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OHI: Healthcare Interoperability at the Olympic Games

Session #148, March 7, 2018

Todd Cooper, Technical Management

Michael Nusbaum, Executive Lead

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Todd Cooper, BA

Michael Nusbaum, BASc, MHSA, FHIMSS

have no real or apparent conflicts of interest to report

Conflict of Interest

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Agenda• What is OHI?

• The Olympic opportunity

• What we’ve learned

• The path forward

• Questions

– for you

– for us

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Learning Objectives• Recognize the healthcare system operated as an integral part of each Olympic

Games, and how digital health can represent a microcosm of an interoperable international ecosystem.

• Analyze the opportunities to add significant interoperability components to the Olympic digital health infrastructure.

• Recognize the lessons that can be learned from the Olympic experience, and apply these to any jurisdictional implementation of digital health.

• Identify the enormous media opportunity afforded by the Olympics to promote the use of established international standards as an essential foundation of interoperability.

• Discuss how the Olympic legacy can benefit from internationally-recognized digital health standards, architecture and an implementation framework, which will be left for an Olympic host country to further develop once the Olympics are over.

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What is OHI?• A Digital Health initiative, sponsored by HIMSS, SNOMED

International, and the HIMSS SoCal Chapter

• A facilitated and managed specification and process to advance the seamless exchange and use of health information, using established international standards, to support an integrated medical services infrastructure at each Olympic Games site.

• OHI leverages multiple vendor solutions to connect pre-Games person-specific healthcare information with information generated at Games time by Olympic and host city service providers

• OHI leaves a legacy that promotes the globalization of digital health

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Our MissionAdvancing the seamless exchange and use of health information, using established international standards, to support an integrated medical services infrastructure at each Olympic Games site.

The OHI network connects pre-Games person-specific healthcare information with information generated at Games time by Olympic and Host City service providers

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The Olympic Opportunity• Every two years, people from around the world converge

on a community to compete in Olympic Games

• Celebration of athletic excellence and inspiring the world to strive to excel in every endeavor

• Promotion of innovative and best practice

• The IOC requires the provision of a “medical services” infrastructure to support:

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From Silos to Ecosystem

NOCs and their

own athletes

health records

Accredited

laboratories

Pharmacy

patient

records

“Polyclinics”

“Clinics”

at venues

Patient transport

Digital

imaging

OCOG EMR

Host City Tertiary

Referral Hospitals

Local EHR

Patient Identity

Manager

Digital Health

ecosystem

Interoperability

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Athlete Cardiac Event

Twenty-four-year-old Jamaican athlete Tasha Morris collapsed on the track while competing in the Women’s 100 Meter event at the London2012 Olympic Games, showing symptoms of dizziness, light-headedness, and a pounding in the chest area.

OHI Interoperability Use Cases*

Olympic Family Member GI Event

George Carson, the 56-year-old father of Canadian Olympic swimmer Brian Carson, exhibited an episode of acute abdominal pain while watching his son’s final heat in the 200 Meter Butterfly event at Rio2016

Benefits to Interoperability at the Olympic Games Faster response between onset of symptoms and treatment Fewer diagnostic tests required (elimination of redundancy),

reducing both time and costs Improved quality of treatment, based on access to more

complete clinical information Improved patient safety, especial with respect to medication

errors Closed loop of clinical information: from patient to clinician and

back to the patient

* Use Case details in slide NOTES

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Multiple “swim lanes”

OHI

Year 11

2027/2028

OHI

Year 1

2017/2018

Paris

2024

OHI

Year 2

2018/2019

Games

Time

Winter

2026

Lock-Down

Pyeongchang

2018

Tokyo

2020

Beijing

2022

Lock-DownDevelopmentStrategic Planning

2024-2yrs-4yrs-8yrs +6mos

Iterative

2022

Development

-2yrs-6yrs

Iterative

Lock-Down

2020

Iterative

Development

-4yrs

Lock-Down

-2yrs

+6mos

+6mos

+6mos

-6yrs

-4yrs

-2yrs

2018

Strategic Planning

-2yrs-4yrs-6yrs-10yrs -8yrs

Lock-Down

2026 +6mos

DevelopmentIterativeStrategic Planning

OHI

Year 3

2019/2020

OHI

Year 4

2020/2021

OHI

Year 5

2021/2022

OHI

Year 6

2022/2023

OHI

Year 7

2023/2024

OHI

Year 9

2025/2026

OHI

Year 8

2024/2025

Games

Time

Games

Time

Games

Time

Games

Time

Los Angeles

2028Strategic Planning

-8yrs-12yrs -10yrs

Strategic Planning

-2yrs-4yrs-6yrs

Lock-Down

2028 +6mos

DevelopmentIterativeStrategic Planning

OHI

Year 10

2026/2027

Strategic

Planning

Iterative

Development

Lock-Down

Post-Games

10-year vision; per-Games objectives & building legacy

Detailed requirements analysis; innovative technology

assessment; prototyping & ”Projectathons”, public

demonstrations, conformity assessment & certification

Final implementation; Operational Readiness

Evaluation; recommendations

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OHI Technical Architecture• Based largely on IHE Profiles

• International standards in this example include:

o Transport: ISO 28380, IHE XDS.b, XDM

o Content: IHE XDS-MS, HL7 IPS, CDA, HL7v2, HL7 FHIR

o Semantic: SNOMED CT

o Functional: IHE XDW, IHE GAO

o Security/Privacy: ISO 27799, IHE BPPC, ATNA

Patient Identity Source

Document Registry

Document Repository

Document Source

Document Consumer

Patient Identity Feed

[ITI-8]

Patient Identity Feed

HL7v3 [ITI-44]

Provide & Register

Document Set-b [ITI-41]

Retrieve Document Set

[ITI-43]

Registry Stored

Query [ITI-18]

Register Document

Set-b [ITI-42]

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Importance of Digital Health at the Olympics• Today, Digital Health is considered an essential component of every healthcare system

worldwide

• Information flow following patient flow throughout the system – leads to improvements in

quality, reduction in medical errors

• Digital Health → lower cost of providing healthcare services

• Real-time Rx/Lab information integrated with the patient’s health record can facilitate

active anti-doping surveillance

• Digital Health is well-understood globally – nearly every country is implementing a

Digital Health strategy. However, the Olympic movement has not taken advantage of its

digital health potential

• Digital Health relies on the collaboration of stakeholders from across the health care

ecosystem, supported by many different systems from many different vendors…

• The IOC can provide increased leadership in this area

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Digital Health Industry Support

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Value Proposition

Monitor and better respond

to public health

outbreaks

Track athlete health, perhaps

trended over some longer time periods

Promote an Olympic class Longitudinal

Electronic Health Record

to support a patient through

the full Care Continuum

Clinical data can be anonymized

and made available to

IOC/OCOG for Analytics &

Planning

Demonstrate commitment

to innovation, to facilitate

welcoming the world

Facilitate the retention of the

medical and pharmacy patient records after the games, according

to national law and industry best

practice

Ensured that prohibited or

contra-indicated medications are not

inadvertently administered by the

OCOG medical team.

Enhance the quality and

efficiency of care provided to all participants

[reduced costs, increased safety,

etc.]

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Myths and Truths• OHI seeks to create an environment that will enable healthcare information to flow alongside a patient

moving through the continuum of care… at the Olympic Games (sports venues, polyclinics, tertiary referral hospitals, testing labs, pharmacies, etc.). The OHI team is a combination of healthcare interoperability experts and Olympic Games leaders, who are seeking only to “facilitate” the establishment of an interoperable health information ecosystem.

• We are not “selling” anything. There is no “company” involved, and no “product” involved with OHI.

• OHI is not seeking any funding from NOC’s. We are funded separately, and globally.

• Our “proposal” is that a few NOCs work together as early adopters of interoperable and longitudinal healthcare information supporting our athletes and Olympic family, as well as volunteers and spectators coming from around the world.

• OHI looks to establish a digital health legacy for each of the cities hosting the Games, as well as sending countries.

• OHI does not seek to change anything about an NOC’s existing choices for an EMR solution to support the team … only to help enable it to communicate with other systems using established international standards. For example, we would work with GE, SAS, and others.

• OHI is very careful to ensure the Olympic brand is maintained and that it doesn't threaten the current businessrelationships and sponsor categories

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Benefits• To the Games:

o More integrated healthcare, better health, less cost, higher quality, etc.

• To the World:

o Digital Health legacy

o Demonstration of innovative and best practice

o Opportunities for developed and developing countries

• To the Digital Health Community:

o Very visible Global demonstration of the use of international standards

o Valuable implementation feedback from a truly international implementation community

o Digital Health visibility on the World stage

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• Based on principle of “exclusivity”

• Digital Health cuts across sponsor domains

• Interoperability involves multiple vendors’ systems

The IOC Sponsorship Program

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The Path Forward

• Program Plan – submitted 31Oct17 to sponsors

o Business Implementation Strategies

o Benefit/Risk Assessment

o Recommendations

o Tasks, Resources, Budget

• OHI Foundation launch 2018

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A new TOP Sponsor Category:Digital Health

① ②

Foundation

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OHI Foundation• Plan and execute a phased, long-range strategy for OHI

interoperability

• Manage interoperability specifications and use of international standards

• Conduct “Projectathon” testing

• Facilitate OHI certification of vendor products

• Manage pre-Games implementation, testing, operational readiness

• Manage user training, security and privacy provisions

• Conduct post-Games evaluations

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Audience Questions:Q1: Do you see value in an Olympic digital health ecosystem?

1. For athletes/spectators

2. For host city/country

3. For national teams

4. All of the abovehttps://live.eventbase.com/polls?event=himss2018&polls=4255

Q2: The most important Digital Health legacy for the Olympics is

1. Education and awareness

2. Demonstrate interoperability

3. Illustrate what is possiblehttps://live.eventbase.com/polls?event=himss2018&polls=4256

Q3: Would you consider joining the OHI Foundation?

1. Yes

2. Need more info

3. No

https://live.eventbase.com/polls?event=himss2018&polls=4257

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OHI will not reinvent the wheel!

Leverage established international standards

Leverage ConCert, “Connectathon”, “Projectathon” &

other testing & Certification events

Focus on Olympic use cases across entire Olympic

community

Include technical, semantic & functional

interoperability

“Future proof” OHI implementation

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The OHI Team of ExpertsMichael Nusbaum, BASc, MHSA, FHIMSSBusiness Management

•Executive Liaison

•Stakeholder Relations

Flavia Dias Moreira, BBA, PMPProgram Management

•Planning and Governance

•Management Framework definition and communications

Todd Cooper, BATechnical Management

•Collaboration with vendors and health organizations

•Technical implementation leadership

Renato Garcia, MBAPartnership Development

●Recruitment of Foundation partners●Contracts and Legal

• Healthcare Management Consultant

• International Expert: interoperability & standards

• Strategist, Visionary, Project Leader

• Board member: HIMSS & IHE

• Vancouver2010 Games volunteer: alpine events

• Healthcare Management Consultant & Head of PMO

• Leadership Role in Rio2016 Games (5 yrs) - General

Manager and TOC Director

• Expert in Programme Leadership & knowledge management

• Healthcare Technology Consultant

• International Expert: trusted interoperable healthcare

systems & medical devices

• Expert in Interoperability standards, testing & certification

• Board member: IHE, HL7 FHIR Foundation

• Business Development Consultant

• Leadership Role in Rio2016 Games - Sponsorship Sales

and Business Development Manager

• IOC Top Olympic Sponsors Account Management

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Questions

Michael Nusbaum• michael@OHIinitiative.org

• +1.250.384.0001

Todd Cooper• todd@OHIinitiative.org

• +1 858.442.9200

Please remember to complete the online session evaluation