Deliverable D3.1.1 State of the Art Technologies and Architectures for EMPOWER Project title: Support of Patient Empowerment by an intelligent self- management pathway for patients Project acronym: EMPOWER Project identifier: FP7-ICT-2011-288209 Project instrument: STREP Web link: www.empower-fp7.eu Dissemination level: PU (public) Contractual delivery: 2012-06-30 Actual delivery: 2012-06-28 Leading partner: HMGU The research leading to these results has received funding from the European Community's Seventh Framework Programme (FP7/2007-2013) under grant agreement No 288209, EMPOWER Project. FP7-288209 EMPOWER Document History Version Date Changes From Review HMGU, V0.1 2012-02-29 Initial Document All Partners SRFG V0.2 2012-05-15 Content added All Partners All Partners V0.4 2012-05-25 Comments SRFG All Partners MOH, SRFG, V0.5 2012-06-14 Content added All Partners GOIN HMGU, V0.6 2012-06-19 Content added All Partners ICOM HMGU, V0.7 2012-06-22 Content added SRFG, MOH, All Partners GOIN, USI V1.0 2012-06-27 Final revision All Partners - EMPOWER Consortium Contacts Beneficiary Name Phone E-Mail SRFG Manuela Plößnig +43 662 2288 402 [email protected] HMGU Claudia Hildebrand +49 89 3187 4182 [email protected] GOIN Siegfried Jedamzik +49 8 41956161 [email protected] USI Peter J. Schulz +41586664724 [email protected] SRDC Asuman Dogac +90 312 210 13 93 [email protected] ICOM Ilias Lamprinos +302106677953 [email protected] MOH Ali Kemal Caylan +903125851907 [email protected] d311_empower_technologies-and-architectures-v10.docx 2 / 136 FP7-288209 EMPOWER Table of Contents 1 Summary ........................................................................................................................ 7 2 EMPOWER in a Nutshell ................................................................................................ 8 3 Related RTD Projects ..................................................................................................... 9 3.1 National Projects ..................................................................................................... 9 3.1.1 ByMedConnect - Improving communication by linking domains thus fostering integrated healthcare in Bavaria ..................................................................................... 9 3.1.2 EHR-Arche - Archetype based Electronic Health Record ................................. 9 3.2 European Projects ..................................................................................................10 3.2.1 FP7 248240 – iCARDEA - An Intelligent Platform for Personalized Remote Monitoring of the Cardiac Patients with Electronic Implant Devices ...............................10 3.2.2 FP6 027074 – SAPHIRE - Intelligent Healthcare Monitoring based on Semantic Interoperability Platform.................................................................................................11 3.2.3 DIABCARD - Improved Communication in Diabetes Care Based on Chip Card Technology....................................................................................................................13 3.2.4 SemanticHealthNet .........................................................................................13 3.2.5 DIAdvisor - Personal Device for Glucose Prediction and Advice in Diabetes ...14 3.2.6 ICT PSP 297260 PALANTE - Patient Leading and Managing Their Healthcare Through E-Health ..........................................................................................................15 4 Diabetes Disease Management .....................................................................................16 4.1 Best Practice and Common Practices ....................................................................16 4.2 Example Germany .................................................................................................18 4.3 Example Turkey .....................................................................................................19 5 Care Pathways and Guidelines for diabetes ..................................................................22 5.1 Best Practice and Common Practices ....................................................................22 5.2 Example Germany .................................................................................................23 5.3 Example Turkey .....................................................................................................23 6 Tools supporting Care Pathways and Guidelines ..........................................................27 6.1 Computer supported Care Pathways ......................................................................27 6.1.1 Rule-based Process Platforms ........................................................................27 6.1.2 Overview and issues for the Enterprise Service Bus (ESB) .............................29 6.1.3 Utilizing EIP Patterns.......................................................................................31 6.1.4 ESB Products (Open Source) ..........................................................................31 6.1.5 Semantic technologies ....................................................................................33 6.2 Computer Interpretable Guidelines and Models ......................................................37 6.2.1 Arden Syntax ..................................................................................................37 6.2.2 Asbru Model ....................................................................................................38 6.2.3 GUIDE ............................................................................................................38 6.2.4 PROforma .......................................................................................................40 6.2.5 GLIF ................................................................................................................40 6.2.6 GLARE ............................................................................................................47 6.2.7 SAGE ..............................................................................................................48 7 Patient Empowerment Approaches ...............................................................................50 d311_empower_technologies-and-architectures-v10.docx 3 / 136 FP7-288209 EMPOWER 7.1 Health Literacy .......................................................................................................50 7.2 Information, Education & Decision Support ............................................................51 7.2.1 Personalized Interventions ..............................................................................51 7.2.2 Doctor-Patient Relationship (embedding the system) ......................................51 7.3 Personal Health Records and PHR Systems ..........................................................53 7.3.1 PHR ................................................................................................................53 7.3.2 HL7 PHR System Functional Model ................................................................55 7.3.3 PHR Systems ..................................................................................................58 7.4 Self-Management ...................................................................................................63 7.4.1 What is Self-Management? .............................................................................63 7.4.2 Self-Management Programs and Initiatives .....................................................65 7.5 Observations of Daily Living ...................................................................................70 7.5.1 Project HealthDesign.......................................................................................72 8 Health Information Technology Standards and Interoperability Initiatives ......................74 8.1 HL7 ........................................................................................................................74 8.1.1 Clinical Record Architecture ............................................................................75 8.2 IHE .........................................................................................................................76 8.2.1 IHE Profile XPHR - Exchange of Patient Health Records ................................77 8.2.2 Relationship of Continuity of Care Document to IHE .......................................78 8.2.3 IHE Patient Care Coordination Technical Framework......................................79 8.3 ISO 13606 ..............................................................................................................83 8.3.1 ISO 13606 Reference Model ...........................................................................83 8.3.2 ISO 13606 Archetype Model ...........................................................................84 8.3.3 OpenEHR Specifications .................................................................................85 8.3.4 OpenEHR Clinical Knowledge Manager ..........................................................86 8.4 Archetypes and Detailed Clinical Models ................................................................87 8.4.1 Existing Archetype Developments ...................................................................87 8.4.2 Detailed Clinical Models ..................................................................................88 8.5 PHR Interoperability