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HEALTHGRID. ORG The European Health. Grid Initiative e-Health and the Grid: Projects and Prospects HEALTHGRID. ORG The European Health. Grid Initiative e-Health and the Grid: Projects and Prospects in the European Union NEC 2005 40 years Tony Solomonides on behalf of The Health. Grid Association Varna, 16 09 05 Varna, NEC 2005

HEALTHGRID. ORG Issues and Projects What is a ‘healthgrid’? Ø Ø Ø combines Grid HEALTHGRID. ORG Issues and Projects What is a ‘healthgrid’? Ø Ø Ø combines Grid and e-Science ideas oriented to biomedical advances supports evidence-based practice What projects? Ø Ø imaging for diagnosis and treatment simulation for treatment guidance bioinformatics for biomedicine legal, ethical, security and trust issues Tony. [email protected] ac. uk NEC 2005 2

HEALTHGRID. ORG History Health. Grid 2003 – Lyon, Jan 03 Health. Grid Association incorporated HEALTHGRID. ORG History Health. Grid 2003 – Lyon, Jan 03 Health. Grid Association incorporated Health. Grid 2004 – Clermont-Ferrand, Jan 04 Health. Grid ‘White Paper’, June 04 Health. Grid 2005 – Oxford, Apr 05 FP 6 Project ‘SHARE’ – December 05 Health. Grid 2006 – Valencia, June 06 Tony. [email protected] ac. uk NEC 2005 3

HEALTHGRID. ORG Principal Themes Integration Levels of life & knowledge: correspondence & convergence Issues HEALTHGRID. ORG Principal Themes Integration Levels of life & knowledge: correspondence & convergence Issues of ethics and trust Services on grid infrastructure Tony. [email protected] ac. uk NEC 2005 4

HEALTHGRID. ORG Principal Theme 1 Integration Ø medical and bioinformatics Ø patient information and HEALTHGRID. ORG Principal Theme 1 Integration Ø medical and bioinformatics Ø patient information and medical knowledge Ø ‘gold standard’ evidence and practice-based evidence Ø patient data – images, labs, history Ø models of the human body Ø legal, ethical, social, trust issues Tony. [email protected] ac. uk NEC 2005 5

Example 1 HEALTHGRID. ORG Knowledge Grid EU project to prototype a pan-European distributed database Example 1 HEALTHGRID. ORG Knowledge Grid EU project to prototype a pan-European distributed database of mammographic images using Grid Technologies. Aim: To provide a demonstrator for use in epidemiological studies, quality control and validation of computer aided detection algorithms. Tony. [email protected] ac. uk NEC 2005 6

Grid Architecture HEALTHGRID. ORG Workstations MG W/s (‘‘MAS’’) CERN Udine Mammo. Grid Data Grid. Grid Architecture HEALTHGRID. ORG Workstations MG W/s (‘‘MAS’’) CERN Udine Mammo. Grid Data Grid. Box High Security Level GRID VPN Mammo. Grid Data Grid. Box Oxford Cambridge MG W/s (‘‘MAS’’) Tony. [email protected] ac. uk NEC 2005 7

HEALTHGRID. ORG Grids and Imaging 1 Diagnosis Ø comparison, ‘find-one-like-it’ Epidemiology Ø virtual databases HEALTHGRID. ORG Grids and Imaging 1 Diagnosis Ø comparison, ‘find-one-like-it’ Epidemiology Ø virtual databases Ø significant statistics Therapy planning Ø targetting, implantation, surgery Problems of heterogeneity Security Issues Tony. [email protected] ac. uk NEC 2005 8

HEALTHGRID. ORG Grids and Imaging 2 Service Oriented Architecture Ø grid services can deal HEALTHGRID. ORG Grids and Imaging 2 Service Oriented Architecture Ø grid services can deal with heterogeneity Ø grid services can be used to plan workflow Ø examples include annotation, detection, analysis, registration, aggregation and visualization services Optimistically … Ø legal, ethical, social and trust negotiations may be implemented through services Tony. [email protected] ac. uk NEC 2005 9

Example 2 HEALTHGRID. ORG Grid Software Computational Grid Simulation & Imaging Bio-numeric modelling Medical Example 2 HEALTHGRID. ORG Grid Software Computational Grid Simulation & Imaging Bio-numeric modelling Medical Expertise Legal Aspects Secure & lawful Grid provision of medical services Build 6 Grid-enabled medical prototype applications Build suitable middleware on top of common standards Install and evaluate a GEMSS test-bed Anticipate privacy, security & other legal concerns Taken from Gerhard Engelbrecht Tony. [email protected] ac. uk NEC 2005 10

Applications HEALTHGRID. ORG Name Domain Class Maxillofacial surgery simulation Medicine – pre-surgical planning On Applications HEALTHGRID. ORG Name Domain Class Maxillofacial surgery simulation Medicine – pre-surgical planning On demand / distributed supercomputing Neurosurgery support Medicine – intra-operative planning On demand Radiotherapy planning Medicine – Monte Carlo treatment simulation On demand / distributed supercomputing Inhaled drug delivery planning Medicine – air flow dynamics On demand / distributed supercomputing Cardio-vascular system simulation Medicine – blood flow dynamics On demand Advanced image reconstruction Medicine – nuclear / in vivo On demand diagnostics Taken from Gerhard Engelbrecht Tony. [email protected] ac. uk NEC 2005 11

HEALTHGRID. ORG Principal Theme 2 Levels of life Levels of knowledge Correspondence and convergence HEALTHGRID. ORG Principal Theme 2 Levels of life Levels of knowledge Correspondence and convergence medicine and genomics Ø ‘molecular medicine’ Ø ‘individualized healthcare’ Ø Tony. [email protected] ac. uk NEC 2005 12

HEALTHGRID. ORG I N B I O M E D Public Health Informatics Medical HEALTHGRID. ORG I N B I O M E D Public Health Informatics Medical Imaging Bioinformatics Tony. [email protected] ac. uk Bio-social being & pathology P A Population Genomic T Epidemiology Disease H O Pharmacogenetics Patient L O Molecular and Tissue, organ Image-based diagnosis G Molecular, genetic I E Taken from Fernando Martín-Sánchez S NEC 2005 13

HEALTHGRID. ORG An example: Integration of clinical and genetic info from heterogeneous remote databases HEALTHGRID. ORG An example: Integration of clinical and genetic info from heterogeneous remote databases A vocabulary server that aims to combine existing terminology systems in Medicine and Genetics Novel framework for clinicians to locate, search, access, retrieve and use genomic information in patient care Taken from Fernando Martín-Sánchez Tony. [email protected] ac. uk NEC 2005 14

HEALTHGRID. ORG Tony. Solomonides@uwe. ac. uk NEC 2005 15 HEALTHGRID. ORG Tony. [email protected] ac. uk NEC 2005 15

HEALTHGRID. ORG Tony. Solomonides@uwe. ac. uk NEC 2005 16 HEALTHGRID. ORG Tony. [email protected] ac. uk NEC 2005 16

HEALTHGRID. ORG Tony. Solomonides@uwe. ac. uk NEC 2005 17 HEALTHGRID. ORG Tony. [email protected] ac. uk NEC 2005 17

HEALTHGRID. ORG Principal Theme 3 ‘LEST’ Issues Ø Ø Ø use of data in HEALTHGRID. ORG Principal Theme 3 ‘LEST’ Issues Ø Ø Ø use of data in care and in research data provenance privacy / confidentiality security national / EU legal framework … extending the concept of a ‘virtual organization’ Ø & building negotiation into the infrastructure Ø Tony. [email protected] ac. uk NEC 2005 18

GRIDs and Privacy HEALTHGRID. ORG Good reasons for talking about privacy here and now! GRIDs and Privacy HEALTHGRID. ORG Good reasons for talking about privacy here and now! – The Health. Grid promises access to large amounts of heterogeneous distributed data – Health related information is very sensitive and prone to abuse – Privacy impacts society as a whole (e. g. loan applications, insurance, scholarship, . . . ) – Privacy violation is irreversible – Confidential information can never be considered confidential again, once it was out in the open – Grid and Privacy Enhancing Technology exist and are used They could both benefit from early integration Adapted from Georges de Moor and Brecht Claerhout Tony. [email protected] ac. uk NEC 2005 19

Sharing of Healthcare Data HEALTHGRID. ORG Local Databases: – Nominative records (e. g. patient Sharing of Healthcare Data HEALTHGRID. ORG Local Databases: – Nominative records (e. g. patient treatment) – Privacy protected DBs Privacy Protecting Interface (PETs): – Locally controlled – Pseudonymisation – Content filtering and transformation – Query evaluation (restriction) Privacy Protecting Interface Data Access through the Grid Adapted from Georges de Moor and Brecht Claerhout Tony. [email protected] ac. uk NEC 2005 20

HEALTHGRID. ORG Principal theme 4 A Grid Infrastructure for Health Applications Technology attitude n HEALTHGRID. ORG Principal theme 4 A Grid Infrastructure for Health Applications Technology attitude n n To build on what already exists To build only what is necessary Healthgrid Components Healthgrid Clinical Data Applications Grid Infrastructure Tony. [email protected] ac. uk NEC 2005 21

Layered Grid Technologies HEALTHGRID. ORG Data Abstraction u Data mining, visualisation, simulation, problem solving Layered Grid Technologies HEALTHGRID. ORG Data Abstraction u Data mining, visualisation, simulation, problem solving methods/environments … u Metadata, middleware, intelligent retrieval, information modelling, warehousing, workflow … u Distributed databases, streaming, near-line storage, large objects, access mechanisms, data staging … Knowledge Grid Information Grid Data Control Tony. [email protected] ac. uk NEC 2005 22

A Grid Infrastructure for Health Applications HEALTHGRID. ORG To address the problems of integration A Grid Infrastructure for Health Applications HEALTHGRID. ORG To address the problems of integration of multi-level medical data, and the exploitation of its intrinsic knowledge n through a health-specific grid Infrastructure and a set of grid applications for health. To integrate grid infrastructures, health-related grid components, and pilot applications n to provide a workbench for medical and clinical support. To develop components to link the available expertise, data, and resources. n to demonstrate the benefits through pilots in epidemiology and personalised healthcare. Tony. [email protected] ac. uk NEC 2005 23

HEALTHGRID. ORG Benefits Expected At the patient level Personalised healthcare, e. g. through simulation HEALTHGRID. ORG Benefits Expected At the patient level Personalised healthcare, e. g. through simulation in therapy. Improvement in the effectiveness of health policies through epidemiological studies. At the medical professional level Development of federated databases and collaborative communities. Development of services to support diagnosis and therapy in day-to-day work. At the IT Level A workbench for the development of tools and services towards specific features of healthcare IT. Tony. [email protected] ac. uk NEC 2005 24

20 Years of e. Health R&D Context HEALTHGRID. ORG NEXT PAST 10 years (1991 20 Years of e. Health R&D Context HEALTHGRID. ORG NEXT PAST 10 years (1991 -2002) ’ 89 -’ 91 -’ 94 Computer Applications for Doctors ’ 94 -’ 98 ’ 02 -’ 06 Research activities (200 Mil. €) ’ 98 -’ 02 Regional Health Info Networks Biomedical Informatics Home-care systems Personal Health Systems Telemedicine systems and services 10 years (2003 -2014) - informatics for Genomic Medicine - Virtual Physiological Human @ Budget 100 M € 140 M € 20 M € Projects 63 158 125 Results batch of Products EU Health -Health. Grid 30 Results AIM Community Feasibility Study 1 st Telematics Personal health systems (Wearable & Implantable) based on new biosensors Decision Support Syst. /Patient Safety Currently preparing activities for ’ 06 -’ 10 Industry www. cordis. lu/ist/directorate_c/ehealth/index. html Tony. [email protected] ac. uk NEC 2005 25

EC - ICT for Health Current Activities and Plans HEALTHGRID. ORG Basic research Biomedical EC - ICT for Health Current Activities and Plans HEALTHGRID. ORG Basic research Biomedical informatics III Health. Grid Applied/ Industrial R&D II Decision Support Systems Personal Health Systems (wearables) I Health info networks & services EHR & interoperability Support to e. Health “Action Plan” General issues EHR, Security, Interoperability Deployment 5 years Tony. [email protected] ac. uk 10 years NEC 2005 15 years Time to results 26

CISTRANA - IST ERA HEALTHGRID. ORG I e. Health ERA III II SYMBIOMATICS BMI CISTRANA - IST ERA HEALTHGRID. ORG I e. Health ERA III II SYMBIOMATICS BMI ERA Pilot I 2 HEALTH Identification doctors/patient Messages/requests SHARE Healthgrid STEP VH CA Certification EHR SSA Semantic Health Interoperability TMA Bridge Interop. approach Implementation Tony. [email protected] ac. uk RIDE Interoperability INFOBIOMED SEMANTIC MINING Short time research NEC 2005 BIOPATTERN Long time research 27

HEALTHGRID. ORG More information References Ø http: //lyon 2003. healthgrid. org/program. php Ø http: HEALTHGRID. ORG More information References Ø http: //lyon 2003. healthgrid. org/program. php Ø http: //clermont 2004. healthgrid. org/program. php Ø http: //oxford 2005. healthgrid. org/program. php HG 2004, HG 2005 Proceedings ‘White paper’ Ø http: //www. healthgrid. org/download. php (June 2004) SHARE Project – Road Maps Tony. [email protected] ac. uk NEC 2005 28