The need of health and social care for community-dwelling elderly is on the rise as population ages. Through the provision of comprehensive services by multiple professionals in local communities, elderly people receive continual care in a non-medical setting which is favorable for early detection and intervention of potential problems. While primary care services generate data that are important for care delivery, the data are usually recorded in paper format or using generic software, in contrast to electronic health record systems adopted by hospitals in secondary care. The lack of digitization thus affects the effectiveness of primary care for elderly and precludes full exploitation of the data. To meet the need, an information system dedicated for caring community-dwelling elderly people is proposed. The system is designed to be in line with the workflow of community care centers. The data generated during care delivery, involving socio-demographic and data, bio-measurements and health assessments and questionnaires, are digitized for effective management and information exchange, and as a source of healthcare predictive intelligence. Interoperability is attained by adopting the health information exchange standard Fast Healthcare Interoperability Resources (FHIR) and the terminology standards Logical Observation Identifiers Names and Codes (LOINC) and Systematized Nomenclature of Medicine-Clinical Terms (SNOMED-CT). The system is implemented with a tiered architecture that permits a fast and decoupled method to introduce FHIR to existing systems without modification. It has been deployed in a community center with 120 elderly clients since September 2020. Evaluation with a survey on the acceptance and usability of the system shows positive response in general. Future work includes the extension of the system to other elderly care centers, followed by a large-scale evaluation and healthcare predictive analytics with the data repository established.
Publications
- K.S. Choi, S.H. Chan, C.L. Ho, M. Matejak. Development of a healthcare information system for community care of older adults and evaluation of its acceptance and usability. Digital Health, (Accepted: 8 June 2022). [doi]
- Community-oriented Interoperable Elderly Healthcare Information System with FHIR and Standardized Terminologies. AMIA 2021 Clinical Informatics Conference, Virtual Conference, USA, 18-20 May 2020.
Funding Support
The work was supported in part by the Innovation and Technology Fund of the HKSAR under Grant MRP/015/18.