Supervisor:Prof. Fabio Casati

Graduand:Jovan Stevovic

Università degli studi di TrentoFacoltà di Scienze Matematiche, Fisiche e Naturali

External Supervisor:Dr. Giampaolo

Armellin

Co-Supervisor:Annamaria Chiasera

Interoperability between Social and Health systems in Trentino:

analysis, design and development

2

Doctor

Patient Social Worker

Enti Erogatori

Reports

PAT

Enti GestoriReports

Reports

Local Healthcaregovernance

National governance

Province governance

The situation of the Socio-Health system

Third party assistance providers2

Model of the inter-related processes of Request, Evaluation, Provisioning of Rest Home Service

Healthcare Rest HomeSocial Service

Social Assistant Family Doctor Hospital Doctor

InsertPersonalData

<event>

E1.PersonalData

Insert/ChangeFamilyData

FillAccessForm

<event>

E2.AccessFormProfessionalActivities

(meetings, visits)

<event>

E3.ActivityTake in charge

Secretariat Activities

<event>

E4.AssignmentForm

<event>

E5.ServiceArea

StartRestHomeService

<event>

E6.StartResthomeServices

StartRestHomeService

<event>

E3.Activity

Activity performed until necessary

New

Not yet assigned

Already Assigned

RestHomeServiceActivationRequest

<event>

E1.PersonalData

<event>

E8.RestHomeServiceRequestRequest From

[Health]

InfoGathering

[Social]

<event>

E9.HealthProfile

<event>

E19.CognitiveProfile

<event>

E18.SocialProfile

CommiteeMeeting

<event>

E10.Result(RestHome, RC, SAD)

<event>E12.RestHome

Admission

CloseRestHomeService

<event>

E7.CloseRestHomeService

AddToRankingList

<event>

E11.RankingListPosition

End

<event>

E17.ServiceTermination

<event>

E17.ServiceTermination

End

TemporaryRestHomeAccess

TemporaryRestHomeDischarge

<event>

E13.TemporaryRestHomeAccess

<event>

E13.TemporaryRestHomeDischargeServiceAdmission

<event>

E15.RestHomeAccess

RestHomeAccess

<event>

E16.RestHomeDischarge

RestHomeDischarge

End

Rest Home Operator

<event>

E#.EventName

D#. DocumentName

ActivityName

Conditional Execution

ParallelExecution

EndExecution

Human Operator

Legend

Termination Termination

D1. RestHomeServiceRequest

D3.SocialProfile

D4.Results (RestHome)

D5.StartServiceLetter

Termination

3

SOCIAL ASSISTANCE

HEALTHCARE

ASSISTANCE

THIRD PARTY AGENCIES

4

The situation of the Socio-Health system:Problems

Low quality of assistance (process

inefficiency)

No global visibility (each institution has

visibility on their part of the process)

Citizen interacts with many different entities (

the complexity transferred to the citizen)

No coordination among structures (sharing of

best practices)

4

5

The CSS project:Goals

Interoperability among institutions

Business Intelligence over processes of

assistance

EHSR – Electronic Health and Social Record

Process-oriented analysis that provides an

overall process view (identify inefficiencies)

5

6

Data

Reports

Doctor

Patient Social Worker

Assistance providers

6

Local Healthcaregovernance

National governance

Province governance

The CSS project:Goals

7

7

Classical approach: Data Integration, EII etc

Big number of agencies from different

domains

• 1 health agency, 13 social assistance agencies, 50+

potential third party agencies

Legacy systems too complex

Different level of ICT adoption

Evolving system:

• New actors / services

• Evolution of legacies / processes

• New processes (we analyzed only 4 of them)

7

8

8

ACCESS PROBLEM ANALYSIS

Social assistanceHealth

assistance

RHCCOMMITTEE DECISIONS

Social

+

Health

ACTIVATION

Third party assistance providers

Tele assistance

Residential Health Care

Our approach of analysis of the domain:Based on 4 more significant scenario (processes) of assistance

Day Center

Home Assistance Service

8

Firstcontac

t

Problem analysis

Providing assistance

Socialapplications

Healthapplications

Third party agencyapplications

S 1

“Processes-oriented data integration”:Based on governance indicators

Problem analysis

Providing assistance

Firstcontac

tS 2

Old BI approach

Our newBI

approach

Governance

Governance

9

Local repository

Local repository

Local repository

10

Our approach of analysis of the domain: Isolating “Process Events”

10

Used applications

Differences among

agencies

Generated events

• Data that an event

contains

Indicators for BI

Goals of the analysis:First

contact

Problem analysis

Definition of ass. plan

Assistance

providing

Personal data

Result

Start date

Days of presenc

e

Social assistance

11

Health assistance

11

Our approach of analysis of the domain:Analysis of internal processes and interactions

Social assistance

Third partyAssistance provider

Patient

OR?

11

Notification Event Detail Event

Privacy:2 types of events: Notification and Detail

12

Details

Metadata that describes Details

CSS

4. notify(Notification)

3. save(Notification)

Producer

ConsumerConsumer

4. notify(Notification)

Privacy:Events notification and Event Registry

EventRepository

1. save(Details)

Enterprise Service BUS

2. notify(Notification)

EHSR Event

Registry1

3

CSS

Consumer

5. return: Detail2. getDetails

4. applyPolicy(Detail, role/purpose)

Privacy policy Manager

Producer

EventRepository

Privacy :Applying privacy policies on details

Enterprise Service BUS

3. return: Detail 1. getDetails (role/purpose)

14

Policy definition:Producer defines visibility rules for its own events

15

Business Intelligence

BI as any other consumer:Event Based Data warehouse

Enterprise Service BUSCSS

Producer

EventRepository

Privacy policy Manager

16

Event Dump Area

Reporting Console

ETL

DWH

5. return: Detail

2. getDetails

3. return: Detail

4. applyPolicy(Detail, role/purpose)

1. getDetails (role/purpose)

Producer

Event Repository

1. publish(Event)

2. save(Detail)

CSS

3. notify(Notification) 4. getDetails(idEvent)

Details retrieving issue:Producer repository provided by CSS

17

Legacy

18

Analysis approach

• Does not require big amount of time

• Can stop at high level

• User friendly approach (involves very easily workers)

Proposed platform

• Very flexible, no data replication

• Pays particular attention on privacy and security

• Simplifies connection and data providing to CSS (low level of ICT

adoption)

• Adopts National standards for communication

18

Lessons learned & Conclusions

18

19

19

Future works

19

Improvements

• Extensions to other scenario

• Deeper analysis of processes (new events and new

inefficiencies)

• Better correlation between events and processes

New features

• Personal Health Record - PHR

• Business Process Management (ESB advances that possibility)