hData: Linking Patients

and Providers

Capstone Project
Kenyetta Cole
Rozmin Pirwani
Candyce Thompson
Tao Yang
6.3.10
 Introduction
• Problem Statement

• Problem Objective

• Project Scope
 Background
• Quest to improve American Healthcare System

• American Recovery and Reinvestment Act

(ARRA)

• EHR Incentive Program

 Personal Health Record (PHR)
• Wave of the future
• Will change healthcare
– Improve healthcare delivery
– Improve quality of care
– Improve data availability and
exchange
– Control cost of care
– Increase patient engagement
 PHR Benefits
• PHR provide patients:
• ability to manage their health record
• Diagnosis
• active medications
• current allergies
• Immunizations
• review lab and radiology results
• review past appointments
• schedule future appointments
• manage prescriptions refill and
receive full secure doctor messaging
integrated into the system.
 PHR Examples
• Google Health
– Utilize CCR standards
– Focus on three key areas: Discovery,
Action and Community

• Microsoft HealthVault
– Allows user to connect their EMR to
application devices designed to
interact with the health data
– An online storage allowing creation of
applications which link and interact
with health records and analyze
information
 Electronic Health Record (EHR)
Questions raised:

• What information should be shared?

• How should patients be

authenticated?

• How should privacy be protected?

 Integration Benefits
Patients:
• Improve understanding of health issues
• Increase sense of control over health
• Increase control over access to personal health information
• Verify accuracy of information in provider records
• Easy and fast prescription refill
Providers:
• Improve access to data from other providers and
organizations
• Avoid redundancy and duplicate tests
• Improve documentation of communication with patients
• Provide information to patients with convenient access to
services
• Reduce ER visits
Organizations:
• Improve workforce productivity
• Strengthen health promotion and disease prevention
 Privacy and Concerns
• Bush Mandate

• Network Benefits

• HIPPA

• Unique Patient Identifier

 Unique Patient Identifier

Direct Method for linking patients to

data
– Unique
– Non-disclosing
– Invariable
– Canonical
– Verifiable
– Ubiquitious
 Cost
Total Costs of a nationwide of Personal Health Records
w/UPI
One Time Annual
Adopt EMR $103 $26
Interoperability 0.37 0.15
Interfaces $26 $10
Host & broker 0 0
PHR User Fee 0 $12
Transaction $1.50
Total $129.37 $49.65

Amount is in millions
Simplified CDA
Sample CCR
hData - Specifications

Beuchelt, G., R. Dingwell, et al. (2009). "hData Secure and Scalable

RESTful Health Data Exchange". Bedford, MITRE Corporation.
hData Record Format (HRF)

Beuchelt, G., R. Dingwell, et al. (2009). "hData Secure and Scalable

RESTful Health Data Exchange". Bedford, MITRE Corporation.
 HRF Structure
• HRF Structure
– URL identifies the record &
corresponding sections
– Section documents are of content
type application/xml

• Section resolve to Atom feeds

 Data Assurance Module

• Control Algorithm
• Defining Quality Check Rules
• Automatic correction
• Correct the invalid records
 Data Assurance Module
• Recycle data
• Standardization and cleansing
• Address validation and enrichment
• Duplication filter *hData has a built
in unique document identifier to
guarantee uniqueness over all other
hData documents,the duplication
filter still is important tool for
multiple hData sets and other data
during transition process.
 IT Security and Compliance

• Secrecy – data should only be viewed by

authorized individuals.

• Authenticity – data should be created by

authorized users, and not be forged.
• Integrity – data should not be destroyed
(without authorization).

• Availability – access to data should not be

maliciously interrupted.
 IT Security and Compliance
• Safeguarding sensitive patient information has
become even more critical given that the Electronic
Protected Health Information (PHI)
• Electronic Medical Records (EMR) as mandated by
the Health Insurance Portability and Accountability
Act (HIPAA)
• hData meets the HIPAA regulation : HIPAA SR
164.312(a)(1)
• hData Access Control mapped to SCAP through NIST
800-53.
• hData’s data structure contain essentially profiles of
existing HITSP Constructs which then map to
requirements of the American Recovery and
Reinvestment Act (ARRA).
Security Governance, Risk Management
and Compliance
hData Security Work Flow

Beuchelt, G., R. Dingwell, et al. (2009). "hData Secure and Scalable

RESTful Health Data Exchange". Bedford, MITRE Corporation.
 New Developments
• Mobile computing: allows users to transmit data
from remote locations to other remote or fixed
locations.

• Virtualization: lets you run multiple virtual

machines on a single physical machine.

• Cloud Computing: can significantly reduce IT costs

& complexities while improving workload
optimization and service delivery.

• One benefit of hData is its internet scalability –

patients (350M+), providers (1M+), and other actors
(1M+),so the Cloud computing can be a good fit.
 Conclusion
• hData is complementary to existing architecture

• Benefits to vendors

• Addresses the need for enabling agile HL7

development

• Separation of content and technical framework

• RESTful approach enables better horizontal and

vertical scaling
Conclusion

“hData Updates” HL7 WSG Presentation 2010

Questions