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Test Data Entry for WATERS (EHR app, webportal, & phone app)

This solution encompasses three IVD-agnostic applications on three separate platforms: an EHR connected SMART on FHIR app, an available-from-anywhere web portal, and a smart phone/tablet app (that does more than simply collect data - see our other Capstone Project entry). Each of these offerings makes data entry easy, by eliminating data redundancy and harmonizing the data into HL7 format for consumptions by HHS's WATERS.

5 min Video of Capstone Project

Elevator Pitch

We want to meet people where they are with intuitive options that eliminate redundancy and harmonize test data entry for WATERS consumption.

Challenge Goals

This IVD-agnostic suite of applications offer a robust solution for multiple platforms: EHRs, web browsers, and smart phones/tablets. These offerings are meant to meet people where they are, whether provider or patient, for both lab-based and non-lab-based testing situations. They are meant to be IVD-agnostic companion applications which are linked to via IVD device packaging. By scanning the IVD device QR code or barcode, IVD device manufacture and product data is automatically collected. If an IVD device is capable, it could link to smart devices via Bluetooth for automated data capture. However, this is not a requirement, which can help to keep IVD device costs lower.

Feasibility

These applications are extremely feasible. The front ends for the SMART on FHIR app and the web portal are already built/prototyped for data harmonized and collection. A database that houses the data packets from each of these solutions can be quickly stood up. The most challenging aspect for our team would be for our full-stack developers to learn the SMART/FHIR protocols. The majority of this set of solutions could be stood up in a matter of weeks.

Design

Provide options, deliver intuitive interfaces, minimize burden, and meet people where they are. All three applications are designed for access. Each of the interfaces provide clear, easy-to-understand, non-redundant prompts. The EHR and smart phone/tablet applications automatically pull information directly from profile data where possible. The EHR app also pushes information back to the EHR system to negate the need for duplicate data entry. If a provider doesn't use an EHR system, or if no smart device is available, a simple web portal is available. These secure options should accommodate most everyone. By harmonizing all data entered using HL7 protocols, WATERS will acquire consistent test data each and every time.

Innovation

For us, innovation isn't about the new, shiny thing... it's about doing things the right way; often the simplest way. Using technology and techniques that already exist, but applying them in a well designed, considerate manner, we can collect data in a way that is easy to capture, harmonize, and transmit. Utilize the EHR system the provider is already using. Provide a simple webpage that is available to anyone that has an internet connection. Meet people on the cell phones and tablets they use everyday. Our innovation is in human-centered design.

Flexibility & Scalability

This solution would reach people across multiple platforms, both professional and personal, where ever they are. The applications are IVD-agnostic and easily translatable into other languages.

Sustainability & Extensibility

Each of these solutions operate across different systems. Each application contains the same data capture and harmonization logic, meaning that each data packet will contain useable, cross-comparable information. The code is simple to translate into other mediums, assuring expandability for accommodation of other platforms or devices. Given that the data capture and harmonization logic can be tweaked, this application suite can be made to accommodate other infectious diseases/pandemic situations.

Team & Collaboration

Brandon L. Barrett, PharmD, MS - Senior innovation developer, polymath, champion of human centric and intuitive design.
Christopher Dunn, MS - Senior data scientist, graphical database wizard, analytical chemistry lab veteran, musician, ninja.
Deepika Katta, MS - Senior prototype developer, creator, designer, figurer-outter.
Aline Martinez, BFA, MLS - Taxonomist, organizer, people connector, info extractor, artist.
Andrew Grothen, PharmD - Data guru, clinical pharmacist, amateur enterprise architect, OCD+, provider of vast amounts of varied knowledge.
Sean Tepper - Senior web developer, UI/UX specialist, a creative, applier of polish, maker of pretty and intuitive things.

USP stands for trust in public health, and it has for over 200 years.

Additional Comments

This was a really great exercise for us to stretch our imaginations and abilities. We hope you like our entries! Here's a Vimeo link to the videos for both of our Capstone Project entries: 

Test Data Entry for WATERS: https://vimeo.com/483603002/f5ee42efbc

#bubble: https://vimeo.com/483602754/819081e7df

What Team(s) contributed to this Capstone Project?

Although we tried linking up with other participating teams initially, this was a USP-only team project. We did call on input from others across our organization: a diagnostic testing specialist, lab scientists, data scientists, communications, etc.

If you are using patient data, are you using real patient data or mock data? Please use MOCK patient data only

MOCK data

edited on Nov 29, 2020 by USP Digital & Innovation
USP Digital & Innovation

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Sophia B Liu 6 months ago

This idea has been advanced to the current phase

People's Choice Voting Extended

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Sophia B Liu 6 months ago

This idea has been advanced to the next phase

People's Choice Voting Extended

Reply 0

Andrea Pitkus 5 months ago

Trying to understand if there are preconditions met by other software. (In general) 1. How to collect AOEs, from ordering provider/patient/specimen collector 2. Integrate into app/LIS or other information source for patient to be married to results of IVD test device/system 3. All transmitted to public health (ELR) 4. All transmitted to HHS (may be met by 3).

Will your approach support all 4 or only portions of above for "tracking lab results"?

Looks like your application is EHR specific. Do you support LIS based reporting of ELR in HL7 v2.51 (per the MU IG)? For patient performed results are they routed to the physician who is required to report via electronic Case Reporting (eCR) by law? Is only CDA supported or other messaging formats like FHIR and V2.51 depending on where the reporting occurs.

How/where are LOINC, SNOMED CT and other codes systems supported in your messaging to meet requirements?

How are CLIA testing requirements met in your system?

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USP Digital & Innovation 5 months ago

Great questions! The unique patient identifier system links patients to bubbles based on a combination of address & phone number & name/demographic info. This is held within the containing database for all three systems (SMART on FHIR EHR connected application, the web portal, and the #bubble app). Each test result will be associated with the correct patient and that data will be accessible by all systems and by HHS's WATERS. If you have specific questions regarding how that'd work in detail, we're happy to answer.

The application is NOT EHR specific. The SMART on FHIR framework allows the application to be EHR agnostic. The idea is to be able to reach everyone... caregivers within the EHR environments they're already working within, providers and/or patients that do not have EHR access or cell phone/tablet access, and to those patients in their homes with the #bubble app. The reporting is done with LIS based reporting support in HL7 format. We condensed each of the question sets for Lab Based and Non-lab Based methods into easy to understand report for both caregivers and patients. (i.e. asking if the test was ordered today and auto-filling today's date, taking a logical approach to information collection, etc.). As part of this offering, device manufacturers will need to link their UPC/QR codes to their individual products so that when scanned, the applications enter the correct data pertaining to the specified test in the correct format.

LOINC and SNOWMED CT and other codes can be automatically generated from answers/profile information provided to meet messaging requirements. The same goes for LOINC and SNOWMED code systems, depending on what is required and when. Profiles are also generated on the provider side that dictates these requirements, and are meant to be automated as much as possible. The system would also be able to implement automatically reported test data (e.g. electronic/BT compatible at-home tests) though is intentionally set for manual data input, at least initially, to keep test costs low and to lower the barrier to participation. Otherwise, a simple pairing process can be implemented that would eliminate the need to take a photo of the UPC/QR codes associated with individual testing products. Test ID, date, results, etc. would then be automatically entered into each of the systems.

Thank you for your questions! Please, let us know if there is anything else we can clarify or if you still have further questions.

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