Re-thinking technology and its growing role in enabling patient empowerment

© The Author(s) 2018. The presence and increase of challenges to eHealth in today’s society have begun to generate doubts about the capability of technology in patient empowerment, especially within the frameworks supporting empowerment. Through the review of existing frameworks and articulation of patient demands, weaknesses in the current application of technology to support empowerment are explored, and key constituents of a technology-driven framework for patient empowerment are determined. This article argues that existing usage of technology in the design, development and implementation of patient empowerment in the healthcare system, although well intentioned, is insufficiently constituted, primarily as a result of fragmentation. Systems theory concepts such as holism and iteration are considered vital in improving the role of technology in enabling patient empowerment

Exploring patient empowerment : presenting an enhanced model for delivery in practice

Patient empowerment evolved as a strategy to address multi-faceted healthcare management issues. Studies over the past decades have provided different patient empowerment frameworks, but even with the emergent frameworks, there is no marked desired result. To date there has been no reliable patient empowerment. This thesis is driven by the ambition to enable greater patient empowerment in our global healthcare services.The methodological approach adopted was a mixed methodology approach based on taxonomical analysis, questionnaire study and focus group discussions. To better understand a patient empowered system, this work explored empowerment, patient empowerment and the role of technology. The thesis built through critical analysis on the knowledge of existing patient empowerment frameworks coupled with technology practice to develop an improved patient empowered system. Through review of existing frameworks and articulation of patients’ demands, weaknesses in current structures to support empowerment are determined.This thesis provides a platform for articulating an improved patient empowerment model, which considered systems theory ideas such as holism and iteration. Further research would propose implementing a trail of this model in practice and exploring with a wider range of stakeholders its potential for integration in the NHS or other health service organisations

Applying the resilient health system framework for universal health coverage

Since the 1978 Declaration of Alma-Ata affirming health as a fundamental human right, policy-makers and stakeholders have proposed many different strategies to achieve the goal of ‘health for all’. However, globally there still remains a lack of access to health information and quality health care, especially in low- and middle-income countries (LMIC). Digital health holds great promise to improve access and quality of care. We propose using the “resilient health system framework” as a guide to scale-up digital health as a means to achieve universal health care (UHC) and health for all. This article serves as a call to action for all governments to include population-based digital health tools as a foundational element in on-going health system priorities and service delivery

SARS-CoV-2 vaccination modelling for safe surgery to save lives: data from an international prospective cohort study

Background: Preoperative SARS-CoV-2 vaccination could support safer elective surgery. Vaccine numbers are limited so this study aimed to inform their prioritization by modelling. Methods: The primary outcome was the number needed to vaccinate (NNV) to prevent one COVID-19-related death in 1 year. NNVs were based on postoperative SARS-CoV-2 rates and mortality in an international cohort study (surgical patients), and community SARS-CoV-2 incidence and case fatality data (general population). NNV estimates were stratified by age (18-49, 50-69, 70 or more years) and type of surgery. Best- and worst-case scenarios were used to describe uncertainty. Results: NNVs were more favourable in surgical patients than the general population. The most favourable NNVs were in patients aged 70 years or more needing cancer surgery (351; best case 196, worst case 816) or non-cancer surgery (733; best case 407, worst case 1664). Both exceeded the NNV in the general population (1840; best case 1196, worst case 3066). NNVs for surgical patients remained favourable at a range of SARS-CoV-2 incidence rates in sensitivity analysis modelling. Globally, prioritizing preoperative vaccination of patients needing elective surgery ahead of the general population could prevent an additional 58 687 (best case 115 007, worst case 20 177) COVID-19-related deaths in 1 year. Conclusion: As global roll out of SARS-CoV-2 vaccination proceeds, patients needing elective surgery should be prioritized ahead of the general population