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PICASO - A Personalised, Integrated Care ApproachPICASO - A Personalised, Integrated Care Approach
Visions
Objectives
Majo...
03/30/16 Picaso Project Overview 2
Health care costs in EuropeHealth care costs in Europe
Costs of health care relative to...
03/30/16 Picaso Project Overview 3
Deficits in Communication and Information Transfer Between Hospital-Deficits in Communi...
03/30/16 Picaso Project Overview 4
Vision – Four Pillars to Better and Cheaper HealthcareVision – Four Pillars to Better a...
03/30/16 Picaso Project Overview 5
The PICASO Overall Cloud ConceptThe PICASO Overall Cloud Concept
03/30/16 Picaso Project Overview 6
Decomposition of Information and Care SpacesDecomposition of Information and Care Spaces
03/30/16 Picaso Project Overview 7
PICASO – Major Technological InnovationsPICASO – Major Technological Innovations
• Care...
PICASO Innovation: Service Orchestration for Care Plan ExecutionPICASO Innovation: Service Orchestration for Care Plan Exe...
03/30/16 Picaso Project Overview 9
Service Formalism and Dynamic OrchestrationService Formalism and Dynamic Orchestration
...
03/30/16 Picaso Project Overview 10
Narratives – Computer Aided Healthcare WorkflowsNarratives – Computer Aided Healthcare...
PICASO Innovation: Constraint Satisfaction Problem Solving to supportPICASO Innovation: Constraint Satisfaction Problem So...
03/30/16 Picaso Project Overview 12
Constraint Satisfaction Problem SolvingConstraint Satisfaction Problem Solving
Provide...
PICASO Innovation: Care Integration based on Federated Cloud ServicesPICASO Innovation: Care Integration based on Federate...
03/30/16 Picaso Project Overview 14
Cloud Federation and Data ManagementCloud Federation and Data Management
• Develop new...
TOSCA Topology and Orchestration Specification for CloudTOSCA Topology and Orchestration Specification for Cloud
Applicati...
Basic Tosca PrinciplesBasic Tosca Principles
03/30/16 Picaso Project Overview 16
PICASO Innovation: Data Sharing, Security and Privacy based onPICASO Innovation: Data Sharing, Security and Privacy based ...
03/30/16 Picaso Project Overview 18
Authentication and Knowledge DiscoveryAuthentication and Knowledge Discovery
• Provide...
Shared & secure access with the BlockchainShared & secure access with the Blockchain
• Originally developed for the Bitcoi...
Blockchain for PICASOBlockchain for PICASO
• A candidate implementation for the Shared Memory/Tuple Space concept
in the D...
PICASO BlockchainPICASO Blockchain
03/30/16 Picaso Project Overview 21
Blockchain
Blockchain architectureBlockchain architecture
03/30/16 Picaso Project Overview 22
03/30/16 Picaso Project Overview 23
PICASO PartnersPICASO Partners
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Integrated Healthcare Approach to manage multi-morbidities

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The PICASO project will improve cooperation and exchange of knowledge between professional caregivers in health, rehabilitation and social care domains and actively include patients and their relatives in the integrated care settings thus supporting patient empowerment and self-care (the safe hand-off).
The project implements blockchain technology to support distributed electronic patient records and cloud service orchestration to support an holistic and integrated care approach

Veröffentlicht in: Gesundheitswesen
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Integrated Healthcare Approach to manage multi-morbidities

  1. 1. PICASO - A Personalised, Integrated Care ApproachPICASO - A Personalised, Integrated Care Approach Visions Objectives Major Innovations Technological Approach
  2. 2. 03/30/16 Picaso Project Overview 2 Health care costs in EuropeHealth care costs in Europe Costs of health care relative to GDP in the EU, 2006 Comparison of EU-27 health care expenditure projections
  3. 3. 03/30/16 Picaso Project Overview 3 Deficits in Communication and Information Transfer Between Hospital-Deficits in Communication and Information Transfer Between Hospital- Based and Primary Care PhysiciansBased and Primary Care Physicians • Direct communication between hospital physicians and primary care physicians occurred infrequently (3%-20%). • The availability of a discharge summary at the first post-discharge visit was low (12%-34%) and remained poor at 4 weeks (51%-77%), affecting the quality of care in approximately 25% of follow-up visits and contributing to primary care physician dissatisfaction • Discharge summaries often lacked important information such as diagnostic test results (missing from 33%-63%), treatment or hospital course (7%-22%), discharge medications (2%-40%), test results pending at discharge (65%), patient or family counselling (90%-92%), and follow-up plans (2%-43%) Source: Sunil Kripalani, MD, AMA. 2007;297(8):831-841. doi:10.1001/jama.297.8.831
  4. 4. 03/30/16 Picaso Project Overview 4 Vision – Four Pillars to Better and Cheaper HealthcareVision – Four Pillars to Better and Cheaper Healthcare • will improve cooperation and exchange of knowledge between professional caregivers in health, rehabilitation and social care domains and actively include patients and their relatives in the integrated care settings thus supporting patient empowerment and self-care (the safe hand-off); • will reinforce medical knowledge and create new care models for management and treatment of patients with multi-morbidity conditions; • will bring about improvements in health outcomes, daily activities, and quality of life of older persons with multi-morbidities by personalising care management programmes to specific characteristics of the patients' profiles and support adherence to care plans at the point of need; • will allow more cost-effective care management through increased skills and collaboration of care professionals and more automated and efficient workflows, which eventually will lead to better health outcome and a reduction in hospitals admissions, and thus contributing significantly to the sustainability of health and social care systems in Europe.
  5. 5. 03/30/16 Picaso Project Overview 5 The PICASO Overall Cloud ConceptThe PICASO Overall Cloud Concept
  6. 6. 03/30/16 Picaso Project Overview 6 Decomposition of Information and Care SpacesDecomposition of Information and Care Spaces
  7. 7. 03/30/16 Picaso Project Overview 7 PICASO – Major Technological InnovationsPICASO – Major Technological Innovations • Care Plan Execution: Service Formalism and Dynamic Orchestration • Multi-Morbidity Care Management: Constraint Satisfaction Problem Solving • Care Integration: Cloud Federation and Data Management • Data Security: Authentication and Knowledge Discovery
  8. 8. PICASO Innovation: Service Orchestration for Care Plan ExecutionPICASO Innovation: Service Orchestration for Care Plan Execution
  9. 9. 03/30/16 Picaso Project Overview 9 Service Formalism and Dynamic OrchestrationService Formalism and Dynamic Orchestration Create a new approach to integrated care based on the concepts of dynamic service narratives that define the content and sequence of care services to be launched in order to perform clinical logistics in care plans that span across a multi-actor, multidisciplinary environment. Dynamically orchestrate services for personalised health, therapies and social care with decision support for multi-actor interaction and enabling patients and relatives to become active participants. Create a Care Management system based on dynamic design of complex care plans guided by narratives using goal-driven heuristic search and with secure authentication of patients and carers involved. Develop a Service Orchestration framework that orchestrates and executes care narratives across a multitude of care platforms providing event detection and processing and incorporating risk assessment based on risk prediction models and contextual situation awareness, which can be used for decision support for professional and non-professional cares.
  10. 10. 03/30/16 Picaso Project Overview 10 Narratives – Computer Aided Healthcare WorkflowsNarratives – Computer Aided Healthcare Workflows • The aim of ‘narratology’ can be defined as that of producing an in-depth description of the ‘syntactic/semantic structures’ of the narratives. The narratologist is in charge of dissecting narratives into their component parts in order to establish their functions, their purposes and the relationships among them.
  11. 11. PICASO Innovation: Constraint Satisfaction Problem Solving to supportPICASO Innovation: Constraint Satisfaction Problem Solving to support Multi-Morbidity Care ManagementMulti-Morbidity Care Management
  12. 12. 03/30/16 Picaso Project Overview 12 Constraint Satisfaction Problem SolvingConstraint Satisfaction Problem Solving Provide multi-actor, multi-disciplinary integration platform with tools for the interpretation of patients’ health status in their physical care space, with the aim to dynamically adjust the content and sequence of the delivered care services so it always is adapted to their personal health and behavioural status. Create a decision support methodology for analysing conflicts, constraints and limitations from single-morbidity care plans and patient/physician/therapist preferences applied to patients with co-morbidities and multi-morbidity conditions by using the concept of constraint satisfaction problem, to allow the cares to define new care programmes for the management of co-morbidities in community and home care settings.
  13. 13. PICASO Innovation: Care Integration based on Federated Cloud ServicesPICASO Innovation: Care Integration based on Federated Cloud Services
  14. 14. 03/30/16 Picaso Project Overview 14 Cloud Federation and Data ManagementCloud Federation and Data Management • Develop new training programmes for the care workforce, new organisational models and new ways of exchanging medical information to improve the coordination of care management across silos. • Develop a robust, privacy compliant, cloud based Resource Management system that can perform acquisition of physiological and behavioural data in non-clinically controlled care spaces, taking into account the variability in the population in order to provide carers with realistic situational awareness. • Develop a Data Management framework for secure, privacy compliant, and role based information sharing based on distributed shared memory and tuple object spaces allowing carers to share patient information and exchange knowledge across care networks using intuitive, interactive ad-hoc information search. • Develop TOSCA Service Templates to support interoperability and application interoperability on cloud environments
  15. 15. TOSCA Topology and Orchestration Specification for CloudTOSCA Topology and Orchestration Specification for Cloud ApplicationsApplications • How to describe software applications and its dependencies to run in a cloud. • Service Templates describes available capabilities • Application requirements are matched against templates 03/30/16 Picaso Project Overview 15
  16. 16. Basic Tosca PrinciplesBasic Tosca Principles 03/30/16 Picaso Project Overview 16
  17. 17. PICASO Innovation: Data Sharing, Security and Privacy based onPICASO Innovation: Data Sharing, Security and Privacy based on BlockchainBlockchain
  18. 18. 03/30/16 Picaso Project Overview 18 Authentication and Knowledge DiscoveryAuthentication and Knowledge Discovery • Provide role based access for carers to distributed shared data and exchange of knowledge about the patient’s status in an intuitive collaborative platform. • Develop a Data Management framework for secure, privacy compliant, and role based information sharing based on distributed shared memory and tuple object spaces allowing carers to share patient information and exchange knowledge across care networks using intuitive, interactive ad-hoc information search. • Develop a log-oriented architecture based om blockchain technology to support distributed and shared electronic journals
  19. 19. Shared & secure access with the BlockchainShared & secure access with the Blockchain • Originally developed for the Bitcoin system (Nakamoto) • A distributed (replicated) transaction ledger – A shared transaction/data log – Focus on privacy, sharing, identity and ownership – Replicated, immutable, encrypted IDs • Now being promoted for various app domains – Supply chain mgmt, contracts, eHealth, … • Baseline tech: – Linux Hyperledger project • https://www.hyperledger.org/ • Parties: IBM (Open Blockchain), Ethereum,… • Other refs: CACM Sept 15 and Lamport et al. July 82 (”Byzantine generals problem”) 03/30/16 Picaso Project Overview 19
  20. 20. Blockchain for PICASOBlockchain for PICASO • A candidate implementation for the Shared Memory/Tuple Space concept in the Data Management subset • Shared patient data ledger(s) – Care System Private Cloud – Patient Private Cloud • Issues – Will it meet security & privacy requirements ? – Legal & ethical considerations ? – Open source (Hyperledger) – … 03/30/16 Picaso Project Overview 20
  21. 21. PICASO BlockchainPICASO Blockchain 03/30/16 Picaso Project Overview 21 Blockchain
  22. 22. Blockchain architectureBlockchain architecture 03/30/16 Picaso Project Overview 22
  23. 23. 03/30/16 Picaso Project Overview 23 PICASO PartnersPICASO Partners

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