1c. Is Your Project an Investigative Project (aka PSS-Lite)?
1d. Is your Project Artifact being Reaffirmed or proceeding to Normative directly after being either Informative or STU?
1e. Today's Date
1f. Name of standard being reaffirmed
1g. Project Artifact Information
1h. ISO/IEC Standard to Adopt
1i. Does the standard include excerpted text from one or more ISO, IEC or ISO/IEC standards, but is not an identical or modified adoption?
1j. Unit of Measure
2a. Primary/Sponsor WG
Modeling & Methodology
2d. Project Facilitator
2e. Other Interested Parties (and roles)
US Office of the National Coordinator for Health IT (AllOfUs Health IT standards research sponsor)
US National Institutes of Health, All of Us Research Project
2f. Modeling Facilitator
2g. Publishing Facilitator
2h. Vocabulary Facilitator
2i. Domain Expert Representative
2j. Business Requirements Analyst
2k. Conformance Facilitator
2l. Other Facilitators
3a. Project Scope
The initial scope of this project is to analyze variation in FHIR data exchanged from mobile health apps and devices for personal health information. Because mobile health apps and devices can convey a wide variety of data including hundreds of different kinds of measurements, this project will first look at a limited scope of data, including vital signs, physical activity, sleep and blood sugar.
These data elements are readily accessible in many mobile health apps and devices. Similar data is often used during treatment of disease affecting cardiovascular, cereberovascular, lower respiratory, and endocryne systems. These diseases are five of the top ten leading causes of death in the US (https://www.cdc.gov/nchs/fastats/leading-causes-of-death.htm) and four out of ten in the world (https://ourworldindata.org/causes-of-death). Thus, they are high priority items to address in this project.
The scope of this project is Universal even though current leadership of the project is US based. We have had participation in project efforts from individuals in the US, Europe and Asia, and who serve markets internationally. We welcome greater international participation in this project.
There are multiple pathways to obtain personal health data from mobile apps and devices in FHIR. Some of these pathways are shown in the attached Powerpoint diagram and include:
* Proprietary API to FHIR Conversion (via cloud, mobile platform, or direct to device APIs).
* Proprietary to FHIR Conversion via an Intermediate Format (e.g., Open mHealth)
* Direct output in FHIR from a Device Gateway
* Exchange to EHR w/ Output in FHIR generated from an EHR
Each of these pathways can introduce variation due to the encoding of sematic codes describing the measurement, or variations in the way that units are expressed, or in the precision of data exchanged.
Because of the increasing use of personal health devices to augment care, this is of concern because it can introduce variation in personal health data that may be used for diagnosis, treatment and research.
The goal of this project is to determine the degree of semantic and precision variation in these pathways and determine what steps are needed to address this challenge to enable healthcare providers to use personal health device data for diagnosis, treatment and research.
3c. Security Risk
3d. External Drivers
3e. Objectives/Deliverables and Target Dates
1. Promote a FHIR Connectathon track (see https://confluence.hl7.org/display/FHIR/2019-09+Mobile+Health+Data+Exchange) to compare variations in pathways for getting FHIR Data. September and possibly January WGM.
2. Analyze variation and develop a plan to address sources of variation. Such a plan might include development of functional requirements or an implementation guide, but those details are not yet determined.
3. Implement action plan.