Care professional or secretary #223 november 2017
Part 2: Taking full control
The current offering in healthcare is very much "offering driven", now is the moment for a paradigm shift. This conclusion was made by the Council for Public Health and Society (RVS) in The Netherlands. Their response: take the individual wishes, needs and abilities of care recipients as starting point. Especially in case of multiple care recipients.
Een Nederlandse versie van dit artikel vindt u hier.
A growing number of people struggle with a range of problems at social, medical and psychological level. These can only be addressed properly in combination. The solution proposed is to have clients take full control, based on a legally bounded, digital personal care plan. Read more in the article by SKIPR here, and the publication of RVS on the subject "Heft in eigen hand" here.
Software suppliers of the widely used ICT products in for e.g. the Youth care domain, offer a module to support these changes. The solution focusses around detailing agreed caregiving in forms consented by the client with their digital signature.
For the care professional, again this results in extra administrative work. Based on the illusion that upfront the complete care trajectory is known, and can be sealed with a digital signature.
As such we also see this happening in other branches of care, like with nurses and carers. As long as we report, describing what we are about to do, and we agree upon this with the client, we comply with national rules. Even though we feel the 'burden of having to register too much', we register something more. Read more about reporting and care plan here.
How do we improve?
Convidad and MEDrecord opt for a different approach. An approach with gradual migration of existing large-scale ICT products to smaller-scale ICT applications focused on particular care tasks.
The umbrella to other care tasks is realised by storing the data in central medical databases of MEDrecord. These are specialised in storing medical data, dossiers and in supporting chains of caregiving.
The small-scale ICT application in this case is custom made focused on the daily practice of the care professional. With this approach, the care task of the professional is supported to the max. This is much different from the current approach, in which mainly the reporting task is put centrally.
Since the solution is small-scale and custom made, it easier grows with the continuously changing dynamics of the daily practice. The jacket fitting well yesterday, grows with you so it still fits you well tomorrow. We apply the principles of Agile working in health care, in the way it already helped successfully innovate other branches.
Another advantage: the development costs are multiple times lower with this approach than the current cost for ICT applicable to caregiving organisations.
This central approach of storing medical data in combination with the distributed approach of custom solutions does not degrade any security- or privacy demands.
The client centrally
On behalf of the client we envision the realisation of custom small-scale ICT applications, addressing particular care needs of the client. The client has full access to all information stored about him/her.
Mandate for access to particular medical information of the client are consented by the client to the care professional. If the care professional wants to share information with colleagues, this can only be done within the boundaries of the given consent. In case an additional consent is needed, the client receives a notification, which can be honoured instantly.
Clients not being able to give consent themselves, are able to pass control to a relative or confidant. All within the boundaries set by the client and/or legislation.
Dynamics in care trajectories
Health care is dynamic. A particular treatment sometimes brings good results sooner, sometimes later. These effects interfere with cost control of care trajectories. By effectively responding to these dynamic aspects, the care trajectory is updated continuously.
When changing within a trajectory, it is important to stick within the boundaries of financial resources allocated. Whenever a treatment is costing more, maybe in another phase of the trajectory a saving can be realised by selecting an alternative treatment. In case a treatment returns good results sooner, this might leave room for additional or alternative treatment in a later phase, or result in an overall saving on the complete trajectory.
Because small-scale ICT applications are better equipped for the daily practice, the usage better aligns with the needs of the care professional. Collecting information needed for consistently detailing and reporting the care offered becomes less a separate administrative task.
How to fulfil reporting demands?
Specific ICT applications focused on composing reports collect all necessary data from the central medical database. This information originates from various small-scale ICT applications, in use throughout the complete care trajectory.
Whenever possible the reporting is done based on anonymous data, which is sufficient for the majority of reporting questions. With this separation in tasks between care professionals and reporting demands, the privacy of the client is protected much better.
Another advantage: the reporting ICT application is now specialised on reporting, and therefore small-scale. Also reporting demands are constantly changing, and by being small-scale now more easily grow with the demands of financing institutions.
Throw away previous investments?
No, quite the opposite: previous investments in current ICT solutions offer the base for creation of dossiers and collection of information, on top of which we build. Integrating these applications with the central medical database of MEDrecord, by means of integrating API-interfaces, information is exchanged in a better way.
Of course, the functionality for directly supporting the care tasks and for sharing information with the client will move gradually from these large-scale ICT solutions to the mentioned particular small-scale ICT solutions.
The existing large-scale applications now again can focus on their origin: delivering good and consistent financial substantiation of the care delivered.
In full control
The deployment of this Agile approach in daily practice of software development and integration results in a range of solutions giving the client control again over their care. Care professionals receive time again to focus on care giving. The role of ICT is now supporting in sharing care giving, instead of dividing responsibilities.
Our vision expressed in this article aligns with platform economy, which appears in many other branches too. The application of new technology optimizes the embedding of software solutions further. In platform economy connected infrastructures appear, consisting of specialised solutions. With centrally positioned the security and protection of the client's privacy.
This development is also stated by Jeroen Tas, Chief Innovation and Strategy Officer of Philips. In an article at World Economic Forum he calls this the fourth industrial revolution: "These solutions offer actionable, data-driven insights and enable patients to collaborate with their full care team, as well as their care-giving family members."
Convidad works together with partners in realising these solutions. As such, we provide specialised software solutions to care professionals. Convidad owns a development team in Barcelona in service of customers in The Netherlands.
MEDrecord is a -ground-breaking- digital health platform for accessing patient data from mobile health and clinical devices, wearables and applications. With their growing ECO system of customers and partners -that includes health IT vendors, health information systems, wellness companies, providers, pharmaceutical companies and CROs- to the continuously expanding list of digital health technologies, MEDrecord enables healthcare companies to better coordinate care, improve engagement strategies and more efficiently manage their populations.
Do you recognize this situation: your organisation is using an EHR (Electronic Health Records), HIS (Hospital Information System) or other application for registering all care related information in dossiers and forms. Based on this information your organisation reports to official institutions the amount of care offered in relation to financial transfers.