Collaborative Care Team in Open Source : Main objectives
version 2.1, 11 Apr 2010, Etienne Saliez
Objectives of Collaborations between healthcare professionals:
Patient Care:
Multidisciplinary collaborations between the care provider
in charge of the same patient, i.e. the "Virtual Care Team"
concept. In general this concept is expected to be useful in many
situations,
where several care providers need to collaborate accross organization
boundaries.
The project is intended to be generic, but pays
particular attention to situations in emerging countries.
However in general even in very developed countries not enough
resources
are available in order to respond to all healthcare needs of all the
population groups.
Focus on the "Patient Record", the patient being at the
center may of course need diverse kinds of services from specialized
actors as GP, specialists, nurses, laboratories, surgery in hospitals,
etc ... rather than softwares dedicated to only one professional target
group.
Continuous management and follow-up of the care of the
patient, maintaining an up to date overview of the current Health
Issues and the current Care plan.
Integration:
Execellent medical super specializations have been developed,
but the reality is that a patient could have several heath issues at
the same time. Thhis project address the need to maintain a
global summary, available to all the members of the care team of
the patient.
The idea is that when reliable information has been acquired
once, it could be made available for several related purposes, avoiding
the need to enter the same information again and again.
For efficiency reasons, beside the main objective of
individual patient care, the project will also provide support for
integration with other related issues in healthcare:
Education:
On occasion of typical cases, to provide
contextual training in order to foster sustainable local training.
Administration:
Make information about the provided services
(consultations, drugs, surgery, ...) available to the administration,
in order to facilitate the production of invoices and refunding by
insurances.
Data collection for statistical purposes:
Make medical information available for classifications
and anonymisation, intended for further epidemiological analysis.
All theses extensions depending on decision about
their relative priorities.
Objectives of Technical Software Collaborations:
Sharing medical informatics know-how at international level,
including source codes. A good way to achieve the above objctives
since the
requirements are similar everywhere in the world. A good way to
avoid to reinvent nearly the same thing in any new installations.
Many Open Source softwares are already available, but the problem is
that most of theses softwares are very specialized to a narrow target
group of healthcare professionals.
Integration of existing medical software components as far as
already
available in open
open source and as far as the integration is possible without too many
adaptations.
Coordination of distributed software developements and
maintenance. The role of the international community is to
provide and maintain a collection of software components, as well to
take care of their compatibilities.
Softwares already in use must continue to
be maintained, until improved and better integrated versions will
become
available. For example IPATH.
Objectives of support of Networks Implementations:
Second line support of regional operators:
Regional organizations and regional operators will normally
take care of all operational aspects, as far as possible.
Installation and maintenance of equipments, training of the users,
first line assistance in case of problems, etc...
However they may ask support from the developer's community,
particularly during the initial phases of new installations.
Virtual Care Team implementation profiles:
Depending on regional priorities and ongoing contacts,
the common Virtual Care Team principles can be implemented in many
different
setups. The basic scenario is any situation in which healthcare
professionals need support for collative work, e.g. :
Home care:
Between nurses, GP, social worker, ...
Elderly care:
Between many actors since aged patient have usually
multiple problems related to aging issues.
Specialized diagnostic technologies:
Between local actors and experts and experts only
available in
remote locations. For example in the domains of radiology,
pathology,
etc...
"Centers of excellence":
Between local primary care dealing with a large range of
usual
problems and the possibility to ask advice and second opinion in remote
centers having specialized expertise, e.g. in pediatrics, in neurology,
etc... as for example in a project starting in the Balkans.
In still very undeveloped regions:
Between a nurse at the village level and one of the very
few
doctors located at distance of maybe more than one day on foot.
Himself having the
possibility to forward some questions to a centre of excellence.
In super developed regions:
Between a GP and many specialists, as well between
specialists. The patient requiring an absolute maximum of safety,
the trend is that no doctor dare anymore to take any responsibilty as
soon a probleem is a
little outside his own super specialized domain.
Continuity of care and travel:
Continuity of care should be better supported when the
patient travel or move somewhere else.
.....
Taking account of the situation of early and late adopter of
informatics:
See the notes on medical informatics seen in an historical
prespective. Late
adopters could go through a shorter developement path.
