What is e-health & smart health trends?
What are the main trends in smart health that can be identified?What is ehealth trends?
An integrated care offer to manage the health journey
The first trend concerns the impact of ICT on the supply of care. With the development of telemedicine and shared medical records, an integrated vision of the healthcare offer is emerging. Healthcare, hospital and ambulatory professionals find themselves in closer ties thanks to the information sharing capabilities made possible by ICT. This concerns information systems, such as the exchange of expertise between professionals at a distance. Likewise, ICT allows remote monitoring of previously unthinkable patients. Finally, these technologies offer new capabilities in preventive policies with remote controls of biological and genetic constants, and in patient self-management. Thus, the idea of a fully integrated care offer bringing together specialists from health establishments, liberal professionals, and actors in the social sector, even if it encounters difficulties, no longer seems utopian. The case of Kaiser Permanente, which combines care providers and insurers in the same system, constitutes an exemplary case in this regard. This trend towards increasingly integrated systems calls for the following comments:
It is first of all a challenge because it corresponds to the expected organization of the care of a patient within the framework of a health journey. It is common to speak of health pathways to illustrate this wider scope which integrates the curative as well as the preventive side, and which also leads the concept of care at the border of health and social. With the ever increasing chronicity of many diseases, due as much to the aging of the population as to medical advances, care is now envisaged for many patients along a course which includes the health establishment, but also city medicine and other medico-social structures, as well as their domicile. By widening the scope of the activity under consideration, different actors are brought in to intervene in the most coordinated way possible: hospital professionals, treating physicians, liberal nurses, social actors, and actors carrying out new professions such as coordinating nurses or telemedicine assistants. During this course, the appearance of certain medical innovations (such as oral chemotherapy), combined with the desire to shorten hospital times and contacts (reduced length of stay, development of ambulatory medicine, control of unjustified readmissions) accentuate the tendency to keep the patient as much as possible at home, and consequently to ensure follow-up at a distance. Finally, there is a trend to recognize the preferences of the patient in a more global manner, as illustrated by the concept of “patient-centered care”, and to personalize the response. We can thus speak of coordinated and personalized health pathways for which the care offer must be as integrated as possible to respond appropriately.
The use of ICT has a structuring effect in the construction of this integrated care offer, but it should not be considered in isolation. If the structuring of information and exchanges between professionals, as between professionals and patients, is associated with the emergence of ICT, it would be naive to think that they constitute the only component of the integrated organization of the care offer. The initiatives that go in this direction are most often inspired by the Chronic Care Model which combines the use of ICT, new organizational methods (such as the creation of coordinating nurses), actions promoting patient self-management, and the establishment of a payment-type incentive for coordination. These new payment methods (capitation, payment per episode of care, global package) aim to compensate for the weaknesses of current payment methods (activity-based pricing, fee-for-service, in particular) to encourage cooperation between professionals and multidisciplinary exercise.
If these dimensions are not inherently innovative, take them head on, assess them qualit