1. Blood Glucose Portal Xinformatics Blue Team

2. Overview Use Case - sumitra Modeling - fred Design - hithika Back-End - scott Front-End - evan Demo - evan Summary - evan/sumitra

3. Use Case Outline Use Case Name : Collaborative Health Care Tracker Goal : Patient and physician develop plan and track progress towards healthy living style with the help of a collaborative health information system Primary Actors : Patient Physician Secondary Actors: Physician's record system Patient's personal health records Nutritionist's record system etc

4. Basic Flow 1.Doctor uses system to retrieve health records of the patient and nutritionist's reports 2.Performs tests and inserts results into the record system 3.If results indicate pre-diabetes symptoms (for example), doctor sets goals for the patients and annotates recommendations 4.Patient takes periodic measurements of weight and blood glucose, enters this into his personal record and compares this with limits imposed by the doctor 5.Patient returns for a check-up after a month having succeeded in meeting goals encoded in system. Symptoms no longer persist.

5. Model conceptual model The patient: o contributes their own data (PHR) o contributes to their PHR as well as the nutrition record The doctor: o updates the EMR o prescribes a treatment plan o diagnoses the patient The EMR: o is updated by the doctor o is the central repository for the patient's medical information

6. Model logical model This details the primary as well as the foreign keys and their relationships in this portal EMR is dependent on all other factors in the portal

7. Design Blood glucose information is displayed on a plot with time on the X-axis and blood glucose in mg/dL on the Y-axis The graph is composed of two components - Unhealthy Areas and Data Point Collection The unhealthy areas are colored in a light red to differentiate them from the ‘normal’ area as defined by the doctor Data points have two attributes: a direction attribute and a goodness attribute Direction is determined by the data point’s value relative to the boundaries

8. Design (contd) The goodness of an attribute is defined by its relationship to the previous data point and as a function of the direction Intuitively, if the data point is closer to the center of the good blood glucose region, then the data point will turn green If it moves in the opposite direction, it turns red and neutral points and will always appear green The averaging feature help smooth out anomalous data The use of a simple triangle as a symbol to indicate desired direction also follows these same principles of making information easily identifiable, easily readable These are some of the areas where information uncertainty, semiotics, cognition, and architectures were taken into consideration

9. Back-End Java HTTP servlets running on Tomcat. Distributed nature makes traditional databases more difficult to use and introduce uncertainty in schema. Data kept on disk in NetCDF. Transfer between Front-End and Back-End done in JSON.

10. NectCDF and Why. Standard for array-based scientific data. Open Standard. Binary. Self-Describing and Machine-Independent. o Reduce Information uncertainty. o Allow for data to be portable. Add annotations to individual data points.

11. Front-End Presentation Optimizing two dimensions: o Understanding of information content (max) o Time spent interpreting information (min) Data points o Triangles indicate direction (square = neutral) o Color indicates direction of movement in addition to change in Y-axis Smoothing via averaging o Reduces noise in the data and presents a more long-term view of how the information changes Annotations o Doctors and patients can annotate data points o Doctors identify healthy boundaries annotated on the graph by light red regions

12. Demonstration

13. Summary In health sciences, reducing information uncertainty should be a high priority goal Growing obesity and diabetes epidemic are candidates where the application of informatics could make large improvements o Information needs to be readily available and understood o Online tools can provide useful feedback at higher frequency than traditional offline methods Informatics over the web introduces additional challenges o Security and authenticity of information o Different interpretations of standards by browsers can introduce information uncertainty

14. Questions?