HiGHmed – Digital Networking in Medicine

Martin Peuker, CIO Charité Universitätsmedizin

HiGHmed-PI Berlin

Private and Networking Partners

Ada Health

Academic Partners

Associate Partners

HiGHmed Partners

BMBF-funded project Partners

8 University hospitals 9 Academic partners 4 Industry partners

8 university hospitals developing data integration centers

HiGHmed- Interesse und Aufnahme neuer Partner

Akademische Klinikpartner Standort Lübeck - Antrag im Mai eingereicht und positiv begutachtet

Private, regionale und sonstige Krankenhausbetreiber Vivantes – Partner seit Mai 2019 Robert-Bosch-Krankenhaus – Partner seit Mai 2019 BG Unfallkliniken Carl-Thiem- Klinikum Cottbus - Antrag im August eingereicht – potenzieller Vernetzungspartner

IT Partner Vitasystems – Partner seit März 2019 Brainwave Hub GmbH – Partner seit März 2019 Dell EMC – Antrag im August eingereicht

Lehre Vorhaben Das Interesse an Vernetzung bei Fachgesellschaften, Arbeitsgruppen und Hochschulen ist groß und zeigt die Potenziale des Themas

HiGHmed – Approach and Goals

Development of an open, interoperable and research-compatible eHealth platform to support local and cross-site patient care and research

Reuse of medical data from healthcare for research

Rapid exploitation of research findings in healthcare

Comprehensive concept for training and further education

Demonstration of benefit from three clinical use cases with excellent researchers and clinicians

Innovative technical concept :

– Semantic layer (based on international standards)

– Joint information management / cooperative modeling

– Cross-site requests and analyses

Multi-level roll out concept (participation model)

HiGHmed – Objectives of Use Cases

Oncology - Integration of various data types for personalized tumor boards – Supporting existing organ-specific tumor boards

– Cross-institution molecular tumor board with experts

– Discovery of „similar patients“, involvement of recent / newest scientific information and knowledge

– Consulting according to recent / newest therapy approaches

Cardiology – Continuous monitoring of patients with heart insufficiency – Study registry for identifying risk factors of heart insufficiency

– Long-term support for patients following stay in hospital

– Connected with sensoric & app

Infection Control – Smart Infection Control System for pathogen outbreaks in hospitals

– Early recognition of clusters and spreading of pathogens in hospitals

– Reducing risks of infection in hospitals

– Close cooperation with Robert Koch Institute in Berlin

HiGHmed Platform

1. Open Service Models: All specifications of the APIs are openly accessible to everybody. Specifications include data security and privacy, electronic health record management, and database queries.

2. Open Information Models: All clinical models (e.g. lab values) are well defined based on established open standards. Data based on these models can be reliably processed and computed in local and distributed environments.

3. Open System Specifications: All system components and protocols are openly specified using licenses feasible for commercial and non-commercial use. i.e. every component in the system can be replaced by software from multiple vendors or by an open source project.

Technical Concept

Each HiGHmed site establishes a Data Integration Center according to common HiGHmed standards Local implementation of the HiGHmed platform to establish shared services and data models Use of IHE XDS Cross-Enterprise Document Sharing to establish vendor-neutral archives and to support continuity of care processes Working on joint semantics through openEHR; with common archetypes and AQL query language interface Implement FHIR interfaces to enhance data exchange capabilities Each site can setup local data analytics layers Striving for vendor neutrality in the implementation of the technological stack to support a dynamic ecosystem of contributions following common standards Providing a support structure for rollout at different sites with exchange of best practice guidelines

HiGHmed – Project Progress

Initial HiGHmed Privacy Concept Approved by TMF Data Protection Working Group

Approval from the ethical committee for the clinical use cases

Minimal data sets generated for the clinical use cases Identification of source systems and interfaces

Governance model established (governs the responsibilities and processes of the preparation, and the cross-site revision of archetypes and templates)

Harmonization of terminology use for the core data set and the extension modules in the medical informatics initiative

Positives Votum der AG Datenschutz der TMF für das initiale HiGHmed Datenschutzkonzept 13. November 2018 in Berlin

Project Progress Use Cases

Oncology

– Inclusion of the first patients

– Modeling of archetypes completed; preparation of first templates

– Round robin test of the work group molecular biology for variant evaluation of given panels

– Specification sheet with technical and functional requirements for the molecular tumor software

Cardiology

– Patient data acquisition at partner sites in progress (n = 437)

– Technical visualization and acquisition of data sets in federated HiGHmed infrastructure in process

– Preparation for sensoric and app-inclusion advanced

Infection Control

– Modeling of archetypes completed

– Virtual Data Spaces: Data analyses, visualization, generation of synthetic datasets,

evaluation of first algorithms on real data sets with pathogen clusters/outbreaks

– Process description SmICS (Smart Infection Control System)

– Interactive dashboard V2.0

interactive dashboard

HiGHmed – Next Steps

Establish technology and methods at all partner sites

– Implementation of the new ethical and data protection-compliant consent processes

– Establishment of use and access committees at all sites

– Availability of an IHE-compatible infrastructure at all sites

– Installation of data protection-compliant pseudonymization (Treuhänder-Dienst)

Creation of use case-specific apps

Conception roll-out

– Utilization for other use cases

– Roll-out of solutions to other hospitals

HiGHmed – next steps Use Case Infection Control

Advancement of visualization and algorithms on the basis of meaningful (large-scale) data sets for test and analysiss purposes

Requirement analysis SmICS V1.0

Test of further algorithms of known data sets (outbreaks) with questions regarding to sensitivity, spezifity und precision

Molecular genetic characterization of a pathogen sentinel for the precision of SmICS

Modeling of (personnel-) time economy (KPI)

Evaluation of usability (KPI)

Courtesy NEC©

HiGHmed Use Case Infection Control

Podcasts „Faszination Medizinische Informatik“ under digitalisierungdermedizin.de

Currently: 4th episode with the title

"Digitalisierung für eine bessere Gesundheitsversorgung –

Forschungsprojekte im Krankenhaus„

SAVE THE DATE:

5th workshop Antibiotika­resistenz of the Robert Koch Institute from 14th -15th of November 2019 with HiGHmed Session „Wie kann Medizin­informatik die Krankenhaus­hygiene verbessern?“ programme and registration on the RKI website

CORD – Cross-Consortia Use Case for Rare Diseases

HiGHmed consortium participates in the use case CORD

Use of HiGHmed infrastructure and MII for research and care will be demonstrated by means of CORD, e.g.

– Research results for specific questions will be exploitable

– Patients will be diagnosed a more target-oriented fashion and allocated to medical experts

The project aims to illustrate that the MII­ and HiGHmed infrastructure can be specifically used to

– (1) Capture the care quality of patients with rare diseases

– (2) Identify patients with rare diseases

– (3) Improve the diagnoses of patients with rare diseases

– (4) Recognize relevant comorbidity of patients with rare diseases

The HiGHmed team says thank you for your attention!