Standardisation and Security in

Personal Health Systems

Milan Petković

Philips Research

pHealth workshop , June 24-26, 2009, Milan Petkovic

Outline

• Continua Health Alliance

• Security Privacy and Trust Issues in pHealth

Continua Health Alliance:

The Next Generation of Personal

Telehealth is Here

A non-profit, open industry alliance of the finest

healthcare and technology companies in the world

joining together in collaboration to improve the

quality of personal healthcare.

Continua Health Alliance

“Our Mission is to

establish an eco-system

of interoperable

personal health systems

that empower people &

organizations to better

manage their health and

wellness”

23-06-2009 5

The Continuum of Care

AmateurAthlete

Diet/FitnessFocused

WorriedWell

Elderly LivingIndependently

ChronicPatient

AcuteRecovery

Infant

CONTINUUM of LIFE

CONTINUUM of CARE GIVERS

Doctor/NP/Nurse

HomeNursingProfessional

The Family

FitnessWellnessCoachNew Parents

Continua Health Alliance enables a personal health eco-system that

empowers individuals & families to better manage their own health and

wellness across the continuum of life and care methods.

Promoter Members Open

International

Over 200 Member

Companies!

Contributors 24eight, LLC

Advanced Digital Institute

Alcatel Lucent

Alere

Allion Test Labs, Inc.

All Medicus Co., Ltd.

American Heart Association

Analog Devices

Andago Ingenieria s.l.

AppsHub, Inc.

ASE Consulting Limited

AT4 Wireless

AT&T Mobility

Authentidate Holding Corp.

AViTA

Awarepoint

BiancaMed

BIOSPACE Co., Ltd.

Bluegiga Technologies Oy

Boston Scientific

Broadcom Corporation

Cambridge Consultants Ltd.

Canada Health Infoway

Capital Health

Cardiomedix Inc.

CELS, Ltd.

Centre for Global eHealth Innovation

Cerner Corporation

Chiptech Limited

Christus Health

Chunghwa Telecom Co., Ltd.

Claricode, Inc.

ConnectBlue AB

Continuity Health

Convergence Wireless, Inc.

CSR plc

CYPAK AB

Dell

Denso Corporation

Dossia Consortium

Dovetail Health

Duodecim Medical Publications

Dynastream Innovations Inc.

eflow Inc.

Ember Corporation

Empirica GmbH

Ericsson Nikola Tesla d.d.

ETRI

EuroTech, Inc.

Fairbanks Scales

FitLinxx

Foundation for Research and Technology

France Telecom R&D, LLC

Freescale Semiconductor

frog design, inc.

Frontline Test Equipment

Fujitsu Limited

Fullpower Technologies

GenerationOne, Inc.

GlaxoSmithKline

Google Inc.

Hill-Rom

Hitachi, Ltd.

Home Guardian, LLC

Honeywell HomMed LLC

Hosiden Corporation

iFoundry Systems Singapore Pte Ltd

Industrial Technology Research Institute

Infineon Technologies

INFORSON Co., Ltd.

Innomed Medical Zrt.

Innovation Centre Scotland

Institute for Infocomm Research

Institute of Biomedical

InterComponentWare, Inc.

Intramed A/S

Kai Sensors, Inc.

KDDI

Konami Sports and Life

Korea Electronics Technology Institute

Lamprey Networks, Inc.

LAXTHA Inc.

LG Electronics Inc.

LifeGate, Inc.

Lifescan

LifeWatch AG

Logic

LS Research, LLC

MEDCEL

Medgate AG

MedHelp International

Medixine Oy

MedSignals

Microlife Corporation

Midmark Corporation

Monitray, LLC

Motorola

MIR- Medical International Research

Murata Manufacturing Co., Ltd.

Neusoft Medical Systems

Nippon Telegraph and Telephone Corporation

Nordic Semiconductor ASA

Novo Nordisk

Nuubo (Smart Solutions Tech)

ON Semiconductor

Oregon Medical Labs

Oregon Scientific Inc.

Orthosensor, Inc.

PA Consulting Group

PDT, Inc.

Pfizer

Precor Fitness

Proskauer Rose LLP

Red Embedded Design

Renesas Technology America

ResMed Corp.

RF Technologies

RMD Networks

Ryoyo Electro Corporation

Sagem Communications SAS

Sensor Technology & Devices Ltd

Shimmer Research

SHL Telemedicine

Shorewood Packaging

Silicon and Software Systems

Silicon Laboratories, Inc.

Smartlife Technology Ltd

Sony Electronics Inc.

Southern Nevada Wellness

Stichting IMEC – Nederland

Stollmann E+V GmbH

STMicroelectronics N.V.

TaiDoc Technology Corporation

Tanita Corporation

TechnoGym

Tekoa Technologies Inc.

Telbios, SpA

Telecom Italia SpA

Telefonica S.A.

Telehealth Solutions Ltd.

Telus Communications Company

Textronics Inc.

Toshiba Home Appliances Corporation

Toumaz Technology Limited

Triage Wireless Inc.

TSB

TTA

Tyco Electronics

Tynetec Ltd

UnitedHealth Group

University of Miami - Miller School of Medicine

Verizon

Vitaphone GmbH

VivoMetrics, Inc.

Vodafone Group Services Ltd.

VTT Technical Research Centre of Finland

Westchester Institute for Human Development

Wind River

Wipro Technologies

Zarlink Semiconductor

Zensys

Ziehm Medical LLC

Liaisons

8

Health and WellnessOne billion adults overweight world wide

Internet

HealthyFamily

“Worried well” vital sign monitoring: Weight Blood pressure Glucose Cholesterol Activity level

Benefits: Monitor and motivate Achieve individuals’ goals Access personal fitness

information anywhere Enhance trainers’ services

Pedometer

Blood-pressure

Cuff

Heart Strap

Medication

Tracking

Weight

Scale

Fitness

Equipment

DigitalHome

Cell Phone

PC

PersonalHealthRecord

HealthcareProfessionals

Weight lossand fitnesscoaching

Continua member companies help people live healthier, more active lives by connecting them to their health and wellness team through a more efficient exchange of their personal fitness information.

Internet

Disease Management860 million chronic disease patients world wide

Continua member companies help people with chronic conditions live healthier lives by connecting them to their care team through a more efficient exchange of personal health information.

Chronic disease

Post trauma

Pre-op

Vital sign monitoring:

(remote patient monitoring)

Diabetes

COPD

CHF

Hypertension

Pedometer

Blood-pressure

Cuff

Pulse Ox

Medication

Tracking

Weight

Scale

Fitness

Equipment

DigitalHome

Cell Phone

Personal Health System

PCFamilyCare

Givers

DiseaseManagement

Service

PersonalHealthRecord

HealthcareProvider

Thermometer

Benefits:

Provide better-coordinated care

Connect to care team

Empower individuals

Encourage early detection

Reduce costs

Internet

Aging Independently600 million elderly individuals world wide

Independent living

Chronic diseaseContinua member companies help the elderly age independently, with dignity and security, through the efficient exchange of personal health and safety information that connects them to their family and care team.

Basic life monitoring:

Bed pressure (sleep)

Bathroom sensor

Gas / water sensor

Emergency sensor

FamilyCare

Givers

ElderlyMonitoringServices

DiseaseManagement

Service, HealthcareProvider

Diet andWellnessServices

DigitalHome

Pedometer

Blood-pressure

Cuff

Medication

Tracking

Home

Automation

& Control

Fitness

Equipment

Pulse Ox

Cell Phone

Personal Health System

Benefits:

Involve family members

Allow remote analysis & care

Provide integrated view

Encourage early detection

Reduce costs

Guidelines Certification Recognizable Logo

GuidelinesContinua member companies will select connectivity standards and publish Guidelines for strict interoperability.

Certification and LogoContinua is establishing a test and certification program with a recognizable logo signifying the promise of interoperability with other certified products.

Product Applications

Product Packaging

Product Substrates

Electronic Media / Software

PC

Personal

Health System

Cell Phone

Set Top Box

Aggregator

Version One Device Connectivity Standards

Weight

Scale

Pulse

Oximeter

Independent

Living Activity

Cardiovascular

and Strength

Fitness Monitor

Medication

Monitor

Glucose

Meter

Pulse /

Blood Pressure

Medical Device

Profile SpecificationPersonal Health Device

Class Specification

11073-10404 = Pulse Oximeter

11073-10406 = Pulse / Heart Rate

11073-10407 = Blood Pressure

11073-10408 = Thermometer

11073-10415 = Weighing Scale

11073-10417 = Glucose

11073-10441 = Cardiovascular Fitness Monitor

11073-10442 = Strength Fitness Equipment

11073-10471 = Independent Living Activity

11073-10472 = Medication Monitor

11073-20601 = Base Framework Protocol

Thermometer

Version One Healthcare Record Standards

Home-based Remote

Patient Monitoring

(RPM) System

Vital Sign Devices

Patient

Healthcare

Provider

Electronic

Health Record

System

EHR

Labs

Disease Management

Service Provider

Disease

management

nurse or home

care nurse

Remote

Patient

Monitoring

(RPM) Server

Personal Health Monitoring

(PHM) [based on CDA / CCD]

Cross-Enterprise Document

Reliable Interchange (XDR)

Personal

Health

Record

15

Serv

ice (W

AN

) Inte

rface

Netw

ork

(LA

N)

Inte

rface

Devic

e (P

AN

)

Inte

rface

Ele

ctric

Health

Record

(XH

R) In

terfa

ce

Application

Hosting Device

Version Two Use Cases Underway

New PAN Devices

WAN DeviceHealth

Record

Device

Final link in end-end connectivity XHR Extension- Portable Media

Physical Activity Monitor

Medication Monitor

Electrocardiogram (ECG)

Insulin Pump

Peak Flow

Low Power Radio

pHealth workshop , June 24-26, 2009, Milan Petkovic

Security and Trust Issues

Home Hub

care

profs

Reading entered

into record;

intervention

triggeredAlert raised

Incorrect

use of

devices

Wrong

user

Uncalibrated

device

Unauthorized

modification

Measurement

Devices

Application Hosting

Device

Backend Services xHR Systems

pHealth workshop , June 24-26, 2009, Milan Petkovic

Privacy Issues

17

Blood

pressure

meter

Pedometer

Fitness Service

Disease Management

Organization

Measurement

Devices

Application Hosting

Device

Backend Services xHR Systems

Patient

Coach

Nurse

Betty

Dr. Phil

Unauthorize

d users

Consent

management /

controlled

sharingDisclosure

control

Confidentiality

pHealth workshop , June 24-26, 2009, Milan Petkovic

• 490 pages, five parts, 29

chapters

• 45 internationally recognized,

leading security experts

Reviews:“Such a book is timely indeed (…) The results covered in this book will have a real impact.” – Dieter Gollmann

pHealth workshop , June 24-26, 2009, Milan Petkovic

Special session on Security and Privacy in

Healthcare

Join us in Lyon – August 28, 2009