[PPT] - Task Analysis and Application Services for Cross-Organizational PowerPoint Presentation

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Task Analysis and Application Services for Cross-Organizational Scheduling and Citizen eBooking

Dr. Juha Mykkänen, University of Kuopio, HIS R&D Unit

Mika Tuomainen, University of Kuopio Pirkko Kortekangas, Medbit Oy Anne Niska, City of Oulu Finland MIE 2009 Conference, Sarajevo, 31 August 2009 pages 332-336 in proceedings

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In this presentation

Context of the work
Methods and materials
Results: eBooking levels
Results: automation and patient

empowerment potential of tasks related to health service scheduling

Results: identified application software

services

Conclusions

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Context

Implementation phase of national healthcare eArchive and

ePrescription in Finland underway

Additional drivers for citizen eServices and eBooking in health:

– reservation and scheduling of health services is one of potential key factors in transformation of health services

patient empowerment
administrative and clinical process improvements in health service production
networked care; requires commensurable definition of health services

– web and mobile-based eBooking in general gaining acceptance – majority of eBooking solutions in healthcare internal to one provider or speciality – need to start gracefully, ensure open development and contracts, etc.

Actors:

– eKat project 2007-2009: coordination of citizen eServices in healthcare – Service-oriented architecture research in SOLEA and SerAPI projects

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Methods and materials

eKat coordinated seven regional citizen-centric eHealth

initiatives in Finland

in six of these, eBooking or scheduling sub-projects were

included

for eBooking, goals, requirements, process descriptions,

solutions of these were evaluated and used as a basis

– heterogeneous goals and solutions, varying provider and citizen tasks

constructive design of guidelines, recommendations for

further national and regional activities

including:

– analysis of scheduling tasks to be automated or potentially transferred to patients capable of handling them, in different ”maturity phases” – identification of application services which promote migration towards more matured and citizen-empowered solutions

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eBooking levels: ”maturity model of eScheduling from citizen viewpoint”

1. Push model

– provider-initiated time slot suggestions to the citizen

2. Calendar model

– provider calendar of available time slots for a given service is revealed to the citizen

3. Location selection model

– level 2+ service provider or provision location selection

4. Pathway model

– combination of levels 1-2-3 constrained by a structured care plan or scheduling plan

5. Automation model

– combines previous levels with automatic intelligent reasoning and routing of patient

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Scheduling tasks

Service Scheduling Tasks Provider Patient Auto View available time slots from calendar Search available time slots using defined criteria Book an appointment from a calendar Confirm an offered time slot Refuse an offered time slot Cancel an appointment Reschedule an appointment Book set of related services (multiple service booking) Book repeated appointments for one service (serial)

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Viewing scheduled appointments and services Provider Patient Auto View scheduled appointments of the patient Query scheduled appointments of the patient View or query by organization / service / resource

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Scheduling: patient empowerment potential

Service Scheduling Tasks Provider Patient Auto View available time slots from calendar Y Level 2 Search available time slots using defined criteria Y Level 3 Book an appointment from a calendar Y Level 2 Confirm an offered time slot Level 1 Refuse an offered time slot Level 1 Cancel an appointment Y Y! Reschedule an appointment Y Y! Book set of related services (multiple service booking) Y

pt 4
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Book repeated appointments for one service (serial) Y

pt
pt

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Viewing scheduled appointments and services Provider Patient Auto View scheduled appointments of the patient Y Y Query scheduled appointments of the patient Y View or query by organization / service / resource Y

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Allocation and planning tasks

(pre-booking and post-booking)

Related planning, ordering and queue mgmt tasks Provider Patient Auto Send booking request to the reserver / patient Define provider or location (e.g. order or referral) Define services for the future (appointment plan) Receive order or referral, leading to other actions Advance the queue of patients, leading to other actions

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Time allocation (pre) and acceptance (post) activities Provider Patient Auto Allocate time slots for a given reserver (pre) Allocate time slots for any authorized reserver (pre) Book internal resources for the service (pre/post) Confirm external time slot booking (post) De-allocate time slots from external booking (pre) Verify authorization and eligibility (pre/post) Send appointment reminder (post)

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Allocation and planning: automation potential

Related planning, ordering and queue mgmt tasks Provider Patient Auto Send booking request to the reserver / patient Level 2 Level 2! Define provider or location (e.g. order or referral) Y Opt L5 Define services for the future (appointment plan) Level 4 Opt L4 Receive order or referral, leading to other actions Y Opt L5 Advance the queue of patients, leading to other actions Y Opt L5

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Time allocation (pre) and acceptance (post) activities Provider Patient Auto Allocate time slots for a given reserver (pre) Level 1 Level 1! Allocate time slots for any authorized reserver (pre) Y Y Book internal resources for the service (pre/post) Y Y! Confirm external time slot booking (post) Y Y De-allocate time slots from external booking (pre) Y Y Verify authorization and eligibility (pre/post) Y Y! Send appointment reminder (post) Y Y!

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Location of applications and services: starting point (level 0)

National and Local services and systems L R N Patient information systems, res.mgmt Y Y Booking repository

available slots
booked appointments
planned appointmes

y y

Citizen eAccess (view appointments) National Code Service y Y

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Implementation scope: L=local, organizational R=regional, cross-organizational N=national

Core and added value services for scheduling L R N Appoitment calendar service (gateway) y Process coordination service (appointments, pathways) Citizen eBooking interface y Repository of inter-organizational rules and contracts Supporting and related services L R N Notification and confirmation Consent management y Citizen identification y Y Care relationship service Other: patient / professional communication, information services, ePrescription renewal, delegation, personal health record services… y y y

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Location of applications and services: Level 1: push model

National and Local services and systems L R N Patient information systems, res.mgmt Y Y Booking repository

available slots
booked appointments
planned appointmes

y y y

Citizen eAccess (view appointments) National Code Service y Y

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Implementation scope: L=local, organizational R=regional, cross-organizational N=national

Core and added value services for scheduling L R N Appoitment calendar service (gateway) y Process coordination service (appointments, pathways) Citizen eBooking interface y Repository of inter-organizational rules and contracts Supporting and related services L R N Notification and confirmation y y Consent management y Citizen identification y Y Care relationship service Other: patient / professional communication, information services, ePrescription renewal, delegation, personal health record services… y y y

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Location of applications and services: Level 2: calendar model

National and Local services and systems L R N Patient information systems, res.mgmt Y Y Booking repository

available slots
booked appointments
planned appointmes

y y Y

Citizen eAccess (view appointments) y Y National Code Service y Y

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Implementation scope: L=local, organizational R=regional, cross-organizational N=national

Core and added value services for scheduling L R N Appoitment calendar service (gateway) Y Process coordination service (appointments, pathways) Citizen eBooking interface y Repository of inter-organizational rules and contracts Supporting and related services L R N Notification and confirmation y y Consent management y Citizen identification y Y Care relationship service y Other: patient / professional communication, information services, ePrescription renewal, delegation, personal health record services… y y y

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Location of applications and services: Level 3: location selection model

National and Local services and systems L R N Patient information systems, res.mgmt Y Y Booking repository

available slots
booked appointments
planned appointmes

y y Y Y Y

Citizen eAccess (view appointments) y Y National Code Service y Y

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Implementation scope: L=local, organizational R=regional, cross-organizational N=national

Core and added value services for scheduling L R N Appoitment calendar service (gateway) Y y Process coordination service (appointments, pathways) Citizen eBooking interface y y Repository of inter-organizational rules and contracts Supporting and related services L R N Notification and confirmation y y Consent management y Citizen identification y Y Care relationship service y y Other: patient / professional communication, information services, ePrescription renewal, delegation, personal health record services… y y y

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Location of applications and services: Level 4: pathway model

National and Local services and systems L R N Patient information systems, res.mgmt Y Y Booking repository

available slots
booked appointments
planned appointmes

y y Y Y

y

Y Y

Citizen eAccess (view appointments) y Y National Code Service y Y

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Implementation scope: L=local, organizational R=regional, cross-organizational N=national

Core and added value services for scheduling L R N Appoitment calendar service (gateway) Y y Process coordination service (appointments, pathways) Y y Citizen eBooking interface y y Repository of inter-organizational rules and contracts Y y Supporting and related services L R N Notification and confirmation y y Consent management Y y Citizen identification y Y Care relationship service y y Other: patient / professional communication, information services, ePrescription renewal, delegation, personal health record services… y y y

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Location of applications and services: Level 5: automation model

National and Local services and systems L R N Patient information systems, res.mgmt Y Y Booking repository

available slots
booked appointments
planned appointmes

y y Y Y

Y

Y Y

Citizen eAccess (view appointments) y Y National Code Service y Y

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Implementation scope: L=local, organizational R=regional, cross-organizational N=national

Core and added value services for scheduling L R N Appoitment calendar service (gateway) Y y Process coordination service (appointments, pathways) Y y Citizen eBooking interface y y Repository of inter-organizational rules and contracts Y y Supporting and related services L R N Notification and confirmation y y Consent management Y y Citizen identification y Y Care relationship service y y Other: patient / professional communication, information services, ePrescription renewal, delegation, personal health record services… y y y

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Conclusions

eBooking and appointment scheduling tasks

– lots of patient empowerment potential in scheduling tasks – lots of automation potential in allocation and planning tasks

even simple push scheduling models can relieve the burden of

professionals

…but only further levels promote patient empowerment and

transformation of service delivery

shared service terminology and definitions, extensible architecture and
pen interfaces are essential basis
service-oriented approach supports gradual renovation and potentially

different regional migration strategies

further recommendations included

– a national pilot on appointments guided by a structured plan (level 4) – development of shared metrics, terminologies and interfaces

no officially announced national implementation plan for eBooking yet

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HVALA VAM

Dr. Juha Mykkänen, Mika Tuomainen, Pirkko Kortekangas, Anne Niska

juha.mykkanen@uku.fi, University of Kuopio, HIS R&D Unit

This work is based on work of eKat and SOLEA projects.

Projects are funded by the Ministry of Social Affairs and Health in Finland, Finnish funding agency for Technology and Innovation TEKES together with several hospital districts and companies UNIVERSITY OF EASTERN FINLAND 2010