1. XDS for Mobile Health Brief Profile Proposal for 2011/2012 presented to the IT Infrastructure Planning Committee Keith W. Boone October 11, 2011

2. IT Infrastructure Planning Committee The Problem Support for XDS in mHealth Evironment mHealth platforms are resource constrainedmHealth platforms are resource constrained –SOAP Stack missing or buggy (e.g., WSDL support for Objective C) –Bandwidth constrained (10Kbps to 10Mbps) –Limited resources (e.g., memory), often no “back-end” server Increasing proliferation of unconnected appsIncreasing proliferation of unconnected apps –~9,000 consumer health apps 1 in Apple’s App store –~13,000 by 2012 mHealth is a quickly emerging market, failure to support this space could reduce relevance of IHEmHealth is a quickly emerging market, failure to support this space could reduce relevance of IHE Difficult to use XMLHttpRequest for browser based, multiplatform mHealth apps.Difficult to use XMLHttpRequest for browser based, multiplatform mHealth apps.XMLHttpRequest 1 Source: MobiHealthNews http://shar.es/HMlff

3. IT Infrastructure Planning Committee Use Case 1.Patient sees a specialist for a particular condition. 2.The specialist asks for detailed information from the patient. 3.The patient, not remembering their list of medications, pulls out their mobile device and activates an application. 4.The application queries the HIE and retrieves a list of clinical summaries in date order, from most to least recent (or on-demand medication list document). 5.They select the most relevant document, and it is downloaded to the device. The application extracts and displays their medication list.

4. IT Infrastructure Planning Committee Proposed Standards & Systems StandardsStandards –XML –XDS Metadata –ebRIM –XSLT –JSON, JSON Schema JSON SchemaJSON Schema –XmlHttpRequest XmlHttpRequest –OHT XML Schemas for XDS Metadata –MOF MOF –QVT QVT –hData –RID with Push/Pull/Query SystemsSystems –EHR, PHR, Patient Portal, HIE, Mobile devices, PACs

5. IT Infrastructure Planning Committee Discussion There has been substantial work already in simplifying the XML in OHT, that could be used as one basis for the effort.There has been substantial work already in simplifying the XML in OHT, that could be used as one basis for the effort. Metadata could be transformed from a simplified representation to ebXML representation using XSLT.Metadata could be transformed from a simplified representation to ebXML representation using XSLT. Transactions could be optimized to use W3C standard XMLHttpRequest object.Transactions could be optimized to use W3C standard XMLHttpRequest object. XMLHttpRequest Mobile Document Source Mobile Document Consumer Document Service [ITI-17] Retrieve Document? [ITI-XX] Provide and Register Document.m [ITI-YY] Stored Query.m

6. IT Infrastructure Planning Committee Evaluation Significance and UrgencySignificance and Urgency –See slide 1 –500m users by 2015 (research2guidance) –$6b industry in US Benefit to Global CommunityBenefit to Global Community Degree of Expected AdoptionDegree of Expected Adoption –4 Expressions of Developer Interest Alignment with Domains outside of ITIAlignment with Domains outside of ITI Alignment with Internal ITI ResponsibilitiesAlignment with Internal ITI Responsibilities