From Dyadic Ties to Information Infrastructures: Care-Coordination between Patients, Providers, Students and Researchers

Summary

Objective: To share how an effectual merging of local and online networks in low resource regions can supplement and strengthen the local practice of patient centered care through the use of an online digital infrastructure powered by all stakeholders in healthcare. User Driven Health Care offers the dynamic integration of patient values and evidence based solutions for improved medical communication in medical care.

Introduction: This paper conceptualizes patient care-coordination through the lens of engaged stakeholders using digital infrastructures tools to integrate information technology. We distinguish this lens from the prevalent conceptualization of dyadic ties between clinician-patient, patient-nurse, clinician-nurse, and offer the holistic integration of all stakeholder inputs, in the clinic and augmented by online communication in a multi-national setting.

Methods: We analyze an instance of the user-driven health care (UDHC), a network of providers, patients, students and researchers working together to help manage patient care. The network currently focuses on patients from LMICs, but the provider network is global in reach. We describe UDHC and its opportunities and challenges in care-coordination to reduce costs, bring equity, and improve care quality and share evidence.

Conclusion: UDHC has resulted in coordinated global based local care, affecting multiple facets of medical practice. Shared information resources between providers with disparate knowledge, results in better understanding by patients, unique and challenging cases for students, innovative community based research and discovery learning for all.

Keywords

Medical informatics - International Medical Informatics Association - yearbook, decision support systems

^* All authors have contributed equally to this work

• References

• 1 Price A, Biswas T, Biswas R. Person-centered healthcare in the information age: Experiences from a user driven healthcare network. Eur J Pers Centered Healthc 2013; 1 (02) 385-93. Available from: http://ubplj.org/index.php/ejpch/article/view/766
• 2 Chandra S, Price A, Biswas T, Bera K, Biswas R. User Driven Learning: Blending the Best of Clinical Medicine and Humanities to Infuse “Joy” into the Medical Curriculum. Int J User-Driven Healthc 2013; 3 (03) 116-21. Available from: services.igi-global.com/resolvedoi/resolve.aspx?-doi=10.4018/ijudh.2013070109
• 3 Price A, Chandra S, Bera K, Biswas T, Chatterjee P, Wittenberg R. et al. Understanding Clinical Complexity Through Conversational Learning in Medical Social Networks: Implementing User-Driven Health Care. In: Sturmberg JP, Martin CM. editors. Handbook of Systems and Complexity in Health SE - 44 [Internet]. Springer; New York: 2013. p. 767-93 Available from: http://dx.doi.org/10.1007/978-1-4614-4998-0_44
• 4 Price A, Chatterjee P, Biswas R. Time for Person Centered Research. Ann Neurosci 2014; Apr 21 (02) 37-40.
• 5 Biswas T, Biswas R, Bera K. BMJ Blogs: BMJ Case Reports blog » Blog Archive » Creating secondary learning resources from the BMJ Case Reports through social-media based discussion groups [Internet]. BMJ Blogs. 2011 [cited 2014 Dec 28]. Available from: http://blogs.bmj.com/case-reports/2011/10/28/creating-secondary-learning-resources
• 6 McDonald K, Schultz E, Albin L, Pineda N, Lon-hart J, Sudaram V. et al. Care coordination measures atlas. Updated June 2014. 2014 [cited 2014 Dec 28];(June). Available from: scholar google.com/scholar?hl=en&btnG=Search&q=intitle:Coordination+Measures+Atlas#0
• 7 Nelson WL, Moser RP, Han PKJ. Exploring objective and subjective numeracy at a population level: findings from the 2007 Health Information National Trends Survey (HINTS). J Health Commun 2013; 18 (02) 192-205. Available from: www.ncbi.nlm.nih.gov/pubmed/23066837
• 8 Chau JP-C, Lee DT-F, Yu DS-F, Chow AY-M, Yu W-C, Chair S-Y. et al. A feasibility study to investigate the acceptability and potential effectiveness of a telecare service for older people with chronic obstructive pulmonary disease. Int J Med Inform 2012; 81 (10) 674-82. Available from: http://www.ncbi.nlm.nih.gov/pubmed/22789911
• 9 Stewart EE, Crabtree BF, Miller WL. Implementing the Patient-Centered Medical Home : Observation and Description of the National Demonstration Project. 2010: 21-32.
• 10 Stacey D, O’Connor AM, Graham ID, Pomey M. Randomized controlled trial of the effectiveness of an intervention to implement evidence-based patient decision support in a nursing call centre. J Telemed Telecare 2006; 12 (08) 410-5.
• 11 Price A, Chatterjee P, Biswas R. time for person centered research in neuroscience: users driving the change. Ann Neurosci 2014; 21 (02) 37-40. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4117163/
• 12 Price A. BMJ Blogs: The BMJ » Blog Archive » Amy Price: Patients doing research for themselves [Internet]. BMJ Blogs. 2014 [cited 2014 Dec 8]. Available from: http://blogs.bmj.com bmj/2014/10/17/amy-price-patients-doing-research-for-themselves/
• 13 Monteiro E, Pollock N, Hanseth O, Williams R. From artefacts to infrastructures. Comput Support Coop Work CSCW An Int J 2013; 22 4-6 575-607.
• 14 Pironti BJP. Key Elements of a Threat and Vulnerability Management Program. 2006: 1-5.
• 15 BMJ.. BMJ Case Reports Student Electives [Internet]. BMJ 2014 [cited 2014 Dec 27]. Available from: http://journals.bmj.com/site/marketing/landing-pages/Indian_Caseelectives.xhtml
• 16 UDHC.. Welcome to the User-driven health network [Internet]. 2014 [cited 2014 Apr 25]. Available from: http://care.udhc.co.in
• 17 Sakagianni K, Evrenoglou D, Mytas D, Vavuranakis M. Platypnea-orthodeoxia syndrome related to right hemidiaphragmatic elevation and a “stretched” patent foramen ovale. BMJ Case Rep 2012 Dec 10 Available from: http://casereports.bmj.com/content/2012/bcr-2012-007735.abstract
• 18 Price A, Burls A. ThinkWell [Internet]. 2013. Available from: http://ithinkwell.org
• 19 Price A, Burls A. PLOT-IT Public Led Online Trials Infrastructure and Tools. Force 2015 [Internet]. Oxford UK: Force 2015; 2015. Available from: https://www.researchgate.net/publication/269700357_PLOT-IT_Public_Led_Online_Trials_Infrastructure_and_Tools
• 20 R3G.. Mission Arogya [Internet]. 2007 [cited 2014 Dec 27]. Available from: http://www.missionarogya.org
• 21 Burls A, Price A, Brice A. PLOT-IT: Public Empowerment and Engagement in Clinical Trials. Medicine 20 Conference [Internet]. JMIR Publications Inc.,; Toronto, Canada: 2014. [cited 2014 Dec 6]. Available from: http://www.medicine-20congress.com/ocs/index.php/med/med2014b/paper/view/2534
• 22 Chatterjee S, Price A, Biswas R. Turning the tables on learning attrition in medical students : Introducing User Driven Healthcare. Indian J Med Informatics 2014: 6-11.
• 23 Chalmers I. What do I want from health research and researchers when I am a patient?. BMJ 1995; May 20 310 6990 1315-8. Available from: http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=2549685&tool=pmcentrez&render-type=abstract
• 24 Greenhalgh T, Howick J, Maskrey N. Evidence based medicine: a movement in crisis?. BMJ 2014; Jun 13 348: g3725. Available from: ww.bmj.com/cgi/doi/10.1136/bmj.g3725
• 25 Rosling H. Hans Rosling: Stats that reshape your world-view [Internet]. TED. 2012 [cited 2014 Dec 6]. Available from: https://www.youtube.com watch?v=hVimVzgtD6w