A Prototype of Mobile app/EHR Communication through Standards for Home Treatment of Transcranial Direct Current Stimulation.

Daily management of neurodegenerative diseases by electrical neuromodulation techniques requires an integrated health care system for the continuous assistance to the patient. In this scenario, a direct bi-directional exchange of information between the patient's electronic health record (EHR) and patient's personal mobile health apps (mHealth) can boost the active contribution of patients and caregivers to safe homecare management. Grounding on a recently proposed standards-based architecture, we describe here a prototype implementing the mHealth App/EHR bi-directional health information exchange for supporting homecare transcranial Direct Current Stimulation (tDCS) therapy. We first modeled the tDCS case study using the Unified Modeling Language (UML) and, then, we developed the mHealth app for the patient side in order to implement the exchange architecture. We then connected the app to an EHR system developed using a web-based platform (Web Bio Bank) based on a framework for EHR management. The neurologist, using the EHR system, can configure the patient's homecare plan sent to the mHealth App, and can see the patient's monitoring reports sent from the mHealth App to the EHR. The integration architecture is implemented by CDA-2 compliant XML encrypted files. The current prototype proves that direct information exchange between mHealth Apps and EHR systems is possible by a standards-based architecture and can be effectively used to improve patient-neurologist communication as well as to support tDCS home therapy.