Biological Models to Better Understanding of Diseases. Purcarea O, Frangi A, Hernandez V. eHealth week 2010 (Barcelona: CCIB Convention Centre; 2010)

1. ICT for a global
infrastructure for health
research
Dr Octavian Purcarea
Global Industry Manager

2. Challenges for eHealth implementation
• Usability
• Trust
• Sustainability (economic model)
• Implication of different actors (empowerment)
• Bringing closer the clinical practice and clinical
research

3. Challenges for clinical research
• Only 7% of eligible patients enrol in a clinical trial.
• Only 3% of eligible cancer patients enrol.
• 86% of all trials fail to enrol on time.
• 85%-95% study days beyond original study timetable
are due to not recruiting subjects on time.
• Women, minorities, children and special populations are
underrepresented.
• Only 3% board-certified physicians participate in clinical
trials.
• The number of clinical investigators dropped 11%
between 2001 and 2003.
Michael G. Kahn MD, PhD University of Colorado The Children’s Hospital, Denver

4. EPR usability
EPR Usability in the daily practice of the GPs
Belgian Study
USE OF DATA FROM THE PRIMARY CARE EPR - RESISTANCES AND SOLUTIONS
Prof Dr Marc VANMEERBEEK DUMG 2004
Analysis of the database records of the EPR in 8 Medical Homes, 3 years, 133.0000 contacts
« 6, 7% of the contacts were recorded in the database »
« exasperation of the user »
« It seems illusory to continue an IT program
without a rapid response to the numerous improvement demands »

5. EPR usability
EPR Usability in public health and quality management
Belgian Study
QUALITY IMPROVEMENT IN THE PRIMARY CARE BASED ON DATA COLLECTION OF DIABETES
AND HYPERTENSION RELATED CONSULTATIONS
Vandenberghe H., Bastiaens H., Jonckheer P., Orban T., Declercq E.,Lafontaine M.-F.,Van Casteren V.
Service d’Epidémiologie Institut Scientifique de la Santé Publique, 2003, Bruxelles
Exploration of the feasibility of data collection for quality improvement interventions .Two groups:
paper based data collection and EPR based data collection
Conclusion
“40% of the physicians from the EPR based group finally didn’t send the data”
« The quality indicators are strongly divergent for the 2 methods”

6. EPR usability
EPR Usability for GPs
German Study
PRAXISNETZ STUDIE 2006 MANAGEMENT -PROZESSE –INFORMATIONSTECHNOLOGIE
Günter Schicker und Oliver Kohlbauer , Wirtschaftsinformatik II Universität Erlangen-Nürnberg
Analysis of the practice mangement and IT situation of GP Associations in Germany and
Switzerland ; ( 72 deutsche Praxisnetze und 18 Schweizer)
Conclusions
- only 20% of care networks have electronically data exchange
- only 9% have enough structured data
- only 3% can document the care processes electronically

7. Clinical Software for USABILITY
1. Software behavior should reflect the work process of the user (workflow )
2. Software objects should reflect the mental model (concepts) of the user (terminology )
Usability threshold
Terminology
+ ---------------------------------------------------->
Clinical Process
Models

8. Trends : the Expansion of Networks:
Numbers of Connected Devices
• ‘60s 10s
• ‘70s 100s
• ‘80s 1,000s
• ‘90s 1,000,000s
• ‘00s 1,000,000,000s
• ‘10s 1,000,000,000,000s
• ‘20s 1,000,000,000,000,000s

9. Platforms, not technologies,
Create Economic Value
• Consistent APIs Cloud
• Standards for
interoperability
Web
• Available at scale
• Compelling business
model LAN
Personal

10. Why Cloud changes the rules
• Instant global scale service creation: Creates
major opportunity for startups
• Adds value to all existing platforms: Software +
Services
• Interoperability based on open standards:
Broadest device, client and data accessibility

11. Enhanced
GUI NUI
Voice
Handwriting
Single
Touch

12. Data Input

13. Innovative interfaces

14. 10 Year View:
An Algorithmic* Transformation
• Automation of the routine
Moore’s
Law • Network Embedding of specialized
+
knowledge and processes
Cloud
• Massive expansion of networked
+
service value chains
Ubiquitous • Value creation moves from
Networking specialized to generalized skills
+
NUI
*Prof. John Zysman, BRIE – UC. Berkeley

15. Implications:
Healthcare Providers
• Will need to add semantic interoperability to
automated processes and knowledge networks
• The role of the GP will change dramatically as
patients become increasingly educated, networked
• Real-time monitoring and sensor based
diagnostics will transform working practices
• Massively increased competition in health services
provision

16. Implications:
Patients
• Move towards ‘end to end’ health and wellness
management strategies
• Increased choice as providers compete with
monitoring and diagnostic services
• Much higher expectations from service providers
• Increased concern about privacy as health
services and data go online

17. Implications:
Research
Integrating Electronic Health Records (EHR) with
Electronic Data Capture (EDC) systems used in
clinical trials:
• avoid duplicated data entry
• assist in automatic identification of patients for
clinical trials
• enable early detection of potential patient safety
issues.
• Take into account multiple parameters
(environmental, physical, genetical)

18. A Fundamental Change is Underway
- World Health
Organization

19. HealthVault = Health Application
Platform

20. Personal Health & Wellness
Patients can:
•store health information
Health & Fitness
Physicians
Device
Manufacturers from many sources
•access a range of health
Health Plans
Laboratories
and fitness apps
•upload data from health
Hospitals
Employers and fitness devices
•share health information
Healthcare
with those they trust.
Associations
Pharmacies
& PBMs
Schools
Application
Providers

21. Future plans
Towards full picture of individual’s health status
Biosensors Biochips
Environmental Genomic data
Data
Phenomic data
Integrated Health Records

22. Connected Health Platform
Connected Health Platform
Infrastructure & Platform Offerings
Application Platform for Health
Business Productivity Infrastructure for Health
Core Infrastructure for Health
Connected Health Framework – Architecture and Design Blueprint
Resources available at: www.microsoft.com/healthICT

23. Knowledge Driven Health Create a Technology
Foundation
Microsoft
Connected Health
Framework

24. Seamless Integration of External
Services: EPR side
Seamless integration at
user interface
Exchange of key patient
data

26. Integration of the HIS side: Microsoft Amalga Unified
Intelligence System

27. Data Citizens
Integration System
Contributors
Health Domain
PHR Applications
Aggregation & Personal Health
Insight System Record System
Interoperability Tools
Healthcare Providers
Primary Care Provider Social Worker
Care Manager
Specialty Care ED Physician Case Manager

28. Data Citizens
Contributors
BizTalk Server
HealthVault Applications - Partners
Connected Health
Connected Health Platform &
Partner Interoperability Tools
Healthcare Providers
Primary Care Provider Social Worker
Care Manager
Specialty Care ED Physician Case Manager

29. What We Need to Make It Happen?
• Support (fund) semantic interoperability including human resources.
• Involve, empower the individuals in management of their own Health,
involve from the beginning in your projects the Health Professionals;
• designing an organisational architecture that bolsters the interest of
health professional, promoting the early assessment of new
therapies for their inclusion among the reimbursable treatments,
fostering the validation of clinical trials protocols based on Evidence
Based Medicine and additionally, on Evidence Based Management.
• validating new reimbursement schemas, assessing the need for
incentives for health professionals and patients involved in clinical
trials, and devising new adherence strategies with patients and
health professionals.
• Think in terms of pay per performance, quality related indicators,
incentives, trust and usability.

30. For More Information about Microsoft Health
• Health Web site: www.microsoft.com/healthcare
• Health Blog: www.blogs/msdn.com/healthblog
• EMEA Health Blog:
http://blogs.msdn.com/ms_emea_health_blog/default.aspx
• Information on Amalga and Health Vault can be found at:
http://www.microsoft.com/hsg/
• You can find information on the Common User Interface and the
design guides at: www.mscui.com
• Here is the link to the CHF (Connected Health Framework) material:
http://msdn2.microsoft.com/en-us/architecture/bb525069.aspx
• For MedStory (now called Live Search – Health) go to
https://ssl.search.live.com/health/default.aspx or www.medstory.com.
E-mail: ocpurca@microsoft.com

31. © 2010 Microsoft Corporation. All rights reserved. Microsoft, Windows, Windows Vista and other product names are or may be registered trademarks and/or
trademarks in the U.S. and/or other countries.The information herein is for informational purposes only and represents the current view of Microsoft Corporation as
of the date of this presentation. Because Microsoft must respond to changing market conditions, it should not be interpreted to be a commitment on the part of
Microsoft, and Microsoft cannot guarantee the accuracy of any information provided after the date of this presentation.
MICROSOFT MAKES NO WARRANTIES, EXPRESS, IMPLIED OR STATUTORY, AS TO THE INFORMATION IN THIS PRESENTATION.