ICT for supporting eCare

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

1Spring School 2014

• Motivation• General interoperability• Intervetions implemented in a

project eCare• Specific tools and frameworks

for interopearability


2Spring School 2014

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


3Spring School 2014

https://eoskrba.pint.upr.si/



http://e-health-ita-slo.eu/

http://e-health-ita-slo.eu/

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.


4Spring School 2014

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.


5Spring School 2014

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.


6Spring School 2014


• 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

Issues for eHealth IntegrationINTEROPERABILITY

SUSTAINABILITY

ENABLES


8Spring School 2014


Technical

Organizational

Semantic

Enterprise

INTEROPERABILITY

SUSTAINABILITY

ENABLES


9Spring School 2014

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


10Spring School 2014

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



Organizational interoperability

• Process representation and alignment• Collaborative process design• Business process re-engineering for

interoperability• Collaborative organizational models

Technical

Organizational

Semantic

Enterprise



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



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!



Interoperability Sample Projects

• epSOS• Parent• NwHIN• eCare



M. Beštek, A. Brodnik: ICT for supporting eCare 20Spring School 2014

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

• Sport Activity• Obesity

CHRO

NIC

CON

DITIO

N

HEALTHYAT RISK

CON

DITIO

N

x x x

Interventions

• Diabetes• Asthma• Schizophrenia


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– …



Interventions

• Definition:

• How to Design?

• How to Deploy?

Psychology Medicine

ICT



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• …



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


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


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


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


• 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


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


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



How to Deploy Interventions?

• eCare in the Cloud– Internet and mobile access

• IHE profiles• Open source technology• …



The big picture

National eHealth

NCPEU

TerminologyServer

CKMCare

models



THANK YOU!

Mate Beštek, Andrej Brodnik: Interoperability and mHealth – precondition for successful eCare, In mHealth: The Technology Road Map, Springer (In Print)


ICT for supporting eCare

Documents

Transcript of ICT for supporting eCare