WO1997035271A1 - A device and a method for providing automated needs analyses and outcome follow-ups in individual-related activities - Google Patents

A device and a method for providing automated needs analyses and outcome follow-ups in individual-related activities Download PDF

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Publication number
WO1997035271A1
WO1997035271A1 PCT/SE1997/000426 SE9700426W WO9735271A1 WO 1997035271 A1 WO1997035271 A1 WO 1997035271A1 SE 9700426 W SE9700426 W SE 9700426W WO 9735271 A1 WO9735271 A1 WO 9735271A1
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WIPO (PCT)
Prior art keywords
data
individual
services
ups
follow
Prior art date
Application number
PCT/SE1997/000426
Other languages
French (fr)
Inventor
Göran SANDELL
Original Assignee
Anonymity Protection In Sweden Ab
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Publication date
Application filed by Anonymity Protection In Sweden Ab filed Critical Anonymity Protection In Sweden Ab
Priority to AU21844/97A priority Critical patent/AU2184497A/en
Publication of WO1997035271A1 publication Critical patent/WO1997035271A1/en

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    • G—PHYSICS
    • G06—COMPUTING; CALCULATING OR COUNTING
    • G06F—ELECTRIC DIGITAL DATA PROCESSING
    • G06F21/00—Security arrangements for protecting computers, components thereof, programs or data against unauthorised activity
    • G06F21/60—Protecting data
    • G06F21/62—Protecting access to data via a platform, e.g. using keys or access control rules
    • G06F21/6218—Protecting access to data via a platform, e.g. using keys or access control rules to a system of files or objects, e.g. local or distributed file system or database
    • G06F21/6245—Protecting personal data, e.g. for financial or medical purposes
    • G—PHYSICS
    • G06—COMPUTING; CALCULATING OR COUNTING
    • G06Q—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR ADMINISTRATIVE, COMMERCIAL, FINANCIAL, MANAGERIAL OR SUPERVISORY PURPOSES; SYSTEMS OR METHODS SPECIALLY ADAPTED FOR ADMINISTRATIVE, COMMERCIAL, FINANCIAL, MANAGERIAL OR SUPERVISORY PURPOSES, NOT OTHERWISE PROVIDED FOR
    • G06Q50/00—Information and communication technology [ICT] specially adapted for implementation of business processes of specific business sectors, e.g. utilities or tourism
    • G06Q50/10—Services
    • G06Q50/22—Social work or social welfare, e.g. community support activities or counselling services
    • G—PHYSICS
    • G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
    • G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
    • G16H10/00—ICT specially adapted for the handling or processing of patient-related medical or healthcare data
    • G16H10/60—ICT specially adapted for the handling or processing of patient-related medical or healthcare data for patient-specific data, e.g. for electronic patient records
    • G—PHYSICS
    • G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
    • G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
    • G16H20/00—ICT specially adapted for therapies or health-improving plans, e.g. for handling prescriptions, for steering therapy or for monitoring patient compliance
    • G16H20/70—ICT specially adapted for therapies or health-improving plans, e.g. for handling prescriptions, for steering therapy or for monitoring patient compliance relating to mental therapies, e.g. psychological therapy or autogenous training
    • G—PHYSICS
    • G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
    • G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
    • G16H70/00—ICT specially adapted for the handling or processing of medical references

Definitions

  • the present invention relates to a device and a method for automated input of individual-related information, such as personal-file data, and associated needs analyses and outcome follow-ups on an individual- related level, which device/method in addition is arranged when required to perform needs analyses and outcome follow-ups on different aggregated levels with respect to the individual-related activities and treat- ment offered by such organizations and services as the health and medical services and the social welfare.
  • individual-related information such as personal-file data
  • needs analyses and outcome follow-ups on an individual- related level which device/method in addition is arranged when required to perform needs analyses and outcome follow-ups on different aggregated levels with respect to the individual-related activities and treat- ment offered by such organizations and services as the health and medical services and the social welfare.
  • the descriptive part is stored directly whereas the identifying part is first encrypted by means of two algorithms, the first of which is non-reversible. This arrangement allows access to data on an individual of known identity or supplementation of the stored data while at the same time it is not possible to deduce from the stored data to which individual identity the data relate.
  • the object of the invention is to provide a device and a method for providing automated file handling and follow-ups related thereto on an individual level as well as on different aggregated levels with respect to the individual-related activities and treatment offered by such organizations and services as the health and medical services where it is imperative that the personal integrity is not threatened.
  • Another object of the inven ⁇ tion is to provide a device and a method by means of which comparative evaluation can be made both between organizations/services of different and identical kind as well as longitudinally, i.e. in the form of follow-ups in time with respect to individuals or groups of individuals.
  • Fig. 1 is a schematical view of a device in accord ⁇ ance with the invention
  • Fig. 2 is a general view of the manner in which quality evaluation may be made in accordance with the present invention.
  • Fig. 3 is a general view of the manner in which entered individual-related data in accordance with the invention may be compiled both on an individual level and in aggregated form with respect to different domains.
  • Input data concerning the condition of the patient prior to treatment are entered via input means 11.
  • the entries advantageously are made integrally with the rest of the description, for instance by one question at the time appearing as a heading in a window, whereupon the descriptive text relating to this question is entered.
  • a codified value is entered as a summary of the descriptive text, whereupon a new window displaying the next question appears.
  • it is appropriate to enter already at this stage the desired goal values relating to the patient, i.e. the values that hopefully the patient will have reached following the treatment, as also the nature of treatment measures to be performed.
  • the entries could be made either directly during the consultation with the patient or, which is likely to be preferable, as a summary after the discussion with and the examination of the patient. Coding may be effected by entering predetermined letter or digit combinations, by ticking off predetermined alternatives of choice, by indicating levels on scales, or in any other suitable manner.
  • the manner in which the data input method is concretely devised depends on the nature of the organization/services, the consultations and examinations to be performed, and the professional nature of the personnel concerned.
  • Data storage is effected in a manner preventing deductions to be made regarding the individual's identity on the basis of the stored information by means of tracking or like methods while at the same time it is possible on the basis of a known individual identity to retrieve and supplement or change the date relating to the individual in question. This may be achieved in the manner described in the prior art.
  • the data flow 16 therefore is passed through a hard-ware unit 12 wherein at least part of the data (the identifying part) is encrypted before being stored in a database.
  • a database consists of three registers, one public register 15, one operative register 13 and one record or file register 14. The entered data are initially stored in the operative register 13.
  • the operative register is in this case used for the conventional keeping of personal files.
  • the input data on the patient are then retrieved and are supplemented with the results from the follow-up studies.
  • the outcome data suitably are entered in the form of text together with integrated codification as a summary of the text. If needed, several follow-ups studies may be made later in the same way.
  • the patient's personal file may be computed in the form of a table, for instance as illustrated below.
  • the nursing and medical staff may thus gain a comprehensive view of the patient and of the results of the treatments.
  • This table may also form the basis of a final report to be issued when the matter is closed, at which time a comprehensive evaluation should also be made of the actual treatment, assistance/actions performed by the services, of what or who contributed to the realisation of the goal, and of the efficiency of the treatment/actions.
  • a computer display or the like preferably is used and preferably it is linked to the input means 11.
  • the needs analysis (1) concerns five different areas, viz. : a) The life situation of the individuals concerned, within different domains of life; b) The need for change, within different domains of life; c) Own resources to bring about desirable changes (in individuals, family, network and/or local community) ; d) Remaining needs for change that cannot be resolved by own resources; and e) Remaining needs for change related to the charge of the organization/services in question, i.e. need for service, education, care or treatment.
  • the aggregation could include the general living conditions in different target groups, in the case of area (lb) general needs for change of life situation for different target groups, in the case of area (lc) general resources of change within different target groups, in the case of area (Id) the needs of various groups from broad aspects of public health/municipality/local urban area, and as regards area (le) the total "need for care" that the organization/ services is charged to meet with respect to the target groups concerned.
  • the needs analysis is carried out as a dialogue between individuals/families concerned and the professional staff, and it is entered in the form of text including codified summaries, for each level of each area of the analysis.
  • the goal (2) of the plan includes desirable changes (what is to happen) in the life of the individuals con ⁇ cerned on the basis of the needs emerging from the needs analysis and on the same levels as above.
  • the aggregation may provide a comprehensive view of desirable changes within different life domains for each target group.
  • the actions/treatment (3) of the plan include what to be done and when, and how and by whom such actions/ treatment are to be performed in order to meet and reach different types of need.
  • the aggregation might show the collected measures of the organization/ services for different target groups related to the substance of the work, attitudes, time perspective, competence and so on.
  • the follow-up of life situation (4) includes: a) Follow-up of new/present life situation. Account of the changes that have taken place within different life domains (i.e. in comparison with the initial situation at the start of the needs analysis) . b) Follow-up of the results of the organization/services. Account of the changes that have taken place with regard to the aspects specified as "need for care" (i.e. in comparison with remaining needs to be met by the organization/services) .
  • the follow-up of goal (5) includes: a) Analysis of goal follow-up. Do the actual changes agree with the set goals? (i.e. compare 4b with 2) . b) Analysis of assistance/actions. What measures accord ⁇ ing to (3) appear to have contributed to the change according to (4b) and the goal follow-up according to (5a) .
  • the aggregation under (4a) may include changed living conditions within different domains/areas for each target group, under (4b) it may include the results obtained by the organization/services with respect to changes within different life domains of various target groups that have received treatment/ assistance, under (5a) it may include general a follow-up goals within different life domains for each target group (i.e. the realism/realistic design of different speci ⁇ fications of goals) , and under (5b) it may include general outlines of treatment/assistance appearing to produce certain general effects.
  • Evaluation involves the use of all knowledge gained from items (l)-(5) to evaluate jointly, in analysing and drawing of conclusions, whether the organization/services fulfil their superordinate purpose within the set task and responsibility areas. Knowledge is thus gained of the real effeciency/total quality and usefulness from the perspectives of the target groups and the society.
  • the knowledge gained from the evaluation is aggregated from the units, departments, divisions etc. so that finally it covers the collected actions of the organization/services as a whole and may be used for internal quality development at different levels of the organisation/services.
  • the evaluation as a whole may in turn be integrated with the account of the collected activities of the organization/services ("yearly account") in order to allow the needs of the individuals, and the purpose, task and results of the organization/services to be related to the measures, achievement and costs of the performed activities, thus to obtain a real cost-benefit analysis.
  • the quality within the wellfare activities such as nursing, care, treatment and the like may be measured and analysed according to the invention in a manner described below and generally illustrated in Fig. 2.
  • individuals seeking help have certain needs.
  • the organization/services have goals, and perform quantitative and qualitative activities in accordance thereto.
  • the end result is a change with respect to the individual concerned.
  • the benefit of the activities performed by the organization/services and the quality of these activities thus could be assessed from the relation between the needs of the individuals concerned and the extent of satisfaction of these needs.
  • the internal quality of the activities of the organization/services may be described by the following schematic table of internal quality aspects: aspect WHAT WHO HOW WHEN
  • the internal quality may then be seen in a wider context.
  • An evalution may be made on the basis of the needs (see above) found in the individuals concerned.
  • the internal work leads to performances/tasks of various kinds, to products/services within care/nursing, service, treatment, exercise of public authority, and these tasks and performances may be expressed as a number of actions, beds, occupancy, through-flow, studies, treatments, consultations, hospital admittances and so on.
  • the evaluation may include a comparison between the initial needs and the outcome of the activities of the organization/services expressed as consequences in the lives of the individuals concerned.
  • the outcome of the evaluation may then be compared with the aim and purpose of the organization/services (often expressed through legislation or in terms of visions) , and the consequential task and goals of the organization/services.
  • Fig. 1 From the operative register illustrated in Fig. 1 all or part of the stored data (data flow 17) are transferred to the records or file register.
  • further descriptive information may be supplemented to the individual entries in this register by linking and matching it to other databases 110, 111, for instance the databases of the Central Bureau of Statistics.
  • From the record or file register information may be retrieved via the data flow 18.
  • this flow passes hardware unit 12 which ensures that only aggregated information may be retrieved therefrom. Consequently, the record register may be used for research purposes and evaluation.
  • the evaluation may relate to certain specific parts of the organization/services, such as the proportion of success ⁇ ful treatments of certain patient categories using certain treatment methods, as well as with regard to the organization/services as a whole, i.e. to evaluate whether the organization/services satisfy the goals/pur ⁇ poses laid down therefor.
  • the presentation of research with respect to information stored in the record register preferably is made graphically on display means, preferably computer display 19. Optionally, these could be interconnected with the input means 11.
  • These two computer registers i.e. the operative register 13 and the record register 14, preferably are accessible only to selected groups, such as e.g. nursing and medical staff or even part of the nursing and medical staff.
  • the database could contain a third register 15 which is unrestricted and available to the public. However, to this register is transferred only non-confidential information in order to prevent viola ⁇ tion of the integrity of the individuals.
  • Similar devices and methods may be used in all well- fare services dealing with individuals, such as personal and family care, geriatric care and children's care.

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Abstract

The present invention relates to a method and a device for automated input of individual-related data, such as personal file data, and associated needs analyses and outcome follow-ups on an individual level and on different aggregated levels with respect to individual-related organisations and services, such as for instance the health and medical services and the social welfare services. The method is characterized by the steps of entering data on the individual prior to, during or after the treatment/activities, in the form of needs, working plans, outcome and goal follow-ups as ordinary text and as summarizing codified answers to predetermined standard questions specific to the organization/services, storing the data in such a manner that on the basis of the stored data it is impossible by tracking or otherwise to deduce the identity of the individual whereas at the same time it is impossible on the basis of known individual identity to retrieve and supplement or change data concerning the individual in question, and displaying the data concerning the discrete individuals or in aggregated form.

Description

A DEVICE AND A METHOD FOR PROVIDING AUTOMATED NEEDS ANALYSES AND OUTCOME FOLLOW-UPS IN INDIVIDUAL-RELATED ACTIVITIES
Technical Field
The present invention relates to a device and a method for automated input of individual-related information, such as personal-file data, and associated needs analyses and outcome follow-ups on an individual- related level, which device/method in addition is arranged when required to perform needs analyses and outcome follow-ups on different aggregated levels with respect to the individual-related activities and treat- ment offered by such organizations and services as the health and medical services and the social welfare.
Background
Within individual-related organizations/services data registering of different kinds is performed mainly by manually entering data on sheets of paper which are assembled in files or the like and are stored in a manner preventing unauthorised access. Such handling suffers from several drawbacks. It is time-consuming and complicated, and the very physical storage of the files requires considerable space. Rapid access to the desired data is also often very difficult. More difficult still is the compilation of aggregated data of various kinds. Such data may be both useful for research purposes and desirable for evaluation of the efficiency of the activities of the organization/services.
The change-over to automated systems has been difficult. To enter often delicate and confidential data into a system the safety of which cannot be guaranteed not only lacks public support but in addition is prevented by law in many countries, among them Sweden. In order to allow automization of the method the system must guarantee the privacy of the individuals, preventing delicate information on the individuals from becoming publicly available. In addition, it is desirable that a system of this kind may be linked and matched to other databases in order to obtain aggregated information on groups of individuals for research purposes as well as for evaluation of the activities of the organization/ services. Means and methods to realise such systems are now available, for instance by means of the apparatus and method for storing data described in the Swedish Patent Specification 501 128. According to this publication the data are divided prior to storage into one identifying part and one descriptive part. The descriptive part is stored directly whereas the identifying part is first encrypted by means of two algorithms, the first of which is non-reversible. This arrangement allows access to data on an individual of known identity or supplementation of the stored data while at the same time it is not possible to deduce from the stored data to which individual identity the data relate.
Object of the Invention
The object of the invention is to provide a device and a method for providing automated file handling and follow-ups related thereto on an individual level as well as on different aggregated levels with respect to the individual-related activities and treatment offered by such organizations and services as the health and medical services where it is imperative that the personal integrity is not threatened. Another object of the inven¬ tion is to provide a device and a method by means of which comparative evaluation can be made both between organizations/services of different and identical kind as well as longitudinally, i.e. in the form of follow-ups in time with respect to individuals or groups of individuals. These objects are achieved by means of a device as defined in claim 1 and a method as defined in claim 7.
Brief Description of the Drawings In the accompanying drawings.
Fig. 1 is a schematical view of a device in accord¬ ance with the invention
Fig. 2 is a general view of the manner in which quality evaluation may be made in accordance with the present invention; and
Fig. 3 is a general view of the manner in which entered individual-related data in accordance with the invention may be compiled both on an individual level and in aggregated form with respect to different domains.
Description of Preferred Embodiments
In the following one example will be described which is related to the automated registration and keeping of personal-file data and associated needs analyses and outcome follow-ups on an individual level, and which is additionally arranged, as the need arises, to carry out needs analysis and outcome follow-ups on different aggregated levels with respect to health and medical services. A device designed for this purpose as illustrated in Fig. 1.
Input data concerning the condition of the patient prior to treatment are entered via input means 11. In addition to the running text and the description of the patient's condition codified answers to certain standard questions adequate to the services are also entered. The entries advantageously are made integrally with the rest of the description, for instance by one question at the time appearing as a heading in a window, whereupon the descriptive text relating to this question is entered. Finally, also a codified value is entered as a summary of the descriptive text, whereupon a new window displaying the next question appears. Likewise, it is appropriate to enter already at this stage the desired goal values relating to the patient, i.e. the values that hopefully the patient will have reached following the treatment, as also the nature of treatment measures to be performed. The entries could be made either directly during the consultation with the patient or, which is likely to be preferable, as a summary after the discussion with and the examination of the patient. Coding may be effected by entering predetermined letter or digit combinations, by ticking off predetermined alternatives of choice, by indicating levels on scales, or in any other suitable manner. The manner in which the data input method is concretely devised depends on the nature of the organization/services, the consultations and examinations to be performed, and the professional nature of the personnel concerned.
Data storage is effected in a manner preventing deductions to be made regarding the individual's identity on the basis of the stored information by means of tracking or like methods while at the same time it is possible on the basis of a known individual identity to retrieve and supplement or change the date relating to the individual in question. This may be achieved in the manner described in the prior art. The data flow 16 therefore is passed through a hard-ware unit 12 wherein at least part of the data (the identifying part) is encrypted before being stored in a database. A database consists of three registers, one public register 15, one operative register 13 and one record or file register 14. The entered data are initially stored in the operative register 13. The operative register is in this case used for the conventional keeping of personal files.
After treatment of the patient follow-up studies are made. The input data on the patient are then retrieved and are supplemented with the results from the follow-up studies. Also in this case the outcome data suitably are entered in the form of text together with integrated codification as a summary of the text. If needed, several follow-ups studies may be made later in the same way.
On the basis of the entered goal data it is possible to obtain goal-follow-up data for comparison with the results found in the follow-up studies. In its codified form the patient's personal file may be computed in the form of a table, for instance as illustrated below.
1. Needs Planning 4. Follow-up 5. Follow-up analysis of life of goal situation
2. Goal 3.Actions 4.1 4.2 4.3 5.1 5.2 5.3
Deficient Planned Planned Situation at Cf 2 with resources desired actions/ follow-up 4.1-3 at start. outcome treat¬ prior to ments treatment
In a simple manner the nursing and medical staff may thus gain a comprehensive view of the patient and of the results of the treatments. This table may also form the basis of a final report to be issued when the matter is closed, at which time a comprehensive evaluation should also be made of the actual treatment, assistance/actions performed by the services, of what or who contributed to the realisation of the goal, and of the efficiency of the treatment/actions.
As a means of presentation a computer display or the like preferably is used and preferably it is linked to the input means 11.
The table above will be explained in more detail in the following.
The needs analysis (1) concerns five different areas, viz. : a) The life situation of the individuals concerned, within different domains of life; b) The need for change, within different domains of life; c) Own resources to bring about desirable changes (in individuals, family, network and/or local community) ; d) Remaining needs for change that cannot be resolved by own resources; and e) Remaining needs for change related to the charge of the organization/services in question, i.e. need for service, education, care or treatment.
In the analysis, all these areas advantageously are divided into different life domains, such as social situation (structural level) comprising occupation, housing, economy etc., relations (inter-personal level) comprising family situation, relations network etc., and personal situation (bio-mental health) comprising physical health, mental health, perception of self etc. In the case of needs analysis area (la), the aggregation could include the general living conditions in different target groups, in the case of area (lb) general needs for change of life situation for different target groups, in the case of area (lc) general resources of change within different target groups, in the case of area (Id) the needs of various groups from broad aspects of public health/municipality/local urban area, and as regards area (le) the total "need for care" that the organization/ services is charged to meet with respect to the target groups concerned.
Preferably, the needs analysis is carried out as a dialogue between individuals/families concerned and the professional staff, and it is entered in the form of text including codified summaries, for each level of each area of the analysis.
The goal (2) of the plan includes desirable changes (what is to happen) in the life of the individuals con¬ cerned on the basis of the needs emerging from the needs analysis and on the same levels as above. In this case, the aggregation may provide a comprehensive view of desirable changes within different life domains for each target group.
The actions/treatment (3) of the plan include what to be done and when, and how and by whom such actions/ treatment are to be performed in order to meet and reach different types of need. In this case, the aggregation might show the collected measures of the organization/ services for different target groups related to the substance of the work, attitudes, time perspective, competence and so on.
The follow-up of life situation (4) includes: a) Follow-up of new/present life situation. Account of the changes that have taken place within different life domains (i.e. in comparison with the initial situation at the start of the needs analysis) . b) Follow-up of the results of the organization/services. Account of the changes that have taken place with regard to the aspects specified as "need for care" (i.e. in comparison with remaining needs to be met by the organization/services) .
The follow-up of goal (5) includes: a) Analysis of goal follow-up. Do the actual changes agree with the set goals? (i.e. compare 4b with 2) . b) Analysis of assistance/actions. What measures accord¬ ing to (3) appear to have contributed to the change according to (4b) and the goal follow-up according to (5a) .
Also with respect to the items above entry of written text in combination with codified summarised answers preferably is made. The aggregation under (4a) may include changed living conditions within different domains/areas for each target group, under (4b) it may include the results obtained by the organization/services with respect to changes within different life domains of various target groups that have received treatment/ assistance, under (5a) it may include general a follow-up goals within different life domains for each target group (i.e. the realism/realistic design of different speci¬ fications of goals) , and under (5b) it may include general outlines of treatment/assistance appearing to produce certain general effects. Evaluation, finally, involves the use of all knowledge gained from items (l)-(5) to evaluate jointly, in analysing and drawing of conclusions, whether the organization/services fulfil their superordinate purpose within the set task and responsibility areas. Knowledge is thus gained of the real effeciency/total quality and usefulness from the perspectives of the target groups and the society.
The results from (4a) and to some extent (4b), the goal follow-up (5a) and the analysis of the treatment/ assistance (5b) in aggregated form for the various target groups concerned are related to the purpose and the task of the organization/services.
The knowledge gained from the evaluation is aggregated from the units, departments, divisions etc. so that finally it covers the collected actions of the organization/services as a whole and may be used for internal quality development at different levels of the organisation/services.
The evaluation as a whole may in turn be integrated with the account of the collected activities of the organization/services ("yearly account") in order to allow the needs of the individuals, and the purpose, task and results of the organization/services to be related to the measures, achievement and costs of the performed activities, thus to obtain a real cost-benefit analysis. The quality within the wellfare activities such as nursing, care, treatment and the like may be measured and analysed according to the invention in a manner described below and generally illustrated in Fig. 2. As illustrated in Fig. 2 individuals seeking help have certain needs. In turn, the organization/services have goals, and perform quantitative and qualitative activities in accordance thereto. The end result is a change with respect to the individual concerned. The benefit of the activities performed by the organization/services and the quality of these activities thus could be assessed from the relation between the needs of the individuals concerned and the extent of satisfaction of these needs.
The internal quality of the activities of the organization/services may be described by the following schematic table of internal quality aspects: aspect WHAT WHO HOW WHEN
Contents & Personnel/ Processes, Phases and conditions of professional relations time dimen¬ work competence sions level
Individual theory/method Competence, attitude, ethics/ education related work with education, treatment, training
"right thing" training adequate work¬ experience experience, ing methods (long)
"right person"
Immaterial theory/method policy of: common values policy-work organization R & D, -recruitment and psycho- (average-long) management & -training- social working control systems -staff manage¬ environment ment -instructions
Material premises, actual adequate and planning of organization equipment, -management rational use of activities and instruments -manning means and re¬ budget
ADP, etc -personnel sources/ (comparatively economy short) 1
The internal quality may then be seen in a wider context. An evalution may be made on the basis of the needs (see above) found in the individuals concerned. The internal work leads to performances/tasks of various kinds, to products/services within care/nursing, service, treatment, exercise of public authority, and these tasks and performances may be expressed as a number of actions, beds, occupancy, through-flow, studies, treatments, consultations, hospital admittances and so on. In this case the evaluation may include a comparison between the initial needs and the outcome of the activities of the organization/services expressed as consequences in the lives of the individuals concerned.
The outcome of the evaluation may then be compared with the aim and purpose of the organization/services (often expressed through legislation or in terms of visions) , and the consequential task and goals of the organization/services.
In this manner the organization/services may be assessed with respect to the overall benefit, i.e. in terms of the actual effect on the lives of the indi¬ viduals concerned and thus consequently the actual benefit to society, as well as in terms of costs distributed on separate units and in aggregated form, respectively. With the aid of the invention all steps (1) - (5) above are investigated and documented on an individual level in the course of meetings between the concerned nursing staff/individual in need and the professional staff concerned within the organization/services, such as the health and medical care, children, geriatric and family care services. Thus it becomes possible to carry out needs analyses, work planning including goal speci¬ fication and treatment/activities as well as outcome follow-ups in every individual "treatment" case. However, in order to evaluate organization/services as a whole, it is necessary to aggregate (1) - (5), e.i. a population or target group of known individuals (patients, clients and so on) may be studied for a pre¬ determined period, since deductions regarding the benefit, the actual effectivity and overall quality of the organization/services require knowledge on the circumstances, changes, and patterns at a suitable target group level, of a kind from which generalisations may be made.
The general structure throughout in (1) - (5) including subtitles relating to the level-related life domains on structural, inter-personal and bio-mental levels together with a descriptive text and codified summaries of the present conditions, needs, goals, treat¬ ment/assistance, outcome and goal follow-up make possible this desired aggregated compilation. This leads to the knowledge - from which generalisations may be made - which is required for the analyses and deductions regard¬ ing the benefit of the organization/services as a whole and which in turn may be used as a basis for strategic decisions and quality development. The data input in the inventive manner, illustrated in a general view in Fig. 3, provides possibilities for performing outcome follow-ups on an individual level, i.e. vertically in Fig. 3, as well as aggregated follow- ups concerning different life domains and different target groups, i.e. horizontally in Fig. 3. Individual needs analysis and outcome follow-ups may thus be made while at the same time it becomes possible to brake down the entire population into defined target groups and to compile a comprehensive picture of the needs, goals, treatments/assistance, outcome and so on for each target group.
From the operative register illustrated in Fig. 1 all or part of the stored data (data flow 17) are transferred to the records or file register. In addition, further descriptive information may be supplemented to the individual entries in this register by linking and matching it to other databases 110, 111, for instance the databases of the Central Bureau of Statistics. From the record or file register information may be retrieved via the data flow 18. However, this flow passes hardware unit 12 which ensures that only aggregated information may be retrieved therefrom. Consequently, the record register may be used for research purposes and evaluation. The evaluation may relate to certain specific parts of the organization/services, such as the proportion of success¬ ful treatments of certain patient categories using certain treatment methods, as well as with regard to the organization/services as a whole, i.e. to evaluate whether the organization/services satisfy the goals/pur¬ poses laid down therefor.
The presentation of research with respect to information stored in the record register preferably is made graphically on display means, preferably computer display 19. Optionally, these could be interconnected with the input means 11.
These two computer registers, i.e. the operative register 13 and the record register 14, preferably are accessible only to selected groups, such as e.g. nursing and medical staff or even part of the nursing and medical staff. However, the database could contain a third register 15 which is unrestricted and available to the public. However, to this register is transferred only non-confidential information in order to prevent viola¬ tion of the integrity of the individuals.
Similar devices and methods may be used in all well- fare services dealing with individuals, such as personal and family care, geriatric care and children's care.

Claims

1. A device for automated input of individual- related data, such as personal-file data, and associated needs analyses and outcome follow-ups on an individual level, said device in addition arranged when required to perform needs analyses and outcome follow-ups on different aggregated levels for with respect to indi¬ vidual related organizations and services, such as the health and medical care services and the social well-fare services, c h a r a c t e r i z e d in that it comprises input means (11) for entry of data, a storage means (13- 15) to store data, and display means (11, 19) to display processed data on different aggregation levels, the data being stored in such a manner that it becomes impossible on the basis of the stored data to deduce the identity of the individual by tracking or similar methods while at the same time, on the basis of a known individual identity, it is possible to retrieve and supplement or change data concerning the individual in question.
2. A device as claimed in claim 1, c h a r a c - t e r i z e d in that the device divides the data on each individual into one identifying part and one descriptive part, wherein the identifying part is processed and stored in a manner making it impossible on the basis of the stored data to deduce the individual's identity by tracking or similar methods while at the same time it is possible, on the basis of a known individual identity, to retrieve and supplement or change data concerning the individual in question.
3. A device as claimed in claim 1 or 2, c h a r - a c t e r i z e d in that the storage means is a data¬ base comprising at least two database registers one of which is an operative register (13) and the second one is a filing register (14), the operative register (13) being coupled directly to the input means (11) via a hardware unit (12) and allowing retrieval of data concerning a specific individual identity whereas the file register (14) does not afford this possibility, while at the same time changes and supplementation of data concerning individuals are possible on the basis of known individual identities, whereby the operative register (13) thus is adapted to support needs analyses and outcome follow-ups on an individual level whereas the file register (14) is adapted to support needs analyses and outcome follow-ups on aggregated levels.
4. A device as claimed in any one of the preceding claims, c h a r a c t e r i z e d in that the input means (14) is adapted for entry of categorised and codified answers to predetermined sets of questions with respect to each part domain of the organization/services.
5. A device as claimed in any one of the preceding claims, c h a r a c t e r i z e d in that the display means (11) is arranged to supply, on an individual level, compiled data on at least input values, set goals, output values and/or goal follow-ups.
6. A device as claimed in any one of claims 3-5, c h a r a c t e r i z e d in that said data registers (13-15) include at least one register adapted to be linked and matched to other databases (110-111) without it being possible to track discrete individuals, the thus added data being accessible only in aggregated form.
7. A method for automated input of individual- related data, such as personal file data, and associated needs analyses and outcome follow-ups on an individual level and in addition, when required, needs analyses and outcome follow-ups on different aggregated levels with respect to individual-related organization and services, such as for instance the health and medical services and the social welfare services, c h a r a c t e r i z e d by entering, at least in partly codified form, data on the individual prior to, during or after the treatment/ activities, storing the data in such a manner that on the basis of the stored data it is impossible by tracking or otherwise to deduce the identity of the individual whereas at the same time it is possible on the basis of known individual identity to retrieve and supplement or change data concerning the individual in question, and displaying data concerning the discrete individuals or in aggregated form.
8. A method as claimed in claim 7, c h a r a c ¬ t e r i z e d in that it is integrated with other data gathering and data processing on the individual level within the organization/services.
9. A method as claimed in claim 7 or 8, c h a r ¬ a c t e r i z e d in that data is entered not only in the form of ordinary text, but also in the form of codified answers to certain specific standard questions related to the organization/services.
10. A method as claimed in any one of claims 7-9, c h a r a c t e r i z e d in that as supplementation individual related data are gathered for aggregated levels from other data basis.
PCT/SE1997/000426 1996-03-13 1997-03-13 A device and a method for providing automated needs analyses and outcome follow-ups in individual-related activities WO1997035271A1 (en)

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SE9600955A SE9600955L (en) 1996-03-13 1996-03-13 Device and procedure for automated needs analysis and performance monitoring in personal management operations

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US9886558B2 (en) 1999-09-20 2018-02-06 Quintiles Ims Incorporated System and method for analyzing de-identified health care data

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Publication number Priority date Publication date Assignee Title
US9886558B2 (en) 1999-09-20 2018-02-06 Quintiles Ims Incorporated System and method for analyzing de-identified health care data
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SE9600955L (en) 1997-09-14
SE9600955D0 (en) 1996-03-13

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