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ICT in Integrated Care April 2-3-4 2014. Dr. Dirk Colaert Agfa HealthCare. We are not there yet …. Although there are still quite some technological challenges the biggest obstacles for large scale implementation of Integrated Care are Psychology Allignment of o rganizations
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ICT in IntegratedCareApril 2-3-4 2014 Dr. Dirk Colaert AgfaHealthCare
We are notthereyet … • Althoughthere are stillquitesometechnologicalchallenges the biggestobstaclesfor large scaleimplementation of Integrated Care are • Psychology • Allignment of organizations • Sustainable ‘business’ models • Health care andreimbursmentpolicies • Legal framework
Whatshould IT tools look like ? • Adaptedto the specificuser (patient, doctor, nurse, payer, …) • Integratingpreventive, diagnostic, therapeuticand follow up activities • Specificto the context of the patientwithjustin time adaptionof the clinical workflow in stead of fixed workflow • Integratingcoaching, education, motivation of patients • Sharingrelevant data between relevantstakeholders • Optimizingeffortsandminimizingburden • SPECIFIC & JUST IN TIME
Personalized Medicine, Decision Support and Dynamic Workflows • How ‘personal’ are clinical pathways, integrated care pathways ? • Squeeze similare patients in the same pathway • Not specific to the patient • Only 20% is evidence based
Adaptable Clinical workflow: the GPS way • The GPS way (dynamic), responding to many types of changes • Changes in the clinical condition (co-morbidity), medical knowledge, operational parameters such as scheduling, reimbursement, patient preferences, …
Closing the loop • Act and produce data • Collect data and analyze • Reuse the acquired knowledgeto steer activities • MEASURE !
Challenges: • Distributed versus centralizeddata: do weneed ‘yetanotherrepository’ ? • Distributesworkflowacrossdifferentsystems • The lack of semanticunderpinning of the current communication standards (HL7, OpenEhr, archetypes, CDE, CCD, CDISC, XDS …) andterminologymapping and the management of the reality of multi standard environments • Integration of primary and secondary use of available information to serve both care for patients and medical research and data analytics. To achieve this, an data sharing and interoperability platform should be able to cope with both individual patients and populations • Seamless mixing of evidence and eminence based reasoning
FromVisiontoImplementation • We needto translate visioninto actions • Chickeneggproblem • Whoprofits, whopays? • We needcombinedinitiativesfrom HC providers, payers, industry, patients. These initiatives (projects) should fit in a bigger plan (program), on nationaland/or EU level. • H2020, PPP’s ? In the interest of the patientandsociety at large we have towalk the talk !