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Analysis model for personal Analysis model for personal eHealth solutions and eHealth solutions and servicesservices
EFMI Special Topic Conference
Reykjavik, 4 June 2010
Juha Mykkänen*, Mika Tuomainen, Irmeli Luukkonen, Timo Itälä
* HIS R&D Unit
School of Computing, Kuopio campus
University of Eastern Finland
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Outline•Introduction:
– the MyWellbeing project
– needs for analysis models of personal eServices for wellbeing
•Materials and methods
•Results: the analysis model
•Discussion and conclusions
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Speaker background• Juha Mykkänen, PhD, researcher
• University of Eastern Finland, Health Information Systems R&D Unit
• Board member in Finnish Social and Health Informatics Association, HL7 Finland vice chair (co-chair common services & IHE SIG), HL7 SOA Ambassador, University of Eastern Finland representative in IMIA WG HIS
• Projects developing and applying SOA and integration approaches– SOLEA: ”Agile Enterprise Architecture using SOA and BPM” 2008-2011
– SerAPI: SOA and integration of healthcare applications 2004-2007
– OmaHyvinvointi (MyWellbeing): personal wellness management 2008-2010
– PlugIT: healthcare application integration 2001-2004
– eKat / guidelines for national eBooking of health services 2008
– Healthcare services specification project (HSSP) / HL7 and OMG, 2005-
– Integrating the Healthcare Enterprise - IHE.fi 2008-
– National project for social services IT - Tikesos 2006-2011
– China/Finland eHealth partnership + other projects in Shanghai 2004-2008
– Various HL7 Finland and web services standards specifications
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the MyWellbeing project (Omahyvinvointi)• a national R&D project in Finland on citizen-centric wellness
management concept – ”coper” / ”pärjäin”
• includes various viewpoints– 2 case groups: citizens retiring from work, families having a baby
– concept development: generic dual model between service providers and citizens
– infrastructure and architecture: relationship of patient-owned solutions to service provider systems, integration
– citizen-centric needs analysis and future scenarios for eWellbeing
– business models and evaluation
• Six universities and various companies in Finland, coordinated by university of Turku
– University of Eastern Finland focuses on connectivity, architectures, information landscape and needs analysis of citizens, applications of Personal Health Records
Why an analysis model for personal eServices?•patient / individual empowerment increasingly required to support improving health and transition towards high quality and affordable health services
•increasingly, personal information management solutions and eServices do not live in isolation but must be integrated, e.g.
– personal health record systems
– citizen eBooking
– patient/provider communication systems
– personalised decision support and knowledge systems
•selection or development of eServices and integrated suites requires systematic analysis models
Materials and methods•Goal: construct a straightforward but comprehensive tool
for evaluation and comparison of personal wellbeing management solutions
1. standards and specifications for PHR functions and content
2. central quality attributes added (portability etc.)
3. information analysis and standards evaluation models
4. refinements in a joint workshop
– goals: simple use, comprehensive feature description, promote identification of gaps and potential feature combinations for integrated offerings
– partial models found in literature, included and referenced in the new model for MANY considerations
Results: the analysis model - overview
•33 features grouped in seven categories
1.administrative
2.basic information (overview)
3.Information aspects
4.Functional capabilities
5.Application architecture, interoperability and security
6.Business model and development approach
7.Other considerations
Administrative and basic information features
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Administrative
Data collector Names of data collector and analyser
Collection time Date or date range of data collection
Collection methods References to literature or web sources, names of experts or workshops, explanation of try-outs
Basic information
Name Name of product, service or project
Provider Provider(s) of service or product
Scope Date or date range of data collection
Lifecycle phase Availability, restrictions and fees, known users, phase of development (if prototype)
References Links to actual service home page or documenctation
Information aspects
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Information features
Personal information contents
Personal information entities or elements, level of structure, formats
Information ownership
Individual ownership or view to provider / professional owned information or other
Personal information sources
self-entered, health service providers, measurement information sources etc.
Knowledge contents and sources
sources and contents of knowledge, links between personal information and knowledge libraries, health search engines, etc.
Service information contents and sources
sources and contents of information about wellbeing service offerings: service directories, eligibility, their links to personal information
Format and structure
structural level and formats supported: e.g. scanned documents, levels of structured text, structured documets or data elements, possible links to formalised ontologies
Related information analysis model
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Authority
Service producers
Peers
Structure
Health professional
I or Famliy
Actor
Content(what kind?)
”Nice to know”
UserSource
Context (Associations)
Paper-based
Displaystructure
(html, cda r1)
Picture (jpg, pdf..)
Text(txt, doc)
Contentstructure
(xml, cda r2)
Ontology-based (semantic web)
Information about
Services
Knowledge of health
and wellbeing
Input type
Manual
Automated
Community shared
Personal
Information
Toivanen M, Mykkänen J, Korpela M. Activity-Driven Information Analysis - Designing personal ubiquitous health and wellbeing systems. In: Ubi-Health'10 - International Workshop on Ubiquitous Healthcare and Supporting Technologies 2010, Shaghai, 31 May - 2 June, p. to appear. 2010.
Functional capability analysis 1
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Functional capability features
Main functions list and description of main functions including content management, access management, sending, search, networking, information transfes (upload / download / measurement / export), management of family members’ information, management of historical / current information
Capture, maintain and render functions
data capture and maintenance mechanisms, rendering (different views, export, printing, screening, access granting for external individuals), both manual and automated
Interacting with service provider organizations
interaction with service providers, e.g. eBooking, payments, preliminary data for encounters, appointment reminders etc.
Functional capability analysis 2
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Functional capability features
Interacting with professionals
secure communication / email with professionals, expert advice services etc.
Community engagement functions
Peer-to-peer or other services fpr the formation of and engagement in virtual communities, forums, social media services
Knowledge service functions
interpreting medical information, individual-oriented decision support, risk assessments
Identification management
federated or service-specific user identification and authentication mechanisms, or anonymous services
Information protection and access management functions
granting access to records in addition to rendering (sending, printing), encryption for unsecured media
Functional model – standard used as basis
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HL7 2007. HL7 Personal Health Record Systems Functional Model, Release 1, Draft Standard for Trial Use, HL7 EHR Technical Committee, November 2007.
Architecture, interoperability and security 1
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Architecture, interoperability and security
User interfaces and applications
e.g. PC applications, USB memory key apps, office applications, scanners, OCR applications, mobile or PDA applications, web user interfaces, measurement instruments, main distributed services, required installations or access to networks
Data storage -data storage such as CD-ROM, USB memory key, data archiving and back-up, databases used over network or used locally, data storage shared by multiple applications or specific to each component, local or networked directories or file folders, supported file formats (for storage, import and export)
Architecture, interoperability and security 2
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Architecture, interoperability and security
Interoperability and interfaces
-data communications-shared data interfaces, service integration or user integration between applications or components-interoperability standards and interface technologies -content interoperability standards such as CCR, CDA and implementation guides, CCD, IHE XPHR, Continua personal health monitoring reports-device interface connections and standards such as ISO/IEEE 11073
Security -confidentiality classification, legal and regulatory compliance, controls for privacy, identity and access management (including authorisation, access privileges, sign-on, authentication), physical data and device protection, security incident management, service continuity, intrusion detection, emergency response, patch management, cryptographic solutions, information integrity controls, resilience, security logging
Business model and development approach
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Business model and development approach
Service providers and provision model
examples: one vendor for the service, combinations of platform & application & knowledge & health or wellbeing service providers, eligibility criteria, tools for component / application providers; required agreements between different actors
Development model
commercial products, open developer communications, licencing models
Fee model and other benefits
-funding and invoicing models: consumer fees, employer fees, insurer fees, healthcare service provider fees, portal provider fees, advertisements-main benefits for users, payers, participants (including non-monetary benefits, right to use information, social benefit, research)
Others
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Other considerations
Definition of the product or service by the provider
quote from documentation or advertising (not for pseudonymised or anonymised evaluations)
Evaluator observations on the use of the solution
Evaluator observations – usability, efficiency etc.
Other observations comparative information to other solutions, information about implementations
Analysis model feedback
for further development of the analysis model
Conclusions•comprehensive model – yes
– incorporates many existing models for analysis
– supported design and analysis of new concepts and solutions
•straightforward model – no!
– many of 33 considerations could require laborious analysis
– but no agreement on which aspects should be left out or diminished – so this must be situation-specific
•several evaluations have been performed (not presented here)
– current model includes refinements from this use
– the model could also be used to reverse-engineer personal eHealth solutions – publication of evaluations must be pseudonymised or anonymised
•many detailed considerations should be more closely studied as critical success factors for personal eHealth solutions
Takk fyrir / Kiitos
additional informationhttp://www.it.abo.fi/cofi/omahyvinvointi/index.php?id=70
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“All old sayings have something in them”-Icelandic proverb quote
