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Empowering individuals to better manage their health
PCHA presents Continua
a key component for the transformation of healthcare
ETSI, Dec. 2015
Laurent Bouskela Chair, Market Adoption Working Group Product Manager Orange
Empowering individuals to better manage their health
Personal Connected Health Alliance
A membership association transforming healthcare through
personalized, interoperable connected health solutions.
PCHA publishes the Continua Design Guidelines.
PCHA works to create favorable markets and regulatory
environments for connected Health.
PCHA convenes the mHealth Summit.
Empowering individuals to better manage their health
Personal Connected Health Benefits
MEDICAL Patients can stay at home and have good care.
“The French government will invest €650 million”
(Le Monde, June the 3rd, 2014)
SOCIAL Families can play an active role.
FINANCIAL Savings resulting from aging in better health.
59% reduction in bed days of care (US Veterans).
51% reduction in CHF patients one-year mortality
(Cardiauvergne, France).
15% reduction in emergency visits (3millionlives, UK)
51% reduction in heart failure hospital readmissions
(Partners Healthcare, USA)
Empowering individuals to better manage their health
PCHA’s Continua Design Guidelines
The only organization in Connected Health to focus on
authentic interoperability (foundational, structural, and semantic)
from the patients to the caregivers, with clear, detailed, and
ready-to-use guidelines based on existing standards such as
IEEE, HL7, or SNOMED CT.
Continua is to the Connected health at home what IHE is to the
hospital environment (definition of profiles). It also provides
certification, assistance, and extensive source code library.
In addition to SDO relationships, PCHA maintains policy,
regulatory and market adoption activities in key markets around
the world: US, EU, China, Japan, SEA, Brazil, India.
“We do not see any alternative to
Continua” wrote Roald Bergstrom,
the Principal Advisor to the National
Health Authority in Norway.
Empowering individuals to better manage their health
132 Members (March 2015)
Promotors and board members
Empowering individuals to better manage their health
More than a hundred certified devices
Empowering individuals to better manage their health
Pulse oximeter
Blood pressure monitor
Thermometer
Weighing-scales
Glucose meter
Cardiovascular fitness
Step counter
Strength fitness
Activity hub
Adherence monitor
Peak flow meter
Fall sensor
Motion sensor
Enuresis sensor
Contact closure sensor
Switch sensor
Dosage sensor
Water sensor
Smoke sensor
Property exit sensor
The 2015 guidelines Continua profiles
Temperature sensor
Usage sensor
PERS sensor (Personal Emergency Response Sensor)
CO sensor (Carbon Monoxide)
Gas sensor
Heart-rate sensor
Basic 1-3 lead ECG sensor (ElectroCardioGram)
Body composition analyzer
INR meter
Sleep Apnea Breathing Therapy Equipment (SABTE)
MoU Continua / Bluetooth SIG
Bluetooth Smart (BLE) Continua profiles (see link):
HTP - Health Thermometer Profile
HRP - Heart Rate Profile
BLP - Blood Pressure Profile
GLP - Glucose Level Profile
WSP - Weighing Scale Profile
BCS - Body Comp Analyzer Service
Pulse oximeter (to come)
CGM (to come)
3 IEEE domains Disease Management, Health and Fitness, and Independent Living (Aging Independently)
Connected Health data
systematically sent to caregivers
Disease Management
Beyond Connected Health
data occasionally sent to
caregivers
Health and Fitness
Independent Living (Aging
Independently)
Smart home
Empowering individuals to better manage their health
8 | Innovation in Diabetes Care | H. Merkle | 17. Sep. 2015
Norway: (Dec. 2014) Parliament adopted Continua standards as the framework for its new national health program. Ministry of Health is Continua member
Latvia: eHealth Week closing plenary: Continua Commitment to support ecosystems with Continua Guidelines
UAE / Qatar: Discuss PCH/Continua as part of HIT plans Singapore: embarks to implement Continua based HIT to serve SE-Asian region Taiwan: New promoter member planning of an Asian Summit to promote standards China: Momentum is building toward utilization of standards in HIT - more members from China
Denmark: (2012) Nationwide health IT framework mandates compliance with interoperability standards (Continua).
Sweden is on its way to follow its neighbors in 2015/2016
Finland (May 2015) announced adoption of the Continua Guidelines in its HIT framework
Brussels: EC Commissioner invited Continua to cooperate to create a Europe wide Health agenda with focus on Health IT
USA: FDA shows keen interest to collaborate in Guidelines and Certification program development. ONC: Continua engaged in commenting on Interoperability Roadmap (Jan 2015)
Market adoption
Empowering individuals to better manage their health.
WHY STANDARDS MATTER
Empowering individuals to better manage their health.
For Healthcare Professionals
Interoperability Means Efficiency
• No wasting valuable time worrying about what device your patient buys, what cellphone they choose, or what carrier they use.
• Focus on practicing medicine, not playing tech support.
• You can trust data will arrive in a ready for clinical use.
Empowering individuals to better manage their health.
Interoperability Means Freedom
• Choose the solution that fits your lifestyle without worrying about whether it will connect to the people you want it to.
• Future-proof your investment ensuring that data you’ve already collected can be used with whatever new products come along
For Patients / Consumers
Empowering individuals to better manage their health.
Interoperability Means Lower Costs
• Standards
– Reduce cost and complexity
– Ensure security and patient safety
– Maintains integrity of medical-grade data
For Hospitals
Empowering individuals to better manage their health.
Interoperability Reduces Costs • Standardization enables
mobility for citizens. • Standardization reduces
regional and economic disparities in connected health availability.
• Standardization reduces the complexity of IT systems for collecting data while maintaining freedom for citizens to choose what they want to use.
• Early interoperability reduces system complexity and lowers long-term costs Photo: Health Care Not Wealth Care: taken from -
https://www.flickr.com/photos/waywuwei/8075025675 Author: Waywuwei https://creativecommons.org/licenses/by-nd/2.0/
For Nations
Empowering individuals to better manage their health.
Interoperability Saves Cost and Time
• Standardization allows R&D resources to
be dedicated to product differentiators, not reinventing data formats.
• Standardization of data reduces barriers to entry into higher value markets like analytics and information management.
• Frees developers to focus on value-added functionality
For Manufacturers
Empowering individuals to better manage their health
Interoperability saves money
Earthquake survivors dwelling in camps at high risk for a stroke in Japan.
A service to remotely monitor blood pressure has been developed ($).
$166,000
without Continua
$27,000
with Continua
- 84%
Empowering individuals to better manage their health
Interoperability saves time
12 weeks
without Continua
2 weeks
with Continua
Earthquake survivors dwelling in camps at high risk for a stroke in Japan.
A service to remotely monitor blood pressure has been developed ($).
Source: Continua
Estimate from participating companies.
Empowering individuals to better manage their health
Plug-and-play Continua Certified Devices
+ Pre-existing Continua Interface
6 times cheaper and faster
Empowering individuals to better manage their health
Continua can help the transition from
pilots to large scale programs
Reference
architecture for
collecting health
data from citizens
Denmark
Reference
architecture for
collecting health
data from
citizens
Denmark
Empowering individuals to better manage their health
What happens without Continua
Homes city 1
Hospital medical system
EHRs
Big data
? Chronic care (coordination)
Acute care (hospitalization)
Homes city 2
MANY INTERFACES
Telemedicine provider
Medical provider
Patients & devices
Gateways
Empowering individuals to better manage their health
With Continua
UNIVERSALCONTINUA INTERFACE
Homes city 1
Hospital medical system
EHRs
Big data
Patient Primary care Hospital care
Physiotherapist Social care Specialist
Nurse HCP
Relatives
Chronic care (coordination)
Acute care (hospitalization)
Telemedicine provider
Medical provider
Patients & devices
Gateways
Homes city 2
Empowering individuals to better manage their health
1. Continua profiles each of the standards organizations listed here. Its certification program ensures that devices are and remain
interoperate in accordance with the requirements specified within the Continua Design Guidelines. Where there are gaps in either
of these standards, Continua adds additional requirements within the Continua Design Guidelines.
2. Continua’s architecture represents 3 interfaces; Personal Health Devices Interface (PAN-LAN-TAN), Services Interface (WAN)
and Healthcare Information Service Interface (HRN).
3. Security and privacy are core values of Continua which are tested as part of Continua certification. Continua Design Guidelines
were designed with HIPAA, EU Directives 95/46, etc.
Continua End-to-End architecture
Empowering individuals to better manage their health.
• Enable secure flow of medical-grade data from remote sensors to EHRs • End-To-End Security
– Identity Management, Consent Management & Enforcement, Entity Authentication, Encryption, Confidentiality, Integrity & Authentication, Non-Repudiation of Origin, and Auditing.
• Personal Health Devices Interface – IEEE 11073 Personal Health Device Family of Standards Compatible Data – USB, NFC, Zigbee, and Bluetooth Transports – Blood Pressure, Heart Rate, Blood Glucose, Activity Monitoring, Weight Scale …
• Services Interface – Uploads Device Observations via IHE PCD-01 – Exchanges Questionnaires via HL7 QFD and QRD – Authenticated Persistent Session Ensures Cellular Connectivity – Employs Enterprise-Oriented SOAP/SAML or Consumer-Oriented Restful/Oauth
• Health Information Services Interface – Exchange of Electronic Health Records via HL7 PHMR – Transport per IHE Cross-Enterprise Document Sharing (XDS)
• Continua Enabling Software Library (CESL) – Head Start on Implementing Design Guidelines – Software Development Kit with Full Source Code
• Test & Certification – Continua test tools save considerable time and money during development
“Plugfests” allow real world testing in a trusted, constructive environment – More than 100 health devices and services Continua certified
Continua Design Guidelines
Empowering individuals to better manage their health.
• Continua guides towards real solutions
– Meaningful Use Cases impacting healthcare NOW
– Provide a flexible implementation framework
– Point at accepted base standards to shape interfaces between system elements
– Specify which optional standard elements to apply
– Select solutions for their functional fit, not for who made them (includes HL7, IHE, IEEE, Bluetooth SIG, IEC, …)
Result oriented
Empowering individuals to better manage their health.
• Continua guidelines are endorsed by a neutral leader – International Telecommunication Union (ITU), the global
standards agency of the United Nations
• Anyone can get the Continua guidelines for FREE – In six languages
– Download via ITU or: www.continuaalliance.org
• Anyone can submit comments – Via Continua or ITU
• Any party can easily join the Personal Connected Health Alliance at the level of choice – Easy market access for vendors, no vendor lock-in for users
– Contribute to new versions
Truly open guidelines
Empowering individuals to better manage their health.
Development Cycle
1. Submission of use case ideas
2. Use Case development
3. UC balloting
4. UC sponsorship
5. UC review – architecture, regulatory, feasibility, effort
6. Decomposition (Work items)
7. Gap Analysis
8. Guidelines Development
9. Balloting
10. Approval
11. Testing, test tools development
12. Public Release & Comment Period
13. Certification Program
Use Case
Requirements
Base Standards
Design Guidelines
Certification Program
ITU-T Standard
Guidelines development process
Empowering individuals to better manage their health.
• There is no alternative for the Continua Guidelines to enable interoperable end to end Personal Connected Health solutions for vendors, providers and consumers.
• Personal Connected Health Alliance promotes Continua.
• The Continua Guidelines are supported by reference code, certification, and a strong organization.
• The Continua Guidelines are freely available for use by any party.
• The Continua Guidelines are being adopted by leading demand side players.
Summary
