Department of Molecular Biology

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Mobility Solutions and Innovative Collaborations
for Healthcare ICT
Harsh Verma, Ph.D. V.P. of Global Innovative
Research Head, Mobility Solutions
Monday, September 28, 2009 300-400
p.m. LIB-110, Dallas, North Texas
Department of Molecular Biology Immunology
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Agenda

• Why Mobile?
• Mobile Applications and Eco-Systems today
• Convergence Trends
• Use Cases and Case Studies
• Location Based Services for Innovation
• Research Areas and Exploring
• Future Goals for Collaboration

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Why Mobile?

• Healthcare professionals need to have instant
  access to patient records and test results

• Doctors need to enter diagnosis in emergency
  situations

• Hospital Administration Staff needs to enter
  billing information during patient visits

• Healthcare information needs to be synchronized
  in real-time

• Mobile Technology provides ideal Always-On
  features

• Mobility Solutions will be driven by Discovery
  and Innovation

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Clinical Research - Why Mobile?

• In advanced countries like US, conducting
  Clinical Research is becoming increasingly
  difficult and expensive

• Doctors need to obtain Patient Data in emergency
  situations

• Monitoring registered Patient Data for conducting
  Clinical Research

• Remotely or thru Remote Management

• Cooperation between Advance and Developing
• Countries

• Mobile Devices can provide an ideal medium

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Health Information Exchange - Why Mobile?

• Decentralization of Health Information

• Mobile Device can provide ideal storage medium

• Periodic synchronization

• Mobile Device is ideal for Work Flow Management

• Always-On and Connected with Patient

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Why Mobile?

• Today there are about 830 million users on 3G
  Networks

• It is expected there will be about 5 Billion
  Users on 4G Networks by 2015

• Characteristics of Mobile Device

• Always with you

• Always-On

• Location Aware

• Highly Personalized

• Processing Power

• Small Screen

• Battery Life

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Why Mobile?

• Mobile Networks are expanding their reach

• Patients can remain under constant observation of
  expert physicians

• Challenges of not being physically present at the
  hospital

• Issues with Usability

• Mobile Networks Infrastructure

• Device Management and Fragmentation

• Ethics and Identity Fraud

• Application Management

• Security and Privacy

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Why Mobile?

• About a hundred thousand patients die every year
  as a result of broken healthcare processes just
  in American healthcare Grossman 2007
• For physicians, having timely access to critical
  information can make the difference between life
  and death.
• This scenario projects a need for research in
  mobile Healthcare (m-Healthcare), which is an
  important extension of electronic healthcare
  (e-healthcare)

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Benefits for all Stakeholders in Healthcare
Enterprise

• Healthcare Providers Improve Quality of Care,
  Workflow, Costs and Accessibility

• Molecular Biology Biopharma Research
  Accelerate Basic Science Research for Drug
  Discovery and optimize e-Clinical Trials

• Payers Improve Healthcare Quality and Cost

• Government Deliver Better Care for More People
  at Lower Cost

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Everything is Connected

• Technology Platforms for Mobile Healthcare Success

• Omni-present and continuous access to patients
  HER and fast co-ordination among team members

• Patients with chronic condition can remain under
  constant observation without the need of being
  physically present at a hospital

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Innovative Collaborations in Healthcare ICT

• Improve Precision in Research, Diagnosis and Cure

• Intelligent Biometric Diagnostics Freeing the
  patient and the System

• Patient Records

• Disease Monitoring

• Communication

• Workflow Management

• Medical Surveys

• Emergency Help and Alarms

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Concept of Mobile Computing

• Today mobile handset is the most preferred medium
  to stay connected with the world on move.
• Mobile is connected to the data networks and
  Internet while moving from cell to cell.
• Capability to deliver everything from an Alarm
  clock to the Video Stream on your finger tips
  anytime and anywhere.
• 3G and 4G Networks are basically differentiated
  on the basis of their access technology and
  bandwidth
• Mobile Devices are getting more processing
  capacity
• Mobile entertainment application (like blogging,
  Social networking, games, multimedia application)
  are the best and comparatively cheap way to
  entertainment.
• Mobile will make the world smaller and
  accessible.

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Mobile Applications and Eco-Systems today..
Video Streaming
Location Based Services
Sports and Wellness
Android Application development
Web Services
Barcode QR Code Analyzing
Bluetooth, Wi-Fi,GPRS, EDGE
Call Handling
Privacy Security
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Emerging Convergence leading to Innovation
Network Convergence
4G WiMAX
Wired Broadband
BcN
Wireless Broadband
3G
WiFi
Service Convergence
Device/Platform Convergence
Wired/Wireless
Converged Device
Broadband Wireless 3G
DTV VoD, KoD PC, TV
Voice/Data
Multiple Access Device
Functionally Converged Device
IT/Broadcasting
Mobile Devices
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Innovation leading to Device and Market
Fragmentation
Internet (IP)-centric
Google Android
iPhone
Mobile Internet WiFi, WiMAX, HSDPA, WCDMA,
DVB-H, BlueTooth
.jad /.jar Files
.prc Files
.cod/.jar Files
.sis Files
.cab Files
Web Browsers .html / .xml Files
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Use Cases and Case Studies

• Location based Emergency Handling and Searching
• Leveraging Location-info from Mobile Networks
• Health Service Interfaces for Discovery Process
• Interactivity with Lab Environment and Content
• Dual Mode Mobile Devices provide interactivity
  using WiFi, Bluetooth
• User-created Content and Mobile Search
• Leveraging location to enhance Experience
• Mobile Work Force
• New ways to improve work operations, Always-on,
  Calendar
• and Contacts to increase Productivity
• Ref http//mobile.rsystems.com

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Data Flows to be watched

• Defining the Data Management

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Patient Care-Provider Opportunities for
Innovative Collaborations
Areas for Behavior Study and Mobile Interface A
Brainstorming

• Scheduling
• Registration
• Admission

• Diagnosis
• Treatment

• Patient Discharge

• Post Discharge accounting

Billing Claims Creation
Medical Records Management and Digitization
Insurance AR follow-up
Tele Scheduling
Registration, Demographic Data Entry, Charge Entry
Patient Statements and Follow-up
Electronic / Manual submission
Coding Compliance LMRP/LCD, CCI
Denial Management
Pre-encounter Eligibility Check
EOB Posting
Reconciliation

• XML provides an ability for
• exchanging messages

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Emergency Request Scenario
Patients health information is displayed on the
UMD
Patient opens UMD Device and launches Mobile
Emergency Request page
Patient submits request for emergency with one
click
Patients current location is dispatched along
with patient info and medical condition
Confirmation is sent back to patient along with
hospital information and current location
e911 processes the request and sends information
to nearest hospital
Confidential Page
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A Framework for Innovative Collaboration
Multi-pronged Research Model Approach
Concept, Ownership, IP
Design, Development, Implementation, Support
Demonstrate usefulness of Mobile Technology I
terms of overall Healthcare
CMMi Level 5 Develop, Build Support
MER
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Everything is Connected HL7

• Standards for critical mass service

• HL7 (Health Level 7)

• Health Level Seven, Inc. (HL7) is the global
  authority on standards
• for interoperability of health information
  technology with members in
• over 55 countries.
• HL7's vision is to create the best and most
  widely used standards in
• healthcare.
• Standards Interfacing
• American Health Information Community (AHIC)
• Centers for Disease Control and Prevention (CDC)
• Healthcare Information Technology Standards Panel
  (HITSP)
• Office of the National Coordinator (ONC)
• American Dental Association (ADA)
• ASTM International
• Clinical Data Interchange Standards Consortium
  (CDISC)
• Digital Imaging and Communications in Medicine
  (DICOM)
• Many more

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Research and Development
Case study 1

• RSI Berkeley Proof-of-Concept Framework
• Participation in proposed UC Berkeley First US
  Mobile WiMAX PoC Lab
• Best practices, White Papers in ITS World
  Congress
• Support delivery of new technologies and high
  quality software
• Industry Forums Partners
• Participation in Global Industry Forums WiMAX,
  MIMITS,ITS CA
• California Center for Innovative Transportation
• Forge Knowledge Alliances with Key Technology
  Providers
• Embedded Systems
• EECS _at_ Berkeley addresses needs of Embedded
  Systems
• Improve Time to Market
• Lower Cost for Ultra-Mobile
• Increase Competitive Advantage Advanced Lab
  being set up

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UC Berkeley Highway Lab
Case study
Source CCIT, BHL
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Case study
Clearwire Innovation Network in Silicon Valley
http//innovation.clear.com/innovation
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Life Sciences and Clinical Research
Client The IT wing of world's largest
biopharmaceutical Contract Research
Organizations. Business Need ? Vast Technology
Span ? Cost Effective Scalable Offshore Model ?
Ready work force trained on GCP/21CFR part 11/
and internal SOP ? Adherence to CMM and ISO
quality processes Challenges ? Evolving
Requirement Specifications. ? Inaccessibility of
client validation database for test case
simulation. ? Aggressive delivery timelines with
a steep learning curve for the team. ?
Criticality of documentation required to meet the
client and FDA/GCP guidelines. Solution ? Setup
of local and sanitized IT infrastructure for
offshore team to simulate testing environment. ?
Domain expertise and rigorous in-house testing to
deliver studies on time with quality. ? Formal
review process adopted by the offshore team to
ensure that the documentation meets client and
FDA process requirements. ? Scalable team
catering to changing business requirements

• Anand Janakiraman,
• R Systems Program Manager

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Healthcare Regulatory Environment Solutions
Administering mandated public health programs and
benefits for California State Department of
Health Services (DHS). As a part of ensuring
these programs meet the needs of Californians,
DHS audits the funded work of contracted
providers and provides audit reports to state and
federal oversight authorities. To manage audit
workflow and documentation, the state built had 3
programs to handle medical service reviews
(MedR), laboratory service reviews (LabR), and
pharmacy service reviews (PharmR) by improving
and cloning parts of the original MedR program.
Problem The program ran on a database system
that was no longer supported by the vendor,
provided no way to coordinate reviews across the
3 programs.
Result The OneR system upgrade provided by R
Systems was successful in bringing together the
functionality needed by the DHS and in
eliminating legacy issues in the original
program. R Systems continues to provide ongoing
consulting and project management services to the
California Department of Health Services and
maintenance on the OneR program.
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Compliance HIPAA, BS7799
Transaction and Code Set Compliance
Security Compliance

• Documented and implemented security policy
• Layered Physical and Network Security, with
  encryption VPN
• Independent Audit by clients

• Compliance with CPT-4 and ICD-9CM
• Geared Up for ICD 10 transition
• Standard Electronic Transaction with payers
• 837, 835, 274/275, 271/272

HIPAA
Business Associate Agreement with Covered Entity
Privacy Compliance

• Audit Trail for all information access
• NDA with employees working on PHI
• Employee Training
• Comprehensive General Liability coverage

• Security and privacy practice and documentation
  is a super-set of HIPAA Business Associate
  Agreement

Client or Clients Auditors are extended the
right to inspect the facilities, remote-monitor
systems, processes, books and records and
interact with R Systems compliance team.
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• Overview
• NuVasive is a medical device company focused on
  the design, development, and marketing of
  products for the surgical treatment of spine
  disorders.
• Solution
• Neuro Vision is a nerve avoidance monitoring
  system to improve the safety of spine surgery.
• This system allows the surgeons to use smart
  instruments avoiding injury to vital nerves
  through audio and visual warning signals that let
  surgeons know nerve proximity and implant
  surgery.
• R Systems were given the task to create the
  remote monitoring application for this new
  version of NeuroVision M5 which will be
  launched through their secure internet website
  which involved the following tasks
• Enhancements to their secure website to provide
  support for the new Remote Monitoring (RM)
  application.
• Created a services framework based on WCF to
  interact with the NeuroVision M5 control unit
  stationed in the operation theatre to store the
  messages in the Database and fetch them to show
  on the remote monitoring application.
• Search and display database information about the
  tests running on the M5 control unit on the
  remote monitoring application.
• Created the Silver Light GUI in the remote
  monitoring website which allows doctors to
  interpret the results and also guide the surgeons
  in the OT about the nerve proximity and implant.

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Intel Demo on Mobile Point of Care Solutions

• Intel Digital Healthcare
• Kirk Dunsavage,
• Intel Application Engineer
• http//www.intel.com/healthcare/hit/index.htm?iid
  healthIT

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SyBase
SyBase Demo on Mobile Healthcare Solutions

• http//www.youtube.com/watch?vuNcRST84Zlgfeature
  player_embeddedt56

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How Partnership benefits you?

• Basic Science Research Organizations can access
  huge skill diversity in R Systems, across
  technologies at a lower cost against current
  skill-deficiency
• Term-based projects can be manned with R Systems
  onsite developers and Co-PIs for 6-12 months,
  instead of perm position
• Mix of Offshore and Onsite team will result
  significant lower development implementation
  cost
• Faster project execution through quick ramp-up
  and ramp-down, without employee liabilities
• Better productivity with hourly billing

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Dallas-Fort Worth Map showing UNTHSC ..
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Creating a Mobile Network at UNTHSC ..

• Create a Mobile Test Bed at UNTHSC Campus
• WiMAX Network in Dallas
• Mobile IP Test Devices
• Software and WorkFlow

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Creating a Mobile Network at UNTHSC ..

• Please provide your Mobile WorkFlow Work Sheets

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