Smart Grid Challenges for a Health Care Computing Infrastructure

1. 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 Ellis Horowitz, 2011

2. Can You Guess Who is in the Photo? Ellis Horowitz, 2011

3. Ellis Horowitz, 2011

4. Outline • The Call to Action • The Challenge • The Approach • The Benefits Ellis Horowitz, 2011

5. 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 Ellis Horowitz, 2011

6. The European Commission and e-Health • The European Union is moving towards eHealth • “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 • 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. Ellis Horowitz, 2011

7. 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 • 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. • 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. Ellis Horowitz, 2011

8. Two Approaches Ellis Horowitz, 2011

9. Mobile Devices Can Play a RoleIndividuals process/act/enter data Personal data repository Self-reporting Our actions 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 Ellis Horowitz, 2011

10. 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 Ellis Horowitz, 2011

11. 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 Ellis Horowitz, 2011

12. Smart Phones Impacting RehabilitationLength:1 minute Video produced by Apple and RehabCare http://www.apple.com/ipad/business/profiles/rehabcare/ Ellis Horowitz, 2011

13. 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 Ellis Horowitz, 2011

14. Body Sensor NetworksGE Wireless Patient MonitoringLength:1.5 minutes http://www.youtube.com/watch?v=K15f1MqB-8U Ellis Horowitz, 2011

15. What is Needed -A Backend System and Set of Services • 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: • 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 Ellis Horowitz, 2011

16. Mobile Personal SensingProposed System for Backend Processing Configuration User Information Database Retrieval & Storage Health/ Wellness Personal Data Stream Location Proximity Activity Social Context Automated Capture Time-Location Trace GPS/WiFi Modifiers Geolocation Data Statistical Tools Advocacy Scientific Models Prompted or Manual Capture User Personalization Server Processing Applications, Analysis Smart Device Processing Smart Device Capture Ellis Horowitz, 2011

17. 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 Ellis Horowitz, 2011

18. The Challenge of Security and Privacy of Medical Data • 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. Ellis Horowitz, 2011

19. An Architectural ApproachThe 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 Ellis Horowitz, 2011

20. One Sample PrototypeThe 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 Ellis Horowitz, 2011

21. Visualization Tools take user data and display trends Ellis Horowitz, 2011

22. 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 Ellis Horowitz, 2011

23. Research ChallengesTechnological 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 Ellis Horowitz, 2011

24. 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 Ellis Horowitz, 2011