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Healthcare Information Standards for Frailty: Why, When and How (5 of 5)


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Trillium II /Focus workshop at Informatics for Health2017: Manchester, April 24-27, 2017
Frailty is an age-related state of vulnerability to the risk of adverse health out-comes after a stressor event. The condition predisposes individuals to progressive decline in different functional domains, leading to falls and fractures, disability and dependency on others, hospitalization, institutional placement and ultimately death. We discuss drivers, challenges and opportunities for healthcare information standards related to frailty in old age in an effort to launch a call for coordinated action across research, policy, and academia. Key issues are selected as the back-drop for this discussion: EHR, patient summaries and frailty in a context of coor-dinated care enabled by health IT standards.
Presentation 5 of 5: Catherine Chronaki, HL7 Foundation

Published in: Health & Medicine
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Healthcare Information Standards for Frailty: Why, When and How (5 of 5)

  1. 1. Reinforcing the Bridges and Scaling up EU/USCooperation on Patient Summary Trillium II
  2. 2. Dissemination and Networking: Development and Evaluation: • LANTANA CONSULTING GROUP, LLC, US • SmartPHR PROSOCIAL APPLICATIONS INC, US • Sequoia, Healtheway, Inc. DBAThe Sequoia Project, US Standards Organizations: Health Systems and Associated Competence centers: • MedCom (Administrative Coordinator) DK • LISPA - LOMBARDIA INFORMATICA, IT • THL -TERVEYDEN JA HYVINVOINNIN LAITOS, FI • eSANTE - AGENCE eSANTE, LU • TicSalut – Catalunia, ES • SPMS, PT • Reliant, Reliant Medical Group, Inc., US • HSCP Healthcare Services Platform Consortium, US • KAISER FOUNDATION HOSPITALS, US
  3. 3. Where are we now? Connected Europe Facility/eHealth Digital Services Infrastructure (eHDSI)? eHDSI funded Member States PS eP Austria Croatia Cyprus Czech Republic Estonia Finland France Germany Greece Hungary Ireland Italy Luxembourg Malta Portugal Sweden Switzerland • Tools and services using ICTs that can improve cross border Healthcare services. • Use Cases: – Patient Summary, provides access for health professionals to verified key health data of a patient during an unplanned care encounter while abroad – ePrescription, enables patients to receive equivalent medication treatment while abroad to what they would receive in their home country
  4. 4. Advancing Standards and Profiles Today: • Massive health data accumulated in silo EHR systems serving documentation. • We need to move from passive documentation to active use of information and knowledge creation: activation! • Patient summaries defined at the macro level: cross-border exchange for emergency or unplanned care at government level. • Move to meso and micro level to address communities and individuals. Shaping the future: Focus on the top level: systems of innovation. 25 April 2017 Informatics for Health 2017 4
  5. 5. Scaling-up the use of patient summaries Emergency • Emergency response teams Manchster April 25, 2017 Informatics for Health 2017 Trillium-II’s ambition touches the individual by their mobile – their personal communication hub and the community through an aggregating dashboard making the most of our data-driven economy.
  6. 6. vaccinations medications encounters Identification allergies Implantable devicesProblems Health team Security preferences Health team Security preferences problems Social history
  7. 7. Manchster April 25, 2017 Informatics for Health 2017
  8. 8. List of current problems / diagnoses Problem/ Diagnosis Description Problems / diagnoses that fit under these conditions: 1) may have a chronic or relapsing course (e.g. irritable bowel syndrome, otitis media), 2) the patient receives repeat medications (e.g. diabetes mellitus, hypertension) 3) persistent and serious contraindications for classes of medication (e.g. dyspepsia, migraine, asthma) Problem Id (code) Normalized identifier Onset time Date of problem onset
  9. 9. Medical Devices and implants Device and Implant description Describes the patient's implanted and external medical devices and equipment that their health status depends on. Includes devices as cardiac pacemakers, implantable fibrillator, prosthesis, ferromagnetic bone implants, etc. that are important to be known by the HP Device Id code Normalized identifier Implant date Date when procedure was performed
  10. 10. Major Surgical Procedures in the past six months Procedure Description Describes the type of procedure Procedure Id (code) Normalized identifier Procedure date Date when procedure was performed Treatment Recommendations Recommendations Description Therapeutic recommendations that do not include drugs (diet, physical exercise constraints, etc) Recommendation ID (code) Normalized identifier
  11. 11. Description Need of the patient to be continuously assessed by third parties, invalidity status may influence decisions about how to administer treatments Invalidity Id code Normalized invalidity identifier (if any, otherwise free text)
  12. 12. List of current medicines Active ingredient Exemption: brand name Substance that alone or in combination with one or more other ingredients produces the intended activity of a medicinal product Brand name if a biological medicinal product or when justified by the health professional (ref. Commission Directive 2012/52/EU) Active ingredient id code Code that identifies the active ingredient (All prescribed medicines whose period of time indicated Strength the content of the active ingredient expressed quantifiably per dosage unit, per unit of volume or per unit of weight, according to the pharmaceutical dose form. Example 500 mg per tablet treatment has not yet expired whether it has been dispensed or not) Pharmaceutical dose form the form in which a pharmaceutical product is presented in the medicinal product package (e.g. tablet, syrup) Number of units per intake the number of units per intake that the patient is taking, e.g. 1 tablet Frequency of intakes Frequency of intakes per hour/day/week/monthe e.g. each 24 hours Duration of treatment Example: 14 days Date of onset of treatment Date when patient needs to start taking the medicine prescribed
  13. 13. Social History Observations Social History Observations related to smoking, alcohol, diet Health related “life-style factors" or "life style observations" Example: cigarette smoker, alcohol consumption Reference date range Example: from 1974 thru 2004 Physical findings Vital Signs Observations Blood pressure One value of blood pressure which includes: systolic blood pressure and diastolic blood pressure Date when blood pressure was measured Date when blood pressure was measured
  14. 14. John Smith A TALE IN SEVERAL ACTS How is responsibility managed among all care professionals (doctors, nurses, social workers, informal caregivers, care managers etc.) What information about the patient health status would be required to ensure efficient professional help along the entire pathway? What information about the patient is necessary to assure a smooth transfer among different health care entities? What kind of data should the patient summary provide to optimize care in planned and every day settings? What kind of data on frailty status is necessary if any?
  15. 15. EvaluateBridge HarmonizeGuide Manchster April 25, 2017 Informatics for Health 2017