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eHealth Case- Maternity and Infant Clinic on the Net (MIC)

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eHealth Case- Maternity and Infant Clinic on the Net (MIC). Speaker: Pirkko Kouri, Pricipal Lecturer in Healthcare Technology, PhD, PHN, RN Guests: Tempus delegation Time: 21 Feb 2007. Ultimate goals of Finnish health care. Cost-effectiveness - PowerPoint PPT Presentation
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eHealth Case- Maternity and Infant Clinic on the Net (MIC) Speaker: Pirkko Kouri, Pricipal Lecturer in Healthcare Technology, PhD, PHN, RN Guests: Tempus delegation Time: 21 Feb 2007
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Page 1: eHealth Case- Maternity and Infant Clinic on the Net (MIC)

eHealthCase- Maternity and Infant Clinic on the Net

(MIC)

Speaker: Pirkko Kouri,

Pricipal Lecturer in Healthcare Technology, PhD, PHN, RN

Guests: Tempus delegation

Time: 21 Feb 2007

Speaker: Pirkko Kouri,

Pricipal Lecturer in Healthcare Technology, PhD, PHN, RN

Guests: Tempus delegation

Time: 21 Feb 2007

Page 2: eHealth Case- Maternity and Infant Clinic on the Net (MIC)

Ultimate goals of Finnish health care

- Cost-effectiveness- Patient/client & population centeredness- Just distribution of the services (equity)

= use based on need

*********************************************************MSAH’s own information society policy- Wide use of information and communication technology- Utilisation of internet penetration

Page 3: eHealth Case- Maternity and Infant Clinic on the Net (MIC)

Development levels – definition and projectwork e.g. Area of eHealth / eWelfare

Levels of development Development work

EU / National Laws, standards, terminology, classifications, forms, data definitions

Regional Aggreements, data transmissions, databases, archives, cooperation Local Working culture, division of labour, cooperation

Individual Personal needs, user interface, way of working, teamwork

Page 4: eHealth Case- Maternity and Infant Clinic on the Net (MIC)

Milestones - Finnish health care system

2002 National Project on Safeguarding the Future of Health Care Services2007 National law EHR

Page 5: eHealth Case- Maternity and Infant Clinic on the Net (MIC)

eHealth, National Project on Safeguarding the Future of Health Care Services – main goals

•Ensure access to treatment•Enhance co-ordination and co-operation in specialized health care•Enhance regional co-ordination in primary health care•Emphasize preventive work, one’s own responsibility for one’s own health and the significance of primary health care• Implementation - divided into 40 sub-projects

•Preparing the ground for the nationwide electronic patient records, which will be introduced in 2007 (law will be launched Spring 2007)

Page 6: eHealth Case- Maternity and Infant Clinic on the Net (MIC)

1. Services/ Products

Electronicdocuments

and lists

2. Basic development

3. Processes

Intranet,Internet

groundwork purpose-built

Planning anddevelopment

of e-processes,working models

Useof e-Health

and e-Socialprocesses

Integrationof IT solutions

in daily life4. Integration

5. Adaptationof work

processes

Evolution of e-processes- strategy and plan - education- culture, values- publicity in control

Info

rmat

ion m

anag

emen

t

Network

s

Adapted from www.done360.com

Page 7: eHealth Case- Maternity and Infant Clinic on the Net (MIC)

The Regional Project Area

• 85.585 km2 • >1.000 lakes• 681.000 inhabitants• One university hospital• Four central hospitals (five 10/03)• 53 health centres• App. 20 000 social and health

care workers

Map of Finland

JYVÄSKYLÄ.

Maternity care – births are over 99% in hospitals

Page 8: eHealth Case- Maternity and Infant Clinic on the Net (MIC)

HEALTH CENTREBEFORE 12 W

BASIC INFORMATION

FORMmaternity clinic

CERTIFICATEM/C CLINICNIB (KELA)

BIRTH TRAINING COURSE, (CONSISTS OF 8-10 MEETINGS)

PAGE2

NORMAL MATERNITY CARE SERVICE CHAININ FINLAND (REGULAR PREGNANCY)

PHN/ FIRST EXAMINATION

8-10 WLABORATORY

DOCTOR´SEXAMINATION

10-12 W

PRE-NATALULTRASOUND

SPECIAL CARE -MATERNITY CLINIC

12-14 WPHN/ EXAMINATION

16-18 W

FIRST CONTACTMOTHER/CHILD UNIT

PHN/ EXAMINATION

22-24 W

DOCTOR´SEXAMINATION

26-28 W

PHN/EXAMINATION

30-32 W

DOCTOR´SEXAMINATION

34-36 W

PHN/EXAMINATION

32-34 W

PHN = publichealth nurse

NIB = National InsuranceBureau

Page 9: eHealth Case- Maternity and Infant Clinic on the Net (MIC)

PAGE2

PHN/ (baby) HOME VISITimmediately after discharge

CHILD CLINICFAMILY

PLANNING

PHN/ EXAMINATION37 W

PHN/ EXAMINATION38-40 W

PHN/ EXAMINATION40-42 W

DELIVERY ROOM

POST NATAL WARD

PHN / Mother´s Medical health check

PHN/ (mother) HOME VISITimmediately after discharge

DOCTOR/ Mother´s Medical health check8-9 W after delivery

Page 10: eHealth Case- Maternity and Infant Clinic on the Net (MIC)

The Long History of the (Finnish) Maternity Care Services (since 1940´s)

E- Service

Basis of the Maternity and Infant Clinic on the Net

Development of Information Society (1990´s)

Idea of Maternity Services on the Internet (1997)

Participants• Health care professionals

• Families• Colleges• Software technology

experts• Multimedia

experts

Participants• Health care professionals

• Families• Colleges• Software technology

experts• Multimedia

experts

Results• Working models for

experts andfamilies

•Networking• Data/info contents

• Software technology

Results• Working models for

experts andfamilies

•Networking• Data/info contents

• Software technology

Basis of Development

Work•Research

• Multi-disciplinary co-operation

• Piloting• Feedback / Evaluation

Basis of Development

Work•Research

• Multi-disciplinary co-operation

• Piloting• Feedback / Evaluation

Page 11: eHealth Case- Maternity and Infant Clinic on the Net (MIC)

Expert teams

• Central team• Social and Health care experts´ team• Technology experts´ team• Education experts´ team (Savonia was co-

ordinator of the MIC project)

• Families

Page 12: eHealth Case- Maternity and Infant Clinic on the Net (MIC)

MIC

•is supplementary to today's mother-child clinic services

•helps the user in decision making

•provides information that has been approved by the special editorial board

•enables the use of the services independently of time and place (Internet connection needed)

•can be used in many countries (adjustments will be made according to the culture)

•is supplementary to today's mother-child clinic services

•helps the user in decision making

•provides information that has been approved by the special editorial board

•enables the use of the services independently of time and place (Internet connection needed)

•can be used in many countries (adjustments will be made according to the culture)

Page 13: eHealth Case- Maternity and Infant Clinic on the Net (MIC)
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Page 19: eHealth Case- Maternity and Infant Clinic on the Net (MIC)

The MIC: options

•Entrance

•News

•Discussion groups (with peers)

•Questions and answers (confidential)

•Search (information)

•Feedback

•Links to other useful Internet sites

•Entrance

•News

•Discussion groups (with peers)

•Questions and answers (confidential)

•Search (information)

•Feedback

•Links to other useful Internet sites

Page 20: eHealth Case- Maternity and Infant Clinic on the Net (MIC)

Search/ information or data bank

• Pregnancy• Delivery• Post- natal period• Infant• Parent's relationship• Parenthood• Personal hygiene, appearance• Nutrition and exercise• Drugs, alcohol and smoking• Services to the public

MIC has 135 articles, two videos, 2 animations, 2 interactive photos, 86 photos and 53 drawings checked and approved by editorial board.

• Pregnancy• Delivery• Post- natal period• Infant• Parent's relationship• Parenthood• Personal hygiene, appearance• Nutrition and exercise• Drugs, alcohol and smoking• Services to the public

MIC has 135 articles, two videos, 2 animations, 2 interactive photos, 86 photos and 53 drawings checked and approved by editorial board.

Page 21: eHealth Case- Maternity and Infant Clinic on the Net (MIC)

MIC / contents

Example: Drawings

Example: Drawings

Page 22: eHealth Case- Maternity and Infant Clinic on the Net (MIC)

Qualified information / content management

• Information is reliable, and easy to understand

• The quantity of information is adequate

• The required information is easy to find

• The content creation and management are carried on as part of current (clinical) work processes

• The technical solutions guarantee e.g. data integrity, authentication, security and data availability

• Information is reliable, and easy to understand

• The quantity of information is adequate

• The required information is easy to find

• The content creation and management are carried on as part of current (clinical) work processes

• The technical solutions guarantee e.g. data integrity, authentication, security and data availability

Page 23: eHealth Case- Maternity and Infant Clinic on the Net (MIC)

Evaluation - family

• Modern way of having services

• No queuing in phone

• Discussions groups for families (anonymously), where professionals appear by their names

• Service in your own language

• Information/contents is versatile, extensive, based on expertise / reliable

• Modern way of having services

• No queuing in phone

• Discussions groups for families (anonymously), where professionals appear by their names

• Service in your own language

• Information/contents is versatile, extensive, based on expertise / reliable

Page 24: eHealth Case- Maternity and Infant Clinic on the Net (MIC)

Evaluation – maternity care professionals

•Extra visits were not needed during pilot phase•The Net Clinic could be used as a manual or in familiarising the new worker•Counselling and giving advice was harmonised•Families got deeper information and advice based on their needs more effectively•Networking and co-operation was more efficient •Written answers took some time to get used to

Page 25: eHealth Case- Maternity and Infant Clinic on the Net (MIC)

The Project of the Year 2000

•Net Clinic is a good example of how project work can be expanded into new application fields like public administration and so called soft values•Net Clinic is based on wide and versatile co-operation and on application of new Internet technology•Net Clinic proves that it is possible to develop new innovations also outside big so called growing centres•Net Clinic proves that women can work successfully in management or other key positions which have conventionally been classified as men´s work

(The evaluation criteria of the The Finnish Project Management Association)

Page 26: eHealth Case- Maternity and Infant Clinic on the Net (MIC)

Diploma of the Excellent Work

•Given by the Provincial State Office of Eastern Finland 4.9.2001

•Net Clinic is a good example of how project work can be expanded into new application fields like public administration in national level and in future international level

Page 27: eHealth Case- Maternity and Infant Clinic on the Net (MIC)

xo

O MIC has been used/is in use

• Kuopio• Helsinki• North-East of Finland (Kuusamo, Taivalkoski, Posio and Salla) • Rovaniemi and its neighbourhood Rovaniemi rural commune and Ranua)

O

OO

O

Page 28: eHealth Case- Maternity and Infant Clinic on the Net (MIC)

An eMaternal Health Care Data System

STORK

Page 29: eHealth Case- Maternity and Infant Clinic on the Net (MIC)

The Stork is

• secured electronic health data system (EHS) made for professional use

• all the information about pregnancy, delivery and puerperium is collected in the same system (so called seamless chain between primary health care and special care)

• mutual data contents to maternal units involved

Page 30: eHealth Case- Maternity and Infant Clinic on the Net (MIC)

Data security

• The application• built on special security system used by the

hospital• Access rights depends on task or position

• those who are involved maternal service chain• Preconditions for usage

• mother´s permission to collect and transfer her data (each organisation needs its own permission)

• agreement between different organisations• every user has personal user identifier, all usage is

logged and saved, even edited/deleted parts will be recorded permanently

Page 31: eHealth Case- Maternity and Infant Clinic on the Net (MIC)

Storks gives information

• Pregnancy follow up, continuous documentation;

appointments with public health nurses, midwifes, doctors

• Graphics; growth of the uterus, hypertension, weight, partogram

• Internal- and external examinations• Medication during pregnancy, delivery, puerperium• Diagnosis of the foetus; e.g ultrasound, lab tests• Lifestyle of the family (nutrition, exercise, smoking,

drugs etc) • Sick leaves of the mother• Special area for the nurse documentation

Page 32: eHealth Case- Maternity and Infant Clinic on the Net (MIC)

Stork gives

• The new-born baby his/her social security number• Basic information from earlier pregnancies• Statistics e.g.

– for the Stakes (the National Research and Development Centre for Welfare and Health

– the nursing research

• Forms and applications

Page 33: eHealth Case- Maternity and Infant Clinic on the Net (MIC)

Name, birth date, age, weeks,

The first page of the StorkForms

Notify: the lamp sign, B-gluc high (red color) Lab, X-ray

Page 34: eHealth Case- Maternity and Infant Clinic on the Net (MIC)

Both the public health nurse in primary care and the midwife in special care fulfil this area. The writtendata is available in real time (mother´s permission needed)

Mother->, Child ->

Social worker documentation

Page 35: eHealth Case- Maternity and Infant Clinic on the Net (MIC)

From Netinformation – Portal From Netinformation – Portal to Dynamic Integrated Desktop (DID)to Dynamic Integrated Desktop (DID)

My personal computer

Page 36: eHealth Case- Maternity and Infant Clinic on the Net (MIC)

Aims of the WorkAims of the Work

• To elaborate the co-operation of different organisations

• To develop a consistent way to manage information in Social Work and Health Care organisations

• To develop the ”Dynamic Integrated Desktop” (DID) for Social Work and Health Care professionals

• To offer further education of Social Work and Health Care professionals

• To determine the reliable security standards

Page 37: eHealth Case- Maternity and Infant Clinic on the Net (MIC)

Professional information• On line (on special fields)• Education

•course enrolment, forms

Professional web services• PubMed, Cinahl• Laws and orders

Partnership information • Contacts• Office times• Information of services

Integration of IT software• ”You get what you need”• EHR, RIS/PACS (digital imaging), biosignals etc.• High level of security

Web services for public • Contact information• Problem solving information• Education

Single sign-on

Dynamic Integrated Desktop (DID ) Dynamic Integrated Desktop (DID ) -a consistent way to manage information in Health Care organisations

Page 38: eHealth Case- Maternity and Infant Clinic on the Net (MIC)

Teams

Discussion Forums

Document management

Maintenance

Magazines & Periodicals

News

Help

Courses

Links

Patients 26.8.2002

Time Name Social security number

8.00 Patrick Patient 12345679573

8.20 Donald Duck 89101128758

8.40 Clark Kent 98459734658

August 2002

Databases

Patients

Mail (3 new messages)

Personified, user oriented

Networked, user organization oriented

Information system, task and position in the organization

View of the DID page

Page 39: eHealth Case- Maternity and Infant Clinic on the Net (MIC)

Tutuks service

• Tutuks, a virtual visit to a maternity ward

• Utilised work done by MIC

• http://www.synnytystutuksi.fi/tutukspalvelu.html

Page 40: eHealth Case- Maternity and Infant Clinic on the Net (MIC)

Challenges for the Future

•Family/citizen participation challenges professionals

•e-working environment (models, processes)

•eEducation and training • “E-gap” between generations

•Usability of ICT-solutions•Integration of ICT-solutions

Page 41: eHealth Case- Maternity and Infant Clinic on the Net (MIC)

New project

• Looking for partner organisations, next Tempus Call or other suitable call

Page 42: eHealth Case- Maternity and Infant Clinic on the Net (MIC)

New project - Tree of problems

Incapability to respond future needs

Incapability to respond future needs

Non-transferability oftacit knowledge

Non-transferability oftacit knowledge

Unfamiliarity with new teaching ways

Unfamiliarity with new teaching ways

Former educationFormer education Lack of ICT skills Lack of ICT skills Retiring (growing)Retiring (growing)

Mobility (teachers and students)

Mobility (teachers and students)

Need to study regardless time and space

Need to study regardless time and space

Lack of resources in distance teaching in cultural maternity care

Lack of resources in distance teaching in cultural maternity care

NO NETWORKINGNO NETWORKINGNO KNOWLEDGE

TRANSFERNO KNOWLEDGE

TRANSFER

Lack of cooperation betweenEuro-Asian HIEs

Lack of cooperation betweenEuro-Asian HIEs

Figure: Project - problem tree

Page 43: eHealth Case- Maternity and Infant Clinic on the Net (MIC)

Tree of objectives

Definition of resources needed

Definition of resources needed

Testing of ICT skills

Testing of ICT skills

Selection of Learning Environment(s)

Selection of Learning Environment(s) Evaluation of

readiness Evaluation of readiness

Accepted planns

Accepted planns

Evaluation of modelImplementation

Evaluation of modelImplementation

ENHANCING READINESS FORDISTANCE TEACHING IN CULTURAL

MATERNITY AND INFANT CARE

ENHANCING READINESS FORDISTANCE TEACHING IN CULTURAL

MATERNITY AND INFANT CARE

FLEXIBLE NETWORKING

FLEXIBLE NETWORKING

CULTURAL MATERNITY CAREAND DISTANCE TEACHING

CULTURAL MATERNITY CAREAND DISTANCE TEACHING

OUTCOMEOUTCOME

EFFECTEFFECT

MAIN AIMMAIN AIM

Designing and evaluatingNetworking and

Distance teaching model

Designing and evaluatingNetworking and

Distance teaching model Reports, workshops(Implementation)

Reports, workshops(Implementation)

Dissemination of Project results

Dissemination of Project results

Page 44: eHealth Case- Maternity and Infant Clinic on the Net (MIC)

Thank you for your attention

Contact info:[email protected]


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