1. Mobile Health Overview
Mobile Health (MH) Working Group
January 2017

2. Mobile Health Work Group Co-Chairs
Gora Datta
Matt Graham
Nathan Botts
Harry Rhodes
Interim Co-Chair
David Tao MH has co-chair elections - Please Vote

3. MH Tuesday Sessions Q1 – Joint (EHR Hosting) Q3 – Security Hosting
Mobile Health Overview
Q3 – Security Hosting
cMHAFF Collaboration (Security/CBCC/MH)
Q5 – Birds of a Feather
MH Pictorial Representation
9/17/2018

4. MH Wednesday Sessions Q1 – Introduction & Overview Q2 – Project Work
State of Mobile Health
MH Projects Overview
Q2 – Project Work
Consumer MH Functional Framework (cMHAFF)
MH Short Messaging Technologies (mFHAST)
MH Application Interoperability Environmental Scan
9/17/2018

5. MH Wednesday Sessions Q3 – Discussion
ONC – Patient Generated Health Data Project
Mobile Health Policy Gaps
Q4 – Joint Session Healthcare Devices
MH Projects Overview
Devices Collaborations
9/17/2018

6. Mobile Health Efforts Emerging Standards Projects
Mobile Framework for Healthcare Adoption of Short-Message Technologies (mFHAST)
Consumer Mobile Health Application Functional Framework - cMHAFF
Projects
MH Interoperability Environmental Scan
Pictorial Representation in MH
Consumer Mobile Application Functional Framework will evolve into the larger Mobile Health Functional Framework.

7. Project of the HL7 Mobile Health Workgroup
HL7 mFHAST Standard
Mobile Framework for Healthcare Adoption of Short-Message Technologies
Project of the HL7 Mobile Health Workgroup

8. HL7 mFHAST Goal
To provide standards for communicating health services through short message technologies (SMTs) (e.g. SMS, Instant Message, Twitter, etc.)
To increase opportunities for consumer / patient engagement and timely communication
To improve communication and response time among providers of health services

9. mFHAST Project Preliminary Findings: by Domain
% of Total (n=75)
Healthcare Domain
24%
Public Health
12%
Research & Education
10%
Child & Maternal Health 9%
Mental Health
Patient Engagment 8%
CardiovascularDisease 5%
Immunizations 4%
Diabetes
Medication 3%
Substance Abuse

10. mFHAST Emerging Standard
Meeting weekly, Thursdays 2 PM EST
Reconciling January 2017 ballot.
9/17/2018

11. Mobile Health January 2017 San Antonio WGM
Consumer Mobile Health Application Functional Framework (cMHAFF) Overview and Update
Mobile Health
January 2017 San Antonio WGM

12. Why cMHAFF? What’s the Need?
Target Audience: mobile health app Developers needing guidance on building apps
Beneficiaries: consumers and providers
Consumers need protection, transparency and assurance regarding mobile apps. Some examples:
What security protections exist behind that “cloud?”
Can I comprehend, or even find, privacy policy and terms of use?
Who can the app disclose data to?
What does the app know about me (location, microphone, contacts, photos, etc.), and what can it do on my device?
Can I access my app data like I can under HIPAA?
What usability assessment has been performed?
What happens to my data if I delete an app?
To refresh your memory on why this project exists, we believe there are unmet needs that exist in the marketplace, as health IT is increasingly moving to mobile delivery platforms, for consumers as well as clinicians.
While some of the results of cMHAFF may benefit clinicians as well, its scope of guidance is targeted towards developers who build mobile apps for consumers, while the benefiiciaries of apps following that guidance should be the consumers who use those apps.
9/17/2018

13. cMHAFF Emerging Standards
Meet weekly Mondays 5 pm EST
Ballot for Comment Only January 2016
Ballot Reconciliation completed
Preparing material for new ballot for May 2017
9/17/2018

14. MH Application Interoperability Environmental Scan
Christopher Doss is the Project Facilitator for the FHIRframe Project Scope Statement.
The short term objective for phase 1 will be to produce the following deliverables:
Survey of the current state of the art in frameworks and API families dealing with exchange of healthcare information. This survey will concentrate on understanding the lessons learned from recent interoperability demonstrations, the impact of mobile devices on the usability of these frameworks and the critical data elements to be exchanged. Security and privacy issues will be itemized for use in later phases of this project. A FHIRframe whitepaper will be prepared and the HL7 Mobile Health Wiki updated to reflect the surveyed information.
High level specification of a family of APIs which can be effectively used for implementing interfaces between mobile devices as well as healthcare repositories. Security and privacy impacts and requirements will be identified. A short report will be prepared for peer-comments and the resulting specification will be posted on the HL7 Mobile Health Wiki.
Implementation of a subset of the mobile API family for a proof of concept demonstration. A subset will be selected and incorporated into a mobile device. A proof of concept demonstrating interoperability between mobile devices and Healthcare Repositories will be carried out. A short report will be prepared and posted to the HL7 Mobile Healthcare Wiki.

15. Strategy
The project will conduct an environmental literature survey of current APIs and standards
Identify current state of healthcare device APIs.
Identify current APIs for exchanging data with EHR and PHR systems.
Look at FHIR Argonaut Project as core set of resources for data interoperability
Project will leverage university students as a educational engagement opportunity.
The phase 2 objective is to develop a set of standardized Application Programming Interface (API) libraries, validated through companion Software Development Kits (SDKs), which would facilitate the implementation of platform agnostic mobile health applications that leverage HL7 FHIR (Fast Healthcare Interoperability Resources) standards.
These APIs will provide platform-independent, real-time, standardized means to:
Access health information using a gamut of mobile devices, facilitate the use of diverse mobile devices as an aggregator for transmitting health information from different medical devices to Electronic Health Record repositories, share health information across applications and devices.
The class libraries will be created that support a variety of mobile/portable platforms, including iOS, Android, .NET, and Arduino. These class libraries will contain APIs that: ease the incorporation of FHIR resources into their corresponding application interfaces; facilitate interaction with EHR systems; manage workflows and use cases set forth by IHE. The FHIRframe SDK will ease the development of mHealth applications by providing sample reusable code and documentation.
The primary focus of these libraries will be to promote interoperability and allow interfacing to mobile devices through the use of FHIR. This interoperability approach differs from that used in the SMART Platform in the following ways:
FHIRFrame will be catered to developing native applications on mobile devices, while SMART is catered towards developing web applications
FHIRFrame will be catered to allowing the capture of data from medical devices, while SMART is catered towards accessing data within various EHRs.
FHIRFrame will incorporate methods for enforcing various workflows for submitting data to an EHR, while SMART does not (currently) allow for submission of data.
These contrasts could allow FHIRFrame and SMART to be utilized in a complementary manner.

16. MH Application Interoperability Environmental Scan Update
Meeting weekly Tuesday 4:30 – 5:30 pm EST.
Created Interoperability Survey Template
Initial Assessments
Apple Healthkit
Google Fit
Smart on FHIR
9/17/2018

17. Pictorial/Visual Representation in Mobile Health

18. Do you know these?
While not universal, these are examples of standardized pictorial communication that many people recognize.
9/17/2018

19. How about these?
These are symbols for abstract concepts that may require explanation (by hover over or other means) upon introduction, but become easily recognizable once accepted within a culture or user group.
9/17/2018

20. Do you know these?
These symbols are even more esoteric. They represent health-related concepts. Development of health-related icons is challenging, although unstandardized elements and sets of icons, as well as a few standardized symbols exist. For example, standardized symbols for pharmaceutical use exist.
Source:
9/17/2018

21. The Issue
Mobile platforms have become consumers’ preferred means for communication
Mobile devices are a big driver of consumer engagement in management of their health
Mobile apps present an opportunity to facilitate monitoring consumer safety and wellbeing, promoting maximal independence
Standardized graphics promote safety
9/17/2018

22. Questions Mobile Health Fridays – Weekly Meeting
Every Friday at 11 am EST
9/17/2018