fhir implementations for personal connected health · cdg a global standard through itu. extend ihe...
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A membership-based HIMSS Innovation Company
FHIR Implementations forPersonal Connected Health
HIMSS’19 Global Conference – Developer Innovation LabFebruary 14, 2019
• personal technology that communicates secure clinical-grade data,
• transformed into actionable information,
• based on evidence to change health behaviors, and
• to enable management of chronic conditions.
PCHAlliance supports a patient/consumer-centered approach to improving health and wellness through…
Continua Design Guidelines
• Healthcare Providers– Achieve outcomes at lower costs
• Remote Care Service Companies– Simplify integration of multiple
observations into healthcare information systems
• Device and Sensor Companies– Furnish medical-grade observations
• Pharmaceutical Companies– Better measure of drug efficacy
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http://www.pchalliance.org/about-continua
H.811 H.812 H.813
H.810
http://www.itu.int/rec/T-REC-H.810-201312-I
H.812.5
Secure Medical-Grade Data from Patient to Care Delivery Using Open Standard
Continua Design Guidelines
JIC
CDG a global standard through ITU
Extend IHE profiles for personal connected health and participate in
both IHE USA and Europe Connect-a-thons.
Development of new standardswithin the IEEE PHD for acquiring
medical-grade data.
Integrating work group collaboration within both CTA and PCHAlliance
Joint initiative on SDO Global Health Informatics Standardization
Driving IEC’s SyC AAL, Assisted Living Working Group
Working to make medical-grade data available over
BTLE
First to profile HL7 FHIR for remote patient monitoring
Advancing HL7 standards to support remote patient monitoring
We enable standards-based solution to be truly interoperable
Role in Ecosystem
CODE Project Overview
• Continua Design Guidelines– Secure Medical Data Exchange– Enables Improved Outcomes at Lower Cost– Implementation Outside Stakeholder Focus
• Commercial Ready Software– Simplifies implementation of Continua
Interfaces– Expedites Regulatory Approvals
• Open Source Software Project– Anyone can Inspect, Modify, Enhance– Broaden Community of Experts &
Developers
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http://www.pchalliance.org/continua-open-development-environment
FHIR Implementations
• Health & Fitness Service: Observation Server– A Kubernetes cluster running under Amazon Web Services that
incorporates a secured FHIR server meeting HL7 and Continua H.812.5 draft specifications.
– Operational• Personal Health Gateway: Observation Upload
– Maps vital signs data from a variety of sensors into FHIR resources and uploads separately or combined as a multi-measurement.
– Available mid-2019• Personal Health Gateway: Bluetooth Low Energy Manager
– Collects vitals signs data over BTLE transport and transcodes to IEEE-11073 data structures.
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Conformity Assessment by Continua
Continua Test ToolCTT
Continua
Certified
Continua
Compliant
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“Continua Compliant”
Continua Certified Product Showcase
Continua CompliantListing
PCHAlliance Match-making(matching buyers to sellers)
Continua Test Tool
Free Listing
Member Only Listing
PCHAlliance MarketsMember’s Product
https://www.pchalliance.org/continua-conformity-assessment
• Ensures products conform to the Continua Design Guidelines and underlying standards and demonstrate interoperability between conforming products.
Opportunity to Engage
• Medical Device Manufacturers– Help grow the ecosystem and your market opportunity
• Medical Providers– Enjoy improved ambulatory care at lower cost
• Health Informatics– Measure population health using reliable consistent data
• Regulators– Ensure secure and reliable data transmission to digitally
connected devices
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Additional Information
PCHAlliance Web Site – Become a Member Today!Fundamentals of Data Exchange White PaperIntroduction to the Continua Design GuidelinesContinua Design GuidelinesConformity Assessment Scheme by ContinuaMichael Kirwan, VP Continua [email protected] Erickson, Director Technical Operations [email protected]
Thank You
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By Light Professional IT Services LLC
IHE on FHIRJohn Moehrke
<[email protected]>Co-Chair: IHE ITI Planning Committee, HL7 Security WG
FHIR Foundation founding memberFHIR Management Group, FHIR Facilitator
www.bylight.com
IHE Domains
•Cardiology•Dental•Eye Care•IT Infrastructure (ITI)•Pathology and Laboratory Medicine
•Patient Care Coordination
•Patient Care Devices•Pharmacy
•Quality, Research and Public Health
•Radiation Oncology•Radiology
•Mammography•Nuclear Medicine
Source: https://www.ihe.net/IHE_Domains/
* Marked in red are domains using FHIR
Mobile
•Most profiles from IHE that leverage FHIR have the word “Mobile” in their title.
• Indicates FHIR was used•Usually only used when historic use-case is re-
evaluated using FHIR•Does NOT restrict the use to non-Mobile use
ITI Profiles on FHIR
• Mobile Access to Health Documents (MHD) • Audit Trail and Node Authentication (ATNA) - Query• Mobile Alert Communication Management (mACM)• Mobile Care Services Discovery (mCSD)
• Healthcare Provider Directory• Mobile Cross-Enterprise Doc Data Element Extraction (mXDE)• Non-patient File Sharing (NPFS)• Patient Identifier Cross-reference for Mobile (PIXm)• Patient Demographic Query for Mobile (PDQm)• Internet User Authentication (IUA) – Special Mention• Patient Identity Management
Appendix Z on FHIR
• Common text for all IHE Domains to re-use• Introduction to FHIR profiling concepts • Common query parameter clarifications• Relationship between CapabilityStatement and IHE
Integration Statement• Pointer to library of conformance resources• Mapping of FHIR Identifier datatype to HL7 v3 root, and
XDS Cxi• Security Considerations
Patient Care Coordination Profiles on FHIR
• Clinical Mapping (CMAP)• Dynamic Care Planning (DCP)• Dynamic Care Team Management (DCTM)• Point of Care Medical Device Tracking (PMDT)• Query for Existing Data for Mobile (QEDm) • Reconciliation of Clinical Content and Care Providers
(RECON)• Routine Interfacility Patient Transport (RIPT)• Paramedicine Care Summary (PCS)
Pharmacy Profiles on FHIR
• Mobile Medication Administration (MMA)• Uniform Barcode Processing (UBP)
QRPH Profiles on FHIR
• Mobile Retrieve Form for Data Capture (mRFD)• Vital Records Death Reporting (VRDR)• Birth and Fetal Death Reporting – Enhanced (BFDE)• Quality Outcome Reporting for EMS (QORE)
Radiology Profiles on FHIR
•Standardized Operational Log of Events (SOLE)
•Special mention as these use compatible DICOM web• Web Image Capture (WIC)• Web Image Access (WIA) formerly called MHD-I• Invoke Image Display (IID) - Special mention
Move to FHIR R4
• All profiles are expected to be revised to use FHIR R4• IHE Governance prevents normative until underlying standard is
normative
• Priority set of Profiles are updated to R4 and are in Public Comment
• Mobile Access to Health Documents (MHD) • Mobile Care Services Discovery (mCSD)• Patient Demographic Query for Mobile (PDQm)• Query for Existing Data for Mobile (QEDm) • Appendix Z• Mobile Cross-Enterprise Doc Data Element Extraction (mXDE)
• Equivalent to US-Core
IHE on FHIR
• 23 Profiles and growing• IT Infrastructure (ITI) - 8• Patient Care Coordination - 8• Pharmacy - 2• Quality, Research and Public Health - 4• Radiology - 1
• https://wiki.ihe.net/index.php/Category:FHIR• http://www.ihe.net
• Blog – John Moehrke’s Healthcare Exchange Standards• https://healthcaresecprivacy.blogspot.com
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Questions?
John MoehrkeGmail JohnMoehrkeTwitter JohnMoehrkeSkype johnmoehrke
Blog healthcareSecPrivacy.blogspot.com