An increasing population share in OECD nations comprises 15 % of individuals above 65 years of age, and the percentage is expected to increase to 22% around 2030 (Laleci Erturkmen et al., 2019). Old age is related to the increased accumulation of various chronic health conditions. However, the clinical treatment process and management of patients with numerous chronic health conditions are time-consuming, disconnected, and much more complex than in traditional healthcare settings. Integrated care refers to addressing the increased demand for better and improved patient care experience and the care outcomes of long-term and multimorbid care patients. Care planning is a current and common way of integrated healthcare to deliver more targeted and personalized care, forming shared healthcare plans through a clear articulation of the responsibilities of each patient and all providers during the care process.
Laleci Erturkmen et al., 2019 effectively present a method together with a corresponding implementation process of a semi-automatic healthcare plan management tool that is integrated with various clinical decision-supporting services that may seamlessly assess and access the electronic health records (EHRs)related to the patients making a comparison with clinical guidelines that are based on evidence to make an implication on personalized recommendations for interventions and goals to be included along with the individualized healthcare plans. The article’s authors report the outcomes of the usability studies conducted by clinicians and patients in four pilot research sites. This paper critically analyzes if Laleci Erturkmen et al., 2019 article “A Collaborative Platform for Management of Chronic Diseases via Guideline-Driven Individualized Care Plans” explains the basics of healthcare delivery systems in America, identifies three major elements impacting healthcare information systems, describes a care management or health service and explains the way health information technology promotes health records.
Healthcare Delivery Systems Basics in the United States of America (U.S.A)
Laleci Erturkmen et al., 2019 explain that multi-morbidity creates contradictory and sometimes diverse needs that trouble and challenge healthcare delivery services and patients in the U.S. Furthermore, the authors describe that the clinical management of older patients and those suffering from various chronic conditions, such as diabetes, cancer, and even hypertension is time-consuming, disconnected and very complex within the traditional healthcare settings. Thus, people with long-term care needs and chronic conditions face gaps and shortcomings in the provision of care. According to the article, management of multi-morbidity using the current treatment ways leads to specialty silos, including various social and healthcare providers who do not efficiently share information and even communicate effectively. As the complexity and the number of chronic health conditions rise with time, with the episodes of chronic illness being superimposed, the number and type of caregivers contributing to individualized care increases. It results in difficulty in coordinating and aligning care across the healthcare teams and related settings. It thus leads to fragmented healthcare due to poor information sharing and communication.
Moreover, Laleci Erturkmen et al., 2019 explain that clinical guidelines are used in the care domain to ensure quality care. When the guidelines are provided as real-time decision-making support systems, they significantly improve patient care and reduce undesired practice variability. The clinical information systems are created to automate the pathways to care to send relative reminders to providers to ensure periodic treatments, diagnostic tests, and clinical assessments. The authors also effectively describe that the patient empowerment platform aims to ensure that patients get access to effective published healthcare plans and their data, increasing informal caregiver and patient participation in the decision-making process. Most of the U.S. healthcare delivery systems face issues and challenges such as increased healthcare provision costs, variation in the quality of treatment, disparities in access to effective healthcare services, especially from ethnic and racial minorities, and fragmentation of care. Laleci Erturkmen et al., 2019 explain that fragmented care delivery results from poor information sharing and communication among the caregivers.
Factors Impacting Healthcare Information Systems
The article’s authors have identified and effectively discussed the three factors impacting healthcare information systems. The first factor discussed in the article is the data privacy and security concerns. According to the authors, the Security and Privacy Suite (SPS) is often responsible for the process of authorization and authentication of the members of the care team as they manage the personalized care plans associated with different patients and make sure that the information shared across and within C3-Clud Software elements is properly auditable and encrypted. With the C3-Cloud architecture, the electronic health records of the patient that are acquired from local HER via the TIS, PEP patient-reported observations, and the patient care plan that C3DP manages are together effectively managed using the C3-cloud FHIR Repository. To ensure the effectiveness of the information sharing and confidentiality, every client’s app, such as C3DP, PEP, and TIS, must be authorized and authenticated to access information to the C3-Cloud FHIR Repository through the functionalities offered by SPS. All the operations require logging into the app to ensure accountability through SPS. SPS ensures the authorization of healthcare team members to use the applications related to C3-Cloud, thus elaborating on compliance with regulations.
Moreover, technological integration and Advancements impact HIS. The article’s authors effectively describe the advancement of HIS to the C3-Cloud system, which has been co-produced and co-designed with final users from the early project stages. Facilitating co-production, the technical partners have established user interface mock-ups at the time of the requirement analysis phase and then formed early prototypes beginning with the phase of architectural design, which is then followed by multiple reviews and iterations by the final users until the integration end (Schommer et al., 2017). The authors clearly illustrate that technological advancement is affecting HIS. Lastly, the authors discuss regulatory standards and compliance in ensuring the integrity of health information systems. The C3-cloud system’s adherence to various international standards, such as HL7, facilitates data exchange and interoperability across the healthcare system.
Care Management Plan
The article comprehensively describes a detailed care management plan involving the C3- Cloud system architecture. The C3-cloud project aims to change the recently fragmented healthcare offered to patients suffering from chronic diseases. The architecture offers an ICT infrastructure to multidisciplinary healthcare teams and allows the patients to coordinate integrated care in a patient-centered fashion. The authors of the article have also implemented a Coordinated care and cure Delivery platform, which allows collaborative execution and creation of individualized healthcare plans for patients having multiple acute illnesses through a multidisciplinary healthcare team involving homecare workers, social care, nutritionists, geriatricians, pharmacists, specialists, psychotherapists, and study nurses. C3DP refers to a website application for personalized and collaborative care plan management.
The article also correctly explains how the C3-Cloud component operates, where it is directly combined with different C3-Cloud elements and integrated indirectly with the traditional EMR systems. Information regarding a patient with multiple chronic sicknesses is generated from the C3-Cloud FHIR Repository. The plan is described in the article as a guideline-driven plan. This collaborative platform shall include all professionals from different fields of health and a patient-centered plan that ensures greater patient engagement and complete adherence to the management plan. The C3-Cloud care plan prioritizes the preferences and needs of every patient, making sure that the diagnosis and the interventions are geared around their particular circumstances. The care plan also incorporates monitoring mechanisms to keep track of the progress of the care and examine the efficiency of the used interventions over time (Percival et al., 2022). It enables the healthcare professionals to make necessary adjustments to the care plan on the patient’s progress. The platform is also created to be adaptable and scalable to distinct healthcare environments and patients, enabling widespread implementation of the care plan in different clinical contexts.
Influence of Electronic Health Information Technology on Health Outcomes
Laleci Erturkmen et al., 2019 illustrate how C3-Cloud technology promotes the results of healthcare. The authors argue that C3-Cloud promotes collaboration among the healthcare professions. Chronic illness requires interventions by different health professionals, such as clinical officers, nurses, and pharmacists. For effective intervention, all departments must collaborate and generate information about the patient to determine the intervention to take. Collaboration is enhanced by electronic health information systems such as the C3-Cloud. Also, better healthcare outcomes are achieved through effective communication and information sharing among the healthcare professions.
A lack of an effective system of common needs among the healthcare provision departments causes fragmented interventions. Electronic health information systems are used to store and share data to ensure accurate information regarding the diagnosis of a patient with chronic illness. C3DP contains its module for messaging and storing patients’ information, which ensures safe messaging between the healthcare team and the patients due to the integration of PEP and C3DP. HL7 FHIR, which is a communication resource, is applied when messaging. Lastly, the patient-offered data screen collects all the data concerning the patient, such as the meal photos and vital sign measures, and sends them to the care team in a single dashboard.
Conclusion
The article effectively explains the basics of healthcare delivery in the U.S., including the time-consuming aspect of treating chronic diseases among older people. The strength of the article is that it comprehensively describes an individualized care management model, which is the C3-Cloud, and the efficiency that it has brought in the personalized care management systems. The three factors impacting healthcare information systems include data privacy and security, technological advancements, and regulation standards and compliance. The C3-Cloud care plan aims to change the recently fragmented healthcare offered to patients suffering from chronic diseases. C3-cloud care plan ensures effective coordination, communication, and collaboration of healthcare workers.
References
Laleci Erturkmen, G. B., Yuksel, M., Sarigul, B., Arvanitis, T. N., Lindman, P., Chen, R., Zhao, L., Sadou, E., Bouaud, J., Traore, L., Teoman, A., Lim Choi Keung, S. N., Despotou, G., De Manuel, E., Verdoy, D., De Blas, A., Gonzalez, N., Lilja, M., Von Tottleben, M., … Kalra, D. (2019). A collaborative platform for managing chronic diseases via guideline-driven individualized care plans. Computational and Structural Biotechnology Journal, 17, 869–885. https://doi.org/10.1016/j.csbj.2019.06.003
Percival, M., Freeman, C., & Cottrell, N. (2022). Pharmacists implementing collaborative pharmaceutical care plans in patients with chronic disease: A prospective cohort feasibility study. https://doi.org/10.21203/rs.3.rs-1694204/v1
Schommer, J. C., Tieger, P. D., Olson, A. W., & Brown, L. M. (2017). Applying personality type theory to develop individualized wellness plans for reducing chronic diseases. INNOVATIONS in pharmacy, 8(1). https://doi.org/10.24926/iip.v8i1.487
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