The local server

The iotaMed iPad clients are supported and managed through a local server. The number of iPads that can be managed by one server varies according to workload and the type of server hardware you provide. The local server maintains an encrypted communication tunnel to each iotaMed iPad client on the one hand, and exchanges data with hospital information systems and legacy EMR systems on the other hand.

If the legacy EMR system can fully support the entities iotaMed uses, such as issue templates and worksheets, all medical data is kept in the legacy EMR system database. If the EMR database cannot be easily adapted for this, templates and worksheets are kept in a database on the iotaMed local server instead. To the user, there is no discernable difference between these two scenarios. In any case, no medical or personal information is ever stored on the iPad itself.

Issue template distribution

Issue templates are distributed top-down, but can also be amended and extended at every level. All versions of an issue template will be made searchable through distributed index servers and provided to clients from distributed storage servers. The servers also take care of verifying the authenticity of the source of the templates. Each template can be made available subject to attributes set by the originator, such as language, area of distribution, access by certain groups, or access on condition of license, etc. This allows for both open and commercial distribution and use of templates.

Patient and paramedic access, and feedback server

iotaMed can send and receive issue blocks with patient information. This is very useful for instructions to the patient and collecting feedback from the patient back into the central iotaMed system, making it part of the regular record. These forwarded fragments of the record can also be used for communication to and from home care and social workers, or workers of any category in the field. The feedback servers have the task of authenticating users and worksheet blocks so they can be picked up and returned by patients or paramedics.

Quality register forwarding

A quality register form is a special kind of issue template which can be exported to quality registers. The iotaMed quality register server accepts such forms from iotaMed local servers, validates, and distributes the form to the right external system.

Any export of personal data carries with it the risk of compromise. To reduce this risk as far as possible, we separate the personal identification data from the medical data already at the source, the local iotaMed server, and randomize the link between the personal data and the medical data. Only the medical data is sent on to the quality register server (QR server) and from there to the quality registers. The personal data takes another route to end up at a third party identifying system (PID). This way, the quality register will never possess any identifying data and must enlist the cooperation of the third party identifying system to match records as coming from the same patient. The identifying system, in turn, never sees any medical data. We suggest that the identifying system should be controlled by an independent authority so that any collusion to derive personal medical data will be made highly unlikely.