QUT’s Capabilities on the application of ICT to Health

1. QUT’s Capabilities on the application of ICT to Health Introduction by: Prof Simon Kaplan, Executive Dean, Faculty of IT Presentation by: Prof Peter Croll, e-Health Research Group, Faculty of IT

2. Typical drivers for IT adoption Information Technology and Culture Change • ICT has the capacity to bring improvements with:- • Safety & Quality • Efficiency Gains • Remote Access & Services • High Speed Access • Management and Strategy • Outsourcing Capabilities • Education & Prevention • Satisfaction & Fulfillment

3. Health is complex • Some problems are so complex you have to be highly intelligent and well informed just to be undecided about them. (Lawrence J. Peter) • Two Key reasons for this: • Wickedness • Complexity

4. What’s Hype in Healthcare ICT– What’s Not? • “Care delivery organizations struggle with how to allocate limited budgets as technologies and IT roles change. Each year, promising IT innovations surface. Some never have an impact, others effect evolutionary improvements, and a few drive fundamental changes in business and IT strategies.” Gartner report: “Hype Cycle for Healthcare Provider Technologies”, 3 July 2006, Barry Runyon, et al.

6. How to Prioritize? • Two key questions: • How much value will an enterprise get from a particular technology? • When will the technology be mature enough to deliver that value? • i.e. what are the technologies that have high or transformational value to Care Delivery Organizations and that are likely to mature within the next few years? • The Priority Matrix - generated from the Benefit Rating and the Time to Plateau information for each technology, as follows:

7. Impact and Maturity (the Priority Matrix)

8. What does QUT do in this space? The QUT areas of expertise in ICT for Health* include: • Effective Health Information Sharing • Electronic Health Records • Health Education • Health Communication - Systems, Processes, and Tools • Risk Management of Resources within Healthcare • Intelligent Pattern Recognition • Management of Health Privacy, Freedom of Information, Confidentiality, Consent • Acute Clinical Care *Surveyed Oct 2004

9. QUT activity on the Priority Matrix Semantic Web Enterprise Master Person Index Electronic Health Record Controlled Medical Vocabulary Business Process Management Web Services Electronic Data Interchange Continuity of Care Record Enterprise Single Sign-On

10. Some specific examples of QUT activity areas: • Workflow/BPM (Business Process Management Group) • Security and Privacy (Information Security Institute) • Ontology and Semantic Web (Information Systems, SEDC) • Sharing Health Knowledge (Business Faculty and FIT) • Medical Imaging and other related projects (ISI/SEDC)

11. Some Key issues for Healthcare • Patient Safety • Inter-Department Interfacing • Education and Training • Effective Management • Geographical Distribution • Preventative Health • Acute Clinical Care • Chronic Diseases

12. How do we see these map to QH needs?

13. BPM Maturity Business Process Management Governance Modelling in the Large Configurable Reference Modelling Critical Success Factors of Process Modelling BPM in Selected Industries (eg Creative Industries) Service-enabled Business Process Management Workflow Patterns Yet Another Workflow Language (YAWL) i) Business Process Management Group Current Projects BPM Research Portfolio – Michael Rosemann & Arthur ter Hofstede • ARC Center of Excellence • ARC Research Network (EII) • 2 ARC Discovery • 7 ARC Linkage • 1 Smart State Fellowship • Main Initiatives: • YAWL / Workflow Patterns • BPM Maturity Assessment Members

14. Business Process Lifecycle Management

15. Business Process Management Maturity Strategic Alignment Governance Methods Information Technology People Culture Process Improvement Plan Process Roles and Responsibilities Process Design &Modeling Process Design & Modeling Process Skills & Expertise Process Values & Beliefs Strategy & Process Capability Linkage Decision Making Processes Process Implementation & Execution Process Implementation & Execution Process Education & Learning Process Attitudes & Behaviors Process Architecture Process Metrics & Performance Linkage Process Control & Measurement Process Control & Measurement Process Collaboration & Communication Responsiveness to Process Change Process Output Measurement Process Management Standards Process Improvement & Innovation Process Improvement & Innovation Process Knowledge Leadership Attention to Process Process Management Controls Process Customers & Stakeholders Process Project & Program Mgmt Process Project & Program Mgmt Process Management Leaders Process Social Networks Process Modelling – The Missing Middle Example 1: Workflow Patterns Example 3: A BPM Maturity Model Example 2: YAWL

16. Relationship with SAP • Since 1997 • SAP/IDS Institute forBusiness Process Innovation • 3 current ARC Linkage projects • State Government Fellowship • Various scholarships • A/Prof. Lutz Heuser • 6 US patent proposals • Regular presentations at SAPPHIRE BPM Community of Practicebpm-roundtable.com

17. ii) Security and Privacy ID Theft: A National Security Threat FBI-2006 Bigger problem than drugs…

18. Plan: ..live in May 2006, at County Durham and Darlington Acute Hospitals NHS Trust,

19. Mechanisms for Ultra-secure Access to Large Repositories of Sensitive Data – ARC Special Initiative on e-research Trusted Node Architecture The heart of the system is a Trusted Computing Base that ensures all data access is regulated by a set of policies enforced by the MAC based Policy Enforcement Server A secure Mandatory Access Control system The rules will be initiated by the organization and ideally specified in a high level language based on the federal and state legislations and regulations that apply to the organization concerned

20. Preventative Health Research Program Colorectal Cancer NeurodegenerativeDiseases Cardiovascular Disease Gut Health • Protective food • Diagnostics • Policy guidelines • Protective food • Novel preventative approaches • Policy guidelines • Protective food • Novel preventative approaches • Policy guidelines Health Data and Information Collaborations with CSIRO Fellowship Fellow National Preventative- Health Flagship “Minimizing Security and Privacy Risks with Health Data Linkages” 1925 2000 2045

21. iii) Ontology and the Semantic Web(Kerry Raymond, Michael Lawley) • NEHTA is promoting SNOMED CT (SCT) to standardise the clinical terms used by computer systems in healthcare • SCT has its semantic foundations in Description Logic which is also the foundation of the W3C's Web Ontology Language (OWL) • We are investigating the use of OWL for representing, reasoning about and processing SCT expressions • Uses include semantic annotation of existing documents (text and images) using SCT such that they can be queried or otherwise processed, and • Enabling the existing set of Semantic Web tools to be used with health-related data

22. cont. Ontology and the Semantic Web • In the context of Shared Electronic Health Records (EHRs), the concept of Archetypes is being promoted by OpenEHR and for CEN 13606 • Archetypes typically use a standardised clinical terminology such as SCT both for values in a particular record and also to describe the structures and fields of a record • However, simple tagging of fields or values in an EHR is not sufficient for performing the kinds of queries required by clinical researchers • We are investigating more powerful ways of combining SCT with Archetypes to exploit the semantics inherent in SCT so that such queries can be performed • We collaborate closely with the E-Health Research Centre to apply this work in context of Health Data Integration to avoid creating yet more islands of data.

23. The Semantic Web- Peter Bruza & Amanda Spink • Developing the capability using computational word meanings which are extracted automatically from text. • These meanings correlate with the those we carry around in our heads. We can exploit the meanings in a number of different ways: - they can act as signatures of terms in semantic web ontologies (and thus help more effectively resolve issues of semantic heterogeneity); - health care consumers have a wide range of experiences which, if shared, can benefit others, not only issues dealing with illness, but also valuable heuristics for getting around the horrendous bureaucracy- capturing these experiences requires processing of unstructured info. Dimensional reduction via singular value decomposition (SVD) Projecting sense of self P = projected computational sense of self I = approximation of sense of self in k approximation of the semantic space E= axes of extraordinariness (a non-orthogonal subspace) • Intuition: • If I projects significantly within bounds of axes (E), then I is in a state of “extraordinariness” • If I doesn’t project significantly onto E, then I is in a state of “ordinariness” • Longitudinal analysis- track I by month “Abstract Concept” = eigenvector (intrinsic semantic space)

24. iv) Sharing Health Knowledge • “Health Information Literacy” (IT Faculty) • “Sharing Health Knowledge in Indigenous Communities” (Business Faculty) • “Improving sexual and reproductive health and safety for Queensland's remote indigenous communities through culturally-appropriate multi-media information services” (IT and USQ) • “EHRbased interoperability - openEHR and Archetypes - between international healthcare institutions” (Info.Sys.)

25. Health Information Literacy What is it? Health Information Literacy (HIL) is “the set of abilities needed to recognize a health information need; identify likely information sources and use them to retrieve relevant information; assess the quality of the information and its applicability to a specific situation; and analyse, understand, and use the information to make good health decisions” (Medical Library Association, 2003) Why research it? Understanding and promoting HIL will assist Australians to age well; to live longer with more years in good health, continuing for longer as part of the Australian economic and social life. This will in turn, help to reduce the cost and other pressures on the health care systems, thereby allowing health services to direct attention towards more substantial national health issues.

26. v) Medical Imaging and other related projects (ISI/SEDC) • Watermarking and Pattern Recognition of Medical Images (Current project in collaboration with EHRC, UQ, GU, NICTA) • To investigate different watermarking methods and evaluate their suitability for authentication of medical images w.r.t. visual quality, robustness, payload, resilience to image manipulation, enhancement, histogram stretching. • Pattern recognition and analysis of medical images (past projects): • Analysis of shape changes of the hippocampus in MRI images to determine epilepsy condition; • Analysis of X-ray images of cervical spines to determine their abnormality; • Analysis of  tongue images for traditional Chinese medicine

27. How do you see this map to QH needs?