Question

Blue River Home Care is a for-profit home care agency affiliated with Blue River Hospital, a private 60-bed hospital. The agency is an early adopter of telehealth services that are now integrated into the home care plans of patients with chronic diseases. The telehealth technology integrates data from portable monitoring devices, including spirometers, blood pressure cuffs, digital weight scales, and videophones. After eight years, the agency is beginning to reap the benefits of investing in the telehealth infrastructure, which both enhances the quality of delivered services and reduces costs. Specifically, regular patient monitoring enabled by technology has reduced the staff's travel time and costs; has made scheduling home care visits more efficient; and, in many cases, has led to proactive interventions to prevent adverse events. So far, it is too early to tell if rehospitalization rates for home care patients with chronic conditions will be reduced, but given that the technology enables early detection of symptoms, such reductions seem likely. Currently, the agency's administration is looking for ways to keep pace with emerging technologies, which would give it a competitive advantage. The leaders are examining the integration of a personal health record (PHR) and a health social network into the existing telehealth infrastructure. This social network would allow patients to access and manage their personal health information, enable them to find and connect with others with similar conditions for support and sharing, and let family members and caregivers participate in virtual support groups. The agency has held informal meetings with its healthcare providers regarding this plan. Some clinicians like the communication and information opportunities that the plan will offer patients and their caregivers, but other clinicians have some concerns, including the following: The health social network might propagate unreliable or wrong information. PHR integration could pose privacy (and thus liability) risks. Patients may not use the health social network. Physician compensation could be negatively affected by the online patient–clinician interaction. Older patients, and those who have no experience with technology, may find it difficult to enter, manage, and find health information (especially to improve health literacy). These reactions are indicative of the diverse views and attitudes of healthcare providers, administrators, patients, and family members toward consumer health applications. Solutions and Considerations Following are factors that Blue River (and other healthcare organizations) should consider and discuss when proposing and implementing an integrated PHR and health social network: Communication between patients and their formal and informal caregivers will greatly improve. This, in turn, may lead to better health outcomes because such a system would form or strengthen the social support for patients, serve as an early detection tool for new health or medical events, facilitate care coordination across various caregivers and care networks, and increase the patient's feeling of independence. The viewpoint of each stakeholder group should be solicited and taken into account. The potential benefits of an integrated PHR and health social network may be offset by problems introduced by the new technology. Although more information may be available to patients, they may not know how to interpret it for decision-making purposes. Most patients lack medical knowledge, so they could misunderstand health research findings, notes, discussions, and other information. The same holds true for family members who have access to their loved one's PHR and social network profile. Different approaches to integrating the PHR and health social network should be tried. For example, before patients are allowed to own, manage, and control their data, the organization should first develop a web portal that lets patients access, annotate, and share their information. This may address the patients’ desire to play a more active role in their own healthcare. The technology will introduce new privacy and information reliability issues. Specifically, family members’ access to their loved one's information and the ability of the social network's members to view each other's profile or pages could breach a patient's privacy and confidentiality. In addition, if the patient is in charge of the PHR, the reliability of information may be compromised and affect the provider's clinical decision making. The organization must assess the usability and compatibility of system interfaces, regardless of whether the system or software was purchased from a vendor or created for the organization's use. The system cannot be difficult to operate or navigate, especially for frail or elderly people (who represent most of Blue River's patients) or those who have little or no experience with technology. User-friendliness must be maximized to enable and encourage access to the system. Initial and ongoing training and customer support must be offered whenever feasible. Because the proposed integrated PHR and health social network is intended to facilitate frequent communication among members of the network and allow patients to get involved in the decision-making process, the organization should build an IT infrastructure that supports these functions. To gain institutional support, leadership must demonstrate that the new system will yield concrete benefits to the organization and its staff (e.g., increased marketability and competitiveness, improved quality of care, enhanced efficiency) without placing an undue burden or additional tasks on the staff. Furthermore, leadership must show evidence that the proposed system has proven effective in other clinical settings or similar organizations. Case Study Discussion Questions Name some of the challenges in ensuring continuity of care for patients with chronic conditions. How can emerging technologies solve or at least ease these challenges? List some of the benefits of integrating a PHR with a health social network for patients with chronic illness, their caregivers, and the organization. Name the specific effects that adopting e-health and social media applications will have on the structure and strategies of a healthcare organization. How might the adoption of an integrated PHR and health social network change the interaction and relationship between patients and health professionals?

Answer 1

1. Absence of appropriate correspondence channels are the primary difficulties that has been looked by many consideration homes and emergency clinics in giving consistent clinical consideration to patients. By setting up a locally situated correspondence framework, care homes and wellbeing frameworks will have the option to defeat this significant test all things considered. The tele-home consideration is one such innovation that is intended to tackle this test and proceed with clinical consideration to the patients with basic sickness significantly after they are released to their homes. Different clinical tests and incorporated into the locally established correspondence framework. The innovation in the locally established framework will assist the clinical group with sourcing the applicable data from gadgets like spirometers, circulatory strain sleeves, videophones and other checking gadgets for these patients. Along these lines these new advances are required to comprehend a large number of the issues in proceeding with the clinical consideration to the fundamentally sick patients.

2. There are numerous potential advantages which can be inferred by coordinating PHR framework with wellbeing and informal communication media with patients, guardians and the association. Because of the improved correspondence with the patients and the guardians, various advantages could be harvested. Patients could benefit better help from the parental figures so as to improve their conditions. Such improved cooperations will lead the clinical group to recognize different other medical problems. It will likewise improve the degree of co-appointment and systems administration among parental figures, and other systems administration locales. The patients will have the option to cooperate with different patients who are having comparative ceaseless ailment, they will have the option to help one another. This facilitates the worry in the patients, empowering and propelling them to care more for themselves. They likewise become increasingly certain about themselves and become progressively autonomous.

3. Incorporating the PHR framework with the wellbeing framework can have positive just as negative effects on the auxiliary limit and procedures of a human services framework. The new innovation may present danger to the protection and unwavering quality worries to information. Further, before incorporating the last form of PHR framework, the human services framework needs to test various methodologies for coordinating patient data to the framework. For example, the association need to dispatch a web-based interface at first where the patients could get to and enter their information. Every one of these methodology require a considerable measure of store portion. This will change the income and reserve portion of the association and affect their operational just as key objectives.

The human services framework needs to give preparing to the patients, guardians and doctors to make the framework familiar with them. They bring to the table client assistance and constant preparing so as to make the framework agreeable to the clients. These are going to take a lot of time, assets of the social insurance framework.

In view of improved and proceeded with clinical consideration, the odds of re-hospitalization will be diminished. It will be profitable to the patients however it may not be not all that gainful to the doctors and medical clinics as far as economies in light of the fact that the income of the doctors will be decreased which will thusly influence the income age of the emergency clinics.

Prior to buying the product from the seller or during attempting various methodologies for the PHR framework, the association needs to choose dependent on 'make or purchase' idea. That is whether they need to purchase the item from the seller or make or adjust their current Management Information Systems or Customer Relationship Management frameworks.

These choices ought to be founded on their monetary techniques just as money saving advantage investigation.

4. With the reception of PHR frameworks, the connection among patients and medicinal services experts will improve. The PHR framework will make the cooperations simpler, fast and spares the hour of patients and wellbeing experts. The physical cooperations will get decreased however there will be more correspondence between the patients by means of on the web. Patients could expect better help from the wellbeing group, as to direction and finding of medical problems. The virtual or online connection among patients and wellbeing group will improve. In any case, there may not the genuine closeness and sharing of emotions which an individual collaboration could give.

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