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MOBILE HEALTH LANDSCAPE & STANDARDSHL7 Plenary-WGM PAYERS SUMMIT @ ChicagoSep, 2014Presented by:Gora Datta gora@cal2cal.com 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 CAL2CAL Corporation1 Group Chairman & CEO CAL2CAL Corporation Sep 2014
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 Summary2 CAL2CAL CorporationSep 2014
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% ofthe world’s population (7.3B ) has mobile /Documents/facts/ICTFactsFigures2014-e.pdf 80% of the world’s population (as of 2006) lives withinrange of a cellular network, (40% in 2000).3 CAL2CAL CorporationSep 2014
MOBILE HEALTH STAKEHOLDERSSource: HL7 Mobile Health Newsletter V1Is14Sep 2014
Mobile Health – what is it? Extension of the EHR? PHR on a mobile platform? Consumer wellness/fitness apps? “new” way to access/provide care MOBILE HEALTH All of the above! Not a vertical domain/sector But a horizontal framework that cuts across andimpacts all health care domains Scenarios illustrating the scope andbenefits of Mobile Health5 CAL2CAL CorporationSep 2014
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 rangeof 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 tohard-to-reach families Public/Population Health Disaster Management to PH outreach6Sep 2014
HL7 MOBILE HEALTH WG MISSION The HL7 Mobile Health WorkGroup creates and promoteshealth information technologystandards and frameworks formobile health. http://wiki.hl7.org/index.php?title Mobile Health7Sep 2014
HL7 MOBILE HEALTH WG CHARTER Identify (and develop, as applicable) data standards andfunctional requirements that are specific to the mobilehealth environment Identify and promote mobile health concepts forinteroperability as adopted and adapted for use in themobile environment Coordinate and cooperate with other groups interestedin using mobile health to promote health, wellness,public health, clinical, social media, and other settings. Provide a forum where HL7 members and stakeholderscollaborate in standardizing to enable the secureexchange, storage, analysis, and transmission of dataand information for mobile applications and/or mobiledevices.8Sep 2014
MH WG 2014-16 ROADMAP9 CAL2CAL CorporationSep 2014
Emerging HL7 MH standards HL7 (emerging) MH Standards: Messaging mFHAST - mobile Framework for Healthcare Adoptionof SMS type Technologies FHIRsidechat Functional Model MHR-S (mobile health record –system) FunctionalProfile Document Architecture Meds-on-FHIR Services FHIRframe10 CAL2CAL CorporationSep 2014
DEEP DIVE: HL7 MH Activities#1: MH Messaging Standards: short but structured chucks for informationfor rapid turnaround Morse code of FHIR resources? MH Functional Models/Profiles: “apps apps all around but non talks withanother” MH Functional Profile derived from both theEHR-S FM and the PHR-S FM11 CAL2CAL CorporationSep 2014
DEEP DIVE: HL7 MH Activities#2: Document Architecture (CDA) impact you are on the road, in a foreign city (likeChicago!), out of your meds You go the local pharmacy, zap (NFC) yourmobile device (smart phone) with the kiosk the kiosk prints out your prescription (in thelocal language, if applicable) You get your meds12 CAL2CAL CorporationSep 2014
DEEP DIVE: HL7 MH Activities#3: Services: many possibilities .patient education is thefirst that comes to mind."Info Button" servicerequest, appointment service request, etc. FHIRframe a set of standardized Application ProgrammingInterface (API) libraries and companion SoftwareDevelopment Kits (SDKs) to facilitate theimplementation of mobile health applications in aplatform-agnostic manner based on HL7 FHIR (FastHealthcare Interoperability Resources) standards.13 CAL2CAL CorporationSep 2014
IEEE 11073 Standards (recognized by FDA)ISO/IEEE 11073 standard family defines parts of a system, with which it is possible, toexchange and evaluate vital signs data between different medical devices, as well asremote control these devices.1. IEEE 11073-10101 "Health informatics—Point-of-care medicaldevice communication—Part 10101: Nomenclature“2. IEEE 11073-10201 “Health informatics—Point-of-care medicaldevice communication—Domain information model”3. IEEE 11073- 20101 “Health informatics—Point-of-care medicaldevice communication—Application profile—Base standard”4. IEEE 11073-20601 “Health informatics—Personal health devicecommunication—Part 20601: Application profile—Optimizedexchange protocol”5. IEEE 11073-20601a-2010 “Health informatics—Personal healthdevice communication—Part 20601: Application profile—Optimizedexchange protocol”6. IEEE 11073-10408 “Health informatics—Personal health devicecommunication—Part 10408: Device specialization—Thermometer”14 CAL2CAL CorporationSep 2014
IEEE 11073 Standards (cont.)7. IEEE 11073-10415 “Health informatics—Personal health devicecommunication—Part 10415: Device specialization—Weighing scale”8. IEEE 11073-10404 “Health informatics—Personal health devicecommunication—Part 10404: Device specialization—Pulse oximeter”9. IEEE 11073-10421-2010 “Health informatics—Personal health devicecommunication Part 10421: Device specialization—Peak expiratory flowmonitor (peak flow)”10. IEEE 11073-10406-2011 “Health informatics—Personal health devicecommunication Part 10406: Device specialization—Basicelectrocardiograph (ECG) (1- to 3-lead ECG)”11. IEEE 11073-10407 “IEEE ISO/IEEE Health informatics—Personalhealth device communication—Part 10407: Device specialization—Bloodpressure monitor”12. IEEE 11073-10417 “IEEE ISO/IEEE Health informatics—Personalhealth device communication—Part 10417: Device specialization—Glucose meter”15 CAL2CAL CorporationSep 2014
USA: Mobile Health Govt. Players FDA Mobile Medical Application (MMA) GuidanceRF Wireless Technology in Medical Devices GuidanceUnique Device Identification (UDI)FDASIA (ONC, FCC FDA: Safety & Innovation Act) FCC FCC Smart Phone Security Guidelines FCC Health FTC Mobile Privacy DisclosuresHHS Mobile Device Privacy & Security GuidelinesOCR (Office of Civil Rights) – HIPAA GuidelinesHouse Panel (Energy & Commerce Committee)NIST Mobile Apps Security vetting (draft)US Meaningful Use EHR ProgramTelehealthNIH Mobile Health Grants CAL2CAL Corporation16Sep 2014
US National Quality Strategy Priorities Work with communities to promote wide use of bestpractices to enable healthy living and well-being. Promote the most effective prevention, treatment, andintervention 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.17 CAL2CAL CorporationSep 2014
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 withpublic 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, patientaccess to self-management tools, access to comprehensive patient dataand improving population health outcomes.18 CAL2CAL CorporationSep 2014
HEALTHCARE IN THE 21st CENTURY TMNext generation: “iPAD ” kidsBlurred Lines: Impact of Social MediaAre we there yet: I want it NOWTake Charge: Consumer HealthGene to genes: from Star-Trek (Gene Roddenberry)to Genetic HealthBack to the Future: longitudinal Health RecordLive long & prosper: from provenance topreservationEmerging Areas: IoT, Big DATA, Open DataGlobal Village: Urban, Rural, Remote, Underserved“Check please”: Mobile Payment19 CAL2CAL CorporationSep 2014
In SUMMARY! MOBILE HEALTH Not a vertical domain But a horizontal framework that cuts across andimpacts all health care domains As we transition to a digital record framework;(access, capture, dissemination of information) useof Mobile Health will continue to rise As Mobile Devices become more and moreubiquitous, accessing our Health Information is onlya few tap/swipe away! TRULY A DISRUPTIVE REVOLUTION!20 CAL2CAL CorporationSep 2014
THANK YOUgora@cal2cal.com21 CAL2CAL CorporationSep 2014
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 -
