Transcript Driver Information Systems

Agenda & Objective
• Stepstone Connected Health project update ( BOCA )
• Connected Health Architecture hi – level overview
– Vision
– Mapping to projects ( existing & potential )
– Scenario example
Stepstone/Continua Project
(a Connected Health Reference Implementation)
2Q2009
Pressures
Content
• Intercept requirements from
OHT Projects
• Set up Continua projects with
namespace
• CUI
• IHE Profiles
• Terminology Service
org.openhealthtools.stepstone.phd
• Understand relationship
with OHT Platform Project
•Understand relationship with
OHT Architecture Project
• Continua Dev Kit
• Continua V2
• Restructure and create OHT Build
based on Eclipse RT pre-req
• Add device support
•Glucose, Med Monitor,
Weight
• “Cookbook” documentation for
creating generic and Continua
builds
Deleted & Changed
• SODA (DeviceKit) Impl of
ASN-1 protocol
Dependencies
• SODA components to move
from Eclipse OHF to Eclipse
Runtime
Added
Packaging Editions
• 0.4.0 to match IHE Profiles project
.
and indicate pre-alpha
status
Statistics
• 1 new contributor
• 284 revisions
Milestones
- Dec 08 Provisioned OHT sub
project
- May release (0.4.0)
Stepstone/Continua
2Q10
1Q10
4Q09
3Q09
2Q09
Continua Dev-Kit
OHT Security Integration,
Stepstone Dev-Kit
Refactoring
First Iteration on Continua V2: WAN/API (WS-I Basic)
Initial OHT Release with Continua Support. Additional device support
Connected Health Architecture - 30k feet
Device manager
(EDGE)
Application
System
Interfaces
Telehealth / care
management applications,
aggregate data, event
processing, format/route to
health systems, services
Health Systems
System
Interfaces
System
Interfaces
Collect device data
Application
EDGE
Interfaces
Devices to provide
personal health data
Controller
Server
Interfaces
Medical Devices
Device
Interfaces
Application
Remote Monitoring
Server
EMRs, PHRs, clinical
trials, analytics, etc.
Connected Health – Stepstone today
Device manager
(EDGE)
Health Systems
System
Interfaces
Application
System
Interfaces
System
Interfaces
Application
EDGE
Interfaces
Controller
Server
Interfaces
Medical Devices
Device
Interfaces
Application
Remote Monitoring
Server
SODA
Devices to provide
personal health data
•Platform to support
multiple device
interfaces
•Supports Continua
(IEEE,USB,Bluetooth)
•No user application
•Platforms
Eclipse project
•Supporting Continua (v2
EDGE is WIP , IHE/HL7
CDA)
•Liteweight, generic user
application
•Uses IHE Profiles project
EMRs, PHRs, clinical
trials, analytics, etc.
Implement Scenarios Using OHT Projects, Refactor
Project Task
1. Medical Device Integration
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(IHE, Stepstone)
Event Processing and Monitoring
Security and sharing (end-to-end for key scenarios)
Dynamic and Distributed Business Rules and Processes
Healthcare Analytics Apps
6. Eventing and associated Business Processes
–
–
(IHE, Security, Tooling)
IHE profiles
EHR/EMR sharing and access
Consumer record access/sharing, and PHRs (Google, Healthvault)
Privacy, Access, Security Services, ID
5. Remote Monitoring Server
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–
–
–
(Stepstone)
dedicated "hard" AHD
soft/mobile AHD
4. Data Sharing and Access
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–
–
–
(CUI, Security)
Information rendering on access devices including tablets, smart phones, soft AHD's, etc
Guidelines
Open alternatives to Silverlight implementation
Consumer Control Dashboard
Context-driven UI (e,g, Gadget/Widget composition)
3. Edge Controllers
–
–
(Stepstone)
Consumer connected health devices
Non medical devices (e.g. RFID, motion, tracking, ID readers, alarms, climate control)
Standard and propriety
Extend to Clinical?
2. Applications
–
–
–
–
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USES .
standard event structure
the easy tie to pre-defined workflow and business processes
(new?)
Scenario example – Chronic Disease Mgmt
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•
Chronic disease accounts for ~75% of healthcare costs ( USA )
Setting: 52 year old male with adult-onset diabetes mellitus (type II diabetes) on two oral medications for diabetes:
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1.
2.
3.
4.
Metformin, which reduces glucose production by the liver. Dose: 850 mg tablet taken orally once a day.
Repaglinide (Prandin®), which stimulates insulin secretion by the pancreas. Dose: 1 mg tablet taken orally before each meal.
Patient is overweight to obese and was put on a diet 2 weeks ago by his physician.
Daily monitoring of weight was recommended by the physician.
Patient provided with the following devices
•
Glucometer
•
Weight scale
•
Medication pack
In morning patient reminded to take meds, readings (weight & glucose ).
Devices upload data to device manager which transmits to remote monitoring server
Patient views own data via Portal application, PHR, diabetes care management application to better manage their
disease.
Care provider ( e.g. Patient centered medical home model, telehealth nurse ) has immediate access to patient data
and can act.
1.
5.
6.
E.g. no readings from this patient, not taking meds, glucose readings irregular  contact patient / arrange doctor visit
Provider / Payer manages care program across a set of chronic disease patients
Device data packaged and made available in physician’s system prior to next scheduled appointment for this
patient.
Scenario Messaging / Value
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Chronic diseases typically require monitoring of multiple parameters.
Knowing that relevant information related to his health condition is reliably captured for review is
very valuable. The electronic record is far superior to the paper diary he used before. The information
is more complete and accurate.
Concentrating all this information in one health management software provides a nice overview and
keeps track of his progress all in one place.
Therapy decisions require contextual information, i.e., putting data in context. Example: Weight
reduction brings the additional benefits of lower average glucose levels as well as lower blood
pressures.
Accurate information takes out the guesswork for the physician. Together, patient and physician can
make informed therapy decisions and lifestyle adjustments.
Good data makes discussions with the physician much more effective and productive. This shortens
consultations.
Patient feels involved and empowered because he more clearly understands the interactions of food,
activity, medication, etc.
The system enables synchronization with a personal health record as well as an electronic health
record for a complete end-to-end solution connecting the patient to the physician, as well as his
support network, improving the quality of data, and ultimately the quality of care.
Outreach to patient / intervention prior to acute care episode benefits patient and less costly to the
system
Takeaways
• Stepstone architecture open, SOA based
• Refactor into subprojects:
– Easily combine components into solutions
– Enable more robust application projects
– Platform for support for multiple interface requirements
• Using IHE Profiles project code today
• Looking ahead:
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CDA modeling project tooling
Security
CUI
…