Is connected care a technological mirage?

vacanze-miraggio

Connected care is a very popular paradigm among technology and information technology providers. But what do professionals and healthcare organizations think about it?

Connected care means the integration of new organizational models and technological solutions, in order to enable the sharing of clinical information of patients between all actors involved in the care process (doctors and hospital nurses, health workers, patients, institutions, etc..).

Technological solutions have been available for some time now and are becoming more and more advanced. These include telemedicine platforms, software solutions for the management of chronic patients, apps for patients and, in theory, the Electronic Health Record, which should be, in this vision, the main tool for collecting information and communication between health professionals and the citizen/patient.

Even the new organizational models, based on the integration of different care settings (integrated care), are in theory there, even if they have not always been designed natively including the support of technology to ensure continuity of care for all patients, especially chronic patients.

There are experiences, especially abroad, where these models of technology-based care integration are a reality and work very well.

But why then does connected care risk being a technological mirage? The availability of technologies is a necessary condition, but not sufficient, for connected care to become a reality.

The first thing we need to observe is, once again, the different language used by technologists and health professionals. The former speak of connected care and interoperability, the latter of integrated care, diagnostic and therapeutic care pathways. It is not just a lexical problem but a different point of view with which the parties look at the problem.

The reality is that today health care is little “connected” and not only because of a problem of lack of technologies. The organisation of health care is based on funding, care settings, roles and responsibilities. Moreover, it should be said that health, mainly public health, is a system in which resources are not sufficient to respond in a timely manner to the demand for services that citizens require.

In order to achieve a real model of integration of care, it is not enough to say that the patient is placed at the centre and to imagine paths in which he is taken care of by the health services at different times, sharing information.

On the contrary, it would be necessary to radically reorganize the care model, in its different areas of care, rethinking the role of the different actors, the care settings (hospital, territory, primary care), perhaps creating new ones (virtual hospitals or hospitals without beds, central care management, etc. ..), the distribution of staff, funding and, of course, the technological tools.

As you can easily guess, this would be a real revolution, with all the difficulties of the case. Think, for example, of the problems encountered in the redevelopment of small hospitals, the reorganization of the hospital network, chronic management models such as CReG in Lombardy. It is good to say that in all these cases the resistance is present both among health workers and among citizens.

In my opinion, there is also a fundamental misunderstanding, on the part of technology, about the concept that technology is an enabling factor for the integration of care (true). Enabling does not mean that they allow their implementation, but that they must be present for this to happen.

I will conclude with two recommendations to my fellow technologists: do not call it connected care but integration of care; let us avoid organising conferences, workshops and talking about it only among ourselves, because it is useless.

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