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>View discussions about this entry Country: United States
Organization: American College of Cardiology
Focus of activity - Technology
Year the initiative began (yyyy) - 2007
Positioning in the Mosaic of solutions
Define the innovation - What is the main focus (product, services, etc) of your innovation? Who are the primary beneficiaries? How does it make health and/or health care more affordable, accessible, and simpler to achieve/use? How does it differ from what currently exists in the market? The purpose of this proposal is to develop a technical framework that can be implemented worldwide, using an Open Source technology platform that is available to any interested health informatics developer around the world, that supports the capture of data for the assessment of baseline cardiovascular health status and follow-up event rates to registries in real-time and facilitate the exchange of dynamic and validated data from and to hospitals, clinics, doctor’s offices and clinical research organizations, in order to support just-in-time reporting capabilities (to support both one-time data collection and multi-year/no limit longitudinal data collection). Measures for patient confidentiality will be protected by implementing HIPAA (Health Insurance Portability and Accountability Act) compliant technology. The measure of success from this proposal is to significantly reduce the time, cost and resource drain that clinicians and their staff incur daily in participation in outcomes research and reporting activities. Secondly, to provide a Framework that is easily deployed and integrated within their pre-existing clinical environment, with minimal interruption to patient care. Currently, nothing exists in the health informatics industry with such widespread adoption, due to a lack of interoperability with health information systems, poor IT infrastructures within disadvantaged healthcare settings, and minimal resources dedicated to this critical effort. Therefore, the urgency and timing for this kind of solution is critical as the rise in cost of treating patients with cardiovascular disease remains the leading challenge within the U.S. for both private and public sector health insurers. By using Open Source technology, it reduces the development costs that disadvantaged or small health informatics vendors incur because most of the standards and technology are in the public domain or universally accepted within the IT world.
Context for Disruption: - Describe how your innovation is transforming traditional health or related systems in the short and long term. The foundation of the Framework will be based on global interoperability standards from the American Society for Testing and Materials (ASTM), HL-7, and Integrating the Healthcare Enterprise (IHE) for EMR (Electronic Medical Record) systems, using Service Oriented Architecture (SOA) as the software engineering approach. The mechanism to facilitate the exchange of dynamic data elements between the EMR and the registries will be powered by Smart Card and radio frequency wireless technology (e.g., Radio Frequency Identification, RFID). There are significant time, cost and resource savings when Smart Card and RFID technology are implemented within the clinical setting (hospital, lab or doctor’s office). Several applications of Smart Card Technology with RFID within the healthcare field are listed below (list cited from the Smart Card Alliance “Smart Card Applications in the U.S. Healthcare Industry, February 2006, publication number HC-06001):
• Supporting privacy and security requirements mandated by HIPAA Smart Card and RFID technology facilitates the collection, exchange and storage of a diverse range of dynamic clinical data that is patient specific. The following list of features is just a sample: • The patient’s eligibility, health history, and payment information are captured dynamically (HIPAA compliant technology) Delivery Model - How does your innovation reach its target populations? What mechanism(s) (e.g., communications, distribution channels, etc.) do you have in place? What is your current market penetration? How do you measure this? The target institutuions are the following: Short Term - private (medical device, pharmaceutical and third party payer entities) and public sector entities including U.S. federal agencies, Canadian and South American health-related agencies and service providers and European Union and Japanese medical institutions and organizations, Long Term - Africa, the Middle East and Asia-Pacific countries.
• • Key Operational Partnerships - What key partnerships have you established to make your disruptive innovation model possible? Who are your partners (business, social, government, other) and what are their roles? How central are these partnerships for your initiative. We are active members with two IHE domains: Cardiology and Quality. We also strategic partnerships with the American Heart Association, the FDA, CMS and NIH - AHRQ as well as third party payers. These organizations will help us to identify key opportunities with the clinical quality outcomes industry as well as private and public sector entities who have a vested interest in health informatics and outcomes research, which include medical device companies, pharmaceutical and biotechnology firms and clinical research institutions.
Financial Model - Describe the financial model for your innovation. What percentage, if any, of the total operating costs does earned income (from products, services, or other fees) represent? The financial model for the Framework would consist of the following: Of the earned profit that we receive from providing the Framework, 80% would be reinvested in research and development of the refinement of the Framework's implementation model, and 20% would be invested in disadvantaged communities worldwide, who need training and support in their adoption of the Framework.
Effectiveness - What has been the measurable impact of your project to date? How many people have benefited from your program in total? What policies, communities, or institutions have been influenced to make fundamental changes because of your work? A preliminary feasibility assessment has been done for the Data Harvesting Framework, and a logical diagram of the “to-be” state for the proposed Framework has been created. The diagrams were presented for review and approval by the Chair of IHE Cardiology, Dr. William Weintraub and the Chief Science Officer of NCDR, Dr. John Rumsfeld. They gave their full endorsement for its potential to provide an effective solution for the acquisition of longitudinal data for Cardiology outcomes research and reporting. Concurrently, a strategic implementation of SOA methods have been incorporated into the CARE (Carotid Artery Revascularization and Endarterectomy Registry) Data Collection Tool, which went into production January 2007, with no impact to the process of data harvesting. As an immediate follow up to NCDR’s success with SOA, the CARE Data Quality Report, to be released in the summer of 2007, will also leverage additional SOA functions within its architecture.
Scaling up Strategy - What is your priority for the next 3 years and please describe why. The following activites are our top priority within the next three years:
Enterprise Architecture Master Plan (which reflects the recommended artifacts based on the Zachman Framework with the premise of utilizing SOA as a primary approach to product development •Design and develop a logical and physical representation of an Enterprise Architecture model, by creating a Data Harvesting Framework, powered by Smart Card and RFID technology with protocols specifically designed to meet the data harvesting requirements for cardiovascular outcomes research and reporting. The technology will be based on an Open Source platform that can be utilized within the U.S. and internationally (Canada, Europe and Japan). •The core of the Framework will be based on standards, frameworks, methodologies and implementation strategies that include ASTM Continuity of Care Record E2369-05 (CCR), IHE Framework for Cardiology profiles for Retrieve Form for Data Capture (RFD) and Data Handling, Six Sigma for business process re-engineering and total quality management, the Zachman Framework for Enterprise Architecture modeling and SOA for the software engineering approach. •Demonstrate successful integration of the Data Harvesting Framework by conducting a pilot within various clinical settings that have pre-existing EMR systems that submit and extract data to and from NCDR for outcomes research and reporting
Origin of the Initiative - Tell the personal story that will help people connect to your work. How did the initiative start? Was there a particular individual or event driving the idea? Tell the reader the story behind the innovation. The ACC-NCDR (American College of Cardiology National Cardiology Data Registry) Cath PCI registry system, data elements have been developed to assess events in follow-up (i.e. death, hospitalization), but only limited participation in this optional program has occurred, with approximately 10% of sites collecting this data. Given that the principal purpose of PCI (Percutaneous Coronary Intervention) is to reduce angina pectoris and improve patients’ quality of life, the lack of health status measurements at baseline and follow-up is recognized to be a serious limitation. As a result, long term safety data are not available and are critically needed to improve intervention strategies. This was the driving force that caused the NCDR Technology Management department to explore alternative software and hardware solutions to this persistent problem within healthcare.
Contact Information:
Kimberly Harding
Director, Technology Management American College of Cardiology (nonprofit) Discussions about this entry |
Develop a universal technology framework for registries focused on capturing outcomes data for cardiovascular disease
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