Healthy Living Illustration For A Collaborative Health-Support Software Organization - Role Three Of 3

Introducing the ReAsure HealthNode™ Software Technology

In my previous ii post (click hither for the 1st inward the series), I (a) presented a instance for using collaborative health-support software systems inward loosely-coupled networks of healthcare professionals in addition to consumers in addition to (b) explained how to implement such systems in addition to networks inward a way that increases value to the consumer. In this post I innovate a next-generation software scheme we've been developing for quite some time, called the ReAsure HealthNode™ software technology, which is designed to assist these networks transform our electrical flow low-value, fragmented, healthcare manufacture into a high-value i past times enabling people inward widely scattered localities to:

• Collaborate around personalized health-support software
• Evolve those programs
• Use the programs to assist prevent, treat, in addition to handle wellness problems efficiently in addition to effectively …

Resulting in:

• Better aid coordination
• Greater consumer-centered cognitive back upward
• superior shared decision-making
• More competent self-maintenance (self-care).

The scheme utilizes innovative methods in addition to the patented CP Split™ technology[1] to deliver a unique ready of benefits in addition to advantages, which follows.

Benefits & Advantages #1:
Influenza A virus subtype H5N1 Simple, Flexible, Low-Cost Way to Exchange Health-Support Software in addition to Data Files

The ReAsure HealthNode™ software apps furnish a simple, flexible, low-cost way to substitution health-support software in addition to information files chop-chop in addition to securely via peer-to-peer mesh networks. These networks operate inward a node-based[2] communications architecture inward which each computerized device loaded alongside a ReAsure HealthNode™ software module in addition to a health-support software plan becomes a node connected to other nodes inward the network. Each node, furthermore, has publisher-subscriber functionality,[3] which agency certainly nodes serve every bit publishers in addition to other every bit subscribers. The publisher nodes shipping the files in addition to the subscriber nodes have them. The scheme uses a "desktop-to-desktop" (application-to-application) architecture in addition to exchanges the files via FTP (file transfer protocol), email attachments, or other methods of file transfer through Internet connections.

At i halt of the connection, the node serving every bit the publisher must authorize the transfer of a health-support software file and/or information file past times authenticating that each subscriber node is allowed to have them. At the other halt of the connection, the subscribing nodes must allow the publisher node to deposit whatsoever necessary file(s) into the subscriber's computer.

Exchanging Health-Support Software Files

The health-support software files designed for the ReAsure HealthNode™ apps consist of special types of software templates. These templates are electronic files that run (execute) the health-support software past times applying special rules (algorithms) consisting of mathematical formulas, logic, text functions, in addition to formatting instructions (which reverberate the software's underlying model). The software templates have got ii basic functions:

• Create Data Files (also called "content files") for distribution, which is a publisher business office
• Consume (extract information from) the content file in addition to homecoming it inward reports or enable novel information to last input, which is a subscriber function.

The health-support software template files are sent from the publisher node to its subscribers when the initial connections are made, in addition to over again if the templates have got been modified. The files are also exchanged when network collaborators desire to compare in addition to examine the dissimilar software programs, utter over their findings, combat the pros in addition to cons of competing programs, modify the programs, build novel programs, etc. This physical care for is crucial for the software's evolution (continuous improvement) in addition to tin last facilitated past times giving the nodes access to cognition administration software containing a virtual forum.[4] The oil & gas industry, for example, has used a node-based virtual forum, which enable participants to part lessons learned, best practices, after activeness reviews, drilling reports, in addition to wellness & security alerts on deep H2O drilling rigs around the globe.[5] Such a plan tin last applied to healthcare to assist collaborators evolve the health-support software.

Exchanging the Data that the Software Uses

In add-on to exchanging health-support software files, the ReAsure HealthNode™ Network scheme uses node networks to substitution in addition to transform information files containing consumers' wellness information. Figure 1 (below) describes the basic components in addition to processes of its node-based information file substitution method, which are explained next the figure.


Click picture to enlarge

Starting on the left of Figure 1, the Software Template File box depicts the health-support software template file in addition to the arrow through it depicts the publisher node sending the file to the subscriber nodes every bit discussed above. Note that ReAsure HealthNode™ apps tin also interface alongside other software programs via application programming interfaces APIs[6] (which is not depicted inward the Figure 1).

The Node every bit Publisher box inward Figure 1 depicts a node that:

• Uses a health-support software template to:
  • Acquire information in addition to information (content) from specified sources, every bit depicted past times the arrow from the Data Input to Data/Information Sources box, which is a template input function. The content may include numbers in addition to text, every bit good every bit links to electronic documents, images, in addition to spider web sites.
  • Process (manipulate, transform, in addition to organize) the content every bit defined past times the template's algorithms in addition to and so packet that content inward encrypted, delimited (e.g., comma separated value)[7] content file (Data File). Since the content file do non contain whatsoever formatting instructions or "markup tags,"[8] they are really small-scale to transmit in addition to efficient to use. These template output functions are depicted past times the arrow to the Content File box.
• Uses its publisher module to transmit the content file to its subscribers via email or whatsoever other methods, every bit depicted past times the arrow to the Node every bit Subscriber box, which is a publisher node transmission function.

The Node every bit Subscriber box depicts a node that:

• Uses its subscriber module to recollect the information & information from the content file, which is a subscriber node input function, every bit depicted past times the arrow coming out of the Content Files box.
• Uses a health-support software template to:
  • Format the content in addition to displays it inward interactive reports, which is a template output function, every bit depicted past times the arrow to the Report Display box.
  • Enable a individual to come inward novel in addition to modified content through its user interface, every bit depicted past times the arrow to the Data Input box, which is template input function. Note that his added or changed content may last used to update the existing content file stored locally inward the person's computer, every bit depicted past times the arrow to the Existing Local content file box, or the content may last exported to whatsoever databases or other information sources, every bit depicted past times the arrow dorsum to the Data Input to Data/Information Sources box; both of which are template input functions.

Since the content files are typically much smaller than the software template files, transmitting the content files every bit encrypted email attachments has several advantages:

• It provides a convenient in addition to transparent automated method that accommodates everyone's needs—from people alongside continuous broadband to those connected to the Internet exclusively occasionally, every bit good every bit those using depression speed dial-up services
• It saves coin past times eliminating the take away for expensive hardware, high-speed networks, costly information technology support, in addition to complex software systems.

Figure 2 (below) depicts how a network of nodes operates to substitution information.


Click picture to enlarge

Following is a description of the half-dozen steps shown inward Figure 2.

Step 1: Line #1 depicts the node at the top retrieving content from databases (including EMR/EHRs, laboratory systems, etc.), every bit good every bit from electronic files in addition to other sources, in addition to and so processing that content to do a content file using node functions defined inward its health-support software file.

Step 2: The venture bluish arrows of employment #2 present the node at the top using the publisher functions to shipping content files via encrypted email attachments to the node at the upper right, the nodes on the left, in addition to the node at the bottom.

Step 3: This dashed arrow (line #3) shows the top node, after sending content files to the node on it left, afterwards receives the content file from that same node in addition to retrieves it via its subscriber functionality. This agency both these nodes invoke their publisher in addition to subscriber functionality.

Step 4: These ii nodes have in addition to recollect content files; exclusively their subscriber functionality is invoked.

Step 5: These dotted arrows present content files existence passed sequentially from i node to the next, alongside each node adding to or modifying the files it receives, earlier sending extended content files to the side past times side node; their provider in addition to subscriber functions are invoked.

Step 6: The bottom node receives content files from ii other nodes via its subscriber functionality. After forming a composite content file from the accumulated content, every bit defined past times its health-support software templates, it sends the composite content file dorsum to the node at the top using its publisher functionality.
Thus, based on Figures 1 in addition to 2, networks of nodes using publisher subscriber modules in addition to health-support software can:

• Exchange in addition to evaluate software template files
• Create in addition to part content files
• Generate personalized, interactive reports
• Modify the contents file in addition to and so reuse it to generate updated reports or export it to other information stores.

Following is a practical instance of a collaborative health-support software scheme inward action.

Influenza A virus subtype H5N1 Practical Example

Imagine a consumer having the ReAsure HealthNode™ modules inward his computer, along alongside a health-support software program. When he installed the node modules, he went through a registration physical care for during which he sent requests, every bit a publisher, to the nodes of people to whom he wants to shipping certainly of his wellness information. He also sent requests, a subscriber, to people from whom he wanted to have information. In addition, he received requests from others who desire to have his wellness information (i.e., they subscribed to him). The nodes used email to transmit the content files, so the email addresses of the corresponding nodes were stored during registration. As each asking was approved past times the appropriate parties, the transfer of software template files in addition to content file began.

Now, whenever he wants to sends special information to the healthcare providers he authorized every bit his subscribers, he click his mouse to initiates certainly publisher node functions, which instruct his node to:

• Retrieve in addition to decrypt his content file
• Extract from his content file the special information authorized for each provider; these authorizations are based on the provider's "role" (e.g., the provider's expanse of specialty)[9] Pack the extracted information into other content files in addition to encrypts them
• Attach the content file to e-mails in addition to sends them to the appropriate providers.

Upon receipt of the e-mails past times his providers, each of their subscriber nodes:

• Retrieves the content file from the email
• Decrypts the content file
• Extract the information from the content file
• Exports the information to the provider's electronic medical tape system.

All these steps taken past times the publisher in addition to subscriber nodes are done automatically.

In a like manner, the consumer may desire to obtain information from a provider or lab, that is, he may desire to last i of their subscribers. If the provider (or lab) has a ReAsure HealthNode™ in addition to the registration physical care for is completed, the consumer would shipping a asking to their nodes for a content file containing certainly information. In this scenario, the consumer's node uses its subscriber functionality, in addition to the provider (or lab) node serves every bit the publisher.

Once the consumer's node receives the email alongside the content file attached, it automatically retrieves in addition to decrypts the content file, extracts its contents, in addition to merges the novel information into his ain (locally stored) content file. Depending on the software rules, the information may supplant (i.e., overwrite) existing information inward his content file or it may last added to the existing data. His content file tin in addition to so last accessed, formatted, in addition to presented past times whatsoever appropriate health-support software program, such every bit the Personal Health Profiler™.[10]

In silent some other scenario, a provider may asking special information from the consumer, or certainly rules the guide inward the consumer's node mightiness last executed on behalf of the provider (e.g., if the consumer has diabetes, a dominion mightiness tell his node to shipping his glucose readings to his primary aid physicians, endocrinologists in addition to wellness double-decker i time a week). In this case, the consumer's node is i time over again the publisher, which automatically extracts those information from his content file in addition to sends it to the subscriber's (i.e., providers') nodes.

Data Transformation in addition to Translation

Transmitting content files betwixt nodes in addition to rendering them every bit reports is exclusively component of the process. What happens when a publisher node sends a content file to subscriber nodes utilized past times people who utilization dissimilar terminologies, speak dissimilar languages, or have got dissimilar information storage in addition to presentation requirements? How are the contents of the content file transformed in addition to translated to come across the various needs of everyone inward such loosely-coupled networks?

Transforming Data

Data oft has to last transformed when existence sent from i database to another. This happens when, for example, the databases have got dissimilar tabular array field[11] names (e.g., "birth_date" in addition to "dob") or information formats/syntax (e.g., whether or non dashes should last included inward a telephone number). What is required, therefore, is either to forcefulness everyone to utilization the same information standard, such every bit transforming everything to XML[12] using a mutual "schema" (data structure). Another is to transform the master information names in addition to formats so the information are received inward the proper configurations.

XML information standards tin last used inward the node network to transform data, in addition to the content files tin last constructed of information transmitted inward XML files. But simpler in addition to most efficient ways include having rules included inward the node functionality that instruct:

• The publisher node to do the necessary information transformations prior to packing the information into the content file earlier sending it to its subscribers
• The subscriber nodes to do the transformation upon receipt of the content file
• Intermediate nodes brand the transformations every bit the content file passes through them.

Note that these transformation methods require that the publisher in addition to subscriber nodes last notified inward advance every bit to the required transformations. This notification physical care for tin spill out during the registration or upon a subscriber node's asking for information from the publisher.

Translating Information

When people inward loosely-coupled networks part information in that location is oft the take away for it to last translated. In add-on to linguistic communication translation (e.g., English linguistic communication to Spanish), the number of terminology translation must last addressed. This refers to the employment that occurs when dissimilar people utilization dissimilar price (their local standards) to refer to the same concept.

One mutual strategy used to avoid such problems is to forcefulness everyone to adopt the same global terminology standards[13] past times agreeing on i ready of price (semantics). While setting arbitrary global standards for health-related price is a way to foster widespread communications betwixt people from dissimilar regions, organizations in addition to healthcare cultures/communities, there's also a downside to eliminating the local standards people rely upon, i.e., they lose information due to reduced semantic precision in addition to nuance.

Take, for example, the term "high blood pressure;" in that location are 126 dissimilar price referring to this concept of elevated blood pressure level levels. These price include "malignant hypertension," which refers to really high blood pressure level alongside swelling of the optic nervus behind the eye; it's a status commonly accompanied past times other organ harm such every bit pump failure, kidney failure, in addition to hypertensive encephalopathy. "Pregnancy-induced hypertension," on the other hand, is when blood pressure level rises during pregnancy (also called toxemia or preeclampsia). These are really dissimilar types of hypertension. So, piece referring to a person's status using a global standard term such every bit "hypertension" clearly conveys that the individual has high blood pressure, the standardized term loses of import details found inward the to a greater extent than detailed local standard terms. These lost details, inward turn, could really good deport upon handling decisions in addition to outcomes. So, in that location is a skillful argue to have got multiple price for a health-related concept.

Furthermore, relying on global standards are problematic because, every bit standards evolve, it tin last really hard in addition to costly to alter the global standards Consider, for example, the clamor over past times switching to the novel ICD-10 global criterion of diagnostic price (codes), which have got evolved from the ICD-9 standard.[14]

It would last much better, therefore, to proceed local standards, back upward their evolution, in addition to utilization the information translation described to a higher house to ensure everyone gets the information needed using the price they take away in addition to understand. In a node network, this tin last accomplished inward a like way information transformation occurs, simply instead of transforming the data, the price that the subscriber node requires either replace, or are added to, the price inward the master content file.

Composite Reporting 

In add-on to modifying a content file information through transformations in addition to translations through node networks, the nodes back upward composite reporting. Composite reports consist of information sent from multiple publisher nodes to a unmarried subscriber node. The subscriber node takes all that information in addition to combines it into a unmarried integrated content file, which is in addition to so used to generate composite reports containing information from multiple sources.

For example, let's state a primary aid physician (PCP) wants to proceed runway of the handling a patient is receiving from several provider specialists. The PCP's node, which serves every bit the subscriber, would shipping a asking for certainly information from all the patient's specialists. Upon receipt of the information request, the specialists' nodes, which serve every bit the publishers, recollect the requested information from their dissimilar electronic wellness tape databases in addition to shipping the information automatically to the PCP's node. The PCP's node in addition to so incorporates the information into a composite study tailored to the PCP's needs in addition to preferences, in addition to and so presents the study on hide for the PCP to view. The PCP's subscriber node could also last instructed to asking information from the publisher node connected to the patient's personal wellness tape and, upon receipt (and every bit authorized past times the patient), add together the information into the same study every bit authorized past times the patient. Likewise, a consumer using the Personal Health Profiler™ software tin do composite reports inward a like mode from information sent past times multiple provider nodes.

Protecting Personal Health Information

With all this personal wellness information existence sent around, a powerful method is needed to protect people's privacy. While encryption in addition to authentication handles security issues (e.g., making it rubber to shipping content file past times e-mail), it doesn't bargain alongside privacy issues (i.e., who is allowed to have a person's wellness information). Instead, protecting the privacy of information sent past times consumers' nodes requires strategies such every bit transmitting "limited information sets" in addition to enabling "granular level" of control. That is, consumers should last able to implement onetime authorisation to part certainly parts of their content files alongside specific types of providers. They should also have got granular command over whom, if anyone, gets to reckon their information past times authorizing special types of providers to have special pieces of information. Warnings in addition to alerts inform the consumer if certainly information non existence authorized ought to last shared alongside certainly providers who take away those information to assist brand diagnostic in addition to handling decisions.[15] The Personal Health Profiler™, for example, deploys these privacy safeguards.

Benefits & Advantages #2:
An Elegant Way to Maintain a Complete in addition to Evolving Data Set 

Influenza A virus subtype H5N1 minute ready of benefits in addition to advantages of the ReAsure HealthNode™ Network scheme is its powerfulness to hold a complete in addition to evolving information ready that excludes nothing. That is, every possible slice of wellness information—about one's wellness status, risks, conditions, treatments received, the clinical outcomes (results) in addition to costs of the treatments, etc.—can last collected, stored in addition to used over a person's entire lifetime. It does it using an indexing in addition to categorizing method like to the Dewey Decimal classification scheme libraries utilization to organize books in addition to magazines.

This all-encompassing method enables rich, detailed health-support software to last built. And it also permits evolution of holistic (mind-body-environment) health-support software that improve aid value past times promoting greater agreement of a consumer's wellness problems, threats, in addition to needs. The holistic approach provides feedback, guidance, in addition to didactics virtually people's:

• Signs & symptoms[16] in addition to their possible human relationship to medications side-effects handling procedures, including complementary in addition to option medicine[17]
• Psychological (emotional, cognitive, in addition to behavioral) wellness in addition to its human relationship to biomedical weather (e.g., the number of mental stress of blood glucose command inward diabetic persons)[18]
• Genetic markers in addition to the associated wellness adventure factors[19]
• Health trends based on wellness status changes in addition to lab attempt out results over fourth dimension
• Methods for coping alongside in addition to solving personal problems.

Benefits & Advantages #3:
Influenza A virus subtype H5N1 Way to Increase Care Value to Consumers piece Protecting Populations

And a tertiary ready of benefits in addition to advantages refers to the ReAsure HealthNode™ Network system's powerfulness to back upward evidence-based query across all healthcare disciplines focused on improving healthcare value to consumers, in addition to to protect populations through surveillance in addition to back upward of emergency personnel.

Increasing Care Value to Consumers through Evidence-Based Research

Increasing in addition to sustaining aid value to consumers requires a simple, flexible, low-cost way to substitution health-support software; a convenient, secure, economical way to substitution the information used past times the software; in addition to an effective, efficient way to hold a consummate in addition to evolving information set. By adding the system's powerfulness to de-identify consumers' wellness data[20] to these previously discussed advantages in addition to benefits, it becomes apparent that the ReAsure HealthNode™ Network scheme is ideal for researchers involved inward creating, studying, in addition to evolving high-value evidence-based guidelines across all healthcare disciplines (both sick-care in addition to well-care, every bit good every bit conventional in addition to complementary & option care[21]).

This sort of query is essential for evolution of evidence-based healthcare conclusion back upward systems utilizing character metrics, exercise guidelines, cognition services in addition to tools, in addition to continuous character improvement feedback loops.[22]

Protecting Populations

• The ReAsure HealthNode™ Network scheme also addresses the take away to protect populations through:
  Comprehensive biosurveillance in addition to post-market drug & medical device surveillance[23]
• Support for first-responder in addition to trauma pump staff during disasters[24][25]
• Has no "single betoken of failure,"^, which leaves centralized systems vulnerable inward disaster situations.[26][27]

Summary in addition to Conclusion

Collaboration amid loosely-coupled networks of healthcare providers, researchers, in addition to consumers using health-support software is an essential strategy for increasing healthcare value. ReAsure HealthNode™ Network scheme demonstrates how to enable efforts to convey consumers high value care.

We welcome whatsoever feedback in addition to opportunities for collaboration.

References and Notes

[1] http://cpsplit.typepad.com/
[2] Influenza A virus subtype H5N1 node is an electronic device (e.g., a PC, laptop, jail cellular telephone phone, in addition to hand-help device) attached to a network, which contains a software module enabling it to send, receive, or frontward information across that network.
[3] /search?q=case-for-collaborative-health-support
[4] Influenza A virus subtype H5N1 virtual forum enables people part information over the Internet, online or offline, through “threaded” discussions inward messages on the same theme are grouped together for slowly retrieval in addition to reading.
[5] http://nhds.com/dwd/kmintro.htm
[6] http://en.wikipedia.org/wiki/API
[7] http://en.wikipedia.org/wiki/Delimited
[8] http://en.wikipedia.org/wiki/Markup_language
[9] Each provider’s role is established during the registration physical care for in addition to used past times the node thereafter.
[10] /search?q=case-for-collaborative-health-support
[11] http://en.wikipedia.org/wiki/Column_(database)
[12] http://www.w3schools.com/XML/xml_whatis.asp
[13] /search?q=case-for-collaborative-health-support
[14] http://www.fiercehealthit.com/story/switch-icd-10-should-be-very-costly/2008-08-24?utm_medium=rss&utm_source=rss&cmp-id=OTC-RSS-FHI0
[15] /search?q=case-for-collaborative-health-support
[16] http://healthfieldmedicare.suite101.com/article.cfm/symptoms
[17] http://wellness.wikispaces.com/Tactic+-+Research+Complementary+and+Alternative+Medicine+and+Human+Genetics+and+Genomics#CAM
[18] /search?q=case-for-collaborative-health-support
[19] http://wellness.wikispaces.com/Tactic+-+Research+Complementary+and+Alternative+Medicine+and+Human+Genetics+and+Genomics#Genetics
[20] The ReAsure HealthNode™ scheme de-identifies consumers’ wellness information past times “decompositing” their content files in addition to extracting the information without identifying to whom it belongs. See /search?q=case-for-collaborative-health-support
[21] http://wellness.wikispaces.com/Tactic+-+Research+Complementary+and+Alternative+Medicine+and+Human+Genetics+and+Genomics
[22] http://wellness.wikispaces.com/Evidence-based+HealthCare+Decision+Support+System
[23] http://wellness.wikispaces.com/Tactic+-+Protect+Populations+with+Biosurveillance
[24] http://www.nhds.com/coms_agent911.html
[25] /search?q=case-for-collaborative-health-support
[26] http://en.wikipedia.org/wiki/Single_Point_of_Failure
[27] http://www.readwriteweb.com/archives/google_failures_serious_time_t.php

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