An adaptive case management system to support integrated care services: Lessons learned from the NEXES project

Cano, Isaac; Alonso, Albert; Hernández, Carme; Burgos, Felip; Barberán-García, Anael; Roldan, Jim; Roca, Josep

doi:10.1016/j.jbi.2015.02.011

Cited by 45 publications

(36 citation statements)

References 18 publications

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“…The technological platform supported core service functionalities: (i) patient-centered adaptive case management [25]; (ii) enhanced patient accessibility (support center), and (iii) enhanced coordination of professionals across healthcare tiers after discharge, as reported in detail in [25] and the on-line supplementary material.…”

Section: Theory and Methodsmentioning

confidence: 99%

Implementation of Home Hospitalization and Early Discharge as an Integrated Care Service: A Ten Years Pragmatic Assessment

Hernández¹,

Aibar²,

Seijas³

et al. 2018

Int J Integr Care

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Home Hospitalization has proven efficacy, but its effectiveness and potential as an Integrated Care Service in a real world setting deserves to be explored.Objective:To evaluate implementation and 10 years follow-up of Home Hospitalization and Early Discharge as an Integrated Care Service in an urban healthcare district in Barcelona.Methods:Prospective study with pragmatic assessment. Patients: Surgical and medical acute and exacerbated chronic patients requiring admission into a highly specialized hospital, from 2006 to 2015. Intervention: Home-based individualized care plan, administered as a hospital-based outreach service, aiming at substituting hospitalization and implementing a transitional care strategy for optimal discharge. Main measurements: Emergency Department, readmissions and mortality. Patients’ and professionals’ perspectives, technologies and costs were evaluated.Results:4,165 admissions (71 ± 15 yrs; Charlson Index 4 ± 3). In-hospital stay was 1 (0–3) days and the length of home-based stay was 6 (5–7) days. The 30-day readmission rate was 11% and mortality was 2%. Patients, careers and health professionals expressed high levels of satisfaction (98%). At the start, the service was reimbursed at a flat rate of 918€ per patient discharged, significantly lower than conventional hospitalization (2,879€) but still allowing the hospital to keep a balanced budget. At present, there is no difference in the payment schemes for both types of services.Conclusions:The service freed an average of 6 in-hospital days per patient. The program showed health value generation, as well as potential for synergies with community-based Integrated Care Services.

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Section: Theory and Methodsmentioning

confidence: 99%

Implementation of Home Hospitalization and Early Discharge as an Integrated Care Service: A Ten Years Pragmatic Assessment

Hernández¹,

Aibar²,

Seijas³

et al. 2018

Int J Integr Care

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“…Adoption of adaptive case management 17, 31 to support collaborative work constitutes an emergent approach that facilitates case managers to adapt well-structured service workflows to the continuously evolving needs of the patients. This implies selection and scheduling of specific tasks during case management and ad-hoc collaboration with other professionals across healthcare and social support tiers, which facilitates collaborative decisions triggered by expected and unexpected events.…”

Section: Methodsmentioning

confidence: 99%

“…Firstly, execution of implementation studies of two integrated care interventions with proven efficacy in previous studies 4 : (i) Community-based management of CCP and, (ii) Integrated care for patients under long-term oxygen therapy (LTOT). The two implementation studies will allow (second aim) to assess the impact of collaborative adaptive case managment 17 supported by information and communication technologies. The third aim of the protocol is to evaluate the impact of enhanced clinical health risk assessment and stratification 19 on the two implementation studies.…”

Section: Aimsmentioning

confidence: 99%

“…The CCP protocol relies on the hypothesis that implementation of (i) structured, but flexible service workflows, that is, a collaborative and adaptive case management approach 17 and (ii) enhanced patient health risk assessment and stratification can overcome current limitations of multimorbidity management. The protocol for management of CCP aims to assess the study hypothesis through the evaluation of the regional deployment of two existing integrated care interventions (i.e., implementation studies) described below.…”

Section: Introductionmentioning

confidence: 99%

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Protocol for regional implementation of community-based collaborative management of complex chronic patients

Cano

Dueñas-Espín

Hernández

et al. 2017

npj Prim Care Resp Med

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“…[16,[21][22][23][24][25][26][27][28][29]. ACM is a goal-and data-driven approach built on the traditional case management concepts that promote a collaborative and ad-hoc work to resolve cases and achieve certain goals.…”

Section: Introductionmentioning

confidence: 99%

Adaptive Case Management Framework to Develop Case-based Emergency Response System

Shahrah¹,

Al‐Mashari²

2017

ijacsa

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Abstract-Emergency response to crisis, disaster, or catastrophe incidents is a clear example of knowledge-intensive and collaboration-heavy process facing all public safety-related organizations. Software systems to support emergency response have existed for decades. However, the limitations of these systems and their development approaches are still significant in terms of flexibility and dynamicity. With the emergence of Adaptive Case Management (ACM) as a new software development approach to support knowledge work and the empower knowledge worker, the authors found that ACM is a promising approach that can be extended to support emergency response especially in large-scale situations. This research aims to study how ACM can be leveraged to design and implement case-based emergency response systems (ERSs). In particular, the authors propose a domain-specific and vendor-neutral Case Management Framework (CMF) that incorporates the essential capabilities to support the ERSs. As a proof-of-concept, the authors support the proposed CMF by a case-based ERS prototype. Finally, the authors conclude that ACM has a great potential to enhance the effectiveness and efficiency of ERSs. This work can be considered as an attempt to advocate the adaptation of ACM in such context.

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An adaptive case management system to support integrated care services: Lessons learned from the NEXES project

Cited by 45 publications

References 18 publications

Implementation of Home Hospitalization and Early Discharge as an Integrated Care Service: A Ten Years Pragmatic Assessment

Implementation of Home Hospitalization and Early Discharge as an Integrated Care Service: A Ten Years Pragmatic Assessment

Protocol for regional implementation of community-based collaborative management of complex chronic patients

Adaptive Case Management Framework to Develop Case-based Emergency Response System

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