Transcript Steven A. Demurjian and Maifi Khan

Enabling Ubiquitous Personal Health Device
Integration through Open Standards
Steven A. Demurjian and Maifi Khan
Computer Science & Engineering Department
The University of Connecticut
371 Fairfield Road, Storrs, CT
Thomas P. Agresta and Michael Blechner
Family Medicine & Pathology Departments
University of Connecticut Health Center
263 Farmington Avenue, Farmington, CT
[email protected], [email protected]
[email protected], [email protected]
CIGNA-1
Introduction
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Today’s Applications and Systems Built around
Multiple Technologies
 APIs, Cloud Computing, Web Services, Data
Mining, etc.
Alternative Data Structure Standards
 XML, RDF, JSON, OWL, etc.
Meta-Systems that Share, Use and Exchange
Information to fully function
 XML as de-facto Standard
What are the Key Challenges?
 Information Interoperation from Multiple Sources
 Integration of Today’s and Emerging Technologies
CIGNA-2
Interplay of Information in Healthcare
Harvard
SMART
EHR
C# Data
JSON-LD
MS
Health Vault
RxTerms
XML
Schema
LOINC
XML
Schema
MeSH
XML DTD
SNOMED
XML
Schema
ASP.NET API
XML-C
REST API
JSON
Open
mHealth
XML-C
Secure
XML
Secure
XML
UMLS
XML DTD
Standards
XML-C
RxNorm
XML
Schema
Secure
XML
XML
EPIC Lucy
PHR Server
Global
Security
Policy and
Control
Secure
XML
Health
Information
Exchange
PHA
Patient App
Mobile
JAVA APIs
XML
OpenEMR
EHR Server
Secure
CDA
PHA
Provider
Mobile App
Secure
CDA
Java APIs
XML Converter
WSDL
CCR
GE
Centricity
EHRServer
Local Security
Policy/Control
SMARTSync
App
PHI
Secure PHI
CIGNA-3
Personal Health Assistant PHA
and SMARTSync
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PHA:
 Mobile App for Medication and Chronic Disease
Management
 iOS/Android Versions hooked to MS Healthvault
 Patient Version to Enter Data/Authorize Providers
 Provider Version to View Authorized Data
SMARTSync (Harvard SMART Platform)
 SMART EMR and MS Healthvault
 Medication Reconciliation
 Identify: Overmedication, Adverse Interactions,
and Adverse Reactions
 Uses Standards and Online Resources NDR-RT
and RxNorm
CIGNA-4
PHA and SMARTSync Architecture
CIGNA-5
PHA – Patient Version
CIGNA-6
PHA – Patient Version
CIGNA-7
PHA – Patient Version
CIGNA-8
PHA – Provider Version
CIGNA-9
SMARTSync and Interactions
Yellow: Significant Red: Critical
CIGNA-10
Proposed Apprach
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Leverage and Extend our HIE Architecture
MSHV Supports
 Medical Devices: blood pressure monitors, glucose
meters, scales, medi-watches, pedometers
 Exercise Data Types and API: Allow Information
to be Stored – fitbit can download into MSHV
Objective: Support Clinical Decision Support on:
 Medications, Observations of Daily Living
 Chronic Disease Management, Exercise/Diet Logs
 Aim for Trending and Potential to Alert
Stakeholders (Patients, Insurers, Providers)
CIGNA-11
Compatibility of our Approach
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Interoperation Architecture Facilitates Communication
Across Multiple Formats (XML, JSON, REST API)
Our Approach Consistent with Current Personal
Health Devices
 fitbit, withings, and bodymedia all Use REST API
and Oauth
 withings uses JSON to Return Responses
 iHealth stores information in Cloud
CIGNA-12
Planned Approach
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Expand HIE Architecture to Wide Range of Sources
 Personal Health Records (MSHV, WebMD)
 Personal Health Devices (fitbits, withings, etc.)
 Electronic Health Records
 CIGNA Data Sources
Propose and Analyze Other Possible Architectural
Alternatives
 Focus on Current and Emerging Platforms
 Rapid Changes in Mobile Technologies
 Identify Relevant Analytics for CIGNA
Stakeholders
CIGNA-13
Team
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Steven Demurjian
 Software/HIE Architectures, Access Control
Maifi Khan
 Cloud Computing, Real-time Health Care
Monitoring, Wireless Sensor Networks
Thomas Agresta
 Clinical Practice, Analyzing Clinical Data, HIE
Michael Belchner
 Pathology Info Systems, HIE, i2b2/Data Analytics
CIGNA-14
S. Demurjian BMI Research Interests
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Collaborative Extensions to NIST RBAC
 Model When and How Interactions Occur
 Support PCMH and Collaborative Care
Security for XML
 Medical Standards (HL7 CDA, CCR, etc.)
 Customize XML Instances Delivered to Users
Health Information Exchange
 Architectural Solutions for Interoperability
Medication Management & Reconciliation
 Android/IOS Apps Linked to MS Health Vault
 Reconciliation via Harvard’s Smart Platform
 Working with openMhealth.org
CIGNA-15
M. Khan BMI Research Interests
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Real-time Monitoring and Preventative Healthcare
 Real-time Access of Patients’ Sensor Data
 Cloud-based Storage Architecture
 Identification of “Early” Symptoms
Reliability and Troubleshooting of Edge Clients
 Troubleshooting Low-power Sensor Devices
 Real-time Failure Diagnosis
Software Architecture for Self-powered Devices
 Fail-safe Energy Management Algorithms
 Energy Harvesting Algorithms
CIGNA-16
Thomas Agresta BMI Research Interests
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Optimal HIT Solutions for Primary Care
 Clinical Decision Support, Patient engagement
 Health Information Exchange for Care Transitions
 Organizational structures for supporting Primary
Care Informatics
Clinical Informatics Education
 Informatics Educational Methods and Strategies
 Use of Simulation in Primary Care Education
 Virtual patients, families & EMR use in clinical care
 High- Tech, High-Touch Primary Care
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Informatics Tools for Collaboration in Clinical
Research Informatics
 Secondary Use of Healthcare data for analysis and
research
CIGNA-17
M. Blechner BMI Research Interests
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Health Information Exchange
 “Leveraging An HIE Infrastructure To Build A
Clinical Research Data Warehouse”
 CICATS pilot grant for system development to capture
clinical data from a Health Information Exchange
(HIE) into a research data warehouse.
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Intelligent Tutoring System Development
 Collaborative e-learning environment leveraging
natural language processing and medical
ontologies (UMLS) to facilitate concept
relationship discovery
Clinical Pathology
 Data warehousing for business and clinical
intelligence in the clinical laboratory
CIGNA-18