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CIGNA-1
Enabling Ubiquitous Personal Health Device Enabling Ubiquitous Personal Health Device Integration through Open StandardsIntegration through Open Standards
Steven A. Demurjian and Maifi KhanComputer Science & Engineering Department
The University of Connecticut371 Fairfield Road, Storrs, CT
Thomas P. Agresta and Michael BlechnerFamily Medicine & Pathology Departments
University of Connecticut Health Center263 Farmington Avenue, Farmington, CT
steve@engr.uconn.edu, mok11002@engr.uconn.eduagresta@nso1.uchc.edu, mblechner@uchc.edu
CIGNA-2
Today’s Applications and Systems Built around Today’s Applications and Systems Built around Multiple TechnologiesMultiple Technologies APIs, Cloud Computing, Web Services, Data
Mining, etc. Alternative Data Structure StandardsAlternative Data Structure Standards
XML, RDF, JSON, OWL, etc. Meta-Systems that Share, Use and Exchange Meta-Systems that Share, Use and Exchange
Information to fully functionInformation to fully function XML as de-facto Standard
What are the Key Challenges?What are the Key Challenges? Information Interoperation from Multiple Sources Integration of Today’s and Emerging Technologies
IntroductionIntroduction
CIGNA-3
Interplay of Information in HealthcareInterplay of Information in Healthcare
PHI
Secure PHI
Local Security Policy/Control
XML Converter
MeSHXML DTD
SNOMEDXML
Schema
RxNormXML
Schema
RxTermsXML
Schema
LOINCXML
Schema
Standards
HealthInformationExchange
UMLSXML DTD
GlobalSecurity
Policy andControl
SecureXML
XML-C
PHA Patient App
Mobile
PHA Provider
Mobile App
SMARTSync App
USE
S
USES
MS Health Vault
ASP.NET API
C# D
ataHarvard SMART
EHR
REST API
JSO
N-L
D
Open mHealth
JSO
N
EPIC LucyPHR Server
JAVA APIs
XM
L
OpenEMREHR Server
Java APIs
XM
L
GE Centricity
EHRServer
WSDL
CC
R
SecureCDA
SecureCDA
SecureXML
SecureXML
SecureXML
XML-C
XML-C
CIGNA-4
PHA:PHA: Mobile App for Medication and Chronic Disease
Management iOS/Android Versions hooked to MS Healthvault Patient Version to Enter Data/Authorize Providers Provider Version to View Authorized Data
SMARTSync (Harvard SMART Platform)SMARTSync (Harvard SMART Platform) SMART EMR and MS Healthvault Medication Reconciliation Identify: Overmedication, Adverse Interactions,
and Adverse Reactions Uses Standards and Online Resources NDR-RT
and RxNorm
Personal Health Assistant PHAPersonal Health Assistant PHAand SMARTSyncand SMARTSync
CIGNA-5
PHA and SMARTSync ArchitecturePHA and SMARTSync Architecture
CIGNA-6
PHA – Patient VersionPHA – Patient Version
CIGNA-7
PHA – Patient VersionPHA – Patient Version
CIGNA-8
PHA – Patient VersionPHA – Patient Version
CIGNA-9
PHA – Provider VersionPHA – Provider Version
CIGNA-10
SMARTSync and InteractionsSMARTSync and InteractionsYellow: Significant Red: CriticalYellow: Significant Red: Critical
CIGNA-11
Leverage and Extend our HIE ArchitectureLeverage and Extend our HIE Architecture MSHV SupportsMSHV Supports
Medical Devices: blood pressure monitors, glucose meters, scales, medi-watches, pedometers
Exercise Data Types and API: Allow Information to be Stored – fitbit can download into MSHV
Objective: Support Clinical Decision Support on:Objective: Support Clinical Decision Support on: Medications, Observations of Daily Living Chronic Disease Management, Exercise/Diet Logs Aim for Trending and Potential to Alert
Stakeholders (Patients, Insurers, Providers)
Proposed ApprachProposed Apprach
CIGNA-12
Interoperation Architecture Facilitates Communication Interoperation Architecture Facilitates Communication Across Multiple Formats (XML, JSON, REST API)Across Multiple Formats (XML, JSON, REST API)
Our Approach Consistent with Current Personal Our Approach Consistent with Current Personal Health DevicesHealth Devices fitbit, withings, and bodymedia all Use REST API
and Oauth withings uses JSON to Return Responses iHealth stores information in Cloud
Compatibility of our ApproachCompatibility of our Approach
CIGNA-13
Expand HIE Architecture to Wide Range of SourcesExpand HIE Architecture to Wide Range of Sources Personal Health Records (MSHV, WebMD) Personal Health Devices (fitbits, withings, etc.) Electronic Health Records CIGNA Data Sources
Propose and Analyze Other Possible Architectural Propose and Analyze Other Possible Architectural AlternativesAlternatives Focus on Current and Emerging Platforms Rapid Changes in Mobile Technologies Identify Relevant Analytics for CIGNA
Stakeholders
Planned ApproachPlanned Approach
CIGNA-14
Steven DemurjianSteven Demurjian Software/HIE Architectures, Access Control
Maifi KhanMaifi Khan Cloud Computing, Real-time Health Care
Monitoring, Wireless Sensor Networks Thomas AgrestaThomas Agresta
Clinical Practice, Analyzing Clinical Data, HIE Michael Belchner Michael Belchner
Pathology Info Systems, HIE, i2b2/Data Analytics
TeamTeam
CIGNA-15
S. Demurjian BMI Research InterestsS. Demurjian BMI Research Interests
Collaborative Extensions to NIST RBAC Collaborative Extensions to NIST RBAC Model When and How Interactions Occur Support PCMH and Collaborative Care
Security for XML Security for XML Medical Standards (HL7 CDA, CCR, etc.) Customize XML Instances Delivered to Users
Health Information ExchangeHealth Information Exchange Architectural Solutions for Interoperability
Medication Management & ReconciliationMedication Management & Reconciliation Android/IOS Apps Linked to MS Health Vault Reconciliation via Harvard’s Smart Platform Working with openMhealth.org
CIGNA-16
M. Khan BMI Research InterestsM. Khan BMI Research Interests
Real-time Monitoring and Preventative HealthcareReal-time Monitoring and Preventative Healthcare Real-time Access of Patients’ Sensor Data Cloud-based Storage Architecture Identification of “Early” Symptoms
Reliability and Troubleshooting of Edge ClientsReliability and Troubleshooting of Edge Clients Troubleshooting Low-power Sensor Devices Real-time Failure Diagnosis
Software Architecture for Self-powered DevicesSoftware Architecture for Self-powered Devices Fail-safe Energy Management Algorithms Energy Harvesting Algorithms
CIGNA-17
Thomas Agresta BMI Research InterestsThomas Agresta BMI Research Interests
Optimal HIT Solutions for Primary CareOptimal HIT Solutions for Primary Care Clinical Decision Support, Patient engagement Health Information Exchange for Care Transitions Organizational structures for supporting Primary Care
Informatics Clinical Informatics Education Clinical Informatics Education
Informatics Educational Methods and Strategies Use of Simulation in Primary Care Education
Virtual patients, families & EMR use in clinical care High- Tech, High-Touch Primary Care
Informatics Tools for Collaboration in Clinical Research Informatics Tools for Collaboration in Clinical Research InformaticsInformatics Secondary Use of Healthcare data for analysis and Secondary Use of Healthcare data for analysis and
researchresearch
CIGNA-18
M. Blechner BMI Research InterestsM. Blechner BMI Research Interests
Health Information ExchangeHealth Information Exchange ““Leveraging An HIE Infrastructure To Build A Leveraging An HIE Infrastructure To Build A
Clinical Research Data Warehouse”Clinical Research Data Warehouse” CICATS pilot grant for system development to capture CICATS pilot grant for system development to capture
clinical data from a Health Information Exchange (HIE) clinical data from a Health Information Exchange (HIE) into a research data warehouse.into a research data warehouse.
Intelligent Tutoring System DevelopmentIntelligent Tutoring System Development Collaborative e-learning environment leveraging Collaborative e-learning environment leveraging
natural language processing and medical ontologies natural language processing and medical ontologies (UMLS) to facilitate concept relationship discovery(UMLS) to facilitate concept relationship discovery
Clinical PathologyClinical Pathology Data warehousing for business and clinical Data warehousing for business and clinical
intelligence in the clinical laboratoryintelligence in the clinical laboratory
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