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Updated: Feb 1, 97 |
SHINE | |
| Contact: Mr. Paul A. Cooper Siemens Nixdorf Info. Systems Ltd. 12 Hadham Road Bishops Stortford Herts CM23 2QR, U.K. Tel.: +44-1279-46.63.66 Fax: +44-1279-46.63.60 |
The project's tenet is that linking people together through IT is much more significant than straightforward data transfer and redefining time and distance: it involves linking people's skills and computing services, wherever they are located, to problems needing those skills and services, wherever they arise. Enhanced team working and sharing of skilled and expensive resources is possible through a combination of networked health care informatic services and the resulting potential for redefining the health care business.
One key issue, from a strategic point of view, is how best networks and existing technologies or standards can be used to create telecommunication services that both satisfy the demands for better health care as well as providing a value added service to the region.
The first year focused on developing the SHINE Methodology (a Business Analysis methodology for health care) in parallel to its application in the pilot sites and elsewhere. The SHINE Methodology has been used extensively to identify the key business processes and to align the IT strategy in the three different pilot regions (in Italy, Ireland and Portugal). The developments for the pilots have shared a common architecture - the Open Health Environment (OHE) for regional health care. It aims to be compatible with, and interface to, emerging standards.
Having identified the common services and the pilot-specific services, the project commenced prototype development based on existing application system software. The evaluation has been undertaken by repeating on a smaller scale the work during the analysis phase with the objective of assessing the outcome of the enhanced IT infrastructure. The health care professionals have been interviewed for their views on the changes to the working practices. Quality has been monitored, both of the telematic services, and in the measurable improvements in health care provision and outcome.
The Framework consists of a number of integrated components that support the analysis, design, implementation and evaluation of common telematic services that meet real operational requirements. The starting point is the Healthcare Analysis and Process Redesign methodology that has been developed from well-founded business analysis research. Information Analysis and Functional Analysis are carried out using standard reference models and a common data dictionary. Detailed design and implementation are followed by a benefits analysis to ensure that the resulting common telematic service meets the original requirements.
The Framework is supported by an underlying open ISO-ODP based architecture which gives guidance on the development of common telematic services. The architecture supports both providers of regional healthcare and value-added service providers, to develop common telematic services (CTS) that have open interfaces and can inter work across heterogeneous platforms. This common architectural approach will enable the development of a whole series of SHINE conformant CTSs that can be shared across the region saving valuable resources and giving direct benefits to patients.
The SHINE Framework was developed in parallel with its application and validation in three pilot regions. The three resulting CTSs were developed because the methodology identified the services that they provide as being critical operational areas within the regions. The use of the methodology can sometimes produce surprising results in this respect; it is only by undertaking a detailed analysis can the most cost effective benefits (and hence opportunities for redesign supported by telematic services) be identified.
In Italy SHINE developed a Booking Service that sits in the network between the GPs and the hospitals or laboratories booking systems. It provides a centralised resource through which GPs can make informed and interactive choices about referrals for their patients. The implementation is complete and other service opportunities are currently being investigated based upon this original concept It links with the EDITH project's Patient Management Server using the interface defined for the SHINE Patient Administration Service developed for the Portuguese pilot.
In Ireland a Notification Service has been implemented to perform, in the first stage, a statutory notification to all concerned of births in a hospital. This first type of service was selected to be low-risk and small-scale while the principles of a common notification service were being evaluated. Now that it is installed and working, further notification types can be implemented using the same server. The birth notification service is fully working and carrying live data.
In Portugal, the critical problem area identified by the Healthcare Analysis and Process Redesign methodology was ensuring that the medical centre's patient records are kept up to date with the hospital's records. A Patient Administration Service was developed to address this and is installed in a hospital and health centre in Aveiro. The plan is to extend it to other hospitals and health centres across the region.
All three pilots have been through the four stages of the Framework, the results of which have been produced in a number of project deliverables. The external functional specifications of the CTSs will be published to allow third-parties to develop interoperable systems.
SHINE has been working with many other projects of the Third Framework Programme from ESPRIT, ENS and AIM. For example, SHINE's Healthcare Analysis and Process Redesign methodology is being used by TRILOGY (in its operational trial sites) and by TELEPRIM.
Regions using shared services will present to the patient a different view of healthcare. Patients should never be asked for information more than once. Their electronic patient records will always be available to whoever is authorised to access them. Healthcare practitioners will be informed about their patients in a timely manner. Patients will be given more choice when being referred by their GP and they will know immediately when their appointment is. Healthcare promotion will become widely available and potentially harmful drug interactions can be avoided. The distinctions between primary and secondary care will become less visible as GPs have more information at their desktop. These examples show some of the benefits that patients can expect to see as healthcare providers across the region are able to integrate their information systems more closely through common telematic services.
Finally, the project's external validation panel concluded that SHINE has accomplished a strategic focus on the participants and their interactions when providing healthcare in a region, that it involves senior management throughout the method, and is able to help management assess investment options and determine priorities. The added value of the SHINE approach is the generic server offering better management information, commonality and the inter working between healthcare users.
| Mr. Valerio Verderio Lombardia Informatica S.p.A. Via Frigia 27 I-20126 Milano, Italy Tel.: +39-2-25.77.43.60 Fax: +39-2-25.77.43.29 | Dr. Ambrose McLoughlin North Eastern Health Board Ceanannus Nazan Road Kells IRL-Co. Meath, Ireland Tel.: +353-46-403.41 Fax: +353-46-414.59 E-mail: nehb02@attmail.com |
| Dr. Maria Joao Lupi Servico de Informatica do Ministerio da Saude Av. Columbano Bordalo Pinheiro 87, 1e4 P-1000 Lisboa, Portugal Tel.: +351-1-726.96.95 Fax: +351-1-726.49.19 | Mr. Fernando Piera Eritel Paseo del la Castellana 141 E-28046 Madrid, Spain Tel.: +34-1-348.12.14 Fax: +34-1-579.10.74 E-mail: fpiera@proint.eritel.es |
| Prof. Jean-Marie Rodrigues Universite St. Etienne Sante Publique Faculte de Medicine 15 rue Ambroise Pare F-42100 St. Etienne, France Tel.: +33-77-42.79.74 Fax: +33-77-42.79.39 | Richard van den Heuvel SIG Services B.V. Maliebaan 50 NL-3508 SC Utrecht, The Netherlands Tel.: +31-30-34.56.11 Fax: +31-30-34.51.72 |
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