Agenda

1
Agenda Objective

• Stepstone Connected Health project update ( BOCA
  )
• Connected Health Architecture hi level overview
• Vision
• Mapping to projects ( existing potential )
• Scenario example

2
Stepstone/Continua Project (a Connected Health
Reference Implementation) 2Q2009
Content
Added
Pressures

• Set up Continua projects with namespace
  org.openhealthtools.stepstone.phd
• Restructure and create OHT Build based on
  Eclipse RT pre-req
• Add device support
• Glucose, Med Monitor, Weight
• Cookbook documentation for creating generic
  and Continua builds

• Intercept requirements from OHT Projects
• CUI
• IHE Profiles
• Terminology Service
• Understand relationship with OHT Platform
  Project
• Understand relationship with OHT Architecture
  Project
• Continua Dev Kit
• Continua V2

Deleted Changed

• SODA (DeviceKit) Impl of ASN-1 protocol

Dependencies
Packaging Editions

• SODA components to move from Eclipse OHF to
  Eclipse Runtime

.

• 0.4.0 to match IHE Profiles project and indicate
  pre-alpha status

Milestones

• Dec 08 Provisioned OHT sub project
• May release (0.4.0)

Statistics

• 1 new contributor
• 284 revisions

3
Stepstone/Continua
2Q10
1Q10
Continua Dev-Kit
OHT Security Integration,
4Q09
Stepstone Dev-Kit Refactoring
3Q09
First Iteration on Continua V2 WAN/API (WS-I
Basic) Initial OHT Release with Continua Support.
Additional device support
2Q09
4
Connected Health Architecture - 30k feet
Device manager (EDGE)
Remote Monitoring Server
Health Systems
Medical Devices
Device Interfaces
Server Interfaces
Application
Controller
Telehealth / care management applications,
aggregate data, event processing, format/route to
health systems, services
Devices to provide personal health data
EMRs, PHRs, clinical trials, analytics, etc.
Collect device data
5
Connected Health Stepstone today
Device manager (EDGE)
Remote Monitoring Server
Health Systems
Medical Devices
Device Interfaces
Server Interfaces
Application
EDGE Interfaces
System Interfaces
Application
Controller
SODA

• Supporting Continua (v2 EDGE is WIP , IHE/HL7
  CDA)
• Liteweight, generic user application
• Uses IHE Profiles project

Devices to provide personal health data
EMRs, PHRs, clinical trials, analytics, etc.

• Platform to support multiple device interfaces
• Supports Continua (IEEE,USB,Bluetooth)
• No user application
• Platforms

Eclipse project
6
Implement Scenarios Using OHT Projects, Refactor

• Project Task USES .
• 1. Medical Device Integration (Stepstone)
• Consumer connected health devices
• Non medical devices (e.g. RFID, motion, tracking,
  ID readers, alarms, climate control)
• Standard and propriety
• Extend to Clinical?
• 2. Applications (CUI, Security)
• Information rendering on access devices including
  tablets, smart phones, soft AHD's, etc
• Guidelines
• Open alternatives to Silverlight implementation
• Consumer Control Dashboard
• Context-driven UI (e,g, Gadget/Widget
  composition)
• 3. Edge Controllers (Stepstone)
• dedicated "hard" AHD
• soft/mobile AHD
• 4. Data Sharing and Access (IHE, Security,
  Tooling)
• IHE profiles
• EHR/EMR sharing and access
• Consumer record access/sharing, and PHRs (Google,
  Healthvault)

7
Scenario example Chronic Disease Mgmt

• Chronic disease accounts for 75 of healthcare
  costs ( USA )
• Setting 52 year old male with adult-onset
  diabetes mellitus (type II diabetes) on two oral
  medications for diabetes
• Metformin, which reduces glucose production by
  the liver. Dose 850 mg tablet taken orally once
  a day.
• Repaglinide (Prandin), which stimulates insulin
  secretion by the pancreas. Dose 1 mg tablet
  taken orally before each meal.
• Patient is overweight to obese and was put on a
  diet 2 weeks ago by his physician.
• Daily monitoring of weight was recommended by the
  physician.
• Patient provided with the following devices
• Glucometer
• Weight scale
• Medication pack
• In morning patient reminded to take meds,
  readings (weight glucose ).
• Devices upload data to device manager which
  transmits to remote monitoring server
• Patient views own data via Portal application,
  PHR, diabetes care management application to
  better manage their disease.
• Care provider ( e.g. Patient centered medical
  home model, telehealth nurse ) has immediate
  access to patient data and can act.
• E.g. no readings from this patient, not taking
  meds, glucose readings irregular ? contact
  patient / arrange doctor visit
• Provider / Payer manages care program across a
  set of chronic disease patients
• Device data packaged and made available in
  physicians system prior to next scheduled
  appointment for this patient.

8
Scenario Messaging / Value

• Chronic diseases typically require monitoring of
  multiple parameters.
• Knowing that relevant information related to his
  health condition is reliably captured for review
  is very valuable. The electronic record is far
  superior to the paper diary he used before. The
  information is more complete and accurate.
• Concentrating all this information in one health
  management software provides a nice overview and
  keeps track of his progress all in one place.
• Therapy decisions require contextual information,
  i.e., putting data in context. Example Weight
  reduction brings the additional benefits of lower
  average glucose levels as well as lower blood
  pressures.
• Accurate information takes out the guesswork for
  the physician. Together, patient and physician
  can make informed therapy decisions and lifestyle
  adjustments.
• Good data makes discussions with the physician
  much more effective and productive. This shortens
  consultations.
• Patient feels involved and empowered because he
  more clearly understands the interactions of
  food, activity, medication, etc.
• The system enables synchronization with a
  personal health record as well as an electronic
  health record for a complete end-to-end solution
  connecting the patient to the physician, as well
  as his support network, improving the quality of
  data, and ultimately the quality of care.
• Outreach to patient / intervention prior to acute
  care episode benefits patient and less costly to
  the system

9
Takeaways

• Stepstone architecture open, SOA based
• Refactor into subprojects
• Easily combine components into solutions
• Enable more robust application projects
• Platform for support for multiple interface
  requirements
• Using IHE Profiles project code today
• Looking ahead
• CDA modeling project tooling
• Security
• CUI