scholarly journals The Development of a Web-Based, Patient-Centered Intervention for Patients With Chronic Myeloid Leukemia (CMyLife): Design Thinking Development Approach

10.2196/15895 ◽  
2020 ◽  
Vol 22 (5) ◽  
pp. e15895 ◽  
Author(s):  
Geneviève ICG Ector ◽  
Peter E Westerweel ◽  
Rosella PMG Hermens ◽  
Karin AE Braspenning ◽  
Barend CM Heeren ◽  
...  
Keyword(s):  
Health Care ◽  
Chronic Myeloid Leukemia ◽  
Treatment Outcomes ◽  
Myeloid Leukemia ◽  
Design Thinking ◽  
Care Delivery ◽  
Added Value ◽  
Care Process ◽  
Patient Centered ◽  
Web Based

Background With the global rise in chronic health conditions, health care is transforming, and patient empowerment is being emphasized to improve treatment outcomes and reduce health care costs. Patient-centered innovations are needed. We focused on patients with chronic myeloid leukemia (CML), a chronic disease with a generally good long-term prognosis because of the advent of tyrosine kinase inhibitors. However, both medication adherence by patients and guideline adherence by physicians are suboptimal, unnecessarily jeopardizing treatment outcomes. Objective The aim of this study was to develop a patient-centered innovation for patients with CML using a design thinking methodology. Methods The 5 phases of design thinking (ie, empathize, define, ideate, prototype, and test) were completed, and each phase started with the patient. Stakeholders and end users were identified and interviewed, and observations in the care system were made. Using tools in human-centered design, problems were defined and various prototypes of solutions were generated. These were evaluated by patients and stakeholders and then further refined. Results The patients desired (1) insights into their own disease; (2) insights into the symptoms experienced, both in terms of knowledge and comprehension; and (3) improvements in the organization of care delivery. A web-based platform, CMyLife, was developed and pilot-tested. It has multiple features, all targeting parts of the bigger solution, including a website with reliable information and a forum, a guideline app, personal medical records with logs of symptoms and laboratory results (including a molecular marker and linked to the guideline app), tailored feedback based on the patients’ symptoms and/or results, screen-to-screen consulting, delivery of medication, and the collection of blood samples at home. Conclusions The multifeatured innovation, CMyLife, was developed in a multidisciplinary way and with active patient participation. The aim of developing CMyLife was to give patients the tools to monitor their results, interpret these results, and act on them. With this tool, they are provided with the know-how to consider their results in relation to their personal care process. Whether CMyLife achieves its goal and the evaluation of the added value will be the focus of future studies. CML could become the first malignancy for which patients are able to monitor and manage their disease by themselves.

scholarly journals The Development of a Web-Based, Patient-Centered Intervention for Patients With Chronic Myeloid Leukemia (CMyLife): Design Thinking Development Approach (Preprint)

2019 ◽  
Author(s):  
Geneviève ICG Ector ◽  
Peter E Westerweel ◽  
Rosella PMG Hermens ◽  
Karin AE Braspenning ◽  
Barend CM Heeren ◽  
...  
Keyword(s):  
Health Care ◽  
Chronic Myeloid Leukemia ◽  
Treatment Outcomes ◽  
Myeloid Leukemia ◽  
Design Thinking ◽  
Care Delivery ◽  
Added Value ◽  
Care Process ◽  
Patient Centered ◽  
Web Based

BACKGROUND With the global rise in chronic health conditions, health care is transforming, and patient empowerment is being emphasized to improve treatment outcomes and reduce health care costs. Patient-centered innovations are needed. We focused on patients with chronic myeloid leukemia (CML), a chronic disease with a generally good long-term prognosis because of the advent of tyrosine kinase inhibitors. However, both medication adherence by patients and guideline adherence by physicians are suboptimal, unnecessarily jeopardizing treatment outcomes. OBJECTIVE The aim of this study was to develop a patient-centered innovation for patients with CML using a design thinking methodology. METHODS The 5 phases of design thinking (ie, empathize, define, ideate, prototype, and test) were completed, and each phase started with the patient. Stakeholders and end users were identified and interviewed, and observations in the care system were made. Using tools in human-centered design, problems were defined and various prototypes of solutions were generated. These were evaluated by patients and stakeholders and then further refined. RESULTS The patients desired (1) insights into their own disease; (2) insights into the symptoms experienced, both in terms of knowledge and comprehension; and (3) improvements in the organization of care delivery. A web-based platform, CMyLife, was developed and pilot-tested. It has multiple features, all targeting parts of the bigger solution, including a website with reliable information and a forum, a guideline app, personal medical records with logs of symptoms and laboratory results (including a molecular marker and linked to the guideline app), tailored feedback based on the patients’ symptoms and/or results, screen-to-screen consulting, delivery of medication, and the collection of blood samples at home. CONCLUSIONS The multifeatured innovation, CMyLife, was developed in a multidisciplinary way and with active patient participation. The aim of developing CMyLife was to give patients the tools to monitor their results, interpret these results, and act on them. With this tool, they are provided with the know-how to consider their results in relation to their personal care process. Whether CMyLife achieves its goal and the evaluation of the added value will be the focus of future studies. CML could become the first malignancy for which patients are able to monitor and manage their disease by themselves.

scholarly journals Unique Challenges for Otolaryngology Patients During the COVID-19 Pandemic

2020 ◽  
pp. 019459982095483
Author(s):  
Melissa Ghulam-Smith ◽  
Yeyoon Choi ◽  
Heather Edwards ◽  
Jessica R. Levi
Keyword(s):  
Health Care ◽  
Health Care Delivery ◽  
Care Delivery ◽  
Patient Centered Care ◽  
Patient Centered ◽  
Intimate Contact ◽  
Respiratory Mucosa ◽  
Increased Risk ◽  
Centered Care ◽  
Upper Respiratory

The coronavirus disease 2019 (COVID-19) pandemic has drastically altered health care delivery and utilization. The field of otolaryngology in particular has faced distinct challenges and an increased risk of transmission as day-to-day procedures involve intimate contact with a highly infectious upper respiratory mucosa. While the difficulties for physicians have been thoroughly discussed, the unique challenges of patients have yet to be considered. In this article, we present challenges for patients of otolaryngology that warrant thoughtful consideration and propose solutions to address these challenges to maintain patient-centered care both during and in the aftermath of the COVID-19 pandemic.

scholarly journals Cultivating Connection: The Magic of Attuning, Wondering, Following & Holding

2018 ◽  
Vol 2 (1) ◽  
Author(s):  
Ann Flanagan Petry
Keyword(s):  
Health Care ◽  
Patient Experience ◽  
Nursing Care ◽  
Interpersonal Relations ◽  
Care Delivery ◽  
Employee Attitudes ◽  
Patient Centered ◽  
Caring Relationships ◽  
Award Winning ◽  
And Performance

Remember what drew you to health care? And what makes your work meaningful now? Chances are caring for people is the answer to both questions. In fact, healthcare is provided through relationships. Over a decade ago we developed a care delivery framework described in the award-winning book Relationship-Based Care: A Model for Transforming Practice. We were on the vanguard of a revolution toward more patient-centered caring. Indeed, we have always known the importance of connection to patient experience, employee attitudes, interpersonal relations, teams and performance. For nurses, caring relationships are so essential at work that it is inseparable from the work itself. We believe the best nursing care requires understanding of three key relationships: A. Relationship to one’s self, B. Relationship to co-workers and C. Relationship to patients and families. And, the hallmark of meaningful connection is attunement or tuning-in to others with genuine interest and care.

scholarly journals Instilling the core concept of inter professional education

1970 ◽  
Vol 9 (3) ◽  
pp. 201-206
Author(s):  
S Bhattacharya ◽  
SK Bhattacharya ◽  
AP Gautam
Keyword(s):  
Health Care ◽  
Health Professional ◽  
Health Care Providers ◽  
Professional Education ◽  
Care Delivery ◽  
Care Providers ◽  
Patient Centered ◽  
Innovative Teaching ◽  
Centered Care ◽  
Teaching Learning

The Inter Professional Education (IPE) is an innovative teaching learning intervention in Health Professions’ Education during which members of more than one health profession learn interactively together to improve collaborative practice and/health of the patients. Thus this approach provides positive outcomes for students enhancing their awareness towards other professional groups, improving knowledge and understanding of how to work in an inter professional team and strengthening their communication and collaboration skills. Within the hierarchical nature of many clinical settings, the aims of IPE courses intersect with socialization of health professional (HP) students into roles of responsibility and authority. The IPE in HP courses emphasizes the practice of frequent high quality communication, strong relationships and partnerships among health care providers to maximize the quality of care thus improving the efficiency of care thereby improving clinical outcomes. Health Professional Schools are this motivated to opt for inter professional education to improve the learning of the students, health care delivery and patient outcomes. Keywords: Inter professional relations; patient centered care; education DOI: http://dx.doi.org/10.3126/hren.v9i3.5591   HR 2011; 9(3): 201-206

The Effects of a Practice Guideline on Endoscopic Sinus Surgery at an Academic Center

1997 ◽  
Vol 11 (2) ◽  
pp. 161-166 ◽  
Author(s):  
Michael G. Stewart ◽  
Edward J. Hillman ◽  
Donald T. Donovan ◽  
Sarper H. Tanli
Keyword(s):  
Health Care ◽  
Clinical Outcomes ◽  
Endoscopic Sinus Surgery ◽  
Care Delivery ◽  
Hospital Costs ◽  
Sinus Surgery ◽  
Care Process ◽  
Short Term ◽  
Academic Center ◽  
Median Hospital

Practice guidelines (PG) (or clinical pathways) are increasingly important tools for standardizing health care delivery, improving efficiency, monitoring quality, and controlling costs. Health services researchers divide the delivery of health care into three stages: structure, process, and outcome. PGs are a technique to standardize the process of health care delivery, which may result in improved clinical outcomes or may maintain clinical outcomes while increasing process efficiency and decreasing costs. We describe the development and implementation of a PG for endoscopic sinus surgery at an academic center, and report preliminary results on the effects of the PG on the health care process. The PG was developed using a multidisciplinary combination of consensus-building and evidence-based techniques. Initially, participation in the PG was voluntary and at the attending physician's discretion. One year after implementation of the PG, 41 patients had been enrolled by members of the medical school's full-time faculty. Process and short-term outcome variables on those patients were compared to a random sample of 50 patients treated by the same physicians, but not using the PG. There was no evidence of selection bias into the PG based on demographics, severity of sinusitis, or the presence of comorbid factors. There were no differences in time spent in the operating room, postanesthesia care unit, or day surgery observation unit, between patients using the PG and not using the PG. However, patients not using the PG had a significantly higher rate of unplanned admission. Patients using the PG had significantly lower median hospital costs and charges than did patients not using the PG. In addition, median hospital costs and charges decreased steadily for all patients (not just those using the PG), simultaneous with the development and implementation of the PG. There were no differences in short-term clinical outcomes between PG and non-PG patients. In summary, the development and implementation of a PG for endoscopic sinus surgery resulted in lower hospital costs and charges while maintaining acceptable short-term clinical outcomes. PGs have important implications for improving the efficiency of the health care process.

Toward More Patient-Centered and Prevention-Oriented Oral Health Care

2016 ◽  
Vol 2 (1) ◽  
pp. 5-9 ◽  
Author(s):  
H. Leggett ◽  
D. Duijster ◽  
G.V.A. Douglas ◽  
K. Eaton ◽  
G.J.M.G. van der Heijden ◽  
...  
Keyword(s):  
Health Care ◽  
Oral Health ◽  
Disease Prevention ◽  
Care Delivery ◽  
Health Care Systems ◽  
Oral Care ◽  
Oral Health Care ◽  
Patient Centered ◽  
Care Systems ◽  
European Union Member States

ADVOCATE (Added Value for Oral Care) is a project funded by the European Commission’s Horizon 2020 program, which aims to develop strategies for a system transition toward more patient-centered and prevention-oriented oral health care delivery within health care systems. This system should balance the restorative and preventive approaches in dental and oral health care. ADVOCATE is a partnership among 6 European Union member states, which involves collaboration among universities, state-funded health care providers, and private insurance companies in Denmark, Germany, Hungary, Ireland, the Netherlands, the United Kingdom, and Aridhia, a biomedical informatics company based in Scotland. There are 6 interrelated work packages, which aim to address the following objectives: 1) in-depth evaluation of oral health care systems in European Union member states to identify best system designs for oral disease prevention, 2) development of a set of measures to provide information on oral care delivery and oral health outcomes, 3) evaluation of a feedback approach in dental practice that aims to facilitate a change toward preventive oral health care delivery, and 4) economic evaluation of strategies to promote preventive oral health care and development of policy recommendations for oral health care systems. The project is novel in its use of data that are routinely collected by health insurance organizations, as well as the engagement of key stakeholders from dental teams, insurers, patients, and policy makers in guiding the development and progress of the project. This article outlines in detail the objectives and research methodology of the ADVOCATE project and its anticipated impact. Knowledge Transfer Statement: This commentary describes the development of policy options to promote a greater focus on disease prevention in general dental practice. The approach builds on identifying the comparative effectiveness of alternative incentive schemes, as well as methods to monitor clinical and patient-derived measures of success in creating health for patients. The article describes the development and application of the measures and the evaluation of their success in orienting clinical practice more toward disease prevention.

HSR19-090: Changes in Adherence to Tyrosine Kinase Inhibitor Treatment Patterns Among Patients With Chronic Myeloid Leukemia and the Impact on Costs: 2001–2017

2019 ◽  
Vol 17 (3.5) ◽  
pp. HSR19-090
Author(s):  
Henry J. Henk ◽  
Lena E. Winestone ◽  
Jennifer J. Wilkes ◽  
Laura Becker ◽  
Pamela Morin ◽  
...  
Keyword(s):  
Health Care ◽  
Chronic Myeloid Leukemia ◽  
Healthcare Costs ◽  
Myeloid Leukemia ◽  
First Line ◽  
Tki Treatment ◽  
The Impact ◽  
Care Costs ◽  
Over Time ◽  
Privately Insured

Background: Chronic myeloid leukemia (CML) treatment improved considerably after introduction of oral tyrosine kinase inhibitors (TKI). As a result, the number of patients living with CML may reach 250,000 by 2040. We track changes in TKI treatment adherence since 2001 and provide an early assessment of treatment costs following the availability of second-generation TKIs and generic imatinib. Methods: A retrospective cohort from the OptumLabs Data Warehouse, which includes claims data for privately insured and Medicare Advantage (MA) enrollees in a large private U.S. health plan with medical and pharmacy benefits, was used. Patients with CML initiated TKI treatment between May 2001 and October 2016 and were continuously enrolled in the health plan 6 months prior through 12 months following TKI start. Adherence was defined by medication possession ratio (MPR1=total days’ supply of imatinib in 1st year divided by 365, 1=perfect adherence). Total health care costs include medical and prescription medication benefits. MPR1 was modeled using ordinary least squares regression. The association between MPR1 and healthcare costs was estimated using a generalized linear model specified with a gamma error distribution and a log link. Results: We identified 1,793 eligible patients. First-line TKI has changed over time (dasatinib and nilotinib represent 45% of all 2016 starts; imatinib 55%). From 2001 to 2016, adherence increased (Table 1). MPR1 was higher in men and increased with age until age ∼62 after which it declined. MPR1 was lower for patients with more comorbid conditions prior to treatment. Overall, MPR1 was inversely associated with total health care costs (medical and pharmacy) among privately insured (P<.001) but not MA enrollees. The net impact of MPR1 on total healthcare costs diminished over time (P<.001) where a 10% point decrease in MPR1 was associated with 12% and 4% lower total costs, prior to and following availability of 2nd generation TKIs, respectively. When examining medical costs only, MPR1 was inversely associated with medical costs for both privately insured (P<.001) and MA enrollees (P=.016). Conclusions: We found that adherence to TKI treatment increased over time. While imatinib is still used more frequently than other TKIs as first-line therapy, second-generation TKIs are becoming increasingly used as first-line agents. Possible cost-offsets are decreasing over time but it may be too early to formally evaluate the impact of generic imatinib.

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