mobile fhir services and ihe profiles for leveraging ... · mobile fhir services and ihe profiles...

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

[email protected]

www.mt2it.com

mailto:[email protected]



http://www.mt2it.com/


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


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»


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


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


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

http://blogs.zdnet.com/open-source/images/iso_logo.gif


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


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”


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

http://hl7.org/fhir

http://hl7.org/fhir







Inpatient and Outpatient Mobile Health Applications


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


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


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


Example: The UKSH Clinical Research-IT Validation and Test Platform,

Converting a HL7 v2.3 ORM Message into an ORM FHIR «Service»


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


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


eHealth Interoperabilitätserzeichnis

https://ddrm.de/tag/elektronisches-interoperabilitaetsverzeichnis/






Mobile FHIR Services and IHE Profiles

for Leveraging Modern IoT Health Delivery

J.-Uwe Meyer,

MT2IT GmbH & Co. KG

[email protected]

www.mt2it.com

Thank you!




http://www.mt2it.com/

mobile fhir services and ihe profiles for leveraging ... · mobile fhir services and ihe profiles...

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