Towards Argumentation-based Recommendations for Personalised Patient Empowerment

Patient empowerment is a key issue in healthcare. Approaches to increase patient empowerment encompass patient self-management programs. In this paper we present ArgoRec, a recommender system that exploits argumentation for leveraging explanatory power and natural language interactions so as to improve patients' user experience and quality of recommendations. ArgoRec is part of a great effort concerned with supporting complex chronic patients in, for instance, their daily life activities after hospitalisation, pursued within the CONNECARE project by following a co-design approach to define a comprehensive Self-Management System

Italian Consensus Statement on Patient Engagement in Chronic Care: Process and Outcomes

Patient engagement has been recognized as a key priority in chronic care. However,scholars agree that guidelines are needed to ensure effective patient engagement strategies. Tothis end, a Consensus Conference process was promoted with the following methodological steps:(1) extensive literature review about patient engagement initiatives in chronic care; (2) a stakeholderssurvey to collect best practices and (3) workshops with experts. On the basis of the informationcollected, a consensus statement was drafted, revised, and finalized by a panel of select renownedexperts. These experts agreed in defining engagement as an eco-systemic concept involving multipleactors all of which contribute to influence patients\u2019 willingness and ability to engage in chronic care.Moreover, experts recommended, whenever possible, to adopt standardized instruments to assess engagement levels and related unmet needs. Then, experts strongly advised appropriate trainings for healthcare professionals about patient engagement strategies. Furthermore, the importance of promoting healthcare professionals\u2019 wellbeing has been advocated. Family caregivers, as well as patients\u2019 organizations - should be trained and engaged to increase the effectiveness of interventions dedicated to patients. Finally, experts agreed that digital technologies should be considered as acrucial enhancer for patient engagement in chronic car

Chapter xCARE: A Development Platform for Supporting Smart and Pervasive Healthcare

We are assisting to an important change in the healthcare domain where healthy citizens and patients are more and more in the center and become active partners in the entire process. In this scenario, smart and pervasive solutions assume a relevant role for remotely assisting citizens and patients together with their carers and supporting the overall team of professionals. From a software-engineering perspective, to follow and/or anticipate changes in requirements, modular solutions must be investigated and developed. Moreover, issues like personalization, adaptation, and scalability must be considered from the very beginning. In this chapter, we present xCARE, a microservices-based platform explicitly implemented to support the development of smart and pervasive healthcare systems. To show the potentiality and adaptability of xCARE, three relevant applications are presented: (i) a self-management system to support chronic complex patients; (ii) a patient management system that allows the team of professionals to assist patients before a major surgery together with a self-management system for the patients themselves; and (iii) an automatic self-management system for healthy citizens that want to follow healthier habits and that supports behavioral change

Precision public health – A critical review of the opportunities and obstacles

The term ‘precision public health’ (PPH) refers to a new approach in public health which involves the use of novel data sources and/or computer science-driven methods of data analysis to predict risk or outcomes, in order to improve how interventions are targeted or tailored, with the aim of making them more individualised and therefore more effective and cost-effective than methods currently in use. These data may include, for example, information from social media or devices, genomic or clinical data, and information from healthcare services. In this critical review, which was conducted between March and October 2019, we outline key assumptions underpinning the PPH approach and identify potential challenges in its application. We adopted a pragmatic, non-systematic review methodology to examine: (i) the general principles underlying PPH; (ii) the validity of claims made about PPH in empirical studies and commentaries; and (iii) the potential opportunities and challenges of adopting a PPH approach through examining two case studies: health checks and community-based interventions. Non-empirical studies (commentaries and think-pieces) were included in this review because PPH represents an emerging approach and many of the ideas around the potential of PPH are only described in such studies Commentary studies emphasise that precision can be achieved in targeting interventions towards narrow social profiles of people through the incorporation of data reflecting micro-level day-to-day insights into the lives of individuals. Structured analysis of commentary studies shows that (i) the PPH field may be highly influenced by commentary and non-systematic review pieces that lack transparent methods but make claims about the potential of PPH; (ii) commentators on PPH often attempt to provide evidence for claims but the link between the evidence and the claim is often unsubstantiated when critically examined; and (iii) many of the assumptions underlying PPH are not supported by empirical evidence suggesting that there needs to be a measured approach to adopting PPH approaches. Claims around the effectiveness of PPH and around PPH being an advance on current public health approaches tended not to be supported by empirical evidence. As a relatively new concept therefore, there is limited direct empirical evidence showing PPH to be effective, and the theoretical arguments in its favour are often not well supported by evidence. The more ambitious claims made for PPH in the literature often rest on questionable readings of the evidence – for example, citing the possibility of identifying subgroups of the population through better targeting as though this automatically promises greater effectiveness among interventions targeting those subgroups. In practice, it seems that PPH is less a radically new paradigm and more a range of incremental improvements to public health interventions. Hypothetical case studies outlining the potential of a PPH approach applied to health checks and community-based interventions indicate several ways in which new data or tools could be productively used to inform the design and implementation of public health interventions. Current evidence suggests the impact of these is likely to be fairly modest, although further focused research (e.g. exploring the utility of strategies for targeting or involving communities using PPH) may merit further exploration and evaluation. Defining PPH is contentious and our findings reflect the difficulty in assessing and operationalising the broad ambition of using emerging data and technologies to better understand profiles, predict risk and outcomes, and act upon this evidence. Future work in this area should seek to introduce more focus around the concept of PPH, including being clearer about the goals and breaking down the concept into a series of components that can each be evaluated. The bulk of the work presented here took place between March and October 2019. There is scope for further analysis to understand the potential of PPH in the future, as the number of studies adopting a PPH approach grows. This larger pool of studies may also lend itself to more systematic approaches to reviewing the evidence, particularly if there is an interest in evaluating a particular component or principle of PPH. In addition, the evidence examined in this report predates the COVID-19 global pandemic, and many of the measures taken to mitigate the spread of the pandemic may provide a further source of evidence and data to understand the potential role of PPH in public health decision-making

General report & recommendations in predictive, preventive and personalised medicine 2012: white paper of the European Association for Predictive, Preventive and Personalised Medicine

This report is the collective product of word-leading experts working in the branches of integrative medicine by predictive, preventive and personalised medicine (PPPM) under the coordination of the European Association for Predictive, Preventive and Personalised Medicine. The general report has been prepared as the consortium document proposed at the EPMA World Congress 2011 which took place in Bonn, Germany. This forum analyzed the overall deficits and trends relevant for the top-science and daily practice in PPPM focused on the patient. Follow-up consultations resulted in a package of recommendations for consideration by research units, educators, healthcare industry, policy-makers, and funding bodies to cover the current knowledge deficit in the field and to introduce integrative approaches for advanced diagnostics, targeted prevention, treatments tailored to the person and cost-effective healthcare

The Future of eGovernment : An Exploration of ICT-driven Models of eGovernment for the EU in 2020

This report aims to describe how ICT can enable and shape future models of eGovernment. It summarizes the results of a research project, carried out by TNO and DTI on behalf of IPTS, based on desk research, expert interviews and a scenario-building exercise. It first identifies seven "hotspots" where ICT has a key impact on specific government tasks. It then analyzes these impacts under different possible future scenarios, in order to assess their robustness and the different implications for future models of eGovernment. It finally proposes a new measurement framework suitable for these future models, and outlines the key research challenges and policy options that emerge from this analysis.JRC.J.4-Information Societ

Person centered care: advanced philosophical perspectives

The ideas and terminology of person-centred care have been part of health discourse for a very long time. Arguments that in healthcare one treats the whole person, not her/his component parts, date back at least to antiquity and the need to treat the patient as a person is articulated persuasively by clinical authors in the early twentieth century. Yet it is only in recent years that we have seen a growing consensus in health policy and practice literature that PCC, and associated ideas including patient expertise, co-production and shared decision-making, are not simply “fine ideals” or “ethical add-ons” to sound scientific clinical practice, but rather they represent indispensable components of any genuinely integrated, realistic and conceptually sound account of healthcare practice. The underlying conviction of this volume - one belief that, despite their differences, unites all of its contributors - is that PCC should not become the latest “revolutionary” concept to be “operationalised” before being “conceptualised”. It is imperative that we develop an open and inclusive dialogue about what we do and do not mean by “person-centred” to inform our attempts to implement PCC

An ICT framework to support a patient-centric approach in public healthcare : A case study of Malawi

vital:59285The proliferation of Information and Communication Technologies (ICTs) worldwide has enhanced the amelioration of the quality of healthcare services. There is evidence that the adoption of electronic health (e-health) and mobile health (m-health) technologies has transformed the healthcare domain by improving the efficiency of healthcare service delivery. Digitising health ecosystems has culminated in increased access to healthcare services, even for remote rural areas. The application of ICTs in the healthcare sector has reduced the overall costs of healthcare services. However, developing countries, such as Malawi, face a plethora of challenges in implementing ICT initiatives in the public health sector. Although Malawi deploys several e-health systems, most are fragmented and, therefore, not interoperable. In addition, many m-health interventions are still in the pilot phase, and the Government does not manage them centrally. These challenges are further exacerbated by a lack of appropriate policy and regulatory framework, insufficient human capacity and development, inadequate financial resources, and poor ICT governance in the public healthcare sector. Furthermore, the current provider-centred approach to healthcare service delivery does not fully meet the needs of health consumers. It is, therefore, not surprising that the dearth of an ICT framework for patient-centric healthcare services has made coordination and management of ICT interventions less sustainable, less health consumer-centric and less cost-effective. Unlike the provider-centred approach, patient-centric healthcare empowers health consumers with health information to control their own health and well-being. A patient-centric healthcare approach provides treatment and care to health consumers based on their preferences, values, and beliefs. It is, therefore, cost-effective as it takes a preventive approach rather than a curative one. An ICT framework is proposed to support patient-centric healthcare services in the public healthcare sector in Malawi. A comprehensive literature review and analysis was succinctly conducted to gain an understanding of the Malawi health landscape and patient healthcare approaches. Semi-structured interviews were also undertaken to solicit information from various key v stakeholders such as policymakers, software developers, health consumers, and healthcare providers. Design science research paradigm coupled with pragmatism was then followed to develop the ICT framework, which will ultimately support patient-centric healthcare services in the public sector in Malawi. This methodology assists in solving social problems in a specific context by providing technology-based solutions in the form of an artefact. Experts in various disciplines domiciled in Malawi validated the ICT framework, as an artefact, for its relevance and applicability. The results showed that the framework is appropriate and relevant in the public healthcare sector in Malawi. This study contributes to design science research methodology as it addressed the improvement quadrant described by Gregor and Hevner. It also contributes to the existing body of knowledge by providing a design science artefact in the form of an ICT framework. It is envisaged that the proposed ICT framework will assist the Ministry of Health and other key stakeholders in providing quality patient-centric healthcare services in the public healthcare in Malawi.Thesis (PhD) -- Faculty of Engineering, the Built Environment, and Technology, 202

An ICT framework to support a patient-centric approach in public healthcare : A case study of Malawi

The proliferation of Information and Communication Technologies (ICTs) worldwide has enhanced the amelioration of the quality of healthcare services. There is evidence that the adoption of electronic health (e-health) and mobile health (m-health) technologies has transformed the healthcare domain by improving the efficiency of healthcare service delivery. Digitising health ecosystems has culminated in increased access to healthcare services, even for remote rural areas. The application of ICTs in the healthcare sector has reduced the overall costs of healthcare services. However, developing countries, such as Malawi, face a plethora of challenges in implementing ICT initiatives in the public health sector. Although Malawi deploys several e-health systems, most are fragmented and, therefore, not interoperable. In addition, many m-health interventions are still in the pilot phase, and the Government does not manage them centrally. These challenges are further exacerbated by a lack of appropriate policy and regulatory framework, insufficient human capacity and development, inadequate financial resources, and poor ICT governance in the public healthcare sector. Furthermore, the current provider-centred approach to healthcare service delivery does not fully meet the needs of health consumers. It is, therefore, not surprising that the dearth of an ICT framework for patient-centric healthcare services has made coordination and management of ICT interventions less sustainable, less health consumer-centric and less cost-effective. Unlike the provider-centred approach, patient-centric healthcare empowers health consumers with health information to control their own health and well-being. A patient-centric healthcare approach provides treatment and care to health consumers based on their preferences, values, and beliefs. It is, therefore, cost-effective as it takes a preventive approach rather than a curative one. An ICT framework is proposed to support patient-centric healthcare services in the public healthcare sector in Malawi. A comprehensive literature review and analysis was succinctly conducted to gain an understanding of the Malawi health landscape and patient healthcare approaches. Semi-structured interviews were also undertaken to solicit information from various key v stakeholders such as policymakers, software developers, health consumers, and healthcare providers. Design science research paradigm coupled with pragmatism was then followed to develop the ICT framework, which will ultimately support patient-centric healthcare services in the public sector in Malawi. This methodology assists in solving social problems in a specific context by providing technology-based solutions in the form of an artefact. Experts in various disciplines domiciled in Malawi validated the ICT framework, as an artefact, for its relevance and applicability. The results showed that the framework is appropriate and relevant in the public healthcare sector in Malawi. This study contributes to design science research methodology as it addressed the improvement quadrant described by Gregor and Hevner. It also contributes to the existing body of knowledge by providing a design science artefact in the form of an ICT framework. It is envisaged that the proposed ICT framework will assist the Ministry of Health and other key stakeholders in providing quality patient-centric healthcare services in the public healthcare in Malawi.Thesis (PhD) -- Faculty of Engineering, the Built Environment, and Technology, 202

xCARE: A Development Platform for Supporting Smart and Pervasive Healthcare

We are assisting to an important change in the healthcare domain where healthy citizens and patients are more and more in the center and become active partners in the entire process. In this scenario, smart and pervasive solutions assume a relevant role for remotely assisting citizens and patients together with their carers and supporting the overall team of professionals. From a software-engineering perspective, to follow and/or anticipate changes in requirements, modular solutions must be investigated and developed. Moreover, issues like personalization, adaptation, and scalability must be considered from the very beginning. In this chapter, we present xCARE, a microservices-based platform explicitly implemented to support the development of smart and pervasive healthcare systems. To show the potentiality and adaptability of xCARE, three relevant applications are presented: (i) a self-management system to support chronic complex patients; (ii) a patient management system that allows the team of professionals to assist patients before a major surgery together with a self-management system for the patients themselves; and (iii) an automatic self-management system for healthy citizens that want to follow healthier habits and that supports behavioral change