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ICT for supporting eCare
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ICT for supporting eCare
Mate Beštek, Andrej Brodnik{mate.bestek,andrej.brodnik}@upr.si
Koper, May 22nd, 2014
M. Beštek, A. Brodnik: ICT for supporting eCare
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• Motivation• General interoperability• Intervetions implemented in a
project eCare• Specific tools and frameworks
for interopearability
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Based on projects• E-health care process support –
eCare– https://eoskrba.pint.upr.si/– Financed by Research Agency of RS
and Ministry of Health RS• E-health on a crossborder area
– http://e-health-ita-slo.eu/– Interreg project
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E-health care process support – eCareChronic noncommunicable diseases represent an important and growing threat to sustainability of health care systems. To fight this challenge reserves in health care system need to be better utilized and health care innovation is needed. The unoptimal care process and poor patient engagement in this process are key topics of this project. eHealth enables relatively quick and effortless implementation of innovative health care services. The project will use years of experience of consortium partners to develop, implement and evaluate innovative health care interventions, utilizing eHealth and contemporary organizational approaches.
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E-health on a crossborder area
The E-health project aims to increase the quality of life through the development of coordinated health and social systems, and specifically the Italian and Slovenian patients’ quality of life through ICT (Information and Communication Technology) tools and new technologies.
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Issues for eHealth Integration
• Interoperability– Integrated systems that can use the
shared data in a meaningful way.– Systems can exchange data in a
standardized way.– Systems can collaborate in a
meaningful way.
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Issues for eHealth Integration
• Sustainability– as part of the Sustainable
Development:• “sustainable development is development that meets the needs of
the present without compromising the ability of future generations to meet their own needs.
– as part of the Triple Bottom Line approach to business sustainability:
• “Triple Bottom Line (TBL) approach to business sustainability” is based not only on economic performance, but also environmental and social accomplishment M. Beštek, A. Brodnik: ICT for
supporting eCare7Spring School 2014
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Issues for eHealth IntegrationINTEROPERABILITY
SUSTAINABILITY
ENABLES
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Issues for eHealth Integration
Technical
Organizational
Semantic
Enterprise
INTEROPERABILITY
SUSTAINABILITY
ENABLES
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Technical Interoperability
• Technical standards and agreements on system interconnection
• Web services collaboration • Information representation formats• Middleware• Platforms• Network connectivity, • Accessibility and security Technical
Organizational
Semantic
Enterprise
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Semantic Interoperability
• Data and representation schemas• XML standards (generic and sectoral)• General ontologies• Metadata sets• Unified code lists• Core components• Data elements• Glossaries
Technical
Organizational
Semantic
Enterprise
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Organizational interoperability
• Process representation and alignment• Collaborative process design• Business process re-engineering for
interoperability• Collaborative organizational models
Technical
Organizational
Semantic
Enterprise
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Enterprise interoperability
• Legislation and business rules representation and alignment
• Collaborative business models• Collaborative enterprise goal setting• Cross enterprise and international supply
chain collaboration• Example: epSOS project, Parent project
Technical
Organizational
Semantic
Enterprise
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How much of interoperability is enough?
• You don‘t want too much focus and lose focus on the main project goals
• You don‘t want too little focus on it and create Just Another Silos – Detached Data Warehouse
• Learn from past experience of other projects!• Reuse as much as possible!
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Interoperability Sample Projects
• epSOS• Parent• NwHIN• eCare
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Motivation for the eCare project
Salt intake
Excercise
Stress mgmtMental fitness
Pre-diabetes mgmt
HEALTHYAT RISK
CON
DITIO
N CHRO
NIC
CON
DITIO
Nx x x
Pre-hypert. mgmt
Diabetes mg.
Hypert.mg.
Depression mg.
Interventions:
SemanticInterop.-OpenEHR-MLHIM
PlatformM. Beštek, A. Brodnik: ICT for supporting
eCare 21Spring School 2014
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• Sport Activity• Obesity
CHRO
NIC
CON
DITIO
N
HEALTHYAT RISK
CON
DITIO
N
x x x
Interventions
• Diabetes• Asthma• Schizophrenia
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Stakeholders• Healthcare System
– General Practitioners (GPs) – Primary Level– Hospitals – Secondary Level– National Institute for Public Health – Tertiary Level– Specialized Clinics – Tertiary Level
• People in different roles:– Healthy, Patients – Doctors, Nurses– …
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Interventions
• Definition:
• How to Design?
• How to Deploy?
Psychology Medicine
ICT
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How to Design Interventions?
• Behaviour Change Techniques• Doctors as business analysts (BPMN2)• Doctors model clinical knowledge (OpenEHR)• Care manager role is crucial• Collaboration is established• Educational content is provided• …
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Interventions – general• Patient empowerment
• Doctors as business analysts (BPMN2)• Doctors model clinical knowledge (OpenEHR)
• Care manager role is crucial
• Collaboration is established• Educational content is provided
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Intervention #1: Diabetes
• University of Ljubljana, Chair for Family Medicine• Diabetes Type 2• Primary sector (GPs) ~ 20 • The nurse is the care manager• Patients receive tasks and are notifed of them
through different channels• Clinical trial was conducted
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Intervention #2: Asthma
• Secondary sector (University Clinic of Respiratory and Allergic Diseases Golnik)
• The nurse is the care manager• Patients receive tasks and are notified of them
through different channels• Clinical trial was conducted
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Intervention #3: Schizophrenia
• Secondary sector (Psychiatric hospital Begunje) • Family members play an active role of care managers
together with nurses• Patients receive tasks and are notified of them
through different channels• Additional role – relatives• The tasks were games for cognitive improvement
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• Intervention #4: Obesity
• Tertiary sector (The National Institute of Public Health of the Republic of Slovenia)
• Clinical trial was conducted• 12 locations in Slovenia• Patients receive tasks and are notified of them
through different channels• Focused on educating the obese
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Intervention #5: Sport Activity
• General public• Clinical trial was conducted• Patients receive tasks and are notified of them
through different channels• Dynamic workout plans were assigned to people • Workout plans changed according to the feedback
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Interventions Common Elements
• Behaviour change techniques (tailoring, alarms,…)
• We reused BPMN2 care process models• We reused OpenEHR clinical knowledge models• The design and development was iterative and
incremental in its nature
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How to Deploy Interventions?
• eCare in the Cloud– Internet and mobile access
• IHE profiles• Open source technology• …
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The big picture
National eHealth
NCPEU
TerminologyServer
CKMCare
models
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THANK YOU!
Mate Beštek, Andrej Brodnik: Interoperability and mHealth – precondition for successful eCare, In mHealth: The Technology Road Map, Springer (In Print)
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