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HIMAP
                    Health Information Map
                              IU CLEAR Project
                     Kristin Eilenberg, Project Leader



                                                         1
@keilenberg #HIMAP #healthapps
School of Law
                                             & Ethics
                                   School of        School of
                                  Informatics       Medicine


     The Indiana University Center for Law, Ethics, and Applied
     Research in Health Information’s purpose is:
     • To enhance the ethical, lawful, and practical use of health information to
       facilitate treatment and research, improve health outcomes for patient,
       and facilitate accountability.
     • To work with key constituencies including healthcare providers and
       payers, patients, ethicists, attorneys, and professional groups, regulators,
       and others to devise a more rational and more trustworthy approach to
       using personal data for health research, one that recognizes that more
       and more relevant data comes from the internet and other digital sources
       that are largely beyond the scope of the current health privacy laws.
                                                                                  2
@keilenberg #HIMAP #healthapps
What is Health 2.0?

                                  [video]




                                                                                                3
@keilenberg #HIMAP #healthapps   Ref: YouTube video - Health 2.0 response to The Machine is Us/ing Us
4
@keilenberg #HIMAP #healthapps   Ref: Geographies of the World’s Knowledge, Convoco 2011
5
@keilenberg #HIMAP #healthapps
6
@keilenberg #HIMAP #healthapps
7
@keilenberg #HIMAP #healthapps
YouTube downloads 48 hours of
                                 video every 1 minute and more
                                    than 3 billion views/day



                                                           8
@keilenberg #HIMAP #healthapps
8 in 10 internet users look online for
                  health information




                                 Ref: Pew Research Center’s Internet & American Life Project and the
                                                                                              9
@keilenberg #HIMAP #healthapps   California HealthCare Foundation, Feb 2011
Who is driving the health discussions?




                                                       10
@keilenberg #HIMAP #healthapps      Ref: NMIncite, 09/2011
11
@keilenberg #HIMAP #healthapps
12
@keilenberg #HIMAP #healthapps
Project Overview




                                                13
@keilenberg #HIMAP #healthapps
HIMAP
                       Health Information Map
     • Purpose
          – Develop a Health Information Map that will represent the
            holistic and complicated view of all of the health
            information that is generated on a daily basis within
            computerized healthcare systems, the internet and social
            media platforms, and through consumer purchases of
            health related products and services
          – To better understand what health information is created,
            where it is created, and how it is used




                                                                       14
@keilenberg #HIMAP #healthapps
Health Information Map
     • How
          – Mobilize and partner with experts in the medical profession, electronic
            health records, health information data transactions, internet search,
            social media platforms, patient communities, and mobile/tele-
            medicine systems
          – Develop an activity based model and mapping of the healthcare
            information/data that is generated on a daily basis related to disease:
            initial symptoms, diagnosis, treatment, survival/recovery, and re-
            occurrence
          – Document key content creators and users of the data, primary
            locations of where the data is generated, how the data is shared and
            merged with other data sources, who owns the data, how the data is
            stored, and the sensitivity or impact of the data


                                                                                 15
@keilenberg #HIMAP #healthapps
Assumptions




                                               16
@keilenberg #HIMAP #healthapps
Patient Stages of Disease
                                 Symptom Recognition


                                      Diagnosis


                                  Treatment Initiated


                                  Treatment Ongoing


                                  Survival/Remission


                                     Maintenance


                                    Re-occurrence       17
@keilenberg #HIMAP #healthapps
Information Seeking, Use, and
                     Creation Behaviors

                                                  Purchase     Seek




                                   Create
                                                                         Find
                           content/Comment/Rate




                                            Share/Connect    Use/Apply




                                                                                18
@keilenberg #HIMAP #healthapps
E-Rx/Pharmacy/PBM
                                                    Prior
                                                                                    Analytics Co
                       Insurance Alerts         Authorization
                                                   Status                                                     Pharma
                                                                                      De-identified
                                                                                       Data Sets
                                                                                                             Research
                            Claim                                                                            De-identified
                                               Adjucated Claim
                         information                                                                          Data Sets




      Health Claim                                                                             Drinking
         Type           Contact info            Medications         Allergies
                                                                                              behaviors




      Prescriber ID      Insurance               Procedures      Immunizations             Smoking history




                        Employment               Diagnoses
                                                                 Hospitalizations           Other health
                                                                                                                Analytics Co
    Claims                                                           history                  history

Clearinghouse                                                                                                       De-identified
       &                 Provider
                                               Biometric data
                                                                   Laboratory                  Genetic               Data Sets
                       seen/referred                                 results                 Information
 Insurance Co

                                          Hospital Electronic Health Record

 Analytics Co

   De-identified
    Data Sets
                                                                                                                             19
@keilenberg #HIMAP #healthapps
Phone ID
                                                       User, Password                                                                            Health                                  Geo-
                                      Preferences
                                                                           Age, Gender                                                           habits                                location
                                      and Interests
                                                                                                                                                                     Drinking
                                                                                                                                                                    behaviors
                                                                                                                                                                                                     User,
                        Activities                                                         Contact Info                       Lab results
                                                                                                                                                                                                   Password
                                                                                                                                            Preferences
                                                                                                                                                                                           Religious
                                                                                                                                                and
                                                                                                                                                                                            beliefs
                                                                                                                                             Interests

                Networks
                                                Social                                            IP Address
                                                                                                                           Allergies
                                                                                                                                                             Mobile                                    Age, Gender
                                                                                                                                                           Phone App
                                               Network
                                                                                                                                                                                           Political
                    Family                                                                     Employment                                     Activities
                                                                                                                                                                                            views
                                                                                                                             Medications                                                          Contact Info

                                                                                                                                                                    Networks
                             Memberships                                             Drinking
                              Affiliations                                           behaviors                                                                                     Biometric
                                                                                                                                             Procedures
                                                                                                                                                                                      data
                                              Political views   Religious beliefs                                                                                Diagnoses




                                                       User, Password                                                                                            User, Password
                                      Genetic info                         Age, Gender                                                           Genetic info                     Age, Gender



                                                         Employment                                                                Lab results                                                    Contact Info
                     Lab results                                                            Contact Info
                                   Preferences and                              Drinking
                                      Interests                                behaviors

                                                                                                                        Hospitalization
                                                                                                                                                                                                            IP Address
                                                                                                                              s
                                                                                                                                                           Personal
         Hospitalizations                                                                              IP Address


                         Activities
                                                Online                                 Religious beliefs

                                                Health                                                     Insurance   Immunizations
                                                                                                                                                            Health                                            Insurance
                                                                                                                                                                                                               coverage
        Immunizations

                                               Network
                                                                                                            coverage
                                                                                                                                                           Records
                              Networks                                              Political views
                                                                                                                                                                                                         Provider
                                                                                                                              Allergies
                                                                                                   Provider                                                                                            seen/referred
                Allergies
                                                                                                 seen/referred
                                                                  Memberships
                                                Family
                                                                   Affiliations
                                                                                                                                          Medications                                    Biometric data
                             Medications                                            Biometric data
                                                                                                                                                           Procedures      Diagnoses
                                               Procedures          Diagnoses




                                                                                                                                                                                                                          20
@keilenberg #HIMAP #healthapps
Basic Framework
Example




                                                                                                                                User,
                                                                                                                   Genetic    Password         Age,
                                                                                                                    info                      Gender

                                                                                                                                                           Contact
                                                                                                    Lab results
                                                                                                                                                            Info


                                                                                             Hospitaliza
                                                                                                                                                                 IP Address
                                                                                               tions
                                                                                                                         Personal
                                                                                           Immunizati                     Health                                     Insurance
                                                                                              ons                                                                    coverage
                                                                                                                         Records
                                                                                                                                                               Provider
                                                                                                 Allergies                                                    seen/refer
                                                                                                                                                                 red

                                                                                                           Medication                               Biometric
                                                                                                               s                                       data
                                                                                                                        Procedures    Diagnoses




Internet                                                                                                                            User,
                                                                                                                                  Password
                                               User,                                                           Genetic info                  Age, Gender
                              Preferences    Password                                                                                                                                                               Phone ID
                                  and                   Age, Gender
                               Interests                                                         Lab results                  Employment                    Contact Info                          Health habits                  Geo-location
                                                                                                            Preferences
                                                                                                                                                  Drinking
                                                                                                                and                                                                                                   Drinking
                 Activities                                       Contact Info                                                                    behaviors
                                                                                                             Interests                                                                                               behaviors
                                                                                                                                                                                                                                                  User,
                                                                                         Hospitalizati                                                                                  Lab results
                                                                                                                                                                       IP Address                                                               Password
                                                                                             ons
                                                                                                                          Online                           Religious
                                                                                                                                                                                                  Preference
                                                                                                                                                                                                     s and
                                                                                                                                                                                                                   Mobile
                                                                                                                                                                                                                                      Religious
                                                                                                                                                                                                                                       beliefs
             Networks
                                      Social                               IP Address
                                                                                                      Activities

                                                                                                                          Health
                                                                                                                                                            beliefs                                Interests


                                     Network                                            Immunizatio                                                                      Insurance   Allergies                     Phone                          Age, Gender


               Family                                                 Employment
                                                                                           ns
                                                                                                                         Network                         Political
                                                                                                                                                                          coverage

                                                                                                                                                                                                                    App
                                                                                                          Networks
                                                                                                                                                          views                                                                        Political
                                                                                                                                                                   Provider                      Activities
                                                                                                                                                                                                                                        views
                                                                                              Allergies                                                          seen/referre          Medications                                           Contact Info
                                                                                                                                       Membership                     d
                    Membership                                 Drinking                                                  Family
                    s Affiliations                             behaviors                                                               s Affiliations
                                                                                                                                                                                                                     Networks
                                                                                                                                                        Biometric                                                                 Biometric
                                      Political    Religious                                             Medications                                                                                  Procedures
                                                                                                                                                           data                                                                      data
                                       views        beliefs
                                                                                                                        Procedures      Diagnoses                                                                   Diagnoses                               21
 @keilenberg #HIMAP #healthapps
Proliferation
Example




                                                                                                                                                                                   User,
                                                                                                                                                                    Genetic      Password         Age,
                                                                                                                                                                     info                        Gender

                                                                                                                                                                                                            Contact
                                                                                                                                                      Lab results
                                                                                                                                                                                                             Info


                                                                                                                                               Hospitaliza
                                                                                                                                                                                                                  IP Address
                                                                                                                                                 tions
                                                                                                                                                                          Personal
                                                                                                                                             Immunizati                    Health                                   Insurance
                                                                                                                                                ons                                                                 coverage
                                                                                                                                                                          Records                                                                         Health habits
                                                                                                                                                                                                                                                                             Phone ID
                                                                                                                                                                                                                                                                                             Geo-location
                                                                                                                                                 User,
                                                                                                                                               Password                                                         Provider
                                                                                                                              Genetic info        Allergies Age, Gender                                        seen/refer
                                                                                                                                                                                                                                                                                Drinking
                                                                                                                                                                                                                  red                                                          behaviors                                                    Phone ID
                                  User,                                                                                                                                                                                                                                                                       User,
                                                                                        User,                                                Employment Medication                                                                            Lab results
                 Preferences    Password                                                                       Lab results                                                 Contact Info              Biometric                                                                                              Password     Health habits                      Geo-location
                     and                      Age, Gender            Preferences      Password                            Preferences                            s                                      data                                          Preference
                                                                                                                                                                Drinking                                                         User,                                                             Religious
                                                                         and                        Age, Gender
                  Interests
                                                                      Interests
                                                                                                                              and
                                                                                                                           Interests
                                                                                                                                                                behaviors
                                                                                                                                                                       Procedures       Diagnoses            Genetic info
                                                                                                                                                                                                                               Password                   s and
                                                                                                                                                                                                                                            Age, Gender Interests       Mobile                      beliefs
                                                                                                                                                                                                                                                                                                                Phone ID
                                                                                                                                                                                                                                                                                                                                                  Drinking
                                                                                                                                                                                                                                                                                                                                                 behaviors
                                                                                                                                                                                                                                                                                                                                                                               User,
                                                                                                        Hospitalizati                                                                                                                                                                                          Lab results
    Activities                                            Contact Info
                                                          Activities                                        onsContact Info
                                                                                                                                        Online
                                                                                                                                                                                    IP Address
                                                                                                                                                                                                Lab results                Employment Allergies         Contact Info    Phone              Health habits
                                                                                                                                                                                                                                                                                                                Age, Gender
                                                                                                                                                                                                                                                                                                                                Geo-location
                                                                                                                                                                                                                                                                                                                          Preference
                                                                                                                                                                                                                                                                                                                                                                            Password
                                                                                                                                                                                                                                                                                                                                                                    Religious
                                                                                                                    Activities
                                                                                                                                                                        Religious
                                                                                                                                                                          beliefs
                                                                                                                                                                                                            Preferences
                                                                                                                                                                                                                and
                                                                                                                                                                                                                                               Drinking
                                                                                                                                                                                                                                                                         App
                                                                                                                                                                                                                                                                                                                   Drinking s and
                                                                                                                                                                                                                                                                                                                  behaviorsInterests   Mobile                        beliefs


                         Social                                                                                                         Health                                                               Interests
                                                                                                                                                                                                                                               behaviors
                                                                                                                                                                                                                                                                                Lab results
                                                                                                                                                                                                                                                                                                     Political
                                                                                                                                                                                                                                                                                                                                                  User,
                                                                                                                                                                                                                                                                                                                                               Password
Networks
                                                    Networks
                                                                 IP Address
                                                                               Social                  Immunizatio
                                                                                                                      IP Address
                                                                                                                                                                                     Insurance
                                                                                                                                                                                       Hospitalizati                                                     Activities
                                                                                                                                                                                                                                                                  IP Address              Preference Allergies
                                                                                                                                                                                                                                                                                                      views                            Phone                                    Age, Gen


                        Network
                                                                                                            ns
                                                                                                                                       Network                                        coverage
                                                                                                                                                                                            ons
                                                                                                                                                                                                                       Online                Medications                                      s and        Contact Info
                                                                                                                                                                                                                                                                                                         Mobile
                                                                                                                                                                                                                                                                                                                                       Religious
                                                                                                                                                                                                                                                                                                                                         beliefs
                                                                      User,   Network                                  Networks
                                                                                                                                            Genetic info
                                                                                                                                                               User,
                                                                                                                                                             PasswordPolitical
                                                                                                                                                                       views Gender
                                                                                                                                                                            Age,
                                                                                                                                                                                                    Activities
                                                                                                                                                                                                                                                       Religious
                                                                                                                                                                                                                                                         beliefs               Networks
                                                                                                                                                                                                                                                                                            Interests
                                                                                                                                                                                                                                                                                                                                        App
  Family
                                                 Preferences

                                                        Family
                                                   Interests
                                                                   Password
                                                      and Employment              Age, Gender
                                                                                                             Allergies
                                                                                                                   Employment
                                                                                                                                                                                 Provider
                                                                                                                                                                               seen/referre
                                                                                                                                                                                    Immunizatio
                                                                                                                                                                                                                       Health  User,
                                                                                                                                                                                                                                                          Procedures
                                                                                                                                                                                                                                                                            Allergies
                                                                                                                                                                                                                                                                   Health habits
                                                                                                                                                                                                                                                                    Insurance
                                                                                                                                                                                                                                                                                       Phone ID
                                                                                                                                                                                                                                                                                               Biometric Phone
                                                                                                                                                                                                                                                                                                  data Geo-location
                                                                                                                                                                                                                                                                                                              Medications
                                                                                                                                                                                                                                                                                                                           Activities              Age, Gender
                                                                                                                                                                                                                                                                                                                                                                    Political
                                                                                                                                                                                                                                                                                                                                                                     views
                                                                                                                                                                                                                                                                                                                                                                          Contact Info
                                                                                                                                                          Employment                 d ns

                                      Activities                                             Contact Info
                                                                                                                                Lab results
                                                                                                                                      Family
                                                                                                                                                     Membership
                                                                                                                                           PreferencesAffiliations
                                                                                                                                               and
                                                                                                                                                     s
                                                                                                                                                                                Drinking
                                                                                                                                                                                          Contact Info
                                                                                                                                                                                                                      Network
                                                                                                                                                                                                             Genetic info
                                                                                                                                                                                                                             Password
                                                                                                                                                                                                                                            Age, Gender
                                                                                                                                                                                                                                                     Political
                                                                                                                                                                                                                                                                     coverage
                                                                                                                                                                                                                                                                            Diagnoses
                                                                                                                                                                                                                                                                                         Drinking
                                                                                                                                                                                                                                                                                        behaviors
                                                                                                                                                                                                                                                                                                          App               Health habits
                                                                                                                                                                                                                                                                                                                                                 Phone ID

                                                                                                                                                                                                                                                                                                                                        PoliticalNetworks      Geo-location
       Membership                                      Drinking                                                                                                     Biometric  behaviors               Networks                                                                             Activities                    User,
       s Affiliations                                        Membership
                                                      behaviors                                              Drinking Medications           Interests                  data
                                                                                                                                                                                                                                                      views
                                                                                                                                                                                                                                                       Lab results                                                                       views                 Biometric
                                                                                                                                                                                                                           Employment                          Provider        Medications                                 Procedures
                                                                                                                                                                                                                                                                                                                       Password               Contact Info
                                                                                                                                                                                                                                                                                                                                                    Drinking
                                                              s Affiliations                                behaviors                                                                           Lab results                                             Contact Info                                                                                              data
                         Political     Religious                                                                       Hospitalizati                                                        AllergiesAddressPreferences                                            Preference
                                                                                                                                                                                                                                                             seen/referre                                                                          behaviors
                                                                                                                                     Procedures      Diagnoses                                     IP                                          Drinking                                                        Religious                       Diagnoses                         User,
                          views         beliefs
                                 Networks
                                                           Social
                                                                                Political
                                                                                 views
                                                                                              Religious
                                                                                                beliefs
                                                                                                    IP Address
                                                                                                                            ons

                                                                                                                                   Activities
                                                                                                                                                        Online                           Religious
                                                                                                                                                                                          beliefs
                                                                                                                                                                                                                and
                                                                                                                                                                                                             InterestsFamily
                                                                                                                                                                                                                                   Membership  behaviors
                                                                                                                                                                                                                                    s Affiliations
                                                                                                                                                                                                                                                                    d s and
                                                                                                                                                                                                                                                                    Interests     Mobile                         Lab results
                                                                                                                                                                                                                                                                                                                 beliefs
                                                                                                                                                                                                                                                                                                                  Networks
                                                                                                                                                                                                                                                                                                                           Preference
                                                                                                                                                                                                                                                                                                                                  Biometric                          Religious
                                                                                                                                                                                                                                                                                                                                                                              Password
                                                                                                                                                                                                                                                                                            Procedures

                                                          Network                                                    Immunizatio
                                                                                                                                                        Health                         Hospitalizati Medications
                                                                                                                                                                                            ons
                                                                                                                                                                                                     Insurance
                                                                                                                                                                                                                       Online
                                                                                                                                                                                                                                                   Biometric
                                                                                                                                                                                                                                                   Allergies
                                                                                                                                                                                                                                                      data        IP Address
                                                                                                                                                                                                                                                                                  Phone                                        s anddata
                                                                                                                                                                                                                                                                                                                          Age, Gender
                                                                                                                                                                                                                                                                                                                Diagnoses Interests      Mobile                        beliefs

                                                                                                                                                                                                                                                       Religious
                                    Family                                                       Employment
                                                                                                                          ns
                                                                                                                                                       Network                        Political
                                                                                                                                                                                                      coverage
                                                                                                                                                                                                    Activities      Procedures

                                                                                                                                                                                                                       Health
                                                                                                                                                                                                                                    Diagnoses
                                                                                                                                                                                                                                                         beliefs
                                                                                                                                                                                                                                                                                   App                       Allergies
                                                                                                                                                                                                                                                                                                                Political
                                                                                                                                                                                                                                                                                                                                         Phone                                   Age, Ge
                                                                                                                                      Networks                                                                                                                      Activities

                                                                                                                            Allergies
                                                                                                                                                                                    Immunizatio
                                                                                                                                                                                       views
                                                                                                                                                                                           ns Provider
                                                                                                                                                                                              seen/referre            Network
                                                                                                                                                                                                                                                                    Insurance
                                                                                                                                                                                                                                                      Medicationscoverage
                                                                                                                                                                                                                                                                                                                 views
                                                                                                                                                                                                                                                                                                                      Contact Info        App                         Political
                                         Membership                                       Drinking                                                                                                   d                                                                                                                       Activities
                                                                                                                                                                   Membership                                                                        Political                                                                                                         views
                                         s Affiliations                                   behaviors                                                  Family                                            Networks                                                                         Networks                Medications                                                 Contact Info
                                                                                                                                                                    s Affiliations                                                                    views
                                                           Political        Religious                                                                                               Biometric
                                                                                                                                                                                            Allergies
                                                                                                                                                                                                                                                               Provider
                                                                                                                                                                                                                                                                    Procedures
                                                                                                                                                                                                                                                             seen/referre
                                                                                                                                                                                                                                                                                                         Biometric
                                                                                                                                                                                                                                                                                                            data
                                                                                                                                                                                                                                                                                                                                                         22
@keilenberg #HIMAP #healthapps                              views            beliefs                                                 Medications

                                                                                                                                                   Procedures       Diagnoses
                                                                                                                                                                                        data
                                                                                                                                                                                                                      Family
                                                                                                                                                                                                                                   Membership
                                                                                                                                                                                                                                    s Affiliations
                                                                                                                                                                                                                                                                    d                  Diagnoses
                                                                                                                                                                                                                                                                                                                             Procedures
                                                                                                                                                                                                                                                                                                                                                   Networks
                                                                                                                                                                                                                                                                                                                                                                Biometric
                                                                                                                                                                                                                                                                                                                                                                   data
E-Rx/Pharmacy/PBM
                                                    Prior
                                                                                    Analytics Co
                       Insurance Alerts         Authorization
                                                   Status                                                     Pharma
                                                                                      De-identified
                                                                                       Data Sets
                                                                                                             Research
                            Claim                                                                            De-identified
                                               Adjucated Claim
                         information                                                                          Data Sets




      Health Claim                                                                             Drinking
         Type           Contact info            Medications         Allergies
                                                                                              behaviors




      Prescriber ID      Insurance               Procedures      Immunizations             Smoking history




                        Employment               Diagnoses
                                                                 Hospitalizations           Other health
                                                                                                                Analytics Co
    Claims                                                           history                  history

Clearinghouse                                                                                                       De-identified
       &                 Provider
                                               Biometric data
                                                                   Laboratory                  Genetic               Data Sets
                       seen/referred                                 results                 Information
 Insurance Co

                                          Hospital Electronic Health Record

 Analytics Co

   De-identified
    Data Sets
                                                                                                                             23
@keilenberg #HIMAP #healthapps
HIMAP Project Maps Health Data Flow
HIMAP Project Maps Health Data Flow
HIMAP Project Maps Health Data Flow
HIMAP Project Maps Health Data Flow
HIMAP Project Maps Health Data Flow
HIMAP Project Maps Health Data Flow
HIMAP Project Maps Health Data Flow
HIMAP Project Maps Health Data Flow
HIMAP Project Maps Health Data Flow
HIMAP Project Maps Health Data Flow
HIMAP Project Maps Health Data Flow
HIMAP Project Maps Health Data Flow
HIMAP Project Maps Health Data Flow
HIMAP Project Maps Health Data Flow
HIMAP Project Maps Health Data Flow
HIMAP Project Maps Health Data Flow
HIMAP Project Maps Health Data Flow
HIMAP Project Maps Health Data Flow

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HIMAP Project Maps Health Data Flow

  • 1. HIMAP Health Information Map IU CLEAR Project Kristin Eilenberg, Project Leader 1 @keilenberg #HIMAP #healthapps
  • 2. School of Law & Ethics School of School of Informatics Medicine The Indiana University Center for Law, Ethics, and Applied Research in Health Information’s purpose is: • To enhance the ethical, lawful, and practical use of health information to facilitate treatment and research, improve health outcomes for patient, and facilitate accountability. • To work with key constituencies including healthcare providers and payers, patients, ethicists, attorneys, and professional groups, regulators, and others to devise a more rational and more trustworthy approach to using personal data for health research, one that recognizes that more and more relevant data comes from the internet and other digital sources that are largely beyond the scope of the current health privacy laws. 2 @keilenberg #HIMAP #healthapps
  • 3. What is Health 2.0? [video] 3 @keilenberg #HIMAP #healthapps Ref: YouTube video - Health 2.0 response to The Machine is Us/ing Us
  • 4. 4 @keilenberg #HIMAP #healthapps Ref: Geographies of the World’s Knowledge, Convoco 2011
  • 8. YouTube downloads 48 hours of video every 1 minute and more than 3 billion views/day 8 @keilenberg #HIMAP #healthapps
  • 9. 8 in 10 internet users look online for health information Ref: Pew Research Center’s Internet & American Life Project and the 9 @keilenberg #HIMAP #healthapps California HealthCare Foundation, Feb 2011
  • 10. Who is driving the health discussions? 10 @keilenberg #HIMAP #healthapps Ref: NMIncite, 09/2011
  • 13. Project Overview 13 @keilenberg #HIMAP #healthapps
  • 14. HIMAP Health Information Map • Purpose – Develop a Health Information Map that will represent the holistic and complicated view of all of the health information that is generated on a daily basis within computerized healthcare systems, the internet and social media platforms, and through consumer purchases of health related products and services – To better understand what health information is created, where it is created, and how it is used 14 @keilenberg #HIMAP #healthapps
  • 15. Health Information Map • How – Mobilize and partner with experts in the medical profession, electronic health records, health information data transactions, internet search, social media platforms, patient communities, and mobile/tele- medicine systems – Develop an activity based model and mapping of the healthcare information/data that is generated on a daily basis related to disease: initial symptoms, diagnosis, treatment, survival/recovery, and re- occurrence – Document key content creators and users of the data, primary locations of where the data is generated, how the data is shared and merged with other data sources, who owns the data, how the data is stored, and the sensitivity or impact of the data 15 @keilenberg #HIMAP #healthapps
  • 16. Assumptions 16 @keilenberg #HIMAP #healthapps
  • 17. Patient Stages of Disease Symptom Recognition Diagnosis Treatment Initiated Treatment Ongoing Survival/Remission Maintenance Re-occurrence 17 @keilenberg #HIMAP #healthapps
  • 18. Information Seeking, Use, and Creation Behaviors Purchase Seek Create Find content/Comment/Rate Share/Connect Use/Apply 18 @keilenberg #HIMAP #healthapps
  • 19. E-Rx/Pharmacy/PBM Prior Analytics Co Insurance Alerts Authorization Status Pharma De-identified Data Sets Research Claim De-identified Adjucated Claim information Data Sets Health Claim Drinking Type Contact info Medications Allergies behaviors Prescriber ID Insurance Procedures Immunizations Smoking history Employment Diagnoses Hospitalizations Other health Analytics Co Claims history history Clearinghouse De-identified & Provider Biometric data Laboratory Genetic Data Sets seen/referred results Information Insurance Co Hospital Electronic Health Record Analytics Co De-identified Data Sets 19 @keilenberg #HIMAP #healthapps
  • 20. Phone ID User, Password Health Geo- Preferences Age, Gender habits location and Interests Drinking behaviors User, Activities Contact Info Lab results Password Preferences Religious and beliefs Interests Networks Social IP Address Allergies Mobile Age, Gender Phone App Network Political Family Employment Activities views Medications Contact Info Networks Memberships Drinking Affiliations behaviors Biometric Procedures data Political views Religious beliefs Diagnoses User, Password User, Password Genetic info Age, Gender Genetic info Age, Gender Employment Lab results Contact Info Lab results Contact Info Preferences and Drinking Interests behaviors Hospitalization IP Address s Personal Hospitalizations IP Address Activities Online Religious beliefs Health Insurance Immunizations Health Insurance coverage Immunizations Network coverage Records Networks Political views Provider Allergies Provider seen/referred Allergies seen/referred Memberships Family Affiliations Medications Biometric data Medications Biometric data Procedures Diagnoses Procedures Diagnoses 20 @keilenberg #HIMAP #healthapps
  • 21. Basic Framework Example User, Genetic Password Age, info Gender Contact Lab results Info Hospitaliza IP Address tions Personal Immunizati Health Insurance ons coverage Records Provider Allergies seen/refer red Medication Biometric s data Procedures Diagnoses Internet User, Password User, Genetic info Age, Gender Preferences Password Phone ID and Age, Gender Interests Lab results Employment Contact Info Health habits Geo-location Preferences Drinking and Drinking Activities Contact Info behaviors Interests behaviors User, Hospitalizati Lab results IP Address Password ons Online Religious Preference s and Mobile Religious beliefs Networks Social IP Address Activities Health beliefs Interests Network Immunizatio Insurance Allergies Phone Age, Gender Family Employment ns Network Political coverage App Networks views Political Provider Activities views Allergies seen/referre Medications Contact Info Membership d Membership Drinking Family s Affiliations behaviors s Affiliations Networks Biometric Biometric Political Religious Medications Procedures data data views beliefs Procedures Diagnoses Diagnoses 21 @keilenberg #HIMAP #healthapps
  • 22. Proliferation Example User, Genetic Password Age, info Gender Contact Lab results Info Hospitaliza IP Address tions Personal Immunizati Health Insurance ons coverage Records Health habits Phone ID Geo-location User, Password Provider Genetic info Allergies Age, Gender seen/refer Drinking red behaviors Phone ID User, User, User, Employment Medication Lab results Preferences Password Lab results Contact Info Biometric Password Health habits Geo-location and Age, Gender Preferences Password Preferences s data Preference Drinking User, Religious and Age, Gender Interests Interests and Interests behaviors Procedures Diagnoses Genetic info Password s and Age, Gender Interests Mobile beliefs Phone ID Drinking behaviors User, Hospitalizati Lab results Activities Contact Info Activities onsContact Info Online IP Address Lab results Employment Allergies Contact Info Phone Health habits Age, Gender Geo-location Preference Password Religious Activities Religious beliefs Preferences and Drinking App Drinking s and behaviorsInterests Mobile beliefs Social Health Interests behaviors Lab results Political User, Password Networks Networks IP Address Social Immunizatio IP Address Insurance Hospitalizati Activities IP Address Preference Allergies views Phone Age, Gen Network ns Network coverage ons Online Medications s and Contact Info Mobile Religious beliefs User, Network Networks Genetic info User, PasswordPolitical views Gender Age, Activities Religious beliefs Networks Interests App Family Preferences Family Interests Password and Employment Age, Gender Allergies Employment Provider seen/referre Immunizatio Health User, Procedures Allergies Health habits Insurance Phone ID Biometric Phone data Geo-location Medications Activities Age, Gender Political views Contact Info Employment d ns Activities Contact Info Lab results Family Membership PreferencesAffiliations and s Drinking Contact Info Network Genetic info Password Age, Gender Political coverage Diagnoses Drinking behaviors App Health habits Phone ID PoliticalNetworks Geo-location Membership Drinking Biometric behaviors Networks Activities User, s Affiliations Membership behaviors Drinking Medications Interests data views Lab results views Biometric Employment Provider Medications Procedures Password Contact Info Drinking s Affiliations behaviors Lab results Contact Info data Political Religious Hospitalizati AllergiesAddressPreferences Preference seen/referre behaviors Procedures Diagnoses IP Drinking Religious Diagnoses User, views beliefs Networks Social Political views Religious beliefs IP Address ons Activities Online Religious beliefs and InterestsFamily Membership behaviors s Affiliations d s and Interests Mobile Lab results beliefs Networks Preference Biometric Religious Password Procedures Network Immunizatio Health Hospitalizati Medications ons Insurance Online Biometric Allergies data IP Address Phone s anddata Age, Gender Diagnoses Interests Mobile beliefs Religious Family Employment ns Network Political coverage Activities Procedures Health Diagnoses beliefs App Allergies Political Phone Age, Ge Networks Activities Allergies Immunizatio views ns Provider seen/referre Network Insurance Medicationscoverage views Contact Info App Political Membership Drinking d Activities Membership Political views s Affiliations behaviors Family Networks Networks Medications Contact Info s Affiliations views Political Religious Biometric Allergies Provider Procedures seen/referre Biometric data 22 @keilenberg #HIMAP #healthapps views beliefs Medications Procedures Diagnoses data Family Membership s Affiliations d Diagnoses Procedures Networks Biometric data
  • 23. E-Rx/Pharmacy/PBM Prior Analytics Co Insurance Alerts Authorization Status Pharma De-identified Data Sets Research Claim De-identified Adjucated Claim information Data Sets Health Claim Drinking Type Contact info Medications Allergies behaviors Prescriber ID Insurance Procedures Immunizations Smoking history Employment Diagnoses Hospitalizations Other health Analytics Co Claims history history Clearinghouse De-identified & Provider Biometric data Laboratory Genetic Data Sets seen/referred results Information Insurance Co Hospital Electronic Health Record Analytics Co De-identified Data Sets 23 @keilenberg #HIMAP #healthapps

Notas del editor

  1. Initial prototype was built to represent the raw data that was captured per Agent. Each box on the grid represents a single attribute. In the live prototype, when the cursor is hoovering over the box, a fly over window appears and shows the name of the attribute and the data value for that Agent.This represents the data that is captured by Gmail. The darker squares are ‘required’ fields. The lighter shade is data that is discretionary for the end user to decide what they will provide.
  2. What this slide means:The YND score represents the amount of data attributes that are collected by an Agent. Each attribute that is required/absolute scores 2; each attribute that is discretionary and allows the user to decide if they are going to provide the information/content scores 1; each attribute that is not collected scores 0.The Sensitivity score represents the sum of attributes that an Agent collects. Each attribute has been assigned a ‘sensitivity’ rating: 1 = not sensitive. Even if the data attribute was revealed/released/known to others it would not cause any harm to the person whether in the form of discrimination, embarrassment etc. 2 = somewhere between 1 and 3... not an ideal definition, but we are working on getting this clarified.3 =  very sensitive. If the data attribute were revealed/released/known to others it could cause harm (or very likely cause harm) to the individual whether directly or indirectly.The size of the orbs represent the sum of each attribute’s YND rating multiplied by the sensitivity ranking. Interpretation of the data – EHRs capture sensitive information, but most elements are considered discretionary. In comparison, there are many internet websites that capture almost as much information as EHRs, yet have higher scores on the Sensitivity axis.
  3. http://www.mappinghealth.com/iuclear/