Create Systems Design

[GarrettS]

Create Systems Design

Requirements

Must Have (Phase I)

• Patient Data Ownership: Patients must be able to share and revoke sharing of any or all data with any provider, on a fine-grained basis.
• Independent Provider Access: Providers must be able to join the network independently without being part of any managed group or institution.
• Independent Facility Access: Labs and other facilities may join with no special privileges.
• Provider Search: The system must include provider search functionality (e.g., provider type, insurance, etc.).
• Extensible Data Fields: The system must support extensible health data fields designed around health optimization (e.g., bloodwork, EKG, imaging, nutrition, supplements, undetermined protocols, etc.).

Will Have (Phase II)

• Health Plan Synthesis: Basic synthesis of personalized health plans using collected data.
• Integration with Personal Health Devices: Capability to integrate device data from fitness trackers and health monitors.
• Big Data Integration: The system must integrate with big data to provide detailed information about health supplements and protocols.
• Comprehensive Health View: Integration with AI and big data to provide a complete view of patient health.
• APIs for Extensibility: APIs must be available for third-party integration of data modeling and analysis.

Should Have (Phase III)

• Anonymized Data for Advertisers: The system should provide anonymized, sandboxed data channels for advertisers to anonymously target users securely.

Won't Have

Direct Advertisement Channels: Direct advertisement channels that are not anonymized will not be supported.

[GarrettS]

= SPEC-: Singular Health Platform :sectnums: :toc:

== Background

Current healthcare systems and Electronic Health Records (EHRs) prioritize institutions over people. They are costly, inefficient, and fail to maximize health outcomes.

=== Current EHR Limitations

Existing EHRs are tied to institutions. Institutions cost way too much money, limit health, depend on illness, paternalize care, and constrain doctors to the institution's protocols or professionally-ordained purview.

Existing EHRs do not address fundamental health optimization. They ignore crucial aspects such as diet, exercise, and supplementation. These systems are outdated and fail to provide comprehensive health management.

=== The Necessity of Singular Health

There is a strong market demand for advanced health plan synthesis, which is not met by the current healthcare and EHR models. Singular Health aims to fill this gap by offering complex and personalized health plan synthesis.

=== The Savings

Healthcare costs are inflated mainly due to institutional factors such as markups (~340%), administrative costs (8-10% of total), and uncompetitive rates. Singular Health seeks to eliminate these costs by removing the need for entire records departments and associated overheads.

Singular Health prioritizes health optimization as a core value. This approach is expected to improve patient health, quality of life, productivity, and reduce healthcare utilization and dependence.

== Requirements

=== Must Have (Phase I)

• Patient Data Ownership: Patients must be able to share and revoke sharing of any or all data with any provider, on a fine-grained basis.
• Independent Provider Access: Providers must be able to join the network independently without being part of any managed group or institution.
• Independent Facility Access: Labs and other facilities may join with no special privileges.
• Provider Search: The system must include provider search functionality (e.g., provider type, insurance, etc.).
• Extensible Data Fields: The system must support extensible health data fields designed around health optimization (e.g., bloodwork, EKG, imaging, nutrition, supplements, undetermined protocols, etc.).

=== Will Have (Phase II)

• Health Plan Synthesis: Basic synthesis of personalized health plans using collected data.
• Integration with Personal Health Devices: Capability to integrate device data from fitness trackers and health monitors.
• Big Data Integration: The system must integrate with big data to provide detailed information about health supplements and protocols.
• Comprehensive Health View: Integration with AI and big data to provide a complete view of patient health.
• APIs for Extensibility: APIs must be available for third-party integration of data modeling and analysis.

=== Should Have (Phase III)

• Anonymized Data for Advertisers: The system should provide anonymized data to advertisers.

[GarrettS]

@startuml package "Singular Health Platform" { [Frontend Service] --> [API Gateway] [API Gateway] --> [Authentication Service] [API Gateway] --> [Patient Data Service] [API Gateway] --> [Provider Service] [API Gateway] --> [Facility Service] [API Gateway] --> [Search Service] [API Gateway] --> [Extensible Data Service] [API Gateway] --> [Data Mapping Engine]

package "Data Storage" {
    [Patient Database]
    [Provider Database]
    [Facility Database]
    [Search Index]
    [Extensible Data Database]
}

[Patient Data Service] --> [Patient Database]
[Provider Service] --> [Provider Database]
[Facility Service] --> [Facility Database]
[Search Service] --> [Search Index]
[Extensible Data Service] --> [Extensible Data Database]

package "Data Mapping Engine" {
    [Data Adapters] --> [Data Mapping Engine]
    [Third-Party Data Services] --> [Data Mapping Engine]
}

[Data Mapping Engine] --> [Extensible Data Service]

} @enduml

[GarrettS]

It's not quite right.

[GarrettS]

This diagram shows the third party data services.

[GarrettS]

And with the Data Mapping Engine

[GarrettS]

Manage and invoke data adapters, normalizing and transforming their outputs. Ideal Models: Build complete models from complete, incomplete, and incongruent data. Fallback Models: Provide fallback representations when data cannot be meaningfully presented.

[GarrettS]

OpenEHR, ISO 13606, and HL7 can significantly enhance the design by providing standards for data representation, interoperability, and integration.

Benefits

OpenEHR: Archetypes and Templates: Define reusable clinical data structures. Interoperability: Facilitate data exchange between systems. Data Consistency: Ensure structured and semantically consistent data storage. ISO 13606: Standardized EHR Communication: Define structures for EHR data exchange. Part 1-5 Specifications: Cover reference models, archetypes, security, and exchange processes. Interoperability: Ensure efficient importing of data from various EHR systems while maintaining legal compliance (e.g., HIPAA) and minimizing effort to accommodate other systems.

Standards for Compliance and Data Portability OpenEHR: Archetypes and Templates: Define reusable clinical data structures to ensure structured and semantically consistent data storage. Interoperability: Facilitate data import without seamless data sharing. ISO 13606: Standardized EHR Communication: Define structures for EHR data import. Part 1-5 Specifications: Cover reference models, archetypes, security, and exchange processes. HL7: FHIR (Fast Healthcare Interoperability Resources): Modern, web-based standards for importing healthcare information. CDA (Clinical Document Architecture): Standardize clinical document imports. Implementation Steps

1. Determine Requirements Identify Data Elements: Patient demographics, medical history, medications, lab results, imaging, vital signs, treatments, procedures. Format and Security: JSON format, encryption, authentication, authorization.
2. Develop Connections with EHR Systems Third-Party Integration/Custom Solutions: Establish connections through authorized access to EHR APIs (e.g., Epic MyChart, Oracle Health, NextGen). Authorization: Ensure authorized access to retrieve required data using HTTPS, OAuth, or API keys.
3. Design API Endpoints Secure Endpoints: Define API endpoints for data retrieval in JSON format using HTTPS, OAuth, or API keys.
4. Implement Data Normalization and Parsing Data Adapters: Create adapters to parse and normalize third-party EHR data formats into internal data models.
5. Implement Flexible Data Representation Data Mapping Engine: Manage and invoke data adapters to transform data. Dynamic Views: Develop views that handle incomplete data and provide multiple views for incongruent data models.
6. Ensure Legal Compliance

HIPAA Compliance: Implement data encryption, access controls, and logging to meet HIPAA requirements. Data Portability Laws: Ensure adherence to relevant laws like GDPR for data import and storage. @startuml package "Singular Health Platform" { [Frontend Service] --> [API Gateway] [API Gateway] --> [Authentication Service] [API Gateway] --> [Patient Data Service] [API Gateway] --> [Provider Service] [API Gateway] --> [Facility Service] [API Gateway] --> [Search Service] [API Gateway] --> [Extensible Data Service] [API Gateway] --> [Data Mapping Engine]

package "Data Storage" {
    [Patient Database]
    [Provider Database]
    [Facility Database]
    [Search Index]
    [Extensible Data Database]
}

[Patient Data Service] --> [Patient Database]
[Provider Service] --> [Provider Database]
[Facility Service] --> [Facility Database]
[Search Service] --> [Search Index]
[Extensible Data Service] --> [Extensible Data Database]

package "Data Mapping Engine" {
    [Data Adapters] --> [Data Mapping Engine]
    [Vendor Adapter Framework] --> [Data Mapping Engine]
    [Rendering Models] --> [Data Mapping Engine]
}

[Data Mapping Engine] --> [Extensible Data Service]

}

package "Vendor Adapter Framework" { [Epic Adapter] [Oracle Health Adapter] [NextGen Adapter] [Third-Party Data Services] }

package "Patient Data Models" { [Patient Data Model] --> [Patient Database] [Medical History Model] --> [Patient Database] [Lab Results Model] --> [Patient Database] [Imaging Model] --> [Patient Database] [Vital Signs Model] --> [Patient Database] [Treatment and Procedures Model] --> [Patient Database] }

package "Rendering Models" { [Incomplete Data View] [Multiple Data Views] }

package "Standards Integration" { [OpenEHR Archetypes] [ISO 13606] [HL7 FHIR] }

[Data Mapping Engine] --> [OpenEHR Archetypes] [Data Mapping Engine] --> [ISO 13606] [Data Mapping Engine] --> [HL7 FHIR] @enduml

[GarrettS]

@startuml package "Singular Health Platform" { [Frontend Service] --> [API Gateway] [API Gateway] --> [Authentication Service] [API Gateway] --> [Patient Data Service] [API Gateway] --> [Provider Service] [API Gateway] --> [Facility Service] [API Gateway] --> [Search Service] [API Gateway] --> [Extensible Data Service] [API Gateway] --> [Data Mapping Engine]

package "Data Storage" {
    [Patient Database]
    [Provider Database]
    [Facility Database]
    [Search Index]
    [Extensible Data Database]
}

[Patient Data Service] --> [Patient Database]
[Provider Service] --> [Provider Database]
[Facility Service] --> [Facility Database]
[Search Service] --> [Search Index]
[Extensible Data Service] --> [Extensible Data Database]

package "Data Mapping Engine" {
    [Data Adapters] --> [Data Mapping Engine]
    [Vendor Adapter Framework] --> [Data Mapping Engine]
    [Rendering Models] --> [Data Mapping Engine]
}

[Data Mapping Engine] --> [Extensible Data Service]

}

package "Vendor Adapter Framework" { [Epic Adapter] [Cerner Adapter] [Meditech Adapter] [Athenahealth Adapter] [NextGen Adapter] [Third-Party Data Services] }

package "Patient Data Models" { [Patient Data Model] --> [Patient Database] [Medical History Model] --> [Patient Database] [Lab Results Model] --> [Patient Database] [Imaging Model] --> [Patient Database] [Vital Signs Model] --> [Patient Database] [Treatment and Procedures Model] --> [Patient Database] }

package "Rendering Models" { [Incomplete Data View] [Multiple Data Views] }

package "Standards Integration" { [OpenEHR Archetypes] [ISO 13606] [HL7 FHIR] }

[Data Mapping Engine] --> [OpenEHR Archetypes] [Data Mapping Engine] --> [ISO 13606] [Data Mapping Engine] --> [HL7 FHIR] @enduml

[GarrettS]

@startuml package "Singular Health Platform" { [Frontend Service] --> [API Gateway] [API Gateway] --> [Authentication Service] [API Gateway] --> [Patient Data Service] [API Gateway] --> [Provider Service] [API Gateway] --> [Facility Service] [API Gateway] --> [Search Service] [API Gateway] --> [Extensible Data Service] [API Gateway] --> [Data Mapping Engine]

package "Data Storage" {
    [Patient Database]
    [Provider Database]
    [Facility Database]
    [Search Index]
    [Extensible Data Database]
    [Imaging Database]
}

[Patient Data Service] --> [Patient Database]
[Provider Service] --> [Provider Database]
[Facility Service] --> [Facility Database]
[Search Service] --> [Search Index]
[Extensible Data Service] --> [Extensible Data Database]
[Imaging Service] --> [Imaging Database]

package "Data Mapping Engine" {
    [Data Adapters] --> [Data Mapping Engine]
    [Vendor Adapter Framework] --> [Data Mapping Engine]
    [Rendering Models] --> [Data Mapping Engine]
}

[Data Mapping Engine] --> [Extensible Data Service]

}

package "Vendor Adapter Framework" { [Epic Adapter] [Cerner Adapter] [Meditech Adapter] [Athenahealth Adapter] [NextGen Adapter] [Third-Party Data Services] }

package "Patient Data Models" { [Patient Data Model] --> [Patient Database] [Medical History Model] --> [Patient Database] [Lab Results Model] --> [Patient Database] [Imaging Model] --> [Imaging Database] [Vital Signs Model] --> [Patient Database] [Treatment and Procedures Model] --> [Patient Database] }

package "Rendering Models" { [Incomplete Data View] [Multiple Data Views] }

package "Standards Integration" { [HL7 FHIR] [HL7 CDA] [DICOM] }

[Data Mapping Engine] --> [HL7 FHIR] [Data Mapping Engine] --> [HL7 CDA] [Data Mapping Engine] --> [DICOM] @enduml