This viewgraph presentation reviews the various Information Technology challenges for aerospace medicine. The contents include: 1) Space Medicine Activities; 2) Private Medical Information; 3) Lifetime Surveillance of Astronaut Health; 4) Mission Medical Support; 5) Data Repositories for Research; 6) Data Input and Output; 7) Finding Data/Information; 8) Summary of Challenges; and 9) Solutions and questions

Johnson-Throop, Kathy

NASA Technical Reports Server

IT Challenges for Space Medicine
Kathy Johnson-Throop
NASA Johnson Space Center
August 16, 2010
https://ntrs.nasa.gov/search.jsp?R=20100033731 2019-08-30T11:55:12+00:00Z
Outline
 What Space Medicine does   
 IT Challenges
 Some Solutions & Questions
IT Challenges for Space 
Medicine
—2—
August 16, 2010
Space Medicine Activities  
 Lifetime Surveillance of Astronaut Health
 Mission medical support
 Occupational health services
Cli i l L b t n ca  a ora ory
 Pharmacy
 Radiation Health 
 Behavioral Health and 
Performance
 Data repositories:
» Clinical Data
» Human Research Data
 And more . . .
IT Challenges for Space 
Medicine
—3—
August 16, 2010
Private Medical Information  
 Applicable Legislation 
» Privacy Act of 1974 as amended
» Health Insurance Portability and 
Accountability Act
 Regulations call for:
» Secure storage
» Secure transmission
Access only by authorized personnel»     
IT Challenges for Space 
Medicine
—4—
August 16, 2010
Lifetime Surveillance of Astronaut 
Health
 Secure systems: Electronic 
Medical Record System (11 yrs),
Clinical Laboratory System
 Secure interfaces: External reference labs     
send data back to Clinical Laboratory 
electronically
 Remote access/Secure transmission 
(physician): Records are requested from 
physicians not associated with NASA (e.g. 
PCP for retired astronaut)
 Remote access/Secure transmission/Data rich 
i t f ( t t) El t i d t fn er ace as ronau : ec ron c up a e o  
medical history & other questionnaires
IT Challenges for Space 
Medicine
—5—
August 16, 2010
Mission Medical Support  
 Uptime - on call 24x7 continuity   , 
of operations during disasters
 Backups: off-region storage 
 Remote Access: flight surgeon’s   
home, JSC, KSC, Star City, 
Kazakhstan, etc.
 Foreign National Access  
» Much pre-, in-, and post-flight medical testing is done 
at JSC
N d t id t di l i f ti» ee  o prov e access o me ca  n orma on 
 Rapid credentialing: in the case of a medical 
contingency, the expertise needed may not have a 
NASA ffili ti l d t d t t it di l a a on a rea y, ye  nee  o ransm  me ca  
information very quickly and securelyIT Challenges for Space Medicine
—6—
August 16, 2010
Data Repositories for Research   
 LSAH-R = data repository containing     
astronaut data under the 10HIMS system of 
record which includes clinical data collected 
d i ti h lth di lur ng rou ne ea  care, me ca  
requirements during a mission, and 
occupational health surveillance data 
 Life Sciences Data Archive = data repository 
containing human research data under the 
10HERD system of record which includes      
both ground and flight experiment data on 
astronauts and other human subjects
IT Challenges for Space 
Medicine
—7—
August 16, 2010
Data Input 
 Remote Access and   
Credentialing
» Some data is 
collected in 
ground-based 
research facilities (e g bed-rest)  . . 
» Accurate, timely data is best facilitated by 
direct entry of data into NASA systems
» Nurses & other personnel are 
employed by the research 
facility – numerous personnel   
due to shifts, turnover, etc.IT Challenges for Space Medicine
—8—
August 16, 2010
Data Output 
 Remote Access – data in the     
repositories can be requested 
by researchers, usually in 
support of a research grant.
 Foreign national access – many research personnel are 
foreign nationals
 Secure Transmission/Protection of information   
» The informed consent that subjects signed may 
enable access to attributable data (able to be 
associated with a single person)    
» Astronaut flight data is particularly attributable even 
when no names are used – many variables identify a 
limited number of individuals such as the number of         
days in flight, gender, and some agesIT Challenges for Space 
Medicine
—9—
August 16, 2010
Finding Data/Information 
 Data standards regular encoding of data is  –      
required to ensure that a complete set of data 
is pulled in support of research requests
 Efficient search for information – searches 
often return too many non-relevant items
IT Challenges for Space 
Medicine
—10—
August 16, 2010
Summary of Challenges  
 Protect Private Medical Information   
» Secure Storage
» Secure Systems
» Secure Transmission
 Remote Access
 Foreign National Access
 Uptime/Backups
 Credentialing
 Data Standards
 Search
IT Challenges for Space 
Medicine
—11—
August 16, 2010
Some Solutions & Questions   
IT Challenges for Space 
Medicine
—12—
August 16, 2010
Secure Transmission 
 Entrust
» Agency resource – low overhead
» Blackberries can use
» Does not work with International Partners
 PGP
» Works with International Partners
» Requires additional overhead (key 
management)
 Kryptiq
» Secure messaging system associated with     
the JSC Electronic Medical Record (EMR)IT Challenges for Space Medicine
—13—
August 16, 2010
Secure Storage 
 Store within applications (e g EMR)   . . 
 Store centrally where possible (Space 
Medicine servers)
» Side benefit = limits risk of data loss
 Encrypt when stored on local machine
IT Challenges for Space 
Medicine
—14—
August 16, 2010
Secure Systems 
 Standard suite of solutions   
» 2-Factor Authentication
» Intrusion Detection
» Regular updates 
» Regular scanning of systems
» Training on protecting private medical 
information in SATERN: JSC-SA-PPCMD 
Protection Privacy and Confidentiality of, ,    
Medical Data
IT Challenges for Space 
Medicine
—15—
August 16, 2010
Remote Access 
 VPN
 Terminal Server
» EMR and other Space Medicine IT services 
available
» Limits local storage of data
» Mitigates issues with some programs timing 
out: EMR will lock a record if a transaction 
takes too long  
IT Challenges for Space 
Medicine
—16—
August 16, 2010
Uptime/Backups
 Disaster Recovery Site  
» Virtualized Servers
» Active synchronization
 Off-region backup
IT Challenges for Space 
Medicine
—17—
August 16, 2010
Data Standards 
 SNOMED
» Standardized NOmenclature for MEDicine
» Nearly complete terminology for coding 
medical data: Diagnoses, symptoms, 
procedures
F d l t d d f h lth t i l» e era  s an ar  or ea care erm no ogy
» Hierarchical Categories, multiple 
relationships = rich ability to pull      
information. E.g. All diagnoses of kidney 
disorders
htt // / /d / d/ t /i» p: www.cap.org apps ocs snome s s n
dex.html
IT Challenges for Space 
Medicine
—18—
August 16, 2010
SNOMED Coding Tool  
IT Challenges for Space 
Medicine
—19—
August 16, 2010
Data Standards 
 MeSH
» Medical Subject Headings
» Controlled vocabulary for indexing, 
cataloging & searching biomedical and 
health-related information and documents
htt // l ih / h» p: www.n m.n .gov mes
IT Challenges for Space 
Medicine
—20—
August 16, 2010
Messaging Standards 
 HL7
» Health Level 7
» International/Federal standard for health 
messaging
» http://www.hl7.org
IT Challenges for Space 
Medicine
—21—
August 16, 2010
Search
 Working with JSC search group – added a 
subset of MESH terms to indexing service      
 Exploring concept-based search
» Set of concepts define the search     
» More relevant search results than keyword-
based search
» Particular product used is Collexis
• Creates a “fingerprint” of concepts and 
their strength of representation for each      
document
• Can be used to also index a person’s 
expertise based on the documents 
associated with them
IT Challenges for Space 
Medicine
—22—
August 16, 2010
Foreign Nationals 
 International Partners try to anticipate needs  –     
and get them the credentials they need to do 
their work
 Researchers at US universities – currently 
working through the lengthy process to get 
NASA credentials 
» Is there a better solution to give them 
access to just the data that they need for 
their research?
IT Challenges for Space 
Medicine
—23—
August 16, 2010
Credentialing
 Researchers currently working through the –     
process to credential all (in the past they had 
a separate account)
» Same question as foreign nationals: Is there 
a better solution to give them access to just 
the data that they need for their research?       
 Research Facility Personnel
» Question: Is there a solution to give them 
access to enter data into NASA systems 
without generating credentials for all the 
personnel at a facility?   
IT Challenges for Space 
Medicine
—24—
August 16, 2010
Discussion
There is a tension between protecting the       
information in our systems and providing the 
access needed. 
Ideas are welcome!  
IT Challenges for Space 
Medicine
—25—
August 16, 2010


IT Challenges for Space Medicine

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