Global Challenges in People-Centered E-Health

People-centered health care seeks an active role for the patient while empowering all other members of the health care team. By promoting greater patient responsibility and optimal usage, patient-centered health care leads to improved health outcomes, quality of life and optimal value for health care investment. This paper reviews some definitions of people-centered health care and various e-health approaches around the world used to implement this vision. The barriers and enablers to implementation this type of approach are explored. This paper provides a proposed research agenda for future implementations of people-centered e-health.

From integrated care towards DIY Health - Combining person-centered health care delivery, mobile technology and entrepreneurship

Introduction and objectives:

To achieve the level of impact necessary to reverse current trends of rising incidence and costs of multimorbidity and enabling healthy ageing will require new health care policy and practices. Notwithstanding integrated care receiving worldwide attention in improving healthcare delivery, the value of data driven and mobile technology for integration of health and care services remains unclear. Nevertheless, person-centered and data driven mobile health (mHealth) has the potential to evolve integrated care from business process re-design towards a new digital health ecosystem that is truly centered around a person facing health challenges. The objective of our study was to identify the opportunities and barriers of mHealth to do this.

Highlights:

MHealth applications attack the underlying causes of the multimorbidity and ageing challenge in various ways. First, mHealth lifestyle apps promise to help in the prevention of chronic disease and multimorbidity by attacking high risk conditions such as ...

Shifting acute care delivery from hospitals to homes in Ireland

Community-based acute care services delivered by mobile nursing teams were introduced by Caredoc, a private nonprofit organization contracted by the Irish Health Services Executive; first-hand insights of providers enabled identification of services delivery challenges and supported development of relevant solutions; supportive senior management generated momentum for change and helped secure necessary approval for activities from authorities; stakeholder engagement was described as time consuming, but crucial to success; electronic medical records and new technologies facilitated the creation of a simple, connected and user-friendly service; training for nursing staff was important for establishing the necessary clinical competencies to deliver acute care services in home settings.

Developing an integrated e-health system in Estonia

A system-wide electronic health information system was introduced by the government and a national e-health foundation was established to guide change; development of e-health aligned with a broader government information strategy, enabling change and motivating necessary political support; early introduction of legislation provided a clear framework for activities and the Estonian Health Information System Development Plan 2005–2008 mapped out the change process; legislation coupled with aligned incentives encouraged widespread uptake of e-health by providers; partnerships with the private sector, universities and research organizations helped drive innovation; features of the electronic system (including electronic medical records, digital imaging, e-prescriptions and a patient portal) were gradually introduced and use of the system is now mandatory for providers.

Developing an integrated e-health system in Croatia to drive care improvements

An electronic Central Health Information System (CEZIH) was introduced by the government to connect stakeholders and provide real-time data on patients and providers; a strong government commitment and top-down leadership established the necessary conditions for the widespread adoption of e-health; data collected through the e-health system helped drive performance improvements; a new payment model for primary care providers was introduced and realigned financial incentives encouraged positive changes in clinical practice; ongoing trainings supported providers to uptake and capitalize on new technologies; a patient e-portal helped engage patients in their own care.

Developing an integrated information system in the Former Yugoslav Republic of Macedonia

The Ministry of Health designed and implemented a web-based appointment platform to streamline information flows and reduce artificially-inflated waiting times. Additional features, such as e-referral and e-prescription applications, have since been incorporated into the information system; a comprehensive investigation at the beginning of the initiative supported the development of an informed solution to directly address key challenges; alignment with previous investments in technological infrastructure enabled rapid uptake of the new information system by providers and more economical use of existing resources; an effective communication plan, including public campaigns and efforts to gain public trust, helped ensure widespread uptake of the new information system.

Integrated care: better and cheaper

Integrated care improves health, increases quality of care and lowers costs. These three goals, this Triple Aim in other words, are achieved in many examples from all over the world: from Alaska to New Zealand, from Western Europe to South Africa. However, disseminating all these good examples is easier said than done, as nationwide implementation means the simultaneous realisation of the following six components of integrated care:

1. Multidisciplinary care pathways and decision trees

2. Patient self-management and shared decision-making by patients and professionals

3. Guaranteeing professional and patient- perceived quality

4. Population-based funding and shared savings

5. An Electronic Health Record and e-health

6. Servant leadership and a strategy for change management.

These are the conclusions Guus Schrijvers draws in his book Integrated Care: better and cheaper. His conclusions are based on more than 500 studies from the 1960s until mid-2016. In addition, he also draws on his own ...

HealthBuddy: a new chatbot to engage with communities in Europe and central Asia on COVID-19

HealthBuddy, a multilingual interactive chatbot, is the newest tool to be launched as a resource for countries in Europe and central Asia in response to the COVID-19 pandemic. The chatbot, developed by WHO/Europe and the United Nations Children’s Fund (UNICEF) Europe and Central Asia Regional Office (ECARO), will help countries in the region to access accurate information, and counter misinformation surrounding the virus.

e-Mental Health International Conference 2020

Delivering person-centred care through new technology

The Priority Research Centre for Brain and Mental Health Research (University of Newcastle, Australia), following their success in organising the e-Mental Health International Conference in 2016 and 2018,  once again brings the conference to you. Because of the COVID-19 pandemic, conference will be held online this year.

The conference will provide a forum focusing on applying information and communication technologies in person-centred strategies of mental health care. It will contribute to generating, verifying and refining theories and practices of employing technologies in person-centred care. Specific objectives are:

• To review initiatives in using information and communication technologies in person-centred care delivery.
• To reinforce the significance of evidence based e-health practice in promoting, maintaining and restoring health.
• To define critically the roles of e-health in attaining excellence in care and explore the issues related to these roles.
• To examine global and regional strategies of enhancing e-health ...

F@ce: a team-based, person-centred intervention for rehabilitation after stroke supported by information and communication technology – a feasibility study

Despite encouraging data about declining stroke incidence, on a global level the aging population and accumulating risk factors contribute to an increasing lifetime risk of stroke. Per the Global Burden of Disease 2016 Lifetime Risk of Stroke Collaborators, the mean global lifetime risk of stroke increased from 22.8% in 1990 to 24.9% in 2016, a relative increase of 8.9% (95% CI, 6.2%–11.5%) after accounting for the competing risk of death of any cause other than stroke.

Globally, there is a growing use of Information and Communication Technology (ICT), including mobile phones, tablets and computers, which are being integrated into people’s daily activities. An ICT-based intervention called F@ce was developed in order to provide a structure for the process in stroke rehabilitation and facilitate change by integrating a global problem-solving strategy using SMS alerts. The aim of the study was to evaluate the ...