Professional Documents
Culture Documents
Provocative proposals
draft 0.3
Warning
This is not an approved Technology Strategy Board, Health KTN, ALIP or dallas document.
10/04/2013 1
‘Use case’ profile coverage
1. Identity authentication & management
2. Workflow coordination & communication
3. PHR functions (access, import, export, etc.)
4. Client‐user’s Device Communications
5. Alarm and/or Monitoring Communication to
Service
6. Client‐user Status Report (PHR & Care pathway
integration)
7. Telecare / telehealth process
10/04/2013 2
1. Identity authentication &
management
10/04/2013 3
2. Workflow coordination &
communication
10/04/2013 4
3. PHR functions
(access, import, export, etc.)
10/04/2013 5
4. Client‐user’s Device
Communications
10/04/2013 6
5. Alarm and/or Monitoring
Communication to Service
10/04/2013 7
6. Client‐user Status Report
(PHR & Care pathway integration)
10/04/2013 8
7. Telecare / telehealth process
10/04/2013 9
Extent of 7 ‘use cases’
10/04/2013 10
Roadmap for standards use
• Implies a ‘direction of travel’ towards
interoperability;
• Loosely based on use case profiles in i‐focus,
Continua and NHS England;
• Attempted prioritisation according to i‐focus
work in dallas;
• Numbers indicate ‘use case’ profile topics;
• … just one person’s initial thoughts – be
constructively radical!
10/04/2013 11
Standards Evolution: key to symbols
Hyperlinked documents have blue underline text
Emerging
Superseded guidance –
guidance not yet
mature
Mature
guidance –
not used
Mature
guidance –
not
widely used
Mature
Proprietary
guidance –
methods
widely used
10/04/2013 12
1.x Identity authentication &
management
• So, the standards are?
• Discuss…
10/04/2013 13
2.x Workflow coordination &
communication
• So, the standards are?
• Discuss…
10/04/2013 14
3.1 Care records – high level
HL7 Personal
HL7 Electronic Health Record
Health Record System
System (EHR‐S) Functional
Functional Model Model (PHR‐S
(FM), Release 1.1 FM)
HL7
Proprietary Implementation
methods for Guide for CDA®
R2: Plan‐to‐Plan
exchanging Personal Health
extracts Record (PHR) Data
Transfer, Release 1
10/04/2013 15
4.1 Telecare ‐ technology
BS EN 50130‐4:2011.
Alarm systems. Electromagnetic compatibility. Product family standard. Immunity
requirements for components of fire, intruder, hold up, CCTV, access control and social
alarm systems
BS EN 50134 series:
Alarm systems. Social Alarm Systems …
• BS EN 50134‐1:2002 … System requirements
• BS EN 50134‐2:2000 … Trigger devices
• BS EN 50134‐3:2012 … Local unit and controller
• BS EN 50134‐5:2004 … Interconnections and communications
• DD CLC/TS 50134‐7:2003 … Application guidelines
BS 8521:2009
Specification for
DTMF signalling ‘NOW‐IP’ ‘ALL‐IP’
protocol for 2012 2018?
social alarm
systems
10/04/2013 16
4.2 Telecare ‐ semantics
BS EN ISO 11073‐
10471:2011
Health Informatics. Personal health device
communication. Device specialization.
Independent living activity hub BS EN ISO
• BS EN ISO 11073‐10101:2005. Health informatics. Point‐of‐care
medical device communications. Nomenclature
11073‐10101:
2014?
Health informatics. Point‐
BS of‐care health device
8521:2009 communications.
Specification for ‘NOW‐IP’ Nomenclature
dual‐tone multi‐
frequency (DTMF) 2012?
signalling protocol
for social alarm
systems
10/04/2013 17
4.4 Telehealth ‐ technology
BS EN 50130‐4:2011.
Alarm systems. Electromagnetic compatibility. Product family standard. Immunity
requirements for components of fire, intruder, hold up, CCTV, access control and social alarm
systems
BS EN ISO 11073‐
20601:2011.
Health informatics. Personal
health device communication.
Application profile. Optimized
exchange protocol
(NICC / ‘ALL‐IP’
• BS EN ISO 11073‐104zz series.
Health informatics. Personal health
ETSI/ ITU) 2018?
device communications. Device
specialization
‘NOW‐IP’
2012
10/04/2013 18
4.5 Telehealth ‐ semantics
10/04/2013 19
4.6 Hub reporting ‐ readings
HL7
Version 2.7
Ch7
• BS ISO/HL7
Proprietary 27931:2009. Data
exchange standards.
IHE Continua Health
methods for Health level seven
version 2.5. An Patient Care Alliance
application protocol
exchanging for electronic data
exchange in
Device TF1 Design
data healthcare
environments
(PCD01) Guidelines:2012
BS EN ISO
11073‐
10101:2005.
HI. PoC MDC.
Nomenclature
10/04/2013 20
5.x Alarm and/or Monitoring
Communication to Service
• So, for telehealth, is there an option apart
from the Continua /IHE adoption of HL7 +
11073?
– See slides 29 & 30.
• Will, should, that converge with telecare?
– See slides 16 & 17.
• Discuss…
10/04/2013 21
6.1 Care report documents
Proprietary
methods for
exchanging HL7
extracts Implementation
Guide for CDA
HL7 CDA® Release 2 ‐
Release 2 Personal
Healthcare
W3C Extensible Monitoring
Markup Report (PHMR)
Language (XML) • NHS England DHID
ITK implementation
guidance
1.0 (Fifth
Edition)
10/04/2013 22
7.1 Telecare ‐ process
10/04/2013 23
10/04/2013
(COP)
Code of
Practice
NEN8028
2011 (nl),
Medische
TSA Telecare
informatica ‐
Kwaliteitseisen
telemedicine
VDE‐AR‐M
3756‐1 2010
(d), Quality
management for
telemonitoring for
medical
applications
7.2 Telehealth ‐ process
EU
TeleSCoPE
(2012)
(COP)
Code of
Practice
TSA Telecare
& Telehealth
24
Candidate ideas
Tentative ranking:
1. Q&A interactions
2. Interactive video
3. Gaming
4. Assistive aids, robotics, etc.
5. Telecare / telehealth / domotics convergence
5
Domotics
convergence
KNX, ECHONET , IEEE, ETSI, ITU M2M, IoT, etc.
4
Assistive
aids 6. Smart grid, smart city, etc.
/ Robotics
7. etc.
1
Q&A Service Suggestions (and reasons) welcome
3
Gaming
6
Smart grid,
2 smart city
Interactive convergence
video
10/04/2013 25
NHS Standards
10/04/2013 26
Continua ‘ecosystem’
Service Provider Domain Service Requester
User Domain Communications
Communications Reporting
•Continua Personal Health Devices
BS (EN ISO/IEEE) 11073–
Device specialization Groups
Health:
– ‐10401 > ‐10439
Wellness:
– ‐10441 > ‐10469
ADL:
– ‐10471 > ‐10499
User to ‘Service provider’
standards Citizen’s Living Zone
Management Service
Zone
Provider
Service Zone
• Continua Wide Area Network
• Integrating the Healthcare Enterprise (IHE) Patient Care
Device TF1 (PCD01):2006‐7
based on
• Health Level Seven (HL7) Version 2.7 Ch7 –
Observation Reporting
• ISO/IEEE 11073‐10101: Nomenclature, as extended by
• ‐20601: Optimized exchange protocol and
• ‐104zz: Specializations
‘Service provider to Service
requester’ Report standard Citizen’s Living Zone
Management Service
Zone
Provider
Service Zone
• Continua Enterprise
– Health Level Seven (HL7) Implementation Guide
for CDA Release 2.0‐ Personal Health Monitoring
Report; DSTU Release 1:July 2008
Specifies the NHS standard semantics‐
• International Health Terminology Standards Development
Organisation (IHTSDO) Systematized Nomenclature of Medicine
‐ Clinical Terms (SNOMED CT)
NHS Standards
Management Service Provider
Citizen’s Living Zone
Zone Service Zone