Care2x Med e Tel 2014

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Care2x

Web Based Integrated Healthcare Information and

Resource Planning

Robert Meggle1, Gjergj Sheldija2,1Care2x Project Manager, robert.meggle@care2x.org

2Care2x Release Manager, gjergj.sheldija@care2x.org

Introduction

Care2x is a Web based Integrated Healthcare Environment (IHE). It

allows the integration of data, information, functions and workflows in one

environment. Its design can also handle non-medical services or functionssuch as security and maintenance. The software is web-based, modular

and highly scalable. All program modules are processed on the server side

therefore module updates and extensions do not require changes on the web

browser, thus avoiding network interruptions and downtimes. Its design

also supports multiple server configuration to distribute traffic and improve

speed and efficiency.

Care2x is open source software released under GPL v2.0 license. The first

public version was released in 2002 and within the first few years it was

translated into over 20 languages. It has a worldwide developer community,comprised of developers mainly from developed countries. The requirement

was to provide software covering all the key areas in the hospital and thus to

avoid the problem of incompatible software in different hospital units - also

still a major problem in developed countries.

The requirements of hospital software tend to differ from country to

country and hospital to hospital and this is the main reason that there is no

standard package commonly used in the hospitals worldwide. This is the

big challenge in creating a large developer community and keeping them

working together. Local customised solutions with good support fromproprietary software companies together with better funding resources in

developed countries, have not given space for open source software in that

market. During the last few years the development efforts of the original

free version have been concentrated in developing countries, which is also

seen in the download statistics. Out of 16500 downloads to 150 countries in

the last year 85% goes to developing countries.

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The four perspectives

Four basic perspectives as described in Fig. 2 are :

the patients perspective

financial perspective

management (internal business perspective)

the internal training (learning and growth perspective).

Fig.2: HIS Perspectives

Each perspective represents a single strategy that can be easily broken

down in simple levels, depending on the individual needs of the hospital.

Care2x can help solve these issues, by its ability to monitor the values of

the main Key Performance Indicators (KPI) in each of the aforementioned

perspectives.

Patient's perspective will focus the value of for example the top 10

diagnosis, infections, etc. when the patient consults a doctor.

The financial perspective concerns hospital stock management and

the financial department.

Management will have the focus on values of reporting like

budgeting aspects and future finances. The learning and growth perspective about visions which will

sustain the ability to change and training improvements for staff.

Thus, by using those perspectives a metric can be designed to classify

processes, structures and finally the needed technical and functional

specification for any implementation.

All those four perspectives are part of the Care2x framework, meaning

that they must be assessed and populated in accordance to each business

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case. In order to achieve this, a list of objectives that can be feasibly

measured has to be created for each perspective. And, a specific target

should be set and the initiative to reach that target has to be described. In

that way, the four basic perspectives create a more valid and future oriented

hospital information system and its strategy. These measurements areintangible aspects of the system as shown in Fig. 2.

Specifications on implementation

In order to measure the key performance indicators, there is always a need

for a specific implementation plan. These include several steps, some of

these could be described as:

Determining of priorities

Comply with standards Collect required information

Managing changes and improvements

Based on Fig. 2 a table can be created where above requirements of an

initial process are described.

As an example of a workflow we created a diagram of a patient flow by

using the patient perspective.

The result of those workflows is a set of tables, in which the minimum

available dataset needed for a correct implementation of Care2x is

described.

Fig.2. example of simplified OPD workflow (patient perspective)

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Each of the table elements below results from the analysis of the internal

hosptial process. Each process describes the base steps upon which specific

metrics for the needs of the hospital can be met.

Table 1: Based on OPD workflow an example to show up the four perspectives

Workflow Perspective KPI destination

Patient registration patient registration Care2x

Appointment patient appointment Care2x

Registration fee financial interface to ERP ERP

Diagnosis patient ICD9/ICD10/OPS301 Care2x

Lab test patient values of batches per

day/doctors/wards

Care2x

... ... ... ...

As can be seen in Fig. 3, graphical reporting tools allow KPI values to be

compared with historic data in a simple way to gain better understanding ofthe health situation covered by the hospital.

Fig.3.Progressive outpatient registration 2011-2014 report of an implementation in Albania

Conclusion

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Name: Gjergj SheldijaDate of Birth:03.08.1981Nationality: AlbanianGjergj Sheldija (MSc) is one of the core members of the

Care2x project. Experience in Computer Science withemphasis in Computer Systems operating in the area ofhealth, has led various HIS implementations in Albania.