A distributed service-oriented architecture for coordinated healthcare services

The aim of Valkyrie is to develop a technical prototype of an ICT architecture to promote health care services coordination. Valkyrie will work to reduce the gap in relevant patient health data availability between health care services in different levels. Patient-centric pathways will guide our models to make the relevant patient health data available to the relevant health professionals. The outcomes of Valkyrie will improve the availability of patient health data at the point of care, and thus helping health professionals to deliver better care. Better care will improve quality of life, increase adherence to treatment and reduce morbidity. Valkyrie focus on mental health services in Norway. A growing number of individuals are not receiving optimum care, partly due to lack of coordination and information. We will study how health care services coordination can be improved by creating an innovative data sharing solution based on the existing systems. This will be achieved through joint research activities with national and international partners. Knowledge will be collected through reviews, observations and interviews with patients and their care providers. In terms of innovation, the outcomes of Valkyrie will advance the digital transformation of health care services. In the third year of Valkyrie, the work with both international and national partners has continued and been productive concerning the development of a "sandbox" for simulation and further development of the first version of Valkyrie, development of security models, development of blockchain technology for storing tokens from the journal systems, ontology development, and collection of data. Regarding the collection of data, patient record data from psychiatry and somatic has taken even more time. This is in relation to the design of applications to Regional Ethics Committee (REK), Data Protection Officer (DPO), and “Helsedataservice, their processing time, and change of authority for processing permits for access to this type of data. As a plan B to get hold of data to work with, we got an agreement with the National Archives in 2022 to get access to record data from 70 deceased people. When we applied for approval in December 2022) for permission, REK was responsible, but during the processing period (15 March 2023) “Helsedataservice” took over this service, and we had to submit a new application to them. We also needed approval from the local DPO. The process took an unforeseeable amount of time but we received approval from DPO and “Helsedataservice” and access to this data in September 2023. Regarding the collection of data from patient records in somatic/psychiatry (municipality/emergency room/specialist health service), this has not been a trivial matter either, but here it looks like it will resolve itself within a short time and recruitment of patients is underway. The technical part of Valkyrie is in its second phase where we work with the development of security models, blockchain technology for storing tokens from the patient journal systems, and ontology development.

The IKTPLUSS work program, the Norwegian e-Health Strategy (2017-2022) and the Norwegian Directorate of Health National Plan for Implementation of Patient Pathways have identified challenges with the digitalization of the Norwegian healthcare sector, recognizing the need for more research aiming a better use of electronic Patient Health Data (ePHD). A need has also been identified for implementing new patient pathways for mental health which improve the coordination between primary and specialist care. But, the challenges of accessing ePHD across multiple HIS and integrating it with patient-centric solutions to form complete digital pathways, threaten the chances of achieving the goals for patient pathways. The aim of the Valkyrie project is to develop a technical prototype of an architecture to promote health care services coordination. The full coordination of health care services entails that the right data is available to the right person at the right time, independently of where the patient has received medical care before, and is identified as in the strategy of One citizen – One Journal [1] as a key objective. From an Information and Communication Technology (ICT) standpoint this means connecting multiple healthcare information systems (HIS) across multiple health care levels. Under Valkyrie we will model patient centric pathways that guide the outline of a Virtual Health Record (VHR). The VHR will be made available to the providers’ HIS, thus making it possible to, when relevant, access a view of the ePHD. Hence, all ePHD will become ubiquitous facilitating health care services coordination.