hl7 plenary-wgm + payers summit @ chicago revolu… · deep dive: hl7 mh activities#2: document...

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Sep 2014 © CAL2CAL Corporation

HL7 Plenary-WGM + PAYERS SUMMIT @ Chicago

Sep, 2014

MOBILE HEALTH LANDSCAPE & STANDARDS

Presented by:

Gora Datta [email protected] HL7 International Ambassador

Co-Chair HL7 Mobile Health Work Group

Co-lead HL7 EHR Interoperability Group

HL7 2009 Volunteer of the Year Award Winner

US Delegate to ISO/TC215 Health Informatics

Vice Chair IEEE OC (Region 6 – USA) (2014 – 16)

HIMSS Ambulatory Committee Member (2014-15)

HL7, IEEE, HIMSS Speaker

HL7 Meaningful Use Tutor/Speaker

IEC TC62: Member

ICT Expert - World Bank, Asian Development Bank

Senior Member IEEE

Senior Member ACM

Advisory Board Member: www.quampus.com - ONLINE LEARNING DELIVERY PALTFORM

Group Chairman & CEO CAL2CAL Corporation

mailto:[email protected]

http://www.quampus.com/

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Agenda

Mobile Revolution: Technology Landscape

What is “Mobile Health”?

HL7 MH WG & (emerging) Standards

IEEE Devices Standards

US Programs & Regulatory Guidance

CMS, FCC, FDA, FTC, NIST, OCR, ONC, …

EHR Program: MU

FFS to P4P

Global impact of MH: Healthcare in the 21st Century

Summary

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MOBILE REVOLUTION!

Mobile phone market

first billion mobile phones: 20 years

second billion phones: 4 years

third billion: 2 years

In 2013: over One Billion “smart” mobile phones sold globally ~ 100 Million in the US

Sep 15, 2014: 4 million iPhone (6 & 6+) sold on day1

ITU (International Telecommunications Union): 96% of the world’s population (7.3B+) has mobile subscription. http://www.itu.int/en/ITU-

D/Statistics/Documents/facts/ICTFactsFigures2014-e.pdf

80% of the world’s population (as of 2006) lives within range of a cellular network, (40% in 2000).

http://money.cnn.com/2014/09/15/technology/mobile/apple-iphone-6-sales/index.html?hpt=hp_t2

http://www.itu.int/en/ITU-D/Statistics/Documents/facts/ICTFactsFigures2014-e.pdf






MOBILE HEALTH STAKEHOLDERS

Source: HL7 Mobile Health Newsletter V1Is1

Sep 2014

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Mobile Health – what is it?

Scenarios illustrating the scope and

benefits of Mobile Health

MOBILE HEALTH

All of the above!

Not a vertical domain/sector

But a horizontal framework that cuts across and

impacts all health care domains

Extension of the EHR?

PHR on a mobile platform?

Consumer wellness/fitness apps?

“new” way to access/provide care

MH Scenarios

Moving around a hospital

EHR System services follow providers around a hospital

independent living

Assisted living drawing on a range of mobile services

Patient empowerment

Patient involvement in care process across a wide range

of lifestyles, including: support for long term conditions

Behavioural health

Behavioural health support anytime, anywhere -

especially there!

Secure/trusted messaging

Getting the message(s) – for example on child health to

hard-to-reach families

Public/Population Health

Disaster Management to PH outreach

Sep 2014

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HL7 MOBILE HEALTH WG MISSION

The HL7 Mobile Health Work

Group creates and promotes

health information technology

standards and frameworks for

mobile health.

http://wiki.hl7.org/index.php?title=

Mobile_Health

Sep 2014

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http://wiki.hl7.org/index.php?title=Mobile_Health

http://wiki.hl7.org/index.php?title=Mobile_Health

HL7 MOBILE HEALTH WG CHARTER

Identify (and develop, as applicable) data standards and

functional requirements that are specific to the mobile

health environment

Identify and promote mobile health concepts for

interoperability as adopted and adapted for use in the

mobile environment

Coordinate and cooperate with other groups interested

in using mobile health to promote health, wellness,

public health, clinical, social media, and other settings.

Provide a forum where HL7 members and stakeholders

collaborate in standardizing to enable the secure

exchange, storage, analysis, and transmission of data

and information for mobile applications and/or mobile

devices.

Sep 2014

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MH WG 2014-16 ROADMAP

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Emerging HL7 MH standards

HL7 (emerging) MH Standards:

Messaging

mFHAST - mobile Framework for Healthcare Adoption

of SMS type Technologies

FHIRsidechat

Functional Model

MHR-S (mobile health record –system) Functional

Profile

Document Architecture

Meds-on-FHIR

Services

FHIRframe

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DEEP DIVE: HL7 MH Activities#1:

MH Messaging Standards:

short but structured chucks for information

for rapid turnaround

Morse code of FHIR resources?

MH Functional Models/Profiles:

“apps…apps all around but non talks with

another”

MH Functional Profile derived from both the

EHR-S FM and the PHR-S FM

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Document Architecture (CDA) impact

you are on the road, in a foreign city (like

Chicago!), out of your meds

You go the local pharmacy, zap (NFC) your

mobile device (smart phone) with the kiosk

the kiosk prints out your prescription (in the

local language, if applicable)

You get your meds

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Services:

many possibilities….patient education is the

first that comes to mind...."Info Button" service

request, appointment service request, etc.

FHIRframe

a set of standardized Application Programming

Interface (API) libraries and companion Software

Development Kits (SDKs) to facilitate the

implementation of mobile health applications in a

platform-agnostic manner based on HL7 FHIR (Fast

Healthcare Interoperability Resources) standards.

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IEEE 11073 Standards (recognized by FDA)

1. IEEE 11073-10101™ "Health informatics—Point-of-care medical

device communication—Part 10101: Nomenclature“

2. IEEE 11073-10201™ “Health informatics—Point-of-care medical

device communication—Domain information model”

3. IEEE 11073- 20101™ “Health informatics—Point-of-care medical

device communication—Application profile—Base standard”

4. IEEE 11073-20601™ “Health informatics—Personal health device

communication—Part 20601: Application profile—Optimized

exchange protocol”

5. IEEE 11073-20601a-2010™ “Health informatics—Personal health

device communication—Part 20601: Application profile—Optimized

exchange protocol”


communication—Part 10408: Device specialization—Thermometer”

ISO/IEEE 11073 standard family defines parts of a system, with which it is possible, to

exchange and evaluate vital signs data between different medical devices, as well as

remote control these devices.

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IEEE 11073 Standards (cont.)


communication—Part 10415: Device specialization—Weighing scale”


communication—Part 10404: Device specialization—Pulse oximeter”

9. IEEE 11073-10421-2010™ “Health informatics—Personal health device

communication Part 10421: Device specialization—Peak expiratory flow

monitor (peak flow)”

10. IEEE 11073-10406-2011™ “Health informatics—Personal health device

communication Part 10406: Device specialization—Basic

electrocardiograph (ECG) (1- to 3-lead ECG)”

11. IEEE 11073-10407™ “IEEE ISO/IEEE Health informatics—Personal

health device communication—Part 10407: Device specialization—Blood

pressure monitor”

12. IEEE 11073-10417™ “IEEE ISO/IEEE Health informatics—Personal

health device communication—Part 10417: Device specialization—

Glucose meter”

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USA: Mobile Health Govt. Players FDA

Mobile Medical Application (MMA) Guidance

RF Wireless Technology in Medical Devices Guidance

Unique Device Identification (UDI)

FDASIA (ONC, FCC + FDA: Safety & Innovation Act)

FCC

FCC Smart Phone Security Guidelines

FCC Health

FTC Mobile Privacy Disclosures

HHS Mobile Device Privacy & Security Guidelines

OCR (Office of Civil Rights) – HIPAA Guidelines

House Panel (Energy & Commerce Committee)

NIST Mobile Apps Security vetting (draft)

US Meaningful Use EHR Program

Telehealth

NIH Mobile Health Grants

http://www.fda.gov/downloads/MedicalDevices/DeviceRegulationandGuidance/GuidanceDocuments/UCM263366.pdf

http://www.fda.gov/downloads/MedicalDevices/DeviceRegulationandGuidance/GuidanceDocuments/ucm077272.pdf

http://www.fda.gov/medicaldevices/deviceregulationandguidance/uniquedeviceidentification/default.htm#ruleguidance

http://www.fda.gov/downloads/AboutFDA/CentersOffices/OfficeofMedicalProductsandTobacco/CDRH/CDRHReports/UCM391521.pdf

http://www.fcc.gov/smartphone-security

http://www.fcc.gov/smartphone-security

http://www.fcc.gov/health

http://www.ftc.gov/sites/default/files/documents/reports/mobile-privacy-disclosures-building-trust-through-transparency-federal-trade-commission-staff-report/130201mobileprivacyreport.pdf

http://www.healthit.gov/providers-professionals/your-mobile-device-and-health-information-privacy-and-security

http://www.healthit.gov/policy-researchers-implementers/hipaa-and-health-it




http://democrats.energycommerce.house.gov/sites/default/files/documents/Testimony-Jarrin-HE-Mobile-Medical-Apps-Health-Software-2013-11-19.pdf

http://csrc.nist.gov/publications/drafts/800-163/sp800_163_draft.pdf

http://csrc.nist.gov/publications/drafts/800-163/sp800_163_draft.pdf

http://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/index.html

http://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/index.html

http://www.hrsa.gov/ruralhealth/about/telehealth/telehealth.html

http://grants.nih.gov/searchGuide/search_guide_results.cfm?searchTerms=mobile health&PAsToo=1&RFAsToo=1&NoticesToo=0&OrderOn=RelDate&OrderDirection=DESC

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US National Quality Strategy Priorities

Work with communities to promote wide use of best

practices to enable healthy living and well-being.

Promote the most effective prevention, treatment, and

intervention practices for the leading causes of mortality,

starting with cardiovascular disease.

Ensure person- and family-centered care.

Make care safer.

Promote effective communication and care coordination.

Make quality care affordable for people, families,

employers, and governments.

http://www.ahrq.gov/workingforquality/index.html

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Changing Landscape: MU

Stage 1: capture coded data 1) Capturing health information in a coded format,

2) Using the information to track key clinical conditions;

3) Communicating captured information for care coordination purposes;

4) Reporting of clinical quality measures and public health information.

Stage 2: share information Focus on interoperability, disease management, clinical decision support,

support for patient access to their health information, transitions in care,

quality measurement, research, and bi-directional communication with

public health agencies.

Stage 3: convert data to knowledge Focus on achieving improvements in quality, safety and efficiency,

focusing on decision support for national high priority conditions, patient

access to self-management tools, access to comprehensive patient data

and improving population health outcomes.

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HEALTHCARE IN THE 21st CENTURY

Next generation: “iPADTM

” kids

Blurred Lines: Impact of Social Media

Are we there yet: I want it NOW

Take Charge: Consumer Health

Gene to genes: from Star-Trek (Gene Roddenberry)

to Genetic Health

Back to the Future: longitudinal Health Record

Live long & prosper: from provenance to

preservation

Emerging Areas: IoT, Big DATA, Open Data

Global Village: Urban, Rural, Remote, Underserved

“Check please”: Mobile Payment

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In SUMMARY!

MOBILE HEALTH

Not a vertical domain

But a horizontal framework that cuts across and

impacts all health care domains

As we transition to a digital record framework;

(access, capture, dissemination of information) use

of Mobile Health will continue to rise

As Mobile Devices become more and more

ubiquitous, accessing our Health Information is only

a few tap/swipe away!

TRULY A DISRUPTIVE REVOLUTION!

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THANK YOU [email protected]