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All data in the
aMedLineNET MHR
constitute central point of reference for use by all possible participating
organizations within a Health Network, like:
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Organization Managing the Health Network (NMO)
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Affiliated Insurance Companies or Organizations
Within each one of the above
organizations, the aMedLineNET system
supports operations across the following axes:
Management Information Systems (MIS)
Medical Services
Administrative Services
The workflow for the above organizations
and roles within the Health Network, based on the three axes mentioned above
is summarized in the next section and is analyzed in more detail in chapters
6-10.
It should be noted at this point that,
in order to ensure the confidentiality of the patient and the security of
data, the access of personnel of the above organizations to the MHR is
selective. In specific, based on the policies of the Network and each
organization in it, it is possible to show or hide specific fields in the
tables of the MHR.
For example, administrative personnel
might not have access to medical data whereas doctors might not have access
to Social Security data of the patient.
The following workflow summarizes a
typical scenario of healthcare service provision by the Network under the
aMedLineNET regime:
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The patient contacts the administrative personnel of
the NMO so as to book an appointment with a GP or healthcare
organization in the Network. The NMO
 administrative
personnel checks availability and location of Networks GPs and proposes a
GP name, date and time to the patient who accepts. When the appointment is
booked, the system of the GP or healthcare organization is automatically
updated on this appointment.
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In case that the patient's MHR does not exist, the
administrator at the NMO opens this MHR by completing the patient's name,
address and telephone numbers. When the patient becomes customer to the
Network he or she acquires a Health Card that contains a portable MHR.
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The patient makes a medical visit to the GP. As
a first step, the GP accesses the MHR of the patient either locally,
either by letting the patient to insert his or her Health Card in
the system and insert his or her PIN or (if there is no Health Card and
the MHR is not available locally) by connecting to the Central System of
the NMO. The GP accesses all patient history including results of past
examinations, past diagnoses, e.t.c. and completes the Medical History and
Medical Visit tab, updates it and with the next connection to the Central
System, the MHR in the Central Database is updated and thus becomes
available to all Network.
From the above procedure, it becomes
evident that the existence of the Health Card greatly facilitates the
procedure of access to the MHR from all Network doctors whereas it
also offers ultimate security since it allows the doctor or anyone to
have access to the MHR only when the patient inserts himself or herself
his or her PIN (Personal Identification Number). Of course, in case of
emergency and when the patient is in no position to insert his or her PIN
(i.e. being unconscious), the medical personnel can access quickly the
most crucial data to treat the patient in an emergency situation (i.e.
blood type) by simply inserting the Card to the reader.
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If the GP orders the implementation of clinical tests,
this order is automatically integrated into the MHR. When the patient goes
to a Clinical Lab of the Network, the Lab personnel accesses the relevant
part of the MHR via the Health Card or the system, and conducts the
examinations. Again the system automatically charges the cost and
separates insurance claims.
-
The system can automatically acquire actual medical
readings (i.e. ECGs, X-Rays, e.t.c.) and integrates them in the patient
MHR. So, the clinical test actual results are automatically
integrated in the MHR and the attendant doctor can access them the next
time he accesses the MHR, probably, at the next patient visit.
-
Based on the medical data integrated in the MHR, as
this comprises of actual medical
 readings,
care actions implemented at medical visits, medical history, e.t.c., the
attendant GP may conduct sophisticated monitoring of the patient's
health in the way that he or she sees fit for the patient's situation,
by conducting correlations and comparisons of actual medical readings.
-
If, in the process, the GP needs an expert opinion, he
makes a Telemedicine Request to a Network Specialist. As soon as
the Specialist receives the request, he or she views the MHR of the
patient and makes a telediagnosis. The Telemedicine service is charged as
another Service to the Customer whereas the Network Specialist might be
located in another city or even another country.
It should be noted here that the
software supports Structured Telemedicine Services in the sense
that the telemedicine procedure is not just a sporadic exchange of
information between two doctors, something that, mistakenly, is often
called "telemedicine" whereas it is really teleconference.
In aMedLineNET, the Telemedicine Service is a structured organized action
which is logged, time stamped and accompanied by names, data and cost
charges as any other service in the system. In addition, the Network
Specialist has at his or her disposal all data from the patient MHR,
not only the latest test results, and thus can conduct telediagnosis with
much greater accuracy.
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In any case, whenever the patient is referred to
one Network organization by another member of the Network for execution of
Care Actions, the name of both the Executioner and the Issuer of the Care
Services is logged. In this way, the system automatically processes the
costs and allocates payments due to each doctor, clinical lab or carer
that participates in the provision of services towards a patient, always
by separating insurance claims according to the patient's insurance
scheme.
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At any point, the GP, clinical lab or specialist at
the local site may issue financial reports with all paid and unpaid
amounts from patients, insurance claims, charges to the NMO for
telemedicine answers and amounts owed to the NMO or other members of the
Network, according to the financial policy of the Network.
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If the patient needs to be hospitalized, the
system automatically updates the selected hospital for the admission and
handles in the same structured way all services provided to the patient
during hospitalization.
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In any case, all medical services provided are
automatically allocated between healthcare providers that offer the
services and the affiliated insurance organization based on the
insurance scheme of the beneficiary / patient.
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Τhe NMO or insurance organization can receive reports
for all medical services provided in the Network either continuously or at
specified time intervals. In any case, the relevant reports from the
healthcare service providers to the insurance organization are issued
automatically by the healthcare service providers and are
homogeneous in format - something that saves great administrative
overhead for all parties in the Network.
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Finally, the NMO can issue summary reports with
all financial issues pertaining to its interest. In this way, the NMO can
conduct claims from Network members, compare the services provided by
different doctors, specialties, sets of services, areas, types of patient,
etc.
In case that the Health Network covers a large
geographical area, the above model applies as it is regardless of the
location of the beneficiary, the healthcare service providers or the
insurance organization. Thus, beneficiaries in urban or rural areas, or even
those traveling, are served in the same high quality manner.
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