cas$757/$ehealth757 modern$so2ware$technology$for$ehealth ...cas757/cas757_week_01_01.pdf ·...

Reza Samavi Modern So/ware Technology for eHealth Week 1 1 Reza Samavi

CAS 757/ eHEALTH 757 Modern So2ware Technology for eHealth An Overview

Course Instructor: Reza Samavi, PhD, PEng [email protected] Jan. 8, 2014

Reza Samavi Modern So/ware Technology for eHealth Week 1 2

Modern So2ware Technology for eHealth

Instructor Reza Samavi, PhD, PEng Email: [email protected]

Office ITB 213

Course Website hRp://www.cas.mcmaster.ca/~cas757/


Current Healthcare challenges

•  Costs are out of control and skyrockeXng

•  Medical errors (same numbers die as car accidents) -  Hard to track (indirect medical error)

•  Goals of Health InformaXcs: -  Lower healthcare costs -  Improve paXent safety

Source: OECD Health Data 2009


Current Healthcare challenges

•  Costs are out of control and skyrockeXng •  Medical errors (same numbers die as car accidents)

-  Hard to track (indirect medical error)

•  Goals of Health InformaXcs: -  Lower healthcare costs -  Improve paXent safety

•  Experimental evidence (Veterans Affairs hospitals) -  Vioxx recall -  Health data exchange

Source: OECD Health Data 2009


Why computerizaEon hasn’t happened in HC intrinsically?

•  More complex than most other industries •  Is constantly changing •  Failed computerizaXon efforts •  ParXal successful efforts (drawback of both) •  Looks like that EHRs typically slow doctors down •  ComputerizaXon has not been incenXvized


eHealth (or Health InformaEcs)

“the knowledge, skills and tools which enable informaXon to be collected, managed, used and shared to support the delivery of healthcare and to promote health.” Making Information Count: A Human

Resources Strategy for Health Informatics Professionals, UK – NHS, October 2002, p3

“the scienXfic field that deals with biomedical informaXon, data, and knowledge – their storage, retrieval, and opXmal use for problem solving and decision making.” Shortliffe, Edward H and Cimino James J.

Biomedical Informatics, Computer Applications in Health Care and Biomedicine, Springer-Verlag London 2014.


Areas under the domain of eHealth

•  Health service delivery (health care) -  Chronic, acute disease medical service, dental, diagnosis, etc.

•  Public Health -  PrevenXve health, epidemiology, environmental health

•  Individual and personal health (healthy life style) •  EducaXon of health professionals •  Biomedical research (clinical trials, public health research, biomedical science)


Associated areas

eHealth

Care Delivery

InformaEon management

InformaEon technology

The goal of Health InformaXcs is improving paEent care by beRer management of health informaEon using informaEon technologies.


What is informaEon?

ContextualizaXon/InterpretaXon

Processing/OrganizaXon

Human judgment


What is informaEon?



Human judgment

Account, $200,000, my Dad

$200,000 is in my Dad’s personal account

My Dad is rich!

I should ask for a Maserati for my BD!


What is informaEon?



Human judgment

215 mg/dL

Patient X blood sugar level at 600am Jan 14, 2007 is 215mg/dL

Patient X blood sugar level is high

Patient X needs further monitoring and treatment

PaXent X A1C reads as 215 mg/dL

higher meaning/semanEc


eHealth as a set of Processes

CollecXon Process UXlizaXon

store

-‐  Primary care -‐  Secondary use -‐  AdministraXon use

CommunicaXon

Images from Shortliffe, Edward H and Cimino James J. Biomedical Informatics, Computer Applications in Health Care and Biomedicine, Springer-Verlag London 2014

EHR + HIE


Why it is hard to achieve?

•  Complexity in integrated health environment, a single-‐entry point into a clinical world for -  paXent-‐care -  AdministraXve and financial topics -  Research -  Scholarly informaXon -  Office automaXon

•  EHR is at the heart of the evolving integrated environments that is intended to be accessible, confidenXal, secure

•  Complexity in moving from paper records to Electronic Health Records -  EHR is not a physical storage for paXent data


eHealth as a set of Processes

CollecXon Process UXlizaXon

store

-‐  Primary care -‐  Secondary use -‐  AdministraXon use

CommunicaXon

Data Process Architecture

Requirements

Modelling Modelling

Design

Engineering

EHR + HIE Images from Shortliffe, Edward H and Cimino James J. Biomedical Informatics, Computer Applications in Health Care and Biomedicine, Springer-Verlag London 2014


CAS 757 descripEon

•  Exposes the graduate students to the eHealth challenges •  Introduces a collecXon of modern so/ware architectures and technologies to build the infrastructure that meets the emerging demands health care systems -  Standards for data, processes and communicaXons -  clinical terminology systems -  web services and service oriented architecture -  decision support systems and health data mining -  data and knowledge interoperability -  security and privacy techniques


Course objecEves

•  From the health care system perspecXve the course will help you to understand -  Healthcare system architecture, (messaging, interoperability) -  The core components of current healthcare systems

•  From the informaXon system perspecXve the course will provide you -  opportuniXes to learn and apply modeling and analyXcal techniques and

methodologies from so/ware engineering discipline for analysis and design of informaXon systems in the context of eHealth.

•  What you learn are the fundamental theories and applicaXons of: -  Requirements engineering and social modeling -  Health data modeling (ER, ODBC, JDBC, NormalizaXon) -  Process modeling (UML, BPMN) -  Ontologies and SemanXc Web -  Data mining -  Security and Privacy Less emphasize on specific technologies,

more emphasize on modeling and abstracXon


Lectures week Lectures (HC) Lectures (CS)

1 eHealth overview So/ware design (development lifecycle)

2 eHealth data collecXon and storage Data Modelling (ER, RDBMS, ODBC, JDBC, NormalizaXon, XML, RDF)

3 eHealth clinical processes Process Modelling (DFD, UML, BPMN)

4 eHealth Standards (HL7) Requirements Engineering (Social Modelling, agent-‐goal modelling (i*))

5 SNOMED CT and UMLS Ontologies & SemanXc Web

6 Health informaXon infrastructure Database IntegraXon / SOA

7 Evidence based medicine/ Health knowledge translaXon

Data mining

8 PHR/Personalized medicine Personal web

9 Health data privacy (treatment /research)

Security/Privacy enhancement technologies (PETs)

10 New trends New trends


References [BEN12] Benson, Tim. Principles of health interoperability HL7 and SNOMED. Springer, 2012

[SHO14] Shortliffe, Edward H and Cimino James J. Biomedical Informa?cs, Computer Applica?ons in Health Care and Biomedicine, Springer-‐Verlag London 2014.

•  Other readings (required and supplementary) are listed in the course website for each lecture.

•  Seminar readings is mandatory for all students!

Most readings are available online via McMaster digital library. For off-campus access, you will need to login through proxy with macid. Please contact the instructor if you cannot find a reading.


Course administraEon

Day Time LocaXon Lectures/Seminars Wed 1900-‐2200 ITB222

Office hour (please email to make an appointment)

Wed 1800-‐1900 ITB213

Seminar and parXcipaXon (individual) 20%

Assignment (individual) 15%

Project Proposal (individual) 15%

Project (group) 50%

•  Course schedule

•  Grading Scheme


Lectures

•  I don’t want to hear myself talk for 2 hours/week -  You’ll get bored, I’ll get bored

•  I’d like to interact rather than lecture, but that means that you have to parXcipate -  Ask some quesXons! Answer some quesXons!


Seminars •  There are two groups of readings for seminars, “A” and “B”

-  The focus of group A is mainly on computer abstracXons -  The focus of group B is mainly on healthcare IS

•  There will be 4 seminars (at most) in each lecture -  2 with prefix A and 2 with prefix B -  When more than 4 readings are available, the unassigned readings will be covered

by the instructor -  Readings will be assigned on FCFS basis by email (opening 900am Jan 9) -  Each student will select three prioriXzed choices -  Students will be randomly assigned if some spots are not filled in

•  PresentaXon will be (at most) 10 minutes -  Focus on main contribuXons -  Not more than 10 slides -  One slide covering your criXques -  One slide your discussion quesXons

•  Seminars will be followed by a 20-‐minutes panel discussion on four presentaXons

•  The seminar is worth 20% of the course marks (15% presentaXon, 5% parXcipaXon)


Design Project •  A design project of the student’s choice in the context of eHealth

•  Details in a separate handout

•  The project should have a narrow scope and target a specific problem -  Health applicaXon challenges are good starXng points

§  hRps://challenge.gov/?q=134-‐smart-‐apps-‐for-‐health §  hRp://gameon.challengepost.com/?ref=featured §  hRp://paXentengagement.challengepost.com/?ref=featured

•  Individual project proposal (15%) -  The problem should be genuine -  Any eHealth related theme is acceptable -  Report 4 pages (at most) – needs and objecXves should be clear -  Pitch the proposal

•  Team up (2-‐3 students) •  Pick one of the individual topics (can not be a new one) •  IteraXve design •  Progress report and presentaXon, learning from each others experience (10%) •  Final report (30%) •  Poster presentaXon (10%)


Assignment

•  Students’ ability to exploit So/ware Engineering modeling techniques for problem analysis will be evaluated

•  Each student will work on her/his project proposal as the design problem

•  describe the problem this Xme using one of the modeling techniques •  E.g. ER, UML, BPMN, i*, etc.

•  The student will report the limitaXons and the advantages of using the modeling technique (15%)

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