My Care Pathways
The project 'My Care Pathways' strives towards the vision to enable citizens to track their health by providing them online access to past history, current state and prospective future events regarding their personal care pathways.
In this context, we define 'personal care pathway' as the chain of a patient's past health events in combination with a prospective possible critical path of future events. We believe that an open platform for e-health innovation is necessary to make more efficient use of the creativity of the mobile industry and application developers outside traditional health IT vendors.
The objectives of the project are:
- To create new mobile citizens' services that allow patients to follow, own and manage their care process related information. Three health conditions are in focus: stroke, lung cancer and hip surgery.
- To develop methods, guidelines and business models that can encourage the formation of strategic alliances to develop further care pathways and ancillary services. We want to achieve this in co-production between research, public sector, industry and patient organizations.
- To provide an open platform and to implement a Software Development Kit (SDK) with web services for software developers to be able to design applications that are interoperable with current health information systems through the platform "Mina vårdkontakter".
Project manager: Nina Lundberg, SLL. The project is supported by 10 millions SEK from VINNOVA within the call 'Challenge-driven innovation'. HIC will lead the research components within the project.
- Lung cancer association (Swe)
- Stroke association in Stockholm (Swe)
- Health Care Administration, Stockholm County Council (Swe)
- Region Skåne, Skåne Regional Council
- Region Västra Götaland, Västra Götalands Council
- Health Informatics Centre, HIC, Karolinska Institutet
- Faculty of law, Stockholms University
- Jönköping International Business School
- Department of Experimental Medical Science
The technical track of the "My Care Pathways" project has set up an open service platform and a Software Development Kit (SDK) that facilitate and encourage the development of new citizen, care or research services. The implementation is integrated with the existing health care platform "My Healthcare Contacts".
The SDK is a set of web services (application programming interfaces, APIs) that provide health care data which can be used for (third-party) applications. There are different types of APIs:
- APIs for public data, e.g. services for contact information of health and social care providers, and national patient surveys
- APIs for patient-related data, e.g. services for patients contacts with healthcare, appointment scheduling and status of electronic referrals
The access to sensitive, patient-related data is regulated through the API gateway and its security features.
The SDK enables open innovation, i.e. it allows for healthcare providers, patient organizations, entrepreneurs etc. to build own end-user services in the form of mobile apps by reusing the services. The SDK is freely available and is continuously updated as more interfaces are opened up.
The open platform defines the secure information infrastructure and contains the following basic services:
The API Gateway is a security service that allows Health 2.0 companies to build apps that interact with electronic health records (EHR) across Swedish healthcare providers. It's an open source project built around RESTful and OAuth 2.0 API architecture and security.
As a result, the patient can choose to authorize health application of third parties to interact with personal healthcare data that is integrated from regional EHRs through the platform. Once the authorization is done, the data exchange is done via an anonymous access token. Furthermore, an application dealing with patient-related data has to be registered and approved with a digital certificate.
Currently the following information assets are integrated through standardized HL7 APIs into the information infrastructure: all patient contact information, request status (referrals, lab orders), diagnosis, radiology images, scheduling of care visits, prescribed medication, care provider preferences.
The template service is a generic service for the development of structured forms and templates to be part of an end-user e-service, e.g. for registration of patient information prior to planned visit.
Resource state service
The resource state service is a basic service that tracks patient-related states in all databases that are connected to the information infrastructure.
The integration service guarantees mapping of existing legacy databases to National service standards.
Hägglund M, Davoody N, Bolin P, Winsnes C, Lundberg N, Vimarlund V, Koch S. Stroke Patients' Needs for Access to Care Process Related Information. Medicine 2.0 2012
Improving quality of life through eHealth - the patient perspective.
Stud Health Technol Inform 2012 ;180():25-9
Critical advances in bridging personal health informatics and clinical informatics.
Koch S, Vimarlund V
Yearb Med Inform 2012 ;7():48-55
Perlich A. Designing an e-service for stroke patients - How can visualization support the management of the individual care process? Universität Heidelberg, November 2012
The research at HIC within MVF is focused on needs and requirements analysis. From the initial stages of the project, three patient groups are involved in the e-service design; stroke patients, lung cancer patients and hip surgery patients.
A series of focus group meetings were performed with each patient group in order to identify their information and function needs. Two meetings with 4-5 patients each per patient group were performed, as well as initial test sessions with early prototypes of user interfaces and visualizations.
We could elicit specific requirements for each group but were also able to generalize information needs and functions that all groups have in common. We identified a number of potential e-services that all patient groups share:
My calendar A service to keep track of care-related or personal appointments and get reminders about appointments and encounters.
My medicine A service to keep an overview of the list of earlier and current drug prescriptions, to get information about drugs (e.g. contraindications) and prescriptions (e.g. retrieval date, reminders about renewal), as well as instructions for administration.
My diary A service to enter personal notes, keep track of the personal health condition (e.g. problems, self-rehab activities, self-monitoring of medical data and life style factors), and to share that data with care givers.
My care providers A service to manage contact data about physicians, institutions involved in the care process (e.g. hospital department, rehabilitation clinic), the stroke team, and nurses. Additionally, the service contains dates of stays at different institutions and other measures to compare and choose between different health care providers.
My health information A service providing an overview of the patient's diagnoses, treatments, patient history, and laboratory results in an understandable way.
My information flows This service represents an excerpt of the patient record concerning the flow of documents and information between different care givers (e.g. discharge summary).
My referrals Sub-service within My Information flows that enables the patient to keep track of referrals between different health care providers.
My aids A service containing information about the available and technical and cognitive aids.
My rights A service helping to clarify the patient's rights in terms of care choice and guarantees.
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Research project leader Sabine Koch