Search results

The disease management approach to improving health care, at the system as well as the hospital level, has proved to be very powerful, producing unprecedented results in reducing costs while improving quality of care and patient satisfaction. The Boston Consulting Group (BCG), working with a variety of leading managed care providers and pharmaceutical clients, has pioneered the development and dissemination of the disease management concept. Defines the disease management approach and outlines how it differs from the traditional component management approach. Also describes the key elements of disease management, characteristics to look for in a candidate disease, and results achieved so far. Finally, discusses the three strategic roles a health‐care player can take in disease management.

Disease management (DM) programs are being implemented throughout the health care delivery system as one way to contain costs, and they have demonstrated mixed efficacy. In most cases, DM programs have shown the best results when they promote access to preventive care services, and often have the poorest performance when they attempt to reduce variation. This paper examines the DM process as a seminal Continuous Quality Improvement intervention in health care. Medical experts have identified disease management as the premier method of influencing the cost and quality of health care as we move into the twentry‐first century. Results of interventions can be tracked and the quality of care is gradually being improved using these methodologies. The proposed presentation will detail the process and some examples of this approach

Discusses measuring outcomes in the context of disease management and provides a single framework in the form of a key question checklist. Identifies key stakeholders. Outlines levels of outcome monitoring, measurement and date type and source. The development of an evaluative culture is essential to successful outcome measurements.

Holistic approaches to public health such as “One Health” emphasize the interconnectedness between people, animals, ecosystems, and epidemic risk, and many advocate for this philosophy to be adopted within disaster risk management (DRM). Historically, animal and human diseases have been managed separately from each other, and apart from other hazards considered for DRM. Shifts in DRM, however, may complement a One Health approach. The taxonomy of hazards considered under DRM has expanded to include medical and social crises such as epizootics and terrorism. However, there is a gap in understanding how epidemic risk is integrated into DRM at the community-level. The paper aims to discuss these issues.

TACTIC adopts a participatory case study approach examining preparedness for multiple hazard types (floods, epidemics, earthquakes, and terrorism) at the community-level. This paper reports on findings from the epidemic case study which took as its focus the 2001 foot-and-mouth disease epidemic in the UK because of the diverse human, social, and environmental impacts of this “animal” disease.

Epizootic preparedness tends to focus on biosecurity and phytosanitary measures, and is geared towards agriculture and farming. Greater engagement with public health and behavioural sciences to manage public health impacts of animal disease epidemics, and activities for citizen engagement to improve preparedness are discussed. The impermeability of boundaries (hazard, institutional, disciplinary, etc.) is a key constraint to integrating One Health into DRM.

This work helps to situate the One Health discussion within the community-level DRM context.

Digital transformation (DT) is a priority for the healthcare sector. In many countries, it is still considered in the early stages with an underestimation of its benefits and potentiality. Especially in Italy, little is known about the impact of digitalization – particularly of the Internet of Things (IoT) – on the healthcare sector, for example, in terms of clinician's jobs and patient's experience. Drawing from such premises, the paper aims to focus on an overlooked healthcare area related to the chronic heart diseases field and its relationship with DT. The authors aim at exploring and framing the main variables of remote Monitoring (RM) adoption as a specific archetype of healthcare digitalization, both on patients and medical staff level, by shedding some lights on its overall implementation.

The authors empirically inquiry the RM adoption within the context of the Cardiology Department of the Casilino General Hospital of Rome. To answer our research question, the authors reconstruct the salient information by using induction-type reasoning, direct observation and interviewees with 12 key informants, as well as secondary sources analysis related to the hospital (internal documentation, presentations and technical reports).

According to a socio-technical framework, the authors build a model composed of five main variables related to medical staff and patients. The authors classify such variables into an input-process-output (I-P-O) model. RM adoption driver represents the input; cultural digital divide, structure flexibility and reaction to change serve the process and finally, RM outcome stands for the output. All these factors, interacting together, contribute to understanding the RM adoption process for chronic disease management.

The authors' research presents two main limitations. The first one is related to using a qualitative method, which is less reliable in terms of replication and the interpretive role of researchers. The second limitation, connected to the first one, is related to the study's scale level, which focuses on a mono-centric consistent level of analysis.

The paper offers a clear understanding of the RM attributes and a comprehensive view for improving the overall quality management of chronic diseases by suggesting that clinicians carefully evaluate both hard and soft variables when undertaking RM adoption decisions.

RM technologies could impact on society both in ordinary situations, by preventing patient mobility issues and transport costs, and in extraordinary times (such as a pandemic), where telemedicine contributes to supporting hospitals in swapping in-person visits with remote controls, in order to minimize the risk of coronavirus disease (COVID-19) contagion or the spread of the virus.

The study enriches the knowledge and understanding of RM adoption within the healthcare sector. From a theoretical perspective, the authors contribute to the healthcare DT adoption debate by focusing on the main variables contributing to the DT process by considering both medical staff and patient's role. From a managerial perspective, the authors highlight the main issues for RM of chronic disease management to enable the transition toward its adoption. Such issues range from the need for awareness of the medical staff about RM advantages to the need for adapting the organizational structure and the training and education process of the patients.

Drawing on the taxonomy of patient empowerment and a sense of community (SoC), the purpose of this paper is to analyze the factors that impact the intention of the individual to continue using online social health support community for their chronic disease management.

A survey design was used to collect the data from multiple online social health support groups related to chronic disease management. The survey yielded a total of 246 usable responses.

The primary findings from this study indicate that the informational support – not the nurturant support such as emotional, network, and esteem support – are the major types of support people are seeking from an online social health support community. This research also found that patient empowerment and SoC would positively impact their intention to continue using the online health community.

This study utilized a survey design method may limit precision and realism. Also, there is the self-selection bias as the respondents self-selected themselves to take the survey.

The findings can help the community managers or webmasters to design strategies for the promotion and diffusion of online social health group among patient of chronic disease. Those strategies should focus on patient’s empowerment through action facilitating and social support and through creating a SoC.

An innovative research model integrates patient empowerment and a SoC to study patient’s chronic disease management through online social health groups to fill the existing research gap.

The purpose of this paper is to raise issues about the design of personal health record systems (PHRs) and self-monitoring technology supporting self-care practices of an increasing number of individuals dealing with the management of a chronic disease in everyday life. It discusses the results of an ethnographic study exposing to analysis the intricacies and practicalities of managing diabetes “in the wild”. It then describe and discuss the patient-centric design of a diabetes journaling platform that followed the analysis.

The study includes ethnometodological investigation based on in depth interviews, observations in a support group for adults with type 1 diabetes, home visits, shadowing sessions and semi-structured interviews with a series of medical experts (endocrinologists, general practitioners and diabetes nurses). Findings informed the design of a proof-of-concept PHR called Tag-it-Yourself (TiY): a mobile journaling platform that enables the personalization of self-monitoring practices. The platform is thoroughly described along with an evaluation of its use with real users.

The investigation sheds light on a series of general characters of everyday chronic self-care practices, and how they ask to re-think some of the assumptions and connotations of the current medical model and the traditional sick role of the patient – often unreflectively assumed also in the design of personal technologies (e.g. PHR) to be used by patients in clinically un-controlled settings. In particular, the analysis discusses: the ubiquitous nature of diabetes that is better seen as a lifestyle, the key role of lay expertises and different forms of knowledge developed by the patient in dealing with a disease on a daily basis, and the need of more symmetrical interactions and collaborations with the medical experts.

Reported discussions suggest the need of a more holistic view of self-management of chronic disease in everyday life with more attention being paid on the perspective of the affected individuals. Findings have potential implications on the way PHR and systems to support self-management of chronic disease in everyday life are conceived and designed.

The paper suggests designers and policy makers to look at chronic disease not as a medical condition to be disciplined by a clinical perspective but rather as a complex life-style where the medical cannot be separated by other aspects of everyday life. Such shift in the perspective might suggest new forms of collaborations, new ways of creative evidence and new form of knowledge creation and validation in chronic self-care.

The paper suggests re-thinking the role of the patient in chronic-disease self-management. In particular, it suggests giving more room to the patient voice and concerns and suggest how these can enrich rather than complicate the generation of knowledge about self-care practices, at least in type 1 diabetes.

The paper sheds light on everyday intricacies and practicalities of dealing with a chronic disease. Studies of self-care practices that shed light on the patient perspectives are sporadic and often assume a clinical perspective, its assumptions (e.g. biomedical knowledge is the only one available to improve health outcome, doctors know best) and implications (e.g. compliance, asymmetry between the specialist and the patient).

Describes the process which Yorkshire Regional Health Authority has chosen to adopt to ensure that a comprehensive, co‐ordinated, region‐wide system has been implemented. The system comprises staffing, training, policy and guidance development, food hygiene monitoring, communication, collaboration, networking and support. Discusses lessons to be learned and future actions.

Noncommunicable diseases (NCDs) count for over 80% of premature death worldwide. More than 76% of the total burden of diseases in Iran is devoted to NCDs. In line with the World Health Organization action plan, Iran has developed its national action plan that led to establishment of the National Committee for Prevention and Control of NCDs (INCDC), whose aim is 30% mortality reduction attributed to NCDs by 2030. The stewardship of health system is the cornerstone of performing and sustaining meaningful actions toward prevention and control of NCDs. The literature is tiny on how to materialize the stewardship and governance of health system. The purpose of this article is to report the findings of a national study that aimed to identity functions and subfunctions of stewardship of NCDs and its related risk factors in Iran.

This is a qualitative study. The authors conducted interviews with 18 purposefully selected interviewees until the authors reached saturation. Thematic content analysis was used for analysis and MAXQDA 10 was employed for data management. The difficulty of coordinating with interviewers and health policymakers in the field slowed the process of research progress.

The authors identified seven themes and categorized them as main functions for appropriate stewardship of NCDs in Iran, including intelligence generation; strategic framework; evidence-based policies/decisions; system design; resource allocation/development; capacity-building and enforcement/alignment; and categorized them as important.

The seven themes presented as stewardship functions include concepts and practical examples of the experiences and performance of leading countries in the field of NCDs control that can help policymakers and health managers for better descion-making.

Iran adopted its national action plan in 2015 and WHO selected Iran as a fast-track country in 2017. The study confirmed that to achieve the global targets, appropriate and contextual stewardship for any specific setting is fundamental. Iran needs to improve its stewardship for prevention and control of NCDs and implement its national action plan. Therefore, the functions and policies outlined in this article for the proper performance of NCDs can improve more meaningful practices in this area in Iran and many other countries.

Personal Health Record (PHR) systems make possible to integrate data from different sources and circulate them within the illness care and management network. The new arrangements prefigure a redefinition of the relations among healthcare practitioners, patients, and caregivers. The purpose of this paper is to consider the role and the meanings attributed to information when a technical artifact enables new forms of communication within the healthcare management network.

The authors adopted a qualitative research design, conducting a pre-post analysis on a theoretical sample of patients and of a paediatrics department. The authors selected 12 patients (six females and six males) aged between four and 20 years old.

The patients were willing to act as “stewards of their own information” (Halamka et al., 2008), but they interpreted this role in terms of restricting access to their information, rather than facilitating its dissemination. In fact, the PHR was symbolized as an instrument to support personal diabetes management but the patients want to preserve their own competence and independent management on the information regarding their “Personal” diseases.

This work highlights two connotation of “Personal” information. The first is the dimension of the right to the privacy of information when it is believed that it may be used to pass judgement on the patient. The second connotation of “Personal” is the assertion by patients of their competence and autonomy in interpreting the information on the basis of personal knowledge about their diabetes.