Mobisams

.. Collaboration, home healthcare, mobility - based on a patient centered focus

Monica Winge 2009-04-15

Participation and partners Research

Industry

Förenade Care AB

Organisation

mobisams

mobilt IT­stöd för samverkan i vården

15 april 2009

Namn Efternamn

2006-05-10

2

Many actors provide services/support to a patient Specialist physician Next-of-kin Economy&Adm. Neighbours General practitioner Pharmacy Specialist nurses Healthcare equipment centre Welfare officer Other physicians Assistant nurses Home service assistants Physiotherapist Primary healthcare nurses Work therapist Dietician Speech therapist

Some basic requirements

• Focus on the patient and his/her problems and needs • A patient care process involving many organisations • Need for agreement on responsibility for collaboration among organisations • Need of a common information structure

Present situation ! • • • • • •

Poor collaboration between healthcare organizations Not goal oriented care for the patient Patients “get stuck” between healthcare units Lack of responsibility for patient security The information is not based on the patient’s needs The information does not focus on the patient’s whole picture – > Inefficient resource utilization – > Poor quality for the patient

• Many non-communicating IT-systems

Mobility

Creates new ways to collaborate between different healthcare actors in a mobile environment

Creates a better way of using time, resources and competence

Team oriented way of working

Creates possibility to enhance quality for the patient but requires new information structures

Collaboration between units round a patient

Expected results • • • • • •

Better collaboration between healthcare units Strong focus on the patient needs Increased support for team oriented way of working Enabling joint patient responsibly Open IT-architecture – having generic components Clarifying user functionality, mobile application, components • Mobile functions with information content • Identifying other demands on mobility • Production of a commercial plan

Stakeholders and forces influencing collaborative care Organizations, economy, reqs for follow-up, laws and regulations

Health and social care staff

CO-CARE (negotiated, reqs focusing on patient needs)

Research and development, the IT market

Patients, their relatives or friends

Informations model 1 (exemple)

Typ av hälsotillstånd (from Begrepp) 1 signeras/valideras av

1

k lassificeras av

Vårdgivare (from Vårdagenter)

1 0..n 0..n Hälsotillstånd består av 0..n kategori : Hälsotillståndskategori händelsetidpunkt : Tidpunkt signeringstidpunkt : Tidpunkt 0..1 rapporteringstidpunkt : Tidpunkt värde : Text status : Hälsotillståndsstatus delordningsnr : Heltal 0..1 0..n 0..1 är senare version av

genereras/samlas in av 0..n för 0..n

Patient 1

0..n samlas in vid

resulterar i

0..1 Vårdkontakt

0..n

mobisams 15 april 2009

mobilt IT­stöd för samverkan i vården

Aktivitet

Namn Efternamn

2006-05-10

9

Informations model 2 (exemple) Vård- och omsorgsaktivitet

resulterar i

0..*

0..*

...

Hälso-/socialt förhållande Förhållandetyp ...

klassificeras av

1

händelsetidpunkt : Tidpunkt [1] valideringstidpunkt : Tidpunkt [0..1]

0..* dokumentationstidpunkt : Tidpunkt [1] 0..* värde/beskrivning : Text [1] 0..* status : Förhållandestatus [1]

uppger/samlar in/genererar

Vård- och omsorgsagent

1

kategori : Förhållandekategori [1] delordningsnr : Heltal [0..1]

avser

0..*

0..1

0..*

0..* validerar/signerar

1

Vård- och omsorgsperson

0..1

är delförhållande till

...

1

Patient/kund ...

specificeras som problem genom

1 avser

0..* 0..*

Hälso-/socialt problem

identifierar/specificerar

0..*

problembeskrivning : Text [1] svårighetsgrad : Text [0..1]

0..* klassificeras av

0..* medför

1

0..1

Vård- och omsorgsbehov behovsbeskrivning : Text [1]

Problemtyp

mobisams 15 april 2009

mobilt IT­stöd för samverkan i vården

Namn Efternamn

10

2006-05-10

Collaboration Architecture Mobile gateway

Healthcare contact

Healthcare plan

Contact server

Activity planning

Carry out avtivities

Resource allocation

Follow up activities

Resource availability component

Communications level Referral/ answer component Healthcare contact component

Healthcare plan component

Activity Plan component

Resources component

Agent component

Concept component (Adapt.)

Authentication

Log service

Authorization

Actor and address service

Healthcare contacts (Journal scr.)

Citizen information

Social care ..... urse at Jan Tillit, n unit, the homecare et signs in to g formation up-to-date in ient about the pat Gustav...

Clinic

Home care Mobile Gateway

3G

GPRS

Mobile situations To be mobile in indoors activities

Specialist medical care

Primary healthcare/ Local healthcare

Municipal home service

To be mobile outdoors

To be mobile at home

n

tio a c i tif rs n e d i se u e r e u il Sec f mob o

Patient’s home

o MS e d i / v S/M Care professional’s home e r SM u t / c Pi data / ice o V

Special accommodation

Future Work • Better understanding for the importance of collaboration along the interorganisational patient process. • Better understanding for how collaboration can be archived. • Better tools that support true collaboration in the best interest of the patient.

Conclusion • more and more patients are treated in their homes by a whole set of organizations sometimes with different ownership • new and heavy demands on health care and home service staff to communicate and to collaborate. • need for communication and collaboration on different managerial and operational levels. • Need for an interorganisational services architecture

Monica Winge Homepage www.ki.lime.se/mobisams

Team based work Primary healthcare nurses

Specialist physician Nurse

General practitioner

Physiotherapist

Next-of-kin

Work therapist

Pain Specialist nurses

mobisams 15 april 2009

mobilt IT­stöd för samverkan i vården

Namn Efternamn

17

2006-05-10

Mobilising Care solutions > Patient Joint care plan

The joint care plan!