Toward Smarter Health and Well-Being: An Implicit Role for Networking and Information Technology

2011 ◽  
Vol 26 (2) ◽  
pp. 120-128 ◽  
Author(s):  
Erwin P Gianchandani

The number of people afflicted with chronic illnesses such as obesity, cancer, and diabetes has soared in recent years, generating new kinds of disparate medical challenges. In turn, these challenges have resulted in skyrocketing costs, preventable deaths, and medical malpractice claims. For example, studies have found nearly half of all US patients receive inadequate care each year, over 2 million are harmed by hospital-acquired infections, and over 1 million suffer disabling complications during surgery – even though half of these are thought to be avoidable. These challenges have catalyzed the beginning of a transformation in care delivery, from a health-care system that focuses on disease to one that must look after patients – including individuals and communities. To provide proper treatment to those who are chronically ill, the health-care system has to support improved individuals’ health-related practices prior to the manifestation of disease; ensure that a range of practitioners can deliver quality clinical care during the onset of an illness; and facilitate patient-provider-family partnerships during post-disease wellness care. As we describe in this review, key advances in networking and information technologies – spanning patient monitoring, data visualization and decision making, robotics and computer vision for diagnosis and surgery, social networking for fostering community-based support systems, and so on – stand to drive forward these changes. Together with social scientists, systems engineers, medical practitioners, and computer scientists, information systems scholars can help alter the nature of care delivery well into the twenty-first century, ultimately contributing to a system that is much more safe, effective, reliable, and timely than it is today.

Author(s):  
Stephanie Morain ◽  
Nancy E. Kass ◽  
Ruth R. Faden

This chapter introduces the concept of a learning health care system (LHCS) and discusses the ethical issues that arise within the LHCS context. The LHCS has gained attention as an organizational innovation to improve the quality and efficiency of health care. In an LHCS, knowledge generation is built into the ongoing practice of clinical care, and findings based on this knowledge are continuously fed back to improve care delivery. The goals of an LHCS are arguably consistent with the moral obligation of health systems to improve quality, safety, and justice in health. However, the LHCS model also presents potential ethical challenges. This article discusses challenges related to continuous data generation, including maintaining privacy and confidentiality; obligations related to data on cost and quality; transparency to patients and other stakeholders; and data interoperability. It also describes issues related to the continued appropriateness of the research-practice distinction and implications for ethical oversight.


2019 ◽  
Vol 10 (05) ◽  
pp. 841-848 ◽  
Author(s):  
Hannah K. Galvin ◽  
Carolyn Petersen ◽  
Vignesh Subbian ◽  
Anthony Solomonides

AbstractAuthentic inclusion and engagement of behavioral health patients in their care delivery and in the process of scientific discovery are often challenged in the health care system. Consequently, there is a growing need to engage with and better serve the needs of behavioral health patients, particularly by leveraging health information technologies. In this work, we present rationale and strategies for improving patient engagement in this population in research and clinical care. First, we describe the potential for creating meaningful patient–investigator partnerships in behavioral health research to allow for cocreation of knowledge with patients. Second, in the context of behavioral health services, we explore the utility of sharing clinical notes to promote patients' agency in care delivery. Both lines of inquiry are centered in a Learning Health System model for behavioral health, where patients are agents in enhancing the therapeutic alliance and advancing the process of knowledge generation. Recommendations include genuinely democratizing the health care system and biomedical research enterprise through patient-centered information technologies such as patient portals. In research and technology development, we recommend seeking and tailoring behavioral health patients' involvement to their abilities, promoting patient input in data analysis plans, evaluating research and informatics initiatives for patients and clinicians, and sharing success and research findings with patients. In clinical practice, we recommend encouraging patients to read behavioral health notes on portals, engaging in proactive communication regarding note content, assessing outcomes including stress and anxiety in response to note content, and working with technology providers to support note-sharing governance and deployment.


2019 ◽  
Vol 7 (5) ◽  
pp. 717-725
Author(s):  
Jacqueline H Stephens ◽  
Maree O’Keefe ◽  
Mark Schembri ◽  
Peter A Baghurst

Objective: To explore the experiences, expectations, and motivations of parents/caregivers of children with otitis media who were booked to undergo tympanostomy tube insertion. Method: A cross-sectional cohort study was conducted using semistructured interviews with 39 parents. Interviews were conducted via telephone and analyzed for key themes. Results: Three themes emerged that incorporated a range of subthemes: (1) the impact of the child’s underlying condition on the family, (2) the cues and prompts that influenced parents to seek intervention, and (3) the parents’ expectations of the health-care system. The child’s otitis media disrupted the day-to-day functioning of the family and the child’s well-being, but despite this, the families found ways to adapt and cope. Parents were influenced by their friends, family, and medical practitioners when making treatment decisions and had differing expectations of the health-care system. Conclusion: Parents need support during their child’s illness to help with pressures placed on the family and also in making health-care decisions for their child. Clinicians should consider these issues when discussing treatment options with parents.


2021 ◽  
Vol 12 ◽  
pp. 215013272110535
Author(s):  
Nathan Wright ◽  
Marylee Scherdt ◽  
Michelle L. Aebersold ◽  
Marjorie C. McCullagh ◽  
Barbara R. Medvec ◽  
...  

Objectives: Rural residents comprise approximately 15% of the United States population. They face challenges in accessing and using a health care system that is not structured to meet their unique needs. It is important to understand rural residents’ perceptions of health and experiences interacting with the health care system to identify gaps in care. Methods: Our team conducted focus groups with members of the Michigan Farm Bureau during their 2019 Annual Meeting. Topics explored included resources to manage health, barriers to virtual health care services, and desired changes to localized healthcare delivery. Surveys were used to capture demographic and internet access information. Conclusion: Analysis included data from 2 focus groups (n = 14). Participants represented a wide age range and a variety of Michigan counties. The majority were full-time farm owners with most—93% (n = 13)—reporting they had access to the internet in their homes and 86% (n = 12) reporting that their cellphones had internet capabilities. Participants identified challenges and opportunities in 4 categories: formal health care; health and well-being supports; health insurance experiences; and virtual health care. Conclusion: The findings from this study provide a useful framework for developing interventions to address the specific needs of rural farming residents. Despite the expressed challenges in access and use of health care services and resources, participants remained hopeful that innovative approaches, such as virtual health platforms, can address existing gaps in care. The study findings should inform the design and evaluation of interventions to address rural health disparities.


2003 ◽  
Vol 31 (2) ◽  
pp. 213-221 ◽  
Author(s):  
Ruiping Fan

It is generally recognized that China, while attempting to develop modern scientific medicine in carrying out its national policy for modernization, has also made significant efforts to integrate traditional Chinese medicine into its health care system. For instance, the World Health Organization's first global strategy on traditional and alternative medicine (released in May 2002) lists China as one of only four of its member states to have attained an integrative health care system. However, medical integration can take many different forms and involve quite different health care standards. A health care standard is a set of mechanisms by which distinct diagnostic and therapeutic practices and products are validated or accredited for use in health care delivery. Traditional Chinese medicine and modern scientific medicine adopt different sets of such mechanisms and thereby engage different health care standards. Accordingly, in appraising the Chinese integrative health care system, it is important to investigate which health care standard has been appealed to.


2021 ◽  
Author(s):  
Rochelle D. Jones ◽  
Chris Krenz ◽  
Kent A. Griffith ◽  
Rebecca Spence ◽  
Angela R. Bradbury ◽  
...  

PURPOSE: Scholars have examined patients' attitudes toward secondary use of routinely collected clinical data for research and quality improvement. Evidence suggests that trust in health care organizations and physicians is critical. Less is known about experiences that shape trust and how they influence data sharing preferences. MATERIALS AND METHODS: To explore learning health care system (LHS) ethics, democratic deliberations were hosted from June 2017 to May 2018. A total of 217 patients with cancer participated in facilitated group discussion. Transcripts were coded independently. Finalized codes were organized into themes using interpretive description and thematic analysis. Two previous analyses reported on patient preferences for consent and data use; this final analysis focuses on the influence of personal lived experiences of the health care system, including interactions with providers and insurers, on trust and preferences for data sharing. RESULTS: Qualitative analysis identified four domains of patients' lived experiences raised in the context of the policy discussions: (1) the quality of care received, (2) the impact of health care costs, (3) the transparency and communication displayed by a provider or an insurer to the patient, and (4) the extent to which care coordination was hindered or facilitated by the interchange between a provider and an insurer. Patients discussed their trust in health care decision makers and their opinions about LHS data sharing. CONCLUSION: Additional resources, infrastructure, regulations, and practice innovations are needed to improve patients' experiences with and trust in the health care system. Those who seek to build LHSs may also need to consider improvement in other aspects of care delivery.


Author(s):  
Gunnar Almgren

The basic premise of this chapter is that we have at our disposal a wealth of evidence-based knowledge of critical health care delivery strategies that would, if implemented on a large scale, yield both a social right to health care for all citizens and favorable population health care outcomes at lower cost. This chapter provides a synthesis of this knowledge, and then identifies a limited set of very specific health care system delivery reforms that meet three evaluative criteria: equity, sustainability, and political feasibility. Equity refers to the extent to which any particular health care system delivery reform achieves a fair balance between the competing interests of different segments of the patient population and society at large. Sustainability refers to the extent to which a health care system delivery reform initiative yields favorable impacts on population health while realizing large reductions in immediate and future health care costs. Finally, political feasibility refers to the likelihood of a given health care system delivery reform in view of the competing interests of different stakeholder groups affected. This chapter offers a principled and empirically justified blueprint for the most promising health care system delivery reforms towards the fulfillment of these three ends.


2019 ◽  
Vol 35 (3) ◽  
pp. 185-191 ◽  
Author(s):  
David A. Agom ◽  
Stuart Allen ◽  
Sarah Neill ◽  
Judith Sixsmith ◽  
Helen Poole ◽  
...  

Background: There is a dearth of research focusing on identifying the social complexities impacting on oncology and palliative care (PC), and no study has explored how the health-care system in Nigeria or other African contexts may be influencing utilization of these services. Aim: This study explored how social complexities and the organization of health-care influenced the decision-making process for the utilization of oncology and PC in a Nigerian hospital. Methods: This qualitative study used an interpretive descriptive design. Data were collected using semistructured interview guides with 40 participants, comprising health-care professionals, patients, and their families. Thematic analysis was conducted to generate and analyze patterns within the data. Findings: Three themes were identified: dysfunctional structural organization of the health-care delivery system, service-users’ economic status, and the influence of social networks. The interrelationship between the themes result in patients and their family members decisions either to present late to the hospital, miss their clinical appointments, or not to seek oncological health care and PC. Conclusion: This article offers insights into the role of the health-care system, as organized currently in Nigeria, as “autoinhibitory” and not adequately prepared to address the increasing burden of cancer. We therefore argue that there is a need to restructure the Nigerian health-care system to better meet the needs of patients with cancer and their families as failure to do so will strengthen the existing inequalities, discourage usage, and increase mortality.


2019 ◽  
Vol 31 (4) ◽  
pp. 397-405 ◽  
Author(s):  
Comfort Tosin Adebayo ◽  
Kimberly Walker ◽  
Maren Hawkins ◽  
Oluwatoyin Olukotun ◽  
Leslie Shaw ◽  
...  

Effective communication is integral to the patient–provider relationship. Yet, as a result of structural factors that ignore the unique health care needs of different populations of patients who identify as Black—both African American and African immigrants—are confronted with communication challenges during health care seeking encounters. Using cultural safety as a framework, in this article, we thematically review communication challenges specifically experienced by patients of African descent in the U.S. health care system. In our review, we focus on complications that might arise from discrimination, mistrust, health literacy, and impacts of culture and language barriers on health literacy. In conclusion, we offer recommendations for improving the health care experiences and potential health outcomes for this population, through nursing care and health care delivery.


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