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The BPM-PaaS platform "Jamio openwork" enables the realization of applications delivered in SaaS for support, monitoring and assistance, to health workers and patients, in which the activities carried out by different operating units, located in the territory and/or at the patient's home, are integrated and coordinated according to process logic.
Jamio openwork makes it possible, specifically, to model a generic diagnostic-therapeutic-assistance pathway(PDTA) to manage chronic conditions according to the most advanced best practices, specify its activities, actors involved, define therapies, identify potential risks, manage significant and/or adverse events etc. and to follow up, integrate diagnostic and laboratory information using international standards(HL7/CDA2) and focusing attention on the patient(patient empowerment) who remains at the center of the process also thanks to the use of mobile and cloud-based technologies.
In use at the OPBG facility headed by Prof. Dello Strologo is the solution created to support the integrated care pathway for children with kidney transplantation. This pathway related to post-transplant follow-up is regulated by a strict clinical protocol specialized on the individual patient. All instrumental examinations are included, and mechanisms are in place to manage alerts, home events, and notifications to remind of the due date of any examinations. Bambino Gesù Children's Hospital (Rome) was also a winner of the prestigious "WfMC Global Awards for Excellence in Case Management - 2015"
The Clinical Trail Management Framework and eCRF (Electronic Case Report Form), allows Principal Investigators to model clinical trails via the web through abstract and linear definition of activities along organizational, temporal and geo-spatial dimensions. The solution is published in "public cloud" mode and is customized to meet the needs of Principal Investigators, Neurologists, Bioengineers, and Care Givers of Parkinson's patients at IRCSS Ca'Granda and other centers involved in clinical trials, while respecting information visibility and assignment. The enrollment of Patients in a clinical pathway generates a calendar of activities in which they are scheduled and proposed, depending on the role held, diaries, clinical assessments, questionnaires, clinical scales, drug administration activities, device setup and activation/deactivation activities, with the possibility of receiving notifications and reminders through different communication channels (email, internal messages, etc.).
Openwork led the research project. It saw the development of an integrated ecosystem of ICT-supported practices, processes and tools for integrated, patient-centered management of Clinical Care Pathways. The characteristics of the proposed solution are its flexibility (including modularity and scalability) and its being "context-aware," features that make the solution adaptable to all chronic disease settings where a structured diagnostic therapeutic pathway description is available and integration with systems for measuring biomedical or lifestyle parameters. The ecosystem, called SmartHealthPlatform aims to: 1) Enable the definition, execution and monitoring of clinical pathways 2) Include in clinical pathways the detection and analysis of bio-signals from patients, therapies and diagnoses, assessments and examinations, so as to holistically interpret his or her condition at all times 3) Realize the constant monitoring of the patient, allowing the prevention of adverse events or the detection of collective changes in vital and environmental parameters .
The Jamio openwork platform was acquired in "private cloud" mode by the ASL BAT IT department, and a Clinical Case Management System (CCMS) was built on that platform. Within the CCMS, it is possible to "model" the PCA, orchestrate information from external health information systems and useful for clinical decision-making, and activate the involved caregivers and enrolled patients to the relevant PCA. Typically, the solution supports: modeling of care protocols, support for clinical decision making , monitoring, control and analysis of activities, support for planning/execution of activities, and finally optimization of activities within the health care facility.
The solution implements: 1) The processes of incident reporting management based on spatial scope, severity of the event, organizational roles and assignment of activities in an automatic(bottom-up) and manual(top-down) manner; 2) The support for the analysis of causes and contributing factors to the occurrence of reports, planning and verification of risk reduction actions 3 ) The automatic generation of the Incident, Event, Cause and Factor Analysis, Alert Report as printable attachments and automatic communication of reported incidents to the appropriate roles, claims to the Legal Affairs Office 4) The digital generation and transmission of tracks 5 ) The 'integration of system identity management repositories in SSO mode and document systems present in the Sardinia region; 6 ) The processes of litigation and claims management and support to the process of the file, from the claim to the settlement of amounts; 7) The Statistics and reports of both medical (analysis of claims by garrison, department, shift, effectiveness of actions etc.) and administrative (practice management times, workloads of different offices etc.).
The Center has been recognized as a Regional Center for Neurodegenerative Diseases, including Amyotrophic Lateral Sclerosis (ALS) and other Rare Neuromuscular and Neurodegenerative Diseases, similar in terms of care. For this reason, the Center can issue Rare Disease certification and issue Therapeutic Plans for the relevant diseases. The software solution in SaaS on Paas Jamio can contextually manage the data flow of patients accepted via "CUP" or "External Reporting" through a multilevel diagnostic pathway.
In the more general area of systems to support clinical pathway management (PDTA), the scope of supply was to implement, on the PaaS Jamio openwork, a software solution for performing patient assessment activities i.e., definition of questionnaires and self-assessment scales, data collection, consultation and extraction. The solution is implemented in compliance with privacy and security requirements imposed by current legislation. In particular, it ensures controlled access to data based on user profiles, pseudoanonymization of sensitive data, adoption of the measures required by the GDPR for encryption and backup and data . The solution enables the complete dematerialization of the assessment process by eliminating the need to copy data from paper questionnaires into a tool for storing them; it avoids the use of computer media such as spreadsheets to manage the data, thereby lowering the operational and security risks associated with such management. Specifically, the solution is applied to conduct an epidemiological study conducted by the scientific directorate on an over-65 sample of the Castellana Grotte population. The study is on a multi-year basis: a sample of about 2,500 people over 65 are called over time to undergo multidisciplinary examinations and the evolution of their frailty over time is tracked. The study began in 2012, and over time data have been collected and archived on spreadsheets.