this report, the discussion will be limited to the first three only. To be sure, security of the ... more this report, the discussion will be limited to the first three only. To be sure, security of the data passing through a network or accessible through a network is of vital importance, and risk management must be an integral part of all telemedicine technology
Strengthening the capacity of public health systems to protect and promote the health of the glob... more Strengthening the capacity of public health systems to protect and promote the health of the global population continues to be essential in an increasingly connected world. Informatics practices and principles can play an important role for improving global health response capacity. A critical step is to develop an informatics agenda for global health so that efforts can be prioritized and important global health issues addressed. With the aim of building a foundation for this agenda, the authors developed a workshop to examine the evidence in this domain, recognize the gaps, and document evidence-based recommendations.
Internet2 is a consortium of leading U.S. universities working in partnership with industry and t... more Internet2 is a consortium of leading U.S. universities working in partnership with industry and the U.S. government's Next Generation Internet (NGI) initiative to develop a faster, more reliable Internet for research and education including enhanced, high-performance networking services and the advanced applications that are enabled by those services [1]. By facilitating and coordinating the development, deployment, operation, and technology transfer of advanced, network-based applications and network services, Internet2 and NGI are working together to fundamentally change the way scientists, engineers, clinicians, and others work together. [http://www.internet2.edu] The NGI Program has three tracks: research, network testbeds, and applications. The aim of the research track is to promote experimentation with the next generation of network technologies. The network testbed track aims to develop next generation network testbeds to connect universities and federal research institu...
The proceedings and conclusions from this meeting are presented in the following report. This pap... more The proceedings and conclusions from this meeting are presented in the following report. This paper was prepared with the
Strengthening the capacity of public health systems to protect and promote the health of the glob... more Strengthening the capacity of public health systems to protect and promote the health of the global population continues to be essential in an increasingly connected world. Informatics practices and principles can play an important role for improving global health response capacity. A critical step is to develop an informatics agenda for global health so that efforts can be prioritized and important global health issues addressed. With the aim of building a foundation for this agenda, the authors developed a workshop to examine the evidence in this domain, recognize the gaps, and document evidence-based recommendations. On 21 August 2011, at the 2011 Public Health Informatics Conference in Atlanta, GA, USA, a four-hour interactive workshop was conducted with 85 participants from 15 countries representing governmental organizations, private sector companies, academia, and non-governmental organizations. The workshop discussion followed an agenda of a plenary session- planning and age...
Studies in health technology and informatics, 2008
The proceedings and conclusions from this meeting are presented in the following report. This pap... more The proceedings and conclusions from this meeting are presented in the following report. This paper was prepared with the involvement of leading biomedical researchers, computer scientists, engineers, and Information & Communication Technology (ICT) experts. The purpose of this document is to provide a research roadmap towards "Net-Centric Healthcare" 1 , all the while reconciling with future USAMRMC priorities. In an effort to produce tools that enable/enhance research, education, and direct patient care under the umbrella of the Department of Defense Tricare System, this report concludes with a call for TATRC (and others) to enable Grid technologies via applied research programs for the Military Healthcare Service (MHS). This document serves to communicate expectations and requirements to all parties-end users, policymakers, scientists, as well as technology leaders. The roadmap provides a foundation upon which TATRC may organize its strategic priorities and commit to resource allocations. HealthGrids are computational environments of shared resources in which heterogeneous and dispersed biomedical data is accessed, mined and computed. Advances in computer science allow biomedical researchers to capitalize on ubiquitous & transparent distributed systems and a broad set of tools for resource sharing (computation, storage, data, replication, security, semantic interoperability, and delivery of software as services). The foremost opportunity of the HealthGrid is the creation of a research climate that transforms the biomedical sector into a functional knowledge society, as the contemporary equivalent of the original Advanced Research Projects Agency Network (ARPANET) 2 transformed networks to become today's Internet. To synthesize a roadmap from the expertise of the IRT participants, four break-out groups were convened to delineate milestones and estimate requirements necessary to overcome current implementation barriers. A mix of academic, industry and government subject matter experts addressed both technological and socio-political dynamics. The HealthGrid was catalogued into four discrete functions which interoperate: Computation Grids, Data Grids, Knowledge Grids, and Collaboration Grids. The breakout groups mirrored this taxonomy. Systems Medicine 3 provided a framework for the HealthGrid IRT and resultant research roadmap. Contributors worked off the predicate that 'functions of life are mediated by biological networks, and human disease occurs when one or more of these networks become perturbed by genetic mutations and/or abnormal environmental signals'. Systems Medicine is driving development of new in-vivo and in-vitro measurement technologies, which, collectively, in the next 5-20 years, will lead to medical care that is predictive, preventative, personalized and participatory (P4 medicine). 4 Grid technologies provide a powerful technology infrastructure and enabler to attain this goal. Derivatively, the HealthGrid aims to foster innovation in how disease is viewed, diagnosed, treated, and prevented. This decade is witness to major revolutions in our comprehension of the human genome, infectious disease, environmental influences, cancer and aging. The advent of electronic health records in combination with Grid technologies and growing interdisciplinary collaborations present the opportunity to participate in new scientific and medical breakthroughs at an everaccelerating pace, emblematic of our transformation to a 'knowledge society'. This report attempts to refine the broad landscape of the HealthGrid into scalable and 'digestable' targets of opportunity.
Background: As the Joint United Nations Programme on HIV/AIDS, the Global Fund, and the US Presid... more Background: As the Joint United Nations Programme on HIV/AIDS, the Global Fund, and the US President's Emergency Plan for AIDS Relief focus on reaching 90-90-90 goals, military health systems are scaling up to meet the data demands of these ambitious objectives. Methods: Since 2008, the US Department of Defense HIV/AIDS Prevention Program (DHAPP) has been working with military partners in 14 countries on implementation and adoption of a Military eHealth Information Network (MeHIN). Each country implementation plan followed a structured process using international eHealth standards. DHAPP worked with the private sector to develop a commercial-off-the-shelf (COTS) electronic medical record (EMR) for the collection of data, including patient demographic information, clinical notes for general medical care, HIV encounters, voluntary medical male circumcision, and tuberculosis screening information. Results: The COTS software approach provided a zero-dollar software license and focused on sharing a single version of the EMR across countries, so that all countries could benefit from software enhancements and new features over time. DHAPP also worked with the public sector to modify open source disease surveillance tools and open access of HIV training materials. Important lessons highlight challenges to eHealth implementation, including a paucity of technology infrastructure, military leadership rotations, and the need for basic computer skills building. Conclusion: While not simple, eHealth systems can be built and maintained with requisite security, flexibility, and reporting capabilities that provide critical information to improve the health of individuals and organizations.
Internet2 is a consortium of leading U.S. universities working in partnership with industry and t... more Internet2 is a consortium of leading U.S. universities working in partnership with industry and the U.S. government's Next Generation Internet (NGI) initiative to develop a faster, more reliable Internet for research and education including enhanced, high-performance networking services and the advanced applications that are enabled by those services [1]. By facilitating and coordinating the development, deployment, operation, and technology transfer of advanced, network-based applications and network services, Internet2 and NGI are working together to fundamentally change the way scientists, engineers, clinicians, and others work together. [http://www.internet2.edu] The NGI Program has three tracks: research, network testbeds, and applications. The aim of the research track is to promote experimentation with the next generation of network technologies. The network testbed track aims to develop next generation network testbeds to connect universities and federal research institutions at speeds that are sufficient to demonstrate new technologies and support future research. The aim of the applications track is to demonstrate new applications, enabled by the NGI networks, to meet important national goals and missions [2]. [http://www.ngi.gov/] The Internet2/NGI backbone networks, Abilene and vBNS (very high performance Backbone Network Service), provide the basis of collaboration and development for a new breed of advanced medical applications. Academic medical centers leverage the resources available throughout the Internet2 high-performance networking community for high-capacity broadband and selectable quality of service to make effective use of national repositories. The Internet2 Health Sciences Initiative enables a new generation of emerging medical applications whose architecture and development have been restricted by or are beyond the constraints of traditional Internet environments. These initiatives facilitate a variety of activities to foster the development and deployment of emerging applications that meet the requirements of clinical practice, medical and related biological research, education, and medical awareness throughout the public sector. Medical applications that work with high performance networks and supercomputing capabilities offer exciting new solutions for the medical industry. Internet2 and NGI,strive to combine the expertise of their constituents to establish a distributed knowledge system for achieving innovation in research, teaching, learning, and clinical care.
The high cost of healthcare information systems (HISs) is driven by a number of factors. Propriet... more The high cost of healthcare information systems (HISs) is driven by a number of factors. Proprietary systems drive the cost of interchanging data much higher than if the systems implemented standard interfaces, by not being able to leverage competitive reusable components. The HL7 data standards have been an excellent help, but provide only partial solutions, because of the normal customization that occurs at each organization. The monolithic nature of most large HISs makes it difficult for them to be best-of-breed in an area and very expensive to upgrade or replace. Service-oriented component-based technologies enable systems to be constructed of replaceable, best-of-breed components. This enables much more competition on lower-cost components, with the promise of much lower overall costs. This lower cost is driven not just by competition but also by providing a mechanism to deal with change, by replacing software parts as newer more powerful ones become available without having to replace the entire system. The value of components is not just in their modularity but also in the use of standard interfaces to facilitate interoperability. In addition, the ultimate value to the consumer of components is to enable the ad-hoc assembly of a patient's virtual medical record over the Internet across multiple healthcare organizations. This paper describes the successful implementation of standard components in an open-source system, called OpenEMed, which can be used for a variety of healthcare-related applications
this report, the discussion will be limited to the first three only. To be sure, security of the ... more this report, the discussion will be limited to the first three only. To be sure, security of the data passing through a network or accessible through a network is of vital importance, and risk management must be an integral part of all telemedicine technology
Strengthening the capacity of public health systems to protect and promote the health of the glob... more Strengthening the capacity of public health systems to protect and promote the health of the global population continues to be essential in an increasingly connected world. Informatics practices and principles can play an important role for improving global health response capacity. A critical step is to develop an informatics agenda for global health so that efforts can be prioritized and important global health issues addressed. With the aim of building a foundation for this agenda, the authors developed a workshop to examine the evidence in this domain, recognize the gaps, and document evidence-based recommendations.
Internet2 is a consortium of leading U.S. universities working in partnership with industry and t... more Internet2 is a consortium of leading U.S. universities working in partnership with industry and the U.S. government's Next Generation Internet (NGI) initiative to develop a faster, more reliable Internet for research and education including enhanced, high-performance networking services and the advanced applications that are enabled by those services [1]. By facilitating and coordinating the development, deployment, operation, and technology transfer of advanced, network-based applications and network services, Internet2 and NGI are working together to fundamentally change the way scientists, engineers, clinicians, and others work together. [http://www.internet2.edu] The NGI Program has three tracks: research, network testbeds, and applications. The aim of the research track is to promote experimentation with the next generation of network technologies. The network testbed track aims to develop next generation network testbeds to connect universities and federal research institu...
The proceedings and conclusions from this meeting are presented in the following report. This pap... more The proceedings and conclusions from this meeting are presented in the following report. This paper was prepared with the
Strengthening the capacity of public health systems to protect and promote the health of the glob... more Strengthening the capacity of public health systems to protect and promote the health of the global population continues to be essential in an increasingly connected world. Informatics practices and principles can play an important role for improving global health response capacity. A critical step is to develop an informatics agenda for global health so that efforts can be prioritized and important global health issues addressed. With the aim of building a foundation for this agenda, the authors developed a workshop to examine the evidence in this domain, recognize the gaps, and document evidence-based recommendations. On 21 August 2011, at the 2011 Public Health Informatics Conference in Atlanta, GA, USA, a four-hour interactive workshop was conducted with 85 participants from 15 countries representing governmental organizations, private sector companies, academia, and non-governmental organizations. The workshop discussion followed an agenda of a plenary session- planning and age...
Studies in health technology and informatics, 2008
The proceedings and conclusions from this meeting are presented in the following report. This pap... more The proceedings and conclusions from this meeting are presented in the following report. This paper was prepared with the involvement of leading biomedical researchers, computer scientists, engineers, and Information & Communication Technology (ICT) experts. The purpose of this document is to provide a research roadmap towards "Net-Centric Healthcare" 1 , all the while reconciling with future USAMRMC priorities. In an effort to produce tools that enable/enhance research, education, and direct patient care under the umbrella of the Department of Defense Tricare System, this report concludes with a call for TATRC (and others) to enable Grid technologies via applied research programs for the Military Healthcare Service (MHS). This document serves to communicate expectations and requirements to all parties-end users, policymakers, scientists, as well as technology leaders. The roadmap provides a foundation upon which TATRC may organize its strategic priorities and commit to resource allocations. HealthGrids are computational environments of shared resources in which heterogeneous and dispersed biomedical data is accessed, mined and computed. Advances in computer science allow biomedical researchers to capitalize on ubiquitous & transparent distributed systems and a broad set of tools for resource sharing (computation, storage, data, replication, security, semantic interoperability, and delivery of software as services). The foremost opportunity of the HealthGrid is the creation of a research climate that transforms the biomedical sector into a functional knowledge society, as the contemporary equivalent of the original Advanced Research Projects Agency Network (ARPANET) 2 transformed networks to become today's Internet. To synthesize a roadmap from the expertise of the IRT participants, four break-out groups were convened to delineate milestones and estimate requirements necessary to overcome current implementation barriers. A mix of academic, industry and government subject matter experts addressed both technological and socio-political dynamics. The HealthGrid was catalogued into four discrete functions which interoperate: Computation Grids, Data Grids, Knowledge Grids, and Collaboration Grids. The breakout groups mirrored this taxonomy. Systems Medicine 3 provided a framework for the HealthGrid IRT and resultant research roadmap. Contributors worked off the predicate that 'functions of life are mediated by biological networks, and human disease occurs when one or more of these networks become perturbed by genetic mutations and/or abnormal environmental signals'. Systems Medicine is driving development of new in-vivo and in-vitro measurement technologies, which, collectively, in the next 5-20 years, will lead to medical care that is predictive, preventative, personalized and participatory (P4 medicine). 4 Grid technologies provide a powerful technology infrastructure and enabler to attain this goal. Derivatively, the HealthGrid aims to foster innovation in how disease is viewed, diagnosed, treated, and prevented. This decade is witness to major revolutions in our comprehension of the human genome, infectious disease, environmental influences, cancer and aging. The advent of electronic health records in combination with Grid technologies and growing interdisciplinary collaborations present the opportunity to participate in new scientific and medical breakthroughs at an everaccelerating pace, emblematic of our transformation to a 'knowledge society'. This report attempts to refine the broad landscape of the HealthGrid into scalable and 'digestable' targets of opportunity.
Background: As the Joint United Nations Programme on HIV/AIDS, the Global Fund, and the US Presid... more Background: As the Joint United Nations Programme on HIV/AIDS, the Global Fund, and the US President's Emergency Plan for AIDS Relief focus on reaching 90-90-90 goals, military health systems are scaling up to meet the data demands of these ambitious objectives. Methods: Since 2008, the US Department of Defense HIV/AIDS Prevention Program (DHAPP) has been working with military partners in 14 countries on implementation and adoption of a Military eHealth Information Network (MeHIN). Each country implementation plan followed a structured process using international eHealth standards. DHAPP worked with the private sector to develop a commercial-off-the-shelf (COTS) electronic medical record (EMR) for the collection of data, including patient demographic information, clinical notes for general medical care, HIV encounters, voluntary medical male circumcision, and tuberculosis screening information. Results: The COTS software approach provided a zero-dollar software license and focused on sharing a single version of the EMR across countries, so that all countries could benefit from software enhancements and new features over time. DHAPP also worked with the public sector to modify open source disease surveillance tools and open access of HIV training materials. Important lessons highlight challenges to eHealth implementation, including a paucity of technology infrastructure, military leadership rotations, and the need for basic computer skills building. Conclusion: While not simple, eHealth systems can be built and maintained with requisite security, flexibility, and reporting capabilities that provide critical information to improve the health of individuals and organizations.
Internet2 is a consortium of leading U.S. universities working in partnership with industry and t... more Internet2 is a consortium of leading U.S. universities working in partnership with industry and the U.S. government's Next Generation Internet (NGI) initiative to develop a faster, more reliable Internet for research and education including enhanced, high-performance networking services and the advanced applications that are enabled by those services [1]. By facilitating and coordinating the development, deployment, operation, and technology transfer of advanced, network-based applications and network services, Internet2 and NGI are working together to fundamentally change the way scientists, engineers, clinicians, and others work together. [http://www.internet2.edu] The NGI Program has three tracks: research, network testbeds, and applications. The aim of the research track is to promote experimentation with the next generation of network technologies. The network testbed track aims to develop next generation network testbeds to connect universities and federal research institutions at speeds that are sufficient to demonstrate new technologies and support future research. The aim of the applications track is to demonstrate new applications, enabled by the NGI networks, to meet important national goals and missions [2]. [http://www.ngi.gov/] The Internet2/NGI backbone networks, Abilene and vBNS (very high performance Backbone Network Service), provide the basis of collaboration and development for a new breed of advanced medical applications. Academic medical centers leverage the resources available throughout the Internet2 high-performance networking community for high-capacity broadband and selectable quality of service to make effective use of national repositories. The Internet2 Health Sciences Initiative enables a new generation of emerging medical applications whose architecture and development have been restricted by or are beyond the constraints of traditional Internet environments. These initiatives facilitate a variety of activities to foster the development and deployment of emerging applications that meet the requirements of clinical practice, medical and related biological research, education, and medical awareness throughout the public sector. Medical applications that work with high performance networks and supercomputing capabilities offer exciting new solutions for the medical industry. Internet2 and NGI,strive to combine the expertise of their constituents to establish a distributed knowledge system for achieving innovation in research, teaching, learning, and clinical care.
The high cost of healthcare information systems (HISs) is driven by a number of factors. Propriet... more The high cost of healthcare information systems (HISs) is driven by a number of factors. Proprietary systems drive the cost of interchanging data much higher than if the systems implemented standard interfaces, by not being able to leverage competitive reusable components. The HL7 data standards have been an excellent help, but provide only partial solutions, because of the normal customization that occurs at each organization. The monolithic nature of most large HISs makes it difficult for them to be best-of-breed in an area and very expensive to upgrade or replace. Service-oriented component-based technologies enable systems to be constructed of replaceable, best-of-breed components. This enables much more competition on lower-cost components, with the promise of much lower overall costs. This lower cost is driven not just by competition but also by providing a mechanism to deal with change, by replacing software parts as newer more powerful ones become available without having to replace the entire system. The value of components is not just in their modularity but also in the use of standard interfaces to facilitate interoperability. In addition, the ultimate value to the consumer of components is to enable the ad-hoc assembly of a patient's virtual medical record over the Internet across multiple healthcare organizations. This paper describes the successful implementation of standard components in an open-source system, called OpenEMed, which can be used for a variety of healthcare-related applications
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