Abstract
Introduction: Using common measures enables clinicians and providers in different care settings to improve the continuity of care, as well as to integrate care and support. The interRAI suite of assessment instruments is based on a common language that can be used as a standard for integrated health information systems. Every interRAI instrument has been developed for a particular population, but they are designed to work together to form an integrated health information system. Each instrument is the product of rigorous research and testing to establish the reliability and validity of items, outcome measures, assessment protocols, case-mix algorithms, and quality indicators.
Aims and Objectives: The objective of this presentation is to demonstrate how integrated health information systems can be developed based on the interRAI assessment standard. We will discuss how instruments are developed, digitalized, and used in daily practice for decision-support on different levels from individual care planning and management to policy making at the national level. The interRAI standard is developed by an international collaborative non-profit research organization that licences software companies to provide digital solutions. Several countries have mandated interRAI to support care planning, quality improvement, and resource allocation. Finland is one of the countries that provides an interesting case of implementation.
Highlights and Key Findings: Many benefits can be shown in using standardized assessment instruments in integrated health information systems, these include a common language, common metrics, standardized and programmable measures. As an assessment standard developer interRAI provides software vendors with manuals, codes for items, and algorithms for measures. Interoperability standards such as HL7/FHIR are also available and under development. These are critical technical tools needed for developing integrated assessment-based information systems to support integrated care. Subsequently, they provide ways to develop care documentation in a standardized way in which information can be shared and understood by clinicians and administrators. In Finland the government mandated the use of interRAI for elderly care in 2020. This was preceded by a 20-year voluntary use by municipalities and regions using digital solutions. Part of the new health care reform interRAI will be used nationwide and applied on three decision-making levels by care providers, health districts, and the central government.
Conclusions: Digitalization is key for successful implementation of standardized assessment instruments, but it requires tools for coding and processing of data. This is evident through the years of implementing interRAI in Finland, where both interRAI, private vendors, and government agencies have been active in developing and supporting information systems.
Implications for applicability/transferability:The interRAI standard and digital applications provide a basis for applicability and transferability of knowledge internationally. When assessment of individual health and functional status can be performed digitally in a standard way regardless of differences in cultures, health delivery and financing systems, it enables international comparison, learning, development, and evaluation of integrated care.