The challenge
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The Challenge. Worldwide today: 1 billion adults overweight 860 million individuals with chronic conditions 600 million individuals age 60 or older 75-85% of healthcare spending is on chronic condition management. Source: World Health Organization; McKinsey .

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The Challenge

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The challenge

The Challenge

Worldwide today:

  • 1 billion adults overweight

  • 860 million individuals with chronic conditions

  • 600 million individuals age 60 or older

  • 75-85% of healthcare spending is on chronic condition management

Source: World Health Organization; McKinsey


The challenge

The Goal: Improve Lifestyle Choices, Health

= Non Modifiable Contributors to Disease

= Modifiable Contributors to Disease

Hu et al. Diet, lifestyle and the risk of type 2 Diabetes in women. NEJM 2001 Sep 13;345(11):790-7.

Stampfer MJ, Hu FB, Manson JE, Rimm EB, Willett WC. Primary prevention of coronary heart disease in women through diet and lifestyle. N Engl J Med. 2000; 343: 16–22


The solution personal connected healthcare

The Solution: Personal Connected Healthcare

There is increasing evidence to support the value of remote monitoring for individuals with chronic conditions, including:

35-56% reduction in mortality;

47% reduction in risk of hospitalization;

6 days reduction in length of hospital admission and

65% reduction in office visits;

40-64% reduction in physician time for checks and

63% reduction in transport costs

(Cleland et al 2005; Lee R, Goldberg et al, 2003; Scalvini S et al., 2001; Elsner et al, 2006; Van Ginneken et al 2006)


Continua domains

Continua Domains

To organize its work, Continua segmented the market in three large Domains

Living Independently Longer

Wellness

Manage Chronic Conditions

People are at the center of everything we do


Interfaces standards

Interfaces & Standards

Personal Device

Thermometer

Health

Records/Networks

Pulse Oximeter

Aggregation

Manager

Telehealth

Service

Center

Pulse /Blood Pressure

Weight Scale

Glucose Meter

Cardio / Strength

PHR

Independent

Living Activity

EHR

Peak Flow

NHIN

Medication

Adherence

Health

Record

Network

(HRN)

Interface

Wide

Area

Network

(WAN)

Interface

Personal

Area

Network

(PAN)

Interface

Physical Activity

HIE

Electrocardiogram

Insulin Pump


Interfaces standards1

Interfaces & Standards


Wan code

WAN Code

The Continua WAN interface is the component of the Continua end to end architecture that enables measurement data to flow from an Application Hosting Device (AHD) to a WAN device with the resources necessary to share this information with a Personal Health Monitoring Report (PHMR) enabled system such as an Electronic Medical Record (EMR).   

The CESL WAN interface is a JAVA based code library that provides the WAN Observation Sender component of the Continua WAN interface for a AHD.  This code library implements the following interoperability standards:


Wan code1

WAN Code

HL7 v2.6 EDI Encoding

IHE PCD-01 transaction of the IHE DEC profile

SOAP 1.2 over HTTP v1.1

Web Services Interoperability Organization Basic Profile Version 1.1 (WS-I BP)

Web Services Interoperability Organization Basic Security Profile 1.0 (WS-I BSP)

Web Services Interoperability Organization Reliable Secure Profile (WS-I RSP)  


Coming mcesl

Coming - mCESL

J2ME version of PAN, Manager and WAN link 


The problem

The Problem

  • Integration of Patient Care Devices

    • Value Proposition:

      • Supports on going care at lower cost points by allowing patient to be at home

    • Issues blocking effectiveness

      • Many different devices

      • Getting useful data to the people who need it


The continua solution

The Continua Solution

  • Continua is an industry trade association that

    • Profiles standards that enable devices to represent and deliver medical observations in a common way

    • Addresses regulatory issues associated with the use of the information

    • Promotes the market adoption of the overall ecosystem

  • Focus – The technical Framework


The challenge

Overview


The challenge

PAN/LAN Interface

(Personal Area Network/Local Area Network)


Representing device information

Representing Device Information

  • Core Technology is from ISO/IEEE 11073

    • 11073 Nomenclature: Maps a medical understanding of an observation to a number (systolic blood pressure)

    • 20601 Standard: Building blocks for representing and communicating information

    • 104XX Specializations: How to represent a particular class of device


Device classes

Device Classes

  • ISO/IEEE 11073-104XX work on going, already covers many common devices including:

    • Pulse oximeter

    • Blood Pressure

    • Weight Scale

    • Glucose meter

    • Medication Monitor

    • Peak Flow


One collection point

One collection point

  • 20601 (Optimized Exchange Protocol) specifies how a common local aggregator collects this information from different devices

    • One hub (PC, cell phone, TV, or home Internet gateway) can collect data from any device from any manufacturer

    • Bluetooth, USB, ZigBee


Pan lan interface 1 of 2

PAN/LAN Interface (1 of 2)

Continua PAN Server (IEEE 20601 Agent)

  • Pan Server sits on the medical sensor component or Personal Health Device (PHD)

    • Implements common data representation

    • (Can) store data while device is “off line”

    • Sends data to PAN Client when communication is possible


Pan lan interface 2 of 2

PAN/LAN Interface (2 of 2)

Continua PAN Client (IEEE 20601 Manager)

  • Resides on a hub or aggregation point (called an Application Hosting Device) such as a cell phone or PC

    • Must be in close proximity to the server component

    • Can store data locally or forward data automatically using other parts of Continua Ecosystem


Lni pan building blocks

LNI PAN Building Blocks

LNI Provides core PAN/LAN technology

  • HealthLink PHD – The PAN Server component for medical sensors

  • HealthLink OXP – The PAN Client for aggregators

    • mOXP- Java implementation of PAN Client targeted at Android platforms

    • HealthLink SDK for Android

    • OXPLib– Continua Certified PC class solution for Windows 32 and 64 bit systems


Wan interface wide area network

WAN Interface(Wide Area Network)


Wan interface

WAN Interface

Purpose – Move the data from the local environment elsewhere

  • WAN Sender

    • Collocated on the AHD in the home environment

    • Converts IEEE 11073 representation to HL7 2.6 form

    • Sends data using IHE PCD-01 transaction

  • WAN Receiver

    • Sits in the web services of a professional organization

    • Collects data from the WAN Sender

    • IHE PCD-01 transaction


Hrn interface health record network

HRN Interface(Health Record Network)


Hrn interface

HRN Interface

Purpose – To move medical documents between organizations

  • HRN Sender - The end point of the Continua ecosystem

    • Can be located on local AHD, or in professional office

    • Data is now represented in a formal HL7 3.0 CDA

      • Measurement is in a component call a Personal Health Monitoring Record


Key points

Key Points

  • Continua technology provides a standard based approach to collecting device data

    • Common tools for representing data

    • Many devices specializations defined

    • Path out of high cost locked proprietary end to end systems

    • Can integrate technology into system in a evolutionary manner


The challenge

Continua Gets it There


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