VISUS Health IT • 14.10.2021 • Internal

JiveX Experts: From idea to product

  • JiveX Experts

That digitalization in medicine optimizes treatment and improves the quality of life of people is a fact that is no longer disputed even by the least progressive among us. This fact is rarely as obviously and directly demonstrated as with the latest member of the JiveX Healthcare Connect family, JiveX Experts. The web-based platform helps, for example, to more reliably diagnose rare medical conditions—even if the treating physician is not an expert in the area. All that needs to be done is to complete a standardized questionnaire in a web browser.

Okay, so some radiology imaging data or other documents have to be uploaded. But that’s all there is to it. You do not need any extra software or a direct line to an accredited specialist.

The critical advantage is that JiveX Experts meets the strict data privacy requirements for sharing medical data. It provides a fast, uncomplicated, and secure way to obtain valid peer responses from selected specialists. Responses that over the long term influence the life of the person to whom the report relates.

Automation and scaling

Of course, the standardized diagnostic path that is accessed here must first be created. This is where the origin of the product lies. JiveX Experts provides a solution to a problem that was brought to the attention of the VISUS developers straight out of clinical practice. The problem is that specialist knowledge about many medical conditions only reaches routine medical care by chance or roundabout routes—if at all. The result is that people with rare or complex disorders often go on a journey lasting many years, moving from one medical practice to another before receiving a diagnosis. The therapeutic failures that result are possibly already irreversible.

For VISUS the question was how to create barrier-free access to specialist medical knowledge for medical practices across Germany without specialists having to meet patients and their physicians. The challenge for VISUS was to develop a scalable solution that can be used not just for a concrete case (a medical condition) but that covers a number of potential scenarios. Several requirements had to be satisfied to achieve this. On one hand, users should have barrier-free access through the exclusive use of existing IT infrastructures. The lowest common denominator was identified as accessing the platform through conventional web browsers. It was also necessary to enable both text and binary information, for example, radiology imaging data, to be captured via the platform. When capturing text information, special attention was paid to ensuring structured acquisition of the information. This enables the greatest possible automation of data processing. All acquired data should be captured strictly case related so that the shared context is retained along the entire communication chain.

Passgenaue Lösungen mit Perspektive mit JiveX

VISUS as platform operator

Solutions that were already available to the VISUS development team such as JiveX Upload, which enables large volumes of data to be securely uploaded via the web and transferred in hospitals, proved advantageous here. Experience relating to the exchange of information with DICOM e-mail and operation of the infrastructure of the largest teleradiology network across Europe was also an asset.

In addition to these well-trodden paths, VISUS also stepped into relatively uncharted territory during the development of JiveX Experts because the company became a platform operator. This step made sense because as many use cases as possible should run on the platform and with VISUS as the operator it was able to develop these use cases together with partner companies.

This development was only possible thanks to the seamless collaboration between VISUS innovation management and the VISUS JiveX Connect Team with its special structure as a DevOps team (Development and IT Operations). For the first time, software development and software operations worked together in one team. This collaboration has the advantage that adaptations to the software necessary for operation can be transferred by short routes straight to the developers. Work in the DevOps team is thus comparable to product development using the design thinking approach, in which product designers implement user requests in short reconciliation intervals until the perfect product from an application perspective is generated.

The platform is based in technical terms on modern architecture (microservices), development frameworks (React), and virtualization technologies (Docker, Kubernetes) that ensure the necessary scalability of the system even under high load. The use of modern technologies also enables a very high degree of automation in the development and operation process as well as tool-supported and simple delivery and commissioning of the software (continuous delivery).

The different possible uses of JiveX Experts are derived from the basic use case of structured acquisition of a query with accompanying information and acquisition of a structured response and any feedback. Customer surveys about quality assurance can be realized just as readily as second opinion portals for patients or consultation platforms for physicians. Ultimately, it is customers who decide how JiveX Experts is used. VISUS is open to project suggestions.

 


A solution for axSpA

The initial spark for the development of JiveX Experts came out of a joint project application by Prof. Xenonfon Baraliakos, Prof. Denis Poddubnyy, MedEcon Telemedizin , and VISUS innovation management. As internationally recognized specialists for axial spondyloarthritis (axSpA), a chronic autoimmune disease on the rheumatoid arthritis spectrum, they were searching for a way to to shorten the arduous path of those affected by giving them the quickest possible diagnosis. When detected and treated early, the consequences of the disease (severe pain and stiffening of the spinal column) can be considerably reduced and even mitigated.

What was critical for the two professors was the option of creating barrier-free expert assessment of a case by specialists that was independent of time and place. This should be implemented using a standardized questionnaire and precise instructions for the necessary imaging. For the scientific project Improve-axSpA, VISUS developed the infrastructure to roll out and complete the consultant forms as well as to exchange medical information and provide automated acknowledgement of the results to the recipient.