scholarly journals Use of patient-generated health data across healthcare settings: implications for health systems

JAMIA Open ◽  
2019 ◽  
Vol 3 (1) ◽  
pp. 70-76 ◽  
Author(s):  
Elizabeth Austin ◽  
Jenney R Lee ◽  
Dagmar Amtmann ◽  
Rich Bloch ◽  
Sarah O Lawrence ◽  
...  
Keyword(s):  
Case Studies ◽  
Health Systems ◽  
Chronic Conditions ◽  
Care Delivery ◽  
Clinical Care ◽  
Health Data ◽  
Mobile Technologies ◽  
Detailed Case ◽  
Healthcare Settings ◽  
Gastrointestinal Conditions

Abstract Objective The growing prevalence of chronic conditions requiring changes in lifestyle and at-home self-management has increased interest in and need for supplementing clinic visits with data generated by patients outside the clinic. Patient-generated health data (PGHD) support the ability to diagnose and manage chronic conditions, to improve health outcomes, and have the potential to facilitate more “connected health” between patients and their care teams; however, health systems have been slow to adopt PGHD use in clinical care. Materials and Methods We surveyed current and potential users of PGHD to catalog how PGHD is integrated into clinical care at an academic health center. The survey included questions about data type, method of collection, and clinical uses of PGHD. Current users were asked to provide detailed case studies of PGHD use in research and care delivery. Results Thirty-one respondents completed the survey. Seventeen individuals contributed detailed case studies of PGHD use across diverse areas of care, including behavioral health, metabolic and gastrointestinal conditions, musculoskeletal/progressive functional conditions, cognitive symptoms, and pain management. Sensor devices and mobile technologies were the most commonly reported platforms for collection. Clinicians and researchers involved in PGHD use cited the potential for PGHD to enhance care delivery and outcomes, but also indicated substantial barriers to more widespread PGHD adoption across healthcare systems. Conclusion The results of our survey illustrate how PGHD is used in targeted areas of one healthcare system and provide meaningful insights that can guide health systems in supporting the widespread use of PGHD in care delivery.

scholarly journals Person-centred care in complementary medicine for individuals with chronic conditions in Australia

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
H Foley ◽  
A Steel ◽  
J Adams
Keyword(s):  
Public Health ◽  
Complementary Medicine ◽  
Health Systems ◽  
Chronic Conditions ◽  
Clinical Care ◽  
Medical Doctors ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Public Health Burden ◽  
Public Health Systems

Abstract Background Increasing chronic condition diagnoses burden public health systems, individuals and communities. The duration and complexity of chronic conditions require ongoing, multifaceted care - such as person-centred care (PCC) - to address the individual needs and quality of life for patients. Many patients with chronic conditions seek additional care outside mainstream medicine, often consulting complementary medicine (CM) practitioners. This study examines the extent of PCC being experienced by patients with chronic conditions who consult CM practitioners. Methods Cross-sectional survey (n = 191), conducted nationally, November 2018 to March 2019, in clinics of the five CM professions most commonly consulted by individuals with chronic conditions in Australia (massage, chiropractic, osteopathy, acupuncture, naturopathy). Participants with chronic conditions (n = 153) were surveyed about experiences of PCC during CM consultation, and regarding consultation with medical doctors, using four validated measures. Results During consultation with CM practitioners, patient perceptions of PCC were consistently high. Ratings of PCC were consistently higher for consultations with any CM practitioners (summary mean 3.33) than consultations with medical doctors (summary mean 2.95). The highest mean scores for PCC were reported by patients of naturopaths (summary mean 4.04). Variations in perceived PCC for different items between professions indicate nuance in the experience of consultation across different CM professions. Conclusions This study indicates PCC is characteristic of CM consultation, which may reflect CM philosophies such as holism. CM practitioners may present an existing resource of PCC. Further attention should be given to CM professions regarding the potential to address unmet needs of individuals with chronic conditions, and subsequently to better manage the public health burden associated with chronic conditions. Key messages Person-centred care appears to be a consistent characteristic of complementary medicine clinical care for individuals with chronic conditions. Due to rising rates of chronic conditions and the associated burden on public health systems, complementary medicine professions should be considered as a resource to optimise chronic illness care.

Palliative care delivery models

2021 ◽  
pp. 111-120
Author(s):  
Irene J. Higginson
Keyword(s):  
Palliative Care ◽  
Care Delivery ◽  
Clinical Care ◽  
Symptom Control ◽  
Palliative Care Service ◽  
Specialist Palliative Care ◽  
Course Of Illness ◽  
Medical Speciality ◽  
Care Services ◽  
Healthcare Settings

Palliative care has grown rapidly across the globe, with a network of services. It is variably a medical speciality or subspeciality, often with academic departments and with different levels of integration. As the population ages and as treatments extend life for children, younger and older people with chronic diseases, and in particular as multimorbidity is growing, so palliative care is more important. Specialist palliative care service are dedicated to palliative care, have staff trained in palliative care, and in addition to providing clinical care, engage in education, research, and the measurement of outcomes. As palliative care extends to support patients with organ failure, dementia, and earlier in the course of illness, new models are emerging. These include short-term palliative care services, working in an integrated way with other services. Principles common to all services include a holistic approach (physical, emotional, social, and spiritual), considering the patient and those important to them as the unit of care, and with impeccable attention to listening, communication, individualized care, and support in decision-making. People with advanced and progressive illness are found in almost all healthcare settings. Therefore, all doctors, nurses, and other health and social care professionals have to offer and know general palliative care and symptom control. Specialist palliative care teams often support those working in general settings with specific tools and/or training.

scholarly journals Ethical challenges in argumentation and dialogue in a healthcare context

2020 ◽  
pp. 1-16
Author(s):  
Mark Snaith ◽  
Rasmus Øjvind Nielsen ◽  
Sita Ramchandra Kotnis ◽  
Alison Pease
Keyword(s):  
Health Systems ◽  
Chronic Conditions ◽  
Cost Effective ◽  
Health Data ◽  
Chronic Illnesses ◽  
Limited Resources ◽  
Effective Solution ◽  
Ethical Challenges ◽  
Health Advice ◽  
Future Work

As the average age of the population increases, so too do the number of people living with chronic illnesses. With limited resources available, the development of dialogue-based e-health systems that provide justified general health advice offers a cost-effective solution to the management of chronic conditions. It is however imperative that such systems are responsible in their approach. We present in this paper two main challenges for the deployment of e-health systems, that have a particular relevance to dialogue and argumentation: collecting and handling health data, and trust. For both challenges, we look at specific issues therein, outlining their importance in general, and describing their relevance to dialogue and argumentation. Finally, we go on to propose six recommendations for handling these issues, towards addressing the main challenges themselves, that act both as general advice for dialogue and argumentation research in the e-health domain, and as a foundation for future work on this topic.

mHealth: Mobile Technologies to Virtually Bring the Patient Into an Oncology Practice

2017 ◽  
pp. 144-154 ◽  
Author(s):  
Nathan A. Pennell ◽  
Adam P. Dicker ◽  
Christine Tran ◽  
Heather S. L. Jim ◽  
David L. Schwartz ◽  
...  
Keyword(s):  
Health Care ◽  
Clinical Practice ◽  
Health Care Providers ◽  
Care Delivery ◽  
Clinical Care ◽  
Quality Care ◽  
Cost Effective ◽  
Mobile Technologies ◽  
Care Providers ◽  
Oncology Practice

Accompanied by the change in the traditional medical landscape, advances in wireless technology have led to the development of telehealth or mobile health (mHealth), which offers an unparalleled opportunity for health care providers to continually deliver high-quality care. This revolutionary shift makes the patient the consumer of health care and empowers patients to be the driving force of management of their own health through mobile devices and wearable technology. This article presents an overview of technology as it pertains to clinical practice considerations. Telemedicine is changing the way clinical care is delivered without regard for proximity to the patient, whereas nonclinical telehealth applications affect distance education for consumers or clinicians, meetings, research, continuing medical education, and health care management. Technology has the potential to reduce administrative burdens and improve both efficiency and quality of care delivery in the clinic. Finally, the potential for telehealth approaches as cost-effective ways to improve adherence to treatment is explored. As telehealth advances, health care providers must understand the fundamental framework for applying telehealth strategies to incorporate into successful clinical practice.

scholarly journals Opportunities and challenges to advance the use of electronic patient-reported outcomes in clinical care: a report from AMIA workshop proceedings

JAMIA Open ◽  
2019 ◽  
Vol 2 (4) ◽  
pp. 407-410
Author(s):  
Elizabeth Austin ◽  
Cynthia LeRouge ◽  
Andrea L Hartzler ◽  
Arlene E Chung ◽  
Courtney Segal ◽  
...  
Keyword(s):  
Human Factors ◽  
Health Systems ◽  
Patient Reported Outcomes ◽  
Data Science ◽  
Care Delivery ◽  
Clinical Care ◽  
Healthcare Delivery ◽  
Patient Centered ◽  
Patient Reported ◽  
Interactive Workshop

Abstract Despite the demonstrated value of patient-centered care, health systems have been slow to integrate the patient’s voice into care delivery through patient-reported outcomes (PROs) with electronic tools. This is due in part to the complex interplay of technology, workflow, and human factors that shape the success of electronic PROs (ePROs) use. The 2018 American Medical Informatics Association Annual Symposium served as the setting for a half-day interactive workshop with diverse stakeholders to discuss proposed best practices for the planning, design, deployment, and evaluation of ePROs. We provide this collective commentary that synthesizes participant feedback regarding critical challenges that prohibit the scale and spread of ePROs across healthcare delivery systems, including governance and leadership, workflow and human factors, informatics, and data science. In order to realize the promise of ePROs at scale, adaptable approaches are critical to balance the needs of individual users with health systems at large.

scholarly journals World Patient Safety Day: the Tuscany region at the forefront of quality of care

2020 ◽  
Vol 32 (3) ◽  
pp. 221-222
Author(s):  
Sara Albolino ◽  
Giulia Dagliana
Keyword(s):  
Patient Safety ◽  
Adverse Events ◽  
Health Systems ◽  
Health Professionals ◽  
Care Delivery ◽  
Clinical Care ◽  
Patient Safety Culture ◽  
World Health ◽  
To Come ◽  
The Impact

Abstract Echoing the World Health Organization’s (WHO) request, the Patient Safety Declaration, launched by Health First Europe at the European Parliament, calls on policymakers, authorities and health professionals, patients and citizens to come together to build health systems that can help health professionals work better for patient-centred outcomes. The objective is to prevent the occurrence of adverse events arising from clinical care activities to focus resources on reducing the impact of the disease by promoting safer health systems and higher quality standards for patient safety in Europe. The Declaration intends to promote a European patient safety culture, starting with safety practices and exchanging effective practices to reduce adverse events arising from health activities. Tuscany, the fifth largest region of Italy, is strongly committed to make this happen. Its Regional Centre for Clinical Risk Management and Patient Safety and WHO Collaborating Centre (GRC Centre—Centro Gestione Rischio Clinico e Sicurezza del Paziente) aims at developing and promoting practices for safety, awareness raising and the analysis of adverse events for the constant improvement of care delivery.

Provision of Palliative Care in Low- and Middle-Income Countries: Overcoming Obstacles for Effective Treatment Delivery

2016 ◽  
Vol 34 (1) ◽  
pp. 62-68 ◽  
Author(s):  
Breffni Hannon ◽  
Camilla Zimmermann ◽  
Felicia M. Knaul ◽  
Richard A. Powell ◽  
Faith N. Mwangi-Powell ◽  
...  
Keyword(s):  
Palliative Care ◽  
Health Systems ◽  
Care Delivery ◽  
Clinical Care ◽  
Scale Up ◽  
Cancer Case ◽  
Public Health Approach ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low And Middle Income

Despite being declared a basic human right, access to adult and pediatric palliative care for millions of individuals in need in low- and middle-income countries (LMICs) continues to be limited or absent. The requirement to make palliative care available to patients with cancer is increasingly urgent because global cancer case prevalence is anticipated to double over the next two decades. Fifty percent of these cancers are expected to occur in LMICs, where mortality figures are disproportionately greater as a result of late detection of disease and insufficient access to appropriate treatment options. Notable initiatives in many LMICs have greatly improved access to palliative care. These can serve as development models for service scale-up in these regions, based on rigorous evaluation in the context of specific health systems. However, a multipronged public health approach is needed to fulfill the humane and ethical obligation to make palliative care universally available. This includes health policy that supports the integration of palliative care and investment in systems of health care delivery; changes in legislation and regulation that inappropriately restrict access to opioid medications for individuals with life-limiting illnesses; education and training of health professionals; development of a methodologically rigorous data and research base specific to LMICs that encompasses health systems and clinical care; and shifts in societal and health professional attitudes to palliative and end-of-life care. International partnerships are valuable to achieve these goals, particularly in education and research, but leadership and health systems stewardship within LMICs are critical factors that will drive and implement change.

(Preprint)

2018 ◽  
Author(s):  
Ram Dixit ◽  
Sahiti Myneni
Keyword(s):  
Cancer Survivors ◽  
Mental Models ◽  
Health Systems ◽  
Information Needs ◽  
Health Data ◽  
Information Architecture ◽  
Personal Health ◽  
User Centered Design ◽  
Card Sort ◽  
Connected Health

BACKGROUND Connected Health technologies are a promising solution for chronic disease management. However, the scope of connected health systems makes it difficult to employ user-centered design in their development, and poorly designed systems can compound the challenges of information management in chronic care. The Digilego Framework addresses this problem with informatics methods that complement quantitative and qualitative methods in system design, development, and architecture. OBJECTIVE To determine the accuracy and validity of the Digilego information architecture of personal health data in meeting cancer survivors’ information needs. METHODS We conducted a card sort study with 9 cancer survivors (patients and caregivers) to analyze correspondence between the Digilego information architecture and cancer survivors’ mental models. We also analyzed participants’ card sort groups qualitatively to understand their conceptual relations. RESULTS We observed significant correlation between the Digilego information architecture and cancer survivors’ mental models of personal health data. Heuristic analysis of groups also indicated informative discordances and the need for patient-centric categories relating health tracking and social support in the information architecture. CONCLUSIONS Our pilot study shows that the Digilego Framework can capture cancer survivors’ information needs accurately; we also recognize the need for larger studies to conclusively validate Digilego information architectures. More broadly, our results highlight the importance of complementing traditional user-centered design methods and innovative informatics methods to create patient-centered connected health systems.

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