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HEALTHGRID.ORG
The EuropeanThe EuropeanHealthGrid InitiativeHealthGrid Initiativee-Health and the Grid: Projects and e-Health and the Grid: Projects and
Prospects in the European UnionProspects in the European Union
NEC 2005 40 years
Tony Solomonides on behalf Tony Solomonides on behalf of of
The HealthGrid AssociationThe HealthGrid Association
22 [email protected]@uwe.ac.uk NEC 2005NEC 2005
HEALTHGRID.ORG Issues and ProjectsIssues and Projects
What is a ‘healthgrid’?What is a ‘healthgrid’? combines Grid and e-Science ideascombines Grid and e-Science ideas oriented to biomedical advancesoriented to biomedical advances supports evidence-based practicesupports evidence-based practice
What projects?What projects? imaging for diagnosis and treatmentimaging for diagnosis and treatment simulation for treatment guidancesimulation for treatment guidance bioinformatics for biomedicinebioinformatics for biomedicine legal, ethical, security and trust issueslegal, ethical, security and trust issues
33 [email protected]@uwe.ac.uk NEC 2005NEC 2005
HEALTHGRID.ORG HistoryHistory
HealthGrid 2003 – Lyon, Jan 03HealthGrid 2003 – Lyon, Jan 03
HealthGrid Association incorporatedHealthGrid Association incorporated
HealthGrid 2004 – HealthGrid 2004 – Clermont-Ferrand, Jan 04Clermont-Ferrand, Jan 04
HealthGrid ‘White Paper’, June 04HealthGrid ‘White Paper’, June 04
HealthGrid 2005 – Oxford, Apr 05HealthGrid 2005 – Oxford, Apr 05
FP6 Project ‘SHARE’ – December 05FP6 Project ‘SHARE’ – December 05
HealthGrid 2006 – Valencia, June 06HealthGrid 2006 – Valencia, June 06
44 [email protected]@uwe.ac.uk NEC 2005NEC 2005
HEALTHGRID.ORG Principal ThemesPrincipal Themes
IntegrationIntegration
Levels of life & knowledge: Levels of life & knowledge: correspondence & convergencecorrespondence & convergence
Issues of ethics and trustIssues of ethics and trust
Services on grid infrastructureServices on grid infrastructure
55 [email protected]@uwe.ac.uk NEC 2005NEC 2005
HEALTHGRID.ORG Principal Theme 1Principal Theme 1
IntegrationIntegration medical and bioinformaticsmedical and bioinformatics
patient information and medical knowledgepatient information and medical knowledge
‘‘gold standard’ evidence and practice-based gold standard’ evidence and practice-based evidenceevidence
patient data – images, labs, historypatient data – images, labs, history
models of the human bodymodels of the human body
legal, ethical, social, trust issueslegal, ethical, social, trust issues
66 [email protected]@uwe.ac.uk NEC 2005NEC 2005
HEALTHGRID.ORG
EU project to prototype a EU project to prototype a pan-European pan-European distributed databasedistributed database of mammographic of mammographic imagesimages using using GridGrid Technologies. Technologies.
AimAim:: To provide a To provide a demonstratordemonstrator for use for use in epidemiological studies, quality control in epidemiological studies, quality control and validation of computer aided detection and validation of computer aided detection algorithms.algorithms.
Example 1Example 1
Knowledge GridKnowledge Grid
77 [email protected]@uwe.ac.uk NEC 2005NEC 2005
HEALTHGRID.ORG Grid ArchitectureGrid Architecture
GRID
VPN
WorkstationsWorkstations
MammoGrid Data
MammoGrid Data
MammoGrid Data
Udine
Oxford
CERN
MammoGrid Data
Cambridge
GridBox
GridBox
GridBox
High Security Level
MG W/s(‘‘MAS’’)
MG W/s(‘‘MAS’’)
88 [email protected]@uwe.ac.uk NEC 2005NEC 2005
HEALTHGRID.ORG Grids and Imaging 1Grids and Imaging 1
DiagnosisDiagnosis comparison, ‘find-one-like-it’comparison, ‘find-one-like-it’
EpidemiologyEpidemiology virtual databasesvirtual databases significant statisticssignificant statistics
Therapy planningTherapy planning targetting, implantation, surgerytargetting, implantation, surgery
Problems of heterogeneityProblems of heterogeneity
Security IssuesSecurity Issues
99 [email protected]@uwe.ac.uk NEC 2005NEC 2005
HEALTHGRID.ORG Grids and Imaging 2Grids and Imaging 2
Service Oriented ArchitectureService Oriented Architecture grid services can deal with heterogeneitygrid services can deal with heterogeneity
grid services can be used to plan workflowgrid services can be used to plan workflow
examples include annotation, detection, examples include annotation, detection, analysis, registration, aggregation and analysis, registration, aggregation and visualization servicesvisualization services
Optimistically …Optimistically … legal, ethical, social and trust negotiations legal, ethical, social and trust negotiations
may be implemented through servicesmay be implemented through services
1010 [email protected]@uwe.ac.uk NEC 2005NEC 2005
HEALTHGRID.ORG
Example 2Example 2
Computational GridComputational Grid
Legal Aspects
Simulation &Imaging
GridSoftware
Bio-numeric modelling
Medical Expertise
Secure & lawful Grid provision of medical services
Build 6 Grid-enabled medical prototype applications
Build suitable middleware on top of common standards
Install and evaluate a GEMSS test-bed
Anticipate privacy, security & other legal concerns
Taken from Gerhard Engelbrecht
1111 [email protected]@uwe.ac.uk NEC 2005NEC 2005
HEALTHGRID.ORG ApplicationsApplicationsNameName DomainDomain ClassClass
Maxillofacial Maxillofacial surgery surgery simulationsimulation
Medicine – pre-surgical Medicine – pre-surgical planningplanning
On demand / On demand / distributed distributed supercomputingsupercomputing
Neurosurgery Neurosurgery supportsupport
Medicine – intra-Medicine – intra-operative planningoperative planning
On demandOn demand
Radiotherapy Radiotherapy planningplanning
Medicine – Monte Carlo Medicine – Monte Carlo treatment simulationtreatment simulation
On demand / On demand / distributed distributed supercomputingsupercomputing
Inhaled drug Inhaled drug delivery planningdelivery planning
Medicine – air flow Medicine – air flow dynamicsdynamics
On demand / On demand / distributed distributed supercomputingsupercomputing
Cardio-vascular Cardio-vascular system system simulationsimulation
Medicine – blood flow Medicine – blood flow dynamicsdynamics
On demandOn demand
Advanced image Advanced image reconstructionreconstruction
Medicine – nuclear / in Medicine – nuclear / in vivo diagnosticsvivo diagnostics
On demandOn demandTaken from Gerhard Engelbrecht
1212 [email protected]@uwe.ac.uk NEC 2005NEC 2005
HEALTHGRID.ORG Principal Theme 2Principal Theme 2
Levels of lifeLevels of life
Levels of knowledgeLevels of knowledge
Correspondence and Correspondence and convergenceconvergence medicine and genomicsmedicine and genomics ‘‘molecular medicine’molecular medicine’ ‘‘individualized healthcare’individualized healthcare’
1313 [email protected]@uwe.ac.uk NEC 2005NEC 2005
HEALTHGRID.ORG Bio-social being & pathologyBio-social being & pathology
Molecular andImage-based
diagnosis
Population
Disease
Patient
Tissue, organ
Molecular, genetic
GenomicEpidemiology
Pharmacogenetics
Bioinformatics
MedicalImaging
MedicalInformatics
Public HealthInformaticsI
NBIOMED
PATHOLOGIESTaken from Fernando Martín-Sánchez
1414 [email protected]@uwe.ac.uk NEC 2005NEC 2005
HEALTHGRID.ORG An example:An example:
Integration of clinical and genetic info Integration of clinical and genetic info from heterogeneous remote databasesfrom heterogeneous remote databases
A vocabulary server that aims to combine A vocabulary server that aims to combine existing terminology systems in Medicine existing terminology systems in Medicine and Geneticsand Genetics
Novel framework for clinicians to locate, Novel framework for clinicians to locate, search, access, retrieve and use genomic search, access, retrieve and use genomic information in patient careinformation in patient care
Taken from Fernando Martín-Sánchez
1818 [email protected]@uwe.ac.uk NEC 2005NEC 2005
HEALTHGRID.ORG Principal Theme 3Principal Theme 3
‘‘LEST’ IssuesLEST’ Issues use of data in care and in researchuse of data in care and in research data provenancedata provenance privacy / confidentialityprivacy / confidentiality securitysecurity national / EU legal frameworknational / EU legal framework … … extending the concept of a ‘virtual extending the concept of a ‘virtual
organization’organization’ & building negotiation into the & building negotiation into the
infrastructureinfrastructure
1919 [email protected]@uwe.ac.uk NEC 2005NEC 2005
HEALTHGRID.ORGGRIDs and Privacy
Good reasons for talking about privacy here and now!
– The HealthGrid promises access to large amounts of heterogeneous distributed data
– Health related information is very sensitive and prone to abuse
– Privacy impacts society as a whole(e.g. loan applications, insurance, scholarship, ...)
– Privacy violation is irreversible– Confidential information can never be considered
confidential again, once it was out in the open– Grid and Privacy Enhancing Technology exist and are used
They could both benefit from early integration
Adapted from Georges de Moor and Brecht Claerhout
2020 [email protected]@uwe.ac.uk NEC 2005NEC 2005
HEALTHGRID.ORGSharing of Healthcare Data
Local Databases:– Nominative records
(e.g. patient treatment)
– Privacy protected DBs
Data Access through the Grid
PrivacyProtectingInterface
Privacy Protecting Interface (PETs):
– Locally controlled– Pseudonymisation– Content filtering and
transformation– Query evaluation
(restriction)
Local Database
Adapted from Georges de Moor and Brecht Claerhout
2121 [email protected]@uwe.ac.uk NEC 2005NEC 2005
HEALTHGRID.ORG Principal theme 4Principal theme 4
A Grid Infrastructure for Health Applications A Grid Infrastructure for Health Applications
Technology attitudeTechnology attitude To build on what already existsTo build on what already exists To build only what is necessaryTo build only what is necessary
Healthgrid Healthgrid ComponentsComponents
Healthgrid Healthgrid ApplicationsApplications Clinical DataClinical Data
Grid Infrastructure
2222 [email protected]@uwe.ac.uk NEC 2005NEC 2005
HEALTHGRID.ORG Layered Grid TechnologiesLayered Grid Technologies
Knowledge Grid
DataControl
DataAbstraction
Data Grid
Information Grid
Distributed databases, Distributed databases, streaming, near-line storage, streaming, near-line storage, large objects, access large objects, access mechanisms, data staging …mechanisms, data staging …
Metadata, middleware, Metadata, middleware, intelligent retrieval, intelligent retrieval, information modelling, information modelling, warehousing, workflow …warehousing, workflow …
Data mining, visualisation, Data mining, visualisation, simulation, problem solving simulation, problem solving methods/environments …methods/environments …
2323 [email protected]@uwe.ac.uk NEC 2005NEC 2005
HEALTHGRID.ORG
A Grid Infrastructure for A Grid Infrastructure for Health ApplicationsHealth Applications
To address the problems of To address the problems of integration of multi-level medical data, andintegration of multi-level medical data, andthe exploitation of its intrinsic knowledgethe exploitation of its intrinsic knowledge
through a health-specific grid Infrastructure and a set of grid through a health-specific grid Infrastructure and a set of grid applications for health.applications for health.
To integrateTo integrategrid infrastructures, grid infrastructures, health-related grid components, andhealth-related grid components, andpilot applications pilot applications
to provide a workbench for medical and clinical support.to provide a workbench for medical and clinical support.
To develop components to linkTo develop components to linkthe available expertise,the available expertise,data, anddata, andresources.resources.
to demonstrate the benefits through pilots in epidemiology to demonstrate the benefits through pilots in epidemiology and personalised healthcare.and personalised healthcare.
2424 [email protected]@uwe.ac.uk NEC 2005NEC 2005
HEALTHGRID.ORG Benefits ExpectedBenefits Expected
At the patient levelAt the patient levelPersonalised healthcare, e.g. through simulation in Personalised healthcare, e.g. through simulation in therapy.therapy.Improvement in the effectiveness of health policies Improvement in the effectiveness of health policies through epidemiological studies.through epidemiological studies.
At the medical professional levelAt the medical professional levelDevelopment of federated databases and collaborative Development of federated databases and collaborative communities.communities.Development of services to support diagnosis and Development of services to support diagnosis and therapy in day-to-day work.therapy in day-to-day work.
At the IT LevelAt the IT LevelA workbench for the development of tools and services A workbench for the development of tools and services towards specific features of healthcare IT.towards specific features of healthcare IT.
2525 [email protected]@uwe.ac.uk NEC 2005NEC 2005
HEALTHGRID.ORG
NEXTNEXT 10 years (2003-2014)PASTPAST 10 years (1991-2002)
Computer Applications for
Doctors
Telemedicine systems and services
Budget20M €
Budget100M €
Budget140M €
Budget200M €
Projects30
Projects
63Projects158
Projects125
ResultsFeasibility Study
ResultsAIM
Community
Results1st batch
of Products
ResultsEU
Health Telematic
s Industry
@@
20 Years of 20 Years of eeHealth R&D ContextHealth R&D Context20 Years of 20 Years of eeHealth R&D ContextHealth R&D Context
Regional Health Info Networks
Home-care systems
Personal Health Systems
-HealthGrid
Biomedical Informatics
- informatics for Genomic Medicine
- Virtual Physiological Human
Personal health systems (Wearable & Implantable)
based on new biosensors Decision Support Syst./Patient Safety
www.cordis.lu/ist/directorate_c/ehealth/index.html
’02-’06 Research activities(200 Mil. €)’89-’91 ’91-’94 ’94-’98 ’98-’02
Currently preparing activities for ’06-’10
2626 [email protected]@uwe.ac.uk NEC 2005NEC 2005
HEALTHGRID.ORG
EC - ICT for Health EC - ICT for Health Current Activities and PlansCurrent Activities and Plans
EC - ICT for Health EC - ICT for Health Current Activities and PlansCurrent Activities and Plans
EHR & interoperability
Biomedical informatics
HealthGrid
Time to results
Deployment
Applied/Industrial R&D
Basic research
5 years 10 years 15 years
Decision Support Systems
Support to eHealth “Action Plan”
Health info networks & services
Personal Health Systems (wearables)
General issuesEHR, Security, Interoperability
I
II
III
2727 [email protected]@uwe.ac.uk NEC 2005NEC 2005
HEALTHGRID.ORG
CISTRANA - IST ERA
Implementation
I
eHealth ERAeHealth ERA
I2HEALTHIdentification
doctors/patientMessages/requests
I2HEALTHIdentification
doctors/patientMessages/requests
Certification EHRSSA
Certification EHRSSA
TMA BridgeInterop. approach
TMA BridgeInterop. approach
RIDEInteroperability
RIDEInteroperability
SHARE Healthgrid
SHARE Healthgrid
SYMBIOMATICSBMI ERA Pilot
SYMBIOMATICSBMI ERA Pilot
STEPVH CA
INFOBIOMEDINFOBIOMED
BIOPATTERNBIOPATTERNSEMANTIC MININGSEMANTIC MINING
Semantic HealthInteroperabilitySemantic HealthInteroperability
II III
Short time research Long time research
2828 [email protected]@uwe.ac.uk NEC 2005NEC 2005
HEALTHGRID.ORG More informationMore information
ReferencesReferences http://lyon2003.healthgrid.org/program.phphttp://lyon2003.healthgrid.org/program.php http://clermont2004.healthgrid.org/program.phphttp://clermont2004.healthgrid.org/program.php http://oxford2005. healthgrid.org/program.phphttp://oxford2005. healthgrid.org/program.php
HG2004, HG2005 ProceedingsHG2004, HG2005 Proceedings
‘‘White paper’White paper’ http://www.healthgrid.org/download.php (June 2004)http://www.healthgrid.org/download.php (June 2004)
SHARE Project – Road MapsSHARE Project – Road Maps