the european healthgrid initiative

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


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


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


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


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


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’’)


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


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


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


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


Inhaled drug Inhaled drug delivery planningdelivery planning

Medicine – air flow Medicine – air flow dynamicsdynamics


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



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’


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


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


HEALTHGRID.ORG



‘‘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


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


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


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


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 …


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.


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.


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


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


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


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

the european healthgrid initiative

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