Responsibility Model

Overview

The Responsibility Model controls responsibility at different levels for the Patient episode of care.

The Episode of Care is registered with three types of responsibility.

1. ManagingOrganization:
   This is the Custodian of the patients data in the platform. GDPR terms it is the “data controlling” Organization.
   The ManagingOrganization never changes. If a Patient moves to another region or municipality, a new Episode of Care must be created in accordance with the new home address.
   These are top-level Organizations including:

   1. A Region

   2. A Municipality
      

2. CareManagerOrganization:
   This is the Organization that has the formal responsibility for the Patient's episode of care.
   The formal responsibility should only be changed once accepted by the receiving CareManagerOrganization.
   Examples include:

   1. A Department in a Hospital. Typically, the ManagingOrganization is a descendent of the top-level ManagingOrganization (1).

   2. A General Practitioner
      

3. Team:
   The Team is a collection of Practitioners in roles, that perform actions at Episode of Care level. Examples of these roles are “behandlingsansvarlig” or “bestillingsansvarlig”.
   These are related to the Patient’s Episode of Care through a CareTeam.
   The Practitioners in the Team can work across CarePlans. Practitioner actions at this level include:

   1. Assigning a new CarePlan to the Patient’s Episode of Care

   2. Closing or pausing an existing CarePlan

   3. Assigning new CareTeams to an active CarePlan (see below)
      

The CarePlan has only one responsibility: the CareTeam.

1. CareTeam:
   The CareTeam element holds references to one or more CareTeam that assumes the operational responsibility for the Patient’s CarePlan.
   CareTeams are formed around Practitioners that are registered at IdP level. Whenever the Practitioner logs into the platform, the CareTeam / Practitioner relation is updated automatically.

   The CareTeam at CarePlan level can be changed by Practitioner with privileges.
   
   

Points of Interest in the example above

EpisodeOfCare.managingOrganization

This Organization is the top level Organization that holds the data controlling for the Patients Episode of Care. In the example above it is Region Midt.

In addition to data separation, this Organization is used for reporting and billing and does not change.

EpisodeOfCare.careManagerOrganization

This is the Organization that has the formal responsibility for the Patient's care. In the example above it is Lungemedicinsk Afdeling.

It can change - but it would usually be to another Organization under the same managingOrganization.
An example with a General Practitioner as a careManagerOrganization, click:
Responsibility with General Practitioner as caremanagerOrganization

EpisodeOfCare.team

This administrative team is for Practitioners with the rights to assign new CarePlans to the Patient's EpisodeOfCare.
Examples include: Behandlingsansvarlig and Administrativt Personale

This team can be changed with the right permissions. The History of the responsibility is kept in EpisodeOfCare.teamHistory.

Careplan.careTeam

This operational team is for Practitioners with rights to monitor the execution and progress of the Patient's CarePlan. It is also for clinical practitioners how adjust plans and approve results for publishing.
Examples include: Examples include Sundhedsfaglig and Sundhedsfaglig monitoreringsansvarlig

Likewise, operational teams can include Practitioners with service and support roles.

CareTeam on CarePlans change. The history is kept CarePlan.ehealth-teamHistory