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1 IHE World Summit, eHealth Week, Amsterdam, 2016.06.08 © Prof. Dr. J.-Uwe Meyer, MT2IT
Mobile FHIR Services and IHE Profiles
for Leveraging Modern IoT Health Delivery
J.-Uwe Meyer,
MT2IT GmbH & Co. KG
joerg-uwe.meyer@mt2it.com
www.mt2it.com
2 IHE World Summit, eHealth Week, Amsterdam, 2016.06.08 © Prof. Dr. J.-Uwe Meyer, MT2IT
Trends in Modern Healthcare
Cyber-Physical Systems and Services for Modern Health Delivery
Integrated Web
Communication,
Integrated Systems
and Networks,
Internet of Things (IoT) & Services
Integrated
Applications
Web
Apps Mobile
Apps
API
Apps
Systems
Apps
… empowering users and patients
3 IHE World Summit, eHealth Week, Amsterdam, 2016.06.08 © Prof. Dr. J.-Uwe Meyer, MT2IT
Internet of Things (IoT) & Services
Entity
IoT Service Entity
Thing representation
Identification
Analytics
Semantics (query, etc.)
Location discovery
Functional security
Device
management
Networks Network security
Data protection
QoS,
Network Identification
«Services»
4 IHE World Summit, eHealth Week, Amsterdam, 2016.06.08 © Prof. Dr. J.-Uwe Meyer, MT2IT
US Interoperability Roadmap for Connecting Health & Care
Source: https://www.healthit.gov/sites/default/files/hie-interoperability/nationwide-
interoperability-roadmap-final-version-1.0.pdf
5 IHE World Summit, eHealth Week, Amsterdam, 2016.06.08 © Prof. Dr. J.-Uwe Meyer, MT2IT
Standards in Modern Healthcare
Source: adapted from https://www.healthit.gov/sites/default/files/hie-
interoperability/nationwide-interoperability-roadmap-final-version-1.0.pdf
1. Vocabulary/terminology standards are sometimes unique to healthcare and specific to use cases (e.g., codes to represent medications cannot be also used for laboratory tests)
2. Content/format standards are also often unique to healthcare and may be use case-specific for things like data capture or computation within a specific clinical workflow or domain (e.g., the content/ format standard used for a referral to a specialist would
not be used to bill for a procedure).
3. Transport standards are typically not unique to healthcare because they are used to connect two or more parties together (without a focus on the data that is transported from one party to another).
4. Security standards are not unique to healthcare and often applied in different ways to meet given data protection requirements. However, in healthcare there are nationally unique legal privacy and security rules for functional security outcomes (U.S.: HIPPA Security Rules, EU: Data Protection Directive with rules in the
area of public health).
5. Standards for services typically represent technical infrastructure used to connect different systems together Services for System-of-Medical-Systems
6 IHE World Summit, eHealth Week, Amsterdam, 2016.06.08 © Prof. Dr. J.-Uwe Meyer, MT2IT
Web IT Standards and Protocols Fuse
with Medical Device and System Standards and Profiles
AS
TM
F2761-1
:2009;
AA
MI
/ U
L 2
800 –
Fam
ily
IEC
80
00
1-x
-x,
ISO
/AW
I IE
C T
R I
80
00
2-x
IEC
62
30
4, I
EC 6
23
66
ISO
/ IE
EE
11073-x
xxxx
HL7
, FH
IR, I
HE,
DIC
OM
IEC
60601-x
-x
ISO
/IEC
20
00
0-X
:20
05
IT--
Se
rvic
e m
anag
em
en
t
ISO
/IEC
25
43
7:2
00
6 IT
–W
eb
Se
rvic
es
RE
ST
/SO
AP
Web
Serv
ice
Sp
ecif
icati
on
s
We
b 2
.0, H
TML5
, Jav
aScr
ipt,
…
Op
en
Data
Pro
toco
l (O
Data
)
…
OA
uth
2.0
(R
FC
6749)
…
Medical Devices Internet of Things & Services
7 IHE World Summit, eHealth Week, Amsterdam, 2016.06.08 © Prof. Dr. J.-Uwe Meyer, MT2IT
New IHE Profiles for Mobile Applications
Interoperability
for Mobile applications:
New IHE profiles
Adapted from source:
Charles Parisot
Chair, IHE European Affairs Committee
Member, IHE International Board
Manager Standards and Testing, GE Healthcare
8 IHE World Summit, eHealth Week, Amsterdam, 2016.06.08 © Prof. Dr. J.-Uwe Meyer, MT2IT
New IHE ITI /FHIR Profiles for Mobile Health Delivery
PDQm: Patient Id/ demographics query PIXm: Patient Id cross-referencing mACM: Mobile Alert Communication Mgt GAO: Guideline Appropriate Ordering IUA: Internet User Authorization MHD: Mobile Health Document
nicknamed “XDS on FHIR”
9 IHE World Summit, eHealth Week, Amsterdam, 2016.06.08 © Prof. Dr. J.-Uwe Meyer, MT2IT
The HL7 FHIR Standard and Resources
http://hl7.org/fhir
http://wiki.hl7.org/index.php?title=FHIR
Clinical - Observation 3 - DiagnosticReport 3 - ImagingStudy 2 - ProcedureRequest 1 - Careplan 1 - Medication 1 - …
Identification - Patient 3 - Practitioner 1 - Location 1 - Organization 1 - Device 1 - DeviceComponent 1 - DeviceMetric 1 - …
Infrastructure - Bundle 2 - MessageHeader 2 - Media 1 - …
FHIR: Fast Healthcare Interoperability Resources
● “it‘s an interoperability API“ (Grahame Grieve
16.02.2016)
● Implementer-centric healthcare data exchange
● Flexible/Extensible
• REST, messaging, services, documents
• XML or JSON, HTTP stack, OAuth
● Resources: Clinical, Administration, Infrastructure
• Includes IEEE 11073 alignment
Workflow
- Encounter 1 - Communication Request 1 - DeviceUseRequest 0 - DeviceUseStatemment 0
Financial …
Conformance …
http://hl7.org/fhir/2016May/resourcelist.html
10 IHE World Summit, eHealth Week, Amsterdam, 2016.06.08 © Prof. Dr. J.-Uwe Meyer, MT2IT
Inpatient and Outpatient Mobile Health Applications
11 IHE World Summit, eHealth Week, Amsterdam, 2016.06.08 © Prof. Dr. J.-Uwe Meyer, MT2IT
Clinical Element Models + Profiles
Open, Service-Oriented mHealth Web Platform in Hospital
utilizing IHE & FHIR data profiles
SOA
IT Services Orchestration
mHealth
Web
Apps Mobile
Apps
API
Apps
Systems
Apps
Smart
Apps
RESTful APIs
Server
HDO
IT Vendors Medical Device Manufacturers
3rd Party System Software Integrators
Others…
Systems Stakeholders
OAuth2
12 IHE World Summit, eHealth Week, Amsterdam, 2016.06.08 © Prof. Dr. J.-Uwe Meyer, MT2IT
mHealth Web Platform in the OR
«Interoperability Gateway & «Services»/ App Proxy & Event Hub»
Open Web Interface (OWIN)
User-specific
Application Frontends
Nurse
Surgeon
Medical Device Systems/ Clinical Workplaces Clinical Systems
1..n PACS
LAB
CIS
Anesthesiologist
Patient
Clinical-IT Network Point-of-Care Network
Web-API
Web-API
e.g.: SDC and/or DDS
Web-API Web-API
Web-API
Comm.
Server
HL7
Backplane Service Bus Integration
Web-API
PCD
13 IHE World Summit, eHealth Week, Amsterdam, 2016.06.08 © Prof. Dr. J.-Uwe Meyer, MT2IT
Service-oriented System-of-Systems Connectivity in the OR
Point-of-Care Network
Clinical IT Network
Open Web Interface (OWIN)
1
2
3
HL7-FHIR = Fast Healthcare Interoperability Resources: Standard for Mobile Communication in Healthcare
4
5
6 7
«FHIR Server»
Doctors, Nurses, …
Patient
«Interoperability Gateway» Service App Engine
View Engine
Sensors
14 IHE World Summit, eHealth Week, Amsterdam, 2016.06.08 © Prof. Dr. J.-Uwe Meyer, MT2IT
Example: The UKSH Clinical Research-IT Validation and Test Platform,
Converting a HL7 v2.3 ORM Message into an ORM FHIR «Service»
15 IHE World Summit, eHealth Week, Amsterdam, 2016.06.08 © Prof. Dr. J.-Uwe Meyer, MT2IT
Bundled FHIR Resources in Surgery
to be used as an ORM FHIR «Service» in the OR Workflow
• Bundled HL7 v2 ORM-related Resources
• „Order“ ≙ “Procedure Request”
(n) = Maturity Level
ProcedureRequest (1)
MessageHeader (2)
Patient (3) (undergoing surgery)
Location (1) (OR)
Practitioner (1) (Surgeon)
Organization (1) Bundle (2) (message)
subject
orderer link
link
performer
Practitioner (1) (OR-Safety Manager)
managing
organization link
16 IHE World Summit, eHealth Week, Amsterdam, 2016.06.08 © Prof. Dr. J.-Uwe Meyer, MT2IT
Vision:
Industry-wide Testbed for Precision 4.0 Health Delivery
Building a vendor-neutral, standards-conform,
patient-centered, user-driven
“Health Validathon”
which is serving as a
Enhanced Cyber-Secure and Safety Infrastructure
for validating
Precision 4.0 Health Delivery
created for medical device manufacturers, health IT vendors, health
delivery organizations, healthcare providers, and users
commencing on both sides of the Atlantic
17 IHE World Summit, eHealth Week, Amsterdam, 2016.06.08 © Prof. Dr. J.-Uwe Meyer, MT2IT
eHealth Interoperabilitätserzeichnis
https://ddrm.de/tag/elektronisches-interoperabilitaetsverzeichnis/
18 IHE World Summit, eHealth Week, Amsterdam, 2016.06.08 © Prof. Dr. J.-Uwe Meyer, MT2IT
Mobile FHIR Services and IHE Profiles
for Leveraging Modern IoT Health Delivery
J.-Uwe Meyer,
MT2IT GmbH & Co. KG
joerg-uwe.meyer@mt2it.com
www.mt2it.com
Thank you!
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