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ICT for supporting eCare
Mate Beštek, Andrej Brodnik
{mate.bestek,andrej.brodnik}@upr.si
Koper, May 22nd, 2014
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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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supporting eCare
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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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supporting eCare
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E-health care process support – eCare
Chronic 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
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Issues for eHealth Integration
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Issues for eHealth Integration
Enterprise
Organizational
Semantic
Technical
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Technical Interoperability
• Technical standards and agreements on system
interconnection
• Web services collaboration
• Information representation formats
• Middleware
• Platforms
• Network connectivity,
Enterprise
Organizational
Semantic
• Accessibility andM. security
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supporting eCare
Technical
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Semantic Interoperability
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Data and representation schemas
XML standards (generic and sectoral)
General ontologies
Metadata sets
Unified code lists
Core components
Data elements
Glossaries
Enterprise
Organizational
Semantic
Technical
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Organizational interoperability
• Process representation and alignment
• Collaborative process design
• Business process re-engineering for
interoperability
• Collaborative organizational models
Enterprise
Organizational
Semantic
Technical
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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
Enterprise
Organizational
Semantic
Technical
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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
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epSOS
Parent
NwHIN
eCare
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Spring School 2014
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supporting eCare
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Motivation for the eCare project
x
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Interventions:
Excercise
Pre-diabetes mgmt
Diabetes mg.
Salt intake
Pre-hypert. mgmt
Hypert.mg.
Stress mgmt
Depression mg.
Mental fitness
Semantic
Interop.
-OpenEHR
-MLHIM
Platform
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Interventions
• Sport Activity
• Obesity
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• Diabetes
• Asthma
• Schizophrenia
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M. Beštek, A. Brodnik: ICT for supporting
eCare
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Stakeholders
• Healthcare System
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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:
Psychology
• How to Design?
Medicine
ICT
• How to Deploy?
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How to Design Interventions?
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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
M. Beštek, A. Brodnik: ICT for supporting
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eCare
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Intervention #1: Diabetes
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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
EU
NCP
National eHealth
Terminology
Server
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CKM
M. Beštek, A. Brodnik: ICT for
supporting eCare
Care
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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