1. Bridget A. Moorman, CCE
Technical Manager, The Continua Alliance, Europe
Overview of System Architectures and Technologies-United4Health Pilot Telehealth Sites
11/15/2018

2. Sample U4H System Architecture-COPD
Patient’s home
Hospital or Primary Care
PATIENT
BRIEFCASE
SERVER
GATEWAY
RESPIRATORY SPECIALIST NURSE OR CLINICIAN
GENERAL
PRACTITIONER
PULMONOLOGITS AT HOSPITAL OR
LOCAL HEALTH
DISTRICT
OTHER INVOLVED HEALTHCARE PROFESSIONALS
DATA TRANSMISSION
DATA ACCESS
TELECONSULTATION (VIDEO OR TELEPHONE)
OPTIONAL CONTACT 1 2 3
22 October 2015

3. Device types and standards used at interfaces1 2 3
Telecommunications standard
Manual Entry (7 sites), RS232 (1 sites), USB (3 sites, BlueTooth (10 sites)
POTS, ADLS, GPRS, GSM); Internet and TCP/IP (12 sites); Web portals and dedicated applications (all sites)
Internet – mix of public, private, VPN and use of mobile
Data/Messaging standard
Continua Compliant (IEEE PHD and HL7) (2 sites), proprietary (all others)
Continua Compliant (IEEE PHD and HL7) (2 sites), proprietary all others
HL7 – most sites
22 October 2015

4. Highlights
Czech Republic – platform being used can be modified to support many different clinical workflows; database drives sensor and telecommunication functions
Scotland – enforced same interface broker for diabetic glucometer input across region – immediately scaled once was implemented
Galicia, Spain – adding telehealth ‘prescription’ into discharge formulary which triggers installation into patient home of kit
Slovenia and Norway wrestled with security issues; Slovenia required that vendor servers be installed and managed within hospital infrastructure; Norway built VPN and locked down product which ensures data security at rest, in transit and in storage
Finland is using PHR portal as part of overall EMR offerings to patients within region; supporting “bring your own device” and web based application delivery for gathering patient generated data and integrating it into healthcare eHealth service offerings
Most of the sites will be providing the service after the project is over; has become a standard of care
22 October 2015

5. HIMSS Interoperability Levels
Foundational– all sites used the basic physical standards for interoperability
Structural – a few of the sites had integration into their EMRs and used messaging standards
Semantic – None of the sites used data standards; three of the sites will be using Continua compliant devices in future
Additional Interoperability category
Clinical Workflow – is this workflow and system going to be a standard of care after the project and does technology enable the care?
Most sites will be using the U4H system or an evolved system to provide chronic condition management after project is over
Some sites will be using platform to support other care workflows
Some sites have electronically integrated the data into their EMRs
22 October 2015

6. Questions? Thank you. Czech and Welsh Demos follow
Questions? Thank you. Czech and Welsh Demos follow
11/15/2018