BI en Salud: Registro de Salud Electrónico, Estado del Arte!
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1 BI en Salud: Registro de Salud Electrónico, Estado del Arte! Manuel Graña Romay! ENGINE Centre, Wrocław University of Technology! Grupo de Inteligencia Computacional (GIC); UPV/EHU; ccwintco! 1!
2 2!
3 ENGINE center at the Wroclaw University of Techonology is funded by the EC for years ! 3!
4 Contents! Introductory ideas and history! Definition! Vertical technological challenges! Privacy, security and authenticity! Interoperability! Workflow embedding! Horizontal technological dimensions! Big Data! Machine Learning and Computational Intelligence! Social networks and personal health management! Business opportunities!! 4!
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7 Introduction! Healthcare is a big data problem! Big Data Analytics for Healthcare! 7!
8 Introduction! Electronic Health Record! The Electronic Health Record (EHR) is a longitudinal electronic record of patient health information generated by one or more encounters in any care delivery setting.! Included in this information are patient demographics, progress notes, problems, medications, vital signs, past medical history, immunizations, laboratory data and radiology reports.! The EHR automates and streamlines the clinician's workflow. The EHR has the ability to generate a complete record of a clinical patient encounter - as well as supporting other care-related activities directly or indirectly via interface - including evidence-based decision support, quality management, and outcomes reporting.! 8!
9 Introduction! Many similar/related concepts! EMR : Electronic Medical Record! PHR : Personal Health Record! EPR: Electronic Patient Record! EHP: Electronic Health Profile! 9!
10 Introduction! EHR: the central information object in health related information processes! Diagnosis! Data Mining! Public health! Industry! Accounting! Mobility and emergencies! 10!
11 Emergency department! Pharmacy and prescriptions! Accounting! Medical imaging! Data mining: knowledge discovery! Electronic Health Record! Personal health management! Nurses: follow up! Diagnostic process! Wearable devices! Mobility: excange of information between care providers! 11!
12 Introduction! Motivations and expectations:! Health care process! Productive industrial process! Improvement of workflow; standardization;! Accountability : Quality control! Economical! Health care! Research of past events! Extraction of knowledge! 12!
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16 Contents! Introductory ideas and history! Definition! Vertical technological challenges! Privacy, security and authenticity! Interoperability! Workflow embedding! Horizontal technological dimensions! Big Data! Machine Learning and Computational Intelligence! Social networks and personal health management! Business opportunities!! 16!
17 Privacy! Informed consent: patient awareness of risks in EHR data sharing! Anonimization of data for! Data management in the cloud! Research! Academic (data repositories on the web)! Industry! 17!
18 Security! Hard security based on cryptography! Data access protocols! Cloud computing: how to ensure that 3d parties manipulate your data without breaking it?! Soft security based on trust assessment! Distributed systems with no central authority! Data exchanges! 18!
19 Authenticity! EHR data must be univocally mapped to an identity! Data exchange needs ID certification! EHR must be guaranteed to be free of manipulations! Image watermarking with demographic information! 19!
20 Interoperability! Semantic web (ontologies)! Mapping between vendor solutions! Standarization of terms! 20!
21 MITRE Corporation, report for the NIH (2006)! 21!
22 22!
23 Interoperability! Universal translators between ontologies by probabilistic semantic reasoning! Barry Robson, Thomas P. Caruso, Ulysses G.J. Balis, Suggestions for a Web based universal exchange and inference language for medicine, Computers in Biology and Medicine, Volume 43, Issue 12, 1 December 2013, Pages ! 23!
24 Secure interoperability! 24!
25 Workflow! Dealing with the EHR data completion hinders clinical processes.! 30-50% time in a visit devoted to filling information! Clear improvements in some critical situations! Emergency departments! 25!
26 Contents! Introductory ideas and history! Definition! Vertical technological challenges! Privacy, security and authenticity! Interoperability! Workflow embedding! Horizontal technological dimensions! Big Data! Machine Learning and Computational Intelligence! Social networks and personal health management! Business opportunities!! 26!
27 Big data! Challenges:! Capturing! Storing! Searching! Sharing! Analyzing! 27!
28 Big data! 28!
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30 30!
31 Big Data Analytics for Healthcare! 31!
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36 36!
37 Social networks! Social networks 1 allow! To share information! Counseling! Amateur epidemics! Analysis of google data uncovers flu epidemy! !
38 38!
39 Contents! Introductory ideas and history! Definition! Vertical technological challenges! Privacy, security and authenticity! Interoperability! Workflow embedding! Horizontal technological dimensions! Big Data! Machine Learning and Computational Intelligence! Social networks and personal health management! Business opportunities!! 39!
40 Barriers to adoption of EHR! Financial: is the system affordable and profitable?! Technical: The EHR may require new computer skills to the physicians and staff members.! time-related: learning and conversion of data to digital format for system initialization,! psychological: changing habits and professional autonomy,! social: the reaction of the social body to the system, adopting or rejecting it,! organizational: how organizations and people assimilate changes in established processes. Is the system impeding or boosting the workflow?! 40!
41 Business oportunities! Improving workflow:! Better interfaces for the human! Natural language processing! Better connectivity of EHR with devices! Body sensors! Wearable sensors! Cloud implementations allow widespread deployment and optimal cost! 41!
42 Business! Big data related! Data management and visualization! Data mining! Avoid prescription errors! Association discovery! Intelligent anonymization processes! 42!
43 Open standards: openehr! Improve quality and confidence of th users! Validation and verification is open! Social media specialization! Language! Endemic local diseases! Local demographic trends and tracks! 43!
44 Business! Implementation of EHR and related techonologies is Government policy! In USA doctors get extra money for demonstrable use of EHR! Good: Government research funding programs! Good for start-ups! Bad: Government tend to trust big companies (trans-national)! 44!
45 Thank you for your attention! Electronic Health Record: implementation, data mining, security and user acceptance, EHRW2015! 45!
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