Care Provider

Introduction

• A class intended for the common properties of care providers, including as well individual persons (eg doctors, nurse, ...), as well group of these persons (eg nursing ward nr 4 A, department of cardiology, Hospital X, ..).
  Remark : Although careproviders and patients are both persons, it has beeen decided not practical to carry the theory of derivations so far.

• The notion of Care Provider is seen as a particular case of Resource, from which it is derived.

• A care provider is a professional concept covering the common properties of all professionals who participate in the patient care, persons as well groups of persons i.e. organisations. Derived classes may specify additional properties for doctors, nurse, hospital, ward, etc...
  Remark : the concept of care provider could perhaps be extended to the family, and even to the patient himself. In some circumstances in the future, they could be in direct contact with the computer system, but in that case the authorization profile will be restricted. (e.g. in case of dialysis at home).

• The concept of care provider may have several degree of precision :
  • The precision is not always available, e.g. when one only know that the patient has been treated in a military hospital by an unknown ananymous doctor.
  • Not always very relevant. For example in the past history it is said that the patient has been operated in a given hospital, but the persons did probably change since 25 years ago.
  • Many organisations works with team of several persons, e.g. covering a 24 hour service. For example the "Emergency team" may be seen as a care provider.
  • All the levels of care providers should be easy to represent.

• Care providers and users :
  • In general any kind of care provider can be registered as responsible of an activity e.g. author of a document or GP, even if he is currently not himself a user.
  • A fraction of the care providers are actually users of the systems.
  • The management of authorisations procedures of any user, is based on the attributes of the associated care provider.

• Accountability and authorizations :
  • The 2 following aspects can be better managed as 2 independent issues :
    1. Every care provider, particularly if he is also a user, receive a precise profile. This is done when any new care provider (a docter or an employee) is admitted to work in the health organisation.
    2. From the point of view of activities or commands in the system, any activity require an authorisation profile. This is expressed in term of professional and responsibilities requirements. This is done when any new software componenent is added in the system. The allocation of profiles depend on the general manager. In practice the power to create profiles can be delegated to the chief of the personnel, the manager of the system, chief of departments for their own employees, etc ...
  • At run time, a match between these 2 profiles is mandatory. This approach in 2 independents steps avoid problems of updates of hundred of users, when a new program is added.

• Messages can be send to any care provider. If a care provider is not a "user", he may receive messages by means of printed papers in the traditional postal organisation, or may be by means of FAX. This should be included in the general mail activities, but a daemon is necessary to perform the sending at appropriated times.

• In a given context, the population of care providers is open, including of course all care providers employed in a hospital, but also a certain number of external care providers, as soon as they appear for at least one patient. For example all GPs who did send at least one patient, will remain in the system. Care providers can be added at any time.

• Remark : At the current provisional stage of developement, it assumed that a care provider object has only one profile of professional activities.

Derived classes

• "Individual care providers" : doctors, nurses, ....
• "Organisations care providers" : group of establisments, hospital, department, ......

Functions

• A function in order to check if the current user, i.e. care provider, match a required profile. If yes, access to the activity will be authorised.
• A dialogue in order to maintain the attributes of the care provider, particularly his/her authorization profile.

Data

• Version number :
  • Any change in profiles should be archived, for at least may be a year. This procedure is similar to versions of medical items.
• Type of care provider :
  • The type : doctor, nurse, hospital, department, etc...
  • Derived classes may extend the specific properties :
    • Care provider organisations
    • Care provider persons
• Identifications :
  • Usual identification desciptors : First, last names, title, ...
  • Usual abreviation unique in the work context.
  • Complete legal identification : in Belgium all individual care providers are registered with an identification code of 11 figures. Institutions have also a similar kind of national identification code.
• Contacts and main locations :
  • Email :
  • Usual work usual location(s) : Institution, address, department, room, telephone, FAX.
  • Residence(s), legal address and may be others where the care provider can be called in case of emergencies, also including telephone and FAX if avaialable.
• Profile:
  • Type of care provider : individual person or any group of persons forming an organisation (a doctor, a nurse, paramedical, secretary, as well an hospital, a department, an unit ...)
  • Professional profile(s) : in most case one, but more than one professional profile may exists in somes cases.
    • Qualifications, specialities, ...
  • Organisational profile :
    • Enrolment in the organisation : institution, department, ..
    • Role in the organisation : director, chief of department, adjunct, assitant, consultant, stagiaire, ...
  • Access to an accountability profile :
    • The key condition is that a Registration, ie an accountability, must exist between the patient and the care provider. Indeed if it is proved that the patient did ask for help to the care provider, the care provider need an access to the patient in order to perform his task.
    • The accountability is not actually registered in the Care Provider object. More information is available in the description of the Registration class.
  • References to "Clinical Scope", optional zero to several clinical scopes. Scopes are inventory of resources normally available by a given care provider.
  • (May bey a few other criterias in special cases ..... ?)
• Group of involved care provideres :
  • Collection of included care providers. Particularly useful in hte case of care providers who are organisations. For example a department contains references to all the individuals working in the department. An institution contains reference to all included departments.
• Preferences of the care provider (applies to individuals and to organisations) :
  • Preferred language.
  • Other known languages.
  • Preferences about how to receive messages : (postal address, FAX, Email, ..)
  • .....
• Referenec to the agenda of the care provider :
  • Dates and times reserved for specific activities.
• Access to the current mailing information :
  • Collection of waiting messages.
    Remark : this information exist for all care providers, even for those who are not yet users of the computer system. They will receive their messages by means of papers, FAX or some type of telecommunication (Regional file transfer as the ACTH, or may be perhaps ordinary Email).
    Several message may accumulate here in the mailbox. In the same as computer users retrieve their box, non users will be represented by a daemon who will start the production of paper documents at appropriate times. The print work should be performed so late as possible, just before the departure of the traditional post, in order to sort the messages properly.
  • as well of accepted mesages, which could temporarily still be recovered.

Open questions

• A profile could become a separate object ?
• Consider an extension of the specification allowing a care provider to have more than one professional activities, for example during the day hours assistant in surgery and at night on duty in the emergency team, which is in fact an other department in the organisation, ...
• (In the NHS this kind of class is called a "party", which seems to have a little more generic character ?)
• It could become necessary to refere to care providers in other domains ?