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Health 2.0

Needs

Differences

  Traditional healthcare frame Emerging self-management frame
Scope Relieve acute conditions now. Maintain well-being over a lifetime.
Approach Intervention: treatment Prevention: healthy living
  expert directed Self-management
  Apply standards of care Measure, assess, and adjust; iterate
  Lengthy regulatory pre-approval Learn and adapt as you go
Subject Symptoms and test results Whole person, seen in context
Response Prescribe medication improve behavior, environment
Relies on Medical establishment Individuals, family and friends
  Social Networks, others like me  
HCP as Authority, expert Coach assistant
  Dispensing knowledge Learning from patients
Patient as Helpless, childlike Responsible adult
  Taking orders Setting goals: testing hunches
Relationship Asymetric, one way Symetric, reciprocal
  Command and control Discussion and collaboration
Records HCP’s notes of visit Patient’s notes, data from sensors
  Sporadic Continuously collected
  Dispersed between offices Connected: aggregated
  Managed by HCP Controlled by patient

Source: Frog Design

Segments

Target groups

Products

The two dominant PHR platforms are Microsoft HealthVault and Indivo X. Google Health had been a dominant platform, but as of June 2011, Google retired the Google Health project and will no longer offer a PHR.

Microsoft

Amalga

Microsoft Amalga (connected to Hospital Legacy System, Segment: Enterprise)
Allows hospital enterprises to unlock the power of data sitting in clinical, financial, and administrative silos. Without replacing current systems, Amalga offers the ability to capture, consolidate, store, access, and quickly present data in meaningful ways. (Source: Microsoft)

HealthVault

Microsoft HealthVault (connected to Partner Applications, Segment: Consumer)
Designed to put consumers in control of their health information. A HealthVault account helps you collect, store and share information with family members and gives you a choice of applications and devices to help manage your fitness, diet and health (Source: Microsoft)

HealthVault provides more than 80 granular data types that enable tracking data re- garding everything from daily exercise to genome sequences.

Health Vault Design Principles
HealthVault ecosystem with devices and applications
Sending Data to HealthVault

The “Share” page, among your user’s profile, enables a link to HealthVault.

Fitbit data HealthVault data type HealthVault field name
Calories burned Exercise Calories burned
Steps Taken Exercise Number of steps
Daily Distance Exercise Distance
Go in to bed Sleep Session Bed Time
Go out of bed Sleep Session Wake Time
Slept for Sleep Session Sleep Minutes
Fell asleep in Sleep Session Settling Minutes
Wake State Sleep Session Wake State

For a bigger load of data extraction there is the HealthVault Powershell (HvPosh). PowerShell can export data to a standard CSV format that can be consumed by a variety of other tools, simple or advanced that let you do calculations and generate charts.

Interfacing with HealthVault
HealthVault Platform APIs
Health Vault API Category API names Purpose
Authentication CreateAuthenticatedSessionToken Authenticate an application and user
  RemoveApplicationRecordAuthorization  
  NewApplicationCreationInfo  
  NewApplicationCreationInfo  
  NewSignupCode  
  GetPersonInfo  
  GetAuthorizedRecords  
Reading Health Items GetThings A rich interface to retrieve health items along with an associated digital signature or streamed BLOBs
Adding & Updating Health Items PutThings Enable an application to add or update health item data.
  OverwriteThings  
  BeginPutBlob  
Delete Health Items RemoveThings Enables an application to delete data.
Patient Connect Associate PackedId Enable clinical applications to create a temporary drop-off or permanent connection for consumers without having a web interface.
  BeginPutConnectPackageBlob  
  CreateConnectPackage  
  CreateConnectRequest  
  GetAuthorizedConnectRequests  
  DeletePendingConnectPackage  
  DeletePendingConnectRequest  
Asynchronous Processing GetAuthorizedPeople Enable an application to work asynchronously with HealtVault and create a publish/subscribe model.
  GetUpdatedRecordsForApplication  
  GetEventSubscriptions  
  UpdateEventSubscription  
  SubscribeToEvent  
  UnsubscribeToEvent  
  UnsubscribeToEvent  
Messaging SendInsecureMessage Enable applications to send messages to consumers using these APIs
  SendInsecureMessageFromApplication  
Terminology GetVocabulary Enable applications to retrieve or search terminologies hosted by HealthVault.
  SearchVocabulary  
Application Management SetApplicationSettings Enable an application to store a record-specific setting and mange derivative applications.
  GetApplicationSettings  
  AddApplication  
  UpdateApplication  
Service Discovery GetServiceDefinition Help with service discovery
  GetThingType  
OpenQuery SaveOpenQuery These are hardly used, but they give the ability to run pre-canned queries for a health record.
  GetOpenQueryInfo  
  DeleteOpenQuery  
HealthVault SDK and Open Source Libraries
SDK library Distribution Supported platform Features available License and support
HealthVault.NET MSDN Windows XP, Vista, 7 (.NET 2.0) All HealthVault features Microsoft Reciprocal License (MS-RL), Microsoft supported
Java Codeplex JDK 1.6, JDK 1.4 (limited) Authentication, method wrappers, thing-type wrappers Microsoft Public License (MS-PL), Community support
Java Codeplex Android (1.6+) Authentication, thing type wrappers Microsoft Public License (MS), Community support
iOS GitHub iOS 4.0+ Mobile authentication Community Support, Apache 2.0
Windows Phone Codeplex Windows Phone 7+ Mobile authentication Apache 2.0, Community support
Python Google Code Python 2.7 Authentication (basic) Apache 2.0, Community support
PHP SourceForge PHP Authentication (basic) Apache 2.0, Community support
Ruby RubyForge Ruby Authentication (basic) Apache 2.0, Community support
Device Connectivity

As of this writing, more than 80 types of devices connect with HealthVault. These devices range from pedometers and weighing scales to blood pressure meters and pulse oximeters.

Continua
Continua Health Alliance is a nonprofit, open industry organization of health care and technology companies joining together to improve the quality of personal connected health care. With more than 230 member companies around the world, it is the leading consortium for personal health care devices.

Applications

Indivo X

Indivo X is the latest iteration of one of the longest standing PHR development efforts in the world. Work on predecessors of Indivo date back to 1994. Both Google Health and HealthVault had the benefit of developing while the lessons and source code from early versions of Indivo were available. The industry regards the Indivo project as the grandfather of PHR systems.

The latest iteration of Indivo is called Indivo X, and is obviously a fourth-generation effort in the PHR arena. The genesis of the design made a tremendous splash with an perspective article in the New England Journal of Medicine in 2009.

Stack

Best practice

Venture Capital

Interesting