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Issue Oriented Tiered Architecture for Medicine


An open project built on modern principles, intended to create the medical records systems that serve primarily to improve the diagnostic and therapeutic workflow in clinical practice.

A good place to start is the Presentation Outline.

November 2015: Next book review!:


April 2015: Martin will (again!) give a presentation during the "Vitalis-mässan":


March 2015: Book review!:


November the 15th 2014: Martin spoke at TED x UU.


September 2014: The first book is here!:


October 2013: Here you can see a short movie: iotaMed with a checklist for "Save the Brain" developed by the neurologist Erik Lundström from Karolinska:


August 2013: Our second state funding for iotaMed!:


April 2013: Our first state funding for commercial verification of iotaMed!:


April 2012: We have (again) presented iotaMed during the "Vitalis-mässan":


January 2012: Our website is (almost) ready!: "MITM - Man In The Middle AB":


April 2011: We presented iotaMed during the "Vitalis-mässan":


Demo movies for iotaMed:


Some important links:


Some pdf documents which can give you a better picture of iotaMed project:


You can see a first short (4 minute) presentation of the first prototype of iotaMed on an iPad here. I'm speaking in Swedish, but you can just watch the pictures if you want. The source code for the demoed prototype is at github, you can get it here.

Lecture at Karolinska Institute

I was invited to give a lecture at Karolinska Institute to the International Masters Programme in Health Informatics. We made a video of it, all 12 sections. With the limitations YouTube has, it resulted in 20 videos which we collected into a YouTube playlist. The lecture is in English as are the lecture notes.

The lecture playlist is here and the lecture notes as pdf is here.
iotaMed is presented in section 12, which consists of four YouTube videos since that part alone was more than 50 minutes.

Introduction


Yet another open project... as if we didn't have enough already. But we really do need this one. This open project is initiated by one very disillusioned physician/developer who is going totally crazy trying to use really poor software to do his job, while knowing full well that it needn't be so.

The software we have today is built to document everything you do, but it doesn't help you one bit to find out what you need to do in the future, and that is what we really need the software to assist us with. But, as I said, it doesn't. Do you know that the medical records software we use today don't even have the concept of "disease" in them? That's like having accounting software that doesn't have the concept of "money". And about as useful.

Typically, a medical record system looks like this, seen from an entity relationship standpoint:

ERD based on encounter

Clearly, the designers must have thought that we doctors are extremely interested in knowing which other doctors the patient has met and exactly when, but this is a huge misunderstanding. That may be interesting for people arranging cocktail parties, but has very little to do with medicine. What we do want to know, though, is what ails the patient, that is what health issues he has, so a few of the entities at the top should be related as follows:

ERD with issue

This little change in the basic domain analysis has wide-ranging consequences. First is that the medical record finally starts to work for us instead of against us. Secondly, that we have a channel to feed new scientific discoveries and guidelines to the doctors that need them, and at the right time and place when they need them.

Note that the second diagram doesn't even contain the entities "doctor" and "encounter". By that I don't mean that they aren't kept somewhere in the system, of course they are, but that they're not important enough to qualify for a top level diagram.

The people


The people involved are you and me.

The Project


The project documentation.
The iotaMed for the iPad (iotaPad) code repository.

Background


The evolution of medical records
How current systems work
How medical records should work
Evidence Based Medicine vs Experience Based Medicine
Frequently Asked Questions and Frequently Misguided Solutions
The problems we solve with iotaMed
Critical Success Factors
Presentation Outline

The parts


The basics of Iota
The Iota Medical Journal project
The Iota Apple iPad project
The Iota Desktop project
The Iota data interchange project

Related projects


OpenEHR
OpenEMR

Related sites


Ursecta - English language blog on tech and medicine
Vård IT - Swedish language blog on IT in healthcare
Vård IT Forum - Swedish language forum on IT in healthcare
List of links to other blogs and sites with some relevance to this subject

The plan


This is about how to make this come true.

The business plan

How to register and contribute


This is a wiki, so all you need to do is to register and start adding pages or changing the ones that already exist. One thing can't be done by just anyone, and that is uploading files such as images, since the ability to add actual files to the wiki isn't without risk.

If you need to upload an image, please send it to me and I'll do it for you. If you put in a marker on a page where it needs to go, I'll add the link, too. If you need to do this regularly, tell me and I'll enable your account for uploads.

Invitation code for user registration


Spam in the form of page spam and comment spam is with us, so I had to limit both edits and comments to registered users. Then I had to limit registration to users who can present an invitation code. That invitation code is not individual, it's just one word, namely 'iotaRulez'. I'm figuring the spambots aren't smart enough to read this paragraph, then go register themselves, but I do figure the average user gets the idea.

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