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ICT for supporting eCare Mate Betek, Andrej Brodnik {mate.bestek,andrej.brodnik}@upr.si Koper, May 22 nd, 2014 M. Betek, A. Brodnik: ICT for supporting eCare 1Spring School 2014

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Motivation General interoperability Intervetions implemented in a project eCare Specific tools and frameworks for interopearability M. Betek, A. Brodnik: ICT for supporting eCare 2Spring School 2014

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Based on projects E-health care process support eCare https://eoskrba.pint.upr.si/ 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/ http://e-health-ita-slo.eu/ Interreg project M. Betek, A. Brodnik: ICT for supporting eCare 3Spring School 2014

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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. M. Betek, A. Brodnik: ICT for supporting eCare 4Spring School 2014

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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. M. Betek, A. Brodnik: ICT for supporting eCare 5Spring School 2014

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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. M. Betek, A. Brodnik: ICT for supporting eCare 6Spring School 2014

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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. Betek, A. Brodnik: ICT for supporting eCare 7Spring School 2014

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Issues for eHealth Integration INTEROPERABILITYINTEROPERABILITY INTEROPERABILITYINTEROPERABILITY SUSTAINABILITYSUSTAINABILITY SUSTAINABILITYSUSTAINABILITY ENABLES M. Betek, A. Brodnik: ICT for supporting eCare 8Spring School 2014

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Issues for eHealth Integration Technical Organizational Semantic Enterprise INTEROPERABILITYINTEROPERABILITY INTEROPERABILITYINTEROPERABILITY SUSTAINABILITYSUSTAINABILITY SUSTAINABILITYSUSTAINABILITY ENABLES M. Betek, A. Brodnik: ICT for supporting eCare 9Spring School 2014

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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 M. Betek, A. Brodnik: ICT for supporting eCare 10Spring School 2014

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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 M. Betek, A. Brodnik: ICT for supporting eCare 11Spring School 2014

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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 M. Betek, A. Brodnik: ICT for supporting eCare 12Spring School 2014

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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 M. Betek, A. Brodnik: ICT for supporting eCare 13Spring School 2014

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How much of interoperability is enough? You dont want too much focus and lose focus on the main project goals You dont 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! M. Betek, A. Brodnik: ICT for supporting eCare 14Spring School 2014

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Interoperability Sample Projects epSOS Parent NwHIN eCare M. Betek, A. Brodnik: ICT for supporting eCare 15Spring School 2014

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Motivation for the eCare project Salt intake Excercise Stress mgmt Mental fitness Pre-diabetes mgmt x xx Pre-hypert. mgmt Diabetes mg. Hypert.mg. Depression mg. Interventions: Semantic Interop. -OpenEHR -MLHIM Platform M. Betek, A. Brodnik: ICT for supporting eCare 21Spring School 2014

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Sport Activity Obesity x xx Interventions Diabetes Asthma Schizophrenia M. Betek, A. Brodnik: ICT for supporting eCare 22Spring School 2014

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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 M. Betek, A. Brodnik: ICT for supporting eCare 23Spring School 2014

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Interventions Definition: How to Design? How to Deploy? Psychology Medicine ICT M. Betek, A. Brodnik: ICT for supporting eCare 24Spring School 2014

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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 M. Betek, A. Brodnik: ICT for supporting eCare 25Spring School 2014

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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. Betek, A. Brodnik: ICT for supporting eCare 26Spring School 2014

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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 M. Betek, A. Brodnik: ICT for supporting eCare 27Spring School 2014

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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 M. Betek, A. Brodnik: ICT for supporting eCare 28Spring School 2014

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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 M. Betek, A. Brodnik: ICT for supporting eCare 29Spring School 2014

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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 M. Betek, A. Brodnik: ICT for supporting eCare 30Spring School 2014

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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 M. Betek, A. Brodnik: ICT for supporting eCare 31Spring School 2014

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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 M. Betek, A. Brodnik: ICT for supporting eCare 32Spring School 2014

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How to Deploy Interventions? eCare in the Cloud Internet and mobile access IHE profiles Open source technology M. Betek, A. Brodnik: ICT for supporting eCare 33Spring School 2014

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The big picture National eHealth NCP EU Terminology Server Terminology Server CKM Care models M. Betek, A. Brodnik: ICT for supporting eCare 35Spring School 2014

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THANK YOU! Mate Betek, Andrej Brodnik: Interoperability and mHealth precondition for successful eCare, In mHealth: The Technology Road Map, Springer (In Print) M. Betek, A. Brodnik: ICT for supporting eCare 36Spring School 2014