Evidence-based Medicine and Patient-centered Care: Cross-Disciplinary Challenges and Healthcare Information Technology-enabled Solutions

2011 ◽  
Vol 1 (2) ◽  
Author(s):  
Roopa Raman
Keyword(s):  
Information Technology ◽  
Evidence Based Medicine ◽  
Patient Centered Care ◽  
Evidence Based ◽  
Healthcare Information Technology ◽  
Patient Centered ◽  
Healthcare Information ◽  
Centered Care ◽  
Based Medicine

Evidence-based medicine offers an optimal starting point for person-centered medicine

2014 ◽  
Vol 2 (1) ◽  
pp. 76 ◽  
Author(s):  
Piet Post ◽  
Gordon Guyatt
Keyword(s):  
Decision Making ◽  
Evidence Based Medicine ◽  
Clinical Decision Making ◽  
Patient Centered Care ◽  
Evidence Based ◽  
Discussion Paper ◽  
Patient Centered ◽  
Starting Point ◽  
Centered Care ◽  
Based Medicine

In their discussion paper, Miles and Mezzich argue that evidence-based medicine (EBM) and patient-centered care have developed in parallel, but rarely have entered into exchange and dialogue. These authors emphasize the need for a rational form of integration to take part between EBM and patient-centered care. We agree wholeheartedly with the desirability of both dialogue and integration. The dialogue will be much less likely to be productive, however, when authors ignore or altogether misconstrue the evolution of evidence-based medicine and the recent work of EBM leaders. Statements claiming “a foundational irreconcilability between the fundamental principles of EBM and those of patient-centered care” are not likely to promote enthusiastic dialogue with the EBM community. In this commentary, we demonstrate that EBM has introduced and aggressively advocated for the integration of patient’s values and preferences in the process of clinical decision-making. Furthermore, EBM has highlighted the need for research into optimal ways of integrating patient values and preferences and, most recently, introduced and studied innovative ways of facilitating shared decision-making.

Operationalizing person-centered medicine

2014 ◽  
Vol 2 (1) ◽  
pp. 98
Author(s):  
James Marcum ◽  
Jackson Griggs ◽  
Lauren Barron
Keyword(s):  
Clinical Practice ◽  
Evidence Based Medicine ◽  
Clinical Case ◽  
Patient Centered Care ◽  
Evidence Based ◽  
Patient Centered ◽  
Working Definition ◽  
Centered Care ◽  
Definition Of ◽  
Based Medicine

To recapture medicine’s “soul” for the “care” of patients, Miles and Mezzich propose a version of person-centered medicine in which they “coalesce” both evidence-based medicine and patient-centered care. To that end, they identify 5 key principles from which they formulate a 4-part working definition of person-centered medicine. In this paper, we first analyze philosophically -ontologically, epistemologically and ethically - both their principles and definition and we then present a clinical case to operationalize their notion of person-centered medicine. We conclude with a brief comment on its feasibility for modern clinical practice.

Is “scientifically informed, yet humanistic medicine” the solution to the crisis of modern medicine? A friendly corrective to the emergent model of Person-Centered Medicine

2014 ◽  
Vol 2 (1) ◽  
pp. 106 ◽  
Author(s):  
Maya Goldenberg
Keyword(s):  
Clinical Practice ◽  
Evidence Based Medicine ◽  
Modern Medicine ◽  
Evidence Based ◽  
Patient Centered ◽  
Centered Care ◽  
Model Evidence ◽  
Humanistic Medicine ◽  
Based Medicine ◽  
Conceptual Confusion

In Miles and Mezzich’s programmatic paper “The care of the patient and the soul of the clinic: person-centered medicine as an emergent model of modern clinical practice”, the authors draw from a wide variety of sources to frame a theoretical underpinning for the emerging concept of “person-centered medicine” as a model of clinical practice. The sources include humanistic and phenomenological medicine, the biopsychosocial model, evidence-based medicine, critics of evidence-based medicine and patient-centered care. Each offer commendable desiderata, which Miles and Mezzich selectively integrate into their burgeoning theoretical framework. My concern is that the selective uptake of desirably qualities from such diverse resources in order to progress person-centered medicine’s developing vision of “medicine for the person, by the person and with the person” obscures important theoretical differences among these sources that will likely result in difficulty for the concept of person-centered medicine. These diverse theoretical resources offer competing correctives to the problems with medicine. Some of these differences are irreconcilable and need to be highlighted in order to avoid creating conceptual confusion and allegiance to unproductive theoretical commitments at this critical point of framing and developing this emergent model of modern clinical practice. 

Adaptive many model medicine trumps monocultural models: comment on the Miles and Mezzich emergent model of modern clinical practice

2014 ◽  
Vol 2 (1) ◽  
pp. 64
Author(s):  
Robin Nunn
Keyword(s):  
Evidence Based Medicine ◽  
Medical Model ◽  
Evidence Based ◽  
Multiple Perspectives ◽  
Single Model ◽  
Discussion Paper ◽  
Medical Problems ◽  
Patient Centered ◽  
Centered Care ◽  
Based Medicine

In their provocative and insightful discussion paper, Miles and Mezzich consider two parallel, but philosophically divergent movements in medicine: evidence-based medicine and patient-centered care. They call for the integration or coalescence of these contrasting movements into one model that "combines the strengths of both movements, but which dispenses with the weaknesses of each." I share their goal of placing the person at the center of medicine, rather than subordinating the person to the depersonalized science and technology represented by current models of evidence-based medicine. Yet I envision a person-centered model, indeed any medical model, not as an overriding unified entity, but rather as one component in a complex "many model medicine". I have tried to show elsewhere that the use of many models is likely to produce better outcomes than the dominance of any single model. Multiple models entail multiple perspectives and methods that may be necessary to solve difficult medical problems. This pluralistic view is consistent with Peabody's view, cited in the discussion paper, that medical art and science are not opposites, but are foundational components of medicine.

scholarly journals Health Information Technology Challenges to Support Patient-Centered Care Coordination

2015 ◽  
Vol 24 (01) ◽  
pp. 8-10 ◽  
Author(s):  
B. Séroussi ◽  
M.-C. Jaulent ◽  
C. U. Lehmann
Keyword(s):  
Information Technology ◽  
Health Information Technology ◽  
Health Information ◽  
Care Coordination ◽  
Clinical Pathways ◽  
Patient Centered Care ◽  
Patient Centered ◽  
Holistic View ◽  
25Th Anniversary ◽  
Centered Care

Summary Objectives: To provide an editorial introduction to the 2015 IMIA Yearbook of Medical Informatics. Methods: We provide a brief overview of the 2015 special topic “Patient-Centered Care Coordination”, discuss the addition of two new sections to the Yearbook, Natural Language Processing and Public Health & Epidemiology Informatics, and present our editorial plans for the upcoming celebration of the 25th anniversary of the Yearbook. Results: Care delivery currently occurs through the processing of complex clinical pathways designed for increasingly multi-morbid patients by various practitioners in different settings. To avoid the consequences of the fragmentation of services, care should be organized to coordinate all providers, giving them the opportunity to share the same holistic view of the patient’s condition, and to be informed of the planned clinical pathway that establishes the roles and interventions of each one. The adoption and use of electronic health records (EHRs) is a solution to address health information sharing and care coordination challenges. However, while EHRs are necessary, they are not sufficient to achieve care coordination, creating information availability does not mean the information will be accessed. This edition of the Yearbook acknowledges the fact that health information technology (HIT), and EHRs in particular, are not yet fully addressing the challenges in care coordination. Emerging trends, tools, and applications of HIT to support care coordination are presented through the keynote paper, survey papers, and working group contributions. Conclusions: In 2015, the IMIA Yearbook has been extended to emphasize two fields of biomedical informatics through new sections. Next year, the 25th anniversary of the Yearbook will be celebrated in grand style! A special issue with a touch of reflection, a bit of rediscovery, and some “science-fiction” will be published in addition to the usual edition.

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