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|Traditional healthcare frame||Emerging self-management frame|
|Scope||Relieve acute conditions now.||Maintain well-being over a lifetime.|
|Approach||Intervention: treatment||Prevention: healthy living|
|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|
|Dispersed between offices||Connected: aggregated|
|Managed by HCP||Controlled by patient|
Source: Frog Design
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 (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)
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.
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|
|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.
|Health Vault API Category||API names||Purpose|
|Authentication||CreateAuthenticatedSessionToken||Authenticate an application and user|
|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.|
|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.|
|Asynchronous Processing||GetAuthorizedPeople||Enable an application to work asynchronously with HealtVault and create a publish/subscribe model.|
|Messaging||SendInsecureMessage||Enable applications to send messages to consumers using these APIs|
|Terminology||GetVocabulary||Enable applications to retrieve or search terminologies hosted by HealthVault.|
|Application Management||SetApplicationSettings||Enable an application to store a record-specific setting and mange derivative applications.|
|Service Discovery||GetServiceDefinition||Help with service discovery|
|OpenQuery||SaveOpenQuery||These are hardly used, but they give the ability to run pre-canned queries for a health record.|
|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|
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 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.
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.