Post on 20-Jun-2020
IBM Research
Smart Healthcare Platform(Medical Information & Care System)
Kyriacos Kokkinos
IBM
Evidence-based Patient Empowerment
© 2011 IBM CorporationUniversity of Piraeus
IBM Research
I Problem Statements
II IBM Healthcare Platform : Overview
Agenda
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III IBM Healthcare Platform : Key Use Cases
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Focus on Value
Market trends and their implications present the need for transformation
Escalating Costs
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Information liquidity and
transparency
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Problem Statement
� Time : Only few minutes per encounter (Only 1 minute for
informing the patient)
� Information : Large volume of information to consider
� Access to data : No single point of access
� Specialization : Doctors are specialized in their own domain
� Regulations : No access to all of the patient information
� ROI of Hospital : Increased patient safety usually leads to
Physicians have “limitations”“I am hesitating to
use the decision
support tool. Can it
make more income
and provide
meaningful
information?”
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� ROI of Hospital : Increased patient safety usually leads to
decrease in ROI
� Patients want to manage their health information as
they manage their finance – with full control
� Patients are not passive any more – become important
part of the decision making flow
� Patients want to know more
� Patients want maximum access to all kind of information
– both personal and public
Patients are entering the conversation about their health
“Give me the tools to
be better prepared
for my next
encounter with my
doctor”
information?
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Changes of Healthcare Provider
� Physicians who share medical information by using web 2.0 are increasing
– Physician, patient, and scientist get medical information from web such as Blog, YouTube, Twitter, etc.
– Medical Blog competes with medical mass media and academic journal
– Sharing information each others through websites and SmartPhones
� Promote public health policy and hospital by web
– Centers for Disease Control and Prevention (CDC) promotes their policies through Twitter.
– Attract foreign patients by taking advantage of IT marketing from domestic hospitals
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[Source] Social Media and Changes of Healthcare Environment (Yang, Guang Mo)
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Changes of Healthcare Consumer
� Increased use of health information through the Internet
– In 2000 : 25% of adults searched online health information.
– In 2009 : 74% of American citizen used internet, 61% of adults use online health information.
� Growth of active utilization medical information
– Medical customers search their particular experienced disease, treatment, and drug through internet.
– The rate of looking for drug information on internet is increasing annually.
� Obtain and share medical information by using social media
– Get or share people’s illness information through social media. (Ex. PatientsLikeMe)
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Ask advice about which hospital should I
go or what treatment should I get…
Search on the internet what my physician
said to me….
[Source] Edelman Health Engagement Barometer 2008
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Empowering The Patients
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Empowering the patients Empowering the physiciansWell-informed patient with self-management skills Evidence-based medicine
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How can we empower the patients?
Patient
Analysts Physician Auditors
To realize evidence-based patient centric health care services requires an innovative system supporting
various patient data integration, knowledge base with standard clinical guidelines, real-time data
analysis and health care information delivery customized for individual patients.
MEDICAL CONTENT PUBLISHERS,
DRUGS COMPENDIA COMPANIESPHYSICIANS AND PATIENTS INSURERS & REGULATORY
Patient
Medical knowledge acquisition and generation Collaboration between
physician and patient
Evidence-based assessment and
reporting adverse drug reaction
FDA
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Evidence-based Clinical Knowledge Base
Gu
ide
line
R
eco
mm
en
da
tio
ns
& E
vid
en
ce
Physician
Analysts Physician
Guideline adherence
Auditors
Content Recommendation
[Reference] IBM GTO 2011 Services Implications
Guideline Generation Assistant
Clinical Guidelines Delivery &
Recommendation
Clinical Guidelines Auditor
EHR(PHR, EMR, Genome)
Physician
op
tim
ized
hea
lth
car
e in
form
atio
n
Clinical data
integration
FDA
ADE Report
Patients’ Records
DrugsMedical
Literature
Audit policies
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Medical Information & Care System
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IBM Healthcare Platform : Overview
IBM Research
Healthcare Solution toward CDSS Platform
IBM Healthcare Platform is a medical diagnosis model-based intelligent clinical system to empower
individual patients with valuable information to play an active role in decision making and implement
their own health care
Evidence DeliveryData ManagementKnowledge
Management
Data Sources
UsersIBM Healthcare Platform
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� HL7 Rim-based
Semantic Data
Warehouse
� Adaptable data
connection with
various healthcare
system (EMR / PHR /
Genomic services, Sensor
devices)
� Ontology-based
CDSS Knowledge
Base platform
� Real-time clinical
analysis engine
� Web-based clinical
rule authoring
toolkit
� Social-Medical
discovery platform
� Clinical mashup
service platform
� Collaborative and
adaptive user
interface framework
�PHR Data
�EMR Data
�Sensor Data
�Genomic Data
�Social Data
�Life style
�Family history
�Patient
�Family
�Physician
�Pharmacist
�Researcher
�Executive
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IBM Healthcare Platform Features
Clinical data integration Clinical knowledge management
�Dynamic incorporation of public knowledge
- Structure, unstructured and semi-structured
- Various knowledge sources : FDA, LODD etc
�Horizontal : Integration of various data sources
- EMR System, PHR System, Genetic testing agency
system, sensor devices etc
�Knowledge authoring toolkit
�Vertical : Integration of heterogeneous
medical data
- Medical records, PHR data, Genetic data,
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Scalable enablement platform Evidence delivery
�Large-scale data and standards-based
knowledge management
�Support analytical services
�3rd-Party service providers
�Rule-based medical data analysis environment
�Leverage social networks for the benefits of
physicians and patients
�User interface framework for personalized UI
- Medical records, PHR data, Genetic data,
Image data, Test results, Sensor data etc
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Medical Information & Care System
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IBM Healthcare Platform : Key Use cases
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Key Use Cases
Smart ADE System
Advanced ADE system to provide personalized contents
and ADE monitoring service in conjunction with various
sources which reflect latest clinical information
Chronic Disease Management System
Remote monitoring system to improve the quality of life
of chronically ill patients by enabling them to be cared at
home rather than have to be admitted to hospitals
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CP Monitoring System
Provides the toolkit which supports clinical pathway
modeling and analyzes the differences between realistic
medical treatment and the pattern of clinical pathway
Prescription Assistance System
Medical diagnosis and treatment planning and
monitoring system to provide the clinical guidelines and
evidence data based on the historical patient records
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Key Use Cases > Prescription Assistance System
CDSS PlatformPrescription
Assistance
Sensor Gateway
Sensor
Adapter
CDSS Applications
IBM Healthcare Platform supports to establish the medical diagnosis and treatment planning and
monitoring system which provides the clinical guidelines and evidence data based on the historical
patient records.
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Patient Data
(EMR,OCS etc)
HIS Interface
HIS AdapterClinical Expert
Group
Knowledge Source
Medical
Knowledge
Historical
Data
Remote Patient
Monitoring
ICU Monitoring
Outpatient
SensorDigital Guideline
Physician
Inpatient
Sensor
Sensor Gateway
Sensor
AdapterClinical Data
Management
Knowledge
Model
Management
Clinical Event
Engine
Knowledge
Toolkit
Social Medical
Discovery
Knowledge
Acquisition
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Denmark Case: The Challenges
Drugs cost rising !
Source: OECD
What medicine is Prescribed?
Is the cheapest drug Prescribed?
Is every doctor prescribing the same medicine?
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Prescriptions are misinterpreted
In Denmark 15 mill prescriptions every year
15 mill prescriptions to be reimbursed
15 mill prescriptions manually handled by Family
doctors, Pharmacies, Health Insurance…
Clarifications has to be made…
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Is every doctor prescribing the same medicine?
Contributions of ePrescription
Drugs cost rising !
Source: OECD
What medicine is Prescribed?
Is the cheapest drug Prescribed?
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Prescriptions are misinterpreted
In Denmark 15 mill prescriptions every year
15 mill prescriptions to be reimbursement
15 mill prescriptions manually handled by Family
doctors, Pharmacies, Health Insurance…
Clarifications has to be made…
IBM Research
For whom is ePrescription?
Health Insurance
Government
� Higher quality in medication� Low cost
� Transparency in medication
� Optimize work routines & reduce time and cost
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Family doctor
Pharmacy
Patient
Hospital
� Optimize work routines & reduce time and cost
� Higher quality in service
� Higher quality in medication
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Key Use Cases > Smart ADE System > Why Adverse Drug Event (ADE) ?
� ADE is a harm associated with the use of given medications at a normal dose
� ADEs result in more than 770,000 injuries and deaths every year
� Cost up to $5.6 millions per hospital per year
� Between 28% to 95% of ADEs can be prevented
� Knowledge about interactions is already out there
* From the Agency for Healthcare Research and Quality (USA)
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[Source] Health Study 2010 | How to engage in the conversation with empowered patients
by © InSites Consulting, 2010
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Key Use Cases > Smart ADE System
ADE Portal established on IBM Healthcare Platform optimizes knowledge management process and
provides real-time drug side effect monitoring service. Also, it provides personalized healthcare contents
as linked with various sources which reflect latest information to knowledge base.
FDAKnowledge
ADE System(Hospital)
③ Confirmed /Adjusted
Knowledge
⑨⑩
⑤ ADE Request ⑤ ADE Request
Knowledge Search Knowledge Generation
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Smart Health
PortalPatient
Clinical Data
Analysis⑪ Personalized
Contents
KFDA
PublicationKnowledge
Toolkit
Knowledge
Base Knowledge Expert
PHR System
Genomic
s
EMR System
Clinical Data(PHR, EMR, Genome)
Doctor
(Hospital)
① Knowledge (Text File)
② Knowledge Annotation
Search Engine
Web
sites
④ Clinical Data,
Medication
④ EMR Data, PHR Data, Genomic Data
⑤ ADE
Request
⑩ Latest Information
⑧Analysi
s Result
⑨Personalize
d ADE
⑩Personalized
Contents
⑦ Patient Data
Future Plan
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Achieve better quality and outcomes:
Anatomical representation of patient and health information
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Towards a smarter healthcare
The information technology is not the solution…
… but, whatever it is, will be based on intensive use of Information Technology and Communications
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IBM Healthcare & Life Sciences Team� 5,000+ employees worldwide
– Services, Systems, Software, Research, & Financing,
Sales
– Large Clinical Consulting Staff
� Clients include:
– Hospitals: 14 of the top 14 US hospitals from the 2010
"U.S. News & World Report" honor roll
– Healthcare Insurance: 12 of top 13 companies
– Government: significant projects in Canada, Singapore,
Denmark, Germany, Ireland, Spain, Italy, China, India
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Denmark, Germany, Ireland, Spain, Italy, China, India
and US
– Pharmaceutical: 30 of the top 30 companies
– Biotech: 18 of top 20 companies
– Also, medical research, state and local, and other
emerging countries’ governments
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IBM’s Commitment to Healthcare and Life Sciences
Recent History� Designated Life Sciences an IBM Emerging Business Oppty Unit -Spring 2000
– $100M initial investment
� IBM Research
– IBM Computational Biology Research Center
– Deep Computing Institute
– Blue Gene Project
� IBM Business Consulting Services
– Healthcare Consultants (2500)
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– Healthcare Consultants (2500)
� Strategic partnerships with industry leaders (Mayo Clinic, Karolinska Institutet, Duke, Johns Hopkins, Pfizer, Affymetrix, etc.)
� Created IBM Healthcare & Life Sciences (1/10)
– $1.350M Investment
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Patient is the Center
UNIQUE SOURCE OF DATA
– Family history
– Life style (nutrition, multi
vitamins, exercise habits,
drinking, smoking...)
– Over the counter (OTC)
drugs
– Sensors
DATA HUB OF EXTERNAL
SOURCES
– Clinical Data : Records from
Hospital, Clinics
– Genetic Data- Today, Genetic tests
- In the future, Sequencing per
patient
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– Sensors
KNOWLEDGE CONSUMER
– Drugs interactions
– Available Therapies and
medications
– Clinical Trials
patient
NODE IN SOCIAL MEDICAL
NETWORK
– Family, Friends
– Other Patients, Physicians
– Medical profile
– Genetic Profile
– Documents
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HealthcareSystem
IBM Healthcare Platform Architecture
Data Sources Data Collection
HomeSensor
Sensor Device
HospitalSensor
Healthcare System
Rule Repository• Clinical Rules• Operational Rules
•Medical Records•PHR data•Genomic Data
CDA Repository
Clinical EventEngine
ClinicalRule Generator
ClinicalRule Processor
Clinical Rule Manager
Clinical DataManagement
Sensor DataDelivery
Sensor Gateway
Sensor Data Transformer
Device Adapters
CDA Transformer
Clinical DataManager
CDA Summarizer
Sensor event
Event
Smart Health Portal
StakeholdersEvidence Delivery
ContentsManagement
User DataManagement
Patient
Executive
Event
Personalized UIFramework
Event
Event
Sensor event
Data Management & Analysis
Portal Service Repository
•User Data•UI Preference
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EMR OCS
PACS DW
PHR Genome
StandardGuideline
Publication
LODD
KnowledgeSources
HealthContents
Healthcare SystemInterface
Clinical DataAdapters
• Operational Rules• Provenance Rules
•Genomic Data•Sensor Data
Knowledge SourceAdapters
Knowledge Data
Knowledge
Hospital event
Event
Semantic Query
Reasoner
Knowledge Base• Ontology Store• Triple Store• Content Store
Evidence SearchKnowledge
Verification Toolkit
Doctor
Executive
Admin
Hospital event
Knowledge•Medical Terminology•Medical Dictionary•Mining Algorithm
Text Analysis Rule
KnowledgeAcquisition
LinkageConstructor
Entity Extractor
Knowledge Model Management
Knowledge Management
Knowledge
Knowledge
Social MedicalDiscovery
•UI Preference•Contents
SMD Repository•Search algorithm•SMD index data•SMD Configuration
Social MedicalIndexing
Social MedicalPrivacy
Social MedicalSearch
Knowledge
Knowledge
SMD Data
Future Plan
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Key Use Cases > Chronic Disease Management System
Family
• Provide real-time health
status information
• Family Portal services
• Emergency alerts (SMS)
Emergency Center
Patient
Home G/W
At Home
Hospital
Emergency Service
• Emergency call for help
• Providing patient data
EMR
HospitalNetworkPatient DataRequest
Remote monitoring system helps improve the quality of life of chronically ill patients by enabling them
to be cared at home rather than have to be admitted to hospitals. IBM Healthcare Platform supports the
system environment to collect, analyze and monitor the biological data from home health sensor devices
and provide personalized health information for multiple patients and caregivers.
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Contents ProviderService Provider
Sensor data acquisition
and transmission
Internet
U-Health Center
Sensor Device
Moving
Smart Phone
Sensor data acquisition
and transmission
Patient Portal Services
(PHR services)
Emergency service
Video Chat Service
Measuring Vital Signs
(Blood pressure,
glucose, motion,
electrocardiogram,
falls, etc.)
Wireless
Communication
U-Health Platform
DataManagement
KnowledgeManagement
EvidenceDelivery
Data
Service
Internet
Data
Treatment
Clinical Data management
Collection, storage, retrieval of knowledge data
Clinical data analysis and context-awareness service
Evidence delivery based on social data
User interface framework for personalized UI
• Provides healthcare
services in conjunction
with u-Health Center
• Provides healthcare
contents in conjunction
with u-Health Center
U-Health Center Interface
Integration with U-Health Center(Transmitting EMR data, Receiving the
patient data from u-Health Center)
Physician’s Device
Physician Portal Service
(Patient history data query,
emergency response, etc.)
Video Chat Service
Service Contents
HospitalNetwork
Wireless
Communication
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Key Use Cases > CP Monitoring System
Clinical Pathway Monitoring System
IBM Healthcare Platform provides the toolkit which supports clinical pathway modeling and analyzes
the differences between realistic medical treatment and the pattern of clinical pathway.
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Variation
Detection Engine
Variation Evaluation
Engine
Alerts
Reports
Historic Data Reference
Patterns
Physicians
CP Modeler
Variation
&outcomes
Care activities
Re
po
stin
g a
nd
da
shb
oa
rds
Service Outcomes
Patients
IBM Research
ENROLLINGin healthcare programs
SHARINGindividual healthinformation
MEASURINGyour progress and plan
IMPROVINGyour long-term health and
everyday experience
Smarter Healthcare enables a more collaborative care process
centered around the wellness of the individual
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UNDERSTANDING
health risks
ACTIVATINGpreventive and value-conscious behavior
ENGAGINGin a self-directed
system of care
BENEFITINGfrom an interconnected
care-giving team
COMPLYINGfulfilling your part of
the patient-doctor covenant
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We approach Healthcare as an ecosystem centered around the needs of
patients and consumers
Healthcare Providers
Drug Health Plans /
Clinical Trial Support
Advocacy Groups
Patients /
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Drug Developers
Health Plans / Payers
Government Agencies
Solution / Equipment Providers
Pharmacies / Retailers
Patients /
Consumers