Phoenix Ambulatory Blood Pressure Monitor Project
5/14/2006 Meeting Notes




Status Review:

* Chris: Three things have happened in the last two weeks. 1) Wrapped up the privacy issue. 2) Created a process framework to present. 3) Discussions with Germaine and Franz on a publication opportunity. I would like to review my needs priorities and standards.

* Larry: Did a few things with the Sphygmochron program, developed a workaround to remove end-of-file characters. Looked at Germaine's Fortran program of the fuller Sphygmochron program developed in 1986, got it running on a PC. Chris said this can lead us to a more complete set of requirements. Germaine said there are differences because there were contradictory "wishes". The first version went step by step, it looked a excesses and deficits, but we didn't have evidence for the impact of this. For the PC program, we just focused on the 24-hour process and provided the summary. Another looked at BP, heart rate and the double product, which is cardiac output. Some people felt it was too much and required too much education to understand. There was a wish to provide something simpler, but it really didn't provide "the complete picture". But, it just a daytime mean and a nighttime mean, and it doesn't have enough information for adequate treatment. These lead to different summaries: and the extensions, Sphymochron, daynight ratio. Simpler sphygmochron and more complex sphymochron. The sphygmochron is a summary with a fixed form that uses Mesor, double amplitude, acrophase, compares to reference values, does a least squares and provides a Mesor, double amplitude, acrophase; it looks and then performs a numerical integration and shows the areas of excess and deficit. Larry said that we are providing informal requirements. Now it is time to provide formal specification of what we want to do. CVRx. Also, Watcom has made their Fortran compiler open source.

* Dennis Lienke:

* How to get a history of the project email. Majordomo. And put it on the website.

* Chris' Priorities
- Franz's abstract on a forthcoming paper and request for Chris to contribute on security. Subsequently, the authors commented that it might be premature.
- We get serious about marketing and a main vehicle is publication, as a way to present it. For example: work that we do be presentable to others and we build a community - those with whom we normally communicate and others who encounter our project. One aspect of community building is creating communications infrastructure and another aspect is outreach. Then, we can include these activities in our project. So, if we develop publishing as a marketing activity.

Chris Adams - Phoenix Privacy Requirements

Click here for Power Point Presentation: * In 'video projector' format. * In 'printer friendly' format.

Historically for privacy, Europeans had to grant access, but in the US peoples' property is protected from access unless they give permission for others to access it. This is governed under HIPAA. The Electronic data interchange standards cover the rules for transactions, code sets, identifiers (provider, health plan, employer, personal- none because of national privacy rules - i.e. there is no national way to identify a patient). The privacy rule includes concepts of a safe harbor (so much information has been pulled out that I don't have to worry or the data set is so limited).

For Phoenix, we want:
* Unburden Phoenix off privacy issues.
* Relegate burden of privacy to caregiver.
* Minimize the constraints on the caregiver process.

Suggested Phoenix Requirements:
* Primary identification by session
- session key available to external system.
* Trace session to device ID.
(device IDs are a safe harbor item, but there is ambiguity - e.g. this is not an implantable item)
* Person (patient) identify managed externally.
* All data within system is anonymous
* Reports/displays include anonymous fields
- Labels and values from external source
- Intended for person identity but can be repurposed
- May be ignored.

Germaine noted that this how BioCos currently does this. Originally, they didn't use device serial numbers (device ID), but included it to assure that they got the device back.



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