Sunday, April 18, 2010

SHARP Focus: Indivo Personally Controlled Health Record

Researchers at Children’s Hospital Boston and Harvard Medical School will lead the efforts of a $15 million grant from the Office of the National Coordinator for Health Information Technology to support research and development of a new health information technology infrastructure. The grant is one of the four awarded through the Strategic Health IT Advanced Research Projects (SHARP) program to address key challenges in adoption and meaningful use of health IT. I wrote previously about the University of Texas Health Science Center at Houston research which will focus on Patient-Centered Cognitive Support. Now we will take a look at the Harvard program on new health care application and network-platform architectures.

This four-year project will be led by Isaac Kohane, MD, PhD, and Kenneth Mandl, MD, MPH, of the Children’s Hospital Informatics Program and Harvard Medical School, and will investigate, evaluate, and prototype approaches to achieving an “iPhone-like” health information technology platform model, as was first described by Mandl and Kohane in a March 2009 Perspectives article in The New England Journal of Medicine.

The platform architecture, described as a “SMArt” (Substitutable Medical Applications, reusable technologies) architecture, will provide core services and support extensively networked data from across the health system, as well as facilitate substitutable applications – enabling the equivalent of the iTunes App Store for health. This will stand in stark contrast to the way health information systems have been designed and implemented to date, and will encourage evolution, competition, innovation and efficiency in health care and technology.

The SMArt platform will provide a common interface to the “App Store” for the Indivo open source personally controlled health record platform developed by the CHIP team more than a decade ago and is the codebase behind Dossia. The work will also include open source platforms created by other subcontractors on the ONC grant: Partners HealthCare System’s i2b2 analytic platform and the Regenstrief Institute’s CareWeb EHR.

This is going to be very important because there will be certification of EHR modules, but as yet there is no data exchange and workflow integration between modules. So hopefully this research will provide some solutions for this difficulty. Also there will eventually be a common platform upon which most personal health applications will need to be built. The dominant platform may eventually be Microsoft HealthVault, Google Health, or perhaps something from the Mirth, NHIN Direct or CONNECT projects. But the Indivo X project appears to me to be an important component of the future of the health Internet.

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