data and generating a diagnostic neural tree based
on inferences. Base rules were encoded in a special format
allowing changes without affecting the application. Rules
were built and modified as subjects were rated and rerated,
giving a new interview much more statistical data for inference
The solution was deployed at the customer’s site and
other beta sites, with constant collation of data and fixing
any bugs that came up. As more users came online the stability
of the solution came to light. Datasnap (MIDAS) allowed us
to build stateless servers, so that additional machines could
be added to support more users without drop in performance.
Additionally, use of fat clients ensured the distribution
of processing power between the server and client, thereby
ensuring a long lasting, stable, evolving and scalable solution
for the customer.
|Development Team Size
The solution provided is scalable, extensible and secure.
The ability to define further rules and build a diagnostic
tree is an immense help to doctors to narrow down to the correct
diagnosis. The recording of voice and its storage helps doctors
rerate a subject later, and the software is capable of playing
back an interview exactly as it happened.
Multi-language support is very helpful for those dealing
with subjects of different cultures, and the effect was first
felt in North America with Spanish and French subjects.
The multi tier architecture and the multi-threaded distribution
of processing ensures that the user of the software does not
feel a performance lag. And the extensive audit trail support
ensures that any legal requirements are complied with. It
is no wonder, now, that this system is being introduced in
a bigger way in hospitals and mental-health institutes all
over the world.