Mobile Health Work Group

HL7 Working Group Meeting

Madrid, Spain– May 06-12, 2017

  • Wednesday, MAY 10 Q1-Q4

Wednesday Q1

HL7 Mobile Health Work Group Meeting Minutes
Location: HL7 WG MAY 2017, Madrid / Date: 2017-05-10
Time: 10:00 - 11:30am (90 Minutes),
(Q1 at the WGM)
Facilitator / Gora Datta / Note taker(s) / Adamu Haruna, Mathew Graham
Attendees / Name / Affiliation
Matt Graham /
Gora Datta
Frank Ploeg
Adamu Haruna
TimoKaskinen
De-Seon Son
Hyungsik CHOI
Quorum Requirements Met: Yes
The Mobile Health Work Group Decision Making Practices (DMP) states: A quorum for committee meetings requires that a co-chair and at least two other HL7 MHWG members be present, where no single organization or party represents more than a simple majority of the voting Work Group membership for that meeting.

Introduction and opening of the MH WG meeting by Gora Datta. Then round of introduction of attendees in the meeting.

The meeting was facilitated by Gora, who first presented the state Mobile Health. In this presentation Gora explained that the mobile health focus area is not a vertical domain but horizontalframework that encompasses latest trends such as the proliferation of mobile devices and IoT evolution. The objective is how to use mobile health to provide health access to all.

Gora showed market size or projection of mobile devices and IoT connected devices to show why Mobile health will be critical for health access now and in the future i.e.

  • Shipmentof mobile devices more than double in a year from 13Billion in 2016 to 26Billion in 2017.
  • Mobile device being the main medium for the young and
  • Some native assets of the mobile devices that can be leveraged
  • Large amount of mHealth applications in the marketplace
  • VC funding hit all-time record in 2016

However this trend comes with challenges and opportunities; for example 90% Mobile Health and financial applications are vulnerable to security risks and multiple stakeholders will have different perspective that need to be accounted for.

There was discussion on Mobile Health mission and activities to address these opportunities and challenges and an invitation to the attendees to join the group and make it happen.

Other information includes announcement of pictorial representation project that was approved in ISO WG in Oslo. This is to address the missing graphical symbol in Health

The changing landscape in Healthcare was also discussed from paper to digital. Some of the key drivers discussed are the increasing world population, increasing aging population, high life expectancy (people live long and importance of longitudinal health record), chronic diseases and technology advancement.

And some of the emerging areas noted are HoT, big Data, Cloud AR/VR/MR, globsl village, micro payments, cyberhealth/blockchaiins

Final thoughts and discussions on the following items

  • Skill gap: User & technology
  • Cultural outreach
  • Socio-economic impact
  • Key question:whether the technology can fill the gap?

There was discussion on healthcare changes in different countries and patient portals

  • Netherlands example :Health delivery structure (regional, main hospitals)
  • Finland example: National archive and patient portal for health services. Also mobile services ramping up
  • South Korea: PHR understating by technology vendors and doctors but there is issue/gap for users to understand , appreciate and the importance of PHR value
  • South Korea: some activities involves 1)changing the criteria for elderly 2) data & service level changes
  • Example of PHR portal UI shown by Mathew Graham
  • South Korea : Samsung Health delegate working on personal repository for health data exchange

Wednesday Q2

HL7 Mobile Health Work Group Meeting Minutes
Location: HL7 WG MAY 2017, Madrid / Date: 2017-01-18
Time: 12:00 - 13:30am (90 Minutes),
(Q2 at the WGM)
Facilitator / Gora Dotta, Matthew Graham, / Note taker(s) / Adamu Haruna, Mathew Graham
Attendees / Name / Affiliation
Matt Graham /
Gora Dotta
Frank Floeg
Adamu Haruna
Quorum Requirements Met: Yes
The Mobile Health Work Group Decision Making Practices (DMP) states: A quorum for committee meetings requires that a co-chair and at least two other HL7 MHWG members be present, where no single organization or party represents more than a simple majority of the voting Work Group membership for that meeting.

Q2 :

cMHAFF

Presention of Mobile Health projects faciliated by Mathew Graham:

CMHAFF scope and goals proviedes a framework for assessment of the common foundation of mobile applications

  1. Why ‘cMHAFF is needed: To map developers need and guidance and also provide consumer transparency and assurance in the market place e.g. includes privacy by design
  2. cMHAFF assessemnt framework is divided into sections and covers the whole Application cycle .
  3. cMHAFF has 3 core use cases 1) simple applications on the mobile device 2) mobile device connected to data collection device 3) Mobile application + data collection devices with diseases management ; this category falls into more regulatory environment

Status :Ballot review have already beenconducted and the group is in the process of preparing for September ballot review

There is no such assessment on consumer health applications in the industry and FDA is not taking the lead on this. So this is a greenfield and all hands are needed to provide

There was dsicussion on the various level of guidance needed for the mobile health applications.

mFHAST

Presentation on mFHAST and about the status of the project and the objective of the project...

  • Main objective is to use short meesgae for delivery of health information in congested/low bandwith and low cost environment leveraging both OTT and SMS
  • Business : Public/Private broadcast, B2P/P2B, P2P
  • Several examples of the use cases and business models were shown. Evidence based findings also documented by the mFHAST project in different categories -Message requirements of the mFHAST projects also listed

Status

Comment only ballot reconcilation already done and looking to come up to additional ballot soon

Gora commented more on the need for mFHAST cases ; low bandwith ./constrained bandwith , device hindering flow of inofrmation

Currently there are already many use casesin the health industry using sms, this project just wants to standised the usage and message format

API Survey rpoject

API scanned of Mobile Health application platforms ...presented by Gora. Hopefully the result of the study will be released by next month...

Call to get involved in the project to help and offer guidance

Most dominante platforms (Apple HealthKits, Google platform and SMART on FHIR) are being assessed and evaluate to find out what the rights questions to ask on application development platforms

Wednesday Q3

HL7 Mobile Health Work Group Meeting Minutes
Location: HL7 WG MAY 2017, Madrid / Date: 2017-01-18
Time:11:00 - 12:30 pm (90 Minutes)
, eastern (Q2 at the WGM
Facilitator / David Tao / Note taker(s) / Nathan Botts
Attendees / Name / Email/Affiliation
Matt Graham /
Gora Datta
Adamu Haruna
JuhaMykkannen
Frank Ploeg
Quorum Requirements Met: Yes
The Mobile Health Work Group Decision Making Practices (DMP) states: A quorum for committee meetings requires that a co-chair and at least two other HL7 MHWG members be present, where no single organization or party represents more than a simple majority of the voting Work Group membership for that meeting.

Agenda topics

Finland’s PHR presentation and other discussions .

Introduction of cMHAFF project of Mobile Health wG by Gora .

Presentation of Finish PHR by Juha Mykkanen :

Distintion between User data and professional data the consequent handling. There questions about how the distinction between well being and professional maybe confusing or blurred with capabilities & features of the current consumer health applications

Landscape of Finnish PHR ecossytem was described by Juha . Major stakeholders includes

Kela (the sociial Insurance insitutuin of finland; the owner of PHR implementation) , THL (national institute of health and welfare) and HL7 Finland (who is facilitating some of technical community work)

In Finlands, there was previous colllaboratipn between private servcie providers and health serivces to provide common platform but it did not work due to lack of viable business model. The governement took over now to provide the Naional healtcare paltform for all to use

Finnish PHR

No production services yet but the PHR production environment to roll out in weeks. The idea is for 3rd party application developers to build their health applications

First phase ready by end of 2017

HL7 Finland association (Personal Health SIG) faciliates the developments, user engagements and requirements for PHR developement. Architecture of the Finnish national health archive is similar to US in terms of using V2 and CDA interfacse

For PHR , developememnt is entirly on FHIR and OAuth 2.0 based on work done by SMART on FHIR. Also other oonline authentication mechanisnn like google and facebook, Finnish governments citizen digital identity will be used.

Finnish National portal features provides a process for creating own accounts .The PHR platform provides most features to make application development easy.

PHR environments

Sandbox : open for all , and anyone can add profile and extensions

  • Client testing .
  • Production and Profile registry
  • Domain model of the PHR platform

Kela owns the platform and data model . It is open for anyone to offer exetnsion but you will have to go through established process including consultauon with HL7 Finland Personal Health SIG.

Work is underway

  • Architecture & specification being designed and published . PHR platform is being built .
  • Acceptance criteria for PHR applications being compiled and Lesgislatuon being finalised

Acceåptance criteria includes

  • Privacy
  • Secuirty
  • Safety
  • Potential for misuse
  • Potential for SW errors & failures

There is already certification for proessional systems but now PHR is tyring to make it lighter but still utilise previous experience

Accetance goal for project : For the Nation to trust in the service & Infrastructure of the PHR platform

Low threshold for wellbeing applications i.e. includes only the absolute essential requirements to build trust, compatibility with test and conformance

There was some discussuon on who owns the data or what are the different responsibilities of stakeholders around data

  • PHR /individual data : patient/data holder is respository
  • Professional data; Repositary owner is responsible
  • Who controls the data in the life cycle of data => some discussions here and no final thoughts

Also some discussionabout amount of data inflow, tsunamic and professional view of the data

Sections of the criteria form ( criteria categories) discussed .

Brief overview of the activities in Netherlands : project called Personal Environment by ceritifed broker ( widme qualification rules) to share personl health information with the provider

Wednesday Q4

HL7 Mobile Health Work Group Meeting Minutes
Location: HL7 WG MAY 2017, Madrid / Date: 2017-01-18
Time:1:45 - 3:00 pm (75 Minutes)
, eastern (Q3 at the WGM)
Facilitator / David Tao / Note taker(s) / Matthew Graham
Attendees / Name / Email/Affiliation
Matt Graham /
Gora Datta
Adamu Haruna
Quorum Requirements Met: Yes
The Mobile Health Work Group Decision Making Practices (DMP) states: A quorum for committee meetings requires that a co-chair and at least two other HL7 MHWG members be present, where no single organization or party represents more than a simple majority of the voting Work Group membership for that meeting.

Agenda topics

Joint Meeting with Healthcare Devices ...

Mobile Health project update presented by Gora

  • cMHAFF gone through ballot and preparing for the next ballots ...
  • The need and scope of the cMHAFF in the mobile ecosystems
  • mFHAST project : using short messaging service for healthcare delivery data in a structured and standard way in a resource constrained /under resource region of the world
  • 1 to 1
  • 1 to many
  • API Survey on Google, Apple Health Kits, SMART on FHIR , etc... eventual target is to have abstract API framework for App developers that is agnostic of the current various plaforms
  • Discussionon on mobile device speific features to leverage for mobile applications : location, images, micro payment, instant messaging, etc

What devices shouldbe looked at : TSC asks for more interaction/collaboration beween the WGs.. Device on FHIR project could be catgeorised on having these mobile feature . Device WG do not differentiate between the devices; just data being captiured

MH should have a page /half page explaining their problems areas and the issues they will like to get some help on.

The problem as described by some of the device WG experts is that a lot of group developing own devices and only support one application that accompanies accompanys the device . They do not want to go into the area of common standrads---These data are crippling into clinical data => accuracy & quality need to be considered ...very difficult problem to handle ...

Sensor data ( health device: low level orietned devices data ) to more processed enterprise level communictaion data and connect to EHR ..that model is being handled in Coordinated according colleagues in Devices WG

Harmonistaion betwee Mobile Health WG and RPM may need to happen ..( all various architectures look the same) but eventually the initiated deployment project ends up proprietary. Continua have been involved in several projects , not single one of them have use standard

The valuechain is the same here : RPM medical data from PH and ED from enduser to medical Enterprise

Mobile Health will receive some documents from Healthcare devices ...

Working on strcuturing the coding fornat fior the messages(for mFHAST) ..Some form of side meeting /event between Device WG and Mobile Heath WG will needed to get MH colleagues up to speed on the work done by Device WG on message coding