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Sharing clinical decisions for multimorbidity case management using social network and open-source tools

Alicia Martínez-García, Alberto Moreno-Conde, Francisco Jódar-Sánchez, Sandra Leal, Carlos Parra
2013 Journal of Biomedical Informatics  
The SCP has two consecutively developed components: social network component, called Clinical Wall, and Clinical Decision Support (CDS) system.  ...  We describe the architecture to incorporate decision support functionalities in a social network tool to enable the adoption of shared decisions among health professionals from different care levels.  ...  Acknowledgments This study has been carried out within the framework of the PITeS project ''Methods and tools for design and implementation of Telemedicine and eHealth for the care of chronic patients'  ... 
doi:10.1016/j.jbi.2013.06.007 pmid:23806275 fatcat:mljibtb7ivbp5hffany6qdqzze

GPs' perspectives on the management of patients with multimorbidity: systematic review and synthesis of qualitative research

Carol Sinnott, Sheena Mc Hugh, John Browne, Colin Bradley
2013 BMJ Open  
; challenges in delivering patient-centred care; and barriers to shared decision-making.  ...  To synthesise the existing published literature on the perceptions of general practitioners (GPs) or their equivalent on the clinical management of multimorbidity and determine targets for future research  ...  It would be valuable to use case-based data in future studies, to see, for example, what specific conflicts arise between guidelines and how shared decision-making is currently broached in practice.  ... 
doi:10.1136/bmjopen-2013-003610 pmid:24038011 pmcid:PMC3773648 fatcat:qr2lnbljpvazdl2a6ojgv2npou

Learning and Caring in Communities of Practice: Using Relationships and Collective Learning to Improve Primary Care for Patients with Multimorbidity

H. Soubhi, E. A. Bayliss, M. Fortin, C. Hudon, M. van den Akker, R. Thivierge, N. Posel, D. Fleiszer
2010 Annals of Family Medicine  
Using a mix of methods, future research should explore the conditions that are necessary for collective learning within communities of clinicians who care for patients with multimorbidity and who develop  ...  We introduce a primary care practice model for caring for patients with multimorbidity.  ...  provide a social context in which clinicians share clinical cases, listen, refl ect, and receive feedback on processes of care for complex patients  ... 
doi:10.1370/afm.1056 pmid:20212304 pmcid:PMC2834724 fatcat:sawf6losnbhtrlqoaycnmsxbpe

Underlying mechanisms of complex interventions addressing the care of older adults with multimorbidity: a realist review

Monika Kastner, Leigh Hayden, Geoff Wong, Yonda Lai, Julie Makarski, Victoria Treister, Joyce Chan, Julianne H Lee, Noah M Ivers, Jayna Holroyd-Leduc, Sharon E Straus
2019 BMJ Open  
selfcare.ConclusionsTo optimise care, both clinical management and patient self-management need to be considered from multiple perspectives (patient, provider and system).  ...  We refined our programme theories to explain multimorbidity management in older adults: (1) care coordination interventions with the best potential for impact are team-based strategies, disease management  ...  and are using findings to codesign a multimorbidity self-management tool for older adults (KeepWell).  ... 
doi:10.1136/bmjopen-2018-025009 pmid:30948577 pmcid:PMC6500199 fatcat:eznrm3nh2jhd3ink2jucdeuwpq

Digital Health Transformation of Integrated Care in Europe: Overarching Analysis of 17 Integrated Care Programs

Erik Baltaxe, Thomas Czypionka, Markus Kraus, Miriam Reiss, Jan Erik Askildsen, Renata Grenkovic, Tord Skogedal Lindén, János György Pitter, Maureen Rutten-van Molken, Oscar Solans, Jonathan Stokes, Verena Struckmann (+2 others)
2019 Journal of Medical Internet Research  
Identification of common factors facilitating and hampering the implementation process may be useful for future policy recommendations.  ...  However, wide scale implementation is uneven among countries and regions.  ...  The content of this paper reflects only the SELFIE group's views and the European Commission is not liable for any use that may be made of the information contained herein.  ... 
doi:10.2196/14956 pmid:31573914 pmcid:PMC6794072 fatcat:jata6qdcjnbzpmo2le5norucai

Health Information Technology to Improve Care for People with Multiple Chronic Conditions

Lipika Samal, Helen Fu, Camara Djibril, Jing Wang, Arlene Bierman, David A. Dorr
2021 Health Services Research  
We identified studies of health IT interventions for PLWMCC across three domains as follows: self-management support, care coordination, and algorithms to support clinical decision making.  ...  The search included a forward citation search of studies nested within a clinical trial to identify the clinical trial protocol and published clinical trial results.  ...  management using social network and open-source tools by patients and clinicians of a care planning platform "Coordinated Care and Cure Delivery Platform" which helps with care planning for older adults  ... 
doi:10.1111/1475-6773.13860 pmid:34363220 pmcid:PMC8515226 fatcat:2uek5e5iobajlj2n4shj6qtwty

Does not compute: challenges and solutions in managing computable biomedical knowledge

David Wong, Niels Peek
2020 BMJ Health & Care Informatics  
Some of these have been suitably addressed through the development of CBK methods and tools, while others require further research and development.  ...  We review the main challenges associated with creating, reasoning with and sharing CBK, and describe current state-of-the-art solutions as well as outstanding issues.  ...  . uk/ Guidance/ CG50) and convert that into a fully computer-interpretable algorithm that can be subsequently used as the basis for clinical decision support.  ... 
doi:10.1136/bmjhci-2019-100123 pmid:32723852 fatcat:k6ntchmasfa3hhe5cwiw2xrbda

The use of computer-interpretable clinical guidelines to manage care complexities of patients with multimorbid conditions: A review

Eda Bilici, George Despotou, Theodoros N Arvanitis
2018 Digital Health  
Clinical practice guidelines (CPGs) document evidence-based information and recommendations on treatment and management of conditions.  ...  CPGs usually focus on management of a single condition; however, in many cases a patient will be at the centre of multiple health conditions (multimorbidity).  ...  Approaches to managing multimorbidity care using a CIG-based CDSS In this section, we discuss the approaches used in the management of multimorbid patients through CIGbased clinical decision support technologies  ... 
doi:10.1177/2055207618804927 pmid:30302270 pmcid:PMC6172935 fatcat:x2fgfcxdtjc5fahsqla7ejjbd4

Integrated primary care and social services for older adults with multimorbidity in England: a scoping review

Hajira Dambha-Miller, Glenn Simpson, Lucy Hobson, Paul Roderick, Paul Little, Hazel Everitt, Miriam Santer
2021 BMC Geriatrics  
This study describes and summarises current evidence, clinical provision and progress towards integrated primary care and social services for older adults with multimorbidity in England.  ...  Background As the prevalence of older adults with multimorbidity increases, greater integration of services is necessary to manage the physical and psycho-social needs of this cohort.  ...  delivery: University study using social network and framework analyses.  ... 
doi:10.1186/s12877-021-02618-8 pmid:34861831 pmcid:PMC8642958 fatcat:xku3ahuqpnfotnvpy22pl5fiti

Fragmentation of care: a major challenge for older people living with multimorbidity

Nafisat Oladayo Akintayo-Usman
2021 Geriatrics Gerontology and Aging  
The leading factors responsible for this issue are use of disease-centered approaches and specialism to manage people living with multimorbidity; poor communication between professionals and people with  ...  for the management of multimorbidity.  ...  We also acknowledge a number of international experts for providing advice and for generously sharing examples of practice: Stewart Mercer (University of Glasgow, Scotland), Renee Lyons (University of  ... 
doi:10.53886/gga.0210030 doaj:cdbb598e6c874a168bebe738e8e0df02 fatcat:yob4j553jfc53l4jkiwn5letvu

A Perspective: Use of Machine Learning Models to Predict the Risk of Multimorbidity

Gayathri Delanerolle
2021 LOJ Medical Sciences  
While there are many AI/ML algorithms and methods to build such a risk assessment tool, an optimal 'fit-for-purpose' model is chosen by comparing and contrasting across many possible alternatives.  ...  management regimens. c) Complex and frequent interactions between multiple clinicians and/or clinical services leading to sub-optimal care coordination and delivery.  ...  Acknowledgements This paper is part of the ELEMI and EINSTEIN projects.  ... 
doi:10.32474/lojms.2021.05.000225 fatcat:bfrijrpmivgnhbccetyefaf4qm

Multimorbidity of chronic non-communicable diseases: burden, care provision and outcomes over time among patients attending chronic outpatient medical care in Bahir Dar, Ethiopia—a mixed methods study protocol

Fantu Abebe Eyowas, Marguerite Schneider, Shitaye Alemu, Fentie Ambaw Getahun
2021 BMJ Open  
The quantitative data will be collected from multiple sources using the KoBo Toolbox software and analysed by STATA V.16. Multiple case study designs will be employed to collect the qualitative data.  ...  organisation of care for patients with multimorbidity, and (3) a longitudinal quantitative study to investigate disease progression and patient outcomes over time.  ...  Relationship between the data collected from the different study participants will be examined and emerging themes in terms of clinical decision-making and healthcare delivery for patients with multimorbidity  ... 
doi:10.1136/bmjopen-2021-051107 pmid:34497085 fatcat:wxbkd3anv5bt7hyypcyyomw4ri

GPs' mindlines around deprescribing antihypertensives in older patients with multimorbidity: qualitative study

Karolina Kuberska, Fiona Scheibl, Carol Sinnott, James Sheppard, Mark Lown, Marney Williams, Rupert Payne, Jonathan Mant, Richard McManus, Jenni Burt
2020 British Journal of General Practice  
knowledge, and non-clinical factors) to guide decision-making.  ...  GPs are less confident to attempt deprescribing in response to generalised concerns about polypharmacy, and work hard to make sense of multiple sources (including available evidence, shared experiential  ...  Acknowledgements The authors thank the GPs who participated in this study, and staff from NIHR Eastern Clinical Research Network for their support.  ... 
doi:10.3399/bjgp21x714305 pmid:34001537 pmcid:PMC8249009 fatcat:fazqyvm3ebg63btz5napdiggue

Personalized care with mass production efficiency: integrating care with a virtual care operator

Paul Lillran, Annika Bengts, An Chen, Perttu Kontunen, Fares Georges Khalil, Satu Kaleva, Paulus Torkki
2022 Journal of Integrated Care  
PurposeThis article aims to describe the thinking behind MASSE, a project in Finland that helps address the fragmentation of care and patient journey disruptions for long-term care.  ...  employs a service engineering and design science approach with the objective of addressing chronic and multimorbid patients in specialized multiprovider environments.  ...  A special case of condition-based maintenance is network operations service providers who employ networks operation centers (NOC) that monitor, manage and coordinate complex networks.  ... 
doi:10.1108/jica-01-2022-0006 fatcat:zioaaanlbfecjlbbdd3g6dg3ci

Value-Based Health Care Supported by Data Science [chapter]

Tiffany I. Leung, G. G. van Merode
2018 Fundamentals of Clinical Data Science  
This could include, for example, clinical decision support systems, e-health technologies, and virtual networks or services.  ...  A disease network involves understanding disease relationships, clinical complexity and multimorbidity [62, 66] .  ... 
doi:10.1007/978-3-319-99713-1_14 fatcat:3wb343askrchrjn3b7p3qbwtla
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