mHIMSS Roadmap 5

7/30/2019 mHIMSS Roadmap 5

http://slidepdf.com/reader/full/mhimss-roadmap-5 1/15

5-01mHIMSS Roadmap

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StandardS andInteroperabIlIty

5Standardsand Interoperability

ContentS

Role o Standards ��5-02

Telecommunications Standards and Organizations �� 5-02

Wireless Health and mHealth Organizations ��5-08

Table o Engagement Opportuniti es or mHealth Standards �� 5-10

“At-a-Glance” Standards Overview ��5-11

Strategies and Recommendations ��5-14

Authors �� 5-14

Reerences ��5-14

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5-02mHIMSS Roadmap



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Role of Standards

Never in history has standards in health-

care been more important. “Health data

is doubling (volume) every 18 months”,

stated Tina Brown-Stevens at the 2012

StrataRX conerence in 20121. This exponential rate

o data growth is just one o the reasons standard are

needed to capture this deluge o data in healthcare.

Standards take on dierent roles in dierent area

o healthcare IT, however, interoperability standards

provide the cornerstone or building usable inter-

aces between disparate systems. Mobile systems and

devices are becoming more prevalent in Healthcare.

Nevertheless they are just starting to be recognized

by traditional standards committees (e.g., HL7) and

agencies (e.g., FDA, FCC, FTC). Non-proft organi-

zation, such as Continua Health Alliance, produces

development guidelines based on existing standards

that ocus on mobile health product certifcation.

Happtique, a startup or-proft company has been

working on mobile health App guidelines, their own

standards and accompanying App certifcation pro-gram. John Wilbanks reerence to caution o mo-

nopolies in standards; “We’re aced with this choice

right now, and the decisions we make will defne the

next twenty years o technology in health.”2

This section o the mHIMSS Roadmap illustrates

the current state o interoperability standards in

mobile health (aka, mHealth). Telehealth systems

and wireless devices (e.g., smartphone, tablets and

sensors) are used or remote monitoring and disease

management as an extension to traditional health-

care deliver. Remote-monitoring and patient-report-

ed data collection sensors and wireless devices that

are accessed within healthcare acilities and beyond

require standards and interoperability certiica-

tions. Hospital administrators need to consider the

standards options needed to support their current

systems and the uture growth.

Mobile Health IT (mHealth IT) an Overview

The Pew Internet Project reported that 40 percent o

American adults accesses the Internet via their mobile

phones, and in some cases, mobile phones are their

primary source o Internet access� Twenty-ve percent

o smart-phone owners go online primarily using their

phone; o these, roughly one-third have no high-speed

home broadband connection� Thereore, it is not

surprised that healthcare providers and hospitals would

want to move into this area and leverage the increase

usage o mobile devices to improve the delivery and cost

eectiveness o care�

As hospital admin istrators consider mobil ity or their

hospital environment they must rethink the workfow

and interaction with the patient beyond the hospital’s

walls� The Cloud inrastructure, which enables mobile

and extends the providers ability to utilize multiple

devices that capture patient data and store within

the EHR encounter all require standards� This section

provides a brie overview o many o the standards

available today and their role or dening communication

leading to interoperability�

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5-03mHIMSS Roadmap



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mHealth Example Business Continuation Benchmark

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See other examples o mHealth examples in

Issues in Technology Innovation rom mHIMSS�

The ollowing is a list o interchange between:

■ Mobile to mobile devices or visual output systems

(M2M - aka machine to machine),

■ Mobile to internal hospital system electronic medical

record (M2EMR),

■ Mobile to patient (M2Patient),

■ Mobile to Device (M2D)

■ Mobile to electronic health record (M2EHR),

■ Mobile to external health inormation

exchange (M2HIE)�

Challenges in Mobile Health4

■ Mobile Devices vs� Controlled/ Secure Network Environments

■ Limited Local Storage vs� Cloud Storage

■ All-in-one device vs� Bluetooth and

secondary computing

■ Tablet/Phone - GPS, Image, Audio,

Video and Text Capture

■ Scale, BP Cu,

■ No Dominant Platorm Form

Tool

■

Tablets■ Phones

■ Smartphones

■ Phablets

■ Other Devices

Operating System

■ IOS

■ Windows Mobile

■ Android

■ Blackberry

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5-04mHIMSS Roadmap



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ATIS

In 2011 ATIS Wireless Technologies and Systems

Committee (WTSC) ocused eorts in mobile healthcare�

The ATIS mHealth initiative ocuses primarily on protocols

and enhancements to wireless networks and the IP

Multimedia Subsystem (IMS) to securely transport

medical data, rather than dening the actual content o

the data that will be sent to health providers� As such,

ATIS plans to work closely with other groups, such as

Continua, Liecomm, GSMA and mHealth Alliance to

dene an end-to-end system or mHealth�

About the ATIS Wireless Technologies

and Systems Committee

The ATIS Wireless Technologies and Systems Committee(WTSC) develops and recommends standards related to

wireless and/or mobile services and systems, including

service descriptions and wireless technologies� WTSC

develops and recommends positions on related subjects

under consideration in other North American, regional

and international standards bodies� For more inormation,

please visit the WTSC website�

About ATIS

ATIS is the leading technical planning and standards

development organization committed to the rapid

development o global, market-driven standards or the

TelecommunicationsStandards and OrganizationsCurrently, telecommunication carriers are developing

new architectures and networks to improve wireless

broadband throughput� Presently, the carriers are using:

■ 3G (3rd Generation telecommunication) that meets

the International Mobile Telecommunications (IMT)

2000 technical standards/specications rom the

International Telecommunication Union, including

standards or reliability and speed (data transer rates)

– this includes wide-area wireless telephone, mobile

Internet access, video calls, and mobile television -

can provide peak data rates up to 56 Mbit/s in thedownlink in theory (28 Mbit/s in existing services) and

22 Mbit/s in the uplink�

■ 4G (4th Generation telecommunication) to allow

ultra-broadband Internet Services or devices with

USB wireless modems, IP telephone, high-denition

TV, video conerencing – use either the Long term

evolution (LTE) standard (Scandinavia 2009), IMT 2000

technical standards, IEEE 802�16m, or WirelessMAN-

Advanced�

■ Other next-gen wireless

The speeds and capability o wireless will continueto grow� International Mobile Telecommunications -

Advanced (IMT-Advanced) may be the next 5G with

speeds up to 10 times aster than 4G5

■ Telecommunications and managing costs:

http://www�temia�org/resources/view-webinars/205-

healthcare-and-telecom-expense-management-

nding-the-right-prescription-or-curing-chronic-costs

■ WBAN -Wireless Body Area Network

■ IEEE 802�11x (Wi-Fi) Connectivity Protocols

Programming Language

■ Objective C

■ C#

■ Java

■ HTML, CSS, JavaScript

■ Emerging Standards

HTML-5

*Source: Keith W� Boone, Standards Opportunities in

Mobile Health, Healthcare Interoperability: ‘ocus on SOA

and Modeling’, June 20, 2012

Telecommunications Connectivity Standards

and Health Information Exchange Standards:

■ FCC Broadband Plan –

■

Recommends substantial changes to the FCC’sRural Health Care Program, better utilizing

authorized unding o $400 M per year to help meet

these challenges�

■ Recommendations will help health care providers

purchase broadband services and expand the

program to more institutions�

■ Improve Indian Health Services broadband

inrastructure

■ Create the economic incentives or broader health IT

adoption and innovation

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5-05mHIMSS Roadmap



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inormation, entertainment and communications industry�

More than 200 companies actively ormulate standards

in ATIS’ Committees, covering issues including: IPTV,

Cloud Services, Energy Eciency, IP-Based and

Wireless Technologies, Quality o Service, Billing and

Operational Support, Emergency Services, Architectural

Platorms and Emerging Networks� In addition, numerous

Incubators, Focus and Exploratory Groups address

evolving industry priorities including Smart Grid, Machine-

to-Machine, Networked Car, IP Downloadable Security,

Policy Management and Network Optimization�

ATIS is the North American Organizational

Partner or the 3rd Generation Partnership Project

(3GPP), a member and major U�S� contributor to the

International Telecommunication Union (ITU) Radio and Telecommunications’ Sectors, and a member o the

Inter-American Telecommunication Commission (CITEL)�

ATIS is accredited by the American National Standards

Institute (ANSI)� For more inormation, please visit

www�atis�org�

Standards or mHealth components –

Telecommunications Area

Small components and electronics technology that

t into these small telecommunication devices must

meet certain standards so these tools don’t overheatand have enough power to run complicated healthcare

applications� Many standardization organizations,

including the In ternational Telecommunications Union

(ITU), work on various areas o eHealth� The eHealth

Standardization Coordination Group (eHSCG), supported

by ITU-T Study Group 16, maintains a list o standards in

both technical and non-technical areas o eHealth on the

World Health Organization web site�

Name Use Frequency Regulatory/Standards

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5-06mHIMSS Roadmap



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than a common one but i the industry bodies can

negotiate a way or M2M devices to be device carrier

and network agnostic, there’s the lucrative prospect

o a massive acceleration in the development o things

untethered to a specic carrier, platorm or server� The

alternative is many internets, each with its own separate

sets o things and associated complexities or users� Not

an ideal standard�”6

Continua Health Alliance

Continua Health Alliance is a non-prot, open industry

coalition o healthcare and technology companies joining

together to improve the quality o personal healthcare�

With more than two hundred member companies around

the world, Continua is dedicated to establishing a systemo interoperable personal health solutions with the

knowledge that extending those solutions into the home,

osters independence, while empowers individuals and

provides the opportunity or truly personalized health and

wellness management�

The Continua Health Alliance’s Design Guidelines

contains reerences to the standards and specications

that Continua selected or ensuring interoperability

o devices� It also contains additional interoperability

design guidelines that urther clariy these standards

and specications by reducing options in the underlyingstandard or specication or by adding a eature missing

in the underlying standard or specication� Continuea’s

End-to-End (E2E) Reerence Architecture provides these

communications (July 2012)� There are now multiple

organization rom around the world working together on

this initiative�

M2M communications, known as the emerging

“Internet o things,” allows seamless communication

across any device anywhere in the world� With 50 billion

devices predicted to be connectable by 2020, M2M

is an economic engine driving growth and innovation

throughout a range o global industries, including health

care, security, transportation and utilities�

AS Telecommunications companies around the world

optimize their networks to meet industry needs or M2M

communications, there is A growing need or the ICT

industry to develop global standards that ensure devices

all over the world can eectively communicate with oneanother�

These leading ICT organizations are joining together

with other organizations and those representing specic

aspects o M2M applications to conront the critical

need or a common M2M Service Layer� Embedded

within various hardware and sotware, and relied upon

to connect the myriad o devices in the eld with M2M

application servers worldwide�

An example o the unctionality; “This common “service

layer” can be embedded in every M2M device, making it

compatible with M2M application servers hosted by anyglobal operator� This requires a business arrangement

with each carrier and also a common protocol� An

alliance, such as this one, can have multiple benets� It

could, or instance, solve Amazons’ predicament with

the Kindle� At present, the Kindle only has one home

network, AT&T, which means that i a user is in a country

not served by the company, download ees would apply�

However, i AT&T were to join the alliance (it’s also a

Jasper Wireless customer), download charges could be

waived� Ad-hoc standards currently seem more easible

Wireless and mHealth Standards &

Interoperability Organizations:

■ Continua Health Alliance■ Bluetooth SIG

■ ZigBee Alliance

■ Wi-Fi Alliance

■ DASH7 Alliance

■ IHE

■ Clinical Groupware Collaborative (CGC)

■ Healthcare Inormation and

Management Systems Society (HIMSS)

■ AAMI

■ IEEE

■

ISO■ NIST

■ HL7

■ W3C

■ NIH-(Bridge Model)

■ DICOM

■ CDISC

Specifc mHealth Activities o Standards

& Interoperability Organizations

Alliance for Telecommunications

Industry Solutions (ATIS)

ATIS is a collaboration o companies, accredited by

the American National Standards Institute (ANSI), who

set standards and solutions in the eld o Inormation

and Communication Technology (ICT)� A standard that

is relevant to the mHealth area is their virtual desktop

standard� ATIS along with the Telecommunication

Industry Association (TIA), and the European

Telecommunications Standards Institute (ETSI) launched

a global organization ocused on the advancement

and standardization o machine-to-machine (M2M)

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5-07mHIMSS Roadmap



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are to publish Bluetooth specications, administer the

qualication program, protect the Bluetooth trademarks

and evangelize Bluetooth wireless technology�

ZigBee Alliance

The ZigBee Alliance is an association o companies

working together to enable reliable, cost-eective, low-

power, wirelessly networked, monitoring and control

products based on an open global standard� The goal

o the ZigBee Alliance is to provide the consumer with

ultimate fexibility, mobility, and ease o use by building

wireless intelligence and capabilities into everyday devices�

ZigBee technology will be embedded in a wide range o

products and applications across consumer, commercial,

industrial and government markets worldwide� For therst time, companies will have a standards-based wireless

platorm optimized or the unique needs o remote

monitoring and control applications, including simplicity,

reliability, low-cost and low-power�

Wi-Fi Alliance

The Wi-Fi Alliance is a global non-prot industry

association o hundreds o leading companies devoted to

the prolieration o Wi-Fi technology across devices and

market segments� With technology development, market

building, and regulatory programs, the Wi-Fi Alliance

has enabled widespread adoption o Wi-Fi worldwide�

The Wi-Fi CERTIFIED program was launched in March

2000� It provides a widely-recognized designation o

interoperability and quality, and it helps to ensure that Wi-

Fi enabled products deliver the best user experience� The

Wi-Fi Alliance has completed more than 8,000 product

certications to date, encouraging the expanded use

o Wi-Fi products and services in new and established

markets�

DASH7 Alliance

The DASH7 Alliance was ormed to advance the use

o DASH7 wireless data technology by developing

extensions the ISO 18000-7 standard, ensuring

interoperability among devices, and educating the

market about DASH7 technology� Formed in 2009, the

Alliance now has more than 20 members� Manuacturers,

systems integrators, developers, regulators, academia,

and end-users all work together to promote the use

o DASH7 technology in a wide array o industries and

applications� The DASH7 Alliance provides a ramework

or extensive application development, seamless

interoperability, and security or DASH7-enabled

transactions� Goals:

■ Develop improvements and extensions to the ISO

18000-7 standard

■ Work to ensure that products claiming DASH7

capabilities comply with DASH7 specications

■ Encourage the development o products using DASH7

technology

■ Educate consumers and enterprises globally about

DASH7 technology

guidelines ocusing on the ol lowing interaces:

■ PAN-IF - Interace to Personal Area Network

health devices

■ Both wired and wireless links (such as USB and

Bluetooth based technologies

■ ISO/IEE 11073-20601 Optimized Exhange Protocols

(data model)– utilizing guidance rom the ISO/IEEE

11073 Medical Device Communication working

group\

■ LAN-IF – Local Area Network Interace

■ xHRN-IF - Interace between Disease

Management Services (DMS)

■ WAN (Wide Area Network) devices (xHR Senders) and

■ Electronic Health Record (EHR) devices

(xHR Receivers)�“These guidelines were specically written or device

manuacturers that intend to go through the Continua

Certication process with their devices, companies that

integrate Continua devices in systems and subsystems,

and test labs that certiy compliance to Continua

specications”, states Continua 7� Members o Continua

may download the Version 2011 Design Guidelines,

Version 2010 Design Guidelines and Version One Design

Guidelines or ree�

Bluetooth SIG

The Bluetooth Special Interest Group (SIG) is a

privately held, not-or-prot trade association ounded

in September 1998� The Bluetooth SIG itsel does

not make, manuacture, or sell Bluetooth enabled

products� The SIG member companies are leaders in

the telecommunications, computing, automotive, music,

apparel, industrial automation, and network industries�

SIG members drive development o Bluetooth wireless

technology, and implement and market the technology

in their products� The main tasks or the Bluetooth SIG

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5-08mHIMSS Roadmap



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IHE Mobile Access to

Health Document (MHD) Paper in Review

Health Enterprise (IHE) International submitted a DratSupplement o the IHE IT In rastructure Prole entitled,

Mobile access to Health Documents (MHD) or public

comment on June 5, 2012� Comments were collected

through July 2012, to specically address the MHD

Prole� Some o the issues addressed in this prole are

the resource and platorm constraints, which lead to

employing less complicated network technologies�

“The Mobile access to Health Documents (MHD) prole

strives to dene one standardized interace to health

documents or use by mobile devices so that deployment

o mobile applications is more consistent and reusable� Inthis context, mobile devices include tablets and smart-

phones, and also include embedded devices like home-

health devices� This prole is also applicable in l arger

systems where the needs are simple, such as to pull the

latest summary or display on a secondary monitor,” the

drat says�8

Wireless Healthand mHealth Organizations Wireless-Life Sciences Alliance (WLSA)

The Wireless-Lie Sciences Alliance is an unparalleled

international think tank that puts CEOs rom the world’s

most innovative wireless health companies together with

global leaders in healthcare and technology, to accelerate

business opportunities�

European MHealth Alliance (EuMHA)

The European MHealth Alliance (EuMHA) is an initiative

to support and promote the wider adoption o healthcare

and wellbeing (including sports and tness) products,

services, applications and innovation across Europe�

EuMHA is a non-prot organization that will concentrate

on the economic development o the MHealth sector�

mHealth Alliance

The mHealth Alliance seeks to leverage the global

reach o wireless networks and mobile devices to

improve health outcomes in underserved communities

through co-development and deployment o innovative,

interoperable mobile health (mHealth) solutions�

mHealth Working Group

The mHealth Working Group is a collaborative orum

or sharing knowledge on mobile technology or health�

Founded in 2009 with global health organizations,

the group seeks to rame mobile technology within a

larger global health strategy� By applying public health

standards and practices to mHealth, the group promotes

approaches that are appropriate, evidence based,

interoperable and scalable in resource-poor settings�

Meetings are hosted by member organizations, recently

including USAID, the World Bank, MSH, PSI and FHI�

More than 150 organizations in over 20 countries

participate in mHealth Working Group�

mHealth Regulatory Coalition (MRC)

The mHealth Regulatory Coalition is a single issue,temporary organization ormed with the single objective

o bringing clarity to the mHealth industry as to what

aspects o the ecosystem, that the FDA intends to

regulate�

WestHealth

The Institute’s mission is to lower health care costs by

accelerating the availability o wireless mHealth solutions�

Founded in March 2009 by the Gary and Mary West

Foundation, the independent nonprot is dedicated to

innovating, validating, advocating or, investing in and

commercializing the use o wireless technologies to

transorm medicine�

UCLA Wireless Health Institute

The UCLA Wireless Health programs are dedicated

to improving the timeliness and reach o healthcare

by development and application o wireless network-

enabled technology solutions combining personal

communication devices, wireless wearable sensors, and

other technologies integrated with medical enterprise

computing� This program leverages clinical, academic,

and industry partnerships to rapidly translate innovative

wireless applications into validated health solutions�

Partnerships with industry have been created in eortsto bridge the well-recognized gap between available

wireless inormation technologies and their translation

into successul, widely adopted products and services�

Wireless Health applications range rom those in

health and wellness to rehabilitative care� In addition

to the primary benets o Wireless Health or new

health management and healthcare delivery methods,

this UCLA program also seeks to exploit technology

advantages to extend healthcare services to those who

otherwise have limited access today�

Center for Connected Health

The Center or Connected Health, a division o Partners

HealthCare in Boston, develops innovative and eective

solutions or delivering quality patient care outside o

the traditional medical setting� The Center engages

in pioneering research in a wide range o connected

health-related areas and works to advance the eld

through its convening and publishing activities� Their

programs use a combination o remote-monitoring,

online communications and intelligence, and technology

applications to improve patient adherence, engagement

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5-09mHIMSS Roadmap



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and clinical outcomes� Participants in our programs are

patients and providers at Partners-aliated practices and

hospitals throughout New England� Their programs are

also being oered by large sel-insured employers who

wish to help employees better manage their health, to

contain healthcare spending and to improve productivity

and satisaction�

Center for Wireless and Population

Health Systems at UCSD

(University of California, San Diego)

Their research ocuses on how the health o individuals,

amilies, communities, social networks, and populations

can be improved through the creative use o wireless

and networked technologies and ubiquitous computing� Their studies include how to promote health and prevent

disease and disability through systems-level interventions

in clinical and community settings�

Focused on Health issues addressed in recent research

have included pediatric and adult obesity and their co-

morbidities, depression, improving outcomes in cancer

survivors, successul aging, the use o games to promote

improved health behaviors, and the dynamics o health-

related states within social networks� Center research is

supported through public and private sources, including

the National Institutes o Health, the U�S� Centers or

Disease Control and Prevention, the National Science

Foundation, the Robert Wood Johnson Foundation, the

American Cancer Society, and Nokia Research�

European Connected

Health Campus (ECHCampus)

The European Connected Health Campus is a ‘not-or-

prot’ organization registered in Northern Ireland, as

a Community Interest Company (CIC NI 070344) and

supervised by the UK CIC Regulator� ECHCampus was

ounded by a team o independent business leaders,

who identied the need to enable innovation in this

extraordinary eld� It is thereore a timely response to

both societal and economic needs� Its primary mission is

to ‘deliver leadership or the development o Connected

Health markets and practice across Europe’�

The ECHCampus is ocused on:

■ The need to transorm Healthcare Delivery, thus

enhancing the quality and eectiveness o care�

■ The need to develop the ‘Connected Health

Economy’, thus enabling innovation and sustainable

investment in the expansion o healthcare�

WavefrontWaveront is a not-or-prot commercialization centre

accelerating the growth o Canada’s wireless and new

media companies� Waveront improves speed-to-

market and delivery o mobile applications and devices

by providing emerging companies with a suite o

WaveGuide™ training, mobile industry advisory services,

incubation oce space and testing resources� Waveront

also helps to acilitate commercial engagement

between the mobile ecosystem (mobile operators,

platorm providers, device manuacturers), enterprise

companies and the innovative developers in Canadaand Pacic Northwest� Mobile network operators value

Waveront as a neutral, independent entry point to

identiy and assess high potential mobile applications

or their particular market and business requirements�

Waveront is in terested in working with international

application providers that are looking to develop business

relationships in the North American market�

ITU

The International Telecommunications Union (ITU) is

a long-standing worldwide standards organization�

Their ocus is on interoperability and coordination via

standards� They support many o the standards mention

in this Roadmap such as HL7 and DICOM to name a

ew� ITU published their report on E-health Standards

and Interoperability in April,2012 There global initiative are

as ollows:

■ (x)DSL – Digital Subscriber Line

■ Digital Video Compression Standards

■ Digital Image Compression Standards

■ Inormation Security Standards

■ Quality o Service Standards

■ Voice over the Internet (VOIP)

epSOS: European Patients

Smart Open Services

epSOS is a emerging standard Initiative, composed o 47

members, 23 EU states� They ocus on building cross-

border Interoperability o EHRs and rameworks

GS1 Healthcare

GS1 global non-prot standards whose ocus to assist

companies in eciency o care delivery, saety and

supply chain�

Prerequisites:

1. Emphasizing Greater Interoperability

2. Increasing Coordination over e-heal Standardization

3. Ensuring Privacy, Security and Saety

4. Reducing the Standardization Gap in the Developing

World

5. Leveraging existing ICTs like Mobile Device and

Social Media

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5-10mHIMSS Roadmap



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Opportunity Dates o Importance Website reerences

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Table of EngagementOpportunities formHealth StandardsUnderstand the Secret Sauce - http://projecthdata�org

HL7

■ New Mobile Health Working Group in HL7

■ Announced March 19, 2012

■ Charter In Development

■ Interim Leadership Elected May 22, 2012

■ http://www�hl7�org/Special/committees/mobile/

■ Fast Health Inormation Resources (FHIR)

■ HL7 FHIR 6/15/2012■ Granular concepts that can be composed to quickly

create and exchange inormation�

■ HL7 RIM-based

■ Simple, well-documented, standard

■ Covers 80% o use cases, with built-in extensibility

■ Exchanges constrained by proling

■ JSon and XML

■ JSon name/key are o CDA headers

■ Good t or mHealth

Documents for Mobile Health

■ IHE Prole Proposed last September

■ Two Use Cases:

■ Download Metadata & Documents

■ Upload o a Single Document

■ RESTul Protocol

■ Aligned with OMG/HL7 hData Eorts

■

JavaScript Object Notation (JSON)■ OAuth authentication

t eggm oiis mHh Ss9

ONC S&I Framework

■ RHEX Project Announced 6/7

■ Promoted as “Web 2�0 or Health”

■ See http://wiki�siramework�org/RHEx

■ Auto-Blue Button

■ Push and Pull documents

■ Pull is based on Direct Project

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5-11mHIMSS Roadmap



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“At-a-Glance”Standards OverviewEmerging Standards

Happtique is an emerging standard created to

benchmark apps developed with a robust interaction

with the healthcare environment� Happtique provides

both patient centric and developer ocused standards

to create a benchmark o authenticity and quality� This

helps patients and provider to manage healthcare app

away rom the noise o other non-healthcare Apps,

in June 2012 there were 650,000 Apps on the Apple

app store and 500,000 on Google Play� They currently

support three phone manuactures Operating Systems;

Blackberry, Android and iPhone� Because o Apple’s

regulations all Apps must be purchased via Apple’s

iTunes site�

Happtique plans to create a set o criteria by which

to judge health applications and build a standards

program around those criteria� These standards are

being developed to help consumers and doctors know

what apps to trust and help them lter the myriad o

available options� Once those standards are released,

developers may have to pay to get their apps certied

by Happtique� This is not a replacement or the

manuactures certication process, which will also have

to be completed by the developer� Happtique is a model

that is similar to the Wi-Fi Alliance certication process�

Source: http://gigaom�com/2012/01/11/happtique-aims-

to-build-a-standard-or-mobile-health-apps/

Standard Use Benefts Other Inormation

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5-12mHIMSS Roadmap



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IEC 80001-Risk Management

for Medical Devices

Risk management application or IT-networks

incorporating medical devices� The drat documentis available on the AAMI marketplace� “The goal o

IEC 80001 is to apply appropriate risk management

consistent with ISO 14971 to address the key properties

o saety, eectiveness, data and system security, and

interoperability�” -Sherman Eagles�

Getting Started with IEC 80001: Essential Information

for Healthcare Providers Managing Medical IT-Networks

- “The handbook is intended to take the ear out o

implementing this standard inside the hospital regardless

o the hospital size,” says Yadin David, director o

Biomedical Engineering Consultants in Houston, TX, oneo three co-authors o the handbook�

The handbook includes an overview o the standard,

how to start a pilot project, and how to identiy who in

an organization is responsible or complying with the

standard� – Source: http://www�aami�org/publications/

Books/80001-GS�html

HL7 Fast Healthcare Interoperability Resources

(FHIR - pronounced “FIRE”)

Designed to be web based, using XLM documents

or mHealth preerred, JSon, with an http-based

RESTul protocol with predictable URLs� This new

specication is aimed at making implementation o the

HL7 interoperability standards easier to implement and

compatible with mobile standards�

The next section, briefy describes a variety o eHealth

standardization initiatives including: DICOM, CEN/TC

251, HL7, ISO/TC 215, and ISO/IEEE 11073�

DICOM

Digital Imaging and Communications in Medicine

(DICOM) is a standard or exchanging medical images�

S&I Framework, ONC

The ONC’s S&I Framework initiative is an open

crowdsourcing collaborative to promote interoperability

or Meaningul Use� Example o current project are ound

on their wiki:

■ Automatic Blue Button (ABBI)

■ Certicate Interoperability (CI)

■ Data Segmentation or privacy

■ Health eDecision (HeD)

■ Transitions o Care (ToC)

■ Lab Results Interace (LRI)

■ Query Health

Existing Interoperability Standards

in mHealth & Wireless

ISO/IEEE 11073

ISO/IEEE 11073 Medical/Health Device Communication

Standards are a set o joint ISO, IEEE, and CEN

standards or medical device interoperability� In this

context, medical devices include primarily personnel, or

end user, health devices such as blood glucose monitors,

blood pressure monitors, thermometers, pulse oximeters,

etc�, that patients use in their own homes or other end

points to monitor existing medical conditions� The ISO/

IEEE 11073 (ormerly called IEEE 1073) standards denemessaging structures but not the transport layer upon

which messages are transmitted�

ISO 18000-7 standard

ISO 18000-7 standard, ensuring interoperability among

mobile devices�

More specically, it is a le ormat and transmission

standard or exchanging medical images and associated

inormation between medical imaging equipment made

by dierent manuacturers� The DICOM standardsare widely adopted in equipment and inormation

systems used in hospitals, imaging centers, and in

providers’ oces to produce, display, store, or exchange

medical images� The standard provides a number o

specications including:

■ Network protocols

■ Syntax and semantics o commands and associated

inormation

■ Media storage services, le ormats, medical

directory structure

There are twenty DICOM working groups, made upo technical and medical proessionals, which maintain

the various DICOM standards� The National Electrical

Manuacturers Association (NEMA) oversees and holds a

copyright to the DICOM standards, originally developed

by a joint committee ormed by NEMA and the American

College o Radiology�

CEN/TC 251

The Comité Européen de Normalisation or European

Committee or Standardization (CEN) is a standards

development organization made up o 31 nationalmembers developing pan-European standards� CEN has

a Health Inormatics Technical Committee (TC 251) which

coordinates the development o standards or Health�

According to its business plan and recent activities, the

ocus o CEN/TC 251 is primarily on technologies at the

content level rather than dealing with communication

technologies� CEN/TC 251 is urther broken down

into working groups such as Working Group IV, which

ocuses on the interoperability o data among devices

and inormation systems�

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5-13mHIMSS Roadmap



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HL7

Health Level Seven (HL7) is a standards development

organization, which issues international application-

layer healthcare standards or the electronic exchange

and management o health inormation such as clinical

data and administrative inormation� HL7 reers to the

standards organization itsel but is also commonly used

to reer to specic standards the institution develops�

HL7 dates back to the mid-1980s, when it was ormed

to develop a standard or hospital inormation systems�

Like other standards organizations, HL7 is organized

into Work Groups chaired by two or more co-chairs and

responsible or dening some area o HL7 standards� HL7

has dozens o Work Groups, including groups addressing

electronic health records, inrastructure and messaging,and imaging integration� To provide one example o an

HL7 specication, the HL7 Clinical Document Architecture

(CDA) serves as an XML-based markup standard dening

the structure, encoding parameters, and semantics o

electronic clinical documents�

HL7 partners with other institutions, such as the

International Organization or Standardization (ISO) in

issuing international eHealth standards, (ISO/HL7 217

31:2006 Health Inormatics-HL7 version 3-Reerence

Inormation Model)�

ISO/TC 215

ISO’s Technical Committee 215 addresses health

inormatics� ISO/TC 215 ocuses primarily on electronic

health records� Various Working Groups (WGs) within TC

215 address topics such as data structure, messaging

and communication, security, pharmacy and medication,

devices, and business requirements or electronic health

records� For example, ISO/TS 25237:2008 address

pseudonymization principles and requirements or privacy

protection o electronic health records�

Many o ISO’s standards are collaborations or

endorsements o standards developed by other standards

organizations such as HL7 or IEEE� For example, ISO/

HL7 27931:2009, Data Exchange Standards - HealthLevel Seven (HL7) Version 2�5 establishes an application

protocol or electronic data exchange in healthcare

environments� ISO Technical Committee 215, WG 8

(Business Requirements or Electronic Health Records)

provides guidance or identiying business requirements to

dene an eHealth enterprise�

FTC – How do others use

inormation rom mobile technology?

The Federal Trade Commission (FTC) recommends

the ollowing “Do Not Track” guidelines or mobiletechnology: 1) “privacy by design,” simpler and

streamlined privacy choices, and transparency as to

what demographic data or detailed inormation about

preerences can be captured o mobile devices that

leads to targeted marketing to dierent groups o

consumers, by previous choices made on the mobile

device or by location tracking GPS� In particular, the

FTC is concerned mostly about the high used o mobile

devices o young people and minors and is reviewing the

Children’s Online Privacy Protection (COPPA) Rule to see

i applies to some o the new mobile technologies�

Health and Human Services (HHS)

Health IT plays a key role in advancing policy priorities

that improve health and health care delivery� Priorities set

orth by HHS include the ollowing:1

■ Improving care quality, saety, eciency

and reducing disparities

1 Medicare and Medicaid Programs; Electronic Health Record Incentive

Program; Proposed Rule, 75 Fed� Reg� 1851 (Jan� 13, 2010)�

■ Engaging patients and amilies in managing

their health

■ Enhancing care coordination

■ Improving population and public health■ Ensuring adequate privacy and security o

health inormation

Federal Communications Commission (FCC)

The FCC controls the requency o radio transmitters

and receivers as in Cell phones, and RFID devices� They

do not play a di rect role in the classication o medical

device as that is the FDA responsibility; however they

do infuence the market and policies� They recently

published a public drat, “mHealth Task Force, Finding

and Recommendations, Improving care delivery throughenhanced communications”10

The report recommendations are organized within the

ollowing ve goals:

■ Goal 1: FCC should continue to play a leadership

role in advancing mobile health adoption�

■ Goal 2: Federal agencies should increase

collaboration to promote innovation, protect patient

saety, and avoid regulatory duplication�

■ Goal 3: The FCC should build on existing programs

and link programs when possible in order to expand

broadband access or healthcare�■ Goal 4: The FCC should continue eorts to increase

capacity, reliability, interoperability, and RF saety o

mHealth technologies�

■ Goal 5: Industry should support continued

investment, innovation, and job creation in the

growing mobile health sector�

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5-14mHIMSS Roadmap



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referenCeS

1 Tina Brown-Stevens� Keynote speaker, StrataRX conerence, San

Francisco, CA� October 2012�

2 John Wilbanks� (2012, October)� Choose Your Monopolies Wisely,

Keynote at StrataRX� San Francisco, CA�

3 Keith W� Boone, Standards Opportunities in Mobile Health, OMG

Healthcare Interoperability: Focus on SOA and Modeling, June 20,

2012

4 Source: Keith W� Boone, Standards Opportunities in Mobile Health,

OMG Healthcare Interoperability: ‘ocus on SOA and Modeling’, June

20, 2012

5 http://www�digitaltrends�com/mobile/is-5g-mobile-broadband-just-

around-the-corner-imt-advanced-explained/

6 How far are we from a unifying standard for the Internet of Things?

Adriana Hamacher, ICT Knowledge Transer Network, July 18, 2012,�

7 Continua Alliance� Guidelines 2011� Available http://www�

continuaalliance�org/products/design-guidelines�html

8 IHE IT Inrastructure� Technical Framework Supplement 10, Mobile

access to Health Documents (MHD)� Available: http://www�ihe�net/

Technical_Framework/upload/IHE_ITI_Suppl_MHD_Rev1-0_PC_2012-06-05�pd

9 *Source: Keith W� Boone, Standards Opportunities in Mobile Health,

OMG Healthcare Interoperability: ‘ocus on SOA and Modeling’, June

20, 2012

10 mHealth Task Force, Finding and Recommendations� FCC� 9/24/2012�

Avail @ https://s3�amazonaws�com/www2�iti�org/2012-mhealth-

taskorce-recommendations�pd �

autHorS & ContrIbutorS

■ Je Brandt Principle

ComSi

■ Charles Jae, MD, PhDCEO

HL7

■ Chuck Parker Executive Director

Continua Health Alliance

Staff lIaISonS

■ James St. Clair Director

HIMSS

■ Mary Ellen Johnson Manager

HIMSS

■ Thomas Martin, MBA Manager

mHIMSS

Strategies andRecommendations

The uture o Interoperability and standards is wide

open and will be changing quickly� As more health

data becomes digitize, technology will play an even

more signicant role in healthcare� Interoperability

becomes more important as the source o data points

increase� Patient-reported data will play a signicant

role in the production o “Big Data”� Sensors, Apps,

home monitoring devices, cars and many soon to be

discovered technologies will produce an onslaught

o patient-reported data� These devices must be

interoperable with EHRs, PHRs and HIEs�

Mobile shall play a signicant role in patient-centric

healthcare and standards organizations are changing to

accommodate the transition� HL7 recently announced a

lightweight protocol, FHIR that is more compatible with

the needs o mobile� A keynote speaker at StrataRX in

San Francisco, 2012 mentioned that we should consider

using open standards such as “iCalendar” which

currently interaces with most calendar programs on the

Web instead o HL7 ADT messages� The S&I ABBI (Auto

Blue Button) utilizes SMTP the Internet email sending

protocol to deliver patient record via the Direct Project�

The point, standards and priorities are changing and we

must keep abreast o these movements�

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5-15mHIMSS Roadmap



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e t

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B u r n e t

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B B u r n e t S

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c h e r

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A n d r e w

s D r

G r i s h

a m C t

G r i s h

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G r i s h

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G r i s h

a m C t s

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a n J a c

i n t o

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Elizabeth St

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W a

i n w r i g

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a d a l u

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s

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a l s e y

L a k e S t

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w t h

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H o w a r d S

t

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Riggan St

i t t

Wac o St

K i n g

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Prescott Ste

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referenCeS

http://www�atis�org/about/

http://www�hospitalmanagement�net/eatures/eaturemobile-medicine-top-

remote-healthcare-innovations/?WT�mc_id=WN_Feat

http://www�crn�com/news/applications-os/231500365/

cover-story-the-mobile-technology-revolution�htm?pgno=1

https://www�wirelesshealthstrategies�com/organizations�html

http://www�tc�gov/opa/2011/05/mobiletestimony�shtm

http://www�pewinternet�org/

http://www�k4health�org/toolkits/mhealth/mhealth-working-group-0

The mHealth Toolkit, http://www�k4health�org/toolkits/mhealth

ITU E-health Standards and Interoperability: http://www�itu�int/dms_pub/

itu-t/oth/23/01/T23010000170001PDFE�pd (April 2012)

http://www�omg�org/news/meetings/tc/ma-12/special-events/Healthcare_

Inormation_Day�htm

mHealtH reSourCeS

on tHe teCHWeb dIGItal lIbrary

Gvm: Cloud/SaaS, Mobile & Wireless

Hw: Handhelds/PDAs, Grid/Cluster Computing Hhc: Mobile & Wireless

Isc: Remote Access, VPNs,

I: B2B, B2C, Browsers, E-Business/E-Commerce, E-retail,

Google, Web Development, Internet Security, Search, Social Networks,

Trac Reporting/Monitoring, Web 2�0, Internet Policy

Mii : WLAN, Wireless Security, Wi-Fi/WiMax, Wi-Fi VOIP,

Smartphones, 3G Wireless/Broadband, Muni Wireless, Mobile

Messaging, Mobile Business, Fixed Mobile Convergence,

802�11x, RFID

ps tch: Blackberry, Bluetooth, Bluray, Digital Cameras,

Digital Music, Digital Rights Management, Virtual worlds, iPhone,

iPod, Peripherals, Smartphones, TVs/Home Theater, Global

Positioning Systems

Sci : Encryption, Perimeter Security, Vulnerabilities and Threats,

Intrusion Prevention

Svics: Telecom/Voice ServicesSw: Web Services

Sg: Data protection, Removable/Portable Storage, Security,

tcm: VOIP, Unied Communications, Voice services, PBXs,

Internet policy, Presence, Collaboration Systems, Business,

Regulation, Call Centers

oh i pivc & Sci : BYOD Security -Virtualization

like a Citrix Receiver: http://www�citrix�com/English/ps2/products/

subeature�asp?contentID=2300390 – TEMIA

170.314(b)(7) Test Tool Supplement: Data portability ONC�

http://www�healthit�gov/sites/deault/les/standards-certication/2014-

edition-drat-test-procedures/170-314-b-7-data-portability-test-tool-

supplement-v-2�pd

Copyright © 2012

Healthcare Inormation and Management Systems Society (HIMSS)

The inclusion o an organization name, product or service in this document

should not be construed as a HIMSS endorsement o such organization,

product or service, nor is the ailure to include an organization name,

product or service to be construed as disapproval�

For more inormation: www.mhimss.org

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http://slidepdf.com/http://www.atis.org/about/

http://www.hospitalmanagement.net/features/featuremobile-medicine-top-remote-healthcare-innovations/?WT.mc_id=WN_Feat


http://www.crn.com/news/applications-os/231500365/cover-story-the-mobile-technology-revolution.htm?pgno=1


https://www.wirelesshealthstrategies.com/organizations.html

http://www.ftc.gov/opa/2011/05/mobiletestimony.shtm

http://www.pewinternet.org/

http://www.k4health.org/toolkits/mhealth/mhealth-working-group-0

http://www.k4health.org/toolkits/mhealth



http://www.omg.org/news/meetings/tc/ma-12/special-events/Healthcare_Information_Day.htm


http://www.informationweek.com/whitepaper/government

http://www.informationweek.com/whitepaper/government/cloud-saas

http://www.informationweek.com/whitepaper/government/mobile

http://www.informationweek.com/whitepaper/Hardware

http://www.informationweek.com/whitepaper/Hardware/Handhelds-PDAs

http://www.informationweek.com/whitepaper/Hardware/Grid-Cluster-Computing

http://www.informationweek.com/whitepaper/healthcare

http://www.informationweek.com/whitepaper/healthcare/mobile-wireless

http://www.informationweek.com/whitepaper/Infrastructure

http://www.informationweek.com/whitepaper/Infrastructure/Remote-Access

http://www.informationweek.com/whitepaper/Infrastructure/VPNs

http://www.informationweek.com/whitepaper/Internet

http://www.informationweek.com/whitepaper/Internet/B2B

http://www.informationweek.com/whitepaper/Internet/B2C

http://www.informationweek.com/whitepaper/Internet/Browsers

http://www.informationweek.com/whitepaper/Internet/E-Business-E-Commerce

http://www.informationweek.com/whitepaper/Internet/E-Retail

http://www.informationweek.com/whitepaper/Internet/Google

http://www.informationweek.com/whitepaper/Internet/Web-Development

http://www.informationweek.com/whitepaper/Internet/Internet-Security

http://www.informationweek.com/whitepaper/Internet/Search

http://www.informationweek.com/whitepaper/Internet/Social-Networks

http://www.informationweek.com/whitepaper/Internet/Traffic-Reporting-Monitoring

http://www.informationweek.com/whitepaper/Internet/Web-2.0

http://www.informationweek.com/whitepaper/Internet/Internet-Policy

http://www.informationweek.com/whitepaper/Mobility

http://www.informationweek.com/whitepaper/Mobility/WLAN

http://www.informationweek.com/whitepaper/Mobility/Wireless-Security

http://www.informationweek.com/whitepaper/Mobility/Wi-Fi-WiMax

http://www.informationweek.com/whitepaper/Mobility/Wi-Fi-VOIP

http://www.informationweek.com/whitepaper/Mobility/Smartphones

http://www.informationweek.com/whitepaper/Mobility/3G-Wireless-Broadband

http://www.informationweek.com/whitepaper/Mobility/Muni-Wireless

http://www.informationweek.com/whitepaper/Mobility/Mobile-Messaging


http://www.informationweek.com/whitepaper/Mobility/Mobile-Business

http://www.informationweek.com/whitepaper/Mobility/Fixed-Mobile-Convergence

http://www.informationweek.com/whitepaper/Mobility/802.11x

http://www.informationweek.com/whitepaper/Mobility/RFID

http://www.informationweek.com/whitepaper/Personal-Tech

http://www.informationweek.com/whitepaper/Personal-Tech/Blackberry

http://www.informationweek.com/whitepaper/Personal-Tech/Bluetooth

http://www.informationweek.com/whitepaper/Personal-Tech/Bluray

http://www.informationweek.com/whitepaper/Personal-Tech/Digital-Cameras

http://www.informationweek.com/whitepaper/Personal-Tech/Digital-Music

http://www.informationweek.com/whitepaper/Personal-Tech/Digital-Rights-Management

http://www.informationweek.com/whitepaper/Personal-Tech/Virtual-Worlds

http://www.informationweek.com/whitepaper/Personal-Tech/iPhone

http://www.informationweek.com/whitepaper/Personal-Tech/iPod

http://www.informationweek.com/whitepaper/Personal-Tech/Peripherals

http://www.informationweek.com/whitepaper/Personal-Tech/Smartphones

http://www.informationweek.com/whitepaper/Personal-Tech/TVs-Home-Theater

http://www.informationweek.com/whitepaper/Personal-Tech/Global-Positioning-Systems


http://www.informationweek.com/whitepaper/Security

http://www.informationweek.com/whitepaper/Security/Encryption

http://www.informationweek.com/whitepaper/Security/Perimeter-Security

http://www.informationweek.com/whitepaper/Security/Vulnerabilities-and-Threats

http://www.informationweek.com/whitepaper/Security/Intrusion-Prevention

http://www.informationweek.com/whitepaper/Services

http://www.informationweek.com/whitepaper/Services/Telecom-Voice-Services

http://www.informationweek.com/whitepaper/Software

http://www.informationweek.com/whitepaper/Software/Web-Services

http://www.informationweek.com/whitepaper/Storage

http://www.informationweek.com/whitepaper/Storage/Data-Protection

http://www.informationweek.com/whitepaper/Storage/Removable-Portable-Storage

http://www.informationweek.com/whitepaper/Storage/Security

http://www.informationweek.com/whitepaper/Telecom

http://www.informationweek.com/whitepaper/Telecom/VOIP

http://www.informationweek.com/whitepaper/Telecom/Unified-Communications

http://www.informationweek.com/whitepaper/Telecom/Voice-Services

http://www.informationweek.com/whitepaper/Telecom/PBXs

http://www.informationweek.com/whitepaper/Telecom/Internet-Policy

http://www.informationweek.com/whitepaper/Telecom/Presence

http://www.informationweek.com/whitepaper/Telecom/Collaboration-Systems

http://www.informationweek.com/whitepaper/Telecom/Business

http://www.informationweek.com/whitepaper/Telecom/Regulation

http://www.informationweek.com/whitepaper/Telecom/Call-Centers

http://www.citrix.com/English/ps2/products/subfeature.asp?contentID=2300390


http://www.healthit.gov/sites/default/files/standards-certification/2014-edition-draft-test-procedures/170-314-b-7-data-portability-test-tool-supplement-v-2.pdf








http://www.informationweek.com/whitepaper/Telecom/Call-Centers

http://www.informationweek.com/whitepaper/Telecom/Regulation

http://www.informationweek.com/whitepaper/Telecom/Business

http://www.informationweek.com/whitepaper/Telecom/Collaboration-Systems

http://www.informationweek.com/whitepaper/Telecom/Presence

http://www.informationweek.com/whitepaper/Telecom/Internet-Policy

http://www.informationweek.com/whitepaper/Telecom/PBXs

http://www.informationweek.com/whitepaper/Telecom/Voice-Services

http://www.informationweek.com/whitepaper/Telecom/Unified-Communications

http://www.informationweek.com/whitepaper/Telecom/VOIP

http://www.informationweek.com/whitepaper/Telecom

http://www.informationweek.com/whitepaper/Storage/Security

http://www.informationweek.com/whitepaper/Storage/Removable-Portable-Storage

http://www.informationweek.com/whitepaper/Storage/Data-Protection

http://www.informationweek.com/whitepaper/Storage

http://www.informationweek.com/whitepaper/Software/Web-Services

http://www.informationweek.com/whitepaper/Software

http://www.informationweek.com/whitepaper/Services/Telecom-Voice-Services

http://www.informationweek.com/whitepaper/Services

http://www.informationweek.com/whitepaper/Security/Intrusion-Prevention

http://www.informationweek.com/whitepaper/Security/Vulnerabilities-and-Threats

http://www.informationweek.com/whitepaper/Security/Perimeter-Security

http://www.informationweek.com/whitepaper/Security/Encryption

http://www.informationweek.com/whitepaper/Security



http://www.informationweek.com/whitepaper/Personal-Tech/TVs-Home-Theater

http://www.informationweek.com/whitepaper/Personal-Tech/Smartphones

http://www.informationweek.com/whitepaper/Personal-Tech/Peripherals

http://www.informationweek.com/whitepaper/Personal-Tech/iPod

http://www.informationweek.com/whitepaper/Personal-Tech/iPhone

http://www.informationweek.com/whitepaper/Personal-Tech/Virtual-Worlds

http://www.informationweek.com/whitepaper/Personal-Tech/Digital-Rights-Management

http://www.informationweek.com/whitepaper/Personal-Tech/Digital-Music

http://www.informationweek.com/whitepaper/Personal-Tech/Digital-Cameras

http://www.informationweek.com/whitepaper/Personal-Tech/Bluray

http://www.informationweek.com/whitepaper/Personal-Tech/Bluetooth

http://www.informationweek.com/whitepaper/Personal-Tech/Blackberry

http://www.informationweek.com/whitepaper/Personal-Tech

http://www.informationweek.com/whitepaper/Mobility/RFID

http://www.informationweek.com/whitepaper/Mobility/802.11x

http://www.informationweek.com/whitepaper/Mobility/Fixed-Mobile-Convergence

http://www.informationweek.com/whitepaper/Mobility/Mobile-Business



http://www.informationweek.com/whitepaper/Mobility/Muni-Wireless

http://www.informationweek.com/whitepaper/Mobility/3G-Wireless-Broadband

http://www.informationweek.com/whitepaper/Mobility/Smartphones

http://www.informationweek.com/whitepaper/Mobility/Wi-Fi-VOIP

http://www.informationweek.com/whitepaper/Mobility/Wi-Fi-WiMax

http://www.informationweek.com/whitepaper/Mobility/Wireless-Security

http://www.informationweek.com/whitepaper/Mobility/WLAN

http://www.informationweek.com/whitepaper/Mobility

http://www.informationweek.com/whitepaper/Internet/Internet-Policy

http://www.informationweek.com/whitepaper/Internet/Web-2.0

http://www.informationweek.com/whitepaper/Internet/Traffic-Reporting-Monitoring

http://www.informationweek.com/whitepaper/Internet/Social-Networks

http://www.informationweek.com/whitepaper/Internet/Search

http://www.informationweek.com/whitepaper/Internet/Internet-Security

http://www.informationweek.com/whitepaper/Internet/Web-Development

http://www.informationweek.com/whitepaper/Internet/Google

http://www.informationweek.com/whitepaper/Internet/E-Retail

http://www.informationweek.com/whitepaper/Internet/E-Business-E-Commerce

http://www.informationweek.com/whitepaper/Internet/Browsers

http://www.informationweek.com/whitepaper/Internet/B2C

http://www.informationweek.com/whitepaper/Internet/B2B

http://www.informationweek.com/whitepaper/Internet

http://www.informationweek.com/whitepaper/Infrastructure/VPNs

http://www.informationweek.com/whitepaper/Infrastructure/Remote-Access

http://www.informationweek.com/whitepaper/Infrastructure

http://www.informationweek.com/whitepaper/healthcare/mobile-wireless

http://www.informationweek.com/whitepaper/healthcare

http://www.informationweek.com/whitepaper/Hardware/Grid-Cluster-Computing

http://www.informationweek.com/whitepaper/Hardware/Handhelds-PDAs

http://www.informationweek.com/whitepaper/Hardware

http://www.informationweek.com/whitepaper/government/mobile

http://www.informationweek.com/whitepaper/government/cloud-saas

http://www.informationweek.com/whitepaper/government





http://www.k4health.org/toolkits/mhealth

http://www.k4health.org/toolkits/mhealth/mhealth-working-group-0

http://www.pewinternet.org/

http://www.ftc.gov/opa/2011/05/mobiletestimony.shtm

https://www.wirelesshealthstrategies.com/organizations.html





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