telemedicine discussion 5 may 2010 - old.ezdravotnictvo.sk · perspective shift from treatment of...
TRANSCRIPT
© 2010 IBM Corporation
Telemedicine discussion5 May 2010
02/10/2010
© 2010 IBM Corporation
Building a smarter planet
Topics
Telemedicine
– Definitions
– What and Why
– Examples
Telemedicine in context of the healthcare IT ecosystem
Interoperability & Standards
References
© 2010 IBM Corporation
Building a smarter planet
Telemedicine definition and scope
Focus Doc-Doc Focus Doc-Patient Focus Care-Social
COCIR Telemedicine Toolkit,
http://www.cocir.org/content.php?level1=14&mode=24&id=58
© 2010 IBM Corporation
Building a smarter planet
Telemedicine was predicted 86 years ago…..
© 2010 IBM Corporation
Building a smarter planet
So why is the time right now for telehealth?
ConnectedPersonal Health
A new path to personal wellness, citizen productivity, and
sustainable health costs
Perspective Shift
From treatment of disease to proactive nurturing of personal wellness
New Knowledge
Modifiable lifestyles are key drivers for population
health and disease
Health Cost Burden
Increasing costs of the old model of health care become a national crisis
National Action
Economic pressures force nations to demand new
health solutions
Enabling Technology
Telehealth devices, personalized biometrics, device interoperability
© 2010 IBM Corporation
Building a smarter planet
Telemedicine – some recent examples
rBay
– Teleradiology network involving 6 European countries in remote medical image reporting
Irish Telestroke Service
– Remote emergency stroke diagnostics using MRI images and video
Providing medical care in remote areas
– Remote consultation in Pakistan using rugged hardware and satellite
– Use of mobile and SMS services to obtain expert advice
© 2010 IBM Corporation
Building a smarter planet
Fact: Accessing quality medical
care in remote locations is
difficult and time-consuming (in
this case no airstrip - 7 days
travel by sea to Capetown)
What‘s smart?
• Using telemedicine to provide access
to clinicians in University of Pittsburgh
Medical Center
• Provision of teleradiology,
telepathology, doctor-to doctor, and
doctor-to-patient consultations, all via
satellite link
Smarter Business Outcomes
• Immediate referrals and 2nd opinions
• Improves quality of patient care
• Eliminates need to travel (a very long
way!) for specialist consultations
Smart Healthcare Innovation
Telemedicine on the island of Tristan de Cunha
© 2010 IBM Corporation
Building a smarter planet
Brigham and Womens Hospital Radiology Theatre
Brigham Docs Share
Medical Scans
Remotely Using IBM
Web Browser
Technology
―We are not all in the same location, and the information that‘s needed to take care of
patients does not all come from the same place,‖ says Francine Jacobson, a thoracic
radiologist at Brigham and Women‘s who is the lead investigator working with IBM‘s
software engineers. ―Bringing together both the data and the radiologists in the same Web
browser in a truly interactive manner, and avoiding a lot of the compatibility issues we‘ve
had in the past, is truly exciting.
© 2010 IBM Corporation
Building a smarter planet
The Value of Telehealth
Source: Continua: The Impact of a Personal Telehealth Ecosystem
Frank Wartena, Johan Muskens and Lars Schmitt Philips Research Europe, Eindhoven,
The VA Home Telehealth Study found a 25% reduction in numbers of days of bed care and 19% reduction in
the number of admissions through a very cost effective TeleHealth program. (1)
© 2010 IBM Corporation
Building a smarter planet
TeleMonitoring Use Cases – Continua Health Alliance
End-to-end demo – Vancouver Q2 2009
Device InterfaceDevice Manager
XHR InterfaceSender Receiver
EHR
PHR
Pulse Oximeter
Glucose Meter
Disease
management
platform
Roche Accu-Chek 360
LNI Android-based G1 Cell
phone 20601 manager
WAN
Wi-fi or 3G
IP network
Web
services
xHR
Based upon
proposed
protocols for
Continua WAN
© 2010 IBM Corporation
Building a smarter planet
Cisco and IBM Innovating In Healthcare – Telemedicine
IBM leading Healthcare change in Healthcare forums and consortia (HITSPE, HIE Standards, Continua)
Investing and Innovating in new delivery models – Patient Centered Medical Home
Partnered in Google Health Providing Expertise in Clinical, Imaging,
Pharmacy, Nursing applications plus integration to ERP and HR
Partnering in new Models in Telemedicine with Cisco HealthPresence
IBM Watson Research – linked to pioneering ―Evidence Based Medicine‖
Providing Grid Computing for Research and Grid Medical Archiving Solutions
Leader in Network Infrastructure, resiliency, performance.
Market Leader in Wireless Infrastructure for Healthcare
Leader in New ―Presence‖ technology for Healthcare delivery
Leading Energy Management for Hospital Buildings supported through the IP Infrastructure and Data Center
Leading Smart and Connected Buildings for Healthcare – Clinics and Hospitals
Innovating with healthcare organizations for new Delivery Models – United Health Group, Orion
IBM Cisco
© 2010 IBM Corporation
Building a smarter planet
Telemedicine definition and scope
Focus Doc-Doc Focus Doc-Patient Focus Care-Social
COCIR Telemedicine Toolkit,
http://www.cocir.org/content.php?level1=14&mode=24&id=58
© 2010 IBM Corporation
Building a smarter planet
Chronic Disease Management – Example - DiaLog Shared Care
Targeting chronically ill patients with IT-technology in order to:
Improve planning and treatment
Follow the patient everywhere – in hospital, in their home, at GP
Involve and motivate the patient
Let the patient take more responsibility and participate more actively
Strenghten GP knowledge of hospital treatments and procedures
- with the objective to create a better quality of life for the patient, improve clinical
treatment, save hospitalresources and strengthen cooperation in healthcare.
Diabetes
Heart related diseases
Respiratory diseases
Depression
Typical diseases:
Disease management can target 80% of medical expense patients with chronic illnesses (20 %)
© 2010 IBM Corporation
Building a smarter planet
Business challenge
The HUMC–Pediatric Nephrology Department provides home dialysis treatment
for children suffering from kidney diseases. In an attempt to identify
complications, the department had been requiring parents to measure their
children‘s blood pressure, pulse and weight at home—before and after nightly
dialysis—and report the results via phone, e-mail or fax. But the data was often
skewed by miscalculations and had to be compiled by staff, preventing doctors
and nurses from viewing it immediately. With bimonthly checkups onsite being
the only dependable way to monitor health conditions, the department started
looking for a better way to assess the day-to-day treatment needs of its patients.
Solution
Families and physicians are now able to better monitor patient health remotely
through an automated telemedicine solution. Patients analyze their health using
blood-pressure cuffs and scales implanted with special Bluetooth chips that
transmit readings wirelessly to a smart phone. IBM Global Technology Services
implemented the system, which is based on IBM monitoring technology.
Configured with IBM software, the phone aggregates the data and sends it via
the Web to an IBM System x server, enabling doctors and nurses to view the
data instantly on PCs or PDAs.
Benefits
Shortened treatment time for complications from 2 weeks to half a day
Reduced administrative workload, improving the focus on patient care
Optimized monitoring makes HUMC more attractive to dialysis patients
“The IBM solution enables us
to receive a much more
precise picture of the
current health conditions
while reducing the effort for
the medical staff.”
— Professor Schaefer, head
of the Pediatric Nephrology
department, Heidelberg
University Medical Center
Chronic Disease Management –Heidelberg University Medical Center
Speeding medical treatment for kids with first-of-a-kind monitoring solution
© 2010 IBM Corporation
Building a smarter planet
Analytics: Program Management, Demonstrate Benefit
Example: NCQA Diabetes criteria based scorecard
© 2010 IBM Corporation
Building a smarter planet
What would you do with an open, industry standard Web 2.0 application model that is…
…highly distributed
…designed to be portable
…inherently embeddable
…formalized the concept of the user
…is designed to support relationships between users and groups
…is inherently built to provide information, or “streams”, about user activity
17
―Health 2.0‖ – Consumer technologies
© 2010 IBM Corporation
Building a smarter planet
Get Care Now
…allow the patient to decide if they want to share their feeds with friends where they choose to socialize?
Would you…
…automatically post an update (feed) to your community when you accomplish a goal?
…allow the patient to let their achieved wellness goals become part of their health record?
18
Big Blue Health
The best fictional care provider ever!
© 2010 IBM Corporation
Building a smarter planet
COCIR 5 Recommendations for Better Deployment of Telehealth:
1. European Commission and Member States to establish an appropriate legal framework
with effective transposition at country level
2. Strengthen cooperation between healthcare stakeholders to ―best practice health
strategies‖ supporting telehealth adoption in routine clinical practice
3. Finance more and sustainable large scale projects with health economic evaluation to
assess the impact of telehealth solutions
4. Integrate telehealth into existing care delivery structures and ensure interoperability of
telehealth solutions
5. Establish sustainable economic model for telehealth by starting dialogue between
healthcare stakeholders
5/3/2010 20
The Continua Health Alliance Mission
© 2010 IBM Corporation
Building a smarter planet
Open Standards: Value Proposition
Choice – The choice I make today doesn‗t limit the choices I can make in the future.
Flexibility – I can connect to internal departments and external partners that made different technology choices.
Speed – I can build new solutions that involve multiple hardware and software platforms quickly.
Agility – I can adjust to changing business parameters (new opportunities, new partners, new employees) quickly.
Skills – I can find skilled resources that understand these solution
Open Standards Value Proposition
Choice - The choice I make today doesn’t limit
the choices I can make in the future.
Flexibility – I can connect to internal departments
and external partners that made different
technology choices.
Speed – I can build new solutions that involve
multiple hardware and software platforms
quickly.
Agility – I can adjust to changing business
parameters (new opportunities, new partners,
new employees) quickly.
Skills – I can find skilled resources that
understand these solutions.
Speed of Development
Fair play
ChoiceSkills reuse
Speed of Adjustment
to changes
Flexibility
See speaker notes
© 2010 IBM Corporation
Building a smarter planet
Industry Vertical Standards Address Specific Challenges
Industry Vertical Standards:– Standardized processes within an industry
– Standardized data formats, system interoperability within an industry
– Integrate infrastructure standards to support industry-specific requirements/regulations
Benefits:– Consistency of processes within an industry
– Interoperability internally and externally (with customers / suppliers / partners, etc.)
– Elimination of vendor lock-in
– Ease of regulatory compliance, submittals
– Quicker, easier completion – no one company, no one vendor, no single standards organization can do it alone
© 2010 IBM Corporation
Building a smarter planet
Home Care
PHARMACIES
Health &
Wellbeing
PROVIDERS
RADIOLOGY LABS
PAYERS
PBMs
PHYSICIANS’ OFFICES
PUBLIC HEALTH
EMPLOYERS
LIFE SCIENCESSMALL CORPORATIONS
Value
Competitive
Ability
New Care
Delivery
Models
Advances
in Medicine
LARGE
CORPORATIONS
Patient
Telemedicine and the larger healthcare ecosystem
Scenarios drive the need for
Healthcare IT systems to
leverage data & interoperability
standards to:
Connect – integrate sytems across the
enterprise boundary
Share – high value data among
communities
Accelerate innovation – rapid
deployment of new services
Improve Efficiency - reuse existing
assets and infrastructure
Address business problems –
transparently allow business
requirements to be captured and
realized in the IT System
© 2010 IBM Corporation
Building a smarter planet
Business Problem: US Healthcare
crisis. US Government is committed
to reducing HC cost through the use
of IT. Goal is to provide longitudinal
electronic health records to improve
quality of care, reduce costs and
support public health issues such as
bio-surveillance and health epidemics
Business Value: Complete information
for point of care, eliminate duplication
of labs, reduce medical errors
Solution: Secure interoperable
community healthcare exchange
Healthcare Standards Used: IHE
PIX/PDQ, ATNA, XDS, XDS-I, HL7
v2/v3, Eclipse OHF, Security Std:
SAML, WS-Security,TLS/SSL, XML
dSIG, XAdES, XMLenc, WS-Policy,
WS-Trust
U.S. National Healthcare Information Network
DUAP -
Durham
Medical
Center
Pinehurst
Surgical
Pinehurst
Medical
Southern
Pines
Women’s Ctr.
Moore
Free Care
ClinicFirstHealth
Duke University
Medical Center
Research
Triangle /
Pinehurst
Community
Hub
Spectrum Labs
LabCorp
Morehead
Memorial
Moses Cone
Eden
Internal
Pulmonary
Clinic of
Danville
Moses Cone
Outpatient
Clinic
Family
Tree
OB/GYN
Rockingham
Co, NC/
Danville
Community
Hub
THINC
Communit
y Hub
Kingston
Hospital
St.
Francis
Hospital
Vassar
Brothers
Medical
Ctr
5/3/2010 25
Remote Patient Monitoring: Standards
• Continua founded to organize and push market in one direction.
•
• Structure (Working groups) is to model real-world Use Cases from industry and healthcare.
• Process then deconstructs requirements and selects best industry standards
• Then vet processes and fill holes either with direct work within SDO’s or add definitions and refinements
• Ballot and then publish program and guidelines
• Certification program for interoperability of devices
5/3/2010 26
Working Group Structure – Internal
Board
Of
Directors
Use Case
WG
Technical
WG
Test &
Certification
WG
Wellness
Solutions
WG
VTM
Admin
Expert Group
NHS, AAFP,
ATA, AHA…
Sub-
Committees
PR &
Marketing
agency
Marketing
WG
Regulatory
WG
Policy
Strategy
WG
Australia
Policy
WG
EU
Policy
WG
Japan
Policy
WG
Latin
America
Policy
WG
U.S.
Policy
WG
Executive
Director
Over 2,000 members
participating
in the various
Working Groups
Testing
and
Certification
Lab
Focused on
guidelines and
certification
development
5/3/2010 28
RPM market now: Current Participants
• Continua membership shows across the board interest both from supply and demand sides:
– Medical devices
– Governmental Agencies
– Fitness
– Pharma
– Health care providers
– Health insurers
– Telecommunications
– IT
– Integrators
– Applications (PHR, EHR, desktop)
© 2010 IBM Corporation
Building a smarter planet
May 3, 2010 2929
EU Program for Personal Health
Jan, 2010- Continua selected for EU Smart Personal Health Grant
Berlin,
September 2010
Brussels,
December 2010
Barcelona,
March 2010
Belfast,
June 2010
Continua- working to raise awareness of standards-based
interoperable personal health solutions by providing
education and demonstrations across the EU.
Partner organizations
© 2010 IBM Corporation
Building a smarter planet
EU - Renewing Health Project
EU funded telehealth project
Goal
– 7 pilot projects – ―implementing large-scale real-life
test beds for the validation of innovative telemedicine
services using a patient centred approach and a
common rigorous assessment methodology ‖
– ―In view of their subsequent scaling up at national
and European levels, integration of the service
solutions at regional levels is a priority for the Project
partners, through the use of international standards
and progressive convergence towards common
interoperable architecture‖
Starting 1Q 2010
Continua owns leadership of Industry Advisory
Board for interoperability
Number Full name Short name Country
1 Regione Veneto VENETO Italy
2 Region Syddanmark RSD Denmark
3 County Council of Norrbotten CCN Sweden
4 Centre for Distance-spanning Healthcare CDH Sweden
5 Northern Norway Regional Health Authority
NORNORWAY Norway
6 Departament de Salut de la Generalitat de Catalunya
DSGC Spain
7 Catalan Agency for Health Technology Assessment and Research
CAHTA Spain
8 South Karelia Social and Health Care District
SKARELIA Finland
9 Digital Cities of Central Greece S.A. DCCG Greece
10 e-Trikala e-TRIKALA Greece
11 Municipality of Trikala TR Greece
12 Regional Health Authority of Sterea & Thessaly
5TH DYPE Greece
13 European Patient‘s Forum EPF Belgium
14 European Health Telematics Association EHTEL Belgium
15 Continua Health Alliance CHA Belgium
1.List of Beneficiaries
Latest Continua Certified™ Products
Nonin Wireless
Fingertip Pulse
Oximeter
Nonin Pulse
Oximeter
Roche Accu-Chek® Smart Pix
Device Reader
A&D Medical Blood
Pressure Monitor
A&D Medical Weight
Scale
A&D Blood Pressure
Monitor w/ CPX186
Converter Cable
A&D Weight Scale
w/ CYPAK
Converter Cable
Omron Blood
Pressure Monitor
Omron Body
Composition
Monitor
Omron Pedometer
Texas Instruments
MSP430 USB Agent
Platform
TB named HRN
interface has
been approved
Industry Liaisons
32
PUCC
© 2010 IBM Corporation
Building a smarter planet
IBM and Continua
Joined 2006 when Continua launched
Promoter level member
Key Contributor award 2007, 2009
Technical – Lead the WAN working group
– Co-led security working group, HRN working group
Also participate in – marketing & policy working groups
Plugfest participant
Continua certification testing
Continua demonstrations incl.– World of Health IT (2010) IHE Interoperability Showcase
– IHE Europe
– HIMSS (2009, 2010) IHE Interoperability Showcase
– TicSalut
– Partners Healthcare Symposium
– eHealth Conference (Canada)
Created open source reference implementation
34
Interfaces & Standards
Health
Record
Network
(HRN)
Interface
Personal Device
Weight Scale
Pulse Oximeter
Independent
Living Activity
Cardio /
Strength
Medication
Adherence
Glucose Meter
Pulse /
Blood Pressure
Thermometer
Physical Activity
Peak Flow
Electrocardiogram
Insulin PumpVersion 2
(underway)
Aggregation
Manager
Personal
Area
Network
(PAN)
Interface
Wide
Area
Network
(WAN)
Interface
Telehealth
Service
Center
Health
Records
EHR
PHR
Continua Health Alliance 355/3/2010 355/3/2010 35
Continua Uses CDA for EMR/EHR Integration
Device
manager
Device
PatientDisease management
nurse or home care nurse
PAN
interface
WAN
interface
Remote
Monitoring
System
HRN
interface
Health system e.g.
RHIO/HIE/NHIN,
EMR/EHR/PHR,
Payers,
Pharmas
CDA PHM Specification
IHE Infrastructure Profiles
(XDR)
© 2010 IBM Corporation
Building a smarter planet
ABOUT HL7 (Health Level Seven)
HL7 Vision: to create the best and most widely used standards in healthcare.
Wide range of HC standards: Clinical, clinical genomics, administrative, clinical trial,
electronic claims attachments, etc
Standards and Implementation Guides built on Standards
Most widely used healthcare standards used in hospitals around the world
500+ organizational members, over 2000 total members
400 to 600 attend Three Working Group Meetings per year
Source: HL7
© 2010 IBM Corporation
Building a smarter planet
Key HL7 Standards include: Messages, Documents, RIM, SOA, Clinical Context
Management CCOW, Functional Models, and more
Messages Documents
A message is event
driven and includes
workflow.
A fragment of information
The Clinical Document Architecture (CDA) can facilitate clinical document exchange within and between medical institutions.
CDA can be used to a bring patient‘s clinical documents into to
patient-centric EHR.
A collection of information
about an encounter
Can be digitally signed
Order Lab
Tests
Lab Test
Results
© 2010 IBM Corporation
Building a smarter planet
IHE – Integrating the Healthcare Enterprise
IHE is a healthcare industry organization promoting coordinated use of established standards to improve healthcare IT system integration
IHE produces healthcare integration profiles which:– Address a given healthcare integration scenario– Build upon one or more existing, established standards– Define constraints which limit the options available when using underlying standards– To reduce the effort and cost to integrate systems spanning a diverse set of healthcare
IT vendors
IHE Infrastructure Profiles used for Healthcare Information Exchanges, within and across enterprises
e.g. IHE Patient Care Devices Profile
Sponsor ―Connect-a-thon‖ to demonstrate standard‘s based interoperability between industry vendors
© 2010 IBM Corporation
Building a smarter planet
Electronic Health Record
Cardiology
Laboratory
Radiology
Oncology
Future Domains
IHE
IT Infrastructure
17 Integration Profiles
7 Integration Profiles
6 Integration Profiles
1144 IInntteeggrraattiioonn PPrrooffiilleess
Patient Care
Coordination 5 Integration Profile
Patient Care
Devices
Pathology Eye Care
Endoscopy
IHE Domains
5 Technical Frameworks, 49 Integration Profiles,
Close to 200 vendors involved world-wide,
Testing at Connectathons in North-America, Europe and Asia
© 2010 IBM Corporation
Building a smarter planet
Continua WAN - A Milestone for device interoperability
Source: http://geekdoctor.blogspot.com/2009/08/milestone-for-device-interoperability.html
―Bravo! All device stakeholders will now benefit from a single universal set of standards used to connect devices to EHRs and PHRs.‖
– John Halamka, HITSP Chair, CIO Harvard Medical
―Together, Continua and IHE have finally made it possible for vendors of Medical Devices and Personal Health Devices to efficiently send patient data to the Personal and Electronic Health Records vendors using a single unified interoperability standard that is endorsed by HITSP."
- Elliot B. Sloane, PhD, IHE Co-Chair, International Executive Director, Center for Healthcare Information Research and Policy
This will facilitate an ecosystem of connected technologies, devices, and
services that provide a compelling way to meet the challenges of increased
access, improve outcomes for patients, and ultimately reduce overall
healthcare costs."
- Rick Cnossen, President, Continua Health Alliance, Director, Personal Health
Enabling, Intel Digital Health Group
© 2010 IBM Corporation
Building a smarter planet
41
Open source software –IBM Sponsored projects for CDA, IHE, & Continua implementations
IHE Profiles Implementation of IHE profiles used in health information
exchanges
Stepstone – remote patient monitoring Personal telehealth for improved chronic disease mgmt.
Reference implementation using healthcare standards and
SOA
Model Driven Health Tools ( joint with Veterans Affairs) UML platform with healthcare standards. Produce tools for
developers, e.g. HL7 CDA tooling
•Open Health Tools – IHE Profiles
https://iheprofiles.projects.openhealthtools.org/
•Open Health Tools – Stepstone
https://stepstone.projects.openhealthtools.org/
•Open Health Tools – MDHT
https://mdht.projects.openhealthtools.org/
© 2010 IBM Corporation
Building a smarter planet
Implementing Industry Standards: The CDA* Example
CDA
Human-to-Human
Machine-to-Machine
Printed
Bedside
…
EMR
Transcription
…
Medical Records
Transformation
…
Clinical Decision Support
Patient held-records alerts
…
* CDA – Clinical Document Architecture, co-edited by Amnon Shabo
© 2010 IBM Corporation
Building a smarter planet
Example: CDA usage in epSoS
CDA Supports Translation and Transcoding through ICD10
Document ACountry
A
ep
SO
S
Te
rmin
olo
gy
se
rve
r A
Document E Document BNCP A NCP B
ep
SO
S
Te
rmin
olo
gy
se
rve
r B
Country
B
CDA
Language A
ICD-10 4-digits codes
CDA
English
ICD-10 3-digits codes
CDA
Language B
ICD-10 3-digits codes
Transformation ICD-10 4-digit to 3-digits codes
Accession to epSOS Terminology Server A
Translation of displayName A to displayName E
Creation of pivot Document E*
Accession to epSOS Terminology Server B
Translation of displayName E to displayName B
Creation of local Document B*
* Initial 4-digits code with displayName A are kept into CDA documents E and B and are still available
Local document A is coded with ICD-10
4-digit codes and sent to NCP A
© 2010 IBM Corporation
Building a smarter planet
Health Information Exchange – Clinical Documents
© 2010 IBM Corporation
Building a smarter planet
45
EMR
Physician Office
EHR System
Teaching Hospital
Community Hospital
Lab Info.
System
Retrieve Document
Provide &
Register
Document
Register Document
Query Document
Document
Registry
Document
Repository
Document
Repository
ED System
14355M8354673993
L-716
A87631
Patient Identity Manager
Audit record
repository
EHR System
Community
Document
Repository
HIE Community Hub
HL7-CDA
Gateway
Health Information Exchange – Clinical Documents & Continua
Personal Telehealth Service
Remote
monitoring system
© 2010 IBM Corporation
Building a smarter planet
Example: RIMON - CDA, and CEN EHR 13606
i
XDS Repository
Interface
XML-Based
Repository
V2V3
transformation
HL7 V3
Messages
HL7 V2.x
Data Source
HL7 V3
Data Source
XDS Document
Source
XDS Document
Consumer
HL7 v3 & QED
ConsumerHealth Information
WarehouseStandard HL7
RIM Query Service
XDS Provide & RegisterIf source is not CDA, perform
XDS Document CDA
2-step transformation:
• XDS Submission set Header
• XDS Document Body
HL7 RIM & QED
Interface
XDS Retrieve
Mass &
non-XML
data types,
e.g.,
genomic,
imaging,
binaries
Longitudinal
and Cross-
institutional
CEN EHR
13606 Layer
EHR
Consumer
Healthcare ConsumersHealth Data Sources
Messages
Documents
Imaging
Proprietary
CDA Diagnostic Imaging Report & DICOM SR
HL7 V3
Clinical Genomics
Genomic
Data Source
Transform data to HL7v3 or XDS
Secondary Consumers
Clinical Research Insurers & Payers
Public HealthPharma
Persistency
XDS Registry
(Metadata)
Ongoing
update
RIMification
Analysis, enrichment,
interpretation and
bubbling-up (including
genomic data)
Ongoing
analysis
DOMAINification
© 2010 IBM Corporation
Building a smarter planet
Sensor Solutions can be a key enabler for Smarter Healthcare
Our world is becoming
INSTRUMENTED
Our world is becoming
INTERCONNECTED
All things becoming
INTELLIGENT
Sensors
Event Processing &
Integration
Visualization &
Tuning
Leading companies in Healthcare can benefit from new sensor data when combined
with IBM's business process management, event processing & business optimization capabilities
New Data
New Insights
Process
Innovation
New & OptimizedBusiness Processes
© 2010 IBM Corporation
Building a smarter planet
48
Teva USA: Improved product visibility and authenticity to ensure a safe and secure pharmaceutical supply chain. Enhanced operational efficiency by reducing manual processes.
Honda Italia: Implemented RFID component tracking solution to improve production efficiency and quality.
DHL: Developed and implemented a real-time monitoring system using RFID and sensing technology to monitor temperature sensitive shipments while in transit.
Airbus: In a strategic move, RFID is being utilized to automate the tracking of aircraft segments while improving supply chain visibility and reducing costs.
Matiq: Employs RFID tags to trace meat and poultry from the farm to store shelves to ensure safety and freshness and provide more transparency to consumers.
Metro: Using RFID technology throughout its entire supply chain to help them get the merchandise the customers want on the shelves when they want them.
IBM is a leader in Sensor Solutions
© 2010 IBM Corporation
Building a smarter planet
Sensor SolutionsCreating value through the integration of new and existing capabilities
Process
Models
Process &
Adapter Modules
Rules &
Patterns
Device
Interfaces
Sensor Event
Services
Asset &
Service
Management
Analytics &
Reports
KPIs &
Dashboards
© 2010 IBM Corporation
Building a smarter planet
Sensor Solution for Telehealth
© 2010 IBM Corporation
Building a smarter planet
Example: Detecting Significant Events
Central services are available at
Provider to monitor results,
respond to alerts, evaluation
and respond to trends, support
technologies, and answer ‗how
to‘ questions from patients and
family
Central Support
IBM software technologies
track events (and non-
events) and measurements
and provide automated
feedback when outliers are
detected.
Dashboard
Alert; John, you are past due on
your INR reading
Alert; John is past due on his
INR reading
Event tracking and rule set
Alerts
© 2010 IBM Corporation
Building a smarter planet
Example: Case Manager Portal
© 2010 IBM Corporation
Building a smarter planet
Example: Analytics incorporated into the Portal from remote
monitoring
© 2010 IBM Corporation
Building a smarter planet
54
Achieving smarter outcomes in Healthcare
Imagine the possibilities …
SMART IS …
A sensor enriched, patient-centric dashboard that
provides a healthcare organization improved
visibility for evidence-based care
SMART IS …
A home healthcare organization monitors
thousands of home patients and detects an
adverse reaction to a new prescription while
one of the patients is home alone.
And today we are …
SMART IS …
Letting your medical devices populate
your personal health record for you
SMART IS …
Identifying preventable health issues
before a patient arrives at the ER
Western North Carolina Health Network: Implemented
an electronic health record exchange that enables patient
data to be securely shared across hospitals, providing
faster, better patient treatment and reducing medical
errors and unnecessary treatments.
Shanghai First People’s Hospital: Developed a
reliable identity repository to eliminate duplicate and
erroneous data, aggregating a patient‘s historical care
information and improving care through the sharing of
trusted information.
© 2010 IBM Corporation
Building a smarter planet
References
Applications of Telemedicine and Wireless Technology to Underserved and Disadvantaged Populations, IBM Center for the Business of Government, http://www.businessofgovernment.org/pdfs/GeislerApplications.pdf
Continua Health Alliance, http://continuaalliance.org
Laying a Foundation for True Patient Intelligence, http://www.initiate.com/resources/exec_summary/downloads/Documents/Laying-a-Foundation-for-True-Patient-Intelligence.pdf
COCIR Telemedicine Toolkit, http://www.cocir.org/content.php?level1=14&mode=24&id=58
European Commission Smart Personal Health Project, http://sph.continuaalliance.org/project.html
epSoS project
Renewing Health Project
IHE Europe, http://www.ihe-europe.net/organisation/
Building a Smarter Medical Device Monitoring Solution, http://www.ibm.com/developerworks/websphere/techjournal/1001_hanis/1001_hanis.html
Using Collaborative Technologies for Healthcare in the Home, http://www.ibm.com/developerworks/data/library/techarticle/dm-0910purexmlhealthcare/
Healthcare Information Integration: Considerations for Remote Patient Monitoring, http://www.drdobbs.com/web-development/221600073;jsessionid=UPYJDOCARTXIBQE1GHPSKH4ATMY32JVN?pgno=1
Creating Telemedicine-Based Medical Networks for Rural and Frontier Areas, Leonard R. Graziplene, IBM Center for Business of Government, http://www.businessofgovernment.org/pdfs/graziplene_magazine.pdf
A Milestone for Device Interoperability, John Halamka, Healthcare IT News, http://www.healthcareitnews.com/blog/milestone-device-interoperability
Kirsch C., et. Al. : Monitoring chronically ill patients using mobile technologies. IBM Systems Journal Vol 46 No 1 2007, http://w3.research.ibm.com/journal/sj/461/kirsch.pdf
© 2010 IBM Corporation
Building a smarter planet
Ďakujem!
Rich Rogers
Healthcare standards & emerging technology
IBM Software Group