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Xavier PastorSICCEB and AISBE project: the land and the partners565.000 inhabitantsFacilities:• 23 PC centers(6 different ...
Reengineering relationship betweenPrimary and Specialized CareOutpatientSpecializedCare centerFamily physician Specialists...
ICTs Architecture in AISBEPlataforma SICCEBAltres
Stepwise approach: beginning from the middle-out with the professionals• All the partners with the same recognition• Profe...
Centre Primària Centre EspecialitzadaDerivació PlataformaVerificació+Integració +CitacióTancamentDocumentsCitaNo OK3 45629...
Stats summary of clinical communicationcarried through SICCEBFrom 2008/10/01:568.000 messages447.000 assistances to patien...
AISBE project: lessons learned in 4 yearsAchievements:• Many patient’s benefits becausenew organization• Interoperability ...
Thank you very muchxpastor@clinic.ub.esKewin M Fickenscher, AMIA’s present PresidentInteroperability – the 30% solution:fr...
FòrumCISMés informació disponible a la web del Fòrum Català dInformació i Salut:www.forumcis.catYou can find more informat...
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SICCEB and AISBE project: the land and the partners by Xavier Pastor

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SICCEB and AISBE project: the land and the partners by Xavier Pastor

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SICCEB and AISBE project: the land and the partners by Xavier Pastor

  1. 1. Xavier PastorSICCEB and AISBE project: the land and the partners565.000 inhabitantsFacilities:• 23 PC centers(6 different providers)• 2 OSC centers(1 provider)• 3 SC Hospitals(3 different providers)All providers hired to deliver healthcare as a public service.BIG DIFFERENCES inDemographicsEpidemiologySizeComplexityOrganizationTechnology and ICTsvvv vvvvvvBARCELONA ESQUERRARound table about Clinical Interoperability
  2. 2. Reengineering relationship betweenPrimary and Specialized CareOutpatientSpecializedCare centerFamily physician SpecialistsDiagnosis / treatment resourcesPatient /citizenSpecializedCenter BPrimary CarecenterSpecializedCenter APoor communication among HC professionalsDelay in diagnosis and treatmentDestination to Specialized Center by chanceTechnical resources always at the HospitalNo update of clinical info from the hospitalsWE WANT THE PATIENT’S DISCHARGE REPORT !!!Primary carecenterSpecialized carecenterFamily physician SpecialistsDiagnosis / treatment resourcesPatient /citizenPatients’ flow by agreements and clinical protocols based on scientific evidenceRequirement: greatest support possible of ICTs with quick wins2006:1st Goal: Improve the patient care with a new approach over therelationship among family physicians and clinical specialists.xml filesClinical msgHL7 2.5PCEMRSCEMR
  3. 3. ICTs Architecture in AISBEPlataforma SICCEBAltres
  4. 4. Stepwise approach: beginning from the middle-out with the professionals• All the partners with the same recognition• Professional involvement since the beginning• Good management of professional teams:leadership and transparency• Reduce complexity: step by step• Clear definition of the goals• Simplicity• Technical Interoperability based uponstandards• Evaluation• GovernancePermanent CommissionTechnicalManagementTeamProcess 1Process 2Process 3Process 4EmergenciesSocialCareHealthTransportHomeCarePediatriccarePharmacyRedesignImplementation& follow-upMentalhealthITOperational CommitteesTerritorial Health Care CommissionBarcelona EsquerraSpecializedCareInstitutionalrepresentatives
  5. 5. Centre Primària Centre EspecialitzadaDerivació PlataformaVerificació+Integració +CitacióTancamentDocumentsCitaNo OK3 456291011RealitzatRecita 7Anulació 8Normal: gestió total del’agenda fins a la visitaPreagendada: gestió del’agenda des de 7 dies abansde la visitaSol·licitud:Generada pel metge:PacientCondicionants i problemesactiusDiagnòsticPrestacióMotiu de DerivacióRebuda per unitat de tractament dela prestació• Gestió administrativa• Valoració i informe mèdicCentre EspecialitzadaNormal: no es gestional’agendaPreagendada: gestió del’agenda fins a 7 dies abansde la visita1Sol·licitud de interconsultaAtenció PrimàriaRebut per metge o infermeraresponsable del pacient.Informes de pre-altaInformes d’altaInformes d’urgènciesDocument +tancamentMalalt: ingréso urgènciesProcés assistencial +alta2351PacientRAE7Generat pel metge o infermera responsable delpacient• Pacient• Tipus de document• Document no estructurat (pdf)ConsultaRCA4Plataforma6AlertesAtenció EspecialitzadaEnviament de documentacióclínica rellevantpdfCentre d’AtencióPrimàriaSICCEBCentre d’AtencióEspecialitzadaPACS125Sol·licitudIntegració3RealitzacióEnviament(informe ienllaç a lesimatges)46LecturaInformeAccés aimatgeSol·licitud de prestacions amb retornd’informe de resultats i accés a imatgeCentre d’AtencióPrimàriaSICCEBCentre d’AtencióEspecialitzadaPACS36Sol·licitudTeleconsulta Integració4RealitzacióEnviament(informe ienllaç a lesimatges)57Accés aimatgeConversorDICOMCapturaimatge21pdfLecturaInformeInterconsulta de Teledermatologiaamb imatge associadaSICCEB: Fully supported clinical processesRequest for a specialized consultationRequest for a teleconsultation in DermatologyRelevant Clinical Documentation from SC to PCRequest for a diagnostic test
  6. 6. Stats summary of clinical communicationcarried through SICCEBFrom 2008/10/01:568.000 messages447.000 assistances to patient’s processes between PC and SCTypes of messages:– 378.000 relevant clinical documentation from SC to PC– 49.000 consultations from PC to SCFrom 2012/11/01:– 20.000 requests for diagnostic examinations from PC to SC– 6.800 images delivered from SC to PC
  7. 7. AISBE project: lessons learned in 4 yearsAchievements:• Many patient’s benefits becausenew organization• Interoperability in a highlyheterogeneous environ-ment (9different providers) thanks to thetechnical support of ICTs.• Additional solution to new needs(Teledermatology)• Better information about activity• Biggest added value:– The PC physicians get the Reports fromthe Hospital immediately– The SC physicians get a clear and properrequest for their servicesProblems unsolved:• Semantic Interoperability• Clinical processmanagement: Patientworkflow still isrepresented byadministrative processes(Centers, Services, etc..)Example:It’s hard to compute theaccuracy in the suspiciondiagnosis of skin disordersamong the PCphysicians, loosing theopportunity to make aspecific training program toempower them
  8. 8. Thank you very muchxpastor@clinic.ub.esKewin M Fickenscher, AMIA’s present PresidentInteroperability – the 30% solution:from dialog and rhetoric to realityJ Am Med Inform Assoc, May 2013, Vol 20, No 3, 593-4
  9. 9. FòrumCISMés informació disponible a la web del Fòrum Català dInformació i Salut:www.forumcis.catYou can find more information at Fòrum Català dInformació i Salut site:www.forumcis.cat

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