mHealth, cloud computing vie for attention at GHIT conference

June 19, 2012 Tom Sullivan, Editor, Government Health IT

Cloud computing services and mobile health tools took up considerable space on the expo floor of the recent Government Health IT Conference.
For starters, Northrop Grumman and Medicomp revealed the yield of a partnership: Northrop Grumman's Clinician App, an iteration of the Defense Department's AHLTA electronic health record system that runs on a seven-inch Samsung Android tablet.

"Clinician App is an extension of the ALTHA system," said Karen Chapman, Northrop Grumman's project manager. "We took core functionality, the pieces clinicians need, and put that on the Android tablet. Clinicians have what they need to do their job right in their own pocket."

Physicians and clinicians might use the tablet application to view patient history or documentation modules, snap pictures or share resources with patients during a visit.
Medicomp's MEDCIN engine, which Northrop Grumman integrated into Clinician App, essentially maps documentation to reference terminology including CPT, DSM, ICD, LOINC, RxNorm and SNOMED-CT. Clinician App uses REST Web services to read and write data back-and-forth with the AHLTA system, via Wi-Fi, 3G or 4G.
"It's the only app that writes data back to AHLTA servers," Chapman said.

Because it uses Web services protocols, Clinician App could potentially serve as a front-end mobile app to just about any EHR supporting those same standards. The VA's VistA is "certainly a possibility for the future," Chapman said, "as are commercial EHRs."

But first, the pilot. Chapman said Northrop Grumman has finished the prototype and is seeking a military facility to test Clinician App and provide feedback.

Also on the mobile front at the show, Terrarecon showed off its Intuition cloud-based visualization and clinical application, which enables customers to upload data and visual images to the cloud and distribute them via browsers such that they can be accessed from a variety of devices.

Aegis used the show to launch its cloud-based Developers Integration Lab (DIL), a hosted testing environment in which to gauge whether their gateways meet the interoperability requirements of other health entities.

Whereas interoperability testing typically requires organizations to message each other, hold meetings, read logs and debug the process, according to Aegis consultant Michael Brown, the DIL enables healthcare entities to test their gateways against those of health partners.

"In a nutshell, the mission the DIL hopes to accomplish is to ensure interoperability among healthcare organizations by providing a 'one-stop-shop' for gateway and interoperability testing," Brown said.

Cloud and mobile technologies both trigger privacy and security concerns – most certainly in the government and public health frays.

To that end, Will Phelps, an IT security specialist in the Office of the National Coordinator for Health IT's Office of the Chief Privacy Officer, shared research finding that while 81 percent of physicians use smart phones or tablets, very few safeguard them, even though Blackberry and iPhone devices meet some 60 percent of the security requirements, albeit after manual configuration. "You have to make sure that the devices are able to apply the appropriate security controls to make sure that the patient records are protected," said Phelps. "We want to reach out to the provider community to make sure that they are able to do these things."

ONC said that it will release this fall a set of best practices for securing mobile devices. One day those might apply to Northrop Grumman's Android-based AHLTA tablet application – that seems likely once Clinician App lifts out of its pilot phase.

Next year's Government Health IT Conference and Expo is already on the calendar for June 12 and 13, 2013, at the Renaissance Washington, D.C., Downtown Hotel. 