Funded by the Australian Government under the National Telehealth Pilots Program A Secure Architecture for Telehealth Trial Surya Nepal, Julian Jang-Jaccard, Rajiv Jayasena, Branko Cellar, Ross Sparks, Marlien Varnfield, Jane Li CSIRO ehealth CSIRO Digital Productivity
NBN Telehealth Pilot Program CSIRO Telehealth Project Summary CSIRO Is lead organisation Six clinical partners and three industry partners Total project size $5.4m ($3.02m from DOHA/DBCDE Pilot Program) Six (6) Trial sites in Five (5) states and territories Focus on Chronic Disease Management (CDM) in the Community Six different models of care represented Trial duration 18 months ends 30 th Dec 2014
CSIRO NBN Telehealth Trial 6 Sites Townsville Penrith Greater Western Sydney Canberra and ACT Ballarat and the Grampians Launceston / Northern Tasmania Number of patients at each site 25 Test Patients 50 Control Patients Total 150 Test patients 300 Control Patients Trial Design Case Matched controls Before-After-Control-Impact (BACI)
Final Numbers Total enrolled N=287 Analysed ACT NSW QLD TAS VIC TOTAL Test 16 16 26 29 26 113 Test Control Control 23 13 29 60 49 174 101 139
Key objectives of the CSIRO trial 1. Identify and model the impact of introducing telehealth services into existing models for the management of chronic disease in the community. 2. Develop robust statistical models to automatically risk stratify patients using questionnaires and vital signs data
Processing Tasks Collection Integration Analysis & Feedback Generation
Overall System Architecture Collection Integration Presentation 7 title Presenter name
collection: Ethics Approvals ETHICS COMMITTEE Commonwealth Science & Industrial Research 1 Organisation (CSIRO) Department of Health & Ageing 2 Department of Veterans Affairs 3 Nepean Blue Mountains LHD 4 Townsville MacKay LHD 5 Ballarat LHD 6 Canberra Hospital and ACT Health 7 Tasmania North Health Service (Launceston 8 Hospital) Security & Privacy Requirements
Service Architecture Push Decision Support Service Pull TMC Hybrid Video conferencing
Layer User Interface Authentication Service Social Network Service Services Video Conference Services Decision Support Service User Management Security Management Content Management Document Management Portal Management Workflows Management bases Secure Document Store CSIRO Telehealth System Secure Encrypted base
size PBS data 102,507 MBS data 74,150 Hospital roundtable 2,244 TMC measurements 207,362 TMC questionnaires 136,179 iinet statistics 925 CSIRO portal access log 4,074 TMC user actions log 440,943 Presentation title Presenter name
Integration: Linkage Protocol (Patient General, OC) PO (OCID) (OCID, Patient Private ) OpenClinica PPD Phase 1 Portal Web Service (OCID, Patient Private ) (OCID, Patient Private ) (OCID, ) (OCID, ) PPD TMC Server TMC Phase 2 Automatic CTC: Portal Link Service (OCID, Patient Private ) (Identifiable ) (OCID, de-identified ) (OCID, PATIENTID) PPD Hospital Round Table Hospital Linked File Phase 2 Manual
Access Control Policies Services Linked Link File Linked RBAC Ethics PPD RBAC RBAC RBAC RBAC RBAC Sources PBS/ MBS Ethics Hospit al Ethics TMC Ethics CPD Ethics PSD Ethics Custodian 1 Custodian 2 Custodian 3 Custodian 4 Custodian 5 Surya 13 Nepal CollaborateCom 2013
Role Hierarchy Project Director (PD) Researchers Project Manager (PM) Clinical Trial Coordinator (CTC) Management HCI Analytics Project Officer(PO) Clinical care Coordinator( CCC)
Decision Support System Anonymised Analytics Analytics Results Service Risk Stratification Result Clinical Care Coordinator Presentation title Presenter name
Audio/ Video Risk Stratification Results Video Conference Web App Service XML CSIRO Android Video Conferencing App Service Patient Specific (demographic data, activity log, etc) WEBRTC Signalling Server Web Application Openclinica bases XM L OpenClinica System Service XML Service PBS/MBS XML Service Hospital data Service Decision Support System Analytics
Summary security and privacy requirements are derived from ethics approvals is stored in different forms Identifiable data - Encrypted form; Linked data anonymised form; All data protected from authorisation and authentication; Communication is secured Secure communication protocol; Services Limited access from outside
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