The Public Health Grid (PHGrid): Overview and Value Proposition

John StinnDeloitte Consulting

Program Manager – PHGridNational Center for Public Health Informatics, CDC

May 19, 2009

Overview

Public Health Challenges What is Grid Value of Grid to Public Health Our Activities Looking Ahead Q&A

Current Challenges in Public Health

Public health data widely distributed Volume of public health data growing rapidly Many cultural, social and political impediments to data

sharing Requires a stronger economic model for long-term

financial sustainability Uniquely dynamic, complex and global in scale

– Situational awareness, population health monitoring, event detection, inventory tracking, countermeasures administration, alerting, etc .

Many redundant systems, application silos and data silos

Current Situation and Challenges

Politics of control of data has been the primary obstacle to formation of a national system

Much existing data remains siloed at the Local/ State level – accessibility and visualization limited

Building systems non collaboratively leads to low adoption rates

LabSystem

BioSenseIntegrator

National Data FeedsHospital, DoD, VA , etc

Clinical data

Local/StateData

Local/State Health Dept

SyndromicSurveillance

CDC

BioSense AVR

BioSenseData

Warehouse

BioSenseIntegrator

BioSenseIntegrator

FacilitySystem

Medical Facilities

Local/StateData

Local/State Health Dept

ExistingCapacity(RODS,

ESSENCE, GIS, etc)

FacilitySystem

Various Integrator

Technologies

Medical Facilities

Future Goal: Federated Architecture (Grid)

Leverage Existing Capacity

– Distribute resources and infrastructure

– Increase flexibility and scalability

Provide Local Control of data and services

– Reduces political barriers

– Address many privacy concerns

Foster Collaboration to define requirements, priorities, develop, and deploy technology

Users / Experts

Public Health Grid Standards, Services,

Guidance

Local/StateData

Local/State Health Dept

Surveillance & Informatics Capacity

Analysis / Visualization Capacity

National Data

Academic / Industry Partners

Local/StateData

CDC & Other Federal

Agencies

Scientific and Public Health Priorities

What is a Grid?

A computing environment for sharing data and capabilities

Characteristics of a Grid– Decentralized - Allows data owners to share data and

applications while maintaining control– Interoperable – Standards-based allows different systems to

interact without costly customizations– Flexible – Allows data and applications to be recombined as

needed

Grid Represents a…

Different way of thinking

Different way of solving problems

Collaborative approach

Grid and Healthcare

International HealthGrid Association– 1 billion Euros

HealthGrid.US US - Federal

– National Cancer Institutes’ Cancer Bioinformatics Grid (caBIG) initiative• Launched in 2004• For cancer research community

– National Science Foundation• “Cyberinfrastructure”

– The coordinated aggregate of software and hardware and other technologies, as well as human expertise, required to support current and future discoveries in science and engineering. The challenge of Cyberinfrastructure is to integrate relevant and often disparate resources to provide a useful, usable, and enabling framework for research and discovery characterized by broad access and “end-to-end” coordination^

» ^ SBE/CISE Workshop on Cyberinfrastructure for the Social Sciences, Fran Berman, San Diego Supercomputer Center and UC San Diego

Public Health Grid in Action

• Presentation, visualization and interactive environments

• Runs on the same grid as the computational grid

• These combined resources are used to support group-to-group interactions, large-scale distributed meetings, collaborative work sessions, seminars, lectures, tutorials, and training

PHGrid Initiative: Purpose of Research

Determine the viability of Federated Architecture in Public Health

Establish relationships with key partners / collaborators

Determine / Inform public health programs and future public health informatics approaches

And….to move from the conceptual to the actual

PHGrid Activities: Goals / Objectives

Provide a secure, easy-to-use technical and social infrastructure for solving public health problems

Lower barriers-to-entry through– Extremely low cost grid appliance – Simplified web services development (drag & drop) – Simplify data access and data exchange (drag & drop)

Connect public health grid to other grids, and to other data sources

Recruit local & state health departments, HIEs, academic institutions, national data sources, medical centers, international public health partners, and vendors

Current State of PHGrid Activities: Research & Practice

Methodology– First develop hypothesis and

then perform research– Develop evidence base– Make evidence-based

decisions on the value of potential tools & resources

– Apply selected tools to both existing and novel systems

– Move systems to production– Continuous evaluation and

enhancement

Leveraging– Existing technology – An open / collaborative

development process – CDC as participant – not has

solution owner– An evidence base (not

personal preference)

Challenges– Gain expertise in the wide

variety of grid-based resources currently available

– Define the gaps between the PH and Grid domains

The Public Health Grid(PHGrid)

Current Activities – the details…

PHGrid Research Projects (examples)

BioSurveillance POC: Federated Search

Primary requirements– Demonstrate the capability to share and visualize biosurveillance data:

• Within a State• Between States • Between States and CDC

– Aggregate data under control of state, share results with external users

– Combine and visualize results in the form of maps and simple analysis (e.g. Epi Curve)

Goal: Explore standards-based federated frameworks to promote distributed data stewardship, analytical access, and collaboration between participating stakeholders. Inform NCPHI and its public health and commercial partners of best practices and potential issues to this approach, and provide a foundation to evaluate existing and emerging interoperability protocols.

RODSA-DAI

Foundation: Real Time Outbreak Detection System and Globus Grid Toolkit• RODS - ~20 production instances across US• Globus – Leading Open Source Grid Middleware; used in NCI’s

caBIG, GeonGrid

Hypothesis: Extending RODS with Globus Services allows the ability to query across installations, and visualize data from disparate / secured nodes

RODSA-DAI Demo

http://ncphi.phgrid.net:8080/rodsadai-web/

Poison Control Data Access & Integration

Demonstrate access and visualization of poison control call data via web services

Display data over multiple days over multiple call classifications

Combine and visualize results in the form of maps and simple charts

Goal: Research ability to augment public health situational awareness, by accessing non-clinical data sources of public health importance, based on secure web services

Quicksilver Demo

http://ncphi.phgrid.net:8080/npdsgmaps-web/

Aggregate Minimum Data Set

Obtain consensus on most relevant elements

Create common biosurveillance data structure aligning to AHIC / HITSP standards

Develop interfaces to existing partner biosurveillance systems

Distribute & refine using open source principles

Proposed elements– Condition– Condition classifier– Patient 3-digit ZIP– Count– Date

Goal: Facilitate multi-state public health situational awareness with simple, common data interchange service based on a subset of key biosurveillance data elements

Research Partners: DEcIDE centers at the HMO Research Network Center for Education

and Research on Therapeutics University of Pennsylvania

Participating Health Plans: Geisinger Health System Group Health Cooperative Harvard Pilgrim Health Care HealthPartners Kaiser Permanente Colorado Kaiser Permanente Northern California

Developing a Distributed Research Network(DRN)

DRN Project Goals and Objective

“The primary goals … are to improve public knowledge about health outcomes in time frames that are quicker than traditional research approaches; and to take advantage of the power of networks…”

-AHRQ DRN task order solicitation

Objective: to design a scalable, secure, distributed health information network—a distributed research network—to conduct population-based studies of the risks and benefits of therapeutics

DRN Proof-of-Principle Demonstration

Build a network proof-of-principle to demonstrate selected functions of a distributed research network

– An authorized user authenticates to a central portal based on digital certificates

– A SAS program is distributed to each data owner (node); the data owner allows or denies the request for the program to run

– The SAS program is configured based on the data owner’s (node) local SAS settings

– The SAS program is executed at each node, and a standard results set is returned

– The results are aggregated and made available to the authorized user

– A log of site activity for each node is generated

Evaluate the proof-of-principle demonstration and characterize the needs, challenges, and barriers to creation of a distributed research network

PHGrid / NHIN Interoperability

Challenges with bidirectional communication between the two environments:– Differences in the level of security of data that resides in each environment

– Differences in the core functions of each platform

Goal:– Demonstrate that the NHIN and PHGrid are complimentary and compatible

platforms for distributed services and federated data

– Demonstrate that the NHIN and PHGrid are capable of trusting data from each other

PHGrid Publisher

Test Script

NHIN CONNECT GW

Test Script

NHIN CONNECT ADAPTER

PH-DGINet: Enabling shareable GIS services

Distributed/shared web services framework based on ESRI GIS technology

PH-DGINet allows Access to data, services and tools available within a single portal per organization

• PH-DGInet portal can be customizable to organization, role, individual

• DGInet supports discretionary service and data sharing

• PH-DGINet can be extended with simple analytical tools

Exploring service integration / interoperability with Globus stack

Results & Lessons Learned

Results PHGrid infrastructure is readily

deployable in public health settings – over 10 nodes established

PH data can remain where it is best secured

Simple PH Analytics / SA can be supported in distributed environment

Lessons Learned PH will likely be supported by

multiple service providers

Collaboration is key to driving requirements and resolving issues

Weakest hardware or connection in a federated model can be the bottleneck for data visualization and analysis

PHGrid Tools(HOW we do it)

PHGrid Service Registry

http://sites.google.com/site/phgrid/Home/service-registry

NCPHI R&D Lab

Facts: Created in 2007 Completely Separate from CDC

Network Running VMWare Virtual Environment

– ESX Servers– Virtual Center– Lab Manager

Workstations– 12 Windows– 3 Mac OS

Platforms/Servers:Desktop OS Platforms:Windows 2000, Windows XP, Windows Vista,

SUSE Linux Enterprise Desktop, and Ubuntu Desktop Edition

Server OS Platforms:Windows 2008 (beta), SUSE Linux Enterprise

Server, Red Had Enterprise Linux, and Ubuntu Server Edition

Application Servers:Microsift IIS, BEA WebLogic, Red Hat JBoss,

PHP

Database Servers:SQL Server 2000, SQL Server 2005, Oracle

(Standard Edition), MySQL

PHGrid – In Action

PHGrid and BioSense

The BioSense Program is migrating to a distributed architecture

– Cardea to enable BioSense data integration and access

– Globus to publish data and services

– AMDS for surveillance / situational awareness

– Grid enabled ‘Viewers’ to allow users to query, view, analyze situational awareness data

Future

Move from Research to Pilot to Production – BioSense Program Committed to the Grid; NEDSS exploring use of AMDS as well

Engage more partners as nodes – Denver PH Explore interoperability between NHIN (and others) and Public Health

Grid architectures Expand public health use cases and adopt / build additional services Refine PH Grid Node Appliance

– Windows & Linux Versions– Simplify, simplify, simplify

Send node & services to data Refine Features, Functions, and Priorities for Situational Awareness

Services– Develop Ability to fuse and analyze data from heterogeneous data

models

Future (cont.)

Many New and Emerging Partners: Within CDC

– CCID / Grid Computing / Pathogen Data

– Birth Defects

– Genomics / Bioinformatics

– NEDSS

– Environmental Tracking

– Cancer

Federal Agencies– ONC, FDA, EPA, NIH

International– WHO

Academia– Emory University

– Georgia Tech

– GeoVista

– OhioState

Reference Implementations– Grid Node (aka publisher) - in

operation– Quicksilver – in operation– Grid Viewer – Alpha June 15;

Operation, July 31– AMDS – Alpha available; Beta May

31; in Operation, July 31

NHIN Interoperability Testing– Mid-to-late July

Denver Pilot– Transitioning BioSense feeds to

grid– PHIN conference

Regional Collaborative / COE activities

– Ongoing

So…How should you think about grid?

Secure….

Service Oriented Architecture (SOA)…

Ecosystem…

Community…

Thank You!

Questions?

Tom Savel, MDtsavel@cdc.gov

NCPHI, CDC2009