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Manan Shukla, Jianjing Lin PhD, Oshani Seneviratne PhD

Rensselaer Polytechnic Institute, Troy, NY, USA

#AMIA2021

BlockIoT: Blockchain-based Health Data Integration using IoT Devices

Oral Presentations - Informatics Data Innovations

S67

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Disclosure

There are no financial conflicts of interest to disclose.

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Learning Objectives

After participating in this session the learner should be better able to:

- Understand the current issues regarding interoperability between various health infrastructures, and specifically consider the potential and accessibility of medical device data.

- Realize potential benefits in terms of quality and efficiency in healthcare delivery from using medical-device sourced physiological data, and understand the challenges that limit its application in current clinical practices.

- Learn about potential benefits of managing and transferring patient information via a decentralized storage mechanism and smart contracts, which may further facilitate the application of emerging technologies like AI/ML in medicine

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Introduction

  • Health Information has become widely accessible from past 10-20 years�
  • EHR Systems provide patient symptomatic history, lab reports, etc�
  • Medical Devices provide physiological and granular data
    • Day-to-day quantitative view of a patient’s health
    • Algorithms can predict, recognize or confirm health events

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Linkous, Lauren & Zohrabi, Nasibeh & Abdelwahed, Sherif. (2019). Health Monitoring in Smart Homes Utilizing Internet of Things. 10.1109/CHASE48038.2019.00020.

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Problems Addressed

  • Lack of trust and accountability with the data shared between healthcare providers

  • Significant lack of integration between medical devices and electronic medical record systems

  • Prevents vital patient information from reaching the provider, and deters proper decision making�

Ex: How can you treat hypertension without knowing the patient’s BP value over time?

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BlockIoT

  • Connects personal health devices and EHR systems

  • Smart contracts monitor, analyze, and intervene if health metric is abnormal �

  • Provides better patient health metrics, and helps facilitate better patient interventions�

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BlockIoT Architecture

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Participatory Design Survey

Goal:

- Gauge the importance of medical device data on a provider’s daily workflow

- Determine whether addition of medical device data can influence a physician's medical decision-making process

- Feedback for improvements to be made with data representation

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Participatory Survey

- 13 physicians (recruited through personal/professional connections)

- Different specialties (cardiologist, GI, dermatologist, geriatrician, emergency physician, surgeon, anesthesiologist, pulmonologist/allergy/sleep medicine, internal medicine, and primary care)

- 1-1.5 hr interviews, with Google Form

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Participatory Survey

- A sample HPI of a patient was given with:

— 5 chronic conditions

— 5 personal health devices whose data reflects these conditions

- A mock EHR was provided that contains the representations of the patient’s device data

- Goal is to make the system comparable to what would be used on a regular basis

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Mock Patient Data for Participatory Survey

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Evaluation Methodology

1. Brief Overview of BlockIoT

2. Questions regarding their current practice- ex. use of medical device data

3. Display the patient’s HPI

4. Questions in regards to how they would treat the patient

5. Display medical device data

6. Ask whether data from each graph would potentially change their treatment decision

7. Ask for the physician’s overall opinion of the system

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Survey Results- After BlockIoT Demo

- Access to means for obtaining physiological data from patients is minimal or non-existent.

- Access to device data is also variable, i.e., no standardized method currently exists

- Physician 4 institutes a log for patients with chronic illnesses

— Admitted that the quality of the data in these logs is only “about 50%”

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Physician 3

“The only way we know whether the patient has high blood pressure is whether the patient takes a one- time blood pressure reading a day at home in the morning, and that is only when we really ask to do it. Even then, they will only do it for some of the time, not all the time. Or when they come to the doctor’s office every 2 to 3 months. A blood pressure reading can change every second, which means that we are missing millions of data points right now!”

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Evaluation Results- After BlockIoT

- 87% of physicians reporting that they would be willing to use the summary views as well as the patient/physician interventions throughout the patient care

- Other 13% were more inclined to just use the summary views

- 2 physicians cited alert fatigue as a reason to not receive alerts from BlockIoT and preferred to simply use the summary views.

- All of the physicians stated that the given data would make them more efficient in the diagnosis process

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Future Work

- Physicians expressed the need for UI changes based on preferences and specific diseases

- More research is needed in using BlockIoT for:

- Insurance claims

- Authorizing Tests

- Malpractice Lawsuits

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Summary

- BlockIoT enables connectivity between personal health devices and EHR systems

- It monitors, analyzes, ands intervenes in case a health metric is abnormal. 

- A 13-physician participatory survey was conducted to determine the impact and utility of BlockIoT in a physician’s workflow

- Physicians expressed a need for standard access for medical data, and found BlockIoT to be useful in their practice

For more information, please contact: Manan Shukla (shuklm@rpi.edu), Dr. Oshani Seneviratne (senveo@rpi.edu), Dr. Jianjing Lin (linj17@rpi.edu)

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Thank you!