Smart Grid Challenges for a Health
Care Computing Infrastructure
Prof. Ellis Horowitz
USC
Presentation at the
KACST Smart Grid Workshop
January 8-9, 2011
horowitz@usc.edu
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Can You Guess Who is in the Photo?
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Outline
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The Call to Action
The Challenge
The Approach
The Benefits
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Call For Action
The United States
National Academy of Engineering
has defined 14 GRAND CHALLENGES
for future research; I am concentrating on
two of them
•Engineering better medicines
•Advance health informatics
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The European Commission and e-Health
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The European Union is moving
towards eHealth
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“e-Health refers to the use of
modern information and
communication technologies to meet
needs of citizens, patients, healthcare
professionals, healthcare providers,
and policy makers.”
Specific objectives are
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to create an electronic health record
architecture by supporting the exchange of
information and standardization;
to set up health information networks
between points of care to coordinate
reactions to health threats;
to ensure online health services such as
information on healthy living and illness
prevention; and
to develop teleconsultation, ePrescribing,
eReferral and eReimbursement capabilities.
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Health Informatics as a Challenge to Computer
Scientists
Physicians
– Medical records today are plagued by mixtures of old technologies (paper) with new
ones (digital)
– Computerized records are often incompatible, using different programs for different
kinds of data, often within a given hospital
– Sharing information over regional, national, or global networks is complicated by
differences in computer systems and data recording rules
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Medical researchers
– Individual data is trapped in doctor’s offices, not available for analysis
– Clinical data across wide populations is difficult or impossible to obtain
– The amount of data being generated by researchers is increasing faster than any
individual can absorb it.
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General Problem
– Existing information resides on legacy systems and as a result, it is not available when,
where, or in the manner it is needed.
– This data includes test results, images, medication and allergy information, chart notes
or entire charts, and details about the care process itself.
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Two Approaches
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Mobile Devices Can Play a Role
Individuals process/act/enter data
Our actions
Self-reporting
Personal data
repository
distance traveled, calories
burned, food consumed
Biking, hiking, running, eating
What is missing is the integration of this information with analysis
tools to make sense out of what is happening
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Personal mobile health apps exist today
but are limited in scope because
they are not tied to back-end systems
Ideal Weight
Blood Alcohol
Calories Burned
This iPhone app from HealthCalc determines risk for type2 diabetes and
hypertension; it tracks heart, sugar, fitness and diet;
It monitors blood pressure, blood glucose, body weight, and workout data
http://www.healthstatus.com/healthcalc
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Smart Phones Can Be Used to Communicate
Public Health Issues
Health information can be pushed to the
individual; e.g.
communicating with the public about
infectious diseases, cancer prevention and
environmental health;
Here is a current app from
The Johns Hopkins
Bloomberg School of Public Health
http://www.apple.com/downloads/dashboard/news/publichealthwidget.html
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Smart Phones Impacting Rehabilitation
Length:1 minute
Video produced by Apple and RehabCare
http://www.apple.com/ipad/business/profiles/rehabcare/
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On-Body Sensors are Breaking New Ground
"Body Computing" refers to an
implanted wireless device,
which can transmit
up-to-the-second physiologic
data to physicians, patients,
and patients' loved ones.
USC's Center for Body Computing
is a place that works with medical
device companies to develop
products that capture and present
patient’ physiological data
E.g. tracking100,000 patients who
currently have pacemakers and/or
defibrillators implanted showed
that mortality rates were halved
when wireless tracking was
included
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Body Sensor Networks
GE Wireless Patient Monitoring
Length:1.5 minutes
http://www.youtube.com/watch?v=K15f1MqB-8U
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What is Needed A Backend System and Set of Services
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A flexible backend system and set of services will enable the development of
a wide variety of applications for public health
Our research: to explore and develop architecture, services, APIs and best practices
through the development of prototypes and pilot projects
Goals of the design include the ability to:
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specialize applications to specific populations, diseases, and treatment protocols
facilitate research in methodology and treatment
gather usage data automatically for evaluation, iterative improvements
perform comparative effectiveness studies
explore protocols across diseases, demographics
Essential is the need to balance privacy protection with data sharing
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Mobile Personal Sensing
Proposed System for Backend Processing
Configuration
User
Information
Personal
Data Stream
Automated
Capture
TimeLocation
Trace
GPS/WiFi
Modifiers
Prompted
or Manual
Capture
Location
Proximity
Activity
Social
Context
Health/
Wellness
Geolocation
Data
Statistical
Tools
Scientific
Models
Advocacy
User
Personalization
Smart Device
Processing
Smart Device
Capture
Database
Retrieval &
Storage
Server
Processing
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Applications,
Analysis
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A joint research effort between USC and UCLA
Personal data streams
will create a living record
of an individuals health
status;
Data will automatically be
stamped and geocoded;
Processed and filtered data
streams would become
part of an emerging database
of health facts of the nation
Support for iPhones and
Android phone
http://openmhealth.org
See also, www.sciencemag.org,
Nov. 2010
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The Challenge of Security and Privacy of Medical
Data
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Security, means not only “locked away” but also guarded against misuse, unauthorized
access, malicious alterations, and the consequences of computer failure and malfunction.
– A key factor is establishing and verifying the identity of users and their authority to
access specific systems and patient data.
Privacy, means to help make patient-related data available at the point of need to those, and
only to those, with a need to know.
– The patients have the right to restrict access to their information
– When used outside a legitimate patient–professional care relationship, health data must
be made anonymous to help prevent identification of the patient.
Trust, means to help ensure that all data recorded, stored, retrieved, and presented is in
context, accurate, timely, and relevant— and may be relied upon in making decisions that are
literally matters of life or death.
– Requests for action must happen, quickly, accurately, and completely, with appropriate
confirmations.
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An Architectural Approach
The Personal Data Vault
Personal Data Vaults as smart phone
apps already exist;
All use a centralized database to store
and retrieved backed up data; the
database should be stored in the cloud
What is needed is to provide the
owner with the ability to formulate
rules that control who has access to
the data;
Rules would include the ability to
specify different policies for different
groups, time intervals, geo-coded
data, facilitating sharing
In this way third party services can
access user data streams for analysis
and clinical
care
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One Sample Prototype
The Challenge of User Input
- an application that lets people
collect data about themselves
and their surroundings using
Twitter
- YFD uses this short message
paradigm with a simple syntax,
which allows users to
- explore their daily habits via an online
visual interface.
- track short-term goals and
keep a long-term data journal
by intertwining data collection
with everyday activity.
the main purpose of these tools is to
provide users with a way to explore
and interact with their data, and in
turn, make conclusions about their
day-to-day activities
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Visualization Tools take user data and display trends
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Geo-Location Is Becoming Commonplace
Yahoo’s Fire Eagle allows any
website to query your location;
Google’s Latitude, “see where your friends
are right now
Users must be able to determine for themselves
when, how and to what extent location
information about them is communicated to
others
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Research Challenges
Technological and Methodological
• Technological
– Human computer interfaces that facilitate data entry
– Data visualization tools for personal use
– Interoperability across smart phones and back-end systems
– Security systems to prevent unauthorized access
• Methodological
– Designing systems that encourage people to enter
information
– Assure individuals that their data is used only with their
permission
– Create open systems so third parties can participate
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The Benefits
• There are now more than 5 billion mobile phone subscribers worldwide
• There is now the opportunity to place a diagnostic and communications tool
in the hands of nearly everyone on the planet.
• A smart phone that receives information from simple sensors worn
inconspicuously on the body or from data entered into a smart phone by a patient,
can
- help individuals monitor a vast array of conditions including how well
their drugs are working and to recognize early signs of disease facilitating
early intervention.
- provide a powerful diagnostic and investigative tool
for researchers to study and analyze health issues over broad populations
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