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PhUSE 2010 Conference - CDISC and Industry Standards Discussion Club - Tuesday, October 19th 2010
Empowering Translational ResearchEmpowering Translational Researchthroughthrough
Distributed Collaborative ComputingDistributed Collaborative Computing
Dr. Ed ConleyDr. Ed Conley
Distributed Collaborative Computing Research1 &Severnside Translational Research Alliance
Schools of Computer Science1 and Medicine2
Cardiff and Bristol Universities, UK
PhUSE 2010 Conference - CDISC and Industry Standards Discussion Club - Tuesday, October 19th 2010
Sintero Server is a prototype distributed clinical computing platform funded by Wellcome Trust Translational Programme
It tries to Simplify INTEROperability in large-scale healthcare & clinical research applications
It aims to be highly cost-efficient with low ‘footprint’to ‘defragment’ collaborative processes
It is based on an internationalised software “stack” intended to work the same way everywhere
PhUSE 2010 Conference - CDISC and Industry Standards Discussion Club - Tuesday, October 19th 2010
Sintero is an internationally-distributed collaborative computing platform. For assisting translation, it is targeted equally into two areas:
1. Affordable healthcare initiatives - providing new “low-cost and scalable” options for open source clinical data “node” infrastructures and patient-centred service hosting. For example, “commodity interoperability” solutions that are portable. Through internationalised software “stack” implementations they work the same way everywhere.
2. Standard computational workflows for translational research – i.e. chained blocks of standard executable server code harmonising multi-site (especially international) clinical research collaborations. These absolutely depend on assisting the collaboration “nodes” to use single semantic/syntax standards. Sintero is designed to implement/deploy any externally defined semantic model and work with multiple EHR’s and EDC systems.
Distributed Collaborative Computing
Low-costreplicable‘STACK’
~creates‘LOCAL’
TRUSTEDSERVER‘NODES’
e.g. Collaboration Ae.g. Collaboration B
Trusted nodes are portable:
and reconfigurable:
…and scalable:LOCAL DATA STORAGE NODE
PhUSE 2010 Conference - CDISC and Industry Standards Discussion Club - Tuesday, October 19th 2010
‘Nodes’ Can Improve Interoperability
Sets InternalINTER-NODE
TRANSACTIONSEMANTICS
External (global)SEMANTIC
REFERENCESTANDARD(S)
…to deploy at scale:
PhUSE 2010 Conference - CDISC and Industry Standards Discussion Club - Tuesday, October 19th 2010
AIM is a COMMODITY solution for
(1) AFFORDABLE HEALTHCARE I.T.
OUTCOMESOUTCOMESMONITORINMONITORIN
GG& RISK& RISK
ANALYSISANALYSIS
DIRECTDIRECTPATIENTPATIENT
CARECARE
PATIENTPATIENTPATHPATH
e.g. @homee.g. @home& mobile& mobile
Monitor timelineMonitor timelineINTERVENTIONSINTERVENTIONS
Centred onCentred onPATIENTPATIENT
PATIENT IDENTIFIABLE DATA USES
CLINICALCLINICALRESEARCHRESEARCH
distributeddistributedcollaborationscollaborations
AUDITAUDIT&&
GOVERNANCEGOVERNANCE
e2ee2eQUALITYQUALITY
e.g. ‘lean e.g. ‘lean clinics’clinics’
VALIDATEVALIDATECOHORTCOHORT
OUTCOMEOUTCOMESS
e.g. for e.g. for efficacyefficacy
& toxicity& toxicity
Modelling & Modelling & DISCOVERYDISCOVERY
PATIENT NON-IDENTIFIABLE DATA USES
ComparativeComparativePERFORMANCPERFORMANC
EE
SemanticSemanticAGGREGATIONAGGREGATION
(2) EHR LINKED-OUTCOMES (PSEUDONYMISED) STUDIES
CONTINUOUS WITH
e.g. TIMELINEe.g. TIMELINEMONITORINGMONITORING
PhUSE 2010 Conference - CDISC and Industry Standards Discussion Club - Tuesday, October 19th 2010
etc.
COMMUNITY
SOCIALCARE
INDEPENDENTCLINIC
GYM
HOSPITAL‘P
atie
nt p
ath’
MOBILE
Mobile hubs
WORK ID data PPBIND
ID data PPBIND
ID data PPBIND
ID data PPBIND
ID data PPBIND
ID data PPBIND ID data PP
BIND
HOME
DEVICES
HL7 CONSENT DIRECTIVE – PRIVACY POLICIESHL7 CONSENT DIRECTIVE – PRIVACY POLICIES
‘Dat
a P
ath
’
+ IDdata
BINDDATA
Devicedata
Patient consentto Privacy Policy
Home hubs
Consistent Timeline Monitoring(incl. data format, HL7 Consent Directive, CDA release 2, CDISC ODM)
PhUSE 2010 Conference - CDISC and Industry Standards Discussion Club - Tuesday, October 19th 2010
Sintero Node Interoperability Layers
Replicated in each server node
L1: data documents (CDA, ODM)
L2: Internationalised XDS
ID’s’, timestamps, ID’s’, timestamps, codes/values, consentcodes/values, consent
Stream Inferable DataStream Inferable DataDocuments Documents RDBMSRDBMS
L3: Semantic Aggregation
L4: Executable Code WorkflowsRe-stream Aggrg. DataRe-stream Aggrg. Data
RBAC Boolean queriesRBAC Boolean queries
INPUTSINPUTS
OUTPUTS
PhUSE 2010 Conference - CDISC and Industry Standards Discussion Club - Tuesday, October 19th 2010
STUDYFEASIBILITY
STUDYFEASIBILITY
LOCAL Aggregation Layer 3
(EHR-linked-pseudonymised)
BENEFIT: Attribute-level subject recruitment
SECOND STREAMSECOND STREAM
= Limited complexity database
STREAMINFERABLEDATA L2-L3
STREAMINFERABLEDATA L2-L3
Globally consistent syntax (Boolean)Inclusion, Exclusion on Code/Value
Globally consistent syntax (Boolean)Inclusion, Exclusion on Code/Value
LAYER 1 VERBOSEDATA DOCUMENTS
CDA / ODMON TIMELINE
L2
PhUSE 2010 Conference - CDISC and Industry Standards Discussion Club - Tuesday, October 19th 2010
BENEFIT: EHR outcomes modelling
Compute Y = function (X) Rank variables
Rank variables
nodeID’s,PSID’s,codes,values,timestamps
TimeXDS XDS
Longitudinalentries
MEASURES= X-variables
XDS
OUTCOME = Y-variable
X YX
Model for Outcome Y
PhUSE 2010 Conference - CDISC and Industry Standards Discussion Club - Tuesday, October 19th 2010
Summary
DCC Group
2011-Q1 2011-Q22010-Q4TIMELINE
Firstrelease
NEXT STEPS• Community of practice funding for internationally-distributed computing• esp. Pharma programmers who analyse results of clinical trials• Regulatory developments (end-to-end)• Information governance for research networks (pseudonymisation)
Funded by
Acknowledgements - Sintero Team
STEERING & ADVISORY GROUP
Charlie McCayHL7 UK
Dave Iberson-HurstCDISC
Prof. FoxCancer ResearchUK + Infermed
Graham Kennedy NWIS
Malcolm NewburyIHE-UK
Funded by
THANKS to PhUSE!THANKS to PhUSE!
Dr. Ed ConleyDr. Ed Conley
Distributed Collaborative Computing Research1 &Severnside Translational Research Alliance
Schools of Computer Science1 and Medicine2
Cardiff and Bristol Universities, UK