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groups:healthcare:connecting_health_data_across_silos_for_diagnostics_and_treatment [2018/07/17 13:45]
Marissa Iannarone updating with correspondence and work of A. Courtney
groups:healthcare:connecting_health_data_across_silos_for_diagnostics_and_treatment [2018/07/24 23:53] (current)
Marissa Iannarone added players from Tony and Jeff
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 **Section 1 - Problem Statement** **Section 1 - Problem Statement**
  
-The Patient Subgroup has submitted an abstract to the Hyperledger Global Forum:​[[https://​events.linuxfoundation.org/​events/​hyperledger-global-forum-2018/​]]. Abstract submitted is as follows:+The Patient Subgroup has submitted an abstract to the Hyperledger Global Forum December 12th-15th, 2018:​[[https://​events.linuxfoundation.org/​events/​hyperledger-global-forum-2018/​]]. Abstract submitted is as follows:
  
 Aggregated healthcare data is a powerful tool. Informing algorithms for patient diagnostics and treatment. Currently, data are across various silos in electronic medical records, laboratories,​ etc., residing with various stakeholders that are disconnected from one another. Aggregated healthcare data is a powerful tool. Informing algorithms for patient diagnostics and treatment. Currently, data are across various silos in electronic medical records, laboratories,​ etc., residing with various stakeholders that are disconnected from one another.
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 The MVP use case with this functionality could be with 4 players: The MVP use case with this functionality could be with 4 players:
   * Patient   * Patient
-  * Healthcare entity A (hosptial, lab, etc)+  * Healthcare entity A (hospital, lab, etc)
   * Healthcare entity B   * Healthcare entity B
   * Researcher   * Researcher
 +
 +Addition players to be taken into consideration to encompass the full ecosystem (highlighted in graphic below):
 +
 +  * Hospitals / Health Systems / Life Science (Research org)
 +  * Health Plans
 +  * Physicians Offices
 +  * Care Coordination Network
 +  * Social / Health Services Organization
 +  * insurer/​payer
  
 If we make the assumption that both healthcare entities use the same data standards (FHIR or other), this is how the work flow could be laid out: If we make the assumption that both healthcare entities use the same data standards (FHIR or other), this is how the work flow could be laid out:
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 **Participants:​** **Participants:​**
-Company--->​Doctor +  * Company--->​Doctor 
-Manufacturer>​Hospital +  ​* ​Manufacturer>​Hospital 
-Auction house----->​Researcher +  ​* ​Auction house----->​Researcher 
-Regulator----->​Insurance +  ​* ​Regulator----->​Insurance 
-Private owner----->??​data private owner. Same as patient +  ​* ​Private owner----->??​data private owner. Same as patient 
-Scrap merchant----->??​deceased data base+  ​* ​Scrap merchant----->??​deceased data base
  
 **Assets:** **Assets:**
-Order----->​Lab/​ procedure order +  * Order----->​Lab/​ procedure order 
-Vehicle----->​Patient+  ​* ​Vehicle----->​Patient
  
 **Transactions:​** **Transactions:​**
-Place order----->​ Order Lab/ procedure +  * Place order----->​ Order Lab/ procedure 
-UpdateOrderStatus------->​ Update Lab/​procedure status +  ​* ​UpdateOrderStatus------->​ Update Lab/​procedure status 
-Application for vehicle registration certificate----->​Insurance application(healthcare) +  ​* ​Application for vehicle registration certificate----->​Insurance application(healthcare) 
-Private Vehicle transfer----->​Patient transfer to new doctor +  ​* ​Private Vehicle transfer----->​Patient transfer to new doctor 
-Scrap vehicle----->​patient deceased +  ​* ​Scrap vehicle----->​patient deceased 
-Update suspicious----->​ ? Fraud or medication abuse  +  ​* ​Update suspicious----->​ ? Fraud or medication abuse  
-Scrap all vehicles by color------>​group patients by disease or category+  ​* ​Scrap all vehicles by color------>​group patients by disease or category
  
 **Events:** **Events:**
-Place order event----->​ order lab/ procedure event +  * Place order event----->​ order lab/ procedure event 
-Update order status event------>​updates lab/ procedure event +  ​* ​Update order status event------>​updates lab/ procedure event 
-Scrap vehicle event------>​ deceased+  ​* ​Scrap vehicle event------>​ deceased 
 + 
 +We've confirmed that we will be working on a open source build. Tony Little suggested looking at the Davinci project from FHIR that that provides an implementation framework for others to follow: [[http://​www.hl7.org/​about/​davinci/​index.cfm?​ref=common]] 
 + 
 +We will also want to work with the Hyperledger ID team to understand better what they have thought of/built already. Once we have a journey map completed, we can loop them in and walk through it with them to gain insights. ​
  
 **Current Solution** **Current Solution**
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 Take a look at how UK NHS is solving this same problem: https://​www.engadget.com/​2018/​06/​29/​britain-nhs-anonymous-health-data-privitar/​ Take a look at how UK NHS is solving this same problem: https://​www.engadget.com/​2018/​06/​29/​britain-nhs-anonymous-health-data-privitar/​
  
-We will also want to work with the Hyperledger ID team to understand better what they have thought of/built alreadyOnce we have journey map completed, we can loop them in and walk through ​it with them to gain insights+We have reviewed [[https://​medicalchain.com/​en/​|Medicalchain]] (Hyperledger project) and believe that they are targeting a very similar solution to what is laid out below. After reviewing the white paper, we do see possible opportunities for a POC to be built that would support Medicalchain work in the following areas: 
 +  * AI - machine learning could be inserted into the network - Anton recommended looking at [[https://​ada.com/​|ADA]] 
 +  * Chain of custody (which appears to be a gap according to the white paper 
 +  * Researchers able to engage with patient data via the '​market place' component laid out in the white paper 
 + 
 +We are waiting to hear back from Medicalchain on the following questions ​and are hopeful that a representative will be on the 7/27 HCWG call so that we can determine whether ​it makes sense to move forward ​with the use case stated above. 
 +  * If Medicalchain has implemented their code onto the main block chain at this time?  
 +  * Where their struggles, if any, may lie in implementation of the project.(This may be a question for them directly.)
  
 _If there are systems in place today which automate the above business problem/​opportunity,​ please explain what exists._ _If there are systems in place today which automate the above business problem/​opportunity,​ please explain what exists._
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 When thinking of this individual-owned health data record, we have identified 2 major use cases to explore (each of these with endless user journey and "sub use cases":​ When thinking of this individual-owned health data record, we have identified 2 major use cases to explore (each of these with endless user journey and "sub use cases":​
-* Clinical trials +  ​* Clinical trials 
-* Sharing data across healthcare entities +  * Sharing data across healthcare entitiesEmergency room visit - how can an individual bring any relevant data with you to an emergency visitAcute incident that requires both in-network and out-network provider visits/​interventions ​ 
-  * Emergency room visit - how can an individual bring any relevant data with you to an emergency visit +
-  * Acute incident that requires both in-network and out-network provider visits/​interventions+
  
 From here we need to deconstruct these use cases to make the work more actionable (we can't boil the ocean) - journey mapping seems like a logical next step - identifying the steps that a user would take along the way to get the expected results - then at each step of the way we can dig into the challenge areas below. From here we need to deconstruct these use cases to make the work more actionable (we can't boil the ocean) - journey mapping seems like a logical next step - identifying the steps that a user would take along the way to get the expected results - then at each step of the way we can dig into the challenge areas below.
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 Initial thoughts on journeys to map: Initial thoughts on journeys to map:
 +
 * someone signs up to engage in our platform in order to manage data from and engage in a clinical trail * someone signs up to engage in our platform in order to manage data from and engage in a clinical trail
 * someone is looking to manage data from a treatment protocol that requires visits/​interventions with multiple physicians * someone is looking to manage data from a treatment protocol that requires visits/​interventions with multiple physicians
 * Opt-in for laboratory sample results to be leveraged to inform patient treatment protocols or diagnosis * Opt-in for laboratory sample results to be leveraged to inform patient treatment protocols or diagnosis
 +
 +Patient Centered Data mapping provided by Tony Hussain on 7/6: {{ :​groups:​healthcare:​screen_shot_2018-07-06_at_12.17.54_pm.png?​200 |}}
 +
 +**Other Use Cases Being Considered by Patient/​Member Subgroup**
 +[[groups:​healthcare:​donor_milk_transparency_and_traceability|Donor Milk Transparency and Traceability]]
  
groups/healthcare/connecting_health_data_across_silos_for_diagnostics_and_treatment.1531835113.txt.gz · Last modified: 2018/07/17 13:45 by Marissa Iannarone