ALAD-HIN - A language to represent care pathway

Abstract

The health state of the Italian population and, more generally in the Western world, shows a significant proportion of elderly people with chronic and polychronic diseases, as well as and also diseases in the acute phase. This implies an increasing importance of time-based clinical reasoning, which is the basis of the HIN™ project. The loss of health is traditionally defined through an abstract act of classification, the diagnosis, seen as an isolated frame with blurred edges, which lacks the sense of time (past and future) and that of complexity, understood as the possible coexistence of multiple morbid conditions. HIN allows to study, in fact, in this project, not only the formalization of a person's clinical history but also the modeling of the clinical path and its linkage (integration) with the clinical history are studied. This integration is the basis for the clinical assessment of a person with chronic conditions (where the diagnosis is generally already known). Such assessment is also possible in case of additional conditions occurring in the acute phase, in different use scenarios, such as clinical assistance, education, and healthcare management. In this working paper, the graphical language ALAD-HIN (Augmented Language for Activity Diagram - Health Issue Network) for modeling a care pathway is introduced and described, along with its linkage to the related clinical history, and the various ways of representing it. Finally, some advantages (e.g., modeling how health conditions and clinical activities interfere with a patient's history) of using this clinical history-care pathway integration at various levels (such as, activity, contact, clinical problem, clinical history, etc.), in different use scenarios, are shown as examples.