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Information Technology Laboratory, National Institute of Standards and Technology
Toward Smart Healthcare
Ram D. Sriram
Chief, Software and Systems Division
URL: http://www.nist.gov/itl/ssd/
Information Technology Laboratory, National Institute of Standards and Technology
HEALTH CARE
Levels of Biological Information
Hood
BIOSCIENCES
Ecologies
Societies/Populations
Individuals
Organs
Tissues
Cells
Protein and gene networks
Protein interaction networks
Protein
mRNA
DNA
Information Technology Laboratory, National Institute of Standards and Technology
“Genomics”
“Transcriptomics”
“Proteomics”
“Metabolomics”
“Cellomics”
From Genomics to Phenotypes
Lucasio
Information Technology Laboratory, National Institute of Standards and Technology
2D gel
electrophoresis
1975 1990
ESI & MALDI
1980
Gene cloning
Sequencing
1994
Complex mixture analysis
LC-MS(/MS)
Chip-based
approaches 1996
1944
DNA
Genetic
material
1953
DNA
structure
1980 1990 2000 1960 1970
Recombinant
technology
Automated
sequencing
High-throughput at Genome scale,
„data rich‟ biology
1995
Haemophilus
influenzae
first genome sequenced 2001
Human genome
sequenced
1931
Non-equilibrium
thermodynamics
1952
Self-
organization
1957 1980 1990 1970
Feedback regulation
In metabolism
Analog simulation,
bioenergetics, lac operon
Large-scale simulators
of metabolic dissipative
structures, energy coupling MAC and BST
2000
„data poor‟ in silico biology,
models of viruses, red blood cell
Genome-scale models and analysis,
large-scale kinetic models
Proteomics
Genomics
BioAnalysis
Computer Science
Systems Biology
(Medicine)
1936
Turing machines
1956
Artificial
Intelligence
1960 Programming
Languages
1980
Commercial
Database
1974
Internet
Bioinformatics
mid 1980
1990
Major advances in AI
2000
Engineering
1943
Finite element
analysis
1950 Systems
engineering
1960
Cybernetics Integrated Circuits
1970 1980
Computational FEM
Mainframe
Computers
1990 VLSI CAD/CAD/
Geometry
Large scale product Process simulation
PDM/Knowl. based Engineering
2000 MEMS
Nano
PLM
PC’S
Supercomputers
Multi-scale Domain
Simulation
Bernhard O. Palsson
Information Technology Laboratory, National Institute of Standards and Technology
Future
Health
Vision Evidence-Based
Healthcare Continuum of Care
Advances
in
Healthcare
Practice Disease
Management
Advances Making Future Health Vision Attainable
Courtesy: Jack Corley
Advances in
Healthcare
Technology Human Genome
Project
Pharmaceuticals
and
Nutraceuticals
Medical
Devices
mPCD
Networking
Communications
and Imaging
Advances in
Computing,
Imaging, and
Information
Technology
Speed and
Storage
Internet-based
Software
Courtesy: Fred Hosea, Ph.D. Program Director Clinical Technology
27
Periodic
Cart
READINESS
CHECK (W/LAN
access reqd)
42
1
Users are
trained on
service model
and contact #
4
SSS
opens Remedy
Incident record
16
BMET
ONSITE
ASSESSMENT
24
HOT SWAP
POOL
Prep, Config,
Charge, Store,
Repair,
Warranty,
Restore
13
BMET
closes any
REMAINING
task(s)
11
IT
Close INCIDENT
RECORD
12
IT may escalate,
involve Vendor,or
refer to Biomed for
further action
10
IT
Resolves?
8
28
Involve
Vendor
as needed
21
Activate & verify
Cart performance.
2
VRU pick on
IT Helpdesk #
or HD forwards
call to SSS
Some users may call KPIT
HelpDesk with cart
problems
IT Depot
Biomed Shop
Sept 11, 2006
17
FIX or
SWAP
unit ?
20
Retrieve Hot Swap
Cart from closet
26
HotSwap
Restore to Closet
completed.
Close CART
RESTORE task
19
CART Assembly
function restored.
Close CART
REPAIR task/
record.
Shop/Depot
relationship &
procedures will
probably vary
from facility to
facility,
depending on
local setups,
distances, and
schedules, but
will be
standardized
over time.
Biomed Shop:
Maintain stock of CART parts
Have 1 spare laptop?
“Down” unit becomes
new hot swap
3
Note: This is a generic model for service management. Actual elements and
sequences may vary between service areas and regions.
22
Configure laptop
for location, for
printing.
Close CART
SWAP task
25
Repair failed
laptop
Return fixed laptop
to Hot Swap pool
Update Asset
records
23
Restore
HOT SWAP
readiness within
(24?) hrs.
18
Fix cart
COMPONENT
problem
Battery
Barcode reader
Elevation motor
Wheels
Keyboard
Mouse
Monitor
Infection control?
Carts should have a
service tag with
contact info
Eventual goal: track both Biomed and Remedy ref. #s in both systems
Remedy record may consist of several subtasks and is not considered
closed until Hot Swap readiness is restore.d
Numbering of steps is for reference purposes and does not
necessarily indicate temporal sequence or relationship.
5
Initial
Triage
6
Resolution
By
Quick Fixes or
Appication consult
14
Dispatch
BIOMED to site
9
Handoff to
IT
7
Close Remedy
Incident Record
15
IT Triage
Laptop
Problem?
SW
Problem?
Network,
Wireless
Problem?
Optional phone consult
Biomed / IT Peer or Help Desk
As needed
Fix
SWAP
8
Assign
Overview of Production Support Model for HC Wireless Cart - rev. 12
BIOMED VENDORIT/Biomed
Coord
KEY
IT
15
Site Suppt
Specialist
3
User calls SSS
(Site Support Spec)
and describes
problem
Smart Healthcare • Smart Devices • Smart Networks • Smart Processes • Smart EMRs • Smart Medicine • Smart Organizations • Smart Collaborations • Smart Society • Smart Planet
Information Technology Laboratory, National Institute of Standards and Technology 7
Plan
Build
Run
Life
cycl
e M
an
agem
ent I
nfr
astr
uct
ure
•System lifecycle •Tech assessment •Design consultation •Standards consultation •Contract consultation •Systems integration
•Planned maintenance •On-call, Dispatch services •Break/fix •Hazard alerts, recalls •Patches, upgrades •Asset retirement
•Facility upgrades •Equipment planning •Deployment, staging •Testing, safety •Asset management
20th Century Medicine: Stand-alone Devices
ENTERPRISE STRATEGY
• HealthConnect integration
• Simulations, prototyping
• System/device testing, certification
• New allied provider sites • ITIL compliance
• ICE – Integrated Clinical Environments
• Meaningful Use compliance
• Major upgrades, conversions: IPv6, ICD-10, HL7 v3
• Home care technologies, services
• Self-monitoring, behavioral support
• Family support technologies
• PHRs
• Telehealth
• Telemedicine
• Nanotechnologies
• Genomics
• Distributed sites of member care • mobile clinics
• ambulance
• gym
• retail
• travel
• worksite pods
• skilled nursing facilities
• assisted living
• New Hospitals
• Robotics
• OR of the future
• Interoperable clinical systems
• Clinical decision-support
• Clinical process re-engineering
21st Century Medicine: Net-New Lifecycle Requirements
