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Bridging the gap: a virtual health record for integrated home care
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
2007 (English)In: International Journal of Integrated Care, ISSN 1568-4156, E-ISSN 1568-4156, Vol. 7, no June, e26- p.Article in journal (Refereed) Published
Abstract [en]

INTRODUCTION: The coexistence of different information systems that are unable to communicate is a persistent problem in healthcare and in integrated home care in particular. THEORY AND METHODS: Physically federated integration is used for design of the underlying technical architecture to implement a mobile virtual health record for integrated home care. A user centered system development approach is followed during design and development of the system. RESULTS: A technical platform based on a service-oriented approach where database functionality and services are separated has been developed. This guarantees flexibility with regard to changed functional demands and allows third party systems to interact with the platform in a standardized way. A physically federated integration enables point-of-care documentation, integrated presentation of information from different feeder systems, and offline access to data on handheld devices. Feeder systems deliver information in XML-files that are mapped against an ideal XML schema, published as an interface for integration with the information broker, and inserted into the mediator database. CONCLUSIONS: A seamless flow of information between both different care professionals involved in integrated home care and patients and relatives is provided through mobile information access and interaction with different feeder systems using the virtual health record.

Place, publisher, year, edition, pages
2007. Vol. 7, no June, e26- p.
Keyword [en]
medical records systems, computerized, integrated advanced information management systems, information storage and retrieval, internet, home care services, nursing record
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:uu:diva-97970PubMedID: 17637872OAI: oai:DiVA.org:uu-97970DiVA: diva2:173110
Available from: 2009-01-23 Created: 2009-01-23 Last updated: 2017-12-14Bibliographically approved
In thesis
1. Sharing is Caring: Integrating Health Information Systems to Support Patient-Centred Shared Homecare
Open this publication in new window or tab >>Sharing is Caring: Integrating Health Information Systems to Support Patient-Centred Shared Homecare
2009 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

In the light of an ageing society with shrinking economic resources, deinstitutionalization of elderly care is a general trend. As a result, homecare is increasing, and increasingly shared between different health and social care organizations. To provide a holistic overview about the patient care process, i.e. to be patient-centred, shared homecare needs to be integrated. This requires improved support for information sharing and cooperation between different actors, such as care professionals, patients and their relatives.

The research objectives of this thesis are therefore to study information and communication needs for patient-centered shared homecare, to explore how integrated information and communication technology (ICT) can support information sharing, and to analyze how current standards for continuity of care and semantic interoperability meet requirements of patient-centered shared homecare.

An action research approach, characterized by an iterative cycle, an emphasis on change and close collaboration with practitioners, patients and their relatives, was used. Studying one specific homecare setting closely, intersection points between involved actors and specific needs for information sharing were identified and described as shared information objects. An integration architecture making shared information objects available through integration of existing systems was designed and implemented. Mobile virtual health record (VHR) applications thereby enable a seamless flow of information between involved actors. These applications were tested and validated in the OLD@HOME-project. Moreover, the underlying information model for a shared care plan was mapped against current standards. Some important discrepancies were identified between these results and current standards for continuity of care, stressing the importance of evaluating standardized models against requirements of evolving healthcare contexts.

In conclusion, this thesis gives important insights into the needs and requirements of shared homecare, enabling a shift towards patient-centered homecare through mobile access to aggregated information from current feeder systems and documentation at the point of need.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2009. 98 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 414
Keyword
health informatics, user-centred design, integrated health information systems, homecare services, cooperative work, health informatics standardization
National Category
Biomedical Laboratory Science/Technology
Identifiers
urn:nbn:se:uu:diva-9527 (URN)978-91-554-7390-7 (ISBN)
Public defence
2009-02-13, Auditorium Minus, Gustavianum, Akademigatan 3, Uppsala, 09:15
Opponent
Supervisors
Available from: 2009-01-23 Created: 2009-01-23Bibliographically approved

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Hägglund, MariaScandurra, IsabellaKoch, Sabine

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