Health Care System III Equipped To Handle Chronic Conditions

Background Current health care systems are rarely designed to meet the needs of people living with chronic conditions. However, some patients and informal caregivers are not waiting for the health care system to redesign itself. These individuals are sometimes referred to as e-patients. The first generation of e-patients used the internet for finding information and for communicating with peers. Compared with the first generation, the second generation of e-patients collects their own health data and appears to be more innovative. Objective The aim of this study was to describe the second generation of e-patients through exploration of their active engagement in their self-care and health care. Methods Semistructured interviews were conducted with 10 patients with chronic conditions and 5 informal caregivers. They were all recruited through a Web-based advertisement. Data were analyzed according to the framework analysis approach, using the 3 concepts of the self-determination theory—autonomy, relatedness, and competence—at the outset. Results Study participants were actively engaged in influencing their self-care and the health care system to improve their own health, as well as the health of others. This occurred at different levels, such as using their own experience when giving presentations and lectures to health care professionals and medical students, working as professional peers in clinical settings, performing self-tracking, contributing with innovations, and being active on social media. When interaction with health care providers was perceived as being insufficient, the participants sought support through their peers, which showed strong relatedness. Competence increased through the use of technology and learning experiences with peers. Their autonomy was important but was sometimes described as involuntary and to give up was not an option for them. Conclusions Like the first generation of e-patients, the participants frequently searched for Web-based information. However, the second generation of e-patients also produce their own health data, which they learn from and share. They also engage in the innovation of digital tools to meet health-related needs. Utilizing technological developments comes naturally to the second generation of e-patients, even if the health care system is not prepared to support them under these new circumstances.

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The Challenge of Comprehensive Care

Clinical Scholars Review ◽

10.1891/1939-2095.8.1.84 ◽

2015 ◽

Vol 8 (1) ◽

pp. 84-86

Author(s):

Dawn Bucher

Keyword(s):

Health Care ◽

Health Care System ◽

Nurse Practitioners ◽

Chronic Conditions ◽

Nursing Practice ◽

Comprehensive Care ◽

Multiple Chronic Conditions ◽

Independent Practice ◽

Doctor Of Nursing Practice ◽

Care System

Adults are living longer with multiple chronic conditions. There are many challenges to providing comprehensive care to patients around the country in today’s system. This article, although personal, discusses some challenges seen by the writer but witnessed by many. It also looks at some challenges nurse practitioners have when practicing in multiple states across the country. Lastly, I offer my opinion on certification as a Diplomate of Comprehensive Care for all Doctor of Nursing Practice clinicians who provide comprehensive care in independent practice settings. It is time to provide safe, quality, comprehensive care to our patients in a reputable health care system.

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People Centeredness, Chronic Conditions and Diversity Sensitive eHealth: Exploring Emancipation of the ‘Health Care System’ and the ‘Patient’ in Health Informatics

Life ◽

10.3390/life10120329 ◽

2020 ◽

Vol 10 (12) ◽

pp. 329

Author(s):

Lars Botin ◽

Pernille S. Bertelsen ◽

Lars Kayser ◽

Paul Turner ◽

Sidsel Villumsen ◽

...

Keyword(s):

Health Care ◽

Health Care System ◽

Health Informatics ◽

Chronic Conditions ◽

Access To Health Care ◽

Health Care Services ◽

Health Care Systems ◽

User Engagement ◽

Care Systems ◽

Care System

Health care systems struggle to consistently deliver integrated high-quality, safe, and patient-centered care to all in an economically sustainable manner. Inequity of access to health care services and variation in diagnostic and treatment outcomes are common. Further, as health care systems become ever more complex, iatrogenesis and counter productivity have emerged as real dangers. In exploring this paradox, this paper considers a subset of those in society living with chronic conditions. Their attributes and circumstances have led to them being marginalized or excluded from ‘end-user’ engagement and/or from their requirements being incorporated into technology supported chronic disease management initiatives. Significantly, these citizens are often the most vulnerable and socially disadvantaged and tend to achieve poorer results and cost more per capita than the ‘average patient’ in their interactions with the health care system. Critically, this paper argues that a truly people-centered technology supported chronic care system can only be designed by understanding and responding to the needs, attributes and capabilities of the most vulnerable in society. This paper suggests innovative ways of supporting interactions with these ‘end-users’ and highlights how reflection on these approaches can contribute to emancipating the health system to move towards more socially inclusive eHealth solutions.

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From Information Seekers to Innovators: Qualitative Analysis Describing Experiences of the Second Generation of E-Patients (Preprint)

10.2196/preprints.13022 ◽

2019 ◽

Author(s):

Therese Scott Duncan ◽

Sara Riggare ◽

Sabine Koch ◽

Lena Sharp ◽

Maria Hägglund

Keyword(s):

Health Care ◽

Health Care System ◽

Chronic Conditions ◽

First Generation ◽

Second Generation ◽

Informal Caregivers ◽

Self Care ◽

Health Data ◽

Web Based ◽

Care System

BACKGROUND Current health care systems are rarely designed to meet the needs of people living with chronic conditions. However, some patients and informal caregivers are not waiting for the health care system to redesign itself. These individuals are sometimes referred to as e-patients. The first generation of e-patients used the internet for finding information and for communicating with peers. Compared with the first generation, the second generation of e-patients collects their own health data and appears to be more innovative. OBJECTIVE The aim of this study was to describe the second generation of e-patients through exploration of their active engagement in their self-care and health care. METHODS Semistructured interviews were conducted with 10 patients with chronic conditions and 5 informal caregivers. They were all recruited through a Web-based advertisement. Data were analyzed according to the framework analysis approach, using the 3 concepts of the self-determination theory—autonomy, relatedness, and competence—at the outset. RESULTS Study participants were actively engaged in influencing their self-care and the health care system to improve their own health, as well as the health of others. This occurred at different levels, such as using their own experience when giving presentations and lectures to health care professionals and medical students, working as professional peers in clinical settings, performing self-tracking, contributing with innovations, and being active on social media. When interaction with health care providers was perceived as being insufficient, the participants sought support through their peers, which showed strong relatedness. Competence increased through the use of technology and learning experiences with peers. Their autonomy was important but was sometimes described as involuntary and to give up was not an option for them. CONCLUSIONS Like the first generation of e-patients, the participants frequently searched for Web-based information. However, the second generation of e-patients also produce their own health data, which they learn from and share. They also engage in the innovation of digital tools to meet health-related needs. Utilizing technological developments comes naturally to the second generation of e-patients, even if the health care system is not prepared to support them under these new circumstances.

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People-Centeredness, Chronic Conditions and Diversity Sensitive eHealth: Exploring Emancipation of the ‘Health Care System’ and the ‘Patient’ in Health Informatics

10.20944/preprints202010.0604.v1 ◽

2020 ◽

Author(s):

Lars Botin ◽

Pernille S. Bertelsen ◽

Christian Nøhr

Keyword(s):

Health Care ◽

Health System ◽

Health Care System ◽

Health Informatics ◽

Chronic Conditions ◽

Chronic Care ◽

End Users ◽

Care System

Critically the paper argues that a truly people-centered technology supported chronic care system can only be designed by understanding and responding to the needs, attributes and capabilities of the most vulnerable in society. The paper suggests innovative ways of supporting interactions with these ‘end-users’ and highlights how reflection on these approaches can contribute to emancipating both the health system to move towards more socially inclusive e-health solutions.

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Does pay-for-performance benefit patients with multiple chronic conditions? Evidence from a universal coverage health care system

Health Policy and Planning ◽

10.1093/heapol/czv024 ◽

2015 ◽

Vol 31 (1) ◽

pp. 83-90 ◽

Cited By ~ 12

Author(s):

Chi-Chen Chen ◽

Shou-Hsia Cheng

Keyword(s):

Health Care ◽

Health Care System ◽

Chronic Conditions ◽

Pay For Performance ◽

Universal Coverage ◽

Multiple Chronic Conditions ◽

Care System

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Teletinnitus Program at the VA Gulf Coast Veterans Health Care System

Perspectives on Telepractice ◽

10.1044/teles4.1.23 ◽

2014 ◽

Vol 4 (1) ◽

pp. 23-29

Author(s):

Constance Hilory Tomberlin

Keyword(s):

Health Care ◽

Patient Satisfaction ◽

Patient Care ◽

Health Care System ◽

Gulf Coast ◽

New Technology ◽

Cost Effective ◽

Veterans Health ◽

Potential Benefits ◽

Care System

There are a multitude of reasons that a teletinnitus program can be beneficial, not only to the patients, but also within the hospital and audiology department. The ability to use technology for the purpose of tinnitus management allows for improved appointment access for all patients, especially those who live at a distance, has been shown to be more cost effective when the patients travel is otherwise monetarily compensated, and allows for multiple patient's to be seen in the same time slots, allowing for greater access to the clinic for the patients wishing to be seen in-house. There is also the patient's excitement in being part of a new technology-based program. The Gulf Coast Veterans Health Care System (GCVHCS) saw the potential benefits of incorporating a teletinnitus program and began implementation in 2013. There were a few hurdles to work through during the beginning organizational process and the initial execution of the program. Since the establishment of the Teletinnitus program, the GCVHCS has seen an enhancement in patient care, reduction in travel compensation, improvement in clinic utilization, clinic availability, the genuine excitement of the use of a new healthcare media amongst staff and patients, and overall patient satisfaction.

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