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OHIOlympic Healthcare Interoperability Initiative
Advancing the seamless exchange and use of health information throughout the Olympic community
Wednesday February 22nd ● 1:30-2:30pm ● Interoperability Showcase Theatre
OHI
Agenda
• The OHI Initiative - background, description and
context
• Technology Infrastructure at the Rio2016 Games
• Designing and building an Interoperable
Healthcare IT infrastructure
• Questions and Discussion
2
OHIIntroducing the OHI Team
3
Michael Nusbaum, BASc, MHSA, FHIMSSBusiness Management
•Executive Liaison
•Stakeholder Relations
Flavia Dias Moreira, BBA, PMPProgram Management
•Planning and Governance
•Management Framework definition and communications
Todd Cooper, BATechnical Management
•Collaboration with vendors and health organizations
•Technical implementation leadership
• Healthcare Management Consultant
• International Expert: interoperability & standards
• Strategist, Visionary, Project Leader
• Board member: HIMSS & IHE
• Vancouver2010 Games volunteer: alpine events
• Extensive contacts in healthcare informatics industry
• Healthcare Management Consultant & Head of PMO
• Leadership Role in Rio2016 Games (5 yrs) - General
Manager and TOC Director
• Expert in Programme Leadership & knowledge management
• Relevant experience and knowledge in the Brazilian Public
and Private Healthcare system
• Healthcare Technology Consultant
• International Expert: trusted interoperable healthcare
systems & medical devices
• Expert in Interoperability standards, testing & certification
• Board member: IHE, HL7 FHIR Foundation
• Chair, US Delegation to ISO/TC215 Health Informatics
• Extensive contacts with Asia Pacific healthcare and
government leadership
OHI
The Imperative• Every two years, people from around the world converge
on a community to compete in Olympic Games
• Celebration of athletic excellence and inspiring the world to
strive to excel in every endeavor
• Providing the world's best healthcare services ecosystem
to all participants attending the Games - from athletes to
volunteers to spectators… supported by state-of-the-art
healthcare IT!
• The Olympic Healthcare Interoperability (OHI) initiative
seeks to advance the seamless exchange and use of
health information throughout the Olympic community,
before, during and after the games
4
OHI
Our MissionAdvancing the seamless exchange and use of health information,
using established international standards, to support an integrated
medical services infrastructure at each Olympic Games site.
The OHI network connects pre-Games person-specific healthcare
information with information generated at Games time by Olympic and
Host City service providers
5
OHI
Objective of the OHI Initiative• Increase the efficiency and effectiveness of the Olympic Medical Services functional
program through the integration of interoperable healthcare information technology
• Demonstrate to the world that the international adoption and implementation of
standards-based interoperable healthcare information technology directly impacts:
– Better health of the “Olympic Population” (athletes, coaches, volunteers, spectators)
– Improved health outcomes through availability of, and secure access to, appropriate information at
the right place, audience and time
– Reduction of total time for diagnosis and treatment
– Reduction of waste of human and system resources
– Improved care coordination, quality, safety, efficiency, population health
6
OHI
What is Healthcare Interoperability?
7
• The ability of different information technology systems and software
applications to communicate, exchange data, and use the information that
has been exchanged.
• Interoperable health information systems work together within and across
organizational and geographic boundaries, in order to advance the effective
delivery of healthcare for individuals and communities.
• Interoperability ensures that appropriate, accurate and complete
information is securely available to clinicians at any point of service,
at the time it is needed to facilitate diagnosis and treatment.
OHI
8
The Current Healthcare IT Infrastructure
NOCs and their
own athletes
health records
“Polyclinics”
Host City Tertiary
Referral
Hospital(s)
Local EHR
Accredited
laboratories
Pharmacy
patient
records
“clinics” at venues Patient transport
records
OCOG Medical
Encounters (EHR)
Separate Systems
Separate Vendors
No integration
Digital
imaging
OHI
Future Interoperable Healthcare IT Model
9
NOCs and their
own athletes
health records
“Polyclinics” Host City Tertiary
Referral Hospitals
Accredited
laboratories
Pharmacy
patient
records
“clinics” at venues
Patient transport
records
OCOG Medical
Encounters (EHR)
Digital
imaging
Local EHR
Interoperability occurs here
And in here too!
OHI
The Olympic Opportunity
10
• An integrated, multi-national, multi-disciplinary healthcare environment
• A multi-national patient population
Athletes(10,000’s)
Olympic “family”
(10,000’s)
Spectators
(1,000,000’s)
Target Populations
Volunteers
(100,000’s)
Olympics by the Numbers London 2012
# people per day using medical facilities 500
% of cases minor illness/injury 95%
# sports medicine doctors 46
# specialist physicians on call 80
% of athletes reporting injuries 11%
# blood & urine tests performed 6000
Prevalence of doping (reported/tested) 6.8%/0.81%
OHIValue Proposition
11
Monitor and better respond
to public health
outbreaks
Track athlete health, perhaps
trended over some longer time periods
Promote an Olympic class Longitudinal
Electronic Health Record
to support a patient through
the full Care Continuum
Clinical data can be anonymized
and made available to
IOC/OCOG for Analytics &
Planning
Demonstrate commitment
to innovation, to facilitate
welcoming the world
Facilitate the retention of the
medical and pharmacy patient records after the games, according
to national law and industry best
practice
Ensured that prohibited or
contra-indicated medications are not
inadvertently administered by the
OCOG medical team.
Enhance the quality and
efficiency of care provided to all participants
[reduced costs, increased safety,
etc.]
OHIValue Proposition
• Automatic alerts to the authorities (WHO and OCOG Public Health). e.g: Zica in Rio2016 http://www.mirror.co.uk/news/world-news/rio-2016-olympic-games-test-8144360
• Access to patient history and previous exams reduces medical errors, eliminates care delays, eliminates redundant procedures. e.g: Rio2016 incidents http://www.mirror.co.uk/sport/other-sports/most-dangerous-olympics-ever-horrific-8587095
• Easy and fast identification of an Olympic Family member involved in a car crash. e.g: Germany canoe coach in Rio2016 http://www.abc.net.au/news/2016-08-16/german-canoe-coach-dies-car-crash-rio-2016/7746580
• Alerts for prohibited and contra-indicated medications during prescribing. e.g: asthma treatment https://www.sciencedaily.com/releases/2012/04/120424210526.htm
• Preventive Care for patients with preexisting diseases. e.g: the case of the French physiotherapist in Rio2016 http://www.smh.com.au/sport/olympics/rio-2016/olympics-off-the-field/french-olympic-tennis-team-physiotherapist-dies-in-rio-20160813-gqrxp0.html
12
OHIIndustry Support
13
• Well-Supported by the International Health Informatics Industry
• Industry (non-commercial) sponsors have been eager to come on-board, either to “endorse” the initiative, or to provide support during the start-up phase
Healthcare Information and
Management Systems SocietyHIMSS is a global, cause-based, not-
for-profit organization focused on
better health through information
technology (IT). Recognized as the
premier worldwide industry
association representing clinicians,
users and vendors of healthcare IT.
SNOMED InternationalGlobal leadership in healthcare
terminology, ensuring that SNOMED
CT is accepted as the common
language for health terms
worldwide.
OHIInternational Healthcare SDO Support
14
• ISO/TC215 – Worldwide standards for Health Informatics
• Joint Initiative Council – collaborative of international health IT SDO’s
• IHE International – world leader in healthcare interoperability standards
• HL7 - standards for the exchange, integration, sharing, and retrieval of electronic health information
• GS1 – world leader in identification standards
* Standards Development Organization
OHI
Rio2016 Technology
15
OHI
Rio Technology Structure
16
OHI
17
Program Management
Projects and programmes
588
Policies and procedures
460
Contracts
60
Headcount
Paid staff
412
Contractors
5509
Volunteers
1341
Operational
readinessTest events
43 venues
2yrs to go
Technical rehearsals 1 and 2
24 venues
6 and 3mths to go
OHI
18
NOCs/NPCs
Press
Broadcasters
IFs
Athletes
Olympic and Paralympic
Family
T&S and OVR (e.g.
scoreboard, TVG)
INFO Diffusion
(e.g. INFO, CIS, IDF)
CATV
GMS
Internet infrastructure
Technology equipment
Reprographics
IT security
Spectators
Fixed and mobile
telephony
Call centre infrastructure
Mobile and internet
applications
Data network
Trunk radio
Frequency spectrum
WorkforceAudio and video systems
Intercom
Omega
AtoS
Panasonic
Samsung
Embratel/Claro
Symantec
Computer and Reprography
Suppliers
Cisco
Trunk radio suppliers
Intercom supplier
Anatel
Facilities
(e.g. TOC, EDC)PartnersCabling
ClientsServicesProviders
217+160
5962
+500 TVs
28
15636
+50000 vol
54
3.5 Bi
172000 park
+10000
OHI
19
SecurityHardware and SoftwareSystems and applications
60Desktops
6307Laptops
8833Reprographic equipment
1980
CRM
Records transferred to IOC
2.43 million
Ticketing 1.5 million
Push notification 0.6 million
Workforce 0.3 million
Newsletter 0.1 million
Security events
12 BillionSecurity incidents
2000Impact
0Website and Mobile app
Threats (blocked attacks)
30 Million
OHIInfrastructureServers
66 Admin
72 Games
LAN Ports
Installed 94776
Activated 62000
Email and
SW licensesEmail accounts
17674Software Licenses
13872
20
Service deskTickets in August 2016 (Games Time)
29739Tickets in July 2016
(Bump In)
28385Tickets in June 2016
(Bump In)
20966
OHI
21
Telecommunications
Mobile phones
25000
Landlines
6800
Radios
12600
Frequencies
32531
Shared
15396
Dedicated
17135
Wi-Fi APs 3267
BoH 1800
FoH 1187
Buses 280
OHI
22
WebsiteUnique users
47 million
Page views
468 million
Hits
9,1 billion
Downloads
7,4 million
Screen views
1,1 billion
Hits
11,3 billion
Mobile App
OHI
23
Video AudioMainframes 43
Operator panels 318
Annoucer panels 131
Beltpacks 430
Headsets 748
Analogue radios 383
FM announcer 28
Intercom
TVs
13400
M2 LED
1886
Venue PA systems 48
Mag&bag PA systems 33
Tech tables 43
Medals ceremonies 43
Mixed zone 40
Conference 34
VTO PA systems 40
Interpretation
systemBooths 41
Interpreter panels 41
Headphones 3000
IR radiators 20
IR modulators 8
Conference rooms 8
Language channels upto10
OHI
24
ResultsT & S Equipment
450 tons
Incoming ODF messages 1.7 million
ODF messages sent to customers 109 million
ODF customers 58 RAC, 11 internal
ODF support e-mail messages sent 6.888
PRD messages sent16.000
Print jobs 161.933
myInfo+ used accounts
9071
Info+ kiosks
577
OHI
25
CompetitionVenues
OperationsCenter
Broadcasters
Press
OlympicNetwork
ODF
On-venue Results
Athletes
Spectators
Internet
Generalpublic
Olympicand Paralympic Family
Technical infrastructure at Olympic games is a world-class challenge!
OHIDesigning and building an Interoperable Healthcare IT infrastructure
26
Bringing the OHI vision of
seamless interoperability
to an extensive, complex,
and dynamic technical
infrastructure
OHIOHI will not reinvent the wheel!
Leverage established international
standards
Leverage “connectathon” & other
testing events
Focus on Olympic use cases
across entire Olympic community
Include technical, semantic &
functional interoperability
“Future proof” OHI implementation
27
OHIAn Interoperable Healthcare Ecosystem
Interoperability across Care Continuum
Interoperability is a fundamental
component of today’s modern
healthcare ecosystem
Interoperability allows health
information to flow seamlessly across
the continuum of care
Interoperability can be expressed as
functional, semantic, technical:
Interoperability across
Geography
Interoperability allows health
information to be available
across geographical
boundaries (cities, states,
countries)
System
A(Vendor
A)
System
B(Vendor
B)
System
A(Vendor
A)
System
B(Vendor
B)
UserQuery
Response
Direct
Infrastructure
Interoperability Architectures
Based on international
standards
Example Implementation Architecture
International standards in this example include: Transport: ISO 28380, IHE
XDS.b, XDM Content: IHE XDS-MS, HL7
IPS, CDA, HL7v2, HL7 FHIR Semantic: SNOMED CT Functional: IHE XDW, IHE
GAO Security/Privacy: ISO
27799, IHE BPPC, ATNA
Patient Identity Source
Document Registry
Document Repository
Document Source
Document Consumer
Patient Identity Feed
[ITI-8]
Patient Identity Feed
HL7v3 [ITI-44]
Provide&Register
Document Set-b [ITI-41]
Retrieve Document
Set [ITI-43]
Registry Stored
Query [ITI-18]
Register Document
Set-b [ITI-42]
OHI
Phased Implementation Approach• Proof of Concept
– OHI concepts have been socialized since 2011, to vendors, OCOG’s, NOC’s, SDO’s and
other organizations, consistently meeting with enthusiastic support from all areas to move the
initiative forward.
• Demonstration & Pilot
– Use OHI as a means to demonstrate the power of open standards-based interoperability in a
controlled, international environment – the Olympics!
– Begin phasing-in components to the Games
• Program Implementation
– The long-term vision is to see OHI implemented as integral part of the Olympic Medical
Services Functional Program, with every NOC eventually participating and every host city’s
healthcare infrastructure connected.
29
OHI
Next Olympic games …
30(Source: www.olympic.org/olympic-games)
… each bringing unique opportunities and challenges
OHI
Questions & Discussion
31
Michael Nusbaum
Flavia Dias
Todd Cooper
Advancing the seamless exchange
and use of health information
throughout the Olympic community.