Open Platforms & Innovation using FHIR/SMART

Transcription

1 Open Platforms & Innovation using FHIR/SMART 1

2 Agenda Intros Open Platforms FHIR & CDS Hooks SMART Product & Platforms Patient Providers Researchers 2

3 Intros 3

4 About - Gajen Sunthara Current Lab Medicine + CS Former PIF Health Technologist Director Laboratory Medicine, Health IT & Computer Science Background Former White House Presidential Innovation HHS/ONC/VA/DoD Former Health Technologist United States Digital The White House Director, Innovation Boston Children s & Founder at 1upHealth 4

5 Boston Children s Hospital is ranked the #1 children s hospital by U.S. News & World Report Key Facts: Year Founded 1869 Beds 415 Inpatient Stays ( 14) 24,021 Outpatient Visits ( 14) 581,254 Staff 10,340 Annual Revenue $1.5B Research Funding $225M Startups Launched ~30 Advantages: Leading informatics program World s largest research enterprise at a pediatric center Only innovation program with dedicated developers on staff (50+) ~$10M annual gross licensing revenue 5

6 Open Platforms 6

7 Open Platforms Cloud Based Products / APIs CRUD: Create/Read/Update/Delete EHR Connectivity via Open FHIR APIs Data Model / Mapping 7

8 Clinical Decision Support CDS Hooks 8

9 Substitutable Medical Applications & Reusable Technologies SMART 101 9

10 SMART Manifesto SMART apps are medical provider apps that integrate into diverse EHR systems at the point of care. It uses FHIR open standards for healthcare data, authorization, and UI integration. Apps ecosystem defines how apps launched within the EHR systems Authentication with OpenID Connect Authorization with OAuth 2 Launch patient context from EHR to a SMART app or SMART as a backend service (B2B) 10

11 SMART/FHIR Patient Context Chart Level Orchestration - Patient Specific Data Providers & Researchers Web Application 1

12 Pediatric Growth Chart TriVox Health Dose Range Check (DRC) Blood Pressure Centiles MedSafe 12

13 EHR Writeback Capabilities Pharmacogenomics via CDS Hooks / CDS Providers Example of EHR write back capabilities as a clinical summary note 13

14 SMART/FHIR Backend Services System Context aka B2B Connections User EHR Connectivity via FHIR DB Application 1

15 SMART Backend Services / B2B FHIR Platform External products accessing EHR data via Open Platforms Example: This product searches across a health system by patient name using OAuth2, System resources, & Patient Read Scope 15

16 Interoperable Open Platforms Open standard interoperable platform for products, devices, patients, providers, payers, pharma and researchers 16

17 Product & Platforms Patients 17

18 Circulation is an intuitive cloud-based software platform to bring on-demand convenience and efficiency to the world of NEMT so patients and their health can get moving

19 1upHealth is a clinical and sensor data aggregation platform built on FHIR for patients, providers, and app developers. Patients Providers & Researchers App Developers Data Providers EMR & Health Systems Wearable Sensors HIEs Rx Managers 1upHealth Platform Wearables & Sensors User / Group HL7 FHIR Open Data API Health App Ecosystem A B C Z 1up Patient App 1up Provider App

20 caremap - Apple CareKit based on FHIR Helping patients manage chronic conditions, EMR integration via FHIR

21 Discharge Communications (DisCo) DisCo helps clinicians target at-risk patients for intervention following discharge, reducing rates of preventable readmission Filtering allows higher quality, targeted interventions for atrisk patients Reduces number of follow-up calls while increasing overall effectiveness Improves continuity of care in high risk period Applicable to adult or pediatric patients

22 Vaccine Finder A free, online service where users can search for locations that offer immunizations.

23 Feverprints - ResearchKit on FHIR Feverprints, a national study on body temperature Study normal temperatures in healthy individuals Understand fever patterns ( feverprints ) in various diseases Study effect of antipyretics on fever and disease course 23

24 Fever API integrated into consumer level products

25 Product & Platforms Providers & Researchers 25

26 Growth Chart Track growth over time Compared with WHO and CDC Percentiles Track height, weight, head circumference and BMI Percentiles Calculator for quick percentile lookup 26

27 Blood Pressure Centiles Calculates systolic and diastolic blood pressure percentiles Normalized by age, sex, and height Graphical history of the child's blood pressure percentile Pop-up calculator Enables full screening at each visit 27

28 DRC on FHIR Dose Range Checking (DRC) on FHIR is a Clinical Decision Support application - CDS Hooks Issues: Medication errors - Recent research study shows that medication errors are still occurring when our current text based DRC alerts are being overridden. Overriding alerts creates cumbersome clinical workflow on providers including pharmacists, nurses and the ordering provider. This image cannot currently be 28

29 DRC on FHIR - Box Plot Dose Range Checking (DRC) on FHIR is a Clinical Decision Support application that now provides visual alerts comparing current and historical dosages. 29

30 Prediction of Patient Placement (POPP) Prediction modelling algorithm using machine-deep learning of EHR data on FHIR to improve ED patient throughput and patient placement to inpatient floors 30

31 TriVox Patient Surveys Patient reported information for improved monitoring of chronic diseases ADHD, Asthma, Anxiety, Depression, Autism and more 5+ years use with significant clinical and patient impact Launch-able in the patient context within PowerChart using SMART on FHIR Portable into any EHR 31

32 Precision Medicine Initiatives 32

33 Digital Phenotype Data EHR Data Structured & Unstructured F H I R F H I R O mics Data Products & Services 33

34 FHIR Genomics Genetics Test: LOINC + Sequence Data + External Genetic Profiles DiagnosticOrder DiagnosticReport FamilyMemberHistory Observation SMALL kilobyte Germline / Somatic Sequence Resource DNA or RNA or AA BIG terabyte Full Sequence Source eg, GA4GH 34

35 Partnership to advance the research 35

36 Thank You! 36