Smart Grid Challenges for a Health Care Computing Infrastructure

Smart Grid Challenges for a Health Care Computing Infrastructure

Prof. Ellis HorowitzUSC

Presentation at the KACST Smart Grid Workshop

January 8-9, [email protected]

Ellis Horowitz, 2011 1

Can You Guess Who is in the Photo?



Outline

• The Call to Action• The Challenge• The Approach• The Benefits


The United States National Academy of Engineering has defined 14 GRAND CHALLENGESfor future research; I am concentrating on two of them

•Engineering better medicines

•Advance health informatics


Call For Action

The European Commission and e-Health• The European Union is moving

towards eHealth• “e-Health refers to the use of

modern information and communication technologies to meet needs of citizens, patients, healthcare professionals, healthcare providers, and policy makers.”

• Specific objectives are – to create an electronic health record

architecture by supporting the exchange of information and standardization;

– to set up health information networks between points of care to coordinate reactions to health threats;

– to ensure online health services such as information on healthy living and illness prevention; and

– to develop teleconsultation, ePrescribing, eReferral and eReimbursement capabilities.


Health Informatics as a Challenge to Computer Scientists

• Physicians– Medical records today are plagued by mixtures of old technologies (paper) with new

ones (digital)– Computerized records are often incompatible, using different programs for different

kinds of data, often within a given hospital– Sharing information over regional, national, or global networks is complicated by

differences in computer systems and data recording rules

• Medical researchers– Individual data is trapped in doctor’s offices, not available for analysis– Clinical data across wide populations is difficult or impossible to obtain– The amount of data being generated by researchers is increasing faster than any

individual can absorb it.

• General Problem– Existing information resides on legacy systems and as a result, it is not available when,

where, or in the manner it is needed. – This data includes test results, images, medication and allergy information, chart notes

or entire charts, and details about the care process itself.


Two Approaches


Mobile Devices Can Play a RoleIndividuals process/act/enter data


Our actionsSelf-reporting

Biking, hiking, running, eating

distance traveled, calories burned, food consumed

Personal data repository

What is missing is the integration of this information with analysistools to make sense out of what is happening


This iPhone app from HealthCalc determines risk for type2 diabetes and hypertension; it tracks heart, sugar, fitness and diet; It monitors blood pressure, blood glucose, body weight, and workout datahttp://www.healthstatus.com/healthcalc

Personal mobile health apps exist today but are limited in scope because they are not tied to back-end systems

Ideal Weight Blood Alcohol Calories Burned

Smart Phones Can Be Used to Communicate Public Health Issues


Health information can be pushed to theindividual; e.g.communicating with the public about infectious diseases, cancer prevention and environmental health;

Here is a current app fromThe Johns Hopkins Bloomberg School of Public Health

http://www.apple.com/downloads/dashboard/news/publichealthwidget.html

http://www.apple.com/downloads/dashboard/news/publichealthwidget.html

Smart Phones Impacting RehabilitationLength:1 minute


Video produced by Apple and RehabCarehttp://www.apple.com/ipad/business/profiles/rehabcare/

On-Body Sensors are Breaking New Ground


"Body Computing" refers to an implanted wireless device, which can transmit up-to-the-second physiologic data to physicians, patients, and patients' loved ones.

USC's Center for Body Computingis a place that works with medicaldevice companies to developproducts that capture and presentpatient’ physiological data

E.g. tracking100,000 patients whocurrently have pacemakers and/ordefibrillators implanted showedthat mortality rates were halvedwhen wireless tracking was included

Body Sensor NetworksGE Wireless Patient Monitoring

Length:1.5 minutes


http://www.youtube.com/watch?v=K15f1MqB-8U

http://www.youtube.com/watch?v=K15f1MqB-8U

What is Needed -A Backend System and Set of Services

• A flexible backend system and set of services will enable the development of a wide variety of applications for public health• Our research: to explore and develop architecture, services, APIs and best

practices through the development of prototypes and pilot projects• Goals of the design include the ability to:

– specialize applications to specific populations, diseases, and treatment protocols– facilitate research in methodology and treatment– gather usage data automatically for evaluation, iterative improvements– perform comparative effectiveness studies– explore protocols across diseases, demographics

• Essential is the need to balance privacy protection with data sharing


Mobile Personal SensingProposed System for Backend Processing


Configuration User

Information

Automated CaptureTime-

Location Trace

GPS/WiFiModifiers

Promptedor Manual

Capture

Personal Data

Stream

LocationProximityActivitySocial

Context

User Personalization

DatabaseRetrieval &

Storage

Geolocation Data

Scientific Models

Health/Wellness

StatisticalTools

Advocacy

ServerProcessing

Applications, Analysis

Smart DeviceProcessing

Smart Device Capture

A joint research effort between USC and UCLA


http://openmhealth.orgSee also, www.sciencemag.org, Nov. 2010

Personal data streamswill create a living recordof an individuals healthstatus;

Data will automatically bestamped and geocoded;

Processed and filtered datastreams would become part of an emerging databaseof health facts of the nation

Support for iPhones and Android phone

http://openmhealth.org/

http://www.sciencemag.org/

The Challenge of Security and Privacy of Medical Data

• Security, means not only “locked away” but also guarded against misuse, unauthorized access, malicious alterations, and the consequences of computer failure and malfunction.

– A key factor is establishing and verifying the identity of users and their authority to access specific systems and patient data.

• Privacy, means to help make patient-related data available at the point of need to those, and only to those, with a need to know.

– The patients have the right to restrict access to their information – When used outside a legitimate patient–professional care relationship, health data must

be made anonymous to help prevent identification of the patient. • Trust, means to help ensure that all data recorded, stored, retrieved, and presented is in

context, accurate, timely, and relevant— and may be relied upon in making decisions that are literally matters of life or death.

– Requests for action must happen, quickly, accurately, and completely, with appropriate confirmations.


An Architectural ApproachThe Personal Data Vault


Personal Data Vaults as smart phone apps already exist;

All use a centralized database to storeand retrieved backed up data; the database should be stored in the cloud

What is needed is to provide the owner with the ability to formulate rules that control who has access to the data;

Rules would include the ability to specify different policies for different groups, time intervals, geo-coded data, facilitating sharing

In this way third party services can access user data streams for analysis and clinical care

One Sample PrototypeThe Challenge of User Input


- an application that lets people collect data about themselves and their surroundings using Twitter

- YFD uses this short message paradigm with a simple syntax, which allows users to

- explore their daily habits via an online visual interface. - track short-term goals and keep a long-term data journal by intertwining data collection with everyday activity.

the main purpose of these tools is to provide users with a way to explore and interact with their data, and inturn, make conclusions about their day-to-day activities

Visualization Tools take user data and display trends


Geo-Location Is Becoming Commonplace


Yahoo’s Fire Eagle allows anywebsite to query your location;

Google’s Latitude, “see where your friends are right now

Users must be able to determine for themselveswhen, how and to what extent locationinformation about them is communicated toothers

Research ChallengesTechnological and Methodological

• Technological– Human computer interfaces that facilitate data entry– Data visualization tools for personal use– Interoperability across smart phones and back-end systems– Security systems to prevent unauthorized access

• Methodological– Designing systems that encourage people to enter

information– Assure individuals that their data is used only with their

permission– Create open systems so third parties can participate


The Benefits


• There are now more than 5 billion mobile phone subscribers worldwide

• There is now the opportunity to place a diagnostic and communications tool in the hands of nearly everyone on the planet.

• A smart phone that receives information from simple sensors worn inconspicuously on the body or from data entered into a smart phone by a patient,can

- help individuals monitor a vast array of conditions including how well their drugs are working and to recognize early signs of disease facilitatingearly intervention.

- provide a powerful diagnostic and investigative toolfor researchers to study and analyze health issues over broad populations

Documents

Smart Grid Challenges for a Health Care Computing Infrastructure