Building infrastructure for digital health using Open innovation 2.0 in co design of a meta data registry framework to support integrated care

摘要

Introduction: Under the themes Digital Health Impact, the Center for eIntegrated Care (CeIC) is conducting research on an ICT supported platform to deliver co-ordinated care nationally. In many countries deployment of large scale projects does not consider interoperability a priority outside their organisational boundaries. Thus resulting in silo fragmented care which has limited impact on service user’s need or systems for social and health care teams. CeIC is engaged with eHealth Ireland on the development of a meta data registry to support an interoperability framework for integrated care in the form of a Health and Social Care National Data Dictionary (HSCNDD). Specifically, we discuss stated requirements for the organic development of meta data registry framework and core catalogues created on identity, self-management support and summary care records for cross border deployment.  Theory/Methods: Theories in use to progress the CeIC mission to advance eIntegrated care in order to improve health and wellbeing include Open Innovation 2.0.   A design methodology to optimise ideas and foster collaboration within a quadruple helix ecosystem. Workshops, ecosystem and advisory group meetings with citizens, government, industry and academia (n=20) were co-ordinated by CeIC in the past two years to define requirements and create a shared vision for HSCNDD. Close collaboration with health informatics community for harmonisation of standards was also conducted through national programme committees. This assisted CeIC to grow capacity at an ecosystem level and define specific metadata properties such as specific terminology classifications and Integrating the Healthcare Enterprise (IHE) profiles for conformance and definition of message metadata.  Results: Phase one of defining requirements with associated tooling for advancing integrated care through Health Service Executive committees is progressing.  For example, national hospital lists are now available through dedicated Information Architecture services to view with related properties such as Global Location Numbers and Global Standard Barcode Identifiers for shared care. Three metadata catalogues relating to patient data, document data and clinical data have been created to align with cross border initiatives such as the eHealth Digital Services Infrastructure Open National Contact Point Programme (OpenNCP). Discussions: Defining the core requirements to create a meta data registry framework and associated catalogue properties for HSCNDD takes time and requires significant investment with people to optimise innovation and progress with a shared vision. Research to date has shown that engaging academic centres in new roles such as the initiatives conducted in CeIC facilitates a strong evidence base, productive collaboration, supports inclusion and accommodates co design opportunities for future holistic patient centered models of care. Conclusion and Lessons learned: As the initial research begins to scale , evaluation methodologies will be required to interpret uptake and use of the business catalogues in progress through national programme delivery mechanisms. As the innovation 2.0 approach and the associated meta data registry framework support a new and evolving platform for integrated care, it is important to investigate the value through benefit realisation with the established quadruple helix ecosystem.