..

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
Pharmacy General practitioner
Healthcare equipment centre Specialist nurses
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
 Creates new ways to
collaborate between Team oriented
different healthcare actors in
Mobility a mobile environment way of working

Creates possibility
Creates a better way of to enhance quality for the
using time, resources patient but requires new
and competence 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 CO-CARE Patients,

social care (negotiated, their relatives
staff reqs focusing or friends
on patient needs)

Research and
development,
the IT market
 Informations model 1 (exemple)

Typ av hälsotillstånd
(from Begrepp)

signeras/valideras av 1 Vårdgivare
(from Vårdagenter)
k lassificeras av
1

0..n 0..n genereras/samlas in av

Hälsotillstånd
består av 0..n kategori : Hälsotillståndskategori 0..n
händelsetidpunkt : Tidpunkt
signeringstidpunkt : Tidpunkt för Patient
0..1 rapporteringstidpunkt : Tidpunkt 0..n
1
värde : Text
status : Hälsotillståndsstatus
delordningsnr : Heltal 0..n
0..1
0..1 0..n
samlas in vid
0..1
är senare resulterar i
version av Vårdkontakt
0..n
Aktivitet

mobisams
15 april 2009
mobilt IT­stöd för samverkan i vården Namn Efternamn 2006-05-10 9
 Informations model 2 (exemple)

resulterar i Vård- och omsorgsaktivitet

0..* ...
0..*
Hälso-/socialt förhållande
Förhållandetyp klassificeras av händelsetidpunkt : Tidpunkt [1]
uppger/samlar in/genererar Vård- och omsorgsagent
valideringstidpunkt : Tidpunkt [0..1]
... 1 0..* dokumentationstidpunkt : Tidpunkt [1] 1
0..*
värde/beskrivning : Text [1]
0..* status : Förhållandestatus [1]
kategori : Förhållandekategori [1]
delordningsnr : Heltal [0..1]
0..*
avser 0..1 0..* 0..*
validerar/signerar Vård- och omsorgsperson
1 är delförhållande till 0..1 ...

Patient/kund 1
...

1 specificeras som problem genom

avser
0..*
0..* Hälso-/socialt problem identifierar/specificerar
0..*
problembeskrivning : Text [1]
svårighetsgrad : Text [0..1]

0..* 0..*
klassificeras av medför Vård- och omsorgsbehov
1 0..1
behovsbeskrivning : Text [1]
Problemtyp

mobisams
15 april 2009
mobilt IT­stöd för samverkan i vården Namn Efternamn 10
2006-05-10
 Collaboration Architecture
Mobile Healthcare Healthcare Activity Carry out Resource Follow up Resource
gateway contact plan planning avtivities allocation activities availability
component

Contact
server Communications level
Referral/
answer
component

Healthcare Healthcare Activity Concept

Resources Agent
contact plan Plan component
component component
component component component (Adapt.)

Authenti- Log
cation service

Actor and
Authori-
address
zation
service

Healthcare
Citizen
contacts
information
(Journal scr.)
 Social care
.....

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

3G GPRS
 Mobile situations
To be mobile in To be mobile outdoors To be mobile
indoors activities at home
tion
i c a
e n tif rs
r e i d
e u se
u il
Sec f mob
o
Specialist medical care Patient’s home

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

Municipal Special accommodation

home service
 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!