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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

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The OpenTeleRehab application is a combination of 3 modules that interact with each other to help therapists and patients with rehabilitation treatmentsupport the delivery of telereheabilitation services. The first module is a web application for Administrators that can manage the contents, users and users settings 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 allowing them to help them follow access the treatment plan given by their therapist and contact them for consultations.

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The Patient Mobile App is designed to assist patients to follow access the treatment plan given designed 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.

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The OpenTeleRehab Library (Library) is a site website 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 website 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 on the sitewebsite.

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 On 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).

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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 an 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

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