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Analysis model for personal e. Health solutions and services EFMI Special Topic Conference Reykjavik, Analysis model for personal e. Health solutions and services 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 juha. [email protected] fi

Outline • Introduction: – the My. Wellbeing project – needs for analysis models of Outline • Introduction: – the My. Wellbeing project – needs for analysis models of personal e. Services for wellbeing • Materials and methods • Results: the analysis model • Discussion and conclusions 2

Speaker background • Juha Mykkänen, Ph. D, researcher • University of Eastern Finland, Health Speaker background • Juha Mykkänen, Ph. D, researcher • University of Eastern Finland, Health Information Systems R&D Unit • Board member in Finnish Social and Health Informatics Association, HL 7 Finland vice chair (co-chair common services & IHE SIG), HL 7 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 – Ser. API: SOA and integration of healthcare applications 2004 -2007 – Oma. Hyvinvointi (My. Wellbeing): personal wellness management 2008 -2010 – Plug. IT: healthcare application integration 2001 -2004 – e. Kat / guidelines for national e. Booking of health services 2008 – Healthcare services specification project (HSSP) / HL 7 and OMG, 2005– Integrating the Healthcare Enterprise - IHE. fi 2008– National project for social services IT - Tikesos 2006 -2011 – China/Finland e. Health partnership + other projects in Shanghai 2004 -2008 – Various HL 7 Finland web services standards specifications 3

the My. Wellbeing project (Omahyvinvointi) • a national R&D project in Finland on citizen-centric the My. Wellbeing 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 e. Wellbeing – 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 e. Services? • patient / individual empowerment increasingly Why an analysis model for personal e. Services? • patient / individual empowerment increasingly required to support improving health and transition towards high quality and affordable health services • increasingly, personal information management solutions and e. Services do not live in isolation but must be integrated, e. g. – personal health record systems – citizen e. Booking – patient/provider communication systems – personalised decision support and knowledge systems • selection or development of e. Services and integrated suites requires systematic analysis models

Materials and methods • Goal: construct a straightforward but comprehensive tool for evaluation and 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. 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 Administrative Data collector Names of data collector and analyser Administrative and basic information features 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 of product, service or project 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 8

Information aspects Information features Personal information contents Personal information entities or elements, level of Information aspects 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 and contents of knowledge, links between personal information and knowledge libraries, health search engines, etc. Service information contents and 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 9

Related information analysis model Toivanen M, Mykkänen J, Korpela M. Activity-Driven Information Analysis Designing Related information analysis model 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. 10

Functional capability analysis 1 Functional capability features Main functions list and description of main Functional capability analysis 1 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. e. Booking, payments, preliminary data for encounters, appointment reminders etc. 11

Functional capability analysis 2 Functional capability features Interacting with professionals secure communication / email Functional capability analysis 2 Functional capability features Interacting with professionals secure communication / email with professionals, expert advice services etc. Community Peer-to-peer or other services fpr the formation engagement functions of and engagement in virtual communities, forums, social media services Knowledge service functions interpreting medical information, individualoriented 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 12

Functional model – standard used as basis HL 7 2007. HL 7 Personal Health Functional model – standard used as basis HL 7 2007. HL 7 Personal Health Record Systems Functional Model, Release 1, Draft Standard for Trial Use, HL 7 EHR Technical Committee, November 2007. 13

Architecture, interoperability and security 1 Architecture, interoperability and security User interfaces and applications e. Architecture, interoperability and security 1 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) 14

Architecture, interoperability and security 2 Architecture, interoperability and security Interoperability and interfaces -data communications Architecture, interoperability and security 2 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 15

Business model and development approach Service providers and examples: one vendor for the service, Business model and development approach Service providers and examples: one vendor for the service, provision model 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) 16

Others Other considerations Definition of the product or service by the provider quote from Others 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 17

Conclusions • comprehensive model – yes – incorporates many existing models for analysis – 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 e. Health solutions – publication of evaluations must be pseudonymised or anonymised • many detailed considerations should be more closely studied as critical success factors for personal e. Health solutions

Takk fyrir / Kiitos “All old sayings have something in them” -Icelandic proverb quote Takk fyrir / Kiitos “All old sayings have something in them” -Icelandic proverb quote additional information http: //www. it. abo. fi/cofi/omahyvinvointi/index. php? id=70 juha. [email protected] fi