Cape Town, Dec 2015, Chris Isaacs and Eduardo Jezierski present the progress of the CDX initiative at the Union Conference.

1. Bringing Connected Diagnostics to Scale

2. Connected Diagnostics Opportunity
Improve
Linkage to Care
Reduce Loss to
Follow Up
Improve
Surveillance Reduce
Transcription
Errors
Monitor
Quality
Assurance
Reduce Stock
Outs
Improve
Training & HR
Diagnostics Data

3. Challenge - Fragmented Data Collection
Dx1 Portal Dx2 Portal Dx3 .. No portal
Dx1 Dx2 Dx3

4. Aggregated View Across Diagnostics
DX2
DX1
DX3
DX2 Portal
DX1 Portal
?
Useful DX1 info
Useful DX2 info

5. CDX: Connected Diagnostics Initiative
CDX Platform:
CDX
Initiative:
• Technology & Services
• Transmit & store data
• Multiple diseases, manufacturers
• Open source
• Secure, PII privacy
• Commitment to standards
• Manufacturer engagement
• Policy maker engagement
• Design Advisory Board
• Ecosystem of field support vendors
• Evaluation and Research
InSTEDD specializes in designing open
source, scalable technology tools to solve
critical health, safety and development issues.
FIND’s expertise is in the domain of diagnostic
development and delivery, particularly for
infectious diseases.

6. CDX Platform
Accelerates connecting
new devices by
manufacturers & 3rd
parties
Device Software
Open & standards-
based protocols
for 2 way
communication
between devices
and servers.
See dxapi.org
Protocols
Software that can
run in the cloud or
your own servers.
Aggregates device,
result, error and
other information
Servers &
Services
Ecosystem of
ehealth & mhealth
tools:
EMR, ERP,
TB Dashboards,
HIMS,
mobile alerts, etc.
3rd Party
Applications
etc….

7. Trained resources for eHealth interventions
CDX Initiative Areas of Effort
Hospitals
& Labs
Health postCommunity
health
worker
eHealth policy & strategy
Evidence of eHealth impact
Standards & Interoperability
Centralised data collection, sharing & access
A
B
D
C
E
National health
programs
Global policy
& surveillance

8. CDX 1.0 Platform Sneak Peak

9. CDX Preview – Basic Stats

10. CDX Preview - Errors

11. CDX Preview – Filters & Alerts

12. Multiple Perspectives

13. CDX Preview – Mapping Results

14. CDX Preview – Workflow Views

15. CDx Preview – Data Sharing

16. CDX 1.0 - Offering
• Platform
– Version 1.0 – Q1 2016
– Available both cloud & institution-hosted
– A portfolio of TB diagnostics
• Technical Assistance
– CDX server deployment guide
– User guide
GeneXpert
Omni
BACTEC
MGIT
GenoScan
Cepheid Alere
Alere-q
BD
Micro Imager
Hain

17. Mike Turnlund
VP/GM, Engineering & Software
Cepheid

18. Connectivity & Roles in the Ecosystem
• Centralized, multivendor data systems (EMR,
ERP, etc) are best served by ISVs, not device
manufacturers
• Quick integration of secure data streams makes
system adoption easier
• Different roles mean different data needs for
institutions and manufacturers
• Manufacturers: system heuristics, usage, errors
• Institution: EMRs, epidemiology, logistics
• CDX allows for quick, uniform, contextual large
scale diagnostic system data collection for an
institution

19. Data Streams in a CDX Ecosystem
GeneXpert harvests data and
Transmits to RemoteXpert
CDX local server
receives data and
stores it in
institution EMR
Tests run on
lab devices –
cross labs and
geos
Heterogeneous
devices transmit
data in CDX format
Institution X data
Institution, NGO users
log into their servers
and use aggregated regional
EMR and logistical data
RemoteXpert receives data and
securely stores it, generates
machine health analysis and
alerts
CDX client transmits
formatted data
from GX to institution servers
RemoteXpertGeneXpert
CDX

20. CDX Cepheid Support
• Cepheid supports integration with many different
LIS, EMR, and multi-disciplined ecosystem tools
• Secure, structured integration with all data
systems is vital
• Quicker, structured integration of
comprehensive diagnostics data (not just PCR)
frees up resources, accelerates care
• Cepheid will make available open source clients
for it’s systems to securely and robustly support
data transmission in the CDX format to support
FIND’s initiative

21. Anita Suresh
Worldwide Mktg Manager, TB Diagnostics
BD Diagnostics
“BD's vision is to enable fully
integrated and connected
informatics solutions for our
diagnostics customers.
In TB, this would include real-
time reporting, data aggregation
and surveillance tools, bringing
together diagnostic results
across multiple platforms at
multiple health settings.
BD is partnering with the
Connected Diagnostics Initiative
to achieve these goals while
allowing institutions to customize
their solutions to drive clinical
impact. ”

22. Dr. Dennis Falzon
Global TB Programme
WHO

23. Global tuberculosis report 2015 (WHO/HTM/TB/2015.22). Geneva, World Health Organization. Geneva,
World Health Organization; 2015. www.who.int/tb/publications/global_report/en/
MDR−TB cases and additional rifampicin−resistant TB cases detected (orange) compared
with TB cases enrolled on MDR−TB treatment (blue), global trend and trend in 27 high MDR−TB
burden countries, 2009−−2014

24. Uses of TB Laboratory Information
1) The requisition, receipt, scheduling and performance of
tests
2) The collection and management of samples, and the chain
of custody
3) The distribution of test results to clinicians
4) Inventory
5) General laboratory reporting (including billing and contracts)
6) Workload statistics and laboratory performance
7) Surveillance of TB and drug-resistance
8) Human resources development, including training
9) Quality control and external quality assessment processes
10) Laboratory biosafety measures
11) Others (specific to an individual laboratory)

25. Laboratory Informatics
• Strengthening TB laboratory informatics important
- Laboratory confirmation desirable in both TB/DR-TB
patients
- Case detection data (TB & DR-TB) are often sourced
directly from laboratories
- As diagnostics become more advanced even in low
resource settings, weaknesses in information
management become more pronounced
- Better informatics offer other potential to improve care
and laboratory performance.

26. WHO/ERS. Digital health for the End TB Strategy: an agenda for action. (WHO/HTM/TB/2015.21).
Geneva, World Health Organization; 2015.
“Connected diagnostics” : a logical
first step in the development of TB
laboratory informatics

27. Extensive Existing & Planned Clients
• Increasing
coverage of
common ehealth &
mhealth solutions
• From self-contained
to national scale
• Promiscuous
interoperability a
core goal

28. 2016 Efforts
• CDX Advisory Board
• Additional Manufacturer Support
• Implementations
• Research & Evidence

29. Thank you
For further information please visit
cdx.io