COCA

2. COCA CoOperation, Concepts and Architecture Magnus Fogelberg, neurologist Project team leader President, Swedish Federation for Medical Informatics

3. OBJECTIVE • To increase quality of health care information systems • Better communication • Users • Decision makers • System providers • by means of • a common language

4. Continuity concepts – CONTSYS Architecture – HISA ?

5. CONTSYS Static image of continuity concepts SAMBA Dynamic image of the process The process is the implementation of continuity

6. HEALTH CARE PROCESS Start: health care professional perceives demand for care Mandatory contact with service: assessment of demand for care Optional contacts with services: program of care, specific services, assessments Decision point: end process

7. PROCESS TERMINATION • Decision point: • No further need for health care (recovered) • No more services applicable within the health care society • Responsible health care provider finds no more services applicable • Health care mandate withdrawn

8. HEALTH CARE PROCESS = CUMULATIVE EPISODE OF CARE (CONTSYS) ?

9. HISA

10. HISA/CONTSYS concepts • health care actor / health care professional + other carer • - / health care agent • subject of care + patient / subject of care • case / contact period + episode of care • health characteristics + reason for contact / health issue + health issue thread • …

11. person subject of care other carer health care professional

12. person subject of care other carer external actor health care professional

13. person 1 1 possesses sendDemandForCare 0..n 0..n demand mandate possesses active demand mandate sendDemandForCare(subjectForDemand : person) delineateHealthIssueThread(healthIssue[1..n])

14. <<signal>> person demand for care <<send>> sendDemandForCare(subjectForDemand : person) delineateHealthIssueThread(healthIssue[1..n]) 0..n 0..n health care professional assesses 0..n assessDemandForCare() receives demand for care from receives health care provider 0..n {at least one of} document bears bears phone call bears personal visit bears sudden event subjectForDemand : person reasonForCareNeed : health issue thread stateHealthCareCommitment() distribute(businessIssue, receiver : health care professional)

15. : person : health care professional : care process Person who is subject to demand for care Receives demand for care Defines health Created issue thread Subject of care services resources? available? yes yes no Delineates health no Being care commitment planned Refers Destroyed Person who is subject to demand for care

16. Health care commitment • a commitment to provide at least one health care service to a subject of care by interfering with at least one health issue encompassed in the health issue thread delineated by the health care professional stating the commitment

17. : person : health care : health care provider professional distributes demand for care delineates health : care process issue thread states : health care commitment sends demand for care

18. : person : health care : health care provider professional sends demand for care distributes demand for care delineates health : care process issue thread finds no applicable service available in the repositry

19. Further work • mandates • contacts • health care services • assessment of service outcome • decision for terminating the health care process

20. Assessment of demand for care Person / Patient hc provider organisation service repository Declining with referral ”do we manage this?” Receive demand for care Demand for care Assessment of demand for care HC commitment --- * perceived condition 1:M result/response • Commitment • plan • ---- • Program of care • 1:M • * Objective Performed HC activity ---- * Result Perform HC activity Care assessment ---- * Degree of fulfillment * Remaining needs Terminate commitment Commitment end state demand for care ”fetch type descriptions” Individual adaption external actions Create plan Assess care need Care need Plan con- tinued care continue according to plan Assess with respect to plan objective change / redefine HC commitment Region-IT/ MA