From OpenHIO

Open Health Information Organization BETA

Open Health Information Organization (OpenHIO) is an initiative focused on sustainable development of high quality health systems through integrated regional infrastructure.

To request a wiki account, please email: wiki@openhio.org

• Executive Summary
• Audience
• Research Project Portfolio
• Knowledge Base

Contents 1 Transformation Strategies 2 Solution Architecture 2.1 Key Architectural Aspects 2.2 Performance Improvement 2.3 Monitoring and Interventional Framework 2.3.1 Monitoring subsystem 2.3.2 Care Coordination

Transformation Strategies

We are actively working to articulate Strategies for health system transformation:

• Patient-Centered
• Team-Based
• Stable
• Quantitatively Driven
• Evidence-Based
• Transparent
• Planned
• Personalized
• Appropriate
• Empowering
• Continuously Learning
• Secure and Trusted
• Available

Solution Architecture

The Solution Architecture is a pragmatic effort to provide a conceptual framework capable of supporting population health goals through performance improvement in care delivery and support processes. Based on the Strategies identified, the required architecture will be realized through a set of infrastructure services, implemented through one or more services platform(s).

Key Architectural Aspects

A key set of architectural aspects are relatively domain-neutral insofar as they may be applicable to solutions targeted beyond the healthcare industry, but are considered foundational to the proposed infrastructure.

• Multi-Agent Architecture
• Bazaar Architecture
• Exchange Architecture
• Network Architecture

Performance Improvement

The solution architecture supports health system transformation by providing an infrastructure capable of improving the quality, safety and value of patient care delivery processes.

Performance improvement represents a cross-cutting concern, applicable to all areas of provider operations, as well as a cross-enterprise concern. Performance improvement necessarily spans the continuum of care, requiring better operational integration across the healthcare delivery partner ecosystem.

The underlying performance improvement strategies rely on iterative optimization of safety, quality and value based on unambiguous patient care goals, objectives and benchmarks, explicitly defined operating policies, procedures and patient care protocols, and quantitative decision analysis and evaluation measures.

Monitoring and Interventional Framework

The conceptual model is based on the concept of a control loop with monitoring and intervention subsystems.

This model has traditionally applied to managing individual health, but will be extended to include the extended social, community and environmental ecosystems within the community.

Monitoring subsystem

The monitoring subsystem is concerned with collecting and organizing the individual’s health findings. A variety of multimodal monitoring channels exist.

Patient health monitoring may occur using wide-ranging data collection modalities and rely on a wide number of monitoring channels. The underlying communication infrastructure is a key dependency in terms of providing support for the various monitoring channels used to track patient health.

Key health monitoring channels include:

• Patient vital signs
• Patient generated content
• Diagnostic and therapeutic reports
• Provider assessments
• Workflow monitoring

Care Coordination

Care Coordination refers to a potentially wide-ranging set of concerns relating to collaboration between care team members in rendering of patient care services. Within the business infrastructure, care coordination refers specifically to patient flow and management of transitions of care.

The terminology used in these areas has historically tended to lack standardized definitions, giving rise to ambiguity and confusion. Clean separation of concerns is important when dealing with various aspects of patient flow and transitions of care. Key aspects to care coordination include the following:

• Administrative Transitions of Care
• Transitions across Organizational Domains
• Patient Transport
• Transfers of Responsibility

The interposition of these various aspects can give rise to fairly Complex Scenarios of care coordination.