HL7 Mobile Health Work Group Joint with EHR-S FM

F2F WGM January 21, 2014 @ San Antonio

Attendees:

Gora Datta

Matt Graham

Harry Rhodes

Gary Dickinson

John Ritter

Diana Warner

Don Mon

Hetty Kahn

Stephen Hufnagel

Tim McKay

Pat VanDyke

James Baker

Roel Barelds

Patrick Cannady

Steve Daviss

Javon Hyland

Iikon Kim

Jim Kretz

Mitra Rocca

Jennifer Trajkovski

Byoung-Kee Yi

Tuesday Q1- 9:00 - 10:30am (90 Minutes)

  • Introduction & General Update – Gora Datta
  • Gora reviewed the make-up the WG. Combination of Members and Non-members. This group is more of a horizontal group instead of a vertical group

Mission: create and promotes health information technology standards and frameworks for mobile health.

HL7 Mobile Health WG Charter:

  • Identify (and develop, as applicable) data standards and functional requirements that are specific to the mobile health environment
  • Identify and promote mobile health concepts for interoperability as adopted and adapted for use in the mobile environment
  • Coordinate and cooperate with other groups interested in using mobile health to promote health, wellness, public health, clinical, social media, and other settings.
  • Provide a forum where HL7 members and stakeholders collaborate in standardizing to enable the secure exchange, storage, analysis, and transmission of data and information for mobile applications and/or mobile devices.
  • Review mobile health stakeholders – Technology, Policy, Science, Business, and Society mobile health dimensions and stakeholders
  • Impact of Mobile Health on Standards:
  • Messaging
  • Documentation
  • Functional Model
  • Services
  • Modeling (DAM, DIM)
  • Impacted of MH on other HL7 WGs:
  • Security
  • Usability
  • Affordability
  • Social Media
  • LMIC
  • Interoperability
  • MH scenarios
  • Providers seeking to use many different HIT solutions that are moving around the healthcare enterprise.
  • Point of care delivery is a driver of Mobile Health solutions.
  • Independent living crisis is a driver – creating communication solutions between patient and care team
  • Patient empowerment is driver, it is not clearly defined.” I’ll know it when I see it.’’ Is the common thinking
  • There are over 200.000 mobile apps. These apps do not talk to each other.
  • Tim McKay – Standards for PHR-S Functional Model.
  • Functional aspects do not need to be changed. The functional aspects are easily transferred from PHR to Mobile devices.
  • Recommendation – Create one or more mobile-format functional models
  • Recommendation - Create a profile that controls security across the enterprise.
  • Mobile devices can become significant actors in using services and transmitting
  • Address user behaviors that may affect models and system functionality.
  • Consider “corner cases” points where the devices and information are shared beyond the primary mobile device user.
  • Gora Datta: Next Steps for MHWG work (decide which road to take):
  • Create a MH functional model derived from EHR-FM
  • Create a MH functional model derived from PHR- FM
  • Create a MH Hybrid functional model derived from both EHR-FM and PHR- FM
  • Create a Mobile Health Functional Model

(Need to decide which of these approaches would be a realistic option.)

  • MH standards that will be needed:
  • Messaging
  • Document Architecture
  • Printing out health information in your language
  • Information Governance (Data Governance)
  • Functional Model
  • Do we need a FHIR Framework?
  • Services
  • Modeling (DAM, DIM)

Impact of MH:

  • Security - Social Media
  • Usability - LMIC
  • Affordability - Interoperability

Q&A:

  • Need to consider the pressure to meet conformance models. What are the expectations with regard conformance when developing a MH Model or Profile?
  • Data entry is a very important staging consideration.
  • Location is another factor to consider in MH, with MH you can track the location in the facility.
  • The ability of mobile device share data automatically.
  • The EHR-FM is Release 2 and PHR-FM is Release 1. How do we merge these two Releases into the new MH Model. Should we go straight to Release 3?
  • There already a group (Happtique) that is stepping up to certify Mobile Health systems and apps.
  • Mobile Health and Meaningful Use

Stage 1 (Impact on mobile delivery of care)

  • Provide clinical summaries for patients for each office visit.
  • Patient Education
  • Access to personal

Stage 2 (Impact on mobile delivery of care)

  • Ability to view online
  • Ability to send information to patient as structured data
  • Access to a “Family History” (genetic history)

Q&A:

  • Why do we need a new set of standards for Mobile Health Systems? Why can’t developers simply use EHR-FM or PHR-FM standards in the Mobile Health Systems.
  • A more important issue creating a fabric of trust. How do we place a Good Housekeeping Seal on mobile solutions?
  • The Ubiquitous nature of mobile devices in our society is complicating the healthcare universe. There is a need for a framework
  • Matthew Graham – Mobile Health Update
  • Interoperability Challenge – Most of the members have more than one system
  • There is a need to aggregate and organize individually Identifiabledata into a personal health record from multiple EHR systems.
  • Patient Mobile Services Profile – What the MHWG want to prepare as a solution to the current disparate networks.
  • Define a core set of servicesDefine a core set of services implemented in HL7 standards.
  • Key function points
  • Defined access points
  • Mobile App Security – BOYD
  • Implementation Guides
  • FHIR is looking to the MHWG as an early adopter
  • Greater collaboration between Service Profiles/ EHRs/and PHR systems
  • Working with Health Care Devices for greater interoperability between Mobile and Health care devices.
  • Q&A:
  • Discussion about managing data across the enterprise
  • How do I track by source
  • How do you create patient profiles, reports, outcomes tracking.
  • Lack of consistency in data across systems.
  • Address data requirements for Decision Support Apps.
  • How do I trust the information
  • An important first step is defining and managing information
  • A basic issues is trust, there is a need to create a trust fabric.
  • Management of medications and the creation of medication lists is critical.
  • A group of developers are standing up to create medical apps without a clear under of healthcare systems.
  • Mobile Health should be focusing on creating a Framework

Upcoming 2014 projects

  • MH LMIC Service Framework
  • MHR-S Functional Framework
  • GS1 Pilot
  • FHIR FRAmE