#patient-member-subgroup | Meeting Notes: Laboratory Use Cases and Hyperledger Global Forum Submission #patient-member-subgroup


Marissa Iannarone
 

Hi All,

Thanks to everyone that could make the call today. Below are my notes, I will work to get these up on the wiki. Please feel free to add any comments/make changes. In summary, the group had a great discussion on several facets of the laboratory use case and how blockchain can enable a patient-centric approach to lab samples and a mechanism that facilitates work between labs. We will use our next subgroup meeting to start building out patient journeys as part of the requirements gathering activities:

Angela's Specific Use Case:

  • Aim is to use urine samples for early breast cancer detection
  • Pain point is getting the right data to feed algorithm for detection
  • Just mining data that are already out there is not feasible b/c there is specific context that is needed along with the lab sample
  • Thought is to have a patient-centric UI (ie Apple CareKit), with a blockchain backend in order to provide documentation of the sample and associated metadata (sample acquisition)

Logistics of Samples Use Case:

  • When samples get lost, there is no way to recover them, which could lead to treatment for the "worst case scenario" instead of the right treatment for the given sample results
  • Reconciliation of the "last touch problem" (the final entity to hold the sample)
  • The blockchain gives a solution to these challenges, and the opportunity/possibility to find samples that have go missing

Blockchain Value in the Laboratory Use Case

  • There are those that have data to enter the exchange, those that need data from the exchange and blockchain provides the accounting and eliminates need for intermediaries
  • The blockchain will not support the data themselves but instead the events that surround the sample
  • Any code that we can development to help the interaction with labs would be powerful
  • Idea: LOINC/HL7 enabled entity to interact with Hyperledger Fabric
  • Provides the ability to register, log, track samples

General Feedback

  • This is a complex use case, but we can segment it out so that we can attack it piece by piece
    • Segment idea: patent-center solution and logistics
  • Concept of Oracles
    • Membrane between real works and blockchain world (in Angela's use case - the de-identified raw data from the actual urine samples)
  • Timeline for the Global forum seems ambitious, but I encourage folks to think about it

Next Steps

  • Define our problem statement and pain points - what problem are we solving?
    • Initial thoughts: "to link data to users identified across silos"
    • Group agrees that a patient-centric approach is best, engaging the patient and making them collaborators in the process
  • Conduct a journey mapping exercise in order to start building requirements that developers can start with
  • Marissa will pull together a proposed 'journey mapping' session agenda for our next subgroup meeting and we can refine agenda before then via email

Questions

  • How do we ensure validity of data?
  • How do directly engage with patients/content document?

Resources:

  • Snowmed: ? (@Eli, please clarify)

Best,
Marissa

Marissa Iannarone
Associate with Forum Solutions LLC
phone number: +01 (360) 525 4961
email: mari.iannarone@...


On Mon, Jun 11, 2018 at 6:20 PM, Marissa Iannarone <mari.iannarone@...> wrote:
Hello Everyone,

This is to let you know that Cris, Angela, and Venu are planning to meet on 6/14 @ 8am PST to discuss laboratory/fertility use cases and how to work towards a Hyperledger Global Forum submission. Please let us know if you would like to join us and I'll forward the invite. Also, if anyone else is looking for support in moving an idea forward, please let me know. I'm happy to help where I can.

Best,
Marissa

Marissa Iannarone
Associate with Forum Solutions LLC
phone number: +01 (360) 525 4961
email: mari.iannarone@...



ben.taylor@sophrosynecapital.com <ben.taylor@...>
 

wikipedia.org/wiki/SNOMED_CT

Great notes, thanks!

On Jun 14, 2018, at 6:10 PM, Marissa Iannarone <mari.iannarone@...> wrote:

Hi All,

Thanks to everyone that could make the call today. Below are my notes, I will work to get these up on the wiki. Please feel free to add any comments/make changes. In summary, the group had a great discussion on several facets of the laboratory use case and how blockchain can enable a patient-centric approach to lab samples and a mechanism that facilitates work between labs. We will use our next subgroup meeting to start building out patient journeys as part of the requirements gathering activities:

Angela's Specific Use Case:

  • Aim is to use urine samples for early breast cancer detection
  • Pain point is getting the right data to feed algorithm for detection
  • Just mining data that are already out there is not feasible b/c there is specific context that is needed along with the lab sample
  • Thought is to have a patient-centric UI (ie Apple CareKit), with a blockchain backend in order to provide documentation of the sample and associated metadata (sample acquisition)

Logistics of Samples Use Case:

  • When samples get lost, there is no way to recover them, which could lead to treatment for the "worst case scenario" instead of the right treatment for the given sample results
  • Reconciliation of the "last touch problem" (the final entity to hold the sample)
  • The blockchain gives a solution to these challenges, and the opportunity/possibility to find samples that have go missing

Blockchain Value in the Laboratory Use Case

  • There are those that have data to enter the exchange, those that need data from the exchange and blockchain provides the accounting and eliminates need for intermediaries
  • The blockchain will not support the data themselves but instead the events that surround the sample
  • Any code that we can development to help the interaction with labs would be powerful
  • Idea: LOINC/HL7 enabled entity to interact with Hyperledger Fabric
  • Provides the ability to register, log, track samples

General Feedback

  • This is a complex use case, but we can segment it out so that we can attack it piece by piece
    • Segment idea: patent-center solution and logistics
  • Concept of Oracles
    • Membrane between real works and blockchain world (in Angela's use case - the de-identified raw data from the actual urine samples)
  • Timeline for the Global forum seems ambitious, but I encourage folks to think about it

Next Steps

  • Define our problem statement and pain points - what problem are we solving?
    • Initial thoughts: "to link data to users identified across silos"
    • Group agrees that a patient-centric approach is best, engaging the patient and making them collaborators in the process
  • Conduct a journey mapping exercise in order to start building requirements that developers can start with
  • Marissa will pull together a proposed 'journey mapping' session agenda for our next subgroup meeting and we can refine agenda before then via email

Questions

  • How do we ensure validity of data?
  • How do directly engage with patients/content document?

Resources:

  • Snowmed: ? (@Eli, please clarify)

Best,
Marissa

Marissa Iannarone
Associate with Forum Solutions LLC
phone number: +01 (360) 525 4961
email: mari.iannarone@...


On Mon, Jun 11, 2018 at 6:20 PM, Marissa Iannarone <mari.iannarone@...> wrote:
Hello Everyone,

This is to let you know that Cris, Angela, and Venu are planning to meet on 6/14 @ 8am PST to discuss laboratory/fertility use cases and how to work towards a Hyperledger Global Forum submission. Please let us know if you would like to join us and I'll forward the invite. Also, if anyone else is looking for support in moving an idea forward, please let me know. I'm happy to help where I can.

Best,
Marissa

Marissa Iannarone
Associate with Forum Solutions LLC
phone number: +01 (360) 525 4961
email: mari.iannarone@...



Eli Perlman
 

SNOMED https://www.nlm.nih.gov/healthit/snomedct/index.html

 

Regards, Eli

Eli B. Perlman

Vice President Alliances

BlackRidge Technology

www.blackridge.us
+1 732-257-6448

“The same boiling water that softens a potato, hardens the egg. It’s about what you are made of, not the circumstances.”

 

From: healthcare-wg@... <healthcare-wg@...> On Behalf Of Marissa Iannarone
Sent: Thursday, June 14, 2018 9:11 PM
To: healthcare-wg <healthcare-wg@...>
Subject: Re: [Hyperledger Healthcare WG] #patient-member-subgroup | Meeting Notes: Laboratory Use Cases and Hyperledger Global Forum Submission

 

Hi All,

 

Thanks to everyone that could make the call today. Below are my notes, I will work to get these up on the wiki. Please feel free to add any comments/make changes. In summary, the group had a great discussion on several facets of the laboratory use case and how blockchain can enable a patient-centric approach to lab samples and a mechanism that facilitates work between labs. We will use our next subgroup meeting to start building out patient journeys as part of the requirements gathering activities:

 

Angela's Specific Use Case:

·        Aim is to use urine samples for early breast cancer detection

·        Pain point is getting the right data to feed algorithm for detection

·        Just mining data that are already out there is not feasible b/c there is specific context that is needed along with the lab sample

·        Thought is to have a patient-centric UI (ie Apple CareKit), with a blockchain backend in order to provide documentation of the sample and associated metadata (sample acquisition)

Logistics of Samples Use Case:

·        When samples get lost, there is no way to recover them, which could lead to treatment for the "worst case scenario" instead of the right treatment for the given sample results

·        Reconciliation of the "last touch problem" (the final entity to hold the sample)

·        The blockchain gives a solution to these challenges, and the opportunity/possibility to find samples that have go missing

Blockchain Value in the Laboratory Use Case

·        There are those that have data to enter the exchange, those that need data from the exchange and blockchain provides the accounting and eliminates need for intermediaries

·        The blockchain will not support the data themselves but instead the events that surround the sample

·        Any code that we can development to help the interaction with labs would be powerful

·        Idea: LOINC/HL7 enabled entity to interact with Hyperledger Fabric

·        Provides the ability to register, log, track samples

General Feedback

·        This is a complex use case, but we can segment it out so that we can attack it piece by piece

·        Segment idea: patent-center solution and logistics

·        Concept of Oracles

·        Membrane between real works and blockchain world (in Angela's use case - the de-identified raw data from the actual urine samples)

·        Timeline for the Global forum seems ambitious, but I encourage folks to think about it

Next Steps

·        Define our problem statement and pain points - what problem are we solving?

·        Initial thoughts: "to link data to users identified across silos"

·        Group agrees that a patient-centric approach is best, engaging the patient and making them collaborators in the process

·        Conduct a journey mapping exercise in order to start building requirements that developers can start with

·        Marissa will pull together a proposed 'journey mapping' session agenda for our next subgroup meeting and we can refine agenda before then via email

Questions

·        How do we ensure validity of data?

·        How do directly engage with patients/content document?

Resources:

·        LONIC: https://loinc.org/

·        You Base: https://www.youbase.io/

·        HL7: http://www.hl7.org/

·        CLEA: http://www.electiondataarchive.org/

·        Snowmed: ? (@Eli, please clarify)

 

Best,

Marissa


Marissa Iannarone

Associate with Forum Solutions LLC

phone number: +01 (360) 525 4961
email: mari.iannarone@...

 

 

On Mon, Jun 11, 2018 at 6:20 PM, Marissa Iannarone <mari.iannarone@...> wrote:

Hello Everyone,

 

This is to let you know that Cris, Angela, and Venu are planning to meet on 6/14 @ 8am PST to discuss laboratory/fertility use cases and how to work towards a Hyperledger Global Forum submission. Please let us know if you would like to join us and I'll forward the invite. Also, if anyone else is looking for support in moving an idea forward, please let me know. I'm happy to help where I can.

 

Best,

Marissa

 

Marissa Iannarone

Associate with Forum Solutions LLC

phone number: +01 (360) 525 4961
email: mari.iannarone@...

 

 


Steven Elliott <selliott@...>
 

Systematized Nomenclature of Medicine -- Clinical Terms
SNOMED and SNOMED-CT are two ontologies used for interoperable standard clinical terminology.

Logical Observation Identifiers Names and Codes, LOINC is a terminology set used in laboratories and clinical services (including imaging) that has become the interoperable means of expressing laboratory and imaging results and is now a full ontology as well.

RxNORM is another vocabulary commonly used for interoperable expression of normalized names for clinical drugs and links its names to many of the drug vocabularies (e.g. NDF-RT, First Databank, Micromedex, etc).

Together these three terminologies provide the standardized vocabulary for interoperable clinical data and are common code systems frequently used within the HL7 FHIR standard for data exchange.  Cognitive routinely uses these ontologies to make clinical data (e.g. EHR) computable.

---------------------------------------------------------

Steven Elliott
Services Engineering Director 

Cognitive Medical Systems, Inc.
9444 Waples Street, Suite 300
San Diego, CA 92121

Office:    858-509-4949 x 117
Mobile:   520.344.0208 

Email:    selliott@...m




On Thu, Jun 14, 2018 at 6:10 PM, Marissa Iannarone <mari.iannarone@...> wrote:
Hi All,

Thanks to everyone that could make the call today. Below are my notes, I will work to get these up on the wiki. Please feel free to add any comments/make changes. In summary, the group had a great discussion on several facets of the laboratory use case and how blockchain can enable a patient-centric approach to lab samples and a mechanism that facilitates work between labs. We will use our next subgroup meeting to start building out patient journeys as part of the requirements gathering activities:

Angela's Specific Use Case:

  • Aim is to use urine samples for early breast cancer detection
  • Pain point is getting the right data to feed algorithm for detection
  • Just mining data that are already out there is not feasible b/c there is specific context that is needed along with the lab sample
  • Thought is to have a patient-centric UI (ie Apple CareKit), with a blockchain backend in order to provide documentation of the sample and associated metadata (sample acquisition)

Logistics of Samples Use Case:

  • When samples get lost, there is no way to recover them, which could lead to treatment for the "worst case scenario" instead of the right treatment for the given sample results
  • Reconciliation of the "last touch problem" (the final entity to hold the sample)
  • The blockchain gives a solution to these challenges, and the opportunity/possibility to find samples that have go missing

Blockchain Value in the Laboratory Use Case

  • There are those that have data to enter the exchange, those that need data from the exchange and blockchain provides the accounting and eliminates need for intermediaries
  • The blockchain will not support the data themselves but instead the events that surround the sample
  • Any code that we can development to help the interaction with labs would be powerful
  • Idea: LOINC/HL7 enabled entity to interact with Hyperledger Fabric
  • Provides the ability to register, log, track samples

General Feedback

  • This is a complex use case, but we can segment it out so that we can attack it piece by piece
    • Segment idea: patent-center solution and logistics
  • Concept of Oracles
    • Membrane between real works and blockchain world (in Angela's use case - the de-identified raw data from the actual urine samples)
  • Timeline for the Global forum seems ambitious, but I encourage folks to think about it

Next Steps

  • Define our problem statement and pain points - what problem are we solving?
    • Initial thoughts: "to link data to users identified across silos"
    • Group agrees that a patient-centric approach is best, engaging the patient and making them collaborators in the process
  • Conduct a journey mapping exercise in order to start building requirements that developers can start with
  • Marissa will pull together a proposed 'journey mapping' session agenda for our next subgroup meeting and we can refine agenda before then via email

Questions

  • How do we ensure validity of data?
  • How do directly engage with patients/content document?

Resources:

  • Snowmed: ? (@Eli, please clarify)

Best,
Marissa

Marissa Iannarone
Associate with Forum Solutions LLC
phone number: +01 (360) 525 4961
email: mari.iannarone@...


On Mon, Jun 11, 2018 at 6:20 PM, Marissa Iannarone <mari.iannarone@...> wrote:
Hello Everyone,

This is to let you know that Cris, Angela, and Venu are planning to meet on 6/14 @ 8am PST to discuss laboratory/fertility use cases and how to work towards a Hyperledger Global Forum submission. Please let us know if you would like to join us and I'll forward the invite. Also, if anyone else is looking for support in moving an idea forward, please let me know. I'm happy to help where I can.

Best,
Marissa

Marissa Iannarone
Associate with Forum Solutions LLC
phone number: +01 (360) 525 4961
email: mari.iannarone@...




ben.taylor@sophrosynecapital.com <ben.taylor@...>
 

Were ICD codes discarded for a reason? Are they worthy of consideration?

On Jun 15, 2018, at 9:56 AM, Steven Elliott <selliott@...> wrote:

Systematized Nomenclature of Medicine -- Clinical Terms
SNOMED and SNOMED-CT are two ontologies used for interoperable standard clinical terminology.

Logical Observation Identifiers Names and Codes, LOINC is a terminology set used in laboratories and clinical services (including imaging) that has become the interoperable means of expressing laboratory and imaging results and is now a full ontology as well.

RxNORM is another vocabulary commonly used for interoperable expression of normalized names for clinical drugs and links its names to many of the drug vocabularies (e.g. NDF-RT, First Databank, Micromedex, etc).

Together these three terminologies provide the standardized vocabulary for interoperable clinical data and are common code systems frequently used within the HL7 FHIR standard for data exchange.  Cognitive routinely uses these ontologies to make clinical data (e.g. EHR) computable.

---------------------------------------------------------

Steven Elliott
Services Engineering Director 

Cognitive Medical Systems, Inc.
9444 Waples Street, Suite 300
San Diego, CA 92121

Office:    858-509-4949 x 117
Mobile:   520.344.0208 

Email:    selliott@...m




On Thu, Jun 14, 2018 at 6:10 PM, Marissa Iannarone <mari.iannarone@...> wrote:
Hi All,

Thanks to everyone that could make the call today. Below are my notes, I will work to get these up on the wiki. Please feel free to add any comments/make changes. In summary, the group had a great discussion on several facets of the laboratory use case and how blockchain can enable a patient-centric approach to lab samples and a mechanism that facilitates work between labs. We will use our next subgroup meeting to start building out patient journeys as part of the requirements gathering activities:

Angela's Specific Use Case:

  • Aim is to use urine samples for early breast cancer detection
  • Pain point is getting the right data to feed algorithm for detection
  • Just mining data that are already out there is not feasible b/c there is specific context that is needed along with the lab sample
  • Thought is to have a patient-centric UI (ie Apple CareKit), with a blockchain backend in order to provide documentation of the sample and associated metadata (sample acquisition)

Logistics of Samples Use Case:

  • When samples get lost, there is no way to recover them, which could lead to treatment for the "worst case scenario" instead of the right treatment for the given sample results
  • Reconciliation of the "last touch problem" (the final entity to hold the sample)
  • The blockchain gives a solution to these challenges, and the opportunity/possibility to find samples that have go missing

Blockchain Value in the Laboratory Use Case

  • There are those that have data to enter the exchange, those that need data from the exchange and blockchain provides the accounting and eliminates need for intermediaries
  • The blockchain will not support the data themselves but instead the events that surround the sample
  • Any code that we can development to help the interaction with labs would be powerful
  • Idea: LOINC/HL7 enabled entity to interact with Hyperledger Fabric
  • Provides the ability to register, log, track samples

General Feedback

  • This is a complex use case, but we can segment it out so that we can attack it piece by piece
    • Segment idea: patent-center solution and logistics
  • Concept of Oracles
    • Membrane between real works and blockchain world (in Angela's use case - the de-identified raw data from the actual urine samples)
  • Timeline for the Global forum seems ambitious, but I encourage folks to think about it

Next Steps

  • Define our problem statement and pain points - what problem are we solving?
    • Initial thoughts: "to link data to users identified across silos"
    • Group agrees that a patient-centric approach is best, engaging the patient and making them collaborators in the process
  • Conduct a journey mapping exercise in order to start building requirements that developers can start with
  • Marissa will pull together a proposed 'journey mapping' session agenda for our next subgroup meeting and we can refine agenda before then via email

Questions

  • How do we ensure validity of data?
  • How do directly engage with patients/content document?

Resources:

  • Snowmed: ? (@Eli, please clarify)

Best,
Marissa

Marissa Iannarone
Associate with Forum Solutions LLC
phone number: +01 (360) 525 4961
email: mari.iannarone@...


On Mon, Jun 11, 2018 at 6:20 PM, Marissa Iannarone <mari.iannarone@...> wrote:
Hello Everyone,

This is to let you know that Cris, Angela, and Venu are planning to meet on 6/14 @ 8am PST to discuss laboratory/fertility use cases and how to work towards a Hyperledger Global Forum submission. Please let us know if you would like to join us and I'll forward the invite. Also, if anyone else is looking for support in moving an idea forward, please let me know. I'm happy to help where I can.

Best,
Marissa

Marissa Iannarone
Associate with Forum Solutions LLC
phone number: +01 (360) 525 4961
email: mari.iannarone@...




Eli Perlman
 

I think they are!

Regards, Eli

Eli B. Perlman
Vice President Alliances
BlackRidge Technology
+1 732-257-6448

“The same boiling water that softens a potato, hardens the egg. It’s about what you are made of, not the circumstances.”


From: healthcare-wg@... <healthcare-wg@...> on behalf of ben.taylor@... <ben.taylor@...>
Sent: Friday, June 15, 2018 1:06:05 PM
To: Steven Elliott; Marissa Iannarone
Cc: healthcare-wg; Ben Taylor
Subject: Re: [Hyperledger Healthcare WG] #patient-member-subgroup | Meeting Notes: Laboratory Use Cases and Hyperledger Global Forum Submission
 
Were ICD codes discarded for a reason? Are they worthy of consideration?

https://en.m.wikipedia.org/wiki/ICD-10


On Jun 15, 2018, at 9:56 AM, Steven Elliott <selliott@...> wrote:

Systematized Nomenclature of Medicine -- Clinical Terms
SNOMED and SNOMED-CT are two ontologies used for interoperable standard clinical terminology.

Logical Observation Identifiers Names and Codes, LOINC is a terminology set used in laboratories and clinical services (including imaging) that has become the interoperable means of expressing laboratory and imaging results and is now a full ontology as well.

RxNORM is another vocabulary commonly used for interoperable expression of normalized names for clinical drugs and links its names to many of the drug vocabularies (e.g. NDF-RT, First Databank, Micromedex, etc).

Together these three terminologies provide the standardized vocabulary for interoperable clinical data and are common code systems frequently used within the HL7 FHIR standard for data exchange.  Cognitive routinely uses these ontologies to make clinical data (e.g. EHR) computable.

---------------------------------------------------------

Steven Elliott
Services Engineering Director 

Cognitive Medical Systems, Inc.
9444 Waples Street, Suite 300
San Diego, CA 92121

Office:    858-509-4949 x 117
Mobile:   520.344.0208 

Email:    selliott@...m




On Thu, Jun 14, 2018 at 6:10 PM, Marissa Iannarone <mari.iannarone@...> wrote:
Hi All,

Thanks to everyone that could make the call today. Below are my notes, I will work to get these up on the wiki. Please feel free to add any comments/make changes. In summary, the group had a great discussion on several facets of the laboratory use case and how blockchain can enable a patient-centric approach to lab samples and a mechanism that facilitates work between labs. We will use our next subgroup meeting to start building out patient journeys as part of the requirements gathering activities:

Angela's Specific Use Case:

  • Aim is to use urine samples for early breast cancer detection
  • Pain point is getting the right data to feed algorithm for detection
  • Just mining data that are already out there is not feasible b/c there is specific context that is needed along with the lab sample
  • Thought is to have a patient-centric UI (ie Apple CareKit), with a blockchain backend in order to provide documentation of the sample and associated metadata (sample acquisition)

Logistics of Samples Use Case:

  • When samples get lost, there is no way to recover them, which could lead to treatment for the "worst case scenario" instead of the right treatment for the given sample results
  • Reconciliation of the "last touch problem" (the final entity to hold the sample)
  • The blockchain gives a solution to these challenges, and the opportunity/possibility to find samples that have go missing

Blockchain Value in the Laboratory Use Case

  • There are those that have data to enter the exchange, those that need data from the exchange and blockchain provides the accounting and eliminates need for intermediaries
  • The blockchain will not support the data themselves but instead the events that surround the sample
  • Any code that we can development to help the interaction with labs would be powerful
  • Idea: LOINC/HL7 enabled entity to interact with Hyperledger Fabric
  • Provides the ability to register, log, track samples

General Feedback

  • This is a complex use case, but we can segment it out so that we can attack it piece by piece
    • Segment idea: patent-center solution and logistics
  • Concept of Oracles
    • Membrane between real works and blockchain world (in Angela's use case - the de-identified raw data from the actual urine samples)
  • Timeline for the Global forum seems ambitious, but I encourage folks to think about it

Next Steps

  • Define our problem statement and pain points - what problem are we solving?
    • Initial thoughts: "to link data to users identified across silos"
    • Group agrees that a patient-centric approach is best, engaging the patient and making them collaborators in the process
  • Conduct a journey mapping exercise in order to start building requirements that developers can start with
  • Marissa will pull together a proposed 'journey mapping' session agenda for our next subgroup meeting and we can refine agenda before then via email

Questions

  • How do we ensure validity of data?
  • How do directly engage with patients/content document?

Resources:

  • Snowmed: ? (@Eli, please clarify)

Best,
Marissa

Marissa Iannarone
Associate with Forum Solutions LLC
phone number: +01 (360) 525 4961
email: mari.iannarone@...


On Mon, Jun 11, 2018 at 6:20 PM, Marissa Iannarone <mari.iannarone@...> wrote:
Hello Everyone,

This is to let you know that Cris, Angela, and Venu are planning to meet on 6/14 @ 8am PST to discuss laboratory/fertility use cases and how to work towards a Hyperledger Global Forum submission. Please let us know if you would like to join us and I'll forward the invite. Also, if anyone else is looking for support in moving an idea forward, please let me know. I'm happy to help where I can.

Best,
Marissa

Marissa Iannarone
Associate with Forum Solutions LLC
phone number: +01 (360) 525 4961
email: mari.iannarone@...




Tony Little <tony_little@...>
 

ICD and CPT should be considered as they are on claims and used as part of medical necessity determination.  I do not believe that they are always used at time of ordering, but at some point they are required for billing.


Sent with BlackBerry Work
(www.blackberry.com)

From: Eli Perlman <eperlman@...>
Date: Friday, Jun 15, 2018, 10:08 AM
To: Steven Elliott <selliott@...>, Marissa Iannarone <mari.iannarone@...>, ben.taylor@... <ben.taylor@...>
Cc: healthcare-wg <healthcare-wg@...>, Ben Taylor <ben.taylor@...>
Subject: Re: [Hyperledger Healthcare WG] #patient-member-subgroup | Meeting Notes: Laboratory Use Cases and Hyperledger Global Forum Submission

I think they are!

Regards, Eli

Eli B. Perlman
Vice President Alliances
BlackRidge Technology
+1 732-257-6448

“The same boiling water that softens a potato, hardens the egg. It’s about what you are made of, not the circumstances.”


From: healthcare-wg@... <healthcare-wg@...> on behalf of ben.taylor@... <ben.taylor@...>
Sent: Friday, June 15, 2018 1:06:05 PM
To: Steven Elliott; Marissa Iannarone
Cc: healthcare-wg; Ben Taylor
Subject: Re: [Hyperledger Healthcare WG] #patient-member-subgroup | Meeting Notes: Laboratory Use Cases and Hyperledger Global Forum Submission
 
Were ICD codes discarded for a reason? Are they worthy of consideration?

https://en.m.wikipedia.org/wiki/ICD-10


On Jun 15, 2018, at 9:56 AM, Steven Elliott <selliott@...> wrote:

Systematized Nomenclature of Medicine -- Clinical Terms
SNOMED and SNOMED-CT are two ontologies used for interoperable standard clinical terminology.

Logical Observation Identifiers Names and Codes, LOINC is a terminology set used in laboratories and clinical services (including imaging) that has become the interoperable means of expressing laboratory and imaging results and is now a full ontology as well.

RxNORM is another vocabulary commonly used for interoperable expression of normalized names for clinical drugs and links its names to many of the drug vocabularies (e.g. NDF-RT, First Databank, Micromedex, etc).

Together these three terminologies provide the standardized vocabulary for interoperable clinical data and are common code systems frequently used within the HL7 FHIR standard for data exchange.  Cognitive routinely uses these ontologies to make clinical data (e.g. EHR) computable.

---------------------------------------------------------

Steven Elliott
Services Engineering Director 

Cognitive Medical Systems, Inc.
9444 Waples Street, Suite 300
San Diego, CA 92121

Office:    858-509-4949 x 117
Mobile:   520.344.0208 

Email:    selliott@...m




On Thu, Jun 14, 2018 at 6:10 PM, Marissa Iannarone <mari.iannarone@...> wrote:
Hi All,

Thanks to everyone that could make the call today. Below are my notes, I will work to get these up on the wiki. Please feel free to add any comments/make changes. In summary, the group had a great discussion on several facets of the laboratory use case and how blockchain can enable a patient-centric approach to lab samples and a mechanism that facilitates work between labs. We will use our next subgroup meeting to start building out patient journeys as part of the requirements gathering activities:

Angela's Specific Use Case:

  • Aim is to use urine samples for early breast cancer detection
  • Pain point is getting the right data to feed algorithm for detection
  • Just mining data that are already out there is not feasible b/c there is specific context that is needed along with the lab sample
  • Thought is to have a patient-centric UI (ie Apple CareKit), with a blockchain backend in order to provide documentation of the sample and associated metadata (sample acquisition)

Logistics of Samples Use Case:

  • When samples get lost, there is no way to recover them, which could lead to treatment for the "worst case scenario" instead of the right treatment for the given sample results
  • Reconciliation of the "last touch problem" (the final entity to hold the sample)
  • The blockchain gives a solution to these challenges, and the opportunity/possibility to find samples that have go missing

Blockchain Value in the Laboratory Use Case

  • There are those that have data to enter the exchange, those that need data from the exchange and blockchain provides the accounting and eliminates need for intermediaries
  • The blockchain will not support the data themselves but instead the events that surround the sample
  • Any code that we can development to help the interaction with labs would be powerful
  • Idea: LOINC/HL7 enabled entity to interact with Hyperledger Fabric
  • Provides the ability to register, log, track samples

General Feedback

  • This is a complex use case, but we can segment it out so that we can attack it piece by piece
    • Segment idea: patent-center solution and logistics
  • Concept of Oracles
    • Membrane between real works and blockchain world (in Angela's use case - the de-identified raw data from the actual urine samples)
  • Timeline for the Global forum seems ambitious, but I encourage folks to think about it

Next Steps

  • Define our problem statement and pain points - what problem are we solving?
    • Initial thoughts: "to link data to users identified across silos"
    • Group agrees that a patient-centric approach is best, engaging the patient and making them collaborators in the process
  • Conduct a journey mapping exercise in order to start building requirements that developers can start with
  • Marissa will pull together a proposed 'journey mapping' session agenda for our next subgroup meeting and we can refine agenda before then via email

Questions

  • How do we ensure validity of data?
  • How do directly engage with patients/content document?

Resources:

  • Snowmed: ? (@Eli, please clarify)

Best,
Marissa

Marissa Iannarone
Associate with Forum Solutions LLC
phone number: +01 (360) 525 4961
email: mari.iannarone@...


On Mon, Jun 11, 2018 at 6:20 PM, Marissa Iannarone <mari.iannarone@...> wrote:
Hello Everyone,

This is to let you know that Cris, Angela, and Venu are planning to meet on 6/14 @ 8am PST to discuss laboratory/fertility use cases and how to work towards a Hyperledger Global Forum submission. Please let us know if you would like to join us and I'll forward the invite. Also, if anyone else is looking for support in moving an idea forward, please let me know. I'm happy to help where I can.

Best,
Marissa

Marissa Iannarone
Associate with Forum Solutions LLC
phone number: +01 (360) 525 4961
email: mari.iannarone@...




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Tony Little <tony_little@...>
 

My comment was very U.S. revenue cycle based. :-)


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From: Tony Little <tony_little@...>
Date: Friday, Jun 15, 2018, 10:16 AM
To: Eli Perlman <eperlman@...>, Steven Elliott <selliott@...>, Marissa Iannarone <mari.iannarone@...>, ben.taylor@... <ben.taylor@...>
Cc: healthcare-wg <healthcare-wg@...>, Ben Taylor <ben.taylor@...>
Subject: Re: [Hyperledger Healthcare WG] #patient-member-subgroup | Meeting Notes: Laboratory Use Cases and Hyperledger Global Forum Submission

ICD and CPT should be considered as they are on claims and used as part of medical necessity determination.  I do not believe that they are always used at time of ordering, but at some point they are required for billing.


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From: Eli Perlman <eperlman@...>
Date: Friday, Jun 15, 2018, 10:08 AM
To: Steven Elliott <selliott@...>, Marissa Iannarone <mari.iannarone@...>, ben.taylor@... <ben.taylor@...>
Cc: healthcare-wg <healthcare-wg@...>, Ben Taylor <ben.taylor@...>
Subject: Re: [Hyperledger Healthcare WG] #patient-member-subgroup | Meeting Notes: Laboratory Use Cases and Hyperledger Global Forum Submission

I think they are!

Regards, Eli

Eli B. Perlman
Vice President Alliances
BlackRidge Technology
+1 732-257-6448

“The same boiling water that softens a potato, hardens the egg. It’s about what you are made of, not the circumstances.”


From: healthcare-wg@... <healthcare-wg@...> on behalf of ben.taylor@... <ben.taylor@...>
Sent: Friday, June 15, 2018 1:06:05 PM
To: Steven Elliott; Marissa Iannarone
Cc: healthcare-wg; Ben Taylor
Subject: Re: [Hyperledger Healthcare WG] #patient-member-subgroup | Meeting Notes: Laboratory Use Cases and Hyperledger Global Forum Submission
 
Were ICD codes discarded for a reason? Are they worthy of consideration?

https://en.m.wikipedia.org/wiki/ICD-10


On Jun 15, 2018, at 9:56 AM, Steven Elliott <selliott@...> wrote:

Systematized Nomenclature of Medicine -- Clinical Terms
SNOMED and SNOMED-CT are two ontologies used for interoperable standard clinical terminology.

Logical Observation Identifiers Names and Codes, LOINC is a terminology set used in laboratories and clinical services (including imaging) that has become the interoperable means of expressing laboratory and imaging results and is now a full ontology as well.

RxNORM is another vocabulary commonly used for interoperable expression of normalized names for clinical drugs and links its names to many of the drug vocabularies (e.g. NDF-RT, First Databank, Micromedex, etc).

Together these three terminologies provide the standardized vocabulary for interoperable clinical data and are common code systems frequently used within the HL7 FHIR standard for data exchange.  Cognitive routinely uses these ontologies to make clinical data (e.g. EHR) computable.

---------------------------------------------------------

Steven Elliott
Services Engineering Director 

Cognitive Medical Systems, Inc.
9444 Waples Street, Suite 300
San Diego, CA 92121

Office:    858-509-4949 x 117
Mobile:   520.344.0208 

Email:    selliott@...m




On Thu, Jun 14, 2018 at 6:10 PM, Marissa Iannarone <mari.iannarone@...> wrote:
Hi All,

Thanks to everyone that could make the call today. Below are my notes, I will work to get these up on the wiki. Please feel free to add any comments/make changes. In summary, the group had a great discussion on several facets of the laboratory use case and how blockchain can enable a patient-centric approach to lab samples and a mechanism that facilitates work between labs. We will use our next subgroup meeting to start building out patient journeys as part of the requirements gathering activities:

Angela's Specific Use Case:

  • Aim is to use urine samples for early breast cancer detection
  • Pain point is getting the right data to feed algorithm for detection
  • Just mining data that are already out there is not feasible b/c there is specific context that is needed along with the lab sample
  • Thought is to have a patient-centric UI (ie Apple CareKit), with a blockchain backend in order to provide documentation of the sample and associated metadata (sample acquisition)

Logistics of Samples Use Case:

  • When samples get lost, there is no way to recover them, which could lead to treatment for the "worst case scenario" instead of the right treatment for the given sample results
  • Reconciliation of the "last touch problem" (the final entity to hold the sample)
  • The blockchain gives a solution to these challenges, and the opportunity/possibility to find samples that have go missing

Blockchain Value in the Laboratory Use Case

  • There are those that have data to enter the exchange, those that need data from the exchange and blockchain provides the accounting and eliminates need for intermediaries
  • The blockchain will not support the data themselves but instead the events that surround the sample
  • Any code that we can development to help the interaction with labs would be powerful
  • Idea: LOINC/HL7 enabled entity to interact with Hyperledger Fabric
  • Provides the ability to register, log, track samples

General Feedback

  • This is a complex use case, but we can segment it out so that we can attack it piece by piece
    • Segment idea: patent-center solution and logistics
  • Concept of Oracles
    • Membrane between real works and blockchain world (in Angela's use case - the de-identified raw data from the actual urine samples)
  • Timeline for the Global forum seems ambitious, but I encourage folks to think about it

Next Steps

  • Define our problem statement and pain points - what problem are we solving?
    • Initial thoughts: "to link data to users identified across silos"
    • Group agrees that a patient-centric approach is best, engaging the patient and making them collaborators in the process
  • Conduct a journey mapping exercise in order to start building requirements that developers can start with
  • Marissa will pull together a proposed 'journey mapping' session agenda for our next subgroup meeting and we can refine agenda before then via email

Questions

  • How do we ensure validity of data?
  • How do directly engage with patients/content document?

Resources:

  • Snowmed: ? (@Eli, please clarify)

Best,
Marissa

Marissa Iannarone
Associate with Forum Solutions LLC
phone number: +01 (360) 525 4961
email: mari.iannarone@...


On Mon, Jun 11, 2018 at 6:20 PM, Marissa Iannarone <mari.iannarone@...> wrote:
Hello Everyone,

This is to let you know that Cris, Angela, and Venu are planning to meet on 6/14 @ 8am PST to discuss laboratory/fertility use cases and how to work towards a Hyperledger Global Forum submission. Please let us know if you would like to join us and I'll forward the invite. Also, if anyone else is looking for support in moving an idea forward, please let me know. I'm happy to help where I can.

Best,
Marissa

Marissa Iannarone
Associate with Forum Solutions LLC
phone number: +01 (360) 525 4961
email: mari.iannarone@...




This e-mail, including attachments, may include confidential and/or
proprietary information, and may be used only by the person or entity
to which it is addressed. If the reader of this e-mail is not the intended
recipient or his or her authorized agent, the reader is hereby notified
that any dissemination, distribution or copying of this e-mail is
prohibited. If you have received this e-mail in error, please notify the
sender by replying to this message and delete this e-mail immediately.


This e-mail, including attachments, may include confidential and/or
proprietary information, and may be used only by the person or entity
to which it is addressed. If the reader of this e-mail is not the intended
recipient or his or her authorized agent, the reader is hereby notified
that any dissemination, distribution or copying of this e-mail is
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Steven Elliott <selliott@...>
 

Absolutely, ICD-9/10 codes are used in health systems mostly diagnostics (CPT codes as well for billing) so they must be part of the knowledge base.  Some systems are moving from ICD-9/10 to SNOMED because it has greater specificity and is hierarchical.  For these reasons most systems will use SNOMED with FHIR although I have seen both CPT and ICD-9/10 used as well - they are not as interoperable, though, because of the lack of specificity and the inability to describe complex findings and of course CPT is proprietary.

---------------------------------------------------------

Steven Elliott
Services Engineering Director 

Cognitive Medical Systems, Inc.
9444 Waples Street, Suite 300
San Diego, CA 92121

Office:    858-509-4949 x 117
Mobile:   520.344.0208 

Email:    selliott@...m



On Fri, Jun 15, 2018 at 10:06 AM, Ben Taylor <ben.taylor@...> wrote:
Were ICD codes discarded for a reason? Are they worthy of consideration?

https://en.m.wikipedia.org/wiki/ICD-10


On Jun 15, 2018, at 9:56 AM, Steven Elliott <selliott@cognitivemedicine.com> wrote:

Systematized Nomenclature of Medicine -- Clinical Terms
SNOMED and SNOMED-CT are two ontologies used for interoperable standard clinical terminology.

Logical Observation Identifiers Names and Codes, LOINC is a terminology set used in laboratories and clinical services (including imaging) that has become the interoperable means of expressing laboratory and imaging results and is now a full ontology as well.

RxNORM is another vocabulary commonly used for interoperable expression of normalized names for clinical drugs and links its names to many of the drug vocabularies (e.g. NDF-RT, First Databank, Micromedex, etc).

Together these three terminologies provide the standardized vocabulary for interoperable clinical data and are common code systems frequently used within the HL7 FHIR standard for data exchange.  Cognitive routinely uses these ontologies to make clinical data (e.g. EHR) computable.

---------------------------------------------------------

Steven Elliott
Services Engineering Director 

Office:    858-509-4949 x 117
Mobile:   520.344.0208 

Email:    selliott@...m




On Thu, Jun 14, 2018 at 6:10 PM, Marissa Iannarone <mari.iannarone@...> wrote:
Hi All,

Thanks to everyone that could make the call today. Below are my notes, I will work to get these up on the wiki. Please feel free to add any comments/make changes. In summary, the group had a great discussion on several facets of the laboratory use case and how blockchain can enable a patient-centric approach to lab samples and a mechanism that facilitates work between labs. We will use our next subgroup meeting to start building out patient journeys as part of the requirements gathering activities:

Angela's Specific Use Case:

  • Aim is to use urine samples for early breast cancer detection
  • Pain point is getting the right data to feed algorithm for detection
  • Just mining data that are already out there is not feasible b/c there is specific context that is needed along with the lab sample
  • Thought is to have a patient-centric UI (ie Apple CareKit), with a blockchain backend in order to provide documentation of the sample and associated metadata (sample acquisition)

Logistics of Samples Use Case:

  • When samples get lost, there is no way to recover them, which could lead to treatment for the "worst case scenario" instead of the right treatment for the given sample results
  • Reconciliation of the "last touch problem" (the final entity to hold the sample)
  • The blockchain gives a solution to these challenges, and the opportunity/possibility to find samples that have go missing

Blockchain Value in the Laboratory Use Case

  • There are those that have data to enter the exchange, those that need data from the exchange and blockchain provides the accounting and eliminates need for intermediaries
  • The blockchain will not support the data themselves but instead the events that surround the sample
  • Any code that we can development to help the interaction with labs would be powerful
  • Idea: LOINC/HL7 enabled entity to interact with Hyperledger Fabric
  • Provides the ability to register, log, track samples

General Feedback

  • This is a complex use case, but we can segment it out so that we can attack it piece by piece
    • Segment idea: patent-center solution and logistics
  • Concept of Oracles
    • Membrane between real works and blockchain world (in Angela's use case - the de-identified raw data from the actual urine samples)
  • Timeline for the Global forum seems ambitious, but I encourage folks to think about it

Next Steps

  • Define our problem statement and pain points - what problem are we solving?
    • Initial thoughts: "to link data to users identified across silos"
    • Group agrees that a patient-centric approach is best, engaging the patient and making them collaborators in the process
  • Conduct a journey mapping exercise in order to start building requirements that developers can start with
  • Marissa will pull together a proposed 'journey mapping' session agenda for our next subgroup meeting and we can refine agenda before then via email

Questions

  • How do we ensure validity of data?
  • How do directly engage with patients/content document?

Resources:

  • Snowmed: ? (@Eli, please clarify)

Best,
Marissa

Marissa Iannarone
Associate with Forum Solutions LLC
phone number: +01 (360) 525 4961
email: mari.iannarone@...


On Mon, Jun 11, 2018 at 6:20 PM, Marissa Iannarone <mari.iannarone@...> wrote:
Hello Everyone,

This is to let you know that Cris, Angela, and Venu are planning to meet on 6/14 @ 8am PST to discuss laboratory/fertility use cases and how to work towards a Hyperledger Global Forum submission. Please let us know if you would like to join us and I'll forward the invite. Also, if anyone else is looking for support in moving an idea forward, please let me know. I'm happy to help where I can.

Best,
Marissa

Marissa Iannarone
Associate with Forum Solutions LLC
phone number: +01 (360) 525 4961
email: mari.iannarone@...





Brian Ahier
 

+1 to Steven

On Fri, Jun 15, 2018 at 2:05 PM, Steven Elliott <selliott@...> wrote:
Absolutely, ICD-9/10 codes are used in health systems mostly diagnostics (CPT codes as well for billing) so they must be part of the knowledge base.  Some systems are moving from ICD-9/10 to SNOMED because it has greater specificity and is hierarchical.  For these reasons most systems will use SNOMED with FHIR although I have seen both CPT and ICD-9/10 used as well - they are not as interoperable, though, because of the lack of specificity and the inability to describe complex findings and of course CPT is proprietary.

---------------------------------------------------------

Steven Elliott
Services Engineering Director 

Office:    858-509-4949 x 117
Mobile:   520.344.0208 

Email:    selliott@...m



On Fri, Jun 15, 2018 at 10:06 AM, Ben Taylor <ben.taylor@sophrosynecapital.com> wrote:
Were ICD codes discarded for a reason? Are they worthy of consideration?

https://en.m.wikipedia.org/wiki/ICD-10


On Jun 15, 2018, at 9:56 AM, Steven Elliott <selliott@...m> wrote:

Systematized Nomenclature of Medicine -- Clinical Terms
SNOMED and SNOMED-CT are two ontologies used for interoperable standard clinical terminology.

Logical Observation Identifiers Names and Codes, LOINC is a terminology set used in laboratories and clinical services (including imaging) that has become the interoperable means of expressing laboratory and imaging results and is now a full ontology as well.

RxNORM is another vocabulary commonly used for interoperable expression of normalized names for clinical drugs and links its names to many of the drug vocabularies (e.g. NDF-RT, First Databank, Micromedex, etc).

Together these three terminologies provide the standardized vocabulary for interoperable clinical data and are common code systems frequently used within the HL7 FHIR standard for data exchange.  Cognitive routinely uses these ontologies to make clinical data (e.g. EHR) computable.

---------------------------------------------------------

Steven Elliott
Services Engineering Director 

Office:    858-509-4949 x 117
Mobile:   520.344.0208 

Email:    selliott@...m




On Thu, Jun 14, 2018 at 6:10 PM, Marissa Iannarone <mari.iannarone@...> wrote:
Hi All,

Thanks to everyone that could make the call today. Below are my notes, I will work to get these up on the wiki. Please feel free to add any comments/make changes. In summary, the group had a great discussion on several facets of the laboratory use case and how blockchain can enable a patient-centric approach to lab samples and a mechanism that facilitates work between labs. We will use our next subgroup meeting to start building out patient journeys as part of the requirements gathering activities:

Angela's Specific Use Case:

  • Aim is to use urine samples for early breast cancer detection
  • Pain point is getting the right data to feed algorithm for detection
  • Just mining data that are already out there is not feasible b/c there is specific context that is needed along with the lab sample
  • Thought is to have a patient-centric UI (ie Apple CareKit), with a blockchain backend in order to provide documentation of the sample and associated metadata (sample acquisition)

Logistics of Samples Use Case:

  • When samples get lost, there is no way to recover them, which could lead to treatment for the "worst case scenario" instead of the right treatment for the given sample results
  • Reconciliation of the "last touch problem" (the final entity to hold the sample)
  • The blockchain gives a solution to these challenges, and the opportunity/possibility to find samples that have go missing

Blockchain Value in the Laboratory Use Case

  • There are those that have data to enter the exchange, those that need data from the exchange and blockchain provides the accounting and eliminates need for intermediaries
  • The blockchain will not support the data themselves but instead the events that surround the sample
  • Any code that we can development to help the interaction with labs would be powerful
  • Idea: LOINC/HL7 enabled entity to interact with Hyperledger Fabric
  • Provides the ability to register, log, track samples

General Feedback

  • This is a complex use case, but we can segment it out so that we can attack it piece by piece
    • Segment idea: patent-center solution and logistics
  • Concept of Oracles
    • Membrane between real works and blockchain world (in Angela's use case - the de-identified raw data from the actual urine samples)
  • Timeline for the Global forum seems ambitious, but I encourage folks to think about it

Next Steps

  • Define our problem statement and pain points - what problem are we solving?
    • Initial thoughts: "to link data to users identified across silos"
    • Group agrees that a patient-centric approach is best, engaging the patient and making them collaborators in the process
  • Conduct a journey mapping exercise in order to start building requirements that developers can start with
  • Marissa will pull together a proposed 'journey mapping' session agenda for our next subgroup meeting and we can refine agenda before then via email

Questions

  • How do we ensure validity of data?
  • How do directly engage with patients/content document?

Resources:

  • Snowmed: ? (@Eli, please clarify)

Best,
Marissa

Marissa Iannarone
Associate with Forum Solutions LLC
phone number: +01 (360) 525 4961
email: mari.iannarone@...


On Mon, Jun 11, 2018 at 6:20 PM, Marissa Iannarone <mari.iannarone@...> wrote:
Hello Everyone,

This is to let you know that Cris, Angela, and Venu are planning to meet on 6/14 @ 8am PST to discuss laboratory/fertility use cases and how to work towards a Hyperledger Global Forum submission. Please let us know if you would like to join us and I'll forward the invite. Also, if anyone else is looking for support in moving an idea forward, please let me know. I'm happy to help where I can.

Best,
Marissa

Marissa Iannarone
Associate with Forum Solutions LLC
phone number: +01 (360) 525 4961
email: mari.iannarone@...






A. Courtney
 

Hello patient member group,
While surfing on EHR providers, it turns out Epic, one of the largest providers of health records software to hospitals has a method for patients to share their records through a button. The records sent are human readable not code centric and are temporary. Perhaps we can collaborate with Epic to expand to adding a "for research button" which can link to drop the data into our creation de-identified. Eliminating the need for us to get into the code weeds. Codes generally do not capture the medical details and are most useful for billing and less useful for understanding the patient dynamic. Which is why records are shared Dr to Dr and not just codes.  Perhaps, what they have built might stimulate conversations around a build method if we cannot or choose not to  collaborate with them. Here are 2 links to what Epic has built in regards to patients ability to share their data:

Thanks!