A Federated Collaborative Care & Cure Cloud Architecture ... · technologies (ICT). C3-Cloud...
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A Federated Collaborative Care & Cure Cloud Architecture for Addressing the Needs of Multi-morbidity and Managing Poly-pharmacy Gokce Banu Laleci Erturkmen a , Mustafa Yuksel a , and Theodoros N. Arvanitis b a SRDC Software Research Development & Consultancy Corp, Ankara, Turkey, email: (gokce, mustafa)@srdc.com.tr b Institute of Digital Healthcare, WMG, University of Warwick, Coventry, UK , email: [email protected] Intr oducon A growing share of the populaon (15% in 2010) in OECD countries is over 65 and expected to reach 22% by 2030. Older age is associated with an increased accumulaon of mulple chronic condions. More than half of all older people have at least three chronic condions, and a significant pr oporon has five or more. The clinical management of paents with mul-morbidity is much more complex, disconnected and me-consuming than that of those with single diseases. As a result, mul-morbid paents with long-term care needs experience shortcomings and gaps in their care provision. There is an increasing need to organise the care around the paent with the involvement of all stakeholder s, and as a response to this requirement, the C3-Cloud project aims to achieve high quality integrated care with the support of informaon and communicaon technologies (ICT). C3-Cloud Approach C3-Cloud establishes an ICT infrastructure to enable connuous coordinaon of paent-centred care acvies by a muldisciplinary care team (MDT) and paents/informal care givers. Reconciliaon of Mulple Care Plans through Clinical Decision Support Systems Clinical Decision Support Modules are ulized for risk predicon and straficaon, poly-pharmacy management, goal and intervenon seng based on evidence based clinical guidelines and reconciliaon of mulple care plans. Seamless int egraon with exis ng health/social care inf ormaon systems Fusion of mulmodal paent data will be achieved via C3-Cloud Interoperability Middleware. FHIR based interfaces with exisng health/social care informaon systems are being implemented for addressing technical interoperability , while a terminology server is ulized for addressing semanc interoperability challenges. Acve P aent Involvement through P aent Empowerment Plaorm Acve paent involvement will be realized through a Paent Empowerment Plaorm, ensuring paent needs are respected in decision making. Project Web Site: hp ://c3-cloud.eu/ Personalised Care Plan Development Plaorm A Personalised Care Plan Development Pla orm allows collaborave creaon and execuon of personalised care plans for mul-morbid paents through systemac and semi-automac reconciliaon of clinical guidelines. Fig. 2 – A snapshot from Personalized Care Plan Development Environment Severity and stage classificaon Diet, exercise, training and self-care Follow-up Pharmacotherapy -Modificaon of the severity and stage -Significant modificaons due to RF -Necessity of new recommendaons -Changes in the content and in the frequency of visits -Criteria of referral to nephrology -New drugs -Changes in “ prescripon module”: Disease-drug and drug-drug interacons. DM2 Care Plan Goals HbA1c Control Lipid control BP control Weight Loss Intervenons Meormin Treat. Stan Treatment ACE-I Treatment Diet & Exercise RF Care Plan Goals Monitor Progress Manage CVD Risk BP control Self Management Intervenons RASA Treatment. Diet & Exercise Interacons Disease- Disease Disease-drugs Drugs-Disease Drug-Drug DM2 & RF Care Plan Goals HbA1c Control Lipid control BP control Weight Loss Intervenons Insulin Treatment Stan (Decreased dose) RASA Treatment Diet & Exercise DM2 Clinical Guidelines RF Clinical Guidelines Clinical Decision Support Modules Personalized Suggesons for goals and intervenons Reconciliaon of Care Plans Personalized Suggesons for goals and intervenons The research leading to these results has received funding from the European Union’s Horizon 2020 research and innovaon programme under grant agreement No 6891810, C3-Cloud Project Fig. 3 – Ulizaon of Clinical Decision Support Modules for Care Plan Creaon and Reconciliaon of Mulple Care Plans Fig. 1 - An overview of C3-Cloud Architecture C M Y CM MY CY CMY K AFcRoll Up_ trillium3.pdf 3 15/03/19 13:38
Transcript of A Federated Collaborative Care & Cure Cloud Architecture ... · technologies (ICT). C3-Cloud...
A Federated Collaborative Care & Cure Cloud Architecture for Addressing the Needs of Multi-morbidity
and Managing Poly-pharmacyGokce Banu Laleci Erturkmena, Mustafa Yuksela, and Theodoros N. Arvanitisb
a SRDC Software Research Development & Consultancy Corp, Ankara, Turkey, email: (gokce, mustafa)@srdc.com.trb Institute of Digital Healthcare, WMG, University of Warwick, Coventry, UK , email: [email protected]
IntroductionA growing share of the population (15% in 2010) in OECD
countries is over 65 and expected to reach 22% by 2030. Older age isassociated with an increased accumulation of multiple chronicconditions. More than half of all older people have at least threechronic conditions, and a significant proportion has five or more.
The clinical management of patients with multi-morbidity is muchmore complex, disconnected and time-consuming than that of thosewith single diseases. As a result, multi-morbid patients with long-termcare needs experience shortcomings and gaps in their care provision.
There is an increasing need to organise the care around the patientwith the involvement of all stakeholders, and as a response to thisrequirement, the C3-Cloud project aims to achieve high qualityintegrated care with the support of information and communicationtechnologies (ICT).
C3-Cloud ApproachC3-Cloud establishes an ICT infrastructure to enable continuous
coordination of patient-centred care activities by a multidisciplinarycare team (MDT) and patients/informal care givers.
Reconciliation of Multiple Care Plans through Clinical Decision Support Systems
Clinical Decision Support Modules are utilized for risk predictionand stratification, poly-pharmacy management, goal and interventionsetting based on evidence based clinical guidelines and reconciliationof multiple care plans.
Seamless integration with existing health/social care information systems
Fusion of multimodal patient data will be achieved via C3-CloudInteroperability Middleware. FHIR based interfaces with existinghealth/social care information systems are being implemented foraddressing technical interoperability, while a terminology server isutilized for addressing semantic interoperability challenges.
Active Patient Involvement through Patient Empowerment Platform
Active patient involvement will be realized through a PatientEmpowerment Platform, ensuring patient needs are respected indecision making.Project Web Site: http://c3-cloud.eu/
Personalised Care Plan Development Platform A Personalised Care Plan Development Platform allows
collaborative creation and execution of personalised care plans formulti-morbid patients through systematic and semi-automaticreconciliation of clinical guidelines.
Fig. 2 – A snapshot from Personalized Care Plan Development Environment
DM2 + RF-Severity and stage-Diet/exercise-Training and self-care-Follow-up-Pharmacotherapy
RF-Severity and stage-Diet/exercise-Training and self-care-Follow-up-Pharmacotherapy
Severity and stage
classification
Diet, exercise, training and self-care
Follow-up Pharmacotherapy
-Modification of the severity and stage
-Significant modificationsdue to RF-Necessity of new recommendations
-Changes in the content and in thefrequency of visits-Criteria of referral to nephrology
-New drugs-Changes in “ prescription module”: Disease-drug and drug-druginteractions.
INTERACTIONSDisease-diseaseDisease-drugsDurgs-diseases
Drug-drug
DM2-Severity and stage-Diet/exercise-Training and self-care-Follow-up-Pharmacotherapy
DM2 Care PlanGoalsHbA1c ControlLipid controlBP control Weight Loss
InterventionsMetformin Treat.Statin TreatmentACE-I TreatmentDiet & Exercise
RF Care PlanGoalsMonitor ProgressManage CVD RiskBP controlSelf Management
InterventionsRASA Treatment.Diet & Exercise
InteractionsDisease-Disease
Disease-drugsDrugs-Disease
Drug-Drug
DM2 & RF Care PlanGoalsHbA1c ControlLipid controlBP control Weight Loss
InterventionsInsulin TreatmentStatin (Decreased dose)RASA TreatmentDiet & Exercise
DM2 Clinical Guidelines RF Clinical Guidelines
Clinical Decision Support Modules
Personalized Suggestions forgoals and interventions
Reconciliation of Care Plans
Personalized Suggestions forgoals and interventions
The research leading to these results has received funding from the European Union’s Horizon 2020 research and innovation programme under grant agreement No 6891810, C3-Cloud Project
Fig. 3 – Utilization of Clinical Decision Support Modules for Care Plan Creation and Reconciliation of Multiple Care Plans
Fig. 1 - An overview of C3-Cloud Architecture
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AFcRoll Up_ trillium3.pdf 3 15/03/19 13:38
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