Ageing – a Global Challenge: Sharing is Caring. Hägglund M. eHealth week 2010 (Barcelona: CCIB Convention Centre; 2010)

1. Sharing is Caring
Integrating Health Information System to Support
Patient-Centered Care

2. Introduction
Maria Hägglund
Ph.D. in medical informatics
Health Informatics Centre
Karolinska institutet
Stockholm, Sweden

3. OLD@HOME
3-year action research project
Municipality of Hudiksvall & County primary care Hälsingland
• Home help service
• Healthcare centre
• Patient still living at home
Industrial partners
PURPOSE: To facilitate cooperation in homecare of elderly
through information sharing

4. Background
Shared homecare of elderly patients Home
Complex interrelated problems; physical, help
personnel
psychological and social health
• Healthcare services (basic or advanced)
• Social care/Home help services
• Family carers District
nurse
? ?
? ?
? ?
? ?
Relatives/
? Family
Elderly
carers
patients
General
practitioner

5. Requirements
Access to
Sharing of information
information
Interaction
with information
Presentation
of integrated
Mobile devices
information
Integration & Interoperability

6. OLD@HOME
Vision
Right information, in the right place, at the right time, for
the right person, presented in the right format
Virtual Health Record (VHR)
• Mobile access to patient-oriented data
• Different views for different user groups
• Support for point of care documentation
• Access to information from different feeder systems
Difficult to capture the
integrated/cooperative aspects of
shared home care!

7. Capturing Shared Work
User centred system development
• Observations and interviews
• Interdisciplinary working groups
• Specification of work scenarios
• Iterative prototyping

8. Virtual Health Record

9. Implemented applications
Web applications for District nurse & General practitioner
District Nurses web
application
• Notification of new Medication: ALBYL MINOR
Preparation: Pill
prescription Strength: 250
Dosage: 1 pill 1 time/day
• Can add further Signature: JF
Date: 2007-07-31
information aimed at
the home help service
personnel

10. Implemented applications
Home help service personnel’s
handheld device application
• Notification of new information
• Information about new drug from
the general practitioner
• Added instructions from the district
nurse

11. Implemented applications
Web application for Patients and/or family carers

12. Impact on participants
District nurse at a patients home
Gets online information!
Home helpers in action
Read, write and communicate!
Patient in his home
Participates and
feels safe!
General Practitioner
Reads up to date information!
Relatives
Participate and are updated!

13. Conclusion
Improvements to elderly care
 Patient centered care
 Cooperative care processes
 Patient empowerment
Further facilitate patient empowerment
 Establish (better) communication between patients, research and
clinical practice
self-management and secondary prevention
 Support communication through standards based information
systems

14. Current and Future work
Continue development of ICT to meet the needs
• Evaluate ICT
• User interfaces for elderly
Expand focus of collaborative
healthcare – continuity of care
• Chronic disease management
• Stroke patients
• Include hospital care and Acknowledge patients’
clinical research and family carers’ roles!

15. References
Scenarios to capture work processes in shared homecare—From
analysis to application
International Journal of Medical Informatics, In Press, Available online 31
August 2008
Maria Hägglund, Isabella Scandurra, Sabine Koch
Studying intersection points: an analysis of information needs in
shared homecare of elderly.
The Journal on Information Technology in Healthcare (2009); 7(1), 23-42
Maria Hägglund, Isabella Scandurra, Sabine Koch
Bridging the Gap: a Virtual Health Record for integrated Homecare
International Journal of Integrated Care – Vol. 7, 27 June 2007, ISSN 1568-
4156
Maria Hägglund, Isabella Scandurra, Dennis Moström, Sabine Koch
From User Needs to System Specifications: Multi-disciplinary Thematic
Seminars as a Collaborative Design Method for Development of
Health Information Systems,
Journal of Biomedical Informatics. 2008;41(4):557-69
Isabella Scandurra, Maria Hägglund, Sabine Koch

16. Thank you for your attention!
Contact Information
Contact information
?
Maria Hägglund
postdoc
Health Informatics Centre
Karolinska institutet
Stockholm, Sweden
Maria.Hagglund@ki.se
My thesis is available at:
http://publications.uu.se/abstract.xsql?dbid=9527