1. HealthVault Integration OptionsChallenges & Possibilities
2. Outline• Brief description of what HealthVault is (and is not)• Scenarios, scenarios, scenarios• FAQ and common issues• Q&A
3. Common misconceptions• Microsoft technology/.NET only• HealthVault is an application• HealthVault is an institutional data store
4. HealthVault is…• A consumer/patient data platform• An ecosystem of connected applications and devices• Technology/platform independent – XML-based web service – First party .NET SDK, external SDKs for other platforms• A single database across all connected applications and devices – Data organized by record, where each record 1:1 with an individual – Central data space • All apps/devices/users access the same user record
5. Scenario: Deliver Summary to PatientDrop Off Pick Up• We have a package of data to deliver to the patient, but we don’t expect to have an ongoing relationship with that patient. – Let’s say CCD for now, but that’s not required• We want the simplest integration model.
6. Delivering a summary to the patientDrop Off Pick Up Institution HealthVault HealthVault.co.uk Patient Record Secret CCD Code Holding User Area Record CCD The institution collects A: Sir Barks a Lot Q: What is the name HealthVault uses the a question & answer of your first pet? user logs into to decrypt used to The answer answer is the The from the patient. data encrypt question and andThe placed in HealthVault.co.uk, it isthe information generates a HealthVault the user’s record. secret sent to A: Sir Barks a Lot their code, and enters information are code that is HealthVault returned to the user provides their answer
7. Drop Off Pick Up (DOPU)• Benefits: – Simple, easy – No need to store any additional data or ID mapping locally• Limitations: – Must repeat process for repeat transfers – Can only send data to patient
8. An ongoing relationship with the patientPatient Connect Institution HealthVault HealthVault.co.uk Patient Record Choose a record: ID: 153453 ID: 153453 Secret Code John Smith Jane Smith’s Record Jane Smith App User ID:BCD… Lab Test Results Suzy Smith App Record ID: A9… A: Sir Barks a Lot Q: What is the name The user and record ids can be selects the The user HealthVault generates user logs into When queried,The a The institution collects The question, answer, HealthVault of your first pet? HealthVault associate. record to used to place information question & answer a into secretand the patientare and the associates sends patient id id sent code that isHealthVault.co.uk, theHealthVault user the patient id with user’s health record. record ids A:returned HealthVault and from code, and a Sir Barksto Lot enters their the patient. to a the to the institution. specific user record provides their answer
9. An ongoing relationship with the patient Linking ApplicationHospital HealthVault HealthVault.co.ukPatient Record Choose a record: User Record Lab Test Results App User ID:BCD… John Smith App Record ID: A9… CCD Jane Smith Suzy SmithWebsite User logsWebsite obtains into Or when the user HealthVault user and candecides to send the HealthVault The hospital use through websiteids, the informationinformation. Selects this stores record and to them withto useinformation to record send patient record the record
10. Patient Connect or Linking?• Patient Connect + No need to create any user interface – More complex user process – Requires Q/A pair, secret code, and offline steps – Requires periodic polling of HV to retrieve newly authorized HV records• Linking Application + Simpler process for user, no need to generate question/answer or enter secret code. + One step process, no polling required – Requires patient facing user interface
11. DOPU, Patient Connect, Linking App• Success! We can: – Connect to a patient using one of three methods – Send packages of data• What if we want to do something more complicated?
12. Diabetes Management• You want to collect home blood glucose measurements from diabetic patients
13. Diabetes Management Device DataClinical System HealthVault User Record BG BG BG Get HealthVault Data User PCHealthVault Connector HealthVault Connection Center Before a patient’s visit, the doctor requests the current The user connects review the data data from HealthVault The doctor can now their blood glucometer, 86 and HealthVault connection center copies the data to the user’s record
14. Diabetes Management How trustworthy is the data?Clinical System HealthVault GlucoseTracker.com User Record BG Device BG Device BG Device BG BG GTHealthVault Connector Data may come from another source, one be presented So the data can review. appropriately that requires moreHealthVault records which application created the data
15. Diabetes Management Remote monitoringClinical System HealthVault User Record #1 #1 BG #1 #2 BG #2 User PCHealthVault Connector HealthVault Connection Center There is now duplicate data. next day, the same thing The Each data item has a id associated with it, happens… The user uploads a reading… That night, the monitoring application the id to know and the application can use 86 copies the data to the clinical system. what items are new.
16. Controlling data access
17. Application identityInstitution A HealthVaultID: 20be3315 ID App Name 20be3315 43a1dcb6 General 20be3315 Institution A f513d74a PlainsSomebody else 20be3315 DataThe application requestsdata using the id it hasregistered… But others could use the same id…
18. Application identityInstitution A HealthVaultID: 20be3315 20be3315 ID App Name Key Certificate x Private Key 43a1dcb6 General Public Key 20be3315 Institution A f513d74a Plains DataSomebody else20be3315 And registers the public key HealthVault with the HealthVault Platformwith validates it The organization obtains a the public key Other applications don’t digital certificate have the private connection request is A key, and signed with the private key can’t access the data…
19. Application data accessHealthVault Application HealthVault HealthVault.co.uk Application Definition User Record Remove access of Application • Name: Institution A Blood Glucose Institution A would to • ID: 20be3315 your record? like to have read • Certificate public key access to your • Access Condition Yes blood glucose No • Read access to data. blood glucose data Lab Test Results Allow Cancel And all other data isThe application wants hidden from theaccess to the Blood But the user doesn’t application.Glucose application is The readings in want to give access Because the data is under userthe defined with only the user’s record… control, the user can to condition or lab The user is asked to at any time access that it needs. revoke that access… tests results… approve an application’s access.
20. Quick Review• “Delivering a summary”: CCD or CCR arrives in HealthVault• “Diabetes management”: individual blood glucose measurements are collected• Questions: – What happens to the summary document once it arrives in HealthVault? – What if my institution wants to retrieve a summary of a user’s HealthVault data as a CCD or CCR? – What is the relationship between the summary document formats and the individual items?
21. Reconciliation & Data SharingInstitution 1 HealthVault HealthVault.co.uk CCD User RecordJoe Hospital CCD contents Medicatio □ Medication 1 ■ n □ Medication 2 ■ Medicatio □ Medication 3 n □ Condition 1 ■ □ Condition 2 ConditionInstitution 2 Allergy Immunization CCR An institution digitally signs a They summarydoctor user’s A CCD choose the items in the at another hospital wants they The userreconcile. patient’s HealthVault want toto review a user. record, and notifiesto HealthVault.co.uk goes the data and chooses to reconcile the CCD.
22. Pulling It All Together• HealthVault is… – A consumer/patient data platform – A single database across all connected applications and devices – An ecosystem of connected applications and devices
23. HealthVault Ecosystem Patient Connect HealthVault Institution B User Record Patient Record ID: 153453 ID: 153453 Lab Test ResultsOur original institution:Drop-off Pick-up HealthVault.co.uk Institution A Patient Record CCD
24. HealthVault Ecosystem Hospital C Linking Application Patient Record Imaging Study Website HealthVault Institution B User Record CCD Patient Record Lab Test Results ID: 153453 ID: 153453 HealthVault.co.uk Institution A Patient Record
25. HealthVault Ecosystem Hospital C User PC 86 BG HealthVault Patient Record Connection Center Remote Monitoring Website HealthVault Institution B User Record CCD BG BG Patient Record Lab Test Results ID: 153453 ID: 153453 Imaging Study HealthVault.co.uk Institution A Patient Record GlucoseTracker.com BG
26. HealthVault Ecosystem Hospital C User PC 86 HealthVault Patient Record Connection BG BG Center Website HealthVault Institution B User Record CCD BG BG Patient Record Lab Test Results ID: 153453 ID: 153453 CCR Imaging Study Data Sharing HealthVault.co.uk Institution A Patient Record GlucoseTracker.com
27. HealthVault Ecosystem Hospital C User PC 86 HealthVault Patient Record Connection BG BG Center Website HealthVault Institution B User Record CCD BG BG Patient Record PHR ID: 153453 Lab Test Results ID: 153453 History Allergy Imaging Study CCRConsumer Applications HealthVault.co.uk Institution A Patient Record GlucoseTracker.com
28. HealthVault Ecosystem Hospital C User PC 86 HealthVault Patient Record Connection BG BG Center Website HealthVault Institution B User Record CCD BG BG Patient Record PHR ID: 153453 Lab Test Results ID: 153453 Imaging Study CCR History Allergy Demographic Info HealthVault.co.uk Hospital D Institution A Patient Record GlucoseTracker.com Community Connect App Example: Pre-registration
29. HealthVault Ecosystem Hospital C User PC 86 HealthVault Patient Record Connection Data Sharing: Variable Fidelity BG BG Med RxNorm Center and Vocabularies Website HealthVault Institution B User Record Multiple applications BG BG CCD reading Patient Record PHR and/or writing Lab vocabulariestype the same data ID: 153453 Different coded Test Results ID: 153453 Med NDC inApplications must determine how to use… or none at all Imaging Study CCR handle known, unknown, or missing History Allergy vocabulary information HealthVault.co.uk Hospital D Institution A Allergy Patient Record Demographic Info Med GlucoseTracker.com
30. HealthVault Ecosystem Hospital C User PC 86 HealthVault Patient Record Connection Center Website HealthVault Institution B User Record Patient Record PHR ID: 153453 ID: 153453 Or… if you prefer an even more colorful anthropomorphized cartoon view (and/or work in marketing) HealthVault.co.uk Hospital D Institution A Patient Record GlucoseTracker.com
31. Questions? HealthVault is… • A consumer/patient data platform • An ecosystem of connected applications and devices • Technology/platform independent • XML-based web service • First party .NET SDK, external SDKs for other platforms • A single database across all connected applications and devices • Data organized by record, where each record 1:1 with an individual • Shared data space • All apps/devices/users use the same records • Users/patients own their copy of the data, must opt-in to authorize connections