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Regional Health Information Network of Crete - HYGEIAnet Stelios C. Orphanoudakis Institute of Computer Science FORTH and Department of Computer Science University of Crete Heraklion, Crete, Greece the healthcare environment is changing Population mobility and continuity of care

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Regional health information network of crete hygeianet l.jpg

Regional Health Information Network of Crete - HYGEIAnet

Stelios C. Orphanoudakis

Institute of Computer Science

FORTH

and

Department of Computer Science

University of Crete

Heraklion, Crete, Greece


The healthcare environment is changing l.jpg
the healthcare environment is changing

  • Population mobility and continuity of care

  • Care to the point of need (incl. Home Care)

  • Distant monitoring of health status

  • Intermittent hospital

  • Personal health management enabled by wellness pathways

  • Evidence-based medicine

  • Increasing role of genomic data and bioinformatics

  • Emphasis on the creation and consistent use of a life-long (active) I-EHR

Technology is taking on a leading role

Stelios C. Orphanoudakis


Information and knowledge transfer l.jpg

Best practice, as determined by experts on the basis of outcomes, requires integrating individual clinical expertise with the best available external evidence from extensive clinical trials.

However, finding, interpreting and applying the results of the thousands of clinical trials reported in published research literature, is a major problem.1

The result is an inefficient transfer of evidence from the research world to the clinic.

“there is an enormous ‘voltage drop’ from what is known in medical science to what the average patient receives for medical care.”2

information and knowledge transfer

1 T.C. Rindfleisch, D.L. Brutlag, Directions for clinical research and genomic research into the next decade: implications for Informatics, J. Am. Med. Inform. Assoc. 5 (5) (1998) 404-411 Sep/Oct

2 L. Weed, Clinical judgment revisited,

Methods Inf. Med. 38 (1999) 279-286

Stelios C. Orphanoudakis


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the challenge to date remains ... outcomes, requires integrating individual clinical expertise with the best available external evidence from extensive clinical trials.

  • Comprehensive

  • Comprehensible

  • Compatible

how to make eHealth services

  • Available

  • Affordable

  • Accountable

A A A

C C C

Stelios C. Orphanoudakis


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priorities for the 21 outcomes, requires integrating individual clinical expertise with the best available external evidence from extensive clinical trials.st century

Today, dominant trends in healthcare include the movement towards shared or integrated care, in which the single doctor-patient relationship is giving way to one in which an individual’s healthcare is the responsibility of a team of professionals across all levels of the healthcare system.

These trends necessitate the development of:

  • Regional Health Information Networks (RHINs)

  • Life-long (active) integrated electronic health record (I-EHR)

  • Synchronous and Asynchronous Collaboration Services

  • Novel eHealth Services

Stelios C. Orphanoudakis


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Region of Crete outcomes, requires integrating individual clinical expertise with the best available external evidence from extensive clinical trials.

  • Population of ~600,000

  • Large number of isolated communities in remote locations

  • Population more than doubles during the summer period

  • Accidents more than triple during the summer period

  • 42% of accidents involve tourists

  • The Healthcare System of Crete includes all levels of the hierarchy

  • The Venizelion General Hospital and EKAB-Crete offer medical services to other islands in the South Aegean

A model for the design

and implementation

of RHINs

Stelios C. Orphanoudakis


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An infrastructure that provides shared resources for health care agents and patients enabling information to flow in an appropriately structured, identifiable (unambiguous) and secure fashion.

The Principles…

Implementation based on a modular and scalable architecture

component-based SW

promotion of interoperability

use of open standards

evolution from the current infrastructure, while adding new capabilities

provision of high quality services

HII – Health Information Infrastructure

Stelios C. Orphanoudakis


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diverse set of mobile, wireless and terrestrial communications

Stelios C. Orphanoudakis


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diverse, heterogeneous applications and services communications

Pre-hospital Emergency Care

Integrated Electronic Health Record

Hospital

Care

Venizeleion

Telematic Services

Home Care

Primary Care

Stelios C. Orphanoudakis


Pre hospital health emergency management ekab crete l.jpg

Caller - Dispatcher communications

GPS - GIS

Medical Doctor

Health Emergency

Coordination Center

Patient/

Consumer

pre-hospital health emergency management (EKAB-Crete)

Mobile

Units

Stelios C. Orphanoudakis


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complementarity and continuity of effort communications

INTERREG II

Deployment of HYGEIAnet on Crete

Services

ISTs

HEALTHNET

I.H.I.S.

R&D

Stelios C. Orphanoudakis


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achieving critical mass communications

  • Diffusion of innovation is a gradual and often difficult process, and requires effective management of change

  • The rate of adoption of innovative solutions is influenced by many social, cultural, economic, organizational, and political factors

  • Education, training, and continuous technical support is a key success factor

All available evidence indicates that a critical mass has been achieved on Crete

Stelios C. Orphanoudakis


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benefits communications

  • benefits are to be assessed regularly until steady-state is achieved

  • in HYGEIAnet, measurable benefits have been observed regarding

    • the cost to benefit ratio

    • access to care

    • quality of care

    • creation of a critical mass and momentum

Stelios C. Orphanoudakis


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conclusions communications

  • a vision and long term strategy

  • adequate investment and continuity of effort

  • empowerment of users

  • effective management of complexity

  • effective management of change

  • resolution of medico-legal issues

    • medical liability

    • reimbursement

The development and deployment of next-generation RHINs and innovative eHealth

services requires:

Stelios C. Orphanoudakis


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