so...integroitu hoito ja hoiva prosessi! vanhuspalvelut active and healthy ageing (aha) eip aha so...

So Te

Seniorit, iäkkäät55+, 65+, 75+Muisti, tapaturmat, ...

Hyvä käytäntö (Good Practice)”Käypä hoiva”Integroitu hoito ja hoiva

prosessi!

Vanhuspalvelut

Active and Healthy Ageing (AHA)EIP AHA

So Te

Lapset, nuoret, aikuiset, seniorit, iäkkäätSairaudet, interventiot, ...

Evicence-Based Medicine (EBM)Käypä hoitoEBMeDS, Cochrane, GRADE, CEBM

informaatio!

Terveyspalvelut (perus/erikois)

It’s not about the 65+ group. We must understand what happens since the 75+ group increases rapidly.

We may need to employ more,but we definitely need to increase competence for home care professionals.

Simple ”political arithmetics” will not suffice to solve the problem.

Japan

World

Sagittaldirection

Coronaldirection

IDB Sweden/Västerbotten injury database (orthopedics)

1 5 9

13

17

21

25

29

33

37

41

45

49

53

57

61

65

69

73

77

81

85

89

93

97

10

1

10

5

10

9

11

3

11

7

12

1

ankle and foot

knee and lower leg

pelvis and femur

hand

forearm and wrist

upper arm and elbow

shoulder

Information

Big DataComplex Structure

Ontology, terminology, nomeclatureWHO FIC (ICD, ICF, ATC, LOINC)NOMESCO, SNOMED, ...

Analytics, ”Logic-Based Medicine” (LBM)

Process

Integrated Care PathwaysBusiness Processes

Process modellingOMG (UML/Behavior, BPMN)Microsoft Visio, IBM BlueWorks,Camunda, QPR, ...

Cochrane, GRADE, Oxford CEBM, ...

Duodecim Käypä Hoito

http://www.glioc.com/logic/health/lbm/

http://www.glioc.com/logic/health/lbm/

Depressionregistered by mood disorder

(ICD)

or as part of geriatric assessment

(e.gf GDS)

Antidepressants, sedativesregistered using drug

classification

(ATC)

Hip fracture surgeryregistered by fracture

(ICD maybe with extensions)

and surgery

(e.g. including NOMESCO)

Maintain/improve functionregistered by strategy for therapy

(coded by ???)

and functioning

(ICF)

fall

Do the arrows make any sense? What do or should the arrows mean? Are there missing arrows?

Is the intuition about these arrows the same across all professionals and stakeholders?

Do the implicit causalities represented by these arrows reflect the way some studies are designed?

Is it really sufficient always just to count How many? and then to create evidence by comparing means?

Quality of life before/after arthroplasty and hip fractures in Norway (Nasjonalt Register for Leddproteser, Rapport 2013)

EIP AHA – A2

EIP AHA – A2

So Te

EIP AHA – A2

EIP AHA – A2

Kärkihankkeen prosessit ja teknologia ovat osana myös EIP AHA, European Innovation Partnership for Active and Healthy Ageing, kehitystyössä.

Prosessi

http://www.sosiaalikollega.fi/mallithttp://www.sosiaalikollega.fi/mallit/seniori-ja-vanhustyo

CaseIreland

AFFINITY

NationalFallsPreventionProgramme

BOTTOMUP

TOPDOWN

Teknologia

SenioriTurva

KeskuslaitteetSafety networkNurse by

phone

Interactiveuser interface

AlarmsCalls

Roommonitoring

Consumptioncontrol

MessagingCamera

surveillance

FireElevatorBuilding

INTEGRATION

Delivered to over 4000 bedsides

HOIVATURVA®

in communication

eMonitoring

Home care surveillance and

alarm folow-up.

Can be connected to task

scheduling.

ES

KH

WC

MH

KOH

Lo

gd

ata

/Ala

rms/

tech

nic

al

mo

nit

ori

ng

Alarm

(SMTP)

Accept and talk (SMS)

Superuser

Seniortek

Virtual

MonitoringAlarm (SMS tai SMTP)

Helper in living location

Accept and reject (SMS)

OR ALTERNATIVELY

Home care monitoring - Interface

Tietorakenteet ja prosessit ovat YHTENÄISIÄ.Informaation koti on prosessissa. Ei koditonta informaatiota.

TEHOKKUUS on prosessin ominaisuus.Hienorakenteinen informaatio mahdollistaa tarkempaa tehokkuuden laskentaa.

KETTERYYS on prosessin muunneltavuus.Organisaatio on jatkuvassa muutoksessa.

SoTe-uudistus on (myös) prosessien uudistusta.So- ja Te-prosessit ovat erilaisia, mutta integroitavissa.