COCACoOperation, Concepts and Architecture

Magnus Fogelberg, neurologistProject team leaderPresident, Swedish Federation for Medical Informatics

OBJECTIVE

To increase quality of health care information systems

Better communication• Users• Decision makers• System providers

by means of• a common language

Continuity concepts – CONTSYS

Architecture – HISA

?

CONTSYS

Static image of continuity concepts

SAMBA

Dynamic image of the process

The process is the implementation of continuity

HEALTH CARE PROCESSStart: health care professional perceives

demand for care

Mandatory contact with service: assessment of demand for care

Optional contacts with services: program of care, specific services, assessments

Decision point: end process

PROCESS TERMINATION

Decision point:1. No further need for health care (recovered)2. No more services applicable within the health

care society3. Responsible health care provider finds no

more services applicable4. Health care mandate withdrawn

HEALTH CARE PROCESS

=

CUMULATIVE EPISODE OF CARE (CONTSYS)

?

HISA

HISA/CONTSYS concepts

• health care actor / health care professional + other carer

• - / health care agent• subject of care + patient / subject of care• case / contact period + episode of care• health characteristics + reason for contact / health

issue + health issue thread• …

person

health care professional subject of care other carer

person

health care professional subject of care other carer external actor

person

sendDemandForCare(subjectForDemand : person)delineateHealthIssueThread(healthIssue[1..n])

demand mandate

0..n

11

possesses

0..n

sendDemandForCare

possesses active demand mandate

demand for care<<signal>>

<<send>>person

sendDemandForCare(subjectForDemand : person)delineateHealthIssueThread(healthIssue[1..n])

subjectForDemand : personreasonForCareNeed : health issue thread

document bears

phone call bears

personal visit bears

sudden event bears

health care provider

distribute(businessIssue, receiver : health care professional)

0..n

0..n

receives

health care professional

stateHealthCareCommitment()assessDemandForCare()

0..n

0..n assesses

receives demand for care from

{at least one of}

Person who is subject to demand for care

Subject of care

Person who is subject to demand for care

Receives demand for care

Defines health issue thread

Refers

Delineates health care commitment

Created

Being planned

Destroyed

resources? services available?

nono

: care process : health care professional : person

yes yes

Health care commitment

• a commitment to provide at least one health care service to a subject of care by interfering with at least one health issue encompassed in the health issue thread delineated by the health care professional stating the commitment

: person : health care provider

: health care professional

: care process

: health care commitment

sends demand for caredistributes

demand for care delineates healthissue thread

states

finds no applicable service available in the repositry

: person : health care provider

sends demand for care

: health care professional

distributes demand for care delineates health

issue thread : care process

Further work

• mandates• contacts• health care services• assessment of service outcome• decision for terminating the health care process

Assessment ofdemand for care

Decliningwith

referral

HCcommitment

---* perceived

condition 1:M

Receivedemand for care

Demandfor care

PerformedHC activity

----* Result

Perform HCactivity

Care assessment----

* Degree of fulfillment* Remaining needs

organisation service repositoryhc providerPerson /

Patient

Assessment ofdemand for care

Commitmentplan----

•Program of care •1:M

* Objective

result/response

Terminatecommitment

Commitmentend

Region-IT/ MA

”do we manage this?”

Assess care need

Care need Plan con-tinued care

Create plan

Assess withrespect to

plan objective

continue according to plan

external actionsIndividual adaption

”fetch type descriptions”

change / redefine HC commitment

state demand for care