scholarly journals BPM Support for Patient-Centred Clinical Pathways in Chronic Diseases

Sensors ◽  
2021 ◽  
Vol 21 (21) ◽  
pp. 7383
Author(s):  
Marek Szelągowski ◽  
Justyna Berniak-Woźny ◽  
Cezary Lipiński
Keyword(s):  
Health Care ◽  
Chronic Diseases ◽  
Clinical Pathways ◽  
Chronic Obstructive Lung Disease ◽  
Healthcare Sector ◽  
Chronic Obstructive ◽  
Illustrative Case ◽  
Communication Tool ◽  
Management Concepts ◽  
Therapeutic Processes

Epidemiological trends over the past decade show a significant worldwide increase in the burden of chronic diseases. At the same time, the human resources of health care are becoming increasingly scarce and expensive. One of the management concepts that can help in solving this problem is business process management (BPM). The results of research conducted in the healthcare sector thus far prove that BPM is an effective tool for optimizing clinical processes, as it allows for the ongoing automatic tracking of key health parameters of an individual patient without the need to involve medical personnel. The aim of this article is to present and evaluate the redesign of diagnostic and therapeutic processes enabling the patient-centric organization of therapy thanks to the use of new telemedicine techniques and elements of hyperautomation. By using an illustrative case study of one of the most common chronic diseases, Chronic Obstructive Pulmonary Disease (COPD), we discuss the use of clinical pathways (CPs) prepared on the basis of the current version of the Global Initiative for Chronic Obstructive Lung Disease (GOLD) as a communication tool between healthcare professionals, the patient and his or her caregivers, as well as the method of identifying and verifying new knowledge generated on an ongoing basis in diagnostic and therapeutic processes. We also show how conducting comprehensive, patient-focused primary health care relieves the health care system, and at the same time, thanks to the use of patient engagement and elements of artificial intelligence (predictive analyses), reduces the significant clinical risk of therapy.

scholarly journals Integrated Prediction System for Chronic Disease Diagnosis to Ensure Better Healthcare

2020 ◽  
pp. 25-39
Author(s):  
Geetha Poornima K. ◽  
Krishna Prasad K.
Keyword(s):  
Health Care ◽  
Chronic Disease ◽  
Chronic Diseases ◽  
Predictive Analytics ◽  
Disease Diagnosis ◽  
Exercise Stress ◽  
Healthcare Sector ◽  
Human Beings ◽  
Healthcare Data ◽  
Using Data

Technology innovation has made life easy for human beings. Technology is being used everywhere. This also extends to the healthcare sector. The healthcare sector produces a large amount of data each minute. Because of privacy issues, much of the data generated is not used and is not publicly accessible. Healthcare data comes from diverse sources hence it will be always varied in nature. Keeping track of such data has become much easier these days. Predictive analysis in healthcare is an emerging technology that identifies the person with poor health where the risks of developing chronic conditions are more likely and provide better solutions in the field of healthcare. Statistical methods and algorithms can be used to predict the disease before the actual symptoms are revealed in humans. By using data analytics algorithms one can easily predict chronic diseases such as obesity, high/low Blood Pressure, diabetes, asthma, cardiopulmonary disorders. Because of an unhealthy diet, lack of proper exercise, stress, consumption of tobacco, alcohol, etc. chronic diseases are most common these days. If the symptoms of chronic diseases are detected in the early stages, there will be less risk of hospitalization by cost-effectively maintaining better health. Big data analysis and health care can be mixed to produce accurate results. The application of predictive analytics in healthcare is highlighted in this paper. It provides a broader analysis in the prevention of different chronic diseases by using predictive analytics. The paper also includes various issues that arise when handling health care data. For each chronic disease, diverse models, techniques, and algorithms are used for predicting and analyzing. The paper comprises a conceptual model that integrates the prediction of most common chronic diseases

scholarly journals Using a Constraint-Based Method to Identify Chronic Disease Patients Who Are Apt to Obtain Care Mostly Within a Given Health Care System: Retrospective Cohort Study

10.2196/26314 ◽  
2021 ◽  
Vol 5 (10) ◽  
pp. e26314
Author(s):  
Yao Tong ◽  
Zachary C Liao ◽  
Peter Tarczy-Hornoch ◽  
Gang Luo
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Health Care ◽  
Chronic Diseases ◽  
Care Management ◽  
Adult Patients ◽  
Chronic Obstructive ◽  
University Of Washington ◽  
Obstructive Pulmonary Disease ◽  
The University

Background For several major chronic diseases including asthma, chronic obstructive pulmonary disease, chronic kidney disease, and diabetes, a state-of-the-art method to avert poor outcomes is to use predictive models to identify future high-cost patients for preemptive care management interventions. Frequently, an American patient obtains care from multiple health care systems, each managed by a distinct institution. As the patient’s medical data are spread across these health care systems, none has complete medical data for the patient. The task of building models to predict an individual patient’s cost is currently thought to be impractical with incomplete data, which limits the use of care management to improve outcomes. Recently, we developed a constraint-based method to identify patients who are apt to obtain care mostly within a given health care system. Our method was shown to work well for the cohort of all adult patients at the University of Washington Medicine for a 6-month follow-up period. It is unknown how well our method works for patients with various chronic diseases and over follow-up periods of different lengths, and subsequently, whether it is reasonable to perform this predictive modeling task on the subset of patients pinpointed by our method. Objective To understand our method’s potential to enable this predictive modeling task on incomplete medical data, this study assesses our method’s performance at the University of Washington Medicine on 5 subgroups of adult patients with major chronic diseases and over follow-up periods of 2 different lengths. Methods We used University of Washington Medicine data for all adult patients who obtained care at the University of Washington Medicine in 2018 and PreManage data containing usage information from all hospitals in Washington state in 2019. We evaluated our method’s performance over the follow-up periods of 6 months and 12 months on 5 patient subgroups separately—asthma, chronic kidney disease, type 1 diabetes, type 2 diabetes, and chronic obstructive pulmonary disease. Results Our method identified 21.81% (3194/14,644) of University of Washington Medicine adult patients with asthma. Around 66.75% (797/1194) and 67.13% (1997/2975) of their emergency department visits and inpatient stays took place within the University of Washington Medicine system in the subsequent 6 months and in the subsequent 12 months, respectively, approximately double the corresponding percentage for all University of Washington Medicine adult patients with asthma. The performance for adult patients with chronic kidney disease, adult patients with chronic obstructive pulmonary disease, adult patients with type 1 diabetes, and adult patients with type 2 diabetes was reasonably similar to that for adult patients with asthma. Conclusions For each of the 5 chronic diseases most relevant to care management, our method can pinpoint a reasonably large subset of patients who are apt to obtain care mostly within the University of Washington Medicine system. This opens the door to building models to predict an individual patient’s cost on incomplete data, which was formerly deemed impractical. International Registered Report Identifier (IRRID) RR2-10.2196/13783

scholarly journals Health Care Burden and Expenditure Associated with Adverse Childhood Experiences in Tennessee and Virginia

2021 ◽  
Author(s):  
Glory Okwori ◽  
Steven Stewart ◽  
Megan Quinn ◽  
Delaney Lawson
Keyword(s):  
Risk Factors ◽  
Health Care ◽  
Chronic Diseases ◽  
Adverse Childhood Experiences ◽  
Chronic Obstructive ◽  
Behavioral Risk ◽  
Cross Sectional ◽  
Childhood Experiences ◽  
Adverse Childhood ◽  
Life Years

AbstractTo estimate attributable burden and costs of conditions associated with exposure to Adverse Childhood Experiences (ACEs) in Tennessee (TN) and Virginia (VA) during 2017. This is a cross-sectional study of individuals aged 18+ having exposure to ACEs using Behavioral Risk Factor Surveillance System (BRFSS) data. Eight chronic diseases (asthma, obesity, hypertension, diabetes, chronic obstructive pulmonary disease (COPD), depression, cardiovascular disease, and arthritis) and two risk factors (smoking and drinking) associated with ACEs were analyzed. Pearson's chi-square tests analyzed the association between ACEs, risk factors and chronic diseases. The population attributable risks (PAR) were estimated for the ACEs related diseases and risk factors and combined with health care expenses and Disability Adjusted-Life-Years (DALYs). Among those who experienced at least 1 ACE in TN, 10% had COPD, 17% had diabetes, 36% had obesity, and 30% had depression. Individuals who experienced at least 1 ACE in VA had higher percentages for COPD, obesity and depression diseases compared to those who had no ACE (p< .0001). ACEs’ exposure resulted in a burden of about 115,000 years and 127,000 years in terms of DALYs in TN and VA, respectively. The total health spending associated with ACEs based on PARs was about $647 million ($165 per adult) and $942 million ($292 per adult) in TN and VA respectively. The total costs associated with ACEs was about $15.5 billion ($3948) per person) and $20.2 billion ($6288 per person) in TN and VA, respectively. This study emphasizes the need to reduce ACEs due to high health and financial costs.

scholarly journals Επισκόπηση και καταγραφή των αισθητήρων και των αντίστοιχων τεχνολογιών μέτρησης βιοσημάτων (Βιοαισθητήρες) - Πρωτόκολλα επικοινωνίας - Ηθικά Ζητήματα

Bioethica ◽  
2018 ◽  
Vol 4 (1) ◽  
pp. 69
Author(s):  
Μαρία - Ιωάννα Κοτοπούλη (Maria-Ioanna Kotopouli)
Keyword(s):  
Health Care ◽  
Chronic Diseases ◽  
Targeted Delivery ◽  
Communication Protocols ◽  
World Health ◽  
Sensor Technology ◽  
Chronic Obstructive ◽  
Medical Monitoring ◽  
Obstructive Pulmonary Disease ◽  
Health Organization

Chronic diseases represent the major expense in healthcare today. Examples include diabetes, asthma, heart failure, chronic obstructive pulmonary disease (COPD), dementia, arthritis, and a number of neurological disorders. The World Health Organization estimates that chronic diseases are the main cause of "disability" in 2020 and that, if not managed properly, will become the most expensive problem for healthcare systems .One of the main goals of modern health care is to ensure that patients with chronic and non-diseases (such as diabetes and COPD), will receive medical monitoring and care at home whenever possible. This would result in lower requirements in necessary sources of health care, in hospital coverage and allow for more targeted delivery of health and care services. Therefore the problem we face is the reliable, easy and fast collection of medical data, i.e. the state of health of an individual. The development of sensor technology, in hardware and software, but also the communication protocols, has enabled wearable, ambient, implantable sensors to be introduced into health service systems. Ideally, this would permit the monitoring of physiological parameters of the patient continuously in contrast to provide a "snapshot" of these parameters when the patient visits the physician or performing some tests.This paper seeks to investigate and analyze simple glucose, pressure, oxygen, and more complex sensor systems available on the market or at research level and to review the communication protocols used in these applications, with particular emphasis on emerging bioethics.

scholarly journals Working with patients suffering from chronic diseases – a balancing act for health care professionals. A meta-synthesis of qualitative studies

2019 ◽  
Author(s):  
Heidi Holmen ◽  
Marie Hamilton Larsen ◽  
Merja Helena Sallinen ◽  
Lisbeth Thoresen ◽  
Birgitte Ahlsen ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Health Care ◽  
Chronic Diseases ◽  
Health Care Professionals ◽  
Qualitative Interviews ◽  
Qualitative Studies ◽  
Chronic Obstructive ◽  
Number Of Patients

Abstract Background: The number of patients with long-term chronic diseases is increasing. These patients place a strain on health care systems and health care professionals (HCPs). Presently, we aimed to systematically review the literature on HCPs’ experiences working with patients with long-term chronic diseases such as type 2 diabetes, chronic obstructive pulmonary disease (COPD), and chronic kidney disease (CKD). Method: A systematic search of papers published between 2002 and July 2019 was conducted in the Embase, AMED, PsycINFO, MEDLINE, CINAHL, and COCHRANE databases to identify studies reporting qualitative interviews addressing HCPs’ experiences working with adults with COPD, CKD or type 2 diabetes. An interdisciplinary research group were involved in all phases of the study. With the help of NVivo, extracts of each paper were coded, and codes were compared across papers and refined using translational analysis. Further codes were clustered in categories that in turn formed overarching themes. Results : Our comprehensive search identified 4170 citations. Of these, 20 papers met our inclusion criteria. Regarding HCPs’ experiences working with patients with COPD, CKD, or type 2 diabetes, we developed 10 sub-categories that formed three overarching main themes of work experiences: 1) individualizing one’s professional approach within the clinical encounter; 2) managing one’s emotions over time; 3) working to maintain professionalism. Overall these three themes suggest that HCPs’ work is a complex balancing act depending on the interaction between patient and professional, reality and professional ideals, and contextual support and managing one’s own emotions. Conclusion: Few qualitative studies highlighted HCPs’ general working experiences, as they mainly focused on the patients’ experiences or HCPs’ experiences of using particular clinical procedures. This study brings new insights about the complexity embedded in HCPs’ work in terms of weighing different, often contrasting aspects, in order to deliver appropriate practice. Acknowledging, discussing and supporting this complexity can empower HCPs to avoid burning out. Leaders, health organizations, and educational institutions have a particular responsibility to provide HCPs with thorough professional knowledge and systematic support.

scholarly journals Using a Constraint-Based Method to Identify Chronic Disease Patients Who Are Apt to Obtain Care Mostly Within a Given Health Care System: Retrospective Cohort Study (Preprint)

2020 ◽  
Author(s):  
Yao Tong ◽  
Zachary C Liao ◽  
Peter Tarczy-Hornoch ◽  
Gang Luo
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Health Care ◽  
Chronic Diseases ◽  
Care Management ◽  
Adult Patients ◽  
Chronic Obstructive ◽  
University Of Washington ◽  
Obstructive Pulmonary Disease ◽  
The University

BACKGROUND For several major chronic diseases including asthma, chronic obstructive pulmonary disease, chronic kidney disease, and diabetes, a state-of-the-art method to avert poor outcomes is to use predictive models to identify future high-cost patients for preemptive care management interventions. Frequently, an American patient obtains care from multiple health care systems, each managed by a distinct institution. As the patient’s medical data are spread across these health care systems, none has complete medical data for the patient. The task of building models to predict an individual patient’s cost is currently thought to be impractical with incomplete data, which limits the use of care management to improve outcomes. Recently, we developed a constraint-based method to identify patients who are apt to obtain care mostly within a given health care system. Our method was shown to work well for the cohort of all adult patients at the University of Washington Medicine for a 6-month follow-up period. It is unknown how well our method works for patients with various chronic diseases and over follow-up periods of different lengths, and subsequently, whether it is reasonable to perform this predictive modeling task on the subset of patients pinpointed by our method. OBJECTIVE To understand our method’s potential to enable this predictive modeling task on incomplete medical data, this study assesses our method’s performance at the University of Washington Medicine on 5 subgroups of adult patients with major chronic diseases and over follow-up periods of 2 different lengths. METHODS We used University of Washington Medicine data for all adult patients who obtained care at the University of Washington Medicine in 2018 and PreManage data containing usage information from all hospitals in Washington state in 2019. We evaluated our method’s performance over the follow-up periods of 6 months and 12 months on 5 patient subgroups separately—asthma, chronic kidney disease, type 1 diabetes, type 2 diabetes, and chronic obstructive pulmonary disease. RESULTS Our method identified 21.81% (3194/14,644) of University of Washington Medicine adult patients with asthma. Around 66.75% (797/1194) and 67.13% (1997/2975) of their emergency department visits and inpatient stays took place within the University of Washington Medicine system in the subsequent 6 months and in the subsequent 12 months, respectively, approximately double the corresponding percentage for all University of Washington Medicine adult patients with asthma. The performance for adult patients with chronic kidney disease, adult patients with chronic obstructive pulmonary disease, adult patients with type 1 diabetes, and adult patients with type 2 diabetes was reasonably similar to that for adult patients with asthma. CONCLUSIONS For each of the 5 chronic diseases most relevant to care management, our method can pinpoint a reasonably large subset of patients who are apt to obtain care mostly within the University of Washington Medicine system. This opens the door to building models to predict an individual patient’s cost on incomplete data, which was formerly deemed impractical. INTERNATIONAL REGISTERED REPORT RR2-10.2196/13783

scholarly journals Working with patients suffering from chronic diseases – a balancing act for health care professionals. A meta-synthesis of qualitative studies

2019 ◽  
Author(s):  
Heidi Holmen ◽  
Marie Hamilton Larsen ◽  
Merja Helena Sallinen ◽  
Lisbeth Thoresen ◽  
Birgitte Ahlsen ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Health Care ◽  
Chronic Diseases ◽  
Health Care Professionals ◽  
Qualitative Interviews ◽  
Qualitative Studies ◽  
Chronic Obstructive ◽  
Number Of Patients

Abstract Background: The number of patients with long-term chronic diseases is increasing. These patients place a strain on health care systems and health care professionals (HCPs). Presently, we aimed to systematically review the literature on HCPs’ experiences working with patients with long-term chronic diseases such as type 2 diabetes, chronic obstructive pulmonary disease (COPD), and chronic kidney disease (CKD). Method: A systematic search of papers published between 2002 and July 2019 was conducted in the Embase, AMED, PsycINFO, MEDLINE, CINAHL, and COCHRANE databases to identify studies reporting qualitative interviews addressing HCPs’ experiences working with adults with COPD, CKD or type 2 diabetes. An interdisciplinary research group were involved in all phases of the study. With the help of NVivo, extracts of each paper were coded, and codes were compared across papers and refined using translational analysis. Further codes were clustered in categories that in turn formed overarching themes. Results : Our comprehensive search identified 4170 citations. Of these, 20 papers met our inclusion criteria. Regarding HCPs’ experiences working with patients with COPD, CKD, or type 2 diabetes, we developed 10 sub-categories that formed three overarching main themes of work experiences: 1) individualizing one’s professional approach within the clinical encounter; 2) managing one’s emotions over time; 3) working to maintain professionalism. Overall these three themes suggest that HCPs’ work is a complex balancing act depending on the interaction between patient and professional, reality and professional ideals, and contextual support and managing one’s own emotions. Conclusion: Few qualitative studies highlighted HCPs’ general working experiences, as they mainly focused on the patients’ experiences or HCPs’ experiences of using particular clinical procedures. This study brings new insights about the complexity embedded in HCPs’ work in terms of weighing different, often contrasting aspects, in order to deliver appropriate practice. Acknowledging, discussing and supporting this complexity can empower HCPs to avoid burning out. Leaders, health organizations, and educational institutions have a particular responsibility to provide HCPs with thorough professional knowledge and systematic support.

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