Plas'O'Soins: a software platform for modeling, planning and monitoring homecare activities

International audienceDemographic changes in recent years have contributed to a shift in care models, with the development of homecare as a new alternative to traditional hospitalization. We present a software platform dedicated to the modeling, planning and monitoring of homecare workflows, developed in the framework of the French research program TecSan. The platform is used on the desktop by care coordinators, and on the go by care workers using mobile devices

TOWARDS ENHANCING INTEROPERABILITY IN MEDICAL INFORMATION SYSTEM

Medical  information  systems  evolve  constantly.  This  paper  shows  a  coherent  architectural  framework  that  allows  the development of interoperable medical information systems in measure or these systems evolve. This architecture is based on agent,  ontology  and  Peer  to  Peer.  The  proposed  architecture  is meant  to  include  all  the  concepts  necessary  to  perform  all activities related to medical information system. This work indicates how to attain the organizational interoperability

Aide à la conception de workflows personnalisés : application à la prise en charge à domicile

Aujourd'hui, les TIC sont reconnues comme un élément inéluctable pour améliorer les pratiques et les usages du secteur de la santé et particulièrement celui de la PAD. Cependant, malgré tout l'engouement et les avancés accomplies dans ce domaine, un problème de coordination et de continuité des soins personnalisés aux patients subsiste toujours. Un système de gestion de workflow semble approprié pour assurer cette coordination de la PAD. Toutefois, les caractéristiques des processus de la PAD, que nous avons identifié, compliquent la conception de ce workflow. En effet, le processus de la PAD a la particularité d'être un processus, personnalisé pour chaque patient, collaboratif évoluant dans un environnement très dynamique et incertain avec une forte contrainte temporelle. Dans le but d'améliorer la coordination en tenant compte des caractéristiques des processus de la PAD, nous avons proposé une approche de conception d'un workflow personnalisé basé sur les modèles de connaissances et guidée par une approche dirigée par les modèles. Cette approche préconise l'utilisation d'ontologies du domaine de la PAD et du BPMN dans un processus de transformations qui aboutit à la conception d'un workflow personnalisé pour un patient donnée selon son profil. Les travaux développés dans ce mémoire présentent une partie de cette approche qui consiste à construire un processus BPMN personnalisé. Les contributions, que nous y exposons sont : premièrement, la conception d'une ontologie du domaine de la PAD. Cette ontologie inclut : le profil patient (pathologie, entourage, environnement,...), l'aspect organisationnel de la PAD (le rôle de chaque intervenant) et le traitement ou les interventions nécessaires pour chaque pathologie. Deuxièmement une proposition de règles de correspondances entre les termes du domaine de la PAD et du BPMN. Finalement des requêtes permettant la conception d'un processus BPMN personnalisé. Cette approche a été testée sur un cas d'étude de la PAD qui montre son bon fonctionnement.Today, ICT is recognized as a requirement to improve the practices of the health sector and particularly the home care area. However, despite all the advances accomplished in this field, a problem of coordination and continuity of personalized care remains. A workflow management system seems appropriate to ensure the coordination of home care. However, the characteristics of the home care processes complicate the design of the workflow. Indeed, the processes of home care need to be customized for each patient, collaborative, evolving in a very dynamic and uncertain environment with a strong time constraint. In order to improve the coordination taking into account the characteristics of the home care process, we propose an approach to design a custom workflow models based on knowledge and guided by a model driven approach. This approach advocates the use of ontologies in the field of home care and BPMN into a process of transformation that leads to the design of a custom workflow for a given patient according to his profile. The work developed in this thesis are part of this approach is to build a customized BPMN process. Contributions are: first, the design of an ontology for home care. This ontology includes: patient profile (pathology, environment, ...), the organizational aspect of the home care (the role of each actor) and the treatment or interventions necessary for each pathology. Secondly, a proposal of correspondence rules between the terms in the field of home care and BPMN. Finally queries are performed to design a customized BPMN process. This approach has been tested on a significative case study

Process Innovation With Lightweight It at an Emergency Unit

In this paper, we are studying the role of lightweight IT in process innovation. Our research question is how can lightweight IT support process innovation within an established e-health information infrastructure? Our empirical evidence is a qualitative case study at a primary care emergency service in Oslo. We provide two contributions. First, applying the lens of business process innovation to the literature on information infrastructures, we retain the value of the installed base, while we at the same time ad speed to the implementation project. Second, we demonstrate the role of lightweight technology in improving logistics and message interaction within and between health units. The lightweight technologies availability on the commercial market makes acquisition and implementation faster. Based on this, we briefly suggest a bypassing strategy where a new layer of technology is built separately from the existing infrastructure in order to effectively address process innovation efforts

A standards-based ICT framework to enable a service-oriented approach to clinical decision support

This research provides evidence that standards based Clinical Decision Support (CDS) at the point of care is an essential ingredient of electronic healthcare service delivery. A Service Oriented Architecture (SOA) based solution is explored, that serves as a task management system to coordinate complex distributed and disparate IT systems, processes and resources (human and computer) to provide standards based CDS. This research offers a solution to the challenges in implementing computerised CDS such as integration with heterogeneous legacy systems. Reuse of components and services to reduce costs and save time. The benefits of a sharable CDS service that can be reused by different healthcare practitioners to provide collaborative patient care is demonstrated. This solution provides orchestration among different services by extracting data from sources like patient databases, clinical knowledge bases and evidence-based clinical guidelines (CGs) in order to facilitate multiple CDS requests coming from different healthcare settings. This architecture aims to aid users at different levels of Healthcare Delivery Organizations (HCOs) to maintain a CDS repository, along with monitoring and managing services, thus enabling transparency. The research employs the Design Science research methodology (DSRM) combined with The Open Group Architecture Framework (TOGAF), an open source group initiative for Enterprise Architecture Framework (EAF). DSRM’s iterative capability addresses the rapidly evolving nature of workflows in healthcare. This SOA based solution uses standards-based open source technologies and platforms, the latest healthcare standards by HL7 and OMG, Decision Support Service (DSS) and Retrieve, Update Locate Service (RLUS) standard. Combining business process management (BPM) technologies, business rules with SOA ensures the HCO’s capability to manage its processes. This architectural solution is evaluated by successfully implementing evidence based CGs at the point of care in areas such as; a) Diagnostics (Chronic Obstructive Disease), b) Urgent Referral (Lung Cancer), c) Genome testing and integration with CDS in screening (Lynch’s syndrome). In addition to medical care, the CDS solution can benefit organizational processes for collaborative care delivery by connecting patients, physicians and other associated members. This framework facilitates integration of different types of CDS ideal for the different healthcare processes, enabling sharable CDS capabilities within and across organizations

A collaborative platform for management of chronic diseases via guideline-driven individualized care plans

Older age is associated with an increased accumulation of multiple chronic conditions. The clinical management of patients suffering from multiple chronic conditions is very complex, disconnected and time-consuming with the traditional care settings. Integrated care is a means to address the growing demand for improved patient experience and health outcomes of multimorbid and long-term care patients. Care planning is a prevalent approach of integrated care, where the aim is to deliver more personalized and targeted care creating shared care plans by clearly articulating the role of each provider and patient in the care process. In this paper, we present a method and corresponding implementation of a semi-automatic care plan management tool, integrated with clinical decision support services which can seamlessly access and assess the electronic health records (EHRs) of the patient in comparison with evidence based clinical guidelines to suggest personalized recommendations for goals and interventions to be added to the individualized care plans. We also report the results of usability studies carried out in four pilot sites by patients and clinicians

The bridge of dreams::Towards a method for operational performance alignment in IT-enabled service supply chains

Concerns on performance alignment, especially on business-IT alignment, have been around for three decades. It is still considered to be one of the most important driving forces for business success, as well as one of the top concerns of many practitioners and organizational researchers. It is also found to be a major issue in two thirds of digital transformation projects. Many attempts from researchers in diverse disciplines have been made to tackle this issue. Unfortunately, they have been working separately and the research appears in various forms and names. This dissertation presents a piece of interdisciplinary research that focuses on identifying operational performance alignment issues, discovering and assessing their root causes with attention to the dynamics in operating IT-enabled service supply chain (SSC). It makes a modest contribution by providing a communication-centred instrument which can modularize complex SSC in terms of a hierarchically-structured set of services and analyze the performance causality between them. With a special focus on the impact of IT, it makes it possible to monitor and tune various performance issues in SSC. This research intends to provide a solution-oriented common ground where multiple service research streams can meet together. Following the framework proposed in this research, services, at different tiers of an SSC, are modelled with a balanced perspective on both business, technical service components and KPIs. It allows a holistic picture of service performances and interactions throughout the entire supply chain to be viewed through a different research lens and permits the causal impact of technology, business strategy, and service operations on supply chain performance to be unveiled

Design science approach

Funding Information: This project (PrimaryCare@COVID-19: Digital Platform for Supporting Chronic Patients and COVID-19 consultations and Monitoring in Primary Care) was funded by the Funda??o para a Ci?ncia e Tecnologia (Ministry of Science of Technology, Portugal) under the Research4COVID-19 program. Funding Information: This project (PrimaryCare@COVID-19: Digital Platform for Supporting Chronic Patients and COVID-19 consultations and Monitoring in Primary Care) was funded by the Fundação para a Ciência e Tecnologia (Ministry of Science of Technology, Portugal) under the Research4COVID-19 program. Publisher Copyright: © 2021 Luís Velez Lapão, Mariana Peyroteo, Melanie Maia, Jorge Seixas, João Gregório, Miguel Mira da Silva, Bruno Heleno, Jorge César Correia.Background: The COVID-19 pandemic is straining health systems and disrupting the delivery of health care services, in particular, for older adults and people with chronic conditions, who are particularly vulnerable to COVID-19 infection. Objective: The aim of this project was to support primary health care provision with a digital health platform that will allow primary care physicians and nurses to remotely manage the care of patients with chronic diseases or COVID-19 infections. Methods: For the rapid design and implementation of a digital platform to support primary health care services, we followed the Design Science implementation framework: (1) problem identification and motivation, (2) definition of the objectives aligned with goal-oriented care, (3) artefact design and development based on Scrum, (4) solution demonstration, (5) evaluation, and (6) communication. Results: The digital platform was developed for the specific objectives of the project and successfully piloted in 3 primary health care centers in the Lisbon Health Region. Health professionals (n=53) were able to remotely manage their first patients safely and thoroughly, with high degrees of satisfaction. Conclusions: Although still in the first steps of implementation, its positive uptake, by both health care providers and patients, is a promising result. There were several limitations including the low number of participating health care units. Further research is planned to deploy the platform to many more primary health care centers and evaluate the impact on patient's health related outcomes.publishersversionpublishe

Managing open innovation in connected health through a living lab

The digital footprint marks all parts of society and impacts our lifestyles. Beyond perceived changes in individual way of life, digital revolution also affects sociotechnical systems, collective structures or communities that delivers primary services for citizens. Healthcare is deeply impacted by such a digital mutation at many levels (patient expectations, caregivers practices and organization). We are probably witnessing the emergence of smart and personalized healthcare with a very large scope. To be included in this dynamics, many healthcare organizations now feature collaborative approaches and open innovation management to improve their performance in a sustainable perspective. But the complexity of systems is often a limit to their progress. This paper discuss the place and role that could be played by new utilities that are naturally based on open innovation approach: the living labs. In connected health where many stakeholders should interact, they are naturally expanding. Using an example, we show the gains in value chain that this new envision of open innovation could provide. In parallel, the paper argues for a development of open innovation engineering in such labs. It leads to the conclusion that a reference framework is helpful in such a perspective