Innovative approaches and processes for capturing expert aged care knowledge for multiple purposes

Evelyn’s career began in earnest in the late 1970s with nursing, then progressed into public sector health administration, health service management and workstudy during the 1980s, followed by applied research, policy analysis, health and nursing informatics, consulting as a company director and finally in 1993 she entered academe at Central Queensland University, first as a senior lecturer and since 2003 as a Professor delivering and promoting Health Informatics education and research. Evelyn's area of consulting expertise, now spanning nearly 20 years, is in the conduct of hospital productivity reviews consisting primarily of the study of nursing work using both qualitative and quantitative research methods. Evelyn developed the Patient Assessment and Information System (PAIS) nursing workload monitoring system during the early 1980s and a Universal Career Evaluation System (UNCES) during the early 1990s. Evelyn’s interest in informatics began in the late 1970s when she undertook a course in computer science. She has actively provided leadership and contributed to various professional organizations since the early 1980s, including the International Medical Informatics Association (IMIA). Evelyn’s personal vision of improving health through the best possible use of information and communication technologies has shaped Evelyn’s subsequent career path. Her networking skills and strong commitment to this vision resulted in her being a foundation board member of the Health Informatics Society of Australia, initiator of the annual National Health Informatics Conferences (HIC) and more recently a foundation Fellow of the newly established Australian College of Health Informatics. Evelyn initiated the publishing of the first Australian text on Health Informatics by Churchill Livingstone, Melbourne in 1996. She is a foundation member of the Standards Australia IT/14 health informatics committee, serves on two technical sub committees and represents this committee as a member of the National ICT Standards Committee, and the National Health Data Standards Committee. She initiated and collaboratively directed an international effort to develop a new ISO standard for the integration of a reference terminology model for nursing. Compliance with this standard ensures that a clinical information system is able to accommodate nursing concepts. This work was supported by the IMIA Nursing Informatics group and the International Council of Nurses. Evelyn Chairs the Medinfo 2007 Organising Committee managing the 12th World Congress on medical Informatics hosted by HISA under the auspices of IMIA to be held in Brisbane, late August 2007.

Sebastian Garde
http://healthinformatics.cqu.edu.au
Health Informatics Research Group, Central Queensland University; ACACI Austin Health

Sebastian has been a Postdoctoral Research Fellow for Health Informatics at Central Queensland University since 2004. He has a strong interest in electronic Health Records and in cooperation with Ocean Informatics, he has developed the openEHR Archetype Finder (http://www.dualitysystems.com.au/archetypefinder). In 2005, Sebastian was co-convenor of a series of workshops on archetype development for clinicians in Brisbane, Melbourne and Sydney. He has also contributed to the development of a prototype User Interface Generator for the openEHR-initiative based on archetypes. He was lead researcher for the Australian Skill Needs Analysis of Health Informatics Professionals which lead to the development of a Health Informatics Educational Framework to provide guidance with regard to ‘good’ Health Informatics education while acknowledging the diversity of different roles in Health Informatics and the diversity of ways that lead to Health Informatics and the diversity of education within the Health Informatics discipline. He was also responsible for the research-part of a pilot study for the adoption of a simulated integrated health care information system for educational purposes. As part of his academic role he also supervises several PhD students in the field of Electronic Health Records and works together with researchers in Germany to foster the design, development and introduction of shared electronic patient records and make patient data available for multiple purposes (e.g. patient care, administrative purposes, and research). Before migrating to Australia, Sebastian conducted his PhD research at the University of Heidelberg, Germany, in the field of Health Information Systems which he completed in 2004. In 2001, Sebastian received a degree in Medical Informatics (Dipl.-Inform. Med., graduate program) from the University of Heidelberg, Germany. From 2001 until 2004, while carrying out his PhD research, he was employed by the Department of Medical Informatics of the Heidelberg University Medical Centre in Germany as a scientific employee. Sebastian worked in several projects in Health Informatics, for example as project manager for a nationwide electronic health record and integrated therapy planning system for paediatric oncology in Germany. Sebastian also worked on an ongoing Germany-wide project, developing and introducing a web-based teaching and case-based-learning system for medical education (CAMPUS, http://campus.fh-heilbronn.de). This system is closely integrated into the new Curriculum Medicinale of the University of Heidelberg, Germany, as well as other German and European universities. Further contributions to the field of health Informatics include the remodelling of legacy systems in health care, as well as the adequate representation of clinical knowledge for routine, research and education and the integration of application systems in hospital information systems using standards like HL7. Sebastian co-supervised diploma and study theses of the graduate program Medical Informatics, University of Heidelberg, was member of the educational committee of the graduate program Medical Informatics and the post-graduate program Information Management in Medicine. Sebastian was Managing Editor of the Yearbook of Medical Informatics of the International Medical Informatics Association, and managed the clinical knowledge server of the Heidelberg University Medical Centre. He is reviewer for several international papers and conferences.

Tineke Carr
Djerriwarrh Health Services, Bacchus Marsh, Victoria

Carola M Hullin
http://www.healthinformatics.cqu.edu.au
Health Informatics Research Group, Central Queensland University

Carola's work has been focussed on the design and development of information systems in order to meet the needs of health professionals, taking account of the clinical workflow of those health care professionals. As a graduate nurse, Carola saw repeated clinical cases of the introduction into daily healthcare delivery of information systems, which were designed without clinician involvement. These new information technologies quickly became a distraction from the real clinical work of healthcare professionals, and were therefore quickly discarded. In consequence, the extensive promise of these technologies was not effectively achieved. Carola undertook formal information systems training as well as her PhD in health informatics, and soon found herself active in the field of Health Informatics. She is instinctively a teacher and qualified trainer, who has always had a passion for sharing her knowledge with national and international colleagues and helping them to develop their health informatics professional skills and their knowledge and curiosity. Throughout her postgraduate study years, Carola worked as a teacher at RMIT University, the University of Melbourne, Victoria University and others, as well as mentoring newly graduated clinicians. Carola's current work involves the recognition of the need for professionally designed information systems in health care, especially for healthcare professionals at the bedside. This led to her instrumental role in the establishment of the Austin Centre for Applied Clinical Informatics, a joint venture between Austin Health, the largest health network in Victoria, and Central Queensland University, where key work was being done in the field of health informatics. In addition, she is committed to transfer all the innovative knowledge created by her research to developing countries, especially Latin America, where she was born. Her motto is: If I can do it, so can you.

Innovative approaches and processes for capturing expert aged care knowledge for multiple purposes

Evelyn JS Hovenga, Sebastian Garde, Tineke Carr, Carola M Hullin

Abstract

Residential aged care is largely considered a ‘green field’ with regard to Information Technology (IT). Systems that already exist usually have their own system architectures, which results in a lack of interoperability within the aged care sector as a whole. The provision, administration and funding of aged care consist of a complex and varied set of arrangements which requires an IT infrastructure that meets the needs of many stakeholders including nurses and personal carers in the aged care residential sector. These health workers must be able to comply with contemporary best practice, and meet all quality and reporting requirements. In this scenario, the implementation of Electronic Health Records (EHRs) is a key strategy for improving the quality, safety and efficiency of residential aged care delivery. The openEHR approach (http://www.openEHR.org) is one of the most recognised approaches for EHR systems. The definition and use of aged care openEHR Archetypes (clinical models representing semantic constructs) can contribute to interoperability of EHRs as well as various health information systems. Based on a review of scientific literature, other relevant documents and stakeholder identification and consultation, this paper describes the current state of play with regard to EHRs in residential aged care. The paper further compares openEHR archetypes, clinical guidelines, terminologies and standards as well as the processes needed for their development to enable the capturing of expert aged care knowledge for multiple purposes. It is argued that a clear process capturing expert knowledge relevant to the aged care sector is required for the purpose of automating all data capture and enabling these data to be used to support clinical practice in accordance with aged care standards as well as to meet various reporting, management, research and planning requirements. This archetype development process should be based on existing clinical guidelines and standard development processes, and enable international collaboration where possible.

Keywords

Semantic Interoperability; Aged Care; Archetypes; openEHR; Electronic Health Records; Computerised Medical Record Systems; openEHR

Full Text: PDF

This work is licensed under a Creative Commons Attribution 3.0 License.

--- eJHI - electronic Journal of Health Informatics - ISSN 1446-4381 ---

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