Entries Tagged 'HealthVault' ↓

Jared Diamond makes a case that our recent history has been shaped by Guns, Germs and Steel. In this century we have seen in various ways how Guns, Germs and Steel wield their power. Currently, we are dealing with one such power fit of *Germs*. They say, flu is in the air, beware!

Earlier this year I had made a post about tracking Swine Flu using Ushahidi’s software. Various folks online have tried to help raise awareness of the pertinent epidemic, most noticeably CDC has launched a comprehensive website flu.gov to inform us better. Microsoft has launched the H1N1 Response Center and Google is helping through Flu trends.

Most common flu is the seasonal flu, which every year takes a toll of about 36,000 lives from late fall (Nov) to early Spring (March) and effects about 5-20 percent of population. This season we have a risk for a getting hit by swine flu (H1N1) which can cause more deaths, and there is an even deadlier version – the avian flu (H5N1).

So what should you do?

• Wash your hands and avoid close contact with sick people.
• Consider taking the Flu shot from a facility near you
• If you feel Flu, take a Flu assessment powered by HealthVault .
• Spread Flu Awareness – may be use the widget below:

Here is the code to copy this widget to your blog / website:

<iframe height="200" src="http://www.reemedix.com/misc/fluwidget.html"
    frameborder="0" width="300" scrolling="no">
</iframe>

Recently the ASP.NET MVC framework came out of beta and has garnered a lot of developer interest. This framework tries to provide interesting things like – total control over HTML, human readable URLs, AJAX, and facilitates test driven development. Successful web development frameworks like Ruby on Rails (ruby), Django (python) and Spring (Java) – also enable these characteristics. So cleary, there is some traction and tread for web frameworks to facilitate the Model, View, Controller paradigm.

There are quite a few challenges with regards to HealthVault SDK to work in this realm. The standard HealthServicePage no longer works in a controller paradigm. Eventually the SDK will need to provide a HealthServiceController, but until then I’ll try and explain how we can use the current SDK to work in an ASP.NET MVC world.

As I have explained earlier in my ruby series HealthVault authenticates an application in three contexts – anonymous, the application itself and the application in presence of user information. In this series I will try to take the same approach and explain how we can do the same with ASP.NET MVC.

It’s relative easy to talk to HealthVault via the anonymous GetServiceDefination method. Here is the heart of the code which enables this:

   1: public ActionResult Index()

   2: {

   3:     ViewData["Message"] = "Welcome to HealthVault ASP.NET MVC!";

   4:     

   5:     // Do an anonymous connection with HealthVault using the Hello World application id

   6:     ApplicationConnection appConnection = new ApplicationConnection(

   7:         new Guid("05a059c9-c309-46af-9b86-b06d42510550"),

   8:         "https://platform.healthvault-ppe.com/platform/");

   9:     // Get the service defination from HealthVault platform

  10:     ServiceInfo sInfo = appConnection.GetServiceDefinition();

  11:     // Pass the data for viewing

  12:     ViewData["ServiceInfo"] = sInfo.HealthServiceUrl.ToString();

  13:     return View();

  14: }

Next time: How to authenticate your application with HealthVault through ASP.NET MVC

In my last article in the vocabulary category, I described the need for semantically enabled data and how different categories of health data have different standard vocabulary / ontology associated with them. In the following table I attempt to summarize the recommended vocabularies for different HealthVault types.

Disclaimer: Please note this is not a definitive or complete list, and I will update the table as I discover inconsistencies. The definitive source are the XSDs associated with HealthVault data types.

As  you can notice above we recommend ICD-9, RxNorm, LOINC, NDC. x12-de-1130, x12-de-335. We do prefer SNOMED-CT as well, however the application using it need to have license for it.

Having written the above I would like to match that with what Dr. Halamka recommends in his post. Note that I mention content column for completeness, however its not useful for comparison.

Next Time: I’ll try to update the above tables with more details and try to come with recommendations of which clinical type (in the Data column above) would potentially match with which HealthVault type.

As usual leave your suggestions in the comments.

A few months back I promised that I will do subsequent posts detailing implementation of WalkMe. In this post I’ll attempt to described the way WalkMe synchronizes with HealthVault. As you might have noticed WalkMe keeps track of your most recent steps when you login to the application and without you having to log-in to the application via the pedometer widget, how does this magic happen?

The Syncing Philosophy
Microsoft provides a sync framework which solves the problem of syncing between various data sources elegantly. However the framework is largely designed for data which is sourced using multiple masters, in WalkMe’s case we simplify this and consider HealthVault to be the master data source. Given that HealthVault is our master data source we radically simplify the complexity of syncing and don’t need to employ the services of sync framework.

To make HealthVault as the master data source any data input from WalkMe is always entered in HealthVault first and then the WalkMe database syncs with HealthVault

The Data Model
In WalkMe’s case it maintains a local database of all its users and their data with regards to aerobic exercise session and exercise. I’ll keep the discussion about where to look for which data in HealthVault data types context for some other day. So why does WalkMe need a local database? We need a local database to maintain running totals of a users total steps, weekly steps and yearly steps. Also various analytical, notificational and graphical tools are only able to run in context of local data.

For each HealthVault user WalkMe keeps the following in the database:

• HealthVault Person Id – This is unique to each person.
• HealthVault Record Id – This is unique to each record Id, since WalkMe is a single record application (doesn’t work on multiple records associated with a person at a time), the record id has one to one mapping with the WalkMe user id
• Last Sync Time with HealthVault – The time at which this user last synched with HealthVault. We will discuss the tuning aspects of sync time later in the mechanics section.
• Last Sync Entity – Who performed the last sync. We will discuss various sync mechanism WalkMe we employs in the mechanics section.
• Last Sync Status – Details about the sync status. This is helpful to reform the sync or flag whether the sync is in progress.

For each activity (aerobic exercise session and exercise) entry for each user, WalkMe keeps the following in the database:

• HealthVault Item Id – This is the GUID of the item (any HealthVault thing). The contents of this HealthVault item are stored in this particular activity row. The content in our case are – steps, aerobic steps, calories, distance.
• Updated_at – This is the time at which this item was last updated.

For each sync job / activity we maintain a database table having:

• sync server name
• sync status
• sync timestamp
• sync frequency (in hours)
• sync job id
• sync msg

Fig1. Relevant Parts Of WalkMe Data Model

The Mechanics
The key aspects to understand in any sync problem is when is it that your user will need the most up to date information and how are they going to access it. Other than the time when a user is directly logged in the application, WalkMe’s needs the most up to date information when showing the WalkMe pedometers (which exist outside the context of WalkMe and HealthVault and they are accessed via a public webpage). Other key piece is for the WalkMe groups to show the most up to date information with regards to the leaders in the group they need each users data to be synched at least in last 24 hours.

So I can summarize that we have the following three scenarios needing the most up to date HealthVault data:

1. When the user in logged in the application – data needed to show his analytics, and standings in age-group, BMI, Zip etx.
2. When the user pedometer is accessed from a public page – data needed to show the most recent steps.
3. When the user accesses their group page – the current standings of participants should be up to date at least as of last 24 hours.

When and How to Sync
Clearly for scenarios 1 and 2 above we need to sync for a single user while for scenario #3 (and a part of #2) we need to sync the entire list of application users. Also note that for scenario 1 the user is present and for scenario 2 the user is not online. Lets name them #1 is UserOnlineSync #2 is UserOfflineSync and #3 is ApplicationSync.

UserOnlineSync : We should sync it every 20 minutes (based on a cookie) and sync the account when the user signs in.

UserOfflineSync: This sync should be done as requested but in the context of this sync user is not online (This is done using HealthVault offline calls). However the frequency is deteremined by output caching enabled on the widgets (I would put that to 20 minutes as well).

ApplicationSync: This is done for all the user and typically by a background process the last table in the data model is primarily meant for this process. However we don’t want to ping HealthVault for all the records so we use the method GetUpdateRecordsForApplication. The background process can run once or twice a day the frequency of the same can be made configurable.

Please note application sync is not fully functional in WalkMe yet owing to resource constraints on background processes in our hosting environment.

What to do when things go wrong?
As you will note in the above three sync mechanisms are primarily tailored to be partial syncs i.e they dont fetch all the user activities all the time. So what happens if a user deletes an entry in HealthVault or lets say the sync never completed? Well the user will see discrepancy is his/ her record and in that case we provide a mechanism for them to do a full sync with HealthVault. The idea of full sync being that all the current items are deleted and all the items form the users HealthVault record are imported again, and of course all the totals are re-calculated. In addition to taking care of uncompleted syncs this process also account for deleted items (there is not other way for delete items to be communicated). This is a powerful “reset” button and is exposed to the user with caution.

The Implementation

 
Here is some code showing the implementation of above three sync mechanisms with full and partial syncs. Please take it with grain of salt its here for illustrative purposes only and is no way meant to be used as is.

• UserOnlineSync

   1: public static void OnlineSyncUser(ProfileModel profile, PersonInfo info, bool partialSync)

   2:  {

   3:      string syncType = "partial";

   4:      DateTime? lastSyncTime = profile.UserCtx.hv_last_sync_time;

   5:      DateTime timeStamp = DateTime.Now;

   6:  

   7:      // reset lastsynctime if this is a full sync

   8:      if (!lastSyncTime.HasValue || !partialSync)

   9:      {

  10:          WlkMiTracer.Instance.Log("HVSync.cs:OnlineSyncUser", WlkMiEvent.UserSync,

  11:                WlkMiCat.Info, string.Format("Full syncing for User: {0}",

  12:                  profile.UserCtx.user_id));

  13:          lastSyncTime = null;

  14:      }

  15:  

  16:      // Retrieve the latest info from HealthVault

  17:      HealthRecordItemCollection items = 

  18:          GetHVItemsOnline(info, lastSyncTime);

  19:      if (items != null && items.Count > 0)

  20:      {

  21:          foreach (HealthRecordItem item in items)

  22:          {

  23:              // Do the distinct per item work

  24:              ProcessStepsHealthItem(item, profile);

  25:          }

  26:      }

  27:  

  28:      //only update the last sync time if we are able to download items

  29:      if (items != null)

  30:      {

  31:          //set last sync time

  32:          profile.UserCtx.hv_last_sync_time = timeStamp;

  33:          profile.Save();

  34:      }

  35:  

  36:      // Clear the WlkMi data cache if the last sync is null or this is a full sync

  37:      if (!lastSyncTime.HasValue || !partialSync)

  38:      {

  39:          WlkMiTracer.Instance.Log("HVSync.cs:OnlineSyncUser", WlkMiEvent.UserSync,

  40:                WlkMiCat.Info, string.Format("Full sync deleting information for User: {0}",

  41:                  profile.UserCtx.user_id));

  42:          lastSyncTime = null;

  43:          WalkLogModel.ClearUserCache(profile);

  44:          syncType = "full";

  45:      }

  46:  

  47:      //Processtotals for this user

  48:      WalkLogModel.ProcessTotals(profile.UserCtx.user_id);

  49:      

  50:      WlkMiTracer.Instance.Log("HVSync:OnlineSyncUser", WlkMiEvent.UserSync,

  51:          WlkMiCat.Info, string.Format("Completed Online {1} Sync of User: {0}",

  52:          profile.UserCtx.user_id.ToString(), syncType));  

  53:  }

  54:  

  55: public static HealthRecordItemCollection GetHVItemsOnline(PersonInfo info, DateTime? lastSync)

  56: {

  57:     HealthRecordSearcher searcher = info.SelectedRecord.CreateSearcher();

  58:  

  59:     HealthRecordFilter filter = new HealthRecordFilter(Exercise.TypeId,

  60:         AerobicSession.TypeId);

  61:  

  62:     if(lastSync.HasValue)

  63:         filter.UpdatedDateMin = (DateTime) lastSync;

  64:  

  65:  

  66:     // TODO: Add filter so that we get only items with steps

  67:     searcher.Filters.Add(filter);

  68:     HealthRecordItemCollection items = searcher.GetMatchingItems()[0];

  69:  

  70:     return items;

  71: }

• UserOfflineSync

   1: public static void OfflineSyncUser(ProfileModel profile)

   2: {

   3:     DateTime timeStamp = DateTime.Now;

   4:  

   5:     // Retrieve the latest info from HealthVault

   6:     if (profile.UserCtx.hv_personid != null)

   7:     {

   8:         HealthRecordItemCollection items = GetHVItemsOffline(profile.UserCtx.hv_personid, 

   9:             profile.UserCtx.hv_recordid,profile.UserCtx.hv_last_sync_time);

  10:         if (items != null && items.Count > 0)

  11:         {

  12:             foreach (HealthRecordItem item in items)

  13:             {

  14:                 // Do the distinct per item work

  15:                 ProcessStepsHealthItem(item, profile);

  16:             }

  17:             WlkMiTracer.Instance.Log("HVSync.cs:OfflineSyncUser", WlkMiEvent.AppSync,

  18:                 WlkMiCat.Info, string.Format("Number of items retrieved from HV: {0}",

  19:                 items.Count));

  20:         }

  21:         //only update the last sync time if we are able to download items

  22:         if (items != null)

  23:         {

  24:             //set last sync time

  25:             profile.UserCtx.hv_last_sync_time = timeStamp;

  26:             profile.Save();

  27:         }

  28:     }

  29:  

  30:     // Clear the WlkMi data cache if the last sync is null

  31:     // In other words, you can also set the time stamp for user's last sync to null

  32:     // to trigger a full offline sync.

  33:     // TODO: Consider not doing this for production

  34:     if (!profile.UserCtx.hv_last_sync_time.HasValue)

  35:     {

  36:         WlkMiTracer.Instance.Log("HVSync.cs:OfflineSyncUser", WlkMiEvent.AppSync,

  37:             WlkMiCat.Info, string.Format("Deleting information for user {0}",

  38:             profile.UserCtx.user_id));

  39:  

  40:         WalkLogModel.ClearUserCache(profile);

  41:     }

  42:  

  43:     // Processtotals for this user

  44:     WalkLogModel.ProcessTotals(profile.UserCtx.user_id);

  45:  

  46:     WlkMiTracer.Instance.Log("HVSync.cs:OfflineSyncUser", WlkMiEvent.AppSync,

  47:         WlkMiCat.Info, string.Format("Completed Offline Sync of User: {0}",

  48:         profile.UserCtx.user_id.ToString()));

  49: }

  50:  

  51: public static HealthRecordItemCollection GetHVItemsOffline(Guid personId, 

  52:     Guid recordGuid, DateTime? lastSync)

  53: {

  54:     // Do the offline connection

  55:     OfflineWebApplicationConnection offlineConn =

  56:         new OfflineWebApplicationConnection(personId);

  57:     offlineConn.RequestTimeoutSeconds = 180;  //extending time to prevent time outs for accounts with large number of items

  58:     offlineConn.Authenticate();

  59:     HealthRecordAccessor accessor =

  60:         new HealthRecordAccessor(offlineConn, recordGuid);

  61:     HealthRecordSearcher searcher = accessor.CreateSearcher();

  62:  

  63:     HealthRecordFilter filter = new HealthRecordFilter(Exercise.TypeId,

  64:         AerobicSession.TypeId);

  65:  

  66:     if (lastSync.HasValue)

  67:         filter.UpdatedDateMin = (DateTime)lastSync;

  68:  

  69:     searcher.Filters.Add(filter);

  70:  

  71:     HealthRecordItemCollection items = null;

  72:     try

  73:     {

  74:         items = searcher.GetMatchingItems()[0];

  75:     }

  76:     catch (Exception err)

  77:     {

  78:         WlkMiTracer.Instance.Log("HVSync.cs:GetHVItemsOffline", WlkMiEvent.AppSync, WlkMiCat.Error,

  79:                 string.Format("Error for user {0} : {1} ", 

  80:                 recordGuid.ToString(),err.ToString()));

  81:     }

  82:     return items;

  83: }

• ApplicationSync

   1: public static void SyncWlkMiWithHealthVault(

   2:     DateTime? lastUpdatedDate)

   3: {

   4:     WlkMiTracer.Instance.Log("HVSync.cs", WlkMiEvent.AppSync, WlkMiCat.Info, 

   5:         "Getting updated records from HealthVault");

   6:     // Do the offline connection

   7:     OfflineWebApplicationConnection offlineConn =

   8:         new OfflineWebApplicationConnection();

   9:     offlineConn.Authenticate();

  10:     IList<Guid> updatedUserIds = 

  11:         offlineConn.GetUpdatedRecordsForApplication(lastUpdatedDate);

  12:     WlkMiTracer.Instance.Log("HVSync.cs", WlkMiEvent.AppSync, WlkMiCat.Info,

  13:         string.Format("Got {0} updated records from HealthVault", updatedUserIds.Count));

  14:  

  15:     foreach(Guid recordid in updatedUserIds)

  16:     {

  17:         ProfileModel syncUser = ProfileModel.Fetch(recordid);

  18:         if (syncUser == null)

  19:         {

  20:             WlkMiTracer.Instance.Log("HVSync.cs", WlkMiEvent.AppSync, WlkMiCat.Error,

  21:                 string.Format("No WlkMi user found for recordif {0} ", recordid));

  22:             continue;

  23:         }

  24:         // Decide to update this guy?

  25:         if (syncUser.UserCtx.hv_last_sync_time > DateTime.Now.AddSeconds(

  26:             -Constants.UserSyncIntervalInSeconds))

  27:         {

  28:             WlkMiTracer.Instance.Log("HVSync.cs", WlkMiEvent.AppSync, WlkMiCat.Info,

  29:                 string.Format("Skipping sync for user {0} ", syncUser.UserCtx.user_id));

  30:         }

  31:         else

  32:         {

  33:             HVSync.OfflineSyncUser(syncUser);

  34:         }

  35:     }

  36: }

Suggestions?

There are various ways in which the HealthVault platform can assist application in syncing with the data native to HealthVault. One thing comes to my mind is support for feedsync. You may have a lot of suggestions, please feel free to chime in the comments!!

Several folks have asked me how can one get the WalkMe pedometer to show in Outlook signature. I’m outlining the steps below, for the restless folks most important step is Step 7.

1. Sign-In the WalkMe HealthVault application
2. Click on the “Share” tab
3. Make sure the “Allow Other to see my WalkMe data” checkbox is checked
4. If you check the box the page refreshes, saying Sharing is turn on
5. Scroll to the bottom of the page – to Share your steps as an image option
6. Click on file part of “Save this file as your outlook signature”
7. Save the walkme.htm file in your C:\Users\[YourUserName]\AppData\Roaming\Microsoft\Signatures director. Please note the part after [YourUserName] of this directory is hidden and you will manually need to type it in your Windows explorer to get to the full directory. Let me know if you can’t locate this directory on Windows systems other Vista or Seven (it should be under C:\Documents & Settings\[YourUserName]\Application Data\Roaming\Microsoft\Signatures on Windows XP).
8. To test the signature open Outlook and and create new mail. Click on the “Signature” part of ribbon (outlook 2007) and you will see WalkMe in drop down. If you select WalkMe signature you should see something like below in your outlook email : 

Enjoy your walking and keep yourself motivated by communicating your live pedometer through the signature.