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Bringing Connected Diagnostics to Scale
Connected Diagnostics Opportunity
Improve Linkage to Care
Reduce Loss to Follow Up
Improve Surveillance Reduce
Transcription Errors
Monitor Quality
Assurance Reduce Stock
Outs
Improve Training & HR
Diagnostics Data
Challenge - Fragmented Data Collection
Dx1 Portal Dx2 Portal Dx3 .. No portal
Dx1 Dx2 Dx3
Aggregated View Across Diagnostics
DX2
DX1
DX3
DX2 Portal
DX1 Portal
?
Useful DX1 info
Useful DX2 info
CDx: Connected Diagnostics Initiative
CDx Platform:
CDx Initiative:
• Technology & Services
• Transmit & store data
• Multiple diseases, manufacturers
• Open source
• Secure, PII privacy
• Commitment to standards
• Manufacturer engagement
• Policy maker engagement
• Design Advisory Board
• Ecosystem of field support vendors
• Evaluation and Research
InSTEDD specializes in designing open
source, scalable technology tools to solve
critical health, safety and development issues.
FIND’s expertise is in the domain of diagnostic
development and delivery, particularly for
infectious diseases.
CDx Platform
Accelerates connecting new devices by manufacturers & 3rd parties
Device Software
Open & standards-based protocols for 2 way communication between devices and servers. See dxapi.org
Protocols
Software that can run in the cloud or your own servers. Aggregates device, result, error and other information
Servers & Services
Ecosystem of ehealth & mhealth tools: EMR, ERP, TB Dashboards, HIMS, mobile alerts, etc.
3rd Party Applications
etc….
Trained resources for eHealth interventions
CDx Initiative Areas of Effort
Hospitals
& Labs Health post Community
health
worker
eHealth policy & strategy
Evidence of eHealth impact
Standards & Interoperability
Centralised data collection, sharing & access
A
B
D
C
E
National health
programs
Global policy
& surveillance
CDx 1.0 Platform Sneak Peak
CDx Preview – Basic Stats
CDx Preview - Errors
CDx Preview – Filters & Alerts
Multiple Perspectives
CDx Preview – Mapping Results
CDx Preview – Workflow Views
CDx Preview – Data Sharing
CDx 1.0 - Offering
• Platform
– Version 1.0 – Q1 2016
– Available both cloud & institution-hosted
– A portfolio of TB diagnostics
• Technical Assistance
– CDx server deployment guide
– User guide
GeneXpert
Omni
BACTEC
MGIT
GenoScan
Cepheid Alere
Alere-q
BD
Micro Imager
Hain
Mike Turnlund VP/GM, Engineering & Software
Cepheid
Connectivity & Roles in the Ecosystem
• Centralized, multivendor data systems (EMR, ERP, etc) are best served by ISVs, not device manufacturers
• Quick integration of secure data streams makes system adoption easier
• Different roles mean different data needs for institutions and manufacturers
• Manufacturers: system heuristics, usage, errors
• Institution: EMRs, epidemiology, logistics
• CDx allows for quick, uniform, contextual large scale diagnostic system data collection for an institution
Data Streams in a CDX Ecosystem
GeneXpert harvests data and Transmits to RemoteXpert
CDX local server receives data and stores it in institution EMR
Tests run on lab devices – cross labs and geos
Heterogeneous devices transmit data in CDX format
Institution X data
Institution, NGO users log into their servers and use aggregated regional EMR and logistical data
RemoteXpert receives data and securely stores it, generates machine health analysis and alerts
CDX client transmits formatted data from GX to institution servers
RemoteXpert GeneXpert
CDX
CDx Cepheid Support
• Cepheid supports integration with many different LIS, EMR, and multi-disciplined ecosystem tools
• Secure, structured integration with all data systems is vital
• Quicker, structured integration of comprehensive diagnostics data (not just PCR) frees up resources, accelerates care
• Cepheid will make available open source clients for it’s systems to securely and robustly support data transmission in the CDx format to support the initiative
Anita Suresh Worldwide Mktg Manager, TB Diagnostics
BD Diagnostics
“BD's vision is to enable fully
integrated and connected
informatics solutions for our
diagnostics customers.
In TB, this would include real-
time reporting, data aggregation
and surveillance tools, bringing
together diagnostic results
across multiple platforms at
multiple health settings.
BD is partnering with the
Connected Diagnostics Initiative
to achieve these goals while
allowing institutions to customize
their solutions to drive clinical
impact. ”
Dr. Dennis Falzon Global TB Programme
WHO
Global tuberculosis report 2015 (WHO/HTM/TB/2015.22). Geneva, World Health Organization. Geneva, World Health Organization; 2015. www.who.int/tb/publications/global_report/en/
MDR−TB cases and additional rifampicin−resistant TB cases detected (orange) compared with TB cases enrolled on MDR−TB treatment (blue), global trend and trend in 27 high MDR−TB
burden countries, 2009−−2014
Uses of TB Laboratory Information
1) The requisition, receipt, scheduling and performance of tests
2) The collection and management of samples, and the chain of custody
3) The distribution of test results to clinicians
4) Inventory
5) General laboratory reporting (including billing and contracts)
6) Workload statistics and laboratory performance
7) Surveillance of TB and drug-resistance
8) Human resources development, including training
9) Quality control and external quality assessment processes
10) Laboratory biosafety measures
11) Others (specific to an individual laboratory)
Laboratory Informatics
• Strengthening TB laboratory informatics important
- Laboratory confirmation desirable in both TB/DR-TB
patients
- Case detection data (TB & DR-TB) are often sourced
directly from laboratories
- As diagnostics become more advanced even in low
resource settings, weaknesses in information
management become more pronounced
- Better informatics offer other potential to improve care
and laboratory performance.
WHO/ERS. Digital health for the End TB Strategy: an agenda for action. (WHO/HTM/TB/2015.21). Geneva, World Health Organization; 2015.
“Connected diagnostics” : a logical
first step in the development of TB
laboratory informatics
Extensive Existing & Planned Clients
• Increasing
coverage of
common ehealth &
mhealth solutions
• From self-contained
to national scale
• Promiscuous
interoperability a
core goal
2016 Efforts
• CDX Advisory Board
• Additional Manufacturer Support
• Implementations
• Research & Evidence
Thank you
For further information please visit
cdx.io