Compendium of Health Telematics Projects 94-98 (Draft)
Home Documents Compendium HT Projects 94-98 Updated: Aug 26, 1998 

This is the most recent structured information on this project. Complementary data can be found on previous documents

CHAINE

Comprehensive hospital & ambulatory care in information networking for episode linkage

Project code: HC 4120
Project value: 440.0 KECU
EC contribution: 440.0 KECU
Number of partners: 5
Number of countries: 15
Duration:24 months
Starting date:  
               
Contact: Jacob Hofdijk
HISCOM
Schipholweg 97
2316 XA Leiden
The Netherlands

Tel: +31.715.256862
Fax:  
E-mail: jacob@HISCOM.nl
Web Site:

Overview

The treatment of the patient’s problem exists of a series of care episodes with different health care providers in the community. When these health care episodes can be linked to the specific health problem of the patient, the total episode of care can be constructed, describing the treatment of this specific condition and the set of “health care products” provided by each of the health care professionals involved. This information should be the basis for the analysis of the health care “produced “ and the resources used. When this information will become available a more objective analysis can be made of the health care provision in the community. Such an approach can lead to a better planning of the health production in the community and a equitable allocation of resources.

Based on operational projects active in this field an attempt will be made to identify the potential of the problem-oriented episode of care approach for resource management. The challenge of building and operationally using total episodes of care can be addressed in two ways, dealing with issues specific for both the input and the output side. The total episode of care is a concept that is valuable from the perspective of service managers, clinical providers and public health physicians as well as patients.

In the CHAINE approach these issues will be covered from three defined health care settings. The approach will contribute to the methodological development of the definition of health products to better manage resources in the emerging transmural health care delivery system, to a better education and training program for case mix management, to a better understanding of the IT requirements for this purpose.

The CHAINE concerted action has adopted an iterative process, which will start with identifying the user needs for managing the care delivery for each of three areas, defined.

  1. The Primary, Acute and Intensive care domain,
  2. The Care for Chronic Conditions and
  3. The Care for patients with Long Term Disabilities.
For each of these areas a case study group will be formed consisting of representatives from a number of national resource management and case mix projects. To create an effective concertation process a European wide approach is adopted. In the CHAINE project a series of four workshops will be organised in the four winds of Europe. Via the national representatives national projects will be invited to participate in the process of making an inventory of the “episode battle field”. Within the budget of the project a number of projects will be invited to participate in the regional workshops. This process will contribute to a European based report on different aspects of episode linkage and resource management within the health care community.

Purpose and objectives

A paradigm shift is rapidly going on within the health care sector. This is caused by several factors. The most important are the rising costs of health care, the development of new medical technologies and the rising awareness that, from the patients point of view, much quality can be gained by substitution of different kinds of outpatient care, including care in the homes, for care in hospitals. The result of all this is that the focus of health care is now shifting from inpatients to ambulatory and primary care, and other forms of care outside hospitals. These changes demand new instruments which can describe and analyse the contents, costs and quality of health care from a patients perspective, covering whole episodes of care. The possibilities to work on these methodological issues have increased radically due to implementation of modern Information Technology within health care. For managerial and policy discussions and decisions at the medical and political levels, it is hypothesised that it is useful to describe health care activities for patients and groups of patients over time, covering all kinds of health care. This is important to enable a better understanding of outcomes, not least because long-term effects will only be clear well after individual packages of care have been completed. This means describing and analysing services for a specific health problem, and the result of the total services given, independent of the diversity of individuals and organisations who provide these services.

Results

The CHAINE project hasn’t started yet, so no results can be reported on.
CHIANE however does not aim to producing prototypes or products. Nevertheless it can be predicted that the development of a common framework of thinking about a resource management concept for transmural care by episode linking will add to the development of information products to support this concept across Europe. It will be necessary to have software products supporting the collection of data about the clinical care process in different health care settings, groupings of episodes of care, episode related cost descriptions, techniques for linking and techniques to protect the privacy of individual patients, care planning, quality management and control. The market for new applications supporting the new situation will grow dramatically in the coming years.

List of deliverables

  • PROJECT MANAGEMENT (Workpackage 1)
    		•
    Deliverable

    Year

    		 Month Type
    Action plan for the CHAINE concertation process 1 2 Public
    Calendar for the four Euro CHAINE Meetings 1 4 Public
    Proceedings of each of the Euro CHAINE Meetings 1,2 6,12,18,23 Public
    Minutes of the CHAINE Management Committee Meetings 1,2 5,11,17,22Restricted
    Reports on the CHAINE networking activities 1,2 6,12,18,24 Public
    A regular updated list of National Projects on episode linkage and resource management based on the input from national representatives. 1,2 6,12,18,24Public
    The CHAINE project manager will provide the periodic progress reports and the financial statements to the European Union. 1 Standard Restricted
  • ISSUE GROUP ON EPISODE LINKAGE (Workpackage 2)
    • A global action plan of the Issue Group for the CHAINE project. This will be presented to the CHAINE management meeting preceding the first EURO CHAINE meeting 1 3 Public
    A report presenting the main themes and conclusions of the workshops of each of the EURO CHAINE meetings. 1,2 6,12,18,23 Public
    WP2 will update the CHAINE position on episode linkage during the two-year process of concertation. This will evolve from the Issue group meeting in between the EURO CHAINE meetings. 1,2 5,11,17,22 Public
    WP2 will provide a final report with the refined description of the CHAINE approach on Episode Linking. This report presents the CHAINE experience on episode linkage by patient condition groups. The report will also give recommendations for practical use and further study 2 24 Public
  • ISSUE GROUP ON RESOURCE MANAGEMENT Workpackage 3
    • A global action plan of the Issue Group for the CHAINE project. This will be presented to the CHAINE management meeting preceding the first EURO CHAINE meeting 1 3 PUBLIC
    WP 3 will update the CHAINE approach on resource management methodologies, especially on costing issues after each Issue workshop. 1,2 6,12,18,23 Public
    WP3 will provide a report presenting the main themes and conclusions of the workshops of each of the EURO CHAINE meetings. 1,2 5,11,17,22 PUBLIC
    WP3 will provide a final report with results on the "CHAINE " approach on Resource Allocation and Management, based on the EURO CHAINE experience and the issue workshops on resource management issues. This final report will also present recommendations for future work in this area 2 24 PUBLIC
  • ISSUE GROUP ON EDUCATION AND TRAINING Workpackage 4
    • A global action plan of the Issue Group for the CHAINE project. This will be presented to the CHAINE management meeting preceding the first EURO CHAINE meeting. 1 3 PUBLIC
    WP 4 will compile a Survey of the existing and needed tools for Resource Management Training and Education based on the EURO CHAINE Meetings 1,2 6,12,18,23 PUBLIC
    WP 4 will provide a report presenting assessment of the tools for education and training as presented at each of the EURO CHAINE meetings. The report will also give an overview of the needs for education and training tools as expressed by the users during these meetings. 1,2 5,11,17,22 PUBLIC
    WP 4 will update the CHAINE approach on a framework for education and training tools for resource management after each Issue workshop. 2 24 PUBLIC
  • ISSUE GROUP ON INFORMATION TECHNOLOGY Workpackage 5
    • WP 5 will provide a global plan of the activities of their Issue Group during the CHAINE project. This will be presented to the CHAINE management meeting preceding the first EURO CHAINE meeting 1 3 PUBLIC
    WP 5 will provide a report on the discussions on the main themes identified for this issue group after each EURO CHAINE meeting. 1,2 6,12,18,23 PUBLIC
    WP 5 will update the CHAINE position paper on the Information Technology Issues after each IT Issue workshop, which is held after an Euro CHAINE meeting. 1,2 5,11,17,22PUBLIC
    WP 5 will provide a final report with recommendations on the use of IT for datacollection, groupers, datawarehousing and a secure and consistent linkage of patient records. This report also contains conclusions of the process, recommendations for use of the concept and proposals for future work in this area. 2 24 PUBLIC
  • DISSEMINATION OF RESULTS Workpackage 6
    • The CHAINE WWW service 1 > 3 PUBLIC
    The publishing of reports of the Euro CHAINE Meetings on the CHAINE website, 1,2 6,12,18,23 PUBLIC
    The publishing of the intermediate and final reports of each of the Issue Perspective Groups on the CHAINE website, 1,2 5,11, 17,22 PUBLIC
    The collection and assembly of documents to promote the results of the CHAINE approach on and outside the CHAINE website 1,2 6,18 PUBLIC
    The publication of the Final CHAINE Report. 2 24 PUBLIC

    List of participants

    Name: Drs W.J. Hofdijk
    Organisation: HISCOM
    Address: Schipholweg 97
    Leiden
    Country: The Netherlands
    Tel: +31715256862
    Fax: +31715219856
    Name: Dr H. Sanderson
    Organisation: NHS National Case Mix Office
    Address: Highcroft Romsey Road
    Winchester, Hants, SO22 5DH
    Country: United Kingdom
    Tel: +441962844588
    Fax: +441962844711
    Name: Prof. J.M. Rodrigues
    Organisation: University of St. Etienne
    Address: School of Public Health Ambroise Pare
    15 St Jean Bonnefonds
    St Etienne 42023
    Country: France
    Tel: +33477427974
    Fax: +33477427939
    Name: Dr. C. Bowes
    Organisation: Tanit Consortium Kontron Instruments
    Address: Blackmoore Lane
    Watford, WD1 8XQ
    Country: United Kingdom
    Tel: +441923412211
    Name: Prof. F. Roger - France
    Organisation: University of Leuven Centre of Medical Informatics
    Address: Avenue Hippocrates 10
    BP 4711
    Brussels , 1200
    Country: Belgium
    Tel: +3227644711
    Fax: +3227644717
    Name: Dr. J. Lindmark
    Organisation: SPRI
    Address: Hornsgatan 20
    Stockholm S10726
    Country: Sweden
    Tel: +4687024755
    Fax: +4687024799

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