Health2.0 Software as a Service Appliance for Wholesalers

The MedCommons HealthURL Appliance reduces the cost of managing, securing, archiving and sharing health records for all providers of health services.

The consumer-centered architecture of the Appliance bridges the requirements of HIPAA and Web 2.0 social networks. This enables health service providers to create innovative and differentiated applications that eliminate barriers between physician and and consumer-based content.

A MedCommons HealthURL Appliance can be hosted by an institution alongside other health IT systems or accessed Software As A Service (SAAS) over the Web. In either case, consumers, patients, clinicians, support and administrative users are offered interfaces and consent mechanisms that can be used directly or integrated into highly customized health care applications.

Your service and application development investment is protected through the use of simple and open Web standards throughout, including OpenID, OAuth, CCR, DICOM and PDF. Additional document types and standards can be managed and integrated as necessary. Interfaces to Facebook and Google are included. Interfaces to enterprise Active Directory / LDAP, Salesforce.com and Microsoft HealthVault are available.

MedCommons HealthURL Appliances are licensed by the Account. An Account is typically a patient / consumer or a clinician-user. Remote hosting and disaster recovery / archival storage at Amazon Web Services are optional.

A Social Networking Health2.0 Backbone

MedCommons supplies the first complete patient-centric healthcare web2.0 backbone and application suite in support of packaged radiology and electronic health record services to hospitals, regional health organizations, governments, employers, insurance providers, and system integrators for next generation web2.0 applications including Telemedicine, HIPAA Record Request Fulfillment, Outcomes Registries, Retail Clinics, Imaging Centers, Home Care, Disease Management, and Sports Medicine. MedCommons is ready for immediate deployment within your organization's web infrastructure or for integration into your ongoing projects.

The MedCommons Social Networking Health2.0 Backbone Platform is a complete ecosystem for all the major actors in next-generation patient-centered healthcare:

  • Patients and their caregivers access the platform via HealthBook, (currently implemented in Facebook, soon in Google), utilizing the social network"s collaboration and inter-personal communications facilities. Every patient has a HealthBook Care Team, which is an extra secure walled garden of friends who have mutually consented to assist the patient.
  • Disease Management Groups utilize HealthBook to collaborate and discuss particular subjects of interest, with direct clinical references to particular anonymous cases.
  • HealthCare Providers (and patients without a social network affiliation) access the platform via an Ajax-based Web Interface, with full DICOM viewing support. This interface is fully re-brandable and can be embedded as needed in portals, websites, and other environments.
  • Imaging Modalities (MRIs, CT scanners) and 3D Workstations at Hospitals, Imaging Centers, and Provider"s facilities are connected via a run-anywhere downloadable MedCommons DDL. Radiologists using the open-source Mac Osirix Workstation can connect directly to the platform via a MedCommons supplied plug-in.
  • Patients, Providers, and Disease Management Groups can communicate via a secure messaging facility and contribute data via secure email, fax, and web interfaces. A variety of editing facilities, including both web and thick client interfaces, are available for fine grained editing of electronic health records in the CCR and other standard formats.

What is a HealthURL?

A full-strength summary of one person"s clinical situation, over a lifetime from childhood immunizations to chronic disease management

healthURL

Independent of insurance companies, employers, bureaucrats, and not tethered to any single provider6.

MedCommons HealthURL Appliance

A Health URL is a patient-centered portfolio of private health information on the Internet. Each Health URL points to an individual person"s account that stores and delivers health records assembled from hospitals and other health care providers, important documents such as advance directives and diagnostic imaging such as CT and MRI studies. Health URL accounts are used collaboratively by physicians and other clinical practitioners as well as by interested patients and their authorized caregivers. Access to the Health URL account is via over 30 standard Web services and legacy enterprise interfaces. Strict, HIPAA-compliant privacy and security safeguards are integral to the Appliance. A hospital, practice or service provider hosts Health URL accounts on behalf of their patients by licensing software for installation on-site or in a hosting center. The MedCommons Health URL Appliance is a convenient, integrated and HIPAA-compliant way for a provider to add Internet collaboration for telemedicine, referrals, secure messaging, paperless health information management, night call coverage, home care devices, interaction with retail clinics as well as new consumer-centered Web sites. A RESTful API is ready for Web 2.0 integration in health care.

MedCommons is a True Commons

Install a MedCommons Health URL Appliance1 and make your practice the "medical home"2 for patient records on your own terms. A MedCommons Health URL Appliance reduces the cost of fulfilling records requests, and increases the value of these records by making them readily available to authorized care team members3. The appliance is secure, HIPAA-compliant and FDA-510k registered to manage and display diagnostic radiology images with or without a PACS4. Use it to fulfill record requests from patients and consultants, end the tyranny of paper, fax and DICOM CDs, park your genome, or as the core of a new Web-scale radiology practice5.

Deploying MedCommons in Your Network

The backbone is deployed as a collection of independently licensed and operated Linux- based MedCommons HealthURL Appliances which can be run anywhere under VMWare or in a hosted data center such as Amazon EC2 or within a RHIO with backup to Amazon S3 or another similar storage farm. The MedCommons HealthURL Appliance can utilize a licensee/owner-supplied pricing matrix and function as a credit-card based vending machine for standard healthcare transactions including CD burning, network transfers, record storage, and additional software applications.

Integration of Social Networking into Your Web Presence

MedCommons believes the distributed and federated architecture of social networks and its HealthURL Appliance provides extensive value:

  • The value of medical records increases when they are aggregated (across all providers: licensed, unlicensed and self), longitudinal and accessible.
  • Each MedCommons HealthURL Appliance is designed to aggregate records from the systems used by providers as conveniently and cost-effectively as possible.
  • Each MedCommons HealthURL is a lifelong longitudinal account with backup to Amazon, Google or other service as well as the patient"s own home if they want.
  • Access to the HealthURL is controlled by the owner of the HealthURL - typically the patient. Each HealthURL Appliance provides means for the initial account creator to pass control to the patient and for the patient to claim control if they choose.

What Distinguishes MedCommons?

  • our mission is to redefine high value legacy, enterprise-centric, healthcare applications and workflows (such as radiology/PACS and records management) to function as distributed, cross-enterprise, virtual networks running on low-cost, commodity infrastructure
  • our platform integrates the social-networking features of web2.0 services like Facebook and Google, offering disease management groups, care teams, and medical homes, and all interested parties a place to operate
  • we will offer standards based interoperability with the forthcoming consumer health offerings from
  • Microsoft Healthvault, Dossia (WalMart, Intel and more...) and Google Health, bridging these and other disparate services
  • we offer a system for long term storage and retrieval of fully standards-based, interoperable patient records that can be operated by the smallest single provider office, the largest hospital network, employer, or healthcare storage provider, and can be configured with or without patient control
  • we offer patient control of her identity, privacy, her personal medical records, and a means to grant consent to others, and to receive notifications about account status; we allow accounts formed by doctors for their own purposes to be transferred to patient control if they choose
  • we run everything over the Internet, including hosted data centers (at the customer"s preferred site or Amazon EC2), backup storage (onsite or Amazon S3)
  • we have bundled all of these capabilities into a shrink-wrapped Appliance, which will be sold as an intelligent router with many customer selectable options
  • our business model is to license appliances and share revenue for transactions vended by the licensee, and separately benefit from advertising revenue from the social networking interfaces.



Benefits to Imaging Modality Owners

For owners of MRI, CT, Mammography and digital X-ray devices, the optional MedCommons DICOM Data Liberator (DDL) permits the movement of images between these devices, professional imaging workstations and the MedCommons Appliance. Together, these products are positioned to disrupt the healthcare imaging market as they eliminate the need for an expensive, on-premises, Picture Archiving and Compression System (PACS) and replace it with commodity equipment supporting modern standards and distributed storage. Potentially even more important, PACS is increasingly seen by radiologists as leading to commodity pricing because it is a barrier to consultation with the physicians and surgeons that drive substantially all of their revenue. HealthURL-based image management enables sub-specialization of radiology services while restoring the collaborative nature of the practice that existed when physicians conferenced around the film and light-box.

Benefits to System Integrators

The Appliance is available in two forms: as a packaged hardware server built on commodity hardware, and as a downloaded virtual appliance that can be installed on hardware of the customer"s choosing. The appliance is built on Linux, Java, PHP, and other open standards. In either case, multiple appliances can be utilized by the customer to support onsite or remote backup, and to provide additional processing as the customer"s business grows. Each MedCommons HealthURL Appliance can also be backed up to a remote storage facility (such as S3, or a hosted storage array) for both long term record keeping and disaster recovery.

MedCommons can be incorporated within 3rd party products and services including home care, medical devices and workstations offered by ISVs, Original Equipment Manufacturers (OEMs), and Regional Health Information Organizations (RHIOs). The system will ultimately operate with the personal healthcare devices that are connecting to the Microsoft HealthVault Connection Center Service.

Benefits to Healthcare Providers and Employers

The MedCommons Appliance benefits a healthcare provider"s practice: a reimbursable e-consultation saves both time and generates revenue for the doctor. A physician associated with multiple practices can view her work from anywhere, and complex coverage situations can be resolved. A referral to another physician in the practice, or to an imaging center, or a consultation with a specialist is handled directly by the appliance. An electronic "clipboard" form can be offered to patients to fill out either in advance of a visit, or via a shared terminal at the doctor"s office. An Employer who deploys MedCommons for his employees benefits from the use of the service through increased leverage over managed care contracts, more efficient on-site employee clinics, and an opportunity to promote wellness through improved communications with employees.

Benefits to Patients

The focus of healthcare is shifting to the consumer at an accelerating pace. MedCommons believes that widespread distribution of standards based healthcare solutions is inevitable and we are committed to delivering low cost, customizable solutions for small practices and large healthcare networks in support of next generation applications: a telemedicine consultation can be arranged in seconds, a retail clinic can communicate instantly with a patient"s own doctor and with other providers, an imaging center can reduce costs and improve its relationship with referring physicians and their patients, and disease management protocols can be driven by an up to date view of the patient"s record.

Benefits to Licensees

For the licensee, installing a MedCommons Appliance provides direct remuneration via the ability to accept and process credit cards directly from patients, yet also benefits all participants in the healthcare ecosystem: Patients are afforded a wallet card for universal emergency room access to vital healthcare information, Families are allowed to selectively control disclosure of personal data, Doctors and Patients can communicate securely and privately via the service, and Patients can obtain second opinions and anonymous tests online without a need to physically retrieve records and film from multiple doctors. Patients with particular illnesses already involved with online Health Management Groups can utilize the MedCommons Appliance to share their records with other group members.

Access to the HealthURL is controlled by a consent mechanism that enables the licensee (operator) of the MedCommons HealthURL Appliance to profit along with MedCommons and the patient in three different ways:
*Open Solicitation - this is typical of a hospital EHR database or the American Heart Association program in HealthVault - the HealthURLs are stored in unencrypted fashion and the operator of the appliance is free to mine the data and sell it or solicit the patient or doctors at will.
*Social Network - this is typical of Facebook and users of the HealthVault medical search service - the HealthURLs are stored separately (typically encrypted) and the operator of the appliance is mining only social details or explicitly disclosed keywords for sale to advertisers and solicitation of the patient or doctor.
*Informed Consent - this is how Dossia and some future health data banks will operate - the HealthURL are stored separately and access is explicitly granted by the owner in return for incentives (social or financial) that are shared with the appliance operator and MedCommons.