Download - COCA
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COCACoOperation, Concepts and Architecture
Magnus Fogelberg, neurologistProject team leaderPresident, Swedish Federation for Medical Informatics
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OBJECTIVE
To increase quality of health care information systems
Better communication• Users• Decision makers• System providers
by means of• a common language
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Continuity concepts – CONTSYS
Architecture – HISA
?
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CONTSYS
Static image of continuity concepts
SAMBA
Dynamic image of the process
The process is the implementation of continuity
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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
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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 Health care mandate withdrawn
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HEALTH CARE PROCESS
=
CUMULATIVE EPISODE OF CARE (CONTSYS)
?
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HISA
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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• …
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person
health care professional subject of care other carer
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person
health care professional subject of care other carer external actor
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person
sendDemandForCare(subjectForDemand : person)delineateHealthIssueThread(healthIssue[1..n])
demand mandate
0..n
11
possesses
0..n
sendDemandForCare
possesses active demand mandate
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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}
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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
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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
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: person : health care provider
: health care professional
: care process
: health care commitment
sends demand for caredistributes
demand for care delineates healthissue thread
states
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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
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Further work
• mandates• contacts• health care services• assessment of service outcome• decision for terminating the health care process
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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
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