An Integrated Model to Capture the Provision of Health and Social Care Services Based on the ContSys and FHIR Standards

Abstract

In the last decades, there is a shi in the provision of health services from the formal facili es to home care. The delivery of care at home is considered a sustainable approach that not only results in substan al cost savings but is also a key step towards achieving op mal outcomes in the delivery of high-quality health services. Moreover, the adop on of this approach is facilitated by the prompt development of medical and non-medical technologies that can simplify care coordina on and enable distant monitoring of the pa ent. However, home care requires the integra on and coordina on of health and social stakeholders in a con nuity of care perspec ve. This requires the adop on of standards to defi ne a common shared conceptual model that improves the interoperability among informa on systems and organiza ons. In this paper to accomplish this task we combine the ContSys standard and the HL7 FHIR (Fast Healthcare Interoperability Resources) framework to iden fy concepts to be exchanged between systems, organiza ons and providers involved in the health and social context. This model has been developed to improve the integra on and coordina on of social and health care services within the Italian H@H project.

A system of concepts to support the integration of Health and social care and assistive domotics services: the Health@Home project

“…They live in the same house and have serious economic problems and they have no parental support. Mark and Martha are treated by the complex case center of the referring territorial municipality of Rome 13 which is composed by the following professionals: the General Practitioner, specialist physicians, a social worker, a psychologist and a voluntary organization. This team has determined the activities (health and social services) needed by both Mark and Martha to improve their daily life with a particular attention on their mobility and housekeeping, according to the health plan defined.…”

“…Some studies have considered the possible intersection of ContSys with other standards often connected with the development of Electronic Healthcare Record (EHR) models in order to support the semantic interoperability among information systems in clinical processes. [11][12][13] Other works, due to the lack of standard conceptual models of social care, have proposed their models on specific social care processes carried out in well-defined contexts, [14][15][16] considering also the integration with health care. 12,17 These studies were focused on the need of developing care plans to be shared among different professionals to manage and provide both health and social care services.…”

“…In the mentioned paper, we selected a fragment of the ContSys conceptual model and insert in it a set of classes that capture social care and assistive domotics services elements. In a previous study, 13 the HL7 FHIR standards have been used to define the integrated schema by emphasizing, essentially, the concepts which can be shared, generalized and extended, in addition to those specified for one context and not included in the others.…”

ContSOnto: A Formal Ontology for Continuity of Care

“…To develop our ContSOnto model we engaged with healthcare professionals as well as standards bodies who originally were involved in development work of ISO 13940:2015 ContSys. Earlier Horizon 2020 project Hospital at Home (H@H) project [12] proposed a conceptual model of social care to be included in the care system but model does not provide an outline for any real implementation after five years. Although those H@H conceptual model is not based on Resource Description Framework (RDF) it therefore hinder the main objective of data exchange with other healthcare systems.…”