IHE XDS for mHealth access to HIE

I submitted (late) a proposal to the IHE IT Infrastructure workgroup a proposal for an IHE Profile titled XDS for mHealth.  I was graciously given time by the planning co-chair to present it even though it was submitted late, to allow the committee to understand it, and determine whether or not to accept it as a late submission.

The committee did agree to accept the proposal through the process, and so now I'll explain it a bit using the same presentation materials I used this morning, just reformatted for this blog.  The next step is to see if it makes the prioritization cut at the October 11-12 IHE ITI Face to Face meeting.  There are 3 other profile submissions and documentation maintenance work to consider.  Ensuring that the committee has identified resources who are willing to work on it is very important in this next step.  After that, it has to make the technical committee cut with respect to "do-ability".  I'll shortly be working on a prototype to show that it is in fact feasible.

If you aren't an IHE member, but want to support this project, join now (it's free).  If you are a member, please show up to the face to face meeting I mentioned above.  I expect there will be T-con access for members who cannot be present at the face to face (there usually is).

  -- Keith

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Support for XDS in mHealth Evironment

The Problem

•  mHealth platforms are resource constrained
•  SOAP Stack missing or buggy (e.g., WSDL support for Objective C)
• Bandwidth constrained (10Kbps to 10Mbps)
• Limited resources (e.g., memory), often no “back-end” server
• Increasing proliferation of unconnected apps
•  ~9,000 consumer health apps¹ in Apple’s App store
•  ~13,000 by 2012
• mHealth is an emerging market, failure to support this space could reduce relevance of IHE
• Difficult to use XMLHttpRequest for browser-based, multi-platform mHealth apps.

¹Source: MobiHealthNews http://shar.es/HMlff

Use Case

1. Patient sees a specialist for a particular condition.
2. The specialist asks for detailed information from the patient.
3. The patient, not remembering their list of medications, pulls out their mobile device and activates an application.
4. The application queries the HIE and retrieves a list of clinical summaries in date order, from most to least recent (or on-demand medication list document).
5. They select the most relevant document, and it is downloaded to the device.  The application extracts and displays their medication list.

Proposed Standards & Systems

Standards

• XML
• XDS Metadata
• ebXML
• XSLT
• JSON, JSON Schema
• XMLHttpRequest
• OHT APIs (not really a standard, but a place to start from)

Systems

• EHR
• PHR
• Patient Portal
• HIE
• Mobile Device (iPhone/iPad/iPod, Tablet, Android, Smart Phone, Windows Phone, etc.)

Discussion

• There has been substantial work already in simplifying the XML in OHT, that could be used as one basis for the effort.
• Metadata could be transformed from a simplified representation to ebXML representation using XSLT.
• Transactions could be optimized to use W3C standard XMLHttpRequest object.
• Below is one example of how the actors and transactions could be organized: