Introduction

OpenTeleRehab was designed and implemented based on the following guiding principles:

1. A future system must be conceptualized and implemented with the needs of the end-users in mind. This means actors have the chance to test early, providing valuable feedback for definition and refinement

2. The system should use a modular system design and micro-services architecture to make it easier to implement changes in the future

3. A thorough and stable implementation and early piloting are achieved incrementally through agile development. It assures strict orientation at business value and improves quality through regular development, validation and learning cycles

4. The information must be integrated and centralized ideally, in the cloud. This decreases vulnerability to local system failure, increases scalability and allows for wider access, process improvement and automation

The key approach for OpenTeleRehab is using micro-services architecture that leaves the door open for integration of other third-party applications that may be able to provide cost-effective solutions for certain components. For example, Google Calendar can be used appointment system instead of custom made solution when the majority of users want to only have one calendar. Or another example, Moodle could be used for the Education Management Service, saving costs and resources over a custom made solution. This approach will enable future extension, scalability and stability to ensure the growth of the app users and coverage from one county to the global expansion. Offline data can be synced thanks to API support. Accessing to the internet in rural areas is challenging, and we have worked with government ministries and organizations to solve this by using mobile applications to store and sync offline data. 

Micro-Services Architecture

Micro-services, also known as the micro-services architecture, is an architectural style that structures an application as a collection of services that are highly maintainable and testable, loosely coupled, independently deployable and organized around business capabilities. See https://hidsi.atlassian.net/wiki/spaces/OpenTeleRehab/pages/8718218/Architecture+Details+and+Diagrams#Micro-services-Architecture .

OpenTeleRehab Modules

The OpenTeleRehab application is a combination of 3 modules that interact with each other to help therapists and patients with rehabilitation treatment. The first module is a web application for Administrators that can manage the contents and users of the system. The second module is a web application for Therapists where they can manage their patients and manage their treatment plans. Lastly, the third module is a mobile application for Patients to help them follow the treatment plan given by their therapist and contact them for consultations.

Admin Portal and Therapist Portal

Are web applications for organizational administrators and therapists who manage other users of the system and provide the clinical content to support therapists to create treatment plans for patients. These portals enables administrators and therapists to manage all content related to other modules. The frontend is developed using ReactJS and Google Material Design following an initial Figma Design prepared by HI. See Initial Figma Designs. The backend of the portal is developed separately and follow the micro-services architecture mentioned above that allows all three modules to connect to these micro-services independently. These micro-services uses technologies like Laravel framework, Restful APIs, Identity and Access Management systems and other open-sourced third-party systems that can easily be integrated as a micro-service using Restful APIs.

Patient Mobile App

The Patient Mobile App is designed to assist patients to follow the treatment plan given by the therapist. It displays the scheduled activities for the day and appointments and the progress the patients have made. It also supports chat and call features that allow the patients to be in contact with their therapists. The mobile app was developed using ReactNative and Google Material Design components that follows the initial Figma Design prepared by HI. See Initial Figma Designs. A kid friendly theme for the mobile app was also developed.

Chosen technologies are all rooted in free Open Source projects and the components are popular and widely used in Android and iOS. Choosing ReactNative means that the system can be developed and compiled for both iOS and Android instead of being built separately.

OpenTeleRehab Library

•  Jeferson Sese to add some content about the library

The OpenTeleRehab Library (Library) is a site where the public can view and search for telerehabilitation resources (Exercises, Education Materials and Questionnaires). These resources are categorized into different subjects and can be filtered by these categories. Users that visit the site can also view translated versions of these resources.

Visitors of the Library can add and contribute resources to the library. They can submit their own Exercises, Education Materials and Questionnaires telerehabilitation resources which are reviewed by a team of moderators. Once approved the submitted resource can be seen in the site.

The resources are automatically translated to different languages available to the site using Google Translate. At the same time, visitors can also add or suggest proper translations of these resources and goes through the same review process by the moderators.

Admin and moderators can access the site’s backend platform. In this platform, they can add and/or remove user access, manage the resource categories, manage the available languages of the site, review and approve submitted resources and translations and manage the site’s other pages (home page, about us, terms and conditions and acknowledgement pages).

Technology Stack

Item	Technology	Comments
Hosting		Amazon Web Services (AWS) provides a wide range of services with option to upscale the match with the peak demands.  It supports Kubernetes and Docker which will use to implement the micro-services architecture. It supports multi-region deployment which complies to GDPR and data protection requirements It provides monitoring tools to manage and optimize your storage
Operating system and webserver		Many micro services that were used (database, firewall, never-proxy, etc.) are available as SaaS and sn operating system is not needed. In case we added extra services which requires an OS, our default and preferred OS is Ubuntu which has been used worldwide.
Programming language and framework		Laravel: open-source PHP web application framework
Databases		MySQL: open-source, well-maintained by community, frequent security fixes